Channeling Consumers to Preferred Providers and the Impact of Status Quo Bias: Does Type of Provider Matter?

PubMed Central

Boonen, Lieke H H M; Donkers, Bas; Schut, Frederik T

2011-01-01

Context To effectively bargain about the price and quality of health services, health insurers need to successfully channel their enrollees. Little is known about consumer sensitivity to different channeling incentives. In particular, the impact of status quo bias, which is expected to differ between different provider types, can play a large role in insurers' channeling ability. Objective To examine consumer sensitivity to channeling strategies and to analyze the impact of status quo bias for different provider types. Data Sources/Study Design With a large-scale discrete choice experiment, we investigate the impact of channeling incentives on choices for pharmacies and general practitioners (GPs). Survey data were obtained among a representative Dutch household panel (n=2,500). Principal Findings Negative financial incentives have a two to three times larger impact on provider choice than positive ones. Positive financial incentives have a relatively small impact on GP choice, while the impact of qualitative incentives is relatively large. Status quo bias has a large impact on provider choice, which is more prominent in the case of GPs than in the case of pharmacies. Conclusion The large impact of the status quo bias makes channeling consumers away from their current providers a daunting task, particularly in the case of GPs. PMID:21029092

Channeling consumers to preferred providers and the impact of status quo bias: does type of provider matter?

PubMed

Boonen, Lieke H H M; Donkers, Bas; Schut, Frederik T

2011-04-01

To effectively bargain about the price and quality of health services, health insurers need to successfully channel their enrollees. Little is known about consumer sensitivity to different channeling incentives. In particular, the impact of status quo bias, which is expected to differ between different provider types, can play a large role in insurers' channeling ability. To examine consumer sensitivity to channeling strategies and to analyze the impact of status quo bias for different provider types. With a large-scale discrete choice experiment, we investigate the impact of channeling incentives on choices for pharmacies and general practitioners (GPs). Survey data were obtained among a representative Dutch household panel (n = 2,500). Negative financial incentives have a two to three times larger impact on provider choice than positive ones. Positive financial incentives have a relatively small impact on GP choice, while the impact of qualitative incentives is relatively large. Status quo bias has a large impact on provider choice, which is more prominent in the case of GPs than in the case of pharmacies. The large impact of the status quo bias makes channeling consumers away from their current providers a daunting task, particularly in the case of GPs. © Health Research and Educational Trust.

Impact of Mutation Type and Amplicon Characteristics on Genetic Diversity Measures Generated Using a High-Resolution Melting Diversity Assay

PubMed Central

Cousins, Matthew M.; Donnell, Deborah; Eshleman, Susan H.

2013-01-01

We adapted high-resolution melting (HRM) technology to measure genetic diversity without sequencing. Diversity is measured as a single numeric HRM score. Herein, we determined the impact of mutation types and amplicon characteristics on HRM diversity scores. Plasmids were generated with single-base changes, insertions, and deletions. Different primer sets were used to vary the position of mutations within amplicons. Plasmids and plasmid mixtures were analyzed to determine the impact of mutation type, position, and concentration on HRM scores. The impact of amplicon length and G/C content on HRM scores was also evaluated. Different mutation types affected HRM scores to varying degrees (1-bp deletion < 1-bp change < 3-bp insertion < 9-bp insertion). The impact of mutations on HRM scores was influenced by amplicon length and the position of the mutation within the amplicon. Mutations were detected at concentrations of 5% to 95%, with the greatest impact at 50%. The G/C content altered melting temperature values of amplicons but had no impact on HRM scores. These data are relevant to the design of assays that measure genetic diversity using HRM technology. PMID:23178437

The impact of diverse types of biomass burning in a tropical country

Treesearch

R. J. Yokelson; I. R. Burling; Shawn Urbanski; T. J. Christian; E. L. Atlas; C. Wiedinmyer; S. K. Akagi; G. Engling

2010-01-01

We couple laboratory work, airborne and ground-based field measurements, remote sensing of fires, and modeling to assess the impact of diverse types of biomass burning (BB) in Mexico as a model tropical country. About 70-80% of open BB occurs in the tropics along with large amounts of biofuel use and garbage burning (GB); both in rural and urban areas. During the...

Impacts of transportation routes on landscape diversity: a comparison of different route types and their combined effects.

PubMed

Su, Shiliang; Xiao, Rui; Li, Delong; Hu, Yi'na

2014-03-01

A comparison of different transportation route types and their combined effects on landscape diversity was conducted within Tiaoxi watershed (China) between 1994 and 2005. Buffer analysis and Mann-Kendall's test were used to quantify the relationships between distance from transportation routes (railway, highway, national, and provincial road) and a family of landscape diversity parameters (Simpson's diversity index, Simpson's evenness index, Shannon's diversity index, and Shannon's evenness index). One-way ANOVA was further applied to compare influences from different route types and their combined effects. Five other landscape metrics (patch density, edge density, area-weighted mean shape index, connectance index, and Euclidean nearest neighbor distance) were also calculated to analyze the associations between landscape diversity and landscape pattern characteristics. Results showed that transportation routes exerted significant impacts on landscape diversity. Impact from railway was comparable to that from highway and national road but was more significant than that from provincial road. The spatial influential range of railway and national road was wider than that of highway and provincial road. Combined effects of routes were nonlinear, and impacts from different route types were more complex than those from the same type. The four landscape diversity metrics were comparably effective at the buffer zone scale. In addition, landscape diversity can be alternatively used to indicate fragmentation, connectivity, and isolation at route buffer scale. This study demonstrates an applicable approach to quantitatively characterize the impacts from transportation routes on landscape patterns and has potential to facilitate route network planning.

Understanding the Impact of Bead Type on Paint and Thermoplastic Pavement Markings

DTIC Science & Technology

2012-03-01

20 Figure 7: Bead Performance Over Time for Polyurea (Needham, 2011) ......................... 23 Figure 8...specifically. Research conducted at the Air Force Institute of Technology reveals that bead type does impact the degradation rate of polyurea ...Preformed tape - profiled < 1.0 8 Methyl methacrylate < 1.0 9 Thermoplastics profiled < 1.0 10 Polyurea < 1.0 11 Cold applied plastics < 1.0 12

Observational evidence for the aerosol impact on ice cloud properties regulated by cloud/aerosol types

NASA Astrophysics Data System (ADS)

Zhao, B.; Gu, Y.; Liou, K. N.; Jiang, J. H.; Li, Q.; Liu, X.; Huang, L.; Wang, Y.; Su, H.

2016-12-01

The interactions between aerosols and ice clouds (consisting only of ice) represent one of the largest uncertainties in global radiative forcing from pre-industrial time to the present. The observational evidence for the aerosol impact on ice cloud properties has been quite limited and showed conflicting results, partly because previous observational studies did not consider the distinct features of different ice cloud and aerosol types. Using 9-year satellite observations, we find that, for ice clouds generated from deep convection, cloud thickness, cloud optical thickness (COT), and ice cloud fraction increase and decrease with small-to-moderate and high aerosol loadings, respectively. For in-situ formed ice clouds, however, the preceding cloud properties increase monotonically and more sharply with aerosol loadings. The case is more complicated for ice crystal effective radius (Rei). For both convection-generated and in-situ ice clouds, the responses of Rei to aerosol loadings are modulated by water vapor amount in conjunction with several other meteorological parameters, but the sensitivities of Rei to aerosols under the same water vapor amount differ remarkably between the two ice cloud types. As a result, overall Rei slightly increases with aerosol loading for convection-generated ice clouds, but decreases for in-situ ice clouds. When aerosols are decomposed into different types, an increase in the loading of smoke aerosols generally leads to a decrease in COT of convection-generated ice clouds, while the reverse is true for dust and anthropogenic pollution. In contrast, an increase in the loading of any aerosol type can significantly enhance COT of in-situ ice clouds. The modulation of the aerosol impacts by cloud/aerosol types is demonstrated and reproduced by simulations using the Weather Research and Forecasting (WRF) model. Adequate and accurate representations of the impact of different cloud/aerosol types in climate models are crucial for reducing the

Observational evidence for the aerosol impact on ice cloud properties regulated by cloud/aerosol types

NASA Astrophysics Data System (ADS)

Zhao, B.; Gu, Y.; Liou, K. N.; Jiang, J. H.; Li, Q.; Liu, X.; Huang, L.; Wang, Y.; Su, H.

2017-12-01

The interactions between aerosols and ice clouds (consisting only of ice) represent one of the largest uncertainties in global radiative forcing from pre-industrial time to the present. The observational evidence for the aerosol impact on ice cloud properties has been quite limited and showed conflicting results, partly because previous observational studies did not consider the distinct features of different ice cloud and aerosol types. Using 9-year satellite observations, we find that, for ice clouds generated from deep convection, cloud thickness, cloud optical thickness (COT), and ice cloud fraction increase and decrease with small-to-moderate and high aerosol loadings, respectively. For in-situ formed ice clouds, however, the preceding cloud properties increase monotonically and more sharply with aerosol loadings. The case is more complicated for ice crystal effective radius (Rei). For both convection-generated and in-situ ice clouds, the responses of Rei to aerosol loadings are modulated by water vapor amount in conjunction with several other meteorological parameters, but the sensitivities of Rei to aerosols under the same water vapor amount differ remarkably between the two ice cloud types. As a result, overall Rei slightly increases with aerosol loading for convection-generated ice clouds, but decreases for in-situ ice clouds. When aerosols are decomposed into different types, an increase in the loading of smoke aerosols generally leads to a decrease in COT of convection-generated ice clouds, while the reverse is true for dust and anthropogenic pollution. In contrast, an increase in the loading of any aerosol type can significantly enhance COT of in-situ ice clouds. The modulation of the aerosol impacts by cloud/aerosol types is demonstrated and reproduced by simulations using the Weather Research and Forecasting (WRF) model. Adequate and accurate representations of the impact of different cloud/aerosol types in climate models are crucial for reducing the

Using Weather Types to Understand and Communicate Weather and Climate Impacts

NASA Astrophysics Data System (ADS)

Prein, A. F.; Hale, B.; Holland, G. J.; Bruyere, C. L.; Done, J.; Mearns, L.

2017-12-01

A common challenge in atmospheric research is the translation of scientific advancements and breakthroughs to decision relevant and actionable information. This challenge is central to the mission of NCAR's Capacity Center for Climate and Weather Extremes (C3WE, www.c3we.ucar.edu). C3WE advances our understanding of weather and climate impacts and integrates these advances with distributed information technology to create tools that promote a global culture of resilience to weather and climate extremes. Here we will present an interactive web-based tool that connects historic U.S. losses and fatalities from extreme weather and climate events to 12 large-scale weather types. Weather types are dominant weather situations such as winter high-pressure systems over the U.S. leading to very cold temperatures or summertime moist humid air masses over the central U.S. leading to severe thunderstorms. Each weather type has a specific fingerprint of economic losses and fatalities in a region that is quantified. Therefore, weather types enable a direct connection of observed or forecasted weather situation to loss of life and property. The presented tool allows the user to explore these connections, raise awareness of existing vulnerabilities, and build resilience to weather and climate extremes.

Update on emissions and environmental impacts from the international fleet of ships: the contribution from major ship types and ports

NASA Astrophysics Data System (ADS)

Dalsøren, S. B.; Eide, M. S.; Endresen, Ø.; Mjelde, A.; Gravir, G.; Isaksen, I. S. A.

2009-03-01

A reliable and up-to-date ship emission inventory is essential for atmospheric scientists quantifying the impact of shipping and for policy makers implementing regulations and incentives for emission reduction. The emission modelling in this study takes into account ship type and size dependent input data for 15 ship types and 7 size categories. Global port arrival and departure data for more than 32 000 merchant ships are used to establish operational profiles for the ship segments. The modelled total fuel consumption amounts to 217 Mt in 2004 of which 11 Mt is consumed in in-port operations. This is in agreement with international sales statistics. The modelled fuel consumption is applied to develop global emission inventories for CO2, NO2, SO2, CO, CH4, VOC (Volatile Organic Compounds), N2O, BC (Black Carbon) and OC (Organic Carbon). The global emissions from ships at sea and in ports are distributed geographically, applying extended geographical data sets covering about 2 million global ship observations and global port data for 32 000 ships. In addition to inventories for the world fleet, inventories are produced separately for the three dominating ship types, using ship type specific emission modelling and traffic distributions. A global Chemical Transport Model (CTM) was used to calculate the environmental impacts of the emissions. We find that ship emissions is a dominant contributor over much of the world oceans to surface concentrations of NO2 and SO2. The contribution is also large over some coastal zones. For surface ozone the contribution is high over the oceans but clearly also of importance over Western North America (contribution 15-25%) and Western Europe (5-15%). The contribution to tropospheric column ozone is up to 5-6%. The overall impact of ship emissions on global methane lifetime is large due to the high NOx emissions. With regard to acidification we find that ships contribute 11% to nitrate wet deposition and 4.5% to sulphur wet deposition

Update on emissions and environmental impacts from the international fleet of ships. The contribution from major ship types and ports

NASA Astrophysics Data System (ADS)

Dalsøren, S. B.; Eide, M. S.; Endresen, Ø.; Mjelde, A.; Gravir, G.; Isaksen, I. S. A.

2008-10-01

A reliable and up-to-date ship emission inventory is essential for atmospheric scientists quantifying the impact of shipping and for policy makers implementing regulations and incentives for emission reduction. The emission modelling in this study takes into account ship type and size dependent input data for 15 ship types and 7 size categories. Global port arrival and departure data for more than 32 000 merchant ships are used to establish operational profiles for the ship segments. The modelled total fuel consumption amounts to 217 Mt in 2004 of which 11 Mt is consumed in in-port operations. This is in agreement with international sales statistics. The modelled fuel consumption is applied to develop global emission inventories for CO2, NO2, SO2, CO, CH4, VOC (Volatile Organic Compounds), N2O, BC (Black Carbon) and OC (Organic Carbon). The global emissions from ships at sea and in ports are distributed geographically, applying extended geographical data sets covering about 2 million global ship observations and global port data for 32 000 ships. In addition to inventories for the world fleet, inventories are produced separately for the three dominating ship types, using ship type specific emission modelling and traffic distributions. A global Chemical Transport Model (CTM) was used to calculate the environmental impacts of the emissions. We find that ship emissions is a dominant contributor over much of the world oceans to surface concentrations of NO2 and SO2. The contribution is also large over some coastal zones. For surface ozone the contribution is high over the oceans but clearly also of importance over western North America (contribution 15 25%) and western Europe (5 15%). The contribution to tropospheric column ozone is up to 5 6%. The overall impact of ship emissions on global methane lifetime is large due to the high NOx emissions. With regard to acidification we find that ships contribute 11% to nitrate wet deposition and 4.5% to sulphur wet deposition

Impacts of pavement types on in-vehicle noise and human health.

PubMed

Li, Qing; Qiao, Fengxiang; Yu, Lei

2016-01-01

Noise is a major source of pollution that can affect the human physiology and living environment. According to the World Health Organization (WHO), an exposure for longer than 24 hours to noise levels above 70 dB(A) may damage human hearing sensitivity, induce adverse health effects, and cause anxiety to residents nearby roadways. Pavement type with different roughness is one of the associated sources that may contribute to in-vehicle noise. Most previous studies have focused on the impact of pavement type on the surrounding acoustic environment of roadways, and given little attention to in-vehicle noise levels. This paper explores the impacts of different pavement types on in-vehicle noise levels and the associated adverse health effects. An old concrete pavement and a pavement with a thin asphalt overlay were chosen as the test beds. The in-vehicle noise caused by the asphalt and concrete pavements were measured, as well as the drivers' corresponding heart rates and reported riding comfort. Results show that the overall in-vehicle sound levels are higher than 70 dB(A) even at midnight. The newly overlaid asphalt pavement reduced in-vehicle noise at a driving speed of 96.5 km/hr by approximately 6 dB(A). Further, on the concrete pavement with higher roughness, driver heart rates were significantly higher than on the asphalt pavement. Drivers reported feeling more comfortable when driving on asphalt than on concrete pavement. Further tests on more drivers with different demographic characteristics, along highways with complicated configurations, and an examination of more factors contributing to in-vehicle noise are recommended, in addition to measuring additional physical symptoms of both drivers and passengers. While there have been many previous noise-related studies, few have addressed in-vehicle noise. Most studies have focused on the noise that residents have complained about, such as neighborhood traffic noise. As yet, there have been no complaints by

Impact of hypoglycaemia on patient-reported outcomes from a global, 24-country study of 27,585 people with type 1 and insulin-treated type 2 diabetes.

PubMed

Khunti, Kamlesh; Alsifri, Saud; Aronson, Ronnie; Cigrovski Berković, Maja; Enters-Weijnen, Catherine; Forsén, Tom; Galstyan, Gagik; Geelhoed-Duijvestijn, Petronella; Goldfracht, Margalit; Gydesen, Helge; Kapur, Rahul; Lalic, Nebojsa; Ludvik, Bernhard; Moberg, Erik; Pedersen-Bjergaard, Ulrik; Ramachandran, Ambady

2017-08-01

Data on the impact of hypoglycaemia on patients' daily lives and diabetes self-management, particularly in developing countries, are lacking. The aim of this study was to assess fear of, and responses to, hypoglycaemia experienced by patients globally. This non-interventional, multicentre, 4-week prospective study using self-assessment questionnaires and patient diaries consisted of 27,585 patients, ≥18years, with type 1 diabetes (n=8022) or type 2 diabetes (n=19,563) treated with insulin for >12months, at 2004 sites in 24 countries worldwide. Increased blood glucose monitoring (69.7%) and seeking medical assistance (62.0%) were the most common responses in the 4weeks following hypoglycaemic events for patients with type 1 diabetes and type 2 diabetes, respectively. Approximately 44% of patients with type 1 diabetes or type 2 diabetes increased calorie intake in response to a hypoglycaemic episode. Following hypoglycaemia, 3.9% (type 1 diabetes) and 6.2% (type 2 diabetes) of patients took leave from work or study. Regional differences in fear of, and responses to, hypoglycaemia were evident - in particular, a lower level of hypoglycaemic fear and utilisation of healthcare resources in Northern Europe and Canada. Hypoglycaemia has a major impact on patients and their behaviour. These global data for the first time reveal regional variations in response to hypoglycaemia and highlight the importance of patient education and management strategies. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

[Impact of facial emotional recognition alterations in Dementia of the Alzheimer type].

PubMed

Rubinstein, Wanda; Cossini, Florencia; Politis, Daniel

2016-07-01

Face recognition of basic emotions is independent of other deficits in dementia of the Alzheimer type. Among these deficits, there is disagreement about what emotions are more difficult to recognize. Our aim was to study the presence of alterations in the process of facial recognition of basic emotions, and to investigate if there were differences in the recognition of each type of emotion in Alzheimer's disease. With three tests of recognition of basic facial emotions we evaluated 29 patients who had been diagnosed with dementia of the Alzheimer type and 18 control subjects. Significant differences were obtained in tests of recognition of basic facial emotions and between each. Since the amygdala, one of the brain structures responsible for emotional reaction, is affected in the early stages of this disease, our findings become relevant to understand how this alteration of the process of emotional recognition impacts the difficulties these patients have in both interpersonal relations and behavioral disorders.

Impact of type 2 diabetes on the plasma levels of vascular endothelial growth factor and its soluble receptors type 1 and type 2 in patients with peripheral arterial disease.

PubMed

Wieczór, Radosław; Gadomska, Grażyna; Ruszkowska-Ciastek, Barbara; Stankowska, Katarzyna; Budzyński, Jacek; Fabisiak, Jacek; Suppan, Karol; Pulkowski, Grzegorz; Rość, Danuta

2015-11-01

Type 2 diabetes coexistent with lower extremity artery disease (peripheral arterial disease (PAD)) can be observed in numerous patients. The mechanism compensating for ischemia and contributing to healing is angiogenesis-the process of forming new blood vessels. The purpose of this study was to assess the likely impact of type 2 diabetes on the plasma levels of proangiogenic factor (vascular endothelial growth factor A (VEGF-A)) and angiogenesis inhibitors (soluble VEGF receptors type 1 and type 2 (sVEGFR-1 and sVEGFR-2)) in patients with PAD. Among 46 patients with PAD under pharmacological therapy (non-invasive), we identified, based on medical history, a subgroup with coexistent type 2 diabetes (PAD-DM2+, n=15) and without diabetes (PAD-DM2-, n=31). The control group consisted of 30 healthy subjects. Plasma levels of VEGF-A, sVEGFR-1, and sVEGFR-2 were measured using the enzyme-linked immunosorbent assay (ELISA) method. The subgroups of PAD-DM2+ and PAD-DM2- revealed significantly higher concentrations of VEGF-A (P=0.000 007 and P=0.000 000 1, respectively) and significantly lower sVEGFR-2 levels (P=0.02 and P=0.000 01, respectively), when compared with the control group. Patients with PAD and coexistent diabetes tended to have a lower level of VEGF-A and higher levels of sVEGFR-1 and sVEGFR-2 comparable with non-diabetic patients. The coexistence of type 2 diabetes and PAD is demonstrated by a tendency to a lower plasma level of proangiogenic factor (VEGF-A) and higher levels of angiogenesis inhibitors (sVEGFR-1 and sVEGFR-2) at the same time. Regardless of the coexistence of type 2 diabetes, hypoxia appears to be a crucial factor stimulating the processes of angiogenesis in PAD patients comparable with healthy individuals, whereas hyperglycemia may have a negative impact on angiogenesis in lower limbs.

Reducing impacts from ammunitions: A comparative life-cycle assessment of four types of 9mm ammunitions.

PubMed

Ferreira, Carlos; Ribeiro, José; Almada, Sara; Rotariu, Traian; Freire, Fausto

2016-10-01

Increase of environmental awareness of the population has pressured research activities in the defence area to cover environment and toxicity issues, where have been considered appropriate manners to reduce the environmental and toxicological impacts of ammunition. One of the adopted approaches to achieve such goal involves the replacement of lead and other heavy metals by alternative materials. However, the consequences of using alternative materials in ammunitions manufacturing are uncertain for the other life-cycle phases and trade-offs can occur. The present paper describes the potential benefits from the replacement of lead in the primer and in the projectile of a 9mm calibre ammunition. For that purpose, it is assessed and compared the environmental and toxicological impacts associated with the life-cycle of four ammunitions: combination of two types of projectiles (steel jacket and lead core; copper and nylon composite) with two types of primers (lead primer; non-lead primer). In addition, some potential improvements for the environmental performance of small calibre ammunition are also presented. To assess the impacts two Life-Cycle Impact Assessment methods are applied: CML for six environmental categories and USEtox to three toxicity categories. Results showed that the conclusion drawn for environmental and toxicological impact categories are distinct. In fact, ammunition production phase presents higher impacts for the environmental categories, whilst the operation phase has a higher impact to the toxicity categories. The substitution of lead in the primer and in the projectile provides a suitable alternative from a toxicology perspective; however, the composite projectile still presents some environmental concerns. The conclusions drawn are important for the procurement (and design) of environmental responsible ammunitions, in order to avoid (or decrease) the impacts for their manufacture and the effects on human health (e.g. shooters) and ecosystems

Prevalence and impact of initial misclassification of pediatric type 1 diabetes mellitus.

PubMed

Tripathi, Avnish; Rizvi, Ali A; Knight, Lisa M; Jerrell, Jeanette M

2012-10-01

To characterize rates of initial misclassification of type 1 diabetes mellitus as type 2/unspecified diabetes mellitus in a cohort of children/adolescents and to examine the impact of misclassification on the risk of diabetes-related complications. An 11-year dataset (1996-2006) was analyzed. Inclusion criteria included age 17 years and younger, enrollees in South Carolina State Medicaid, and diagnosis of type 2/unspecified or type 1 diabetes mellitus for at least two visits, 15 days apart. Survival analysis was used to assess the association of "misclassification" with the incidence of diabetic ketoacidosis (DKA), and the cumulative incidence of neuropathy, nephropathy, and cardiovascular complications, after controlling for individual risk factors and comorbid conditions. A total of 1130 individuals meeting the inclusion criteria were studied for a median of 7 years. Of the 1130 individuals, 669 (59.2%) maintained a diagnosis of type 2/unspecified diabetes mellitus, 205 (18.1%) were consistently diagnosed as type 1 diabetes mellitus, and the remaining 256 individuals (22.7%) were misclassified. Insulin treatment was used in 100% of the type 1 diabetes mellitus group and 73% of the misclassified group. Compared with the type 2 diabetes mellitus group, being misclassified was associated with earlier development of DKA (adjusted hazard ratio [aHR] 5.08, 95% confidence interval [CI] 3.09-8.37), neuropathy (aHR 1.94, CI 1.31-2.88), and nephropathy (aHR 1.72, CI 1.19-2.50), whereas being consistently classified with type 1 diabetes mellitus was associated only with earlier development of DKA (aHR 4.96, CI 2.56-9.61). Proper categorization of pediatric diabetes can be challenging, especially with comorbid obesity. Failure to ascertain type 1 diabetes mellitus in a timely manner in a pediatric population may increase the risk of substandard care and diabetes-related complications.

Impact of telemedicine in managing type 1 diabetes among school-age children and adolescents: an integrative review.

PubMed

Guljas, Rebecca; Ahmed, Azza; Chang, Karen; Whitlock, Analei

2014-01-01

Patients with diabetes who have limited access to healthcare services are less likely to maintain adequate diabetes control. Telemedicine represents a useful solution to the strict follow up required in diabetes management. This review analyzes the impact that telemedicine has on the management of type 1 diabetes among school-age children and adolescents, as measured by compliance with blood glucose monitoring, glycemic control, satisfaction, and self management. In general, this review supports the use of telemedicine in maintaining glycemic control. Further studies are desired to observe the impact of telemedicine in managing type 1 diabetes in school-age children and adolescents. Copyright © 2014 Elsevier Inc. All rights reserved.

Shifts in plant functional types have time-dependent and regionally variable impacts on dryland ecosystem water balance

USGS Publications Warehouse

Bradford, John B.; Schlaepfer, Daniel R.; Lauenroth, William K.; Burke, Ingrid C.

2014-01-01

5. Synthesis. This study provides a novel, regional-scale assessment of how plant functional type transitions may impact ecosystem water balance in sagebrush-dominated ecosystems of North America. Results illustrate that the ecohydrological consequences of changing vegetation depend strongly on climate and suggest that decreasing woody plant abundance may have only limited impact on evapotranspiration and water yield.

Impact of exposure measurement error in air pollution epidemiology: effect of error type in time-series studies.

PubMed

Goldman, Gretchen T; Mulholland, James A; Russell, Armistead G; Strickland, Matthew J; Klein, Mitchel; Waller, Lance A; Tolbert, Paige E

2011-06-22

Two distinctly different types of measurement error are Berkson and classical. Impacts of measurement error in epidemiologic studies of ambient air pollution are expected to depend on error type. We characterize measurement error due to instrument imprecision and spatial variability as multiplicative (i.e. additive on the log scale) and model it over a range of error types to assess impacts on risk ratio estimates both on a per measurement unit basis and on a per interquartile range (IQR) basis in a time-series study in Atlanta. Daily measures of twelve ambient air pollutants were analyzed: NO2, NOx, O3, SO2, CO, PM10 mass, PM2.5 mass, and PM2.5 components sulfate, nitrate, ammonium, elemental carbon and organic carbon. Semivariogram analysis was applied to assess spatial variability. Error due to this spatial variability was added to a reference pollutant time-series on the log scale using Monte Carlo simulations. Each of these time-series was exponentiated and introduced to a Poisson generalized linear model of cardiovascular disease emergency department visits. Measurement error resulted in reduced statistical significance for the risk ratio estimates for all amounts (corresponding to different pollutants) and types of error. When modelled as classical-type error, risk ratios were attenuated, particularly for primary air pollutants, with average attenuation in risk ratios on a per unit of measurement basis ranging from 18% to 92% and on an IQR basis ranging from 18% to 86%. When modelled as Berkson-type error, risk ratios per unit of measurement were biased away from the null hypothesis by 2% to 31%, whereas risk ratios per IQR were attenuated (i.e. biased toward the null) by 5% to 34%. For CO modelled error amount, a range of error types were simulated and effects on risk ratio bias and significance were observed. For multiplicative error, both the amount and type of measurement error impact health effect estimates in air pollution epidemiology. By modelling

Differential impacts of participation in organized activities and maltreatment types on adolescent academic and socioemotional development.

PubMed

Kwak, Yoonyoung; Mihalec-Adkins, Brittany; Mishra, Aura A; Christ, Sharon L

2018-04-01

Participation in organized activities has been largely regarded as beneficial for academic and socioemotional development for adolescents, but the impacts of various types of organized activities for adolescents at risk for maltreatment have been rarely tested. In this study, we investigated the differential impacts of five types of maltreatment exposure (physical maltreatment, sexual maltreatment, neglect, other type, and multiple types) on the associations between four types of organized activities (mentored groups, art and music clubs, sport clubs, and academic clubs) and academic and socioemotional development (school engagement, delinquency, depressive symptoms, and trauma symptoms) of adolescents who were investigated by Child Protective Services (CPS) for maltreatment exposure. Data came from a national, longitudinal sample of 790 adolescents in contact with CPS in the U.S. After controlling for demographic characteristics of participants and prior levels of each outcome, multiple linear regression models were fitted to the data with interactions between the organized activities and the maltreatment types. The main findings of this study included: 1) adolescents who participated in mentored groups, sport clubs, and academic clubs reported higher levels of school engagement; 2) adolescents who participated in academic clubs reported fewer depressive symptoms; 3) adolescents who participated in art and music clubs reported more trauma symptoms compared to non-participants; and 4) the effects of participation in mentored groups on delinquency and trauma symptoms differed by maltreatment type. These results indicate both possible benefits and risks of organized activity participation for adolescents with certain maltreatment exposures. Copyright © 2017 Elsevier Ltd. All rights reserved.

The impact of environmental stressors and types of work contract on occupational stress.

PubMed

Corrêa, Ana Paula; Ferreira, Maria Cristina

2011-05-01

This study aimed to investigate the impact of seven environmental stressors (role conflict, work overload, interpersonal difficulties, work-family conflict, work instability, lack of autonomy and pressure of responsibility) and the nature of the employment contract (permanent or atypical) on three psychological reactions to occupational stress (job satisfaction, positive emotions, and negative emotions at work). 305 Brazilian workers from both sexes participated in this research, distributed between permanent and atypical workers. The results showed that the role conflict and the work overload had a negative impact on job satisfaction. The role conflict had a negative impact on the positive emotions at work, while the pressure of responsibility interfered positively in it. The work overload interfered positively in the negative emotions at work, while the pressure of responsibility interfered negatively in it. The type of contract did not affect significantly any one of the dependent variables. The implications of the results for future research are discussed.

The Impact of Type 2 Diabetes on Bone Fracture Healing

PubMed Central

Marin, Carlos; Luyten, Frank P.; Van der Schueren, Bart; Kerckhofs, Greet; Vandamme, Katleen

2018-01-01

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease known by the presence of elevated blood glucose levels. Nowadays, it is perceived as a worldwide epidemic, with a very high socioeconomic impact on public health. Many are the complications caused by this chronic disorder, including a negative impact on the cardiovascular system, kidneys, eyes, muscle, blood vessels, and nervous system. Recently, there has been increasing evidence suggesting that T2DM also adversely affects the skeletal system, causing detrimental bone effects such as bone quality deterioration, loss of bone strength, increased fracture risk, and impaired bone healing. Nevertheless, the precise mechanisms by which T2DM causes detrimental effects on bone tissue are still elusive and remain poorly studied. The aim of this review was to synthesize current knowledge on the different factors influencing the impairment of bone fracture healing under T2DM conditions. Here, we discuss new approaches used in recent studies to unveil the mechanisms and fill the existing gaps in the scientific understanding of the relationship between T2DM, bone tissue, and bone fracture healing. PMID:29416527

The Impact of University Housing Construction Type on Psychosocial Development of First-Year Students

ERIC Educational Resources Information Center

Owens, Justin Tyler

2010-01-01

The purpose of this study was to explore the impact of university housing construction type on psychosocial development of first-year students. Data were collected at a large, four-year, public, research university in the Southeast using the Student Development Task and Lifestyle Assessment. The population considered for this study consisted of…

The impact of ethical climate types on nurses' behaviors in Bosnia and Herzegovina.

PubMed

Dinc, M Sait; Huric, Alma

2017-12-01

The performance of nurses has become vital in hospitals. Some studies have suggested that nurses' perceptions of the ethical climate in their hospitals are related to higher job satisfaction and organizational commitment and in turn lessen the issue of nursing shortage. (1) The ethical climate types "caring," "independent," "law and code," and "rules" have a significant positive impact on overall job satisfaction. (2) The ethical climate types and overall job satisfaction have significant positive influences on normative and affective and significant negative influences on continuance commitment. The study uses path analysis to understand which types of ethical climate impact overall job satisfaction. It also tries to find the effect of different types of ethical climate and overall job satisfaction on the components of organizational commitment. The relationships between variables were evaluated using factor analysis, reliability, descriptive statistics, correlations, and regression in this study. Participants and research context: A total of 171 useful questionnaires were collected from nurses working in public and private hospitals in Bosnia and Herzegovina. Ethical considerations: Formal research approval was obtained from the administration of each study hospital. Questionnaires with a cover letter were mailed to the hospitals that agreed to participate in the study. In the cover letter, the researchers explained the study purpose, encouraged nurses' voluntary participation, and guaranteed the anonymity of participants. In the first path analyses, "rules" and "caring" climates significantly and positively affected overall job satisfaction. In the second one, while overall job satisfaction and "rules" climate significantly influenced normative commitment, "caring" climate and overall job satisfaction significantly affected affective commitment. The findings of the study have been convenient with the literature. Public and private hospitals can enhance overall

Resonant-type Smooth Impact Drive Mechanism (SIDM) actuator using a bolt-clamped Langevin transducer.

PubMed

Nishimura, Takuma; Hosaka, Hiroshi; Morita, Takeshi

2012-01-01

The Smooth Impact Drive Mechanism (SIDM) is a linear piezoelectric actuator that has seen practically applied to camera lens modules. Although previous SIDM actuators are easily miniaturized and enable accurate positioning, these actuators cannot actuate at high speed and cannot provide powerful driving because they are driven at an off-resonant frequency using a soft-type PZT. In the present study, we propose a resonant-type SIDM using a bolt-clamped Langevin transducer (BLT) with a hard-type PZT. The resonant-type SIDM overcomes the above-mentioned problems and high-power operation becomes possible with a very simple structure. As a result, we confirmed the operation of resonant-type SIDM by designing a bolt-clamped Langevin transducer. The properties of no-load maximum speed was 0.28m/s at driving voltages of 80V(p-p) for 44.9kHz and 48V(p-p) for 22.45kHz with a pre-load of 3.1N. Copyright © 2011 Elsevier B.V. All rights reserved.

Effect of age, impaction types and operative time on inflammatory tissue reactions following lower third molar surgery

PubMed Central

2011-01-01

Background Postoperative mobidity following third molar surgery is affected by a number of factors. The study of these factors is essential for effective planning and limitation of morbidity. The aim of this study was to determine the effect of age, type of impaction and operative time on immediate postoperative tissue reactions following mandibular third molar surgery. Methods Consecutive patients with impacted mandibular third molar teeth were studied. All the third molars were classified according to Winter's classification. Surgical extraction was performed on all the patients by a single surgeon under local anaesthesia. The operation time was determined by the time lapse between incision and completion of suturing. Postoperative pain, swelling and trismus were evaluated. Results There were 120 patients with an age range of 19-42 years. Patients in the age range of 35-42 years recorded a lower pain score (p = 0.5) on day 1. The mouth opening was much better in the lower age group on day 2 and 5 (p = 0.007 and p = 0.01 respectively). Pain, swelling and trismus increased with increasing operative time. Distoangular impaction was significantly associated with higher VAS score on day 1 and 2 (p = 0.01, 0.0, 04). Distoangular and horizontal impaction are associated with a higher degree of swelling and reduced mouth opening on postoperative review days. Vertical impaction was associated with the least degree of facial swelling and best mouth opening. Conclusions Increasing operating time and advancing age are associated with more postoperative morbidity, likewise distoangular and horizontal impaction types. PMID:21527036

Teachers' Perceptions about the Types, Quality, and Impact of Their Job-Embedded Professional Development Experiences

ERIC Educational Resources Information Center

Mitchell, Delilah

2013-01-01

This study was designed to determine eighth grade teachers' perceptions of the impact, quality, and types of job-embedded professional development activities they have participated in and the relationship to student achievement in language arts, math, or science. The researcher identified school districts with 50% or more of their eighth grade…

Influence of Article Type on the Impact Factor of Dermatology Journals.

PubMed

Rodríguez-Lago, L; Molina-Leyva, A; Pereiro-Ferreirós, M; García-Doval, I

2018-06-01

For scientific journals, achieving a high impact factor (IF) has become a goal in its own right. Our aim was to describe the influence of article type on the IF of dermatology journals. We used the Scopus database to calculate an IF for Actas Dermo-Sifiliográficas and the major dermatology journals, excluding articles without abstracts, letters to the editor, and conference proceedings. Included articles were classified into 4 categories: case reports, original articles, narrative reviews, and other. We also calculated the mean IF for each article type. We then compared our results with IFs published by the Institute for Scientific Information. The proportion of each type of article differed between journals. Original articles carried the greatest weight in the major journals (BJD, 76.8%; Contact, 81.1%; JAAD, 63.4%; JAMA Dermatol, 63.7%.) but not in Actas Dermo-Sifiliográficas, where only 31.7% were original research articles. A higher IF was associated with the publication of reviews and original articles; a lower IF was associated with the publication of case reports and other article types. Publishing case reports, which have lower citation rates, leads to a lower IF. Publishing reviews and original articles will lead to a higher IF. Journals that seek a higher IF should probably publish more reviews and original articles and fewer case reports. Editorial boards should seek a balance between the interests of their clinician readers and the journal's need for a higher IF. Copyright © 2018 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

Manipulating Cognitive Complexity across Task Types and Its Impact on Learners' Interaction during Oral Performance

ERIC Educational Resources Information Center

Gilabert, Roger; Baron, Julia; Llanes, Angels

2009-01-01

The goal of this study is to investigate the impact of manipulating the cognitive complexity of three different types of oral tasks on interaction. The study first considers the concepts of task complexity and interaction and then examines the specific studies that have looked at the effects of increasing task complexity on conversational…

Adipose Tissue Angiogenesis: Impact on Obesity and Type-2 Diabetes

PubMed Central

Corvera, Silvia; Gealekman, Olga

2013-01-01

The growth and function of tissues is critically dependent on their vascularization. Adipose tissue is capable of expanding many-fold during adulthood, therefore requiring the formation of new vasculature to supply growing and proliferating adipocytes. The expansion of the vasculature in adipose tissue occurs through angiogenesis, where new blood vessels develop from those pre-existing within the tissue. Inappropriate angiogenesis may underlie adipose tissue dysfunction in obesity, which in turn increases type-2 diabetes risk. In addition, genetic and developmental factors involved in vascular patterning may define the size and expandability of diverse adipose tissue depots, which are also associated with type-2 diabetes risk. Moreover, the adipose tissue vasculature appears to be the niche for pre-adipocyte precursors, and factors that affect angiogenesis may directly impact the generation of new adipocytes. Here we review recent advances on the basic mechanisms of angiogenesis, and on the role of angiogenesis in adipose tissue development and obesity. A substantial amount of data point to a deficit in adipose tissue angiogenesis as a contributing factor to insulin resistance and metabolic disease in obesity. These emerging findings support the concept of the adipose tissue vasculature as a source of new targets for metabolic disease therapies. PMID:23770388

Identifying the Machine Translation Error Types with the Greatest Impact on Post-editing Effort.

PubMed

Daems, Joke; Vandepitte, Sonia; Hartsuiker, Robert J; Macken, Lieve

2017-01-01

Translation Environment Tools make translators' work easier by providing them with term lists, translation memories and machine translation output. Ideally, such tools automatically predict whether it is more effortful to post-edit than to translate from scratch, and determine whether or not to provide translators with machine translation output. Current machine translation quality estimation systems heavily rely on automatic metrics, even though they do not accurately capture actual post-editing effort. In addition, these systems do not take translator experience into account, even though novices' translation processes are different from those of professional translators. In this paper, we report on the impact of machine translation errors on various types of post-editing effort indicators, for professional translators as well as student translators. We compare the impact of MT quality on a product effort indicator (HTER) with that on various process effort indicators. The translation and post-editing process of student translators and professional translators was logged with a combination of keystroke logging and eye-tracking, and the MT output was analyzed with a fine-grained translation quality assessment approach. We find that most post-editing effort indicators (product as well as process) are influenced by machine translation quality, but that different error types affect different post-editing effort indicators, confirming that a more fine-grained MT quality analysis is needed to correctly estimate actual post-editing effort. Coherence, meaning shifts, and structural issues are shown to be good indicators of post-editing effort. The additional impact of experience on these interactions between MT quality and post-editing effort is smaller than expected.

Predicting the impact of blocking human immunodeficiency virus type 1 Nef in vivo.

PubMed

Wick, W David; Gilbert, Peter B; Yang, Otto O

2009-03-01

Human immunodeficiency virus type 1 (HIV-1) Nef is a multifunctional protein that confers an ability to evade killing by cytotoxic T lymphocytes (CTLs) as well as other advantages to the virus in vivo. Here we exploited mathematical modeling and related statistical methods to estimate the impact of Nef activity on viral replication in vivo in relation to CTLs. Our results indicate that downregulation of major histocompatibility complex class I (MHC-I) A and B by wild-type Nef confers an advantage to the virus of about 82% in decreased CTL killing efficiency on average, meaning that abolishing the MHC-I downregulation function of Nef would increase killing by more than fivefold. We incorporated this estimate, as well as prior estimates of replicative enhancement by Nef, into a previously published model of HIV-1 and CTLs in vivo (W. D. Wick, O. O. Yang, L. Corey, and S. G. Self, J. Virol. 79:13579-13586, 2005), generalized to permit CTL recognition of multiple epitopes. A sequence database analysis revealed that 92.9% of HIV-1 epitopes are A or B restricted, and a previous study found an average of about 19 epitopes recognized (M. M. Addo et al., J. Virol. 77:2081-2092, 2003). We combined these estimates in the model in order to predict the impact of inhibiting Nef function in the general (chronically infected) population by a drug. The predicted impact on viral load ranged from negligible to 2.4 orders of magnitude, depending on the effects of the drug and the CTL dynamical scenario assumed. We conclude that inhibiting Nef could make a substantial reduction in disease burden, lengthening the time before the necessity of undertaking combination therapy with other antiretroviral drugs.

Resonant-Type Smooth Impact Drive Mechanism Actuator Operating at Lower Input Voltages

NASA Astrophysics Data System (ADS)

Morita, Takeshi; Nishimura, Takuma; Yoshida, Ryuichi; Hosaka, Hiroshi

2013-07-01

We report on the design and fabrication of a resonant-type smooth impact drive mechanism (SIDM) actuator based on a multilayered piezoelectric ceramic transducer. Conventional SIDMs use off-resonant sawtooth-shaped displacement in developing stick-slip motion of a slider, but require large input voltages for high-speed operation. In contrast, in resonant-type SIDMs, a quasi-sawtooth-shaped displacement is obtained by combining two resonant vibrational modes. This driving principle enables low input voltage operations. In combining the modes, their frequency ratio must be 1:2. To design and optimize the stator transducer to generate sawtooth-shaped displacements, a transfer matrix method was adopted. With a preload of 270 mN, the no-load speed was 40 mm/s under a driving voltage of 1.6 V (peak to peak). This input voltage was one-sixth that of previous SIDMs for the same performance. Concurrently, heat generation was significantly reduced because dielectric losses were suppressed under the lower input voltage operation.

How fuel treatment types, locations, and amounts impact landscape-scale fire behavior and carbon dynamics

Treesearch

Christopher A. Dicus; Kevin J. Osborne

2015-01-01

When managing for fire across a large landscape, the types of fuel treatments, the locations of treatments, and the percentage of the landscape being treated should all interact to impact not only potential fire size, but also carbon dynamics across that landscape. To investigate these interactions, we utilized a forest growth model (FVS-FFE) and fire simulation...

A Multi-criteria Decision Analysis System for Prioritizing Sites and Types of Low Impact Development Practices

NASA Astrophysics Data System (ADS)

Song, Jae Yeol; Chung, Eun-Sung

2017-04-01

This study developed a multi-criteria decision analysis framework to prioritize sites and types of low impact development (LID) practices. This framework was systemized as a web-based system coupled with the Storm Water Management Model (SWMM) from the Environmental Protection Agency (EPA). Using the technique for order of preference by similarity to ideal solution (TOPSIS), which is a type of multi-criteria decision-making (MCDM) method, multiple types and sites of designated LID practices are prioritized. This system is named the Water Management Prioritization Module (WMPM) and is an improved version of the Water Management Analysis Module (WMAM) that automatically generates and simulates multiple scenarios of LID design and planning parameters for a single LID type. WMPM can simultaneously determine the priority of multiple LID types and sites. In this study, an infiltration trench and permeable pavement were considered for multiple sub-catchments in South Korea to demonstrate the WMPM procedures. The TOPSIS method was manually incorporated to select the vulnerable target sub-catchments and to prioritize the LID planning scenarios for multiple types and sites considering socio-economic, hydrologic and physical-geometric factors. In this application, the Delphi method and entropy theory were used to determine the subjective and objective weights, respectively. Comparing the ranks derived by this system, two sub-catchments, S16 and S4, out of 18 were considered to be the most suitable places for installing an infiltration trench and porous pavement to reduce the peak and total flow, respectively, considering both socio-economic factors and hydrological effectiveness. WMPM can help policy-makers to objectively develop urban water plans for sustainable development. Keywords: Low Impact Development, Multi-Criteria Decision Analysis, SWMM, TOPSIS, Water Management Prioritization Module (WMPM)

The Potential Impact of Displacing Sedentary Time in Adults with Type 2 Diabetes

PubMed Central

FALCONER, CATHERINE L.; PAGE, ANGIE S.; ANDREWS, ROB C.; COOPER, ASHLEY R.

2015-01-01

ABSTRACT Purpose Sedentary time, in particular, prolonged unbroken sedentary time, is detrimental to health and displaces time spent in either light or moderate intensity physical activity. This cross-sectional study aimed to identify the potential impact of reallocating time from sedentary behaviors to more active behaviors on measures of body composition and metabolic health in people with type 2 diabetes. Methods Participants were 519 adults with newly diagnosed type 2 diabetes who had been recruited to the Early Activity in Diabetes (Early ACTID) randomized controlled trial. Waist-worn accelerometers were used to obtain objective measurement of sedentary time, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) at baseline alongside clinical measurements and fasting blood samples to determine cholesterol, triglycerides, HOMA-IR, and glucose. Isotemporal substitution modeling was performed to determine the potential impact of reallocating 30 min of sedentary time accumulated in a single bout (long bout) with 30 min of interrupted sedentary time, LPA, or MVPA. Results Sedentary time accounted for 65% of the waking day, of which 45% was accumulated in prolonged (≥30 min) bouts. Reallocation of 30 min of long-bout sedentary time with 30 min of short-bout sedentary time was associated with lower body mass index (BMI) (adjusted β, −0.60; 95% confidence interval [CI], −1.00, −0.21) and waist circumference (WC) (adjusted β, −1.16; 95% CI, −2.08, −0.25). Stronger effects were seen for LPA and MVPA. Reallocation of 30 min of long-bout sedentary time with LPA was associated with higher HDL-cholesterol (adjusted β, 0.02; 95% CI, 0.00–0.03 mmol·L−1). Conclusions Encouraging adults with newly diagnosed type 2 diabetes to break up prolonged periods of sedentary time may be an effective strategy for improving body composition and metabolic health. PMID:26378943

Genetic Parameters and the Impact of Off-Types for Theobroma cacao L. in a Breeding Program in Brazil

PubMed Central

DuVal, Ashley; Gezan, Salvador A.; Mustiga, Guiliana; Stack, Conrad; Marelli, Jean-Philippe; Chaparro, José; Livingstone, Donald; Royaert, Stefan; Motamayor, Juan C.

2017-01-01

Breeding programs of cacao (Theobroma cacao L.) trees share the many challenges of breeding long-living perennial crops, and genetic progress is further constrained by both the limited understanding of the inheritance of complex traits and the prevalence of technical issues, such as mislabeled individuals (off-types). To better understand the genetic architecture of cacao, in this study, 13 years of phenotypic data collected from four progeny trials in Bahia, Brazil were analyzed jointly in a multisite analysis. Three separate analyses (multisite, single site with and without off-types) were performed to estimate genetic parameters from statistical models fitted on nine important agronomic traits (yield, seed index, pod index, % healthy pods, % pods infected with witches broom, % of pods other loss, vegetative brooms, diameter, and tree height). Genetic parameters were estimated along with variance components and heritabilities from the multisite analysis, and a trial was fingerprinted with low-density SNP markers to determine the impact of off-types on estimations. Heritabilities ranged from 0.37 to 0.64 for yield and its components and from 0.03 to 0.16 for disease resistance traits. A weighted index was used to make selections for clonal evaluation, and breeding values estimated for the parental selection and estimation of genetic gain. The impact of off-types to breeding progress in cacao was assessed for the first time. Even when present at <5% of the total population, off-types altered selections by 48%, and impacted heritability estimations for all nine of the traits analyzed, including a 41% difference in estimated heritability for yield. These results show that in a mixed model analysis, even a low level of pedigree error can significantly alter estimations of genetic parameters and selections in a breeding program. PMID:29250097

Impacted Mandibular Third Molars: A Retrospective Study of 1198 Cases to Assess Indications for Surgical Removal, and Correlation with Age, Sex and Type of Impaction-A Single Institutional Experience.

PubMed

Patel, Shital; Mansuri, Saloni; Shaikh, Faizan; Shah, Taksh

2017-03-01

To study the incidence of mandibular third molar impaction in relation to type and side of impaction, age and sex of patients and indications for its surgical removal through data collected from a single institute over a period of 3 and half years. The records of 1198 patients who underwent the surgical removal of impacted mandibular third molars were reviewed retrospectively. Records were divided into groups according to sex, age, type and side of impaction. Radiographs were studied to determine angular position of impacted mandible third molar. We found that there was a high incidence of mesioangular lower third molar impaction (33.97 %), highest number of patients were found in 15-30 years of age group (48.33 %), a left side (56.93 %) was more commonly involved, female predominance (63.44 %) was observed and recurrent pericoronitis (33.81 %) was the most common indication. Awareness of the indications for surgical removal of impacted mandibular third molar to the patients will help to avoid future risk of complications and morbidity associated with the same. This will not only help in saving time and money but also prevents the psychological trauma associated with delayed treatment. Removal of only symptomatic IMTM seems to be the logical choice in view of financial constraint in developing countries like India but at the same time early removal offers freedom from future complications in selected cases. So surgeons should apply a meticulous approach in selecting the patients for SRIMTM.

Identifying the Machine Translation Error Types with the Greatest Impact on Post-editing Effort

PubMed Central

Daems, Joke; Vandepitte, Sonia; Hartsuiker, Robert J.; Macken, Lieve

2017-01-01

Translation Environment Tools make translators’ work easier by providing them with term lists, translation memories and machine translation output. Ideally, such tools automatically predict whether it is more effortful to post-edit than to translate from scratch, and determine whether or not to provide translators with machine translation output. Current machine translation quality estimation systems heavily rely on automatic metrics, even though they do not accurately capture actual post-editing effort. In addition, these systems do not take translator experience into account, even though novices’ translation processes are different from those of professional translators. In this paper, we report on the impact of machine translation errors on various types of post-editing effort indicators, for professional translators as well as student translators. We compare the impact of MT quality on a product effort indicator (HTER) with that on various process effort indicators. The translation and post-editing process of student translators and professional translators was logged with a combination of keystroke logging and eye-tracking, and the MT output was analyzed with a fine-grained translation quality assessment approach. We find that most post-editing effort indicators (product as well as process) are influenced by machine translation quality, but that different error types affect different post-editing effort indicators, confirming that a more fine-grained MT quality analysis is needed to correctly estimate actual post-editing effort. Coherence, meaning shifts, and structural issues are shown to be good indicators of post-editing effort. The additional impact of experience on these interactions between MT quality and post-editing effort is smaller than expected. PMID:28824482

Seven Types of Ambiguity in Evaluating the Impact of Humanities Provision in Undergraduate Medicine Curricula.

PubMed

Bleakley, Alan

2015-12-01

Inclusion of the humanities in undergraduate medicine curricula remains controversial. Skeptics have placed the burden of proof of effectiveness upon the shoulders of advocates, but this may lead to pursuing measurement of the immeasurable, deflecting attention away from the more pressing task of defining what we mean by the humanities in medicine. While humanities input can offer a fundamental critical counterweight to a potentially reductive biomedical science education, a new wave of thinking suggests that the kinds of arts and humanities currently used in medical education are neither radical nor critical enough to have a deep effect on students' learning and may need to be reformulated. The humanities can certainly educate for tolerance of ambiguity as a basis to learning democratic habits for contemporary team-based clinical work. William Empson's 'seven types of ambiguity' model for analyzing poetry is transposed to medical education to: (a) formulate seven values proffered by the humanities for improving medical education; (b) offer seven ways of measuring impact of medical humanities provision, thereby reducing ambiguity; and (c) --as a counterweight to (b) - celebrate seven types of ambiguity in contemporary medical humanities that critically reconsider issues of proof of impact.

Four types of interference competition and their impacts on the ecology and evolution of size-structured populations and communities.

PubMed

Zhang, Lai; Andersen, Ken H; Dieckmann, Ulf; Brännström, Åke

2015-09-07

We investigate how four types of interference competition - which alternatively affect foraging, metabolism, survival, and reproduction - impact the ecology and evolution of size-structured populations. Even though all four types of interference competition reduce population biomass, interference competition at intermediate intensity sometimes significantly increases the abundance of adult individuals and the population׳s reproduction rate. We find that foraging and metabolic interference evolutionarily favor smaller maturation size when interference is weak and larger maturation size when interference is strong. The evolutionary response to survival interference and reproductive interference is always larger maturation size. We also investigate how the four types of interference competition impact the evolutionary dynamics and resultant diversity and trophic structure of size-structured communities. Like other types of trait-mediated competition, all four types of interference competition can induce disruptive selection and thus promote initial diversification. Even though foraging interference and reproductive interference are more potent in promoting initial diversification, they catalyze the formation of diverse communities with complex trophic structure only at high levels of interference intensity. By contrast, survival interference does so already at intermediate levels, while reproductive interference can only support relatively smaller communities with simpler trophic structure. Taken together, our results show how the type and intensity of interference competition jointly affect coexistence patterns in structured population models. Copyright © 2015 Elsevier Ltd. All rights reserved.

Type-Specific Human Papillomavirus Distribution in Invasive Squamous Cervical Carcinomas in Tunisia and Vaccine Impact.

PubMed

Ennaifer, Emna; Salhi, Faten; Laassili, Thalja; Fehri, Emna; Ben Alaya, Nissaf; Guizani, Ikram; Boubaker, Samir

2015-01-01

High risk human papillomaviruses (HPVs) are the leading cause of cervical cancer (CC) and Pap smear screening has not been successful in preventing CC in Tunisia. HPV vaccination that targets HPV16 and 18 offers a new efficient prevention tool. Identification of HPV types in CC is thus essential to determine the impact of HPV vaccine implementation. The aim of this study is to provide specific data from Tunisia. A total of 89 histological confirmed paraffin embedded samples isolated from patients with CC diagnosed between 2001 and 2011 were collected from five medical centres from Northern and Southern Tunisia. HPV DNA was detected using a nested PCR (MY09/MY11-GP5+/GP6+) and genotyping was assessed using a reverse blot line hybridisation assay that enables the detection of 32 HPV types. HPV DNA was detected in all samples. Twelve high risk types were detected; HPV16 and/or 18 were predominant, accounting together for 92.1% of all the CC cases (HPV16: 83.1%). Single infections accounted for 48.8% of the cases and were mostly linked to HPV 16 (32.6%) and less frequently to HPV 18 (2.4%). The other high risk HPV single infections were linked to HPV 35 (4.6%), 45 (4.6%), 58 (2.3%) and 59 (2.3%). Multiple infections with mixing of 2 to 4 genotypes predominately featrued HPV16 and/or 18 with HPV 35 and 45 (96.6 %) and less frequently with HPV 59, 40, 66, 73 and 58. There was no statistically significant variation in the relative distribution of HPV types with age. These results strongly indicate that prophylactic HPV vaccines can have a major impact in preventing CC in Tunisia.

Risks of asphyxia-related neonatal complications in offspring of mothers with type 1 or type 2 diabetes: the impact of maternal overweight and obesity.

PubMed

Cnattingius, Sven; Lindam, Anna; Persson, Martina

2017-07-01

We aimed to compare the risks of severe asphyxia-related neonatal complications in the offspring of mothers with type 1 or type 2 diabetes, and to assess the impact of maternal overweight/obesity on these risks. This was a population-based study of 1,343,751 live-born singleton infants in Sweden between 1997 and 2011, including 5941 and 711 infants of mothers with type 1 and type 2 diabetes, respectively. ORs with 95% CIs were calculated for low Apgar score (0-6) at 5 min after birth, hypoxic ischaemic encephalopathy and neonatal seizures. The rates of a low Apgar score were 0.9%, 2.6% and 2.1% in the offspring of mothers without diabetes or with type 1 or type 2 diabetes, respectively. After controlling for maternal confounders (including BMI), the risk of a low Apgar score increased in the offspring of mothers with type 1 diabetes (OR 2.67, 95% CI 2.23, 3.20) but not in the offspring of mothers with type 2 diabetes (OR 1.25, 95% CI 0.66, 2.35). The ORs of hypoxic ischaemic encephalopathy or neonatal seizures were increased in the offspring of mothers with type 1 diabetes (OR 3.41, 95% CI 2.58, 4.49) and type 2 diabetes (OR 2.54, 95% CI 1.13, 5.69). Maternal overweight/obesity was a risk factor for asphyxia-related neonatal complications and low Apgar scores in the offspring of mothers with type 1 diabetes and mothers without diabetes. The risks of a low Apgar score and severe asphyxia-related neonatal complications are increased in the offspring of mothers with type 1 or type 2 diabetes. Maternal overweight/obesity is an important contributing factor.

Why childhood-onset type 1 diabetes impacts labour market outcomes: a mediation analysis.

PubMed

Persson, Sofie; Dahlquist, Gisela; Gerdtham, Ulf-G; Steen Carlsson, Katarina

2018-02-01

Previous studies show a negative effect of type 1 diabetes on labour market outcomes such as employment and earnings later in life. However, little is known about the mechanisms underlying these effects. This study aims to analyse the mediating role of adult health, education, occupation and family formation. A total of 4179 individuals from the Swedish Childhood Diabetes Register and 16,983 individuals forming a population control group born between 1962 and 1979 were followed between 30 and 50 years of age. The total effect of having type 1 diabetes was broken down into a direct effect and an indirect (mediating) effect using statistical mediation analysis. We also analysed whether type 1 diabetes has different effects on labour market outcome between the sexes and across socioeconomic status. Childhood-onset type 1 diabetes had a negative impact on employment (OR 0.68 [95% CI 0.62, 0.76] and OR 0.76 [95% CI 0.67, 0.86]) and earnings (-6%, p < 0.001 and -8%, p < 0.001) for women and men, respectively. Each of the mediators studied contributed to the total effect with adult health and occupational field accounting for the largest part. However, some of the effect could not be attributed to any of the mediators studied and was therefore likely related to other characteristics of the disease that hamper career opportunities. The effect of type 1 diabetes on employment and earnings did not vary significantly according to socioeconomic status of the family (parental education and earnings). A large part of the effect of type 1 diabetes on the labour market is attributed to adult health but there are other important mediating factors that need to be considered to reduce this negative effect.

Associated characteristics and impact on recurrence and survival of free-floating tumor fragments in the lumen of fallopian tubes in Type I and Type II endometrial cancer.

PubMed

Albright, Benjamin B; Black, Jonathan D; Passarelli, Rachel; Gysler, Stefan; Whicker, Margaret; Altwerger, Gary; Menderes, Gulden; Buza, Natalia; Hui, Pei; Santin, Alessandro D; Azodi, Masoud; Silasi, Dan-Arin; Ratner, Elena S; Litkouhi, Babak; Schwartz, Peter E

2018-02-01

This study sought to evaluate characteristics of cases of free-floating tumor fragments within the lumen of fallopian tubes ('floaters') on final pathology for Type I and Type II endometrial adenocarcinoma, including relationships with disease recurrence and mortality. A single institution experience of 1022 consecutive cases of uterine cancer presenting between 2005 and 2010 was retrospectively reviewed, with data extraction from electronic medical records. Associations of floaters with baseline characteristics were studied with logistic regression, and relationships with disease recurrence and survival were assessed with Cox proportional hazards models. Among 816 included cases of Type I or Type II endometrial adenocarcinoma, floaters were identified on final pathology for 20 patients (2.5%). Patient characteristics of cases with floaters mirrored the overall sample. With adjustment, presence of floaters trended towards association with laparoscopic/robotic approach (OR = 3.84; 95%CI 0.98-15.1), and was significantly associated with lymphovascular invasion (OR = 9.65; 95%CI 2.35-39.6) and higher stage disease. Although floaters were associated with increased risk of recurrence in unadjusted analysis (HR = 3.22; 95%CI 1.41-7.37), after adjustment for disease type, stage, and patient comorbidities, no evidence for impact on disease recurrence or overall survival was found. The presence of floaters is rare. Floaters were generally associated with more extensive disease, but no evidence was found to show any independent prognostic impact on risk of recurrence or death. In agreement with prior research, this study found a trend towards association of floaters with laparoscopic/robotic approach, indicating the possibility of floaters sometimes being the result of trauma from uterine manipulator insertion.

Impacts of the Callipyge Mutation on Ovine Plasma Metabolites and Muscle Fibre Type

PubMed Central

Li, Juan; Greenwood, Paul L.; Cockett, Noelle E.; Hadfield, Tracy S.; Vuocolo, Tony; Byrne, Keren; White, Jason D.; Tellam, Ross L.; Schirra, Horst Joachim

2014-01-01

The ovine Callipyge mutation causes postnatal muscle hypertrophy localized to the pelvic limbs and torso, as well as body leanness. The mechanism underpinning enhanced muscle mass is unclear, as is the systemic impact of the mutation. Using muscle fibre typing immunohistochemistry, we confirmed muscle specific effects and demonstrated that affected muscles had greater prevalence and hypertrophy of type 2X fast twitch glycolytic fibres and decreased representation of types 1, 2C, 2A and/or 2AX fibres. To investigate potential systemic effects of the mutation, proton NMR spectra of plasma taken from lambs at 8 and 12 weeks of age were measured. Multivariate statistical analysis of plasma metabolite profiles demonstrated effects of development and genotype but not gender. Plasma from Callipyge lambs at 12 weeks of age, but not 8 weeks, was characterized by a metabolic profile consistent with contributions from the affected hypertrophic fast twitch glycolytic muscle fibres. Microarray analysis of the perirenal adipose tissue depot did not reveal a transcriptional effect of the mutation in this tissue. We conclude that there is an indirect systemic effect of the Callipyge mutation in skeletal muscle in the form of changes of blood metabolites, which may contribute to secondary phenotypes such as body leanness. PMID:24937646

Impacts of the Callipyge mutation on ovine plasma metabolites and muscle fibre type.

PubMed

Li, Juan; Greenwood, Paul L; Cockett, Noelle E; Hadfield, Tracy S; Vuocolo, Tony; Byrne, Keren; White, Jason D; Tellam, Ross L; Schirra, Horst Joachim

2014-01-01

The ovine Callipyge mutation causes postnatal muscle hypertrophy localized to the pelvic limbs and torso, as well as body leanness. The mechanism underpinning enhanced muscle mass is unclear, as is the systemic impact of the mutation. Using muscle fibre typing immunohistochemistry, we confirmed muscle specific effects and demonstrated that affected muscles had greater prevalence and hypertrophy of type 2X fast twitch glycolytic fibres and decreased representation of types 1, 2C, 2A and/or 2AX fibres. To investigate potential systemic effects of the mutation, proton NMR spectra of plasma taken from lambs at 8 and 12 weeks of age were measured. Multivariate statistical analysis of plasma metabolite profiles demonstrated effects of development and genotype but not gender. Plasma from Callipyge lambs at 12 weeks of age, but not 8 weeks, was characterized by a metabolic profile consistent with contributions from the affected hypertrophic fast twitch glycolytic muscle fibres. Microarray analysis of the perirenal adipose tissue depot did not reveal a transcriptional effect of the mutation in this tissue. We conclude that there is an indirect systemic effect of the Callipyge mutation in skeletal muscle in the form of changes of blood metabolites, which may contribute to secondary phenotypes such as body leanness.

Impact of a Pioneer/Rindler-type acceleration on the Oort Cloud

NASA Astrophysics Data System (ADS)

Iorio, Lorenzo

2012-01-01

According to a recent modified model of gravity at large distances, a radial constant and uniform extra-acceleration ? of Rindler type acts upon a test particle p in the static field of a central mass M if certain conditions are satisfied. Among other things, it was proposed as a potentially viable explanation of a part of the Pioneer anomaly. We study the impact that an anomalous Rindler-type term as large as ? m s-2 may have on the the orbital dynamics of a typical object of the Oort Cloud whose self-energy is quite smaller than its putative Rindler energy. By taking a typical comet moving along a highly eccentric and inclined orbit throughout the expected entire extension of the Oort Cloud (? pc), it turns out that the addition of an outward Rindler-like acceleration, that is, for ?, does not allow bound orbits. Instead, if ?, the resulting numerically integrated trajectory is limited in space, but it radically differs from the standard Keplerian ellipse. In particular, the heliocentric distance of the comet gets markedly reduced and experiences high-frequency oscillations, its speed is increased, and the overall pattern of the trajectory is quite isotropic. As a consequence, the standard picture of the Oort Cloud is radically altered since its modified orbits are much less sensitive to the disturbing actions of the Galactic tide and nearby passing stars whose effects, in the standard scenario, are responsible for the phenomenology on which our confidence in the existence of the cloud itself is based. The present analysis may be supplemented in future by further statistical Monte Carlo type investigations by randomly varying the initial conditions of the comets.

Impact of xerostomia on the quality of life of adolescents with type 1 diabetes mellitus.

PubMed

Busato, Ivana Maria Saes; Ignácio, Sérgio Aparecido; Brancher, João Armando; Grégio, Ana Maria Trindade; Machado, Maria Angela Naval; Azevedo-Alanis, Luciana Reis

2009-09-01

To evaluate the impact of xerostomia on the quality of life (QOL) of adolescents with type 1 diabetes mellitus (DM1). The sample was comprised of 51 adolescents with DM1. Diabetic status was determined by glycosylated hemoglobin (HbG) and capillary glucose (CG) tests. Poor metabolic control was defined as HbG >8.0% and CG <90 mg/dL or >130 mg/dL. Measurement of salivary flow was performed by means of stimulated saliva collection. Xerostomia was detected by asking a question about the sensation of having "dry mouth," and OHIP-14 was used to measure the impact of xerostomia on QOL. A total of 52.9% of subjects presented with xerostomia and 40.8% with hyposalivation. Significant differences between the subjects with and without xerostomia regarding metabolic control levels were not observed (P > .05). However, OHIP-14 scores were significantly different between the subjects with and without xerostomia (P < .001). Xerostomia is frequent and has a negative impact on QOL of adolescents with DM1.

Differential impact of diabetes mellitus type II and arterial hypertension on collateral artery growth and concomitant macrophage accumulation.

PubMed

Ito, Wulf D; Lund, Natalie; Sager, Hendrik; Becker, Wiebke; Wenzel, Ulrich

2015-01-01

Diabetes mellitus type II and arterial hypertension are major risk factors for peripheral arterial disease and have been considered to reduce collateral growth (arteriogenesis). Collateral growth proceeds through different stages. Vascular proliferation and macrophage accumulation are hallmarks of early collateral growth. We here compare the impact of arterial hypertension and diabetes mellitus type II on collateral proliferation (Brdu incorporation) and macrophage accumulation (ED 2 staining) as well as collateral vessel function (collateral conductance) in a rat model of peripheral vascular disease (femoral artery occlusion), diabetes mellitus type II (Zucker fatty diabetic rats and Zucker lean rat controls) and arterial hypertension (induced via clip placement around the right renal arteriy). We furthermore tested the impact of monocyte chemoattractant protein-1 (MCP‑1) on collateral proliferation and macrophage accumulation in these models Diabetic animals showed reduced vascular proliferation and macrophage accumulation, which however did not translate into a change of collateral conductance. Hypertensive animals on the contrary had reduced collateral conductances without altered macrophage accumulation and only a marginal reduction in collateral proliferation. Infusion of MCP‑1 only enhanced vascular proliferation in diabetic animals. These findings illustrate that impaired monocyte/macrophage recruitment is responsible for reduced collateral growth under diabetic conditions but not in arterial hypertension suggesting that diabetes mellitus in particular affects early stages of collateral growth whereas hypertension has its impact on later remodeling stages. Successful pro-arteriogenic treatment strategies in a patient population that presents with diabetes mellitus and arterial hypertension need to address different stages of collateral growth and thus different molecular and cellular targets simultaneously.

Diversity and Impacts of Mining on the Non-Volant Small Mammal Communities of Two Vegetation Types in the Brazilian Amazon.

PubMed

Ardente, Natália Carneiro; Ferreguetti, Átilla Colombo; Gettinger, Donald; Leal, Pricila; Mendes-Oliveira, Ana Cristina; Martins-Hatano, Fernanda; Bergallo, Helena Godoy

2016-01-01

The Carajás National Forest contains some of the largest iron ore deposits in the world. The majority of the minerals are found below a plant community known as Savana Metalófila, or "Canga", which represents only 3% of the landscape within the Carajás National Forest (CNF). The aim of our study was to understand the diversity of community of non-volant small mammals in the two predominant vegetation types: Ombrophilous Forest and Canga, and to examine how mining impacts these communities. Sampling was conducted from January 2010 to August 2011 in 11 sampling sites divided by the total area of Canga and 12 sampling sites in the forest, totalizing 23 sites. Of these, 12 sites (Canga and Forest) were considered impacted areas located close to the mine (< 900 meters) and 11 sites (Canga and Forest), serving as controls, which were at least 7,000 meters from the mine. We recorded 28 species, 11 from the Order Didelphimorphia and 17 from the Order Rodentia. The two forest types shared 68.42% of the species found in the CNF. A gradient analysis (Non-metric multidimensional scaling) revealed that the first axis clearly separated the non-flying small mammal communities by vegetation type. Occupancy models showed that the detectability of species was affected by the distance from the mining activities. Of all the small mammals analyzed, 10 species were positively affected by the distance from mining in areas impacted (e.g. more likely to be detected farther from mining areas) and detectability was lower in impacted areas. However, three species were negatively affected by the distance from mining, with higher detectability in the impacted areas, and seven species showed no effect of their proximity to mining operations. To date, there are no studies in Brazil about the impact of mining on mammals or other vertebrates. This study reveals that the effect of mining may go beyond the forest destruction caused by the opening of the mining pits, but also may negatively affect

Diversity and Impacts of Mining on the Non-Volant Small Mammal Communities of Two Vegetation Types in the Brazilian Amazon

PubMed Central

Ardente, Natália Carneiro; Ferreguetti, Átilla Colombo; Gettinger, Donald; Leal, Pricila; Mendes-Oliveira, Ana Cristina; Martins-Hatano, Fernanda; Bergallo, Helena Godoy

2016-01-01

The Carajás National Forest contains some of the largest iron ore deposits in the world. The majority of the minerals are found below a plant community known as Savana Metalófila, or “Canga”, which represents only 3% of the landscape within the Carajás National Forest (CNF). The aim of our study was to understand the diversity of community of non-volant small mammals in the two predominant vegetation types: Ombrophilous Forest and Canga, and to examine how mining impacts these communities. Sampling was conducted from January 2010 to August 2011 in 11 sampling sites divided by the total area of Canga and 12 sampling sites in the forest, totalizing 23 sites. Of these, 12 sites (Canga and Forest) were considered impacted areas located close to the mine (<< 900 meters) and 11 sites (Canga and Forest), serving as controls, which were at least 7,000 meters from the mine. We recorded 28 species, 11 from the Order Didelphimorphia and 17 from the Order Rodentia. The two forest types shared 68.42% of the species found in the CNF. A gradient analysis (Non-metric multidimensional scaling) revealed that the first axis clearly separated the non-flying small mammal communities by vegetation type. Occupancy models showed that the detectability of species was affected by the distance from the mining activities. Of all the small mammals analyzed, 10 species were positively affected by the distance from mining in areas impacted (e.g. more likely to be detected farther from mining areas) and detectability was lower in impacted areas. However, three species were negatively affected by the distance from mining, with higher detectability in the impacted areas, and seven species showed no effect of their proximity to mining operations. To date, there are no studies in Brazil about the impact of mining on mammals or other vertebrates. This study reveals that the effect of mining may go beyond the forest destruction caused by the opening of the mining pits, but also may negatively

Divergent Impacts of Two Cattle Types on Vegetation in Coastal Meadows: Implications for Management

NASA Astrophysics Data System (ADS)

Laurila, Marika; Huuskonen, Arto; Pesonen, Maiju; Kaseva, Janne; Joki-Tokola, Erkki; Hyvärinen, Marko

2015-11-01

The proportion of beef cattle in relation to the total number of cattle has increased in Europe, which has led to a higher contribution of beef cattle in the management of semi-natural grasslands. Changes in vegetation caused by this change in grazers are virtually unexplored so far. In the present study, the impacts of beef and dairy cattle on vegetation structure and composition were compared on Bothnian Bay coastal meadows. Vegetation parameters were measured in seven beef cattle, six dairy heifer pastures, and in six unmanaged meadows. Compared to unmanaged meadows, vegetation in grazed meadows was significantly lower in height and more frequently colonized by low-growth species. As expected, vegetation grazed by beef cattle was more open than that on dairy heifer pastures where litter cover and proportion of bare ground were in the same level as in the unmanaged meadows. However, the observed differences may have in part arisen from the higher cattle densities in coastal meadows grazed by beef cattle than by dairy heifers. The frequencies of different species groups and the species richness values of vegetation did not differ between the coastal meadows grazed by the two cattle types. One reason for this may be the relatively short management history of the studied pastures. The potential differences in grazing impacts of the two cattle types on vegetation structure can be utilized in the management of coastal meadows for species with divergent habitat requirements.

Modeling the economic impact of medication adherence in type 2 diabetes: a theoretical approach.

PubMed

Cobden, David S; Niessen, Louis W; Rutten, Frans Fh; Redekop, W Ken

2010-09-07

While strong correlations exist between medication adherence and health economic outcomes in type 2 diabetes, current economic analyses do not adequately consider them. We propose a new approach to incorporate adherence in cost-effectiveness analysis. We describe a theoretical approach to incorporating the effect of adherence when estimating the long-term costs and effectiveness of an antidiabetic medication. This approach was applied in a Markov model which includes common diabetic health states. We compared two treatments using hypothetical patient cohorts: injectable insulin (IDM) and oral (OAD) medications. Two analyses were performed, one which ignored adherence (analysis 1) and one which incorporated it (analysis 2). Results from the two analyses were then compared to explore the extent to which adherence may impact incremental cost-effectiveness ratios. In both analyses, IDM was more costly and more effective than OAD. When adherence was ignored, IDM generated an incremental cost-effectiveness of $12,097 per quality-adjusted life-year (QALY) gained versus OAD. Incorporation of adherence resulted in a slightly higher ratio ($16,241/QALY). This increase was primarily due to better adherence with OAD than with IDM, and the higher direct medical costs for IDM. Incorporating medication adherence into economic analyses can meaningfully influence the estimated cost-effectiveness of type 2 diabetes treatments, and should therefore be considered in health care decision-making. Future work on the impact of adherence on health economic outcomes, and validation of different approaches to modeling adherence, is warranted.

The Impact of Gender, Family Type and Age on Undergraduate Parents' Perception of Causes of Sexual Abuse

ERIC Educational Resources Information Center

Onoyase, Anna

2016-01-01

The purpose of this study was to investigate the Impact of Gender, Family type and Age on undergraduate parents' perception of causes of child Sexual Abuse. Three hypotheses were formulated and tested. There was a review of relevant literature. The population for the study were 2014 sandwich contact students of Delta State University, Abraka who…

The Impact of Multiple Types of Child Maltreatment on Subsequent Risk Behaviors among Women during the Transition from Adolescence to Young Adulthood

ERIC Educational Resources Information Center

Hahm, Hyeouk Chris; Lee, Yoona; Ozonoff, Al; Van Wert, Michael J.

2010-01-01

The purpose of this study was to investigate how different types of child maltreatment, independently and collectively, impact a wide range of risk behaviors that fall into three domains: sexual risk behaviors, delinquency, and suicidality. Cumulative classification and Expanded Hierarchical Type (EHT) classification approaches were used to…

Weather Type classification over Chile; patterns, trends, and impact in precipitation and temperature

NASA Astrophysics Data System (ADS)

Frias, T.; Trigo, R. M.; Garreaud, R.

2009-04-01

The Andes Cordillera induces considerable disturbances on the structure and evolution of the pressure systems that influences South America. Different weather types for southern South America are derived from the daily maps of geopotential height at 850hPa corresponding to a 42 year period, spanning from 1958 to 2000. Here we have used the ECWMF ERA-40 reanalysis dataset to construct an automated version of the Lamb Weather type (WTs) classification scheme (Jones et al., 1993) developed for the UK. We have identified 8 basic WTs (Cyclonic, Anticyclonic and 6 main directional types) following a similar methodology to that previously adopted by Trigo and DaCamara, 2000 (for Iberia). This classification was applied to two regions of study (CLnorth and CLsouth) which differ 20° in latitude, so that the vast Chile territory could be covered. Then were assessed the impact of the occurrence of this weather types in precipitation in Chile, as well as in the distribution of precipitation and temperature fields (reanalysis data) in southern half of South America. The results allow to conclude that the precipitation in central region of Chile is largely linked with the class occurrence (concerning CLnorth) of cyclonic circulation and of West quadrant (SW, W and NW), despite of it's relatively low frequency. In CLsouth, for its part, it is verified that the most frequent circulation is from the west quadrant, although the associated amount of rainfall is lower than in CLnorth. There was also a general decrease of precipitation at local weather stations chosen in the considered period of study, particularly in austral winter.

Exposure to Gestational Diabetes Mellitus: Impact on the Development of Early-Onset Type 2 Diabetes in Canadian First Nations and Non-First Nations Offspring.

PubMed

Sellers, Elizabeth A C; Dean, Heather J; Shafer, Leigh Anne; Martens, Patricia J; Phillips-Beck, Wanda; Heaman, Maureen; Prior, Heather J; Dart, Allison B; McGavock, Jonathan; Morris, Margaret; Torshizi, Ali A; Ludwig, Sora; Shen, Garry X

2016-12-01

Type 2 diabetes is increasing in children worldwide, with Canadian First Nations (FN) children disproportionally affected. The prevalence of gestational diabetes mellitus (GDM) also is increasing. The objective of this study was to evaluate the impact of GDM exposure in utero and FN status on the subsequent risk of type 2 diabetes in offspring in the first 30 years of life. In this population-based historical prospective cohort study, we used administrative databases linked to a clinical database to explore the independent association and interaction between GDM and FN status on the subsequent development of type 2 diabetes in offspring. Among 321,008 births with a median follow-up of 15.1 years, both maternal GDM and FN status were independently associated with subsequent risk of type 2 diabetes in offspring in the first 30 years of life (hazard ratio 3.03 [95% CI 2.44-3.76; P < 0.0001] vs. 4.86 [95% CI 4.08-5.79; P < 0.0001], respectively). No interaction between GDM and FN status on type 2 diabetes risk was observed. FN status had a stronger impact on the development of type 2 diabetes in offspring than GDM. GDM is an important modifiable risk factor for type 2 diabetes, and its prevention may reduce the prevalence of subsequent type 2 diabetes in offspring. This study adds unique and rigorous evidence to the global public health debate about the impact of GDM on the long-term health of offspring. © 2016 by the American Diabetes Association.

An impact source localization technique for a nuclear power plant by using sensors of different types.

PubMed

Choi, Young-Chul; Park, Jin-Ho; Choi, Kyoung-Sik

2011-01-01

In a nuclear power plant, a loose part monitoring system (LPMS) provides information on the location and the mass of a loosened or detached metal impacted onto the inner surface of the primary pressure boundary. Typically, accelerometers are mounted on the surface of a reactor vessel to localize the impact location caused by the impact of metallic substances on the reactor system. However, in some cases, the number of accelerometers is not sufficient to estimate the impact location precisely. In such a case, one of useful methods is to utilize other types of sensor that can measure the vibration of the reactor structure. For example, acoustic emission (AE) sensors are installed on the reactor structure to detect leakage or cracks on the primary pressure boundary. However, accelerometers and AE sensors have a different frequency range. The frequency of interest of AE sensors is higher than that of accelerometers. In this paper, we propose a method of impact source localization by using both accelerometer signals and AE signals, simultaneously. The main concept of impact location estimation is based on the arrival time difference of the impact stress wave between different sensor locations. However, it is difficult to find the arrival time difference between sensors, because the primary frequency ranges of accelerometers and AE sensors are different. To overcome the problem, we used phase delays of an envelope of impact signals. This is because the impact signals from the accelerometer and the AE sensor are similar in the whole shape (envelope). To verify the proposed method, we have performed experiments for a reactor mock-up model and a real nuclear power plant. The experimental results demonstrate that we can enhance the reliability and precision of the impact source localization. Therefore, if the proposed method is applied to a nuclear power plant, we can obtain the effect of additional installed sensors. Crown Copyright © 2010. Published by Elsevier Ltd. All

An evaluation of the impact of flooring types on exposures to fine and coarse particles within the residential micro-environment using CONTAM.

PubMed

Bramwell, Lisa; Qian, Jing; Howard-Reed, Cynthia; Mondal, Sumona; Ferro, Andrea R

2016-01-01

Typical resuspension activities within the home, such as walking, have been estimated to contribute up to 25% of personal exposures to PM10. Chamber studies have shown that for moderate walking intensities, flooring type can impact the rate at which particles are re-entrained into the air. For this study, the impact of residential flooring type on incremental average daily (24 h) time-averaged exposure was investigated. Distributions of incremental time-averaged daily exposures to fine and coarse PM while walking within the residential micro-environment were predicted using CONTAM, the multizone airflow and contaminant transport program of the National Institute of Standards and Technology. Knowledge of when and where a person was walking was determined by randomly selecting 490 daily diaries from the EPA's consolidated human activity database (CHAD). On the basis of the results of this study, residential flooring type can significantly impact incremental time-averaged daily exposures to coarse and fine particles (α=0.05, P<0.05, N=490, Kruskal-Wallis test) with high-density cut pile carpeting resulting in the highest exposures. From this study, resuspension from walking within the residential micro-environment contributed 6-72% of time-averaged daily exposures to PM10.

The impact of subgroup type and subgroup configurational properties on work team performance.

PubMed

Carton, Andrew M; Cummings, Jonathon N

2013-09-01

Scholars have invoked subgroups in a number of theories related to teams, yet certain tensions in the literature remain unresolved. In this article, we address 2 of these tensions, both relating to how subgroups are configured in work teams: (a) whether teams perform better with a greater number of subgroups and (b) whether teams perform better when they have imbalanced subgroups (majorities and minorities are present) or balanced subgroups (subgroups are of equal size). We predict that the impact of the number and balance of subgroups depends on the type of subgroup-whether subgroups are formed according to social identity (i.e., identity-based subgroups) or information processing (i.e., knowledge-based subgroups). We first propose that teams are more adversely affected by 2 identity-based subgroups than by any other number, yet the uniquely negative impact of a 2-subgroup configuration is not apparent for knowledge-based subgroups. Instead, a larger number of knowledge-based subgroups is beneficial for performance, such that 2 subgroups is worse for performance when compared with 3 or more subgroups but better for performance when compared with no subgroups or 1 subgroup. Second, we argue that teams perform better when identity-based subgroups are imbalanced yet knowledge-based subgroups are balanced. We also suggest that there are interactive effects between the number and balance of subgroups-however, the nature of this interaction depends on the type of subgroup. To test these predictions, we developed and validated an algorithm that measures the configurational properties of subgroups in organizational work teams. Results of a field study of 326 work teams from a multinational organization support our predictions. PsycINFO Database Record (c) 2013 APA, all rights reserved

Perception of the impact of type 1 diabetes on low-income families.

PubMed

Edmonds-Myles, Sadiqa; Tamborlane, William V; Grey, Margaret

2010-01-01

The purpose of this study was to explore the psychosocial impact of type 1 diabetes (T1DM) on low-income families of various racial/ethnic backgrounds. A qualitative study using qualitative descriptive methods was conducted with a total of 21 patient-parent dyads from African American, Hispanic, and white heritage, respectively. An interview guide was developed to explore each family's attitudes and beliefs related to diabetes. Although all subjects were in excellent metabolic control (mean A1C levels were between 7.3% and 7.6%), there were a number of identifiable differences in the perception of the impact of T1DM among the 3 groups. Themes in the data demonstrated differences in the following areas: (1) view of diabetes and its effects on the family; (2) ability to successfully treat diabetes; (3) ability to cope with diabetes; and (4) experiences with the health care system. Most notable themes include a disparity across racial/ethnic groups in the preoccupation with the disease after diagnosis, cultural and financial factors identified, and differences in treatment modalities and reasons for their use. Diabetes education and care need to carefully address such differences. Although these differences are likely multifactorial, with components of socioeconomic status, family structure, and family experiences involved, it is evident that ethnicity itself is an important factor that can affect the ability of families to manage and cope with diabetes.

The responses of subjective feeling, task performance ability, cortisol and HRV for the various types of floor impact sound: a pilot study.

PubMed

Yun, Seok Hyeon; Park, Sang Jin; Sim, Chang Sun; Sung, Joo Hyun; Kim, Ahra; Lee, Jang Myeong; Lee, Sang Hyun; Lee, Jiho

2017-01-01

Recently, noise coming from the neighborhood via floor wall has become a great social problem. The noise between the floors can be a cause of physical and psychological problems, and the different types of floor impact sound (FIS) may have the different effects on the human's body and mind. The purpose of this study is to assess the responses of subjective feeling, task performance ability, cortisol and HRV for the various types of floor impact. Ten men and 5 women were enrolled in our study, and the English listening test was performed under the twelve different types of FIS, which were made by the combinations of bang machine (B), tapping machine (T), impact ball (I) and sound-proof mattress (M). The 15 subjects were exposed to each FIS for about 3 min, and the subjective annoyance, performance ability (English listening test), cortisol level of urine/saliva and heart rate variability (HRV) were examined. The sound pressure level (SPL) and frequency of FIS were analyzed. Repeated-measures ANOVA, paired t-test, Wilcoxon signed rank test were performed for data analysis. The SPL of tapping machine (T) was reduced with the soundproof mattress (M) by 3.9-7.3 dBA. Impact ball (I) was higher than other FIS in low frequency (31.5-125 Hz) by 10 dBA, and tapping machine (T) was higher than other FIS in high frequency (2-4 k Hz) by 10 dBA. The subjective annoyance is highest in the combination of bang machine and tapping machine (BT), and next in the tapping machine (T). The English listening score was also lowest in the BT, and next in T. The difference of salivary cortisol levels between various types of FIS was significant ( p  = 0.003). The change of HRV parameters by the change of FIS types was significant in some parameters, which were total power (TP) ( p  = 0.004), low frequency (LF) ( p  = 0.002) and high frequency (HF) ( p  = 0.011). These results suggest that the human's subjective and objective responses were different according to FIS types

Type 1 diabetes - impact on children and parents at diagnosis and 1 year subsequent to the child's diagnosis.

PubMed

Jönsson, Lisbeth; Lundqvist, Pia; Tiberg, Irén; Hallström, Inger

2015-03-01

When a child is diagnosed with type 1 diabetes, it is a complex and challenging situation for the whole family. The management of the disease places substantial demands on the family and they need to change their daily life. The short- and long-term impact on the family has rarely been described; therefore, the aim of this study was to describe and compare the disease impact on parents and children in terms of health-related quality of life (HRQOL) at diagnosis and 1 year subsequent to the child's diagnosis with type 1 diabetes. A further aim was to describe and compare the parents' satisfaction with the care received. Sixty-nine children and their parents were included. Parents independently filled in the PedsQL(™) Family Impact Module and the PedsQL(™) Health Care Satisfaction Generic Module. The PedsQL(™) 3.0 Diabetes Module was filled in by parents and children over the age of 5. Mothers reported a lower HRQOL than fathers both at the time of diagnosis (p = 0.003) and 1 year later (p = 0.041). For diabetes-specific HRQOL, children aged 5-7 years and their parents reported more worry than children and parents in older age groups (p = 0.037). Children aged 8-12 and 13-18 years reported a higher treatment adherence than mothers (p = 0.011 and p = 0.039, respectively); no differences were found between children and fathers. Both parents expressed overall satisfaction with the child's health care. The family is affected during the first year after their child is diagnosed with type 1 diabetes. Both parents and the youngest children estimated a high degree of worry. The diabetes team needs to be aware of this and to take it into consideration. © 2014 Nordic College of Caring Science.

[Impacts of dominated landscape types on hydrogen and oxygen isotope effects of spring water in the Hani Rice Terraces].

PubMed

Jiao, Yuan Mei; Liu, Cheng Jing; Liu, Xin; Liu, Zhi Lin; Ding, Yin Ping

2017-07-18

Analysis of hydrogen and oxygen stable isotopes is an effective method to track the water cycle in watershed. Impact of landscape pattern on the isotope effects of spring water is a new interdisciplinary topic between landscape ecology and isotope hydrology. Taking the Quanfuzhuang River basin located in the core area of UNESCO World Cultural Heritage of Honghe Hani Rice Terrace as the object, collecting the monthly samples of 78 points of spring water and 39 precipitation at altitude of 1500 m (terraces), 1700 m (terraces) and 1900 m (forest) from March 2015 to March 2016, we analyzed the hydrogen and oxygen stable isotopes of water samples under the different landscape types. The results indicated that the dominated landscape types were forests and rice terraces, being 66.6% and 22.1% of the whole landscape area respectively, and they had a spatial vertical pattern of forest located at the mountain top and rice terraces at the down-slope. The correlation analysis showed that the spring water not only came from the precipitation, but also from other water sources which had a more positive δ 18 O and δD values, the spring water in up-slope forests mainly came from precipitation, while that in down-slope rice terraces came from precipitation, ri-ver water, rice terrace water and under ground water. Therefore, the mixing effects of spring water δ 18 O and δD were more significant in rice terraces. The overall altitude effect of the hydrogen and oxygen stable isotopes in spring water was obvious. The linear decreasing rates of δ 18 O and δD values were -0.125‰·(100 m) -1 and -0.688‰·(100 m) -1 , respectively. The deuterium surplus value increased with the altitude because of the impacts of landscape pattern and the local cycle of water isotopes. In summary, the dominant landscape types had a significant impact on the hydrogen and oxygen isotopes of spring water, which could be used as response indicator to reveal the impacts of landscape pattern on

The Impact of Social Support on Outcomes in Adult Patients with Type 2 Diabetes: A Systematic Review

PubMed Central

Strom, Joni L.; Egede, Leonard E.

2012-01-01

Diabetes is one of the fastest growing chronic diseases globally and in the United States. Although preventable, type 2 diabetes accounts for 90% of all cases of diabetes worldwide and continues to be a source of increased disability, lost productivity, mortality, and amplified health-care costs. Proper disease management is crucial for achieving better diabetes-related outcomes. Evidence suggests that higher levels of social support are associated with improved clinical outcomes, reduced psychosocial symptomatology, and the adaptation of beneficial lifestyle activities; however, the role of social support in diabetes management is not well understood. The purpose of this systematic review is to examine the impact of social support on outcomes in adults with type 2 diabetes. PMID:22949135

A Synoptic Weather Typing Approach to Assess Climate Change Impacts on Meteorological and Hydrological Risks at Local Scale in South-Central Canada

NASA Astrophysics Data System (ADS)

Cheng, Chad Shouquan; Li, Qian; Li, Guilong

2010-05-01

The synoptic weather typing approach has become popular in evaluating the impacts of climate change on a variety of environmental problems. One of the reasons is its ability to categorize a complex set of meteorological variables as a coherent index, which can facilitate analyses of local climate change impacts. The weather typing method has been applied in Environment Canada to analyze climatic change impacts on various meteorological/hydrological risks, such as freezing rain, heavy rainfall, high-/low-flow events, air pollution, and human health. These studies comprise of three major parts: (1) historical simulation modeling to verify the hazardous events, (2) statistical downscaling to provide station-scale future climate information, and (3) estimates of changes in frequency and magnitude of future hazardous meteorological/hydrological events in this century. To achieve these goals, in addition to synoptic weather typing, the modeling conceptualizations in meteorology and hydrology and various linear/nonlinear regression techniques were applied. Furthermore, a formal model result verification process has been built into the entire modeling exercise. The results of the verification, based on historical observations of the outcome variables predicted by the models, showed very good agreement. This paper will briefly summarize these research projects, focusing on the modeling exercise and results.

Synthesis of Cation and Water Free Cryptomelane Type OMS-2 Cathode Materials: The Impact of Tunnel Water on Electrochemistry

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

Poyraz, Altug S.; Huang, Jianping; Zhang, Bingjie

Cryptomelane type manganese dioxides (α-MnO 2, OMS-2) are interesting potential cathode materials due to the ability of their one dimensional (1D) tunnels to reversibly host various cations including Li +and an accessible stable 3+/4+ redox couple. Here, we synthesized metal cation free OMS-2 materials where the tunnels were occupied by only water and hydronium ions. Water was subsequently removed from the tunnels. Cation free OMS-2 and Dry-OMS-2 were used as cathodes in Li based batteries to investigate the role of tunnel water on their electrochemistry. The initial discharge capacity was higher for Dry-OMS-2 (252 mAh/g) compared to OMS-2 (194 mAh/g),more » however, after 100 cycles Dry-OMS-2 and OMS-2 delivered 137 mAh/g and 134 mAh/g, respectively. Li +ion diffusion was more facile for Dry-OMS as evidenced by rate capability, at 400 mA/g. Dry-OMS-2 delivered 135mAh/g whereas OMS-2 delivered ~115 mAh/g. This first report of the impact of tunnel water on the electrochemistry of OMS-2 type materials demonstrates that the presence of tunnel water in OMS-2 type materials negatively impacts the electrochemistry.« less

Fatigue in Type 2 Diabetes: Impact on Quality of Life and Predictors.

PubMed

Singh, Rupali; Teel, Cynthia; Sabus, Carla; McGinnis, Patricia; Kluding, Patricia

2016-01-01

Fatigue is a persistent symptom, impacting quality of life (QoL) and functional status in people with type 2 diabetes, yet the symptom of fatigue has not been fully explored. The purpose of this study was to explore the relationship between fatigue, QoL functional status and to investigate the predictors of fatigue. These possible predictors included body mass index (BMI), Hemoglobin A1C (HbA1C), sleep quality, pain, number of complications from diabetes, years since diagnosis and depression. Forty-eight individuals with type 2 diabetes (22 females, 26 males; 59.66±7.24 years of age; 10.45 ±7.38 years since diagnosis) participated in the study. Fatigue was assessed by using Multidimensional Fatigue Inventory (MFI-20). Other outcomes included: QoL (Audit of Diabetes Dependent QoL), and functional status (6 minute walk test), BMI, HbA1c, sleep (Pittsburg sleep quality index, PSQI), pain (Visual Analog Scale), number of complications, years since diagnosis, and depression (Beck's depression Inventory-2). The Pearson correlation analysis followed by multivariable linear regression model was used. Fatigue was negatively related to quality of life and functional status. Multivariable linear regression analysis revealed sleep, pain and BMI as the independent predictors of fatigue signaling the presence of physiological (sleep, pain, BMI) phenomenon that could undermine health outcomes.

Fatigue in Type 2 Diabetes: Impact on Quality of Life and Predictors

PubMed Central

Teel, Cynthia; Sabus, Carla; McGinnis, Patricia; Kluding, Patricia

2016-01-01

Fatigue is a persistent symptom, impacting quality of life (QoL) and functional status in people with type 2 diabetes, yet the symptom of fatigue has not been fully explored. The purpose of this study was to explore the relationship between fatigue, QoL functional status and to investigate the predictors of fatigue. These possible predictors included body mass index (BMI), Hemoglobin A1C (HbA1C), sleep quality, pain, number of complications from diabetes, years since diagnosis and depression. Forty-eight individuals with type 2 diabetes (22 females, 26 males; 59.66±7.24 years of age; 10.45 ±7.38 years since diagnosis) participated in the study. Fatigue was assessed by using Multidimensional Fatigue Inventory (MFI-20). Other outcomes included: QoL (Audit of Diabetes Dependent QoL), and functional status (6 minute walk test), BMI, HbA1c, sleep (Pittsburg sleep quality index, PSQI), pain (Visual Analog Scale), number of complications, years since diagnosis, and depression (Beck’s depression Inventory-2). The Pearson correlation analysis followed by multivariable linear regression model was used. Fatigue was negatively related to quality of life and functional status. Multivariable linear regression analysis revealed sleep, pain and BMI as the independent predictors of fatigue signaling the presence of physiological (sleep, pain, BMI) phenomenon that could undermine health outcomes. PMID:27824886

Impact of Haemophilus influenzae Type b conjugate vaccine in Mongolia: prospective population-based surveillance, 2002-2010.

PubMed

Scott, Susana; Altanseseg, Dorjpurev; Sodbayer, Demberelsuren; Nymadawa, Pagvajav; Bulgan, Davaadash; Mendsaikhan, Jamsran; Watt, James P; Slack, Mary P E; Carvalho, Maria G; Hajjeh, Rana; Edmond, Karen M

2013-07-01

Bacterial meningitis is associated with high mortality and long-term complications. This study assessed the impact of Haemophilus influenzae type b (Hib) conjugate vaccine on childhood bacterial meningitis in Ulaanbaatar, Mongolia. Prospective, active, population-based surveillance for suspected meningitis in children aged 2-59 months was conducted (February 2002-January 2011) in 6 hospitals. Clinical data, blood, and cerebrospinal fluid were collected. The impact of Hib conjugate vaccine was assessed by comparing Hib and all cause meningitis data in the 3 years preceding pentavalent conjugate vaccine implementation (2002-2004) with 3 years postimplementation (2008-2010). Five hundred eleven cases of suspected meningitis were identified from 2002-2011. Pentavalent conjugate vaccine coverage in December 2005 in Ulaanbaatar city was 97%. The proportion of suspected cases confirmed as Hib meningitis decreased from 25% (50/201) in the prevaccination era to 2% (4/193) in the postvaccination era (P < .0001). The annual incidence of Hib decreased from 28 cases per 100,000 children in 2002-2005 to 2 per 100,000 in 2008-2010 (P < .0001). This article demonstrates the marked impact of Hib conjugate vaccine introduction on meningitis in Mongolia. It is important to sustain this surveillance system to monitor the long-term impact of Hib conjugate vaccine, as well as other interventions such as pneumococcal and meningococcal vaccines. Copyright © 2013. Published by Mosby, Inc.

Impact of primary care-based disease management on the health-related quality of life in patients with type 2 diabetes and comorbidity.

PubMed

Ose, Dominik; Wensing, Michel; Szecsenyi, Joachim; Joos, Stefanie; Hermann, Katja; Miksch, Antje

2009-09-01

This study examined the effectiveness of the German diabetes disease management program (DMP) for patients with varying numbers of other medical conditions with respect to their health-related quality of life (HRQoL). A questionnaire, including the HRQoL-measured EQ-5D, was mailed to a random sample of 3,546 patients with type 2 diabetes (59.3% female). The EQ-5D score was analyzed by grouping patients according to those on a DMP and those receiving routine care. The analysis showed that participation in the DMP (P < 0.001), the number of other medical conditions (P < 0.001), and the interaction between the DMP and the number of other conditions (P < 0.05) had a significant impact on the EQ-5D score. Our findings suggest that the number of other medical conditions may have a negative impact on the HRQoL of patients with type 2 diabetes. The results demonstrate that the German DMP for type 2 diabetes may help counterbalance this effect.

Evaluating the impact of mobile telephone technology on type 2 diabetic patients' self-management: the NICHE pilot study.

PubMed

Faridi, Zubaida; Liberti, Lauren; Shuval, Kerem; Northrup, Veronika; Ali, Ather; Katz, David L

2008-06-01

Utilizing information technology, such as Internet and cellphones, holds great promise in enhancing diabetic care. Yet few studies have examined the impact of cellphone technology on type 2 diabetics' self-care. The primary aim of the study is to examine the feasibility of utilizing this technology to assist with diabetes self-care in a clinic population as well as its impact on clinical outcomes. Thirty patients with a diagnosis of type 2 diabetes at two Community Health Centers were randomized to intervention or control. Intervention patients participated in a brief intervention and received tailored daily messages via cellphone prompting them to enhance their diabetic self-care behaviour. Patients at the control site continued with their standard diabetes self-management. A mean improvement in HbA1c levels was apparent (-0.1, SD = 0.3%; P = 0.1534) in the intervention group, compared with a mean deterioration in the control (0.3, SD = 1.0%; P = 0.3813), yet without statistical significance. Self-efficacy scores improved significantly in the intervention group (-0.5, SD = 0.6; P = 0.0080) compared with no improvement in the control (0.0, SD = 1.0; P = 0.9060). Participants encountered numerous technological barriers when attempting to adhere to the intervention protocol. The results indicate the intervention had a positive impact on some clinical outcome and self-efficacy. Although the technology appears feasible in a clinical setting technology must be made more user-friendly before a larger phase II trial is conducted.

Prevalence of overactive bladder and its impact on quality of life in 1025 patients with type 2 diabetes in mainland China.

PubMed

Xu, Dongjuan; Gao, Jie; Wang, Xiaojuan; Huang, Liqun; Wang, Kefang

2017-08-01

This study examined the prevalence of overactive bladder (OAB) and investigated the impact of OAB on quality of life (QOL) in patients with type 2 diabetes in Mainland China. A total of 1025 patients with type 2 diabetes were surveyed. Patients were grouped into no OAB, dry OAB, and wet OAB groups according to the presence of OAB and urge incontinence. Descriptive analyses, one-way analysis of variance (ANOVA) and multivariable regression models were conducted to assess the prevalence of OAB and the effect of OAB on QOL. The prevalence of OAB among patients with type 2 diabetes was 13.9% (with dry OAB, 6.1%; with wet OAB, 7.8%). Multivariable regression models showed that OAB symptoms caused significant deterioration of the physical and mental aspects of QOL. Compared with dry OAB, wet OAB further decreased the mental aspect of QOL. Moreover, the effect sizes of the impacts of dry and wet OAB on QOL were larger than those of diabetic neuropathy or retinopathy, diabetes duration, or urinary tract infection history. OAB is more common in patients with type 2 diabetes than in the general population and substantially decreases patient QOL. Copyright © 2017 Elsevier Inc. All rights reserved.

The impact of compaction, moisture content, particle size and type of bulking agent on initial physical properties of sludge-bulking agent mixtures before composting.

PubMed

Huet, J; Druilhe, C; Trémier, A; Benoist, J C; Debenest, G

2012-06-01

This study aimed to experimentally acquire evolution profiles between depth, bulk density, Free Air Space (FAS), air permeability and thermal conductivity in initial composting materials. The impact of two different moisture content, two particle size and two types of bulking agent on these four parameters was also evaluated. Bulk density and thermal conductivity both increased with depth while FAS and air permeability both decreased with it. Moreover, depth and moisture content had a significant impact on almost all the four physical parameters contrary to particle size and the type of bulking agent. Copyright © 2012 Elsevier Ltd. All rights reserved.

The Impact of Environmental Factors on the Amount of Nitrates and Nitrites in Different Types of Soils and Ways of Their Utilization

NASA Astrophysics Data System (ADS)

Bachvarova, Darina; Rafi, Renay; Doichinov, Aleksandar

2017-03-01

Despite the last decade considerable advances in the study of nitrate and nitrite pollution of soil, there are still some gaps in research related to neglecting or ignoring the role of soil in the food chain and its effects on upper trophic units. The article presents the results of a study on the impact of air and soil humidity and temperature, as well as soil type and utilization on the amount of nitrates and nitrites in the soil solution at the end of vegetation period. It was proved that statistically significant impact on the amounts of residual nitrate and nitrite ions was caused by the temperature and moisture of soil, its type, and the specific properties of the crops grown.

Environmental impact assessment of a package type IFAS reactor during construction and operational phases: a life cycle approach.

PubMed

Singh, Nitin Kumar; Singh, Rana Pratap; Kazmi, Absar Ahmad

2017-05-01

In the present study, a life cycle assessment (LCA) approach was used to analyse the environmental impacts associated with the construction and operational phases of an integrated fixed-film activated sludge (IFAS) reactor treating municipal wastewater. This study was conducted within the boundaries of a research project that aimed to investigate the implementation related challenges of a package type IFAS reactor from an environmental perspective. Along with the LCA results of the construction phase, a comparison of the LCA results of seven operational phases is also presented in this study. The results showed that among all the inputs, the use of stainless steel in the construction phase caused the highest impact on environment, followed by electricity consumption in raw materials production. The impact of the construction phase on toxicity impact indicators was found to be significant compared to all operational phases. Among the seven operational phases of this study, the dissolved oxygen phase III, having a concentration of ∼4.5 mg/L, showed the highest impact on abiotic depletion, acidification, global warming, ozone layer depletion, human toxicity, fresh water eco-toxicity, marine aquatic eco-toxicity, terrestrial eco-toxicity, and photochemical oxidation. However, better effluent quality in this phase reduced the eutrophication load on environment.

Haemophilus influenzae type b conjugate vaccine impact against purulent meningitis in Rwanda.

PubMed

Muganga, Narcisse; Uwimana, Jeannine; Fidele, Ngabo; Gahimbare, Laetitia; Gessner, Bradford D; Mueller, Judith E; Mhlanga, Bekithemba R; Katsande, Reggis; Herbinger, Karl-Heinz; Rugambwa, Celse

2007-09-28

Rwanda introduced Haemophilus influenzae type b (Hib) conjugate vaccine in January 2002 and simultaneously implemented pediatric bacterial meningitis surveillance at a major referral hospital in the capital Kigali. We reviewed clinical and laboratory information collected during January 2002 to June 2006. Due to a variety of laboratory limitations, only eight confirmed Hib cases were identified, all before 2004. However, the proportion of cerebrospinal fluid with purulence decreased from 26.0% during 2002, to 15.9% during 2003, 9.7% during 2004 and 8.4% in 2005 (p<0.001). Vaccine effectiveness of two or three doses of Hib vaccine against purulent meningitis was 52% (95% confidence interval, 5-75%). In an African setting with few resources and in which few confirmed Hib meningitis cases were identified, Hib vaccine impact nevertheless could be demonstrated against the outcome of purulent meningitis and was found to be high.

Differential coronary resistance microvessel remodeling between type 1 and type 2 diabetic mice: impact of exercise training.

PubMed

Trask, Aaron J; Delbin, Maria A; Katz, Paige S; Zanesco, Angelina; Lucchesi, Pamela A

2012-01-01

The goals of the present study were to compare coronary resistance microvessel (CRM) remodeling between type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) mice, and to determine the impact of aerobic exercise training on CRM remodeling in diabetes. Eight week old male mice were divided into T1DM: control sedentary (Control-SD), T1DM sedentary (T1DM-SD) induced by streptozotocin, and T1DM exercise trained (T1DM-TR); T2DM: control sedentary (Db/db-SD), T2DM sedentary (db/db-SD), and T2DM trained (db/db-TR). Aerobic exercise training (TR) was performed on a mouse treadmill for 8weeks. CRMs were isolated and mounted on a pressure myograph to measure and record vascular remodeling and mechanics. CRM diameters, wall thickness, stress-strain, incremental modulus remained unchanged in T1DM-SD mice compared to control, and exercise training showed no effect. In contrast, CRMs isolated from db/db-SD mice exhibited decreased luminal diameter with thicker microvascular walls, which significantly increased the wall:lumen ratio (Db/db-SD: 5.8±0.3 vs. db/db-SD: 8.9±0.7, p<0.001). Compared to db/db-SD mice, coronary arterioles isolated from db/db-TR mice had similar internal diameter and wall thickness, while wall:lumen ratio (6.8±0.2, p<0.05) and growth index (db/db-SD: 16.2 vs. db/db-TR: 4.3, % over Db/db) were reduced. These data show that CRMs undergo adverse inward hypertrophic remodeling only in T2DM, but not T1DM, and that aerobic exercise training can partially mitigate this process. Copyright © 2012 Elsevier Inc. All rights reserved.

Impact of Information Technology on the Therapy of Type-1 Diabetes: A Case Study of Children and Adolescents in Germany

PubMed Central

Berndt, Rolf-Dietrich; Takenga, Claude; Preik, Petra; Kuehn, Sebastian; Berndt, Luise; Mayer, Herbert; Kaps, Alexander; Schiel, Ralf

2014-01-01

Being able to manage and adjust insulin doses is a key part of managing type-1 diabetes. Children and adolescents with type-1 diabetes mellitus often have serious difficulties with this dosage adjustment. Therefore, this paper aims to investigate the impact of using novel mobile, web and communication technologies in assisting their therapy and treatment. A trial was conducted in the north-eastern part of Germany to evaluate the impact of the “Mobil Diab”, a mobile diabetes management system, on the clinical outcome. 68 subjects aged between 8 and 18 years, divided randomly into control and intervention groups, were included into the study. Metrics such as changes in the quality of metabolic control, changes in psychological parameters, usability and acceptance of the technology were used for evaluation purpose. Metabolic control was mainly assessed by the mean HbAlc. Analysis showed a good acceptance of the proposed system. An overall improvement in mean levels of HbA1c was observed, however further studies will be conducted to prove evidence of the weight and BMI improvements. Moreover, initial indications of positive impact on the improvement in psychological parameters were presumed based on the result of the conducted study. The system appeared to be an efficient and time saving tool in diabetes management. PMID:25563223

Tracheostomy Tube Type and Inner Cannula Selection Impact Pressure and Resistance to Air Flow.

PubMed

Pryor, Lee N; Baldwin, Claire E; Ward, Elizabeth C; Cornwell, Petrea L; O'Connor, Stephanie N; Chapman, Marianne J; Bersten, Andrew D

2016-05-01

Advancements in tracheostomy tube design now provide clinicians with a range of options to facilitate communication for individuals receiving ventilator assistance through a cuffed tube. Little is known about the impact of these modern design features on resistance to air flow. We undertook a bench model test to measure pressure-flow characteristics and resistance of a range of tubes of similar outer diameter, including those enabling subglottic suction and speech. A constant inspiratory ± expiratory air flow was generated at increasing flows up to 150 L/min through each tube (with or without optional, mandatory, or interchangeable inner cannula). Driving pressures were measured, and resistance was calculated (cm H2O/L/s). Pressures changed with increasing flow (P < .001) and tube type (P < .001), with differing patterns of pressure change according to the type of tube (P < .001) and direction of air flow. The single-lumen reference tube encountered the lowest inspiratory and expiratory pressures compared with all double-lumen tubes (P < .001); placement of an optional inner cannula increased bidirectional tube resistance by a factor of 3. For a tube with interchangeable inner cannulas, the type of cannula altered pressure and resistance differently (P < .001); the speech cannula in particular amplified pressure-flow changes and increased tube resistance by more than a factor of 4. Tracheostomy tube type and inner cannula selection imposed differing pressures and resistance to air flow during inspiration and expiration. These differences may be important when selecting airway equipment or when setting parameters for monitoring, particularly for patients receiving supported ventilation or during the weaning process. Copyright © 2016 by Daedalus Enterprises.

Impact of complications and bladder cancer stage on quality of life in patients with different types of urinary diversions.

PubMed

Prcic, Alden; Aganovic, Damir; Hadziosmanovic, Osman

2013-12-01

Determine correlation between complications and stage of the disease and their impact on quality of life in patients with different types of ileal urinary derivation after radical cystectomy, and upon estimation of acquired results, to suggest the most acceptable type of urinary diversion. In five year period a prospective clinical study was performed on 106 patients, to whom a radical cystectomy was performed due to bladder cancer. Patients were divided into two groups, 66 patients with ileal conduit derivation and 40 patients with orthotopic derivation, whereby in each group a comparison between reflux and anti-reflux technique of orthotopic bladder was made. All patients from both groups filled the Sickness Impact Profile score six months after the operation. All patients had CT urography or Intravenous urography performed, as well as standard laboratory, vitamin B12 blood values, in order to evaluate early (ileus or subileus, wound dehiscence, bladder fistula, rupture of orthotopic bladder, urine extravazation) and late complications (VUR, urethral stricture, ureter stenosis, metabolic acidosis, mineral dis-balance, hypovitaminosis of vitamin B12, increased resorption of bone calcium, urinary infection, kidney damage, relapse of primary disease), so as disease stage and it's impact on quality of life. From gained results we observe that each category of SIP score correlates with different rate of correlation with the type of operation, group, T, N, and R grade, except work category. Average value of SIP score rises depending on the type of operation and T stage. It is notable that there is no difference in T1 stage, no matter the type of operation. So the average value of SIP score in T1 stage for conduit was 20.3, for Abol-Enein and Ghoneim 17.25 and Hautmann 18.75 respectively. Average value of SIP score in T2 stage for conduit was 31, for Abol-Enein and Ghoneim 19.1 and Hautmann 17.8. Average value of SIP score in T3 stage for conduit was 38.03, for Abol

The Impact of Weight Gain on Motivation, Compliance, and Metabolic Control in Patients with Type 2 Diabetes Mellitus

PubMed Central

Pi-Sunyer, F. Xavier

2010-01-01

Patients with type 2 diabetes, approximately 85% of whom are overweight or obese, often have an increased incidence of cardiovascular disease (CVD) risk factors such as hypertension and dyslipidemia. Both type 2 diabetes and obesity are independent risk factors for CVD. Unfortunately, many therapies aimed at maintaining and improving glucose control are associated with weight gain. Among the older antidiabetes agents, most, including the insulin secretagogues and sensitizers, can lead to weight gain, except for metformin, which is weight-neutral. Among the newer agents, the dipeptidyl peptidase-4 inhibitors generally are weight-neutral in addition to lowering glucose, while the glucagon-like peptide–1 receptor agonists lead to weight reduction. Patients with type 2 diabetes are at an increased risk for both diabetes-and CV-related outcomes, and weight reduction is an important component of diabetes management. Weight gain in patients with type 2 diabetes can contribute to patient frustration and may negatively impact their compliance to therapeutic regimens. The selection of antidiabetes agents that not only improve glucose control but reduce or have a neutral effect on weight with beneficial effects on lipids are ideal options for managing patients with type 2 diabetes. PMID:19820278

Improving profitability through slurry management: a look at the impact of slurry pH on various glass types

NASA Astrophysics Data System (ADS)

Hooper, Abigail R.; Boffa, Christopher C.; Sarkas, Harry W.; Cureton, Kevin

2015-08-01

When building an optical system, optical fabricators and designers meticulously choose the glass types for their application knowing that each one will have different chemical, thermal and mechanical properties. As the requirements for new optical systems have grown more demanding, the range of available glass types has vastly expanded and the specifications on the produced products have grown tighter. In an attempt to simplify processes and streamline consumable purchases, optical polishing houses often rely on one polishing slurry to manage these vast array of glass types. An unforeseen consequence of these practices can be a reduction in productivity by reduced removal rate, poor yields and frequent rework all translating into higher costs and reduced profitability. In this paper, the authors will examine the impact slurry pH has on glass types of different compositions and chemical, thermal and mechanical properties when using a double-sided polishing process. Experiments will use material removal rate, surface quality, and surface figure to provide insight into improving process control for differing glass types. Further guidance will be provided on how simple on-site monitoring and adjustment can deliver improved profitability on challenging substrates.

Impact of diabetes education on type 1 diabetes mellitus control in children.

PubMed

Alonso Martín, Daniel E; Roldán Martín, M Belén; Álvarez Gómez, M Ángeles; Yelmo Valverde, Rosa; Martín-Frías, María; Alonso Blanco, Milagros; Barrio Castellanos, Raquel

2016-12-01

Diabetes education is an essential tool to achieve treatment objectives in type1 diabetes mellitus (T1DM). The aim of this study was to determine if understanding of diabetes by caregivers/patients or sociodemographic factors affect blood glucose control in children and adolescents with T1DM. The level of knowledge of 105 caregivers of children and adolescents with T1DM was assessed using a survey adapted to the type of treatment used (multiple dose insulin [MDI] or continuous subcutaneous insulin infusion [CSII]). Mean HbA1c levels in the previous year was considered as metabolic control marker. Mean HbA1c levels were similar in both treatment groups, with slightly higher values in children over 12years of age. Patients on CSII had a longer time since disease onset and had poorer results, maybe because the items were more difficult due to the higher level of knowledge required for this treatment modality (P=.005). Caregivers with lower educational levels achieved poorer scores in the survey, but mean HbA1c levels of their children were lower, probably because of their greater involvement in disease care. The level of knowledge of caregivers and/or patients with T1DM was high, and this was associated to good metabolic control. Studies to assess the impact of caregiver knowledge on metabolic control of children are needed. Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

Ecological footprint analysis of environmental impacts by cascaded exploitation of diversion-type small hydropower: a case study in southwest china

NASA Astrophysics Data System (ADS)

Wang, Zhenhua; Li, Qingyun; Huang, Zhuo; Tang, Xianqiang; Zhao, Weihua

2017-05-01

Cascaded exploitation of diversion-type small hydropower (SHP) offers a source of new energy as well as socioeconomic benefits; however, it inevitably causes environmental disturbance and damage. Previous studies on the cumulative effect of cascaded diversion SHP rarely discussed using quantitative analysis method. In this paper, the ecological footprint analysis approach is proposed to assess the positive and negative impacts of cascaded diversion SHP on environment of a small-scale river in Southwest China. Positive impact is defined as ecological supply footprint (ESF), which refers to vegetation protection by replacing firewood with SHP. Negative impact is defined as ecological loss footprint (ELF), which includes fish and net primary productivity loss, vegetation destruction and soil erosion. With the raising in the number (n>4) of diversion SHP stations, the difference between ELF and ESF increases remarkably, suggesting that the adverse impacts of cascaded diversion SHP accumulate in the study area. Compared with vegetation destruction and soil erosion, the cumulative loss of fish and net productivity is the most important aspect of the adverse impacts which needs more attentions.

Analysis of the impact of environmental and social factors, with a particular emphasis on education, on the level of metabolic control in type 1 diabetes in children.

PubMed

Stefanowicz, Anna; Birkholz, Dorota; Myśliwiec, Małgorzata; Niedźwiecki, Maciej; Owczuk, Radosław; Balcerska, Anna

2012-01-01

Type 1 diabetes is a chronic, incurable childhood disease. Chronically uncontrolled diabetes is associated with eye, kidney, nerve, heart and blood vessel damage and function impairment. The aim of this study was to evaluate the impact of various social and environmental factors, with a particular emphasis on education, on the level of metabolic control in diabetes. The survey research was conducted in 102 children aged 0-18 years, diagnosed with type 1 diabetes. Based on the HbA(1c ) level, patients were divided into: group A (63 patients with fairly well and moderately controlled type 1 diabetes mellitus) and group B (39 patients with metabolically uncontrolled type 1 diabetes mellitus). The impact of various environmental and social factors on the degree of metabolic control of type 1 diabetes was analysed. No effect of typical environmental and social factors, such as: place of residence, gender, parents' education and their professional activity, on the level of metabolic control of type 1 diabetes was found. However, groups A and B significantly differed in the level of knowledge about diabetes and its treatment, in the regularity of meals, in possessing a nutrition scale and in the self-assessed preparation for taking care and custody of a child with type 1 diabetes. 1. Children with type 1 diabetes and their parents require ongoing education about the disease and its treatment. 2. The regularity of meals and the use of a nutrition scale have considerable impact on the level of metabolic control of the disease.

Impact of endothelin blockade on acute exercise-induced changes in blood flow and endothelial function in type 2 diabetes mellitus.

PubMed

Schreuder, Tim H A; van Lotringen, Jaap H; Hopman, Maria T E; Thijssen, Dick H J

2014-09-01

Positive vascular effects of exercise training are mediated by acute increases in blood flow. Type 2 diabetes patients show attenuated exercise-induced increases in blood flow, possibly mediated by the endothelin pathway, preventing an optimal stimulus for vascular adaptation. We examined the impact of endothelin receptor blockade (bosentan) on exercise-induced blood flow in the brachial artery and on pre- and postexercise endothelial function in type 2 diabetes patients (n = 9, 60 ± 7 years old) and control subjects (n = 10, 60 ± 5 years old). Subjects reported twice to the laboratory to perform hand-grip exercise in the presence of endothelin receptor blockade or placebo. We examined brachial artery endothelial function (via flow-mediated dilatation) before and after exercise, as well as blood flow during exercise. Endothelin receptor blockade resulted in a larger increase in blood flow during exercise in type 2 diabetes patients (P = 0.046), but not in control subjects (P = 0.309). Exercise increased shear rate across the exercise protocol, unaffected by endothelin receptor blockade. Exercise did not alter brachial artery diameter in either group, but endothelin receptor blockade resulted in a larger brachial artery diameter in type 2 diabetes patients (P = 0.033). Exercise significantly increased brachial artery flow-mediated dilatation in both groups, unaffected by endothelin receptor blockade. Endothelin receptor blockade increased exercise-induced brachial artery blood flow in type 2 diabetes patients, but not in control subjects. Despite this effect of endothelin receptor blockade on blood flow, we found no impact on baseline or post-exercise endothelial function in type 2 diabetes patients or control subjects, possibly related to normalization of the shear stimulus during exercise. The successful increase in blood flow during exercise in type 2 diabetes patients through endothelin receptor blockade may have beneficial effects in

Initial shunt type at the Norwood operation impacts myocardial function in hypoplastic left heart syndrome.

PubMed

Ruotsalainen, Hanna K; Pihkala, Jaana; Salminen, Jukka; Hornberger, Lisa K; Sairanen, Heikki; Ojala, Tiina

2017-08-01

We investigated the impact of initial shunt type, a Blalock-Taussig (BT) shunt versus a right ventricle to pulmonary artery conduit (RV-PA) on myocardial function at different stages of surgical palliation in patients with hypoplastic left heart syndrome (HLHS). A population-based cohort of 63 Finnish children with HLHS (BT n  = 23, RV-PA n  = 40) born between 2003 and 2010 were studied retrospectively by echocardiography prior to Stages 1, 2 and 3 palliation and 0.5-3 years after Stage 3. For comparison of systolic myocardial function, we evaluated the RV fractional area change (FAC), strain, strain rate and mechanical synchrony from the apical 4-chamber view by velocity vector imaging. There were no intergroup differences in demographics during the study period. At baseline, no intergroup differences were detected in RV systolic myocardial function. Before Stage 2, RV FAC was higher ( P  = 0.03) in the RV-PA conduit group. At Stage 3, an increase in all systolic myocardial functional parameters was observed in the BT shunt group. After Stage 3, the BT shunt group had better RV systolic function. In multiple regression analysis, the shunt type and the stage of palliation had an impact on myocardial function. Although patients with HLHS initially palliated with a BT shunt demonstrate lower RV FAC after Stage I, RV FAC improves after Stage 2 with better systolic performance after Stage 3 compared with those initially palliated with an RV-PA conduit. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Impact of Type 2 Myocardial Infarction (MI) on Hospital-Level MI Outcomes: Implications for Quality and Public Reporting.

PubMed

Arora, Sameer; Strassle, Paula D; Qamar, Arman; Wheeler, Evan N; Levine, Alexandra L; Misenheimer, Jacob A; Cavender, Matthew A; Stouffer, George A; Kaul, Prashant

2018-03-26

The International Classification of Diseases (ICD) coding system does not recognize type 2 myocardial infarction (MI) as a separate entity; therefore, patients with type 2 MI continue to be categorized under the general umbrella of non-ST-segment-elevation myocardial infarction (NSTEMI). We aim to evaluate the impact of type 2 MI on hospital-level NSTEMI metrics and discuss the implications for quality and public reporting. We conducted a single-center retrospective analysis of 1318 patients discharged with a diagnosis of NSTEMI between July 2013 and October 2014. The Third Universal Definition was used to define type 1 and type 2 MI. Weighted Kaplan-Meier curves were used to analyze risk of mortality and readmission. Overall, 1039 patients met NSTEMI criteria per the Third Universal Definition; of those, 264 (25.4%) had type 2 MI. Patients with type 2 MI were older, were more likely to have chronic kidney disease, and had lower peak troponin levels. Compared with type 1 MI patients, those with type 2 MI had higher inpatient mortality (17.4% versus 4.7%, P <0.0001) and were more likely to die from noncardiovascular causes (71.7% versus 25.0%, P <0.0001). Despite weighting for patient characteristics and discharge medications, patients with type 2 MI had higher mortality at both 30 days (risk ratio: 3.63; 95% confidence interval, 1.67-7.88) and 1 year (risk ratio: 1.98; 95% confidence interval, 1.44-2.73) after discharge. Type 2 MI was also associated with a lower 30-day cardiovascular-related readmission (risk ratio: 0.49; 95% confidence interval, 0.12-2.06). NSTEMI metrics are significantly affected by type 2 MI patients. Type 2 MI patients have distinct etiologies, are managed differently, and have higher mortality compared with patients with type 1 MI. Moving forward, it may be appropriate to exclude type 2 MI data from NSTEMI quality metrics. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Impact of Substrate Types on Structure and Emission of ZnO Nanocrystalline Films

NASA Astrophysics Data System (ADS)

Ballardo Rodriguez, I. Ch.; El Filali, B.; Díaz Cano, A. I.; Torchynska, T. V.

2018-02-01

Zinc oxide (ZnO) films were simultaneously synthesized by an ultrasonic spray pyrolysis (USP) method on p-type Si (100), silicon carbide polytype [6H-SiC (0001)], porous 6H-SiC and amorphous glass substrates with the aim of studying the impact of substrate types on the structure and emission of ZnO nanocrystalline films. Porous silicon carbide (P-SiC) was prepared by the electrochemical anodization method at a constant potential of 20 V and etching time of 12 min. ZnO films grown on the SiC and P-SiC substrates are characterized by a wurtzite crystal structure with preferential growth along the (002) direction and with grain sizes of 90-180 and 70-160 nm, respectively. ZnO films grown on the Si substrate have just some small irregular hexagonal islands. The amorphous glass substrate did not promote the formation of any regular crystal forms. The obtained x-ray diffraction and photoluminescence (PL) results have shown that the better ZnO film crystallinity and high PL intensity of near-band edge emissions were achieved in the films grown on the porous SiC and SiC substrates. The preferential growth and crystalline nature of ZnO films on the SiC substrate have been discussed from the point of view of the lattice parameter compatibility between ZnO and SiC crystals.

Impact of Different Standard Type A7A Drum Closure-Ring Practices on Gasket Contraction and Bolt Closure Distance– 15621

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

Ketusky, Edward; Blanton, Paul; Bobbitt, John H.

The Department of Energy, the Savannah River National Laboratory, several manufacturers of specification drums, and the United States Department of Transportation (DOT) are collaborating in the development of a guidance document for DOE contractors and vendors who wish to qualify containers to DOT 7A Type A requirements. Currently, the effort is focused on DOT 7A Type A 208-liter (55-gallons) drums with a standard 12-gauge bolted closure ring. The U.S. requirements, contained in Title 49, Part 178.350 “Specification 7A; general packaging, Type A specifies a competent authority review of the packaging is not required for the transport of (Class 7) radioactivemore » material containing less than Type A quantities of radioactive material. For Type AF drums, a 4 ft. regulatory free drop must be performed, such that the drum “suffers maximum damage.” Although the actual orientation is not defined by the specification, recent studies suggest that maximum damage would result from a shallow angle top impact, where kinetic energy is transferred to the lid, ultimately causing heavy damage to the lid, or even worse, causing the lid to come off. Since each vendor develops closure recommendations/procedures for the drums they manufacture, key parameters applied to drums during closing vary based on vendor. As part of the initial phase of the collaboration, the impact of the closure variants on the ability of the drum to suffer maximum damage is investigated. Specifically, closure testing is performed varying: 1) the amount of torque applied to the closure ring bolt; and, 2) stress relief protocol, including: a) weight of hammer; and, b) orientation that the hammer hits the closure ring. After closure, the amount of drum lid gasket contraction and the distance that the closure bolt moves through the closure ring is measured.« less

Comparing the impacts of hiking, skiing and horse riding on trail and vegetation in different types of forest.

PubMed

Törn, A; Tolvanen, A; Norokorpi, Y; Tervo, R; Siikamäki, P

2009-03-01

Nature-based tourism in protected areas has increased and diversified dramatically during the last decades. Different recreational activities have a range of impacts on natural environments. This paper reports results from a comparison of the impacts of hiking, cross-country skiing and horse riding on trail characteristics and vegetation in northern Finland. Widths and depths of existing trails, and vegetation on trails and in the neighbouring forests were monitored in two research sites during 2001 and 2002. Trail characteristics and vegetation were clearly related to the recreational activity, research site and forest type. Horse trails were as deep as hiking trails, even though the annual number of users was 150-fold higher on the hiking trails. Simultaneously, cross-country skiing had the least effect on trails due to the protective snow cover during winter. Hiking trail plots had little or no vegetation cover, horse riding trail plots had lower vegetation cover than forest plots, while skiing had no impact on total vegetation cover. On the other hand, on horse riding trails there were more forbs and grasses, many of which did not grow naturally in the forest. These species that were limited to riding trails may change the structure of adjacent plant communities in the long run. Therefore, the type of activities undertaken and the sensitivity of habitats to these activities should be a major consideration in the planning and management of nature-based tourism. Establishment of artificial structures, such as stairs, duckboards and trail cover, or complete closure of the site, may be the only way to protect the most sensitive or deteriorated sites.

Budget impact of treating commercially insured type 1 and type 2 diabetes patients in the United States with insulin degludec compared to insulin glargine.

PubMed

Weatherall, James; Bloudek, Lisa; Buchs, Sarah

2017-02-01

To quantify the annual budget impact if all US commercially insured type 1 diabetes mellitus patients on basal-bolus therapy (T1DM BBT ), type 2 diabetes mellitus patients on basal-oral therapy (T2DM BOT ), and type 2 diabetes mellitus patients on basal-bolus therapy (T2DM BBT ) switched from insulin glargine (IGlar) to insulin degludec (IDeg). A short-term (1 year) budget impact model was developed to evaluate the costs of IDeg vs. IGlar in three treatment groups (T1DM BBT , insulin-naïve T2DM BOT , and T2DM BBT ) through a simulation for a potential US health plan population of 35 million. The analysis captured direct medical costs associated with insulin treatment (insulin, needles, and self-monitored glucose testing) and costs related to managing hypoglycemic episodes. There were a total of 59,780 T1DM BBT patients, 383,145 T2DM BOT patients, and 171,325 T2DM BBT patients expected to be using long-acting insulin. A sensitivity analysis on the entire US population was also conducted. Among T1DM BBT patients, IDeg was associated with an annual cost savings of -$357.13 per patient per year (PPPY), driven primarily by reduced insulin utilization. IDeg was also found to be cost saving among T2DM BOT patients (-$1206.61 PPPY), driven primarily by reductions in the cost of treating severe hypoglycemic episodes. Among T2DM BBT patients, IDeg was associated with an additional cost to the plan of $1420.04 PPPY; however, this result was driven by a higher insulin dose for IDeg compared to IGlar. Overall, IDeg demonstrated cost savings of $240 million per year, which accounted for total cost savings of 3.5% vs. IGlar. The results of this analysis suggest that the reduced insulin utilization and fewer hypoglycemic episodes associated with IDeg may translate into reduced costs for payers. The model is limited by simplification of a complex disease state and assumptions surrounding disease state, treatment patterns, and costs. Therefore, results may not accurately reflect

Impact of temperature and soil type on Mycobacterium bovis survival in the environment

PubMed Central

Barbier, Elodie; Rochelet, Murielle; Gal, Laurent; Boschiroli, Maria Laura

2017-01-01

Mycobacterium bovis, the causative agent of the bovine tuberculosis (bTB), mainly affects cattle, its natural reservoir, but also a wide range of domestic and wild mammals. Besides direct transmission via contaminated aerosols, indirect transmission of the M. bovis between wildlife and livestock might occur by inhalation or ingestion of environmental substrates contaminated through infected animal shedding. We monitored the survival of M. bovis in two soil samples chosen for their contrasted physical and-chemical properties (i.e. pH, clay content). The population of M. bovis spiked in sterile soils was enumerated by a culture-based method after 14, 30, 60, 90, 120 and 150 days of incubation at 4°C and 22°C. A qPCR based assay targeting the IS1561’ locus was also performed to monitor M. bovis in both sterile and biotic spiked soils. The analysis of survival profiles using culture-based method showed that M. bovis survived longer at lower temperature (4°C versus 22°C) whereas the impact of soil characteristics on M. bovis persistence was not obvious. Furthermore, qPCR-based assay detected M. bovis for a longer period of time than the culture based method with higher gene copy numbers observed in sterile soils than in biotic ones. Impact of soil type on M. bovis persistence need to be deepened in order to fill the gap of knowledge concerning indirect transmission of the disease. PMID:28448585

Impact of temperature and soil type on Mycobacterium bovis survival in the environment.

PubMed

Barbier, Elodie; Rochelet, Murielle; Gal, Laurent; Boschiroli, Maria Laura; Hartmann, Alain

2017-01-01

Mycobacterium bovis, the causative agent of the bovine tuberculosis (bTB), mainly affects cattle, its natural reservoir, but also a wide range of domestic and wild mammals. Besides direct transmission via contaminated aerosols, indirect transmission of the M. bovis between wildlife and livestock might occur by inhalation or ingestion of environmental substrates contaminated through infected animal shedding. We monitored the survival of M. bovis in two soil samples chosen for their contrasted physical and-chemical properties (i.e. pH, clay content). The population of M. bovis spiked in sterile soils was enumerated by a culture-based method after 14, 30, 60, 90, 120 and 150 days of incubation at 4°C and 22°C. A qPCR based assay targeting the IS1561' locus was also performed to monitor M. bovis in both sterile and biotic spiked soils. The analysis of survival profiles using culture-based method showed that M. bovis survived longer at lower temperature (4°C versus 22°C) whereas the impact of soil characteristics on M. bovis persistence was not obvious. Furthermore, qPCR-based assay detected M. bovis for a longer period of time than the culture based method with higher gene copy numbers observed in sterile soils than in biotic ones. Impact of soil type on M. bovis persistence need to be deepened in order to fill the gap of knowledge concerning indirect transmission of the disease.

Impact and cost-effectiveness of Haemophilus influenzae type b conjugate vaccination in India.

PubMed

Clark, Andrew D; Griffiths, Ulla K; Abbas, Syed Shahid; Rao, Krishna D; Privor-Dumm, Lois; Hajjeh, Rana; Johnson, Hope; Sanderson, Colin; Santosham, Mathuram

2013-07-01

To estimate the potential health impact and cost-effectiveness of nationwide Haemophilus influenzae type b (Hib) vaccination in India. A decision support model was used, bringing together estimates of demography, epidemiology, Hib vaccine effectiveness, Hib vaccine costs, and health care costs. Scenarios favorable and unfavorable to the vaccine were evaluated. State-level analyses indicate where the vaccine might have the greatest impact and value. Between 2012 and 2031, Hib conjugate vaccination is estimated to prevent over 200 000 child deaths (∼1% of deaths in children <5 years of age) in India at an incremental cost of US$127 million per year. From a government perspective, state-level cost-effectiveness ranged from US$192 to US$1033 per discounted disability adjusted life years averted. With the inclusion of household health care costs, cost-effectiveness ranged from US$155-US$939 per discounted disability adjusted life year averted. These values are below the World Health Organization thresholds for cost effectiveness of public health interventions. Hib conjugate vaccination is a cost-effective intervention in all States of India. This conclusion does not alter with plausible changes in key parameters. Although investment in Hib conjugate vaccination would significantly increase the cost of the Universal Immunization Program, about 15% of the incremental cost would be offset by health care cost savings. Efforts should be made to expedite the nationwide introduction of Hib conjugate vaccination in India. Copyright © 2013. Published by Mosby, Inc.

Impact and Cost-Effectiveness of Haemophilus influenzae Type b Conjugate Vaccination in India

PubMed Central

Clark, Andrew D.; Griffiths, Ulla K.; Abbas, Syed Shahid; Rao, Krishna D.; Privor-Dumm, Lois; Hajjeh, Rana; Johnson, Hope; Sanderson, Colin; Santosham, Mathuram

2017-01-01

Objective To estimate the potential health impact and cost-effectiveness of nationwide Haemophilus influenzae type b (Hib) vaccination in India. Study design A decision support model was used, bringing together estimates of demography, epidemiology, Hib vaccine effectiveness, Hib vaccine costs, and health care costs. Scenarios favorable and unfavorable to the vaccine were evaluated. State-level analyses indicate where the vaccine might have the greatest impact and value. Results Between 2012 and 2031, Hib conjugate vaccination is estimated to prevent over 200 000 child deaths (~1% of deaths in children <5 years of age) in India at an incremental cost of US$127 million per year. From a government perspective, state-level cost-effectiveness ranged from US$192 to US$1033 per discounted disability adjusted life years averted. With the inclusion of household health care costs, cost-effectiveness ranged from US$155-US$939 per discounted disability adjusted life year averted. These values are below the World Health Organization thresholds for cost effectiveness of public health interventions. Conclusions Hib conjugate vaccination is a cost-effective intervention in all States of India. This conclusion does not alter with plausible changes in key parameters. Although investment in Hib conjugate vaccination would significantly increase the cost of the Universal Immunization Program, about 15% of the incremental cost would be offset by health care cost savings. Efforts should be made to expedite the nationwide introduction of Hib conjugate vaccination in India. PMID:23773596

Impact of the type of mask on the effectiveness of and adherence to continuous positive airway pressure treatment for obstructive sleep apnea.

PubMed

Andrade, Rafaela Garcia Santos de; Piccin, Vivien Schmeling; Nascimento, Juliana Araújo; Viana, Fernanda Madeiro Leite; Genta, Pedro Rodrigues; Lorenzi-Filho, Geraldo

2014-01-01

Continuous positive airway pressure (CPAP) is the gold standard for the treatment of obstructive sleep apnea (OSA). Although CPAP was originally applied with a nasal mask, various interfaces are currently available. This study reviews theoretical concepts and questions the premise that all types of interfaces produce similar results. We revised the evidence in the literature about the impact that the type of CPAP interface has on the effectiveness of and adherence to OSA treatment. We searched the PubMed database using the search terms "CPAP", "mask", and "obstructive sleep apnea". Although we identified 91 studies, only 12 described the impact of the type of CPAP interface on treatment effectiveness (n = 6) or adherence (n = 6). Despite conflicting results, we found no consistent evidence that nasal pillows and oral masks alter OSA treatment effectiveness or adherence. In contrast, most studies showed that oronasal masks are less effective and are more often associated with lower adherence and higher CPAP abandonment than are nasal masks. We concluded that oronasal masks can compromise CPAP OSA treatment adherence and effectiveness. Further studies are needed in order to understand the exact mechanisms involved in this effect.

Impact of the type of mask on the effectiveness of and adherence to continuous positive airway pressure treatment for obstructive sleep apnea*

PubMed Central

de Andrade, Rafaela Garcia Santos; Piccin, Vivien Schmeling; Nascimento, Juliana Araújo; Viana, Fernanda Madeiro Leite; Genta, Pedro Rodrigues; Lorenzi-Filho, Geraldo

2014-01-01

Continuous positive airway pressure (CPAP) is the gold standard for the treatment of obstructive sleep apnea (OSA). Although CPAP was originally applied with a nasal mask, various interfaces are currently available. This study reviews theoretical concepts and questions the premise that all types of interfaces produce similar results. We revised the evidence in the literature about the impact that the type of CPAP interface has on the effectiveness of and adherence to OSA treatment. We searched the PubMed database using the search terms "CPAP", "mask", and "obstructive sleep apnea". Although we identified 91 studies, only 12 described the impact of the type of CPAP interface on treatment effectiveness (n = 6) or adherence (n = 6). Despite conflicting results, we found no consistent evidence that nasal pillows and oral masks alter OSA treatment effectiveness or adherence. In contrast, most studies showed that oronasal masks are less effective and are more often associated with lower adherence and higher CPAP abandonment than are nasal masks. We concluded that oronasal masks can compromise CPAP OSA treatment adherence and effectiveness. Further studies are needed in order to understand the exact mechanisms involved in this effect. PMID:25610507

Impact of education and training on type of care provided by community-based breastfeeding counselors: a cross-sectional study

PubMed Central

2011-01-01

Background Studies using community-based breastfeeding counselors (CBBCs) have repeatedly shown positive impact on breastfeeding initiation, exclusivity and duration, particularly among low-income mothers. To date, there has not been a comprehensive study to determine the impact of CBBC attributes such as educational background and training, on the type of care that CBBCs provide. Methods This was a cross-sectional study of a convenience sample of CBBCs to ascertain the influence of counselor education and type of training on type of support and proficiency of CBBCs in communities across the United States. Invitations to participate in this online survey of CBBCs were e-mailed to program coordinators of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), La Leche League, and other community-based health organizations, who in turn invited and encouraged their CBBCs to participate. Descriptive analysis was used to describe participants (N = 847), while bivariate analysis using χ2 test was used to examine the differences between CBBC education, training received and breastfeeding support skills used. Multivariate logistic regression was used to assess the independent determinants of specific breastfeeding support skills. Results The major findings from the research indicate that overall, educational attainment of CBBCs is not a significant predictor for the curriculum used in their training and type of support skills used during counseling sessions, but initial training duration was positively associated with the use of many breastfeeding support skills. Another major influence of counselor support to clients is the type of continuing education they receive after their initial training, with higher likelihood of use of desirable support skills associated with counselors continuing their breastfeeding education at conferences or trainings away from their job sites. Conclusions Our results show that different programs use different

Impact of study design on development and evaluation of an activity-type classifier.

PubMed

van Hees, Vincent T; Golubic, Rajna; Ekelund, Ulf; Brage, Søren

2013-04-01

Methods to classify activity types are often evaluated with an experimental protocol involving prescribed physical activities under confined (laboratory) conditions, which may not reflect real-life conditions. The present study aims to evaluate how study design may impact on classifier performance in real life. Twenty-eight healthy participants (21-53 yr) were asked to wear nine triaxial accelerometers while performing 58 activity types selected to simulate activities in real life. For each sensor location, logistic classifiers were trained in subsets of up to 8 activities to distinguish between walking and nonwalking activities and were then evaluated in all 58 activities. Different weighting factors were used to convert the resulting confusion matrices into an estimation of the confusion matrix as would apply in the real-life setting by creating four different real-life scenarios, as well as one traditional laboratory scenario. The sensitivity of a classifier estimated with a traditional laboratory protocol is within the range of estimates derived from real-life scenarios for any body location. The specificity, however, was systematically overestimated by the traditional laboratory scenario. Walking time was systematically overestimated, except for lower back sensor data (range: 7-757%). In conclusion, classifier performance under confined conditions may not accurately reflect classifier performance in real life. Future studies that aim to evaluate activity classification methods are warranted to pay special attention to the representativeness of experimental conditions for real-life conditions.

A Synoptic Weather Typing Approach and Its application to Assess Climate Change Impacts on Extreme Weather Events at Local Scale in South-Central Canada

NASA Astrophysics Data System (ADS)

Shouquan Cheng, Chad; Li, Qian; Li, Guilong

2010-05-01

The synoptic weather typing approach has become popular in evaluating the impacts of climate change on a variety of environmental problems. One of the reasons is its ability to categorize a complex set of meteorological variables as a coherent index, which can facilitate analyses of local climate change impacts. The weather typing method has been successfully applied in Environment Canada for several research projects to analyze climatic change impacts on a number of extreme weather events, such as freezing rain, heavy rainfall, high-/low-flow events, air pollution, and human health. These studies comprise of three major parts: (1) historical simulation modeling to verify the extreme weather events, (2) statistical downscaling to provide station-scale future hourly/daily climate data, and (3) projections of changes in frequency and intensity of future extreme weather events in this century. To achieve these goals, in addition to synoptic weather typing, the modeling conceptualizations in meteorology and hydrology and a number of linear/nonlinear regression techniques were applied. Furthermore, a formal model result verification process has been built into each of the three parts of the projects. The results of the verification, based on historical observations of the outcome variables predicted by the models, showed very good agreement. The modeled results from these projects found that the frequency and intensity of future extreme weather events are projected to significantly increase under a changing climate in this century. This talk will introduce these research projects and outline the modeling exercise and result verification process. The major findings on future projections from the studies will be summarized in the presentation as well. One of the major conclusions from the studies is that the procedures (including synoptic weather typing) used in the studies are useful for climate change impact analysis on future extreme weather events. The implication of

Impact of type 1 diabetes mellitus on the family is reduced with the medical home, care coordination, and family-centered care.

PubMed

Katz, Michelle L; Laffel, Lori M; Perrin, James M; Kuhlthau, Karen

2012-05-01

To examine whether the medical home, care coordination, or family-centered care was associated with less impact of type 1 diabetes mellitus (T1D) on families' work, finances, time, and school attendance. With the 2005 to 2006 National Survey of Children with Special Health Care Needs, we compared impact in children with T1D (n = 583) with that in children with other special health care needs (n = 39 944) and children without special health care needs (n = 4945). We modeled the associations of the medical home, care coordination, and family-centered care with family impact in T1D. Seventy-five percent of families of children with T1D reported a major impact compared with 45% of families of children with special health care needs (P < .0001) and 17% of families of children without special health care needs (P < .0001). In families of children with T1D, 35% reported restricting work, 38% reported financial impact, 41% reported medical expenses >$1000/year, 24% reported spending ≥11 hours/week caring or coordination care, and 20% reported ≥11 school absences/year. The medical home, care coordination, and family-centered care were associated with less work and financial impact. In childhood T1D, most families experience major impact. Better systems of health care delivery may help families reduce some of this impact. Copyright © 2012 Mosby, Inc. All rights reserved.

Predictability of two types of El Niño and their climate impacts in boreal spring to summer in coupled models

NASA Astrophysics Data System (ADS)

Lee, Ray Wai-Ki; Tam, Chi-Yung; Sohn, Soo-Jin; Ahn, Joong-Bae

2017-12-01

The predictability of the two El Niño types and their different impacts on the East Asian climate from boreal spring to summer have been studied, based on coupled general circulation models (CGCM) simulations from the APEC Climate Center (APCC) multi-model ensemble (MME) hindcast experiments. It was found that both the spatial pattern and temporal persistence of canonical (eastern Pacific type) El Niño sea surface temperature (SST) are much better simulated than those for El Niño Modoki (central Pacific type). In particular, most models tend to have El Niño Modoki events that decay too quickly, in comparison to those observed. The ability of these models in distinguishing between the two types of ENSO has also been assessed. Based on the MME average, the two ENSO types become less and less differentiated in the model environment as the forecast leadtime increases. Regarding the climate impact of ENSO, in spring during canonical El Niño, coupled models can reasonably capture the anomalous low-level anticyclone over the western north Pacific (WNP)/Philippine Sea area, as well as rainfall over coastal East Asia. However, most models have difficulties in predicting the springtime dry signal over Indochina to South China Sea (SCS) when El Niño Modoki occurs. This is related to the location of the simulated anomalous anticyclone in this region, which is displaced eastward over SCS relative to the observed. In boreal summer, coupled models still exhibit some skills in predicting the East Asian rainfall during canonical El Nino, but not for El Niño Modoki. Overall, models' performance in spring to summer precipitation forecasts is dictated by their ability in capturing the low-level anticyclonic feature over the WNP/SCS area. The latter in turn is likely to be affected by the realism of the time mean monsoon circulation in models.

Commentary: Types of bullying, types of intervention: reflections on Arseneault (2018).

PubMed

Smith, Peter K

2018-04-01

Arseneault's review is a timely reminder of the strong evidence for the negative impact of school bullying, especially although not only on the victims of it. It is particularly important in dealing with the evidence for causal links, mechanisms and possible moderating factors. In this Commentary, I raise some issues about the definition of bullying; the importance of separating out the bully/victim category; differing impacts of types of victimisation, and notably cyber victimization, perhaps interacting with gender; and evidence on school antibullying policies and impact of interventions. © 2018 Association for Child and Adolescent Mental Health.

Stigma in People With Type 1 or Type 2 Diabetes

PubMed Central

Liu, Nancy F.; Brown, Adam S.; Folias, Alexandra E.; Younge, Michael F.; Guzman, Susan J.; Close, Kelly L.

2017-01-01

IN BRIEF This study quantitatively measures diabetes stigma and its associated psychosocial impact in a large population of U.S. patients with type 1 or type 2 diabetes using an online survey sent to 12,000 people with diabetes. A majority of respondents with type 1 (76%) or type 2 (52%) diabetes reported that diabetes comes with stigma. Perceptions of stigma were significantly higher among respondents with type 1 diabetes than among those with type 2 diabetes, with the highest rate in parents of children with type 1 diabetes (83%) and the lowest rate in people with type 2 diabetes who did not use insulin (49%). Our results suggest that a disturbingly high percentage of people with diabetes experience stigma, particularly those with type 1 or type 2 diabetes who are on intensive insulin therapy. The experience of stigma disproportionately affects those with a higher BMI, higher A1C, and poorer self-reported blood glucose control, suggesting that those who need the most help are also the most affected by stigma. PMID:28144043

Pasta quality as impacted by the type of flour and starch and the level of egg addition.

PubMed

Saleh, Mohammed; Al-Ismail, Khalid; Ajo, Radwan

2017-10-01

This study investigated the effects of substituting wheat flour with fractions of different starch types and egg levels on pasta quality. First order mixture response surface model was used where the effects of various starch types and egg levels on pasta quality were evaluated. Coefficients of estimation were determined and fractional contribution of wheat, starch type and egg levels were evaluated. Egg levels negatively (p < .05) impacted treatments pasting viscosities, except in potato starch and rice flour. Stabilized rice bran peak viscosity increased from 215.0 to 3420.0 cP with decrease in egg level from 33 to 0%. Flow behavior index of treatments solution with various fractions of starch types and egg level ranged from 0.34 to 1.42 and was significantly (p < .05) lower than control (i.e., 2.15) indicating a better fit as a shear thinning model. Water holding capacity values of acorn starch and lupine flour were the greatest among treatment ranging from 86.8% to 176.0% and from 83.3% to 152.0%, respectively. Results also showed a possible modification of cooked pasta quality including firmness, stickiness, cooking loss, and water uptake, keeping with consumer acceptability through varying starch type and egg level. Results show that flour and starch type and egg level interaction play significant role in pasta blends formulation. Moreover, substitution of wheat flour with acorn, native or modified corn and potato starches fractions, as well as with lupine, rice, tapioca, and stabilized rice bran flours would have significant effects on the physical properties and acceptability of various cereal products. For instance, the use of rice bran in potentially developed products would enhance the consumption of whole grain foods, resulting in improved intake of fiber and other healthy components. © 2016 Wiley Periodicals, Inc.

Impact of Finger Type in Fingerprint Authentication

NASA Astrophysics Data System (ADS)

Gafurov, Davrondzhon; Bours, Patrick; Yang, Bian; Busch, Christoph

Nowadays fingerprint verification system is the most widespread and accepted biometric technology that explores various features of the human fingers for this purpose. In general, every normal person has 10 fingers with different size. Although it is claimed that recognition performance with little fingers can be less accurate compared to other finger types, to our best knowledge, this has not been investigated yet. This paper presents our study on the topic of influence of the finger type into fingerprint recognition performance. For analysis we employ two fingerprint verification software packages (one public and one commercial). We conduct test on GUC100 multi sensor fingerprint database which contains fingerprint images of all 10 fingers from 100 subjects. Our analysis indeed confirms that performance with small fingers is less accurate than performance with the others fingers of the hand. It also appears that best performance is being obtained with thumb or index fingers. For example, performance deterioration from the best finger (i.e. index or thumb) to the worst fingers (i.e. small ones) can be in the range of 184%-1352%.

Impact of soil type, moisture, and depth on swede midge (Diptera: Cecidomyiidae) pupation and emergence.

PubMed

Chen, Mao; Shelton, Anthony M

2007-12-01

Contarinia nasturtii (Kieffer) (Diptera: Cecidomyiidae), a common insect pest in Europe and a new invasive pest in North America, causes severe damage to cruciferous crops. Currently, many counties in Canada and the United States in which C. nasturtii has not been previously reported are at risk of being infested by C. nasturtii. Effectiveness of chemical control is limited, especially under high population pressure in fields, because the cryptic habits of C. nasturtii protect them from insecticidal sprays. Alternative management strategies against C. nasturtii that are needed to protect crucifers and soil management for the pupal stage were studied as one option. Six different types of soils (loam fine sand, fine sand, clay loam, muck, Chenango shale loam, and silt loam soil) were collected from commercial cabbage fields in New York and studied in the laboratory for their impact on C. nasturtii pupation and emergence. The results indicated that extremely wet or dry soils significantly hindered C. nasturtii emergence, regardless of soil type, suggesting that soil type alone may not be a major factor regulating C. nasturtii abundance. Optimal moisture content for C. nasturtii emergence varied for different soils. Most C. nasturtii pupated within the top 1 cm of soil. Furthermore, we found that >5 cm of soil cover effectively reduced the emergence number and delayed the time of emergence. Based on these results, we suggest that soil manipulation (moisture content and cultivation practices) should be considered as an important component in an overall integrated pest management program for C. nasturtii.

Glycemic control and type 1 diabetes: the differential impact of model of care and income.

PubMed

Hatherly, Kristy; Smith, Lorraine; Overland, Jane; Johnston, Christine; Brown-Singh, Lin; Waller, Dan; Taylor, Sue

2011-03-01

To examine the effect of model of care (specialist care vs. shared care), and income, on glycemic control in a sample of young people with type 1 diabetes. A total of 158 children and young people with type 1 diabetes, aged 8-19 yr, and their families, were recruited independent of their source of care as part of a longitudinal, cross-sectional exploratory study. At enrollment, participants completed a series of questionnaires and underwent a structured interview to gather data regarding the type of specialist and healthcare services attended, as well as demographic, healthcare, and self-care information. Capillary sample was taken for HbA1c determination. The mean HbA1c for the group as a whole was 8.6 ± 1.4%. There was no effect for model of care on glycemic control. However, young people living in households with a family income of less than AUS$83,000 (US$73,500) per year had a significantly higher mean HbA1c than their counterparts reporting a higher household income (8.8 ± 1.4% vs. 8.3 ± 1.1%; p = 0.019). Although no differences were found with respect to the short-term impact of specialist vs. shared care, it is evident that more support is required to improve glycemic control in this sample of young people where the mean level of HbA1c was significantly higher than target. Further research is also indicated to determine the relationship between glycemic control and socioeconomic status. © 2010 John Wiley & Sons A/S.

Emissions Associated with Electric Vehicle Charging: Impact of Electricity Generation Mix, Charging Infrastructure Availability, and Vehicle Type

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

McLaren, Joyce; Miller, John; O'Shaughnessy, Eric

With the aim of reducing greenhouse gas emissions associated with the transportation sector, policy-makers are supporting a multitude of measures to increase electric vehicle adoption. The actual level of emission reduction associated with the electrification of the transport sector is dependent on the contexts that determine when and where drivers charge electric vehicles. This analysis contributes to our understanding of the degree to which a particular electricity grid profile, vehicle type, and charging patterns impact CO2 emissions from light-duty, plug-in electric vehicles. We present an analysis of emissions resulting from both battery electric and plug-in hybrid electric vehicles for fourmore » charging scenarios and five electricity grid profiles. A scenario that allows drivers to charge electric vehicles at the workplace yields the lowest level of emissions for the majority of electricity grid profiles. However, vehicle emissions are shown to be highly dependent on the percentage of fossil fuels in the grid mix, with different vehicle types and charging scenarios resulting in fewer emissions when the carbon intensity of the grid is above a defined level. Restricting charging to off-peak hours results in higher total emissions for all vehicle types, as compared to other charging scenarios.« less

Impact-Locator Sensor Panels

NASA Technical Reports Server (NTRS)

Christiansen, Eric L.; Byers, Terry; Gibbons, Frank

2008-01-01

Electronic sensor systems for detecting and locating impacts of rapidly moving particles on spacecraft have been invented. Systems of this type could also be useful on Earth in settings in which the occurrence of impacts and/or the locations of impacts are not immediately obvious and there are requirements to detect and quickly locate impacts to prevent or minimize damage.

Impact of Glycemic Control on Healthcare Resource Utilization and Costs of Type 2 Diabetes: Current and Future Pharmacologic Approaches to Improving Outcomes

PubMed Central

Banerji, Mary Ann; Dunn, Jeffrey D.

2013-01-01

Background The incidence and prevalence of type 2 diabetes continue to grow in the United States and worldwide, along with the growing prevalence of obesity. Patients with type 2 diabetes are at greater risk for comorbid cardiovascular (CV) disease (CVD), which dramatically affects overall healthcare costs. Objectives To review the impact of glycemic control and medication adherence on morbidity, mortality, and healthcare costs of patients with type 2 diabetes, and to highlight the need for new drug therapies to improve outcomes in this patient population. Methods This comprehensive literature search was conducted for the period between 2000 and 2013, using MEDLINE, to identify published articles that report the associations between glycemic control, medication adherence, CV morbidity and mortality, and healthcare utilization and costs. Search terms included “type 2 diabetes,” “adherence,” “compliance,” “nonadherence,” “drug therapy,” “resource use,” “cost,” and “cost-effectiveness.” Discussion Despite improvements in the management of CV risk factors in patients with type 2 diabetes, outcomes remain poor. The costs associated with the management of type 2 diabetes are increasing dramatically as the prevalence of the disease increases. Medication adherence to long-term drug therapy remains poor in patients with type 2 diabetes and contributes to poor glycemic control in this patient population, increased healthcare resource utilization and increased costs, as well as increased rates of comorbid CVD and mortality. Furthermore, poor adherence to established evidence-based guidelines for type 2 diabetes, including underdiagnosis and undertreatment, contributes to poor outcomes. New approaches to the treatment of patients with type 2 diabetes currently in development have the potential to improve medication adherence and consequently glycemic control, which in turn will help to reduce associated costs and healthcare utilization

Impact of glycemic control on healthcare resource utilization and costs of type 2 diabetes: current and future pharmacologic approaches to improving outcomes.

PubMed

Banerji, Mary Ann; Dunn, Jeffrey D

2013-09-01

The incidence and prevalence of type 2 diabetes continue to grow in the United States and worldwide, along with the growing prevalence of obesity. Patients with type 2 diabetes are at greater risk for comorbid cardiovascular (CV) disease (CVD), which dramatically affects overall healthcare costs. To review the impact of glycemic control and medication adherence on morbidity, mortality, and healthcare costs of patients with type 2 diabetes, and to highlight the need for new drug therapies to improve outcomes in this patient population. This comprehensive literature search was conducted for the period between 2000 and 2013, using MEDLINE, to identify published articles that report the associations between glycemic control, medication adherence, CV morbidity and mortality, and healthcare utilization and costs. Search terms included "type 2 diabetes," "adherence," "compliance," "nonadherence," "drug therapy," "resource use," "cost," and "cost-effectiveness." Despite improvements in the management of CV risk factors in patients with type 2 diabetes, outcomes remain poor. The costs associated with the management of type 2 diabetes are increasing dramatically as the prevalence of the disease increases. Medication adherence to long-term drug therapy remains poor in patients with type 2 diabetes and contributes to poor glycemic control in this patient population, increased healthcare resource utilization and increased costs, as well as increased rates of comorbid CVD and mortality. Furthermore, poor adherence to established evidence-based guidelines for type 2 diabetes, including underdiagnosis and undertreatment, contributes to poor outcomes. New approaches to the treatment of patients with type 2 diabetes currently in development have the potential to improve medication adherence and consequently glycemic control, which in turn will help to reduce associated costs and healthcare utilization. As the prevalence of type 2 diabetes and its associated comorbidities grows

Laboratory-size three-dimensional x-ray microscope with Wolter type I mirror optics and an electron-impact water window x-ray source

NASA Astrophysics Data System (ADS)

Ohsuka, Shinji; Ohba, Akira; Onoda, Shinobu; Nakamoto, Katsuhiro; Nakano, Tomoyasu; Miyoshi, Motosuke; Soda, Keita; Hamakubo, Takao

2014-09-01

We constructed a laboratory-size three-dimensional water window x-ray microscope that combines wide-field transmission x-ray microscopy with tomographic reconstruction techniques, and observed bio-medical samples to evaluate its applicability to life science research fields. It consists of a condenser and an objective grazing incidence Wolter type I mirror, an electron-impact type oxygen Kα x-ray source, and a back-illuminated CCD for x-ray imaging. A spatial resolution limit of around 1.0 line pairs per micrometer was obtained for two-dimensional transmission images, and 1-μm scale three-dimensional fine structures were resolved.

Laboratory-size three-dimensional x-ray microscope with Wolter type I mirror optics and an electron-impact water window x-ray source.

PubMed

Ohsuka, Shinji; Ohba, Akira; Onoda, Shinobu; Nakamoto, Katsuhiro; Nakano, Tomoyasu; Miyoshi, Motosuke; Soda, Keita; Hamakubo, Takao

2014-09-01

We constructed a laboratory-size three-dimensional water window x-ray microscope that combines wide-field transmission x-ray microscopy with tomographic reconstruction techniques, and observed bio-medical samples to evaluate its applicability to life science research fields. It consists of a condenser and an objective grazing incidence Wolter type I mirror, an electron-impact type oxygen Kα x-ray source, and a back-illuminated CCD for x-ray imaging. A spatial resolution limit of around 1.0 line pairs per micrometer was obtained for two-dimensional transmission images, and 1-μm scale three-dimensional fine structures were resolved.

Impacts of invasive plants on resident animals across ecosystems, taxa, and feeding types: a global assessment.

PubMed

Schirmel, Jens; Bundschuh, Mirco; Entling, Martin H; Kowarik, Ingo; Buchholz, Sascha

2016-02-01

As drivers of global change, biological invasions have fundamental ecological consequences. However, it remains unclear how invasive plant effects on resident animals vary across ecosystems, animal classes, and functional groups. We performed a comprehensive meta-analysis covering 198 field and laboratory studies reporting a total of 3624 observations of invasive plant effects on animals. Invasive plants had reducing (56%) or neutral (44%) effects on animal abundance, diversity, fitness, and ecosystem function across different ecosystems, animal classes, and feeding types while we could not find any increasing effect. Most importantly, we found that invasive plants reduced overall animal abundance, diversity and fitness. However, this significant overall effect was contingent on ecosystems, taxa, and feeding types of animals. Decreasing effects of invasive plants were most evident in riparian ecosystems, possibly because frequent disturbance facilitates more intense plant invasions compared to other ecosystem types. In accordance with their immediate reliance on plants for food, invasive plant effects were strongest on herbivores. Regarding taxonomic groups, birds and insects were most strongly affected. In insects, this may be explained by their high frequency of herbivory, while birds demonstrate that invasive plant effects can also cascade up to secondary consumers. Since data on impacts of invasive plants are rather limited for many animal groups in most ecosystems, we argue for overcoming gaps in knowledge and for a more differentiated discussion on effects of invasive plant on native fauna. © 2015 John Wiley & Sons Ltd.

Do Perceptions of Insulin Pump Usability Impact Attitudes Toward Insulin Pump Therapy? A Pilot Study of Individuals With Type 1 and Insulin-Treated Type 2 Diabetes

PubMed Central

Gilgen, Emily

2014-01-01

Background: We assessed the impact of perceived insulin pump usability on attitudes toward insulin pump therapy in diabetic individuals currently treated with multiple daily insulin injections (MDI). Method: This comparative, single-arm study recruited 28 adults with type 1 (n = 16) and insulin-treated type 2 diabetes (n = 12) to evaluate 2 current insulin pumps: Medtronic Revel 723 (Pump 1), Asante Snap Insulin Pump (Pump 2). Participants were randomized 1:1 to 1 of 2 assessment sequences: Pump 1 followed by Pump 2; and Pump 2 followed by Pump 1. Structured observational protocols were utilized to assess participants’ ability and time required to learn/perform common tasks associated with pump setup/use. Participants used a modified version of the System Usability Scale (SUS) and investigator-developed questionnaires to rate pump usability and task difficulty; pre-post questionnaires assessed changes in attitudes toward insulin pump therapy. Results: All participants completed the study. SUS scores showed Pump 2 to be more usable than Pump 1 on all usability attributes. Participants rated Pump 2 more positively than Pump 1, overall mean SUS scores of 5.7 versus 4.1 respectively, F(1, 52) = 32.7, P < .001, and SUS scores were higher if participants used the Pump 2 last, 5.3 versus 4.4 for Pump 1 last, F(1, 52) = 10.8, P < .01. Pump 2 was preferred for all tasks: manual bolus (86%), bolus calculation (71%), managing basal rates (93%), interpreting alarms (96%), transferring settings (100%), changing insulin and infusion sets (93%), all P < .05. Conclusions: Perceptions of pump usability can directly impact acceptance and use of features that may benefit those who wear them. Simpler pump devices that decrease perceptions of complexity may encourage broader use of this technology. PMID:25269659

Impact melts in the MAC88105 lunar meteorite - Inferences for the lunar magma ocean hypothesis and the diversity of basaltic impact melts

NASA Technical Reports Server (NTRS)

Taylor, G. J.

1991-01-01

The MAC88105 lunar meteorite, as represented by thin section 78, contains three major types of impact melt breccias. The most abundant type is clast-laden, fine-grained, and rich in Al2O3 (28 wt pct); these clasts constitute most of the meteorite. Their abundance and aluminous nature indicate that the MAC88105 source area was very aluminous. This is consistent with formation of the primordial lunar crust from a global magma ocean. The second type of impact melt is represented by only one clast in 78. It has a basaltic bulk composition similar to many other lunar impact melts, but is significantly richer in P2O5 than most and has a much lower MgO/(MgO + FeO). The third impact-melt type resembles a prominent melt group at Apollo 16, but has lower MgO/(MgO + FeO). These data show that basaltic impact melts are compositionally diverse. Dating samples of the Al-rich impact melts and the new types of basaltic impact melts from this meteorite can test the idea that the Moon suffered a terminal cataclysm 3.9 Ga ago.

Impacts of Cellulose Fiber Particle Size and Starch Type on Expansion During Extrusion Processing.

PubMed

Kallu, Sravya; Kowalski, Ryan J; Ganjyal, Girish M

2017-07-01

Objective of this study was to understand the impacts of cellulose fiber with different particle size distributions, and starches with different molecular weights, on the expansion of direct expanded products. Fiber with 3 different particle size distributions (<125, 150 to 250, 300 to 425 μm) and 4 types of starches representing different amylose contents (0%, 23%, 50%, and 70%) were investigated. Feed moisture content (18 ± 0.5 % w.b) and extruder temperature (140 °C) were kept constant and only the extruder screw speed was varied (100, 175, and 250 rpm) to achieve different specific mechanical energy inputs. Fiber particle size and starch type significantly influenced the various product parameters. In general, the smaller fiber particle size resulted in extrudate with higher expansion ratio. Starch with an amylose: amylopectin ratio of 23:77 resulted in highest expansion compared to the other starches, when no fiber was added. Interestingly, starch with 50:50, amylose: amylopectin ratio in combination with smaller fiber particles resulted in product with significantly greater expansion than the control starch extrudates. Aggregation of fiber and shrinkage of surface was observed in the Scanning Electron Microscope images at 10% fiber level. The results suggest the presence of active interactions between the cellulose fiber particles and corn starch molecules during the expansion process. A better understanding of these interactions can help in the development of high fiber extruded products with better expansion. © 2017 Institute of Food Technologists®.

Impact and Crashworthiness Characteristics of Venera Type Landers for Future Venus Missions

NASA Technical Reports Server (NTRS)

Schroeder, Kevin; Bayandor, Javid; Samareh, Jamshid

2016-01-01

In this paper an in-depth investigation of the structural design of the Venera 9-14 landers is explored. A complete reverse engineering of the Venera lander was required. The lander was broken down into its fundamental components and analyzed. This provided in-sights into the hidden features of the design. A trade study was performed to find the sensitivity of the lander's overall mass to the variation of several key parameters. For the lander's legs, the location, length, configuration, and number are all parameterized. The size of the impact ring, the radius of the drag plate, and other design features are also parameterized, and all of these features were correlated to the change of mass of the lander. A multi-fidelity design tool used for further investigation of the parameterized lander was developed. As a design was passed down from one level to the next, the fidelity, complexity, accuracy, and run time of the model increased. The low-fidelity model was a highly nonlinear analytical model developed to rapidly predict the mass of each design. The medium and high fidelity models utilized an explicit finite element framework to investigate the performance of various landers upon impact with the surface under a range of landing conditions. This methodology allowed for a large variety of designs to be investigated by the analytical model, which identified designs with the optimum structural mass to payload ratio. As promising designs emerged, investigations in the following higher fidelity models were focused on establishing their reliability and crashworthiness. The developed design tool efficiently modelled and tested the best concepts for any scenario based on critical Venusian mission requirements and constraints. Through this program, the strengths and weaknesses inherent in the Venera-Type landers were thoroughly investigated. Key features identified for the design of robust landers will be used as foundations for the development of the next generation of

The impact of educational intervention on physical activity, nutrition and laboratory parameters in type II diabetic patients

PubMed Central

Maheri, Aghbabak; Asnaashari, Maryam; Joveini, Hamid; Tol, Azar; Firouzian, Ali Asghar; Rohban, Alireza

2017-01-01

Background Diabetes is one of the most common chronic diseases that is now widely spread around the world, and day by day the number of patients is increasing. The purpose of this study was to determine the impact of educational intervention on physical activity, nutrition and laboratory parameters in type 2 diabetic patients. Methods This semi-experimental study was performed from March to October 2015 on 100 patients with type 2 diabetes who referred to the Niknejad health center. The type of sampling was simple random. Data were collected using a questionnaire including demographic questions, assessment of nutritional status and physical activity, history of diabetes, physical measurements and laboratory parameters of patients. Data were analyzed using SPSS 16, and descriptive and analytical tests (paired-samples t-test) and the results were significant at the level of (p<0.05). Results In present study, body measurements, the mean number of units of fruit and vegetable intake per day, type of oil consumption, the mean number of days of fish intake per week or the mean number of days with intense physical activity per week, had no significant difference before and after the intervention, while the variables of FBS level (p<0.003), rate of HbA1c (p<0.027), the mean number of days of fruit intake (p<0.001) and vegetable intake (p<0.037) per week and the mean number of days with moderate physical activity (p<0.03) of patients, had significant difference before and after the intervention. Conclusion According to the findings of this study, to improve BMI, fish intake, type of oil consumption and also increased daily fruit and vegetable intake in these patients, a variety of educational-supportive interventions are recommended. PMID:28607657

Impact of Vaccination on 14 High-Risk HPV Type Infections: A Mathematical Modelling Approach

PubMed Central

Vänskä, Simopekka; Auranen, Kari; Leino, Tuija; Salo, Heini; Nieminen, Pekka; Kilpi, Terhi; Tiihonen, Petri; Apter, Dan; Lehtinen, Matti

2013-01-01

The development of high-risk human papillomavirus (hrHPV) infection to cervical cancer is a complicated process. We considered solely hrHPV infections, thus avoiding the confounding effects of disease progression, screening, and treatments. To analyse hrHPV epidemiology and to estimate the overall impact of vaccination against infections with hrHPVs, we developed a dynamic compartmental transmission model for single and multiple infections with 14 hrHPV types. The infection-related parameters were estimated using population-based sexual behaviour and hrHPV prevalence data from Finland. The analysis disclosed the important role of persistent infections in hrHPV epidemiology, provided further evidence for a significant natural immunity, and demonstrated the dependence of transmission probability estimates on the model structure. The model predicted that vaccinating girls at 80% coverage will result in a 55% reduction in the overall hrHPV prevalence and a higher 65% reduction in the prevalence of persistent hrHPV infections in females. In males, the reduction will be 42% in the hrHPV prevalence solely by the herd effect from the 80% coverage in girls. If such high coverage among girls is not reached, it is still possible to reduce the female hrHPV prevalence indirectly by the herd effect if also boys are included in the vaccination program. On the other hand, any herd effects in older unvaccinated cohorts were minor. Limiting the epidemiological model to infection yielded improved understanding of the hrHPV epidemiology and of mechanisms with which vaccination impacts on hrHPV infections. PMID:24009669

An objective daily Weather Type classification for Iberia since 1850; patterns, trends, variability and impact in precipitation

NASA Astrophysics Data System (ADS)

Ramos, A. M.; Trigo, R. M.; Lorenzo, M. N.; Vaquero, J. M.; Gallego, M. C.; Valente, M. A.; Gimeno, L.

2009-04-01

In recent years a large number of automated classifications of atmospheric circulation patterns have been published covering the entire European continent or specific sub-regions (Huth et al., 2008). This generalized use of objective classifications results from their relatively straightforward computation but crucially from their capacity to provide simple description of typical synoptic conditions as well as their climatic and environmental impact. For this purpose, the vast majority of authors has employed the Reanalyses datasets, namely from either NCEP/NCAR or ECMWF projects. However, both these widely used datasets suffer from important caveats, namely their restricted temporal coverage, that is limited to the last six decades (NCEP/NCAR since 1948 and ECMWF since 1958). This limitation has been partially mitigated by the recent availability of continuous daily mean sea level pressure obtained within the European project EMULATE, that extended the historic records over the extra-tropical Atlantic and Europe (70°-25° N by 70° W-50° E), for the period 1850 to the present (Ansell, T. J. et al. 2006). Here we have used the extended EMULATE dataset to construct an automated version of the Lamb Weather type (WTs) classification scheme (Jones et al 1993) adapted for the center of the Iberian Peninsula. We have identified 10 basic WTs (Cyclonic, Anticyclonic and 8 directional types) following a similar methodology to that previously adopted by Trigo and DaCamara, 2000 (for Portugal) and Lorenzo et al. 2008 (for Galicia, northwestern Iberia). We have evaluated trends of monthly/seasonal frequency of each WT for the entire period and several shorter periods. Finally, we use the long-term precipitation time series from Lisbon (recently digitized) and Cadiz (southern Spain) to evaluate, the impact of each WT on the precipitation regime. It is shown that the Anticyclonic (A) type, although being the most frequent class in winter, gives a rather small contribution to

Odour-impact assessment around a landfill site from weather-type classification, complaint inventory and numerical simulation.

PubMed

Chemel, C; Riesenmey, C; Batton-Hubert, M; Vaillant, H

2012-01-01

Gases released from landfill sites into the atmosphere have the potential to cause olfactory nuisances within the surrounding communities. Landfill sites are often located over complex topography for convenience mainly related to waste disposal and environmental masking. Dispersion of odours is strongly conditioned by local atmospheric dynamics. Assessment of odour impacts needs to take into account the variability of local atmospheric dynamics. In this study, we discuss a method to assess odour impacts around a landfill site located over complex terrain in order to provide information to be used subsequently to identify management strategies to reduce olfactory nuisances in the residential neighbourhoods. A weather-type classification is defined in order to identify meteorological conditions under which olfactory nuisances are to be expected. A non-steady state Gaussian model and a full-physics meteorological model are used to predict olfactory nuisances, for both the winter and summer scenarios that lead to the majority of complaints in neighbourhoods surrounding the landfill site. Simulating representative scenarios rather than full years make a high resolution simulation of local atmospheric dynamics in space and time possible. Results underline the key role of local atmospheric dynamics in driving the dispersion of odours. The odour concentration simulated by the full-physics meteorological model is combined with the density of the population in order to calculate an average population exposure for the two scenarios. Results of this study are expected to provide helpful information to develop technical solutions for an effective management of landfill operations, which would reduce odour impacts within the surrounding communities. Copyright © 2011 Elsevier Ltd. All rights reserved.

Soft impacts on aerospace structures

NASA Astrophysics Data System (ADS)

Abrate, Serge

2016-02-01

This article provides an overview of the literature dealing with three types of soft impacts of concern for the aerospace applications, namely impacts of rain drops, hailstones and birds against aircraft. It describes the physics of the problem as it has become better understood through experiments, analyses, and numerical simulations. Some emphasis has been placed on the material models and the numerical approaches used in modeling these three types of projectiles.

Impact of age at diagnosis and duration of type 2 diabetes on mortality in Australia 1997-2011.

PubMed

Huo, Lili; Magliano, Dianna J; Rancière, Fanny; Harding, Jessica L; Nanayakkara, Natalie; Shaw, Jonathan E; Carstensen, Bendix

2018-05-01

Current evidence suggests that type 2 diabetes may have a greater impact on those with earlier diagnosis (longer duration of disease), but data are limited. We examined the effect of age at diagnosis of type 2 diabetes on the risk of all-cause and cause-specific mortality over 15 years. The data of 743,709 Australians with type 2 diabetes who were registered on the National Diabetes Services Scheme (NDSS) between 1997 and 2011 were examined. Mortality data were derived by linking the NDSS to the National Death Index. All-cause mortality and mortality due to cardiovascular disease (CVD), cancer and all other causes were identified. Poisson regression was used to model mortality rates by sex, current age, age at diagnosis, diabetes duration and calendar time. The median age at registration on the NDSS was 60.2 years (interquartile range [IQR] 50.9-69.5) and the median follow-up was 7.2 years (IQR 3.4-11.3). The median age at diagnosis was 58.6 years (IQR 49.4-67.9). A total of 115,363 deaths occurred during 7.20 million person-years of follow-up. During the first 1.8 years after diabetes diagnosis, rates of all-cause and cancer mortality declined and CVD mortality was constant. All mortality rates increased exponentially with age. An earlier diagnosis of type 2 diabetes (longer duration of disease) was associated with a higher risk of all-cause mortality, primarily driven by CVD mortality. A 10 year earlier diagnosis (equivalent to 10 years' longer duration of diabetes) was associated with a 1.2-1.3 times increased risk of all-cause mortality and about 1.6 times increased risk of CVD mortality. The effects were similar in men and women. For mortality due to cancer (all cancers and colorectal and lung cancers), we found that earlier diagnosis of type 2 diabetes was associated with lower mortality compared with diagnosis at an older age. Our findings suggest that younger-onset type 2 diabetes increases mortality risk, and that this is mainly through earlier CVD

Impact of keyboard typing on the morphological changes of the median nerve

PubMed Central

Yeap Loh, Ping; Liang Yeoh, Wen; Nakashima, Hiroki; Muraki, Satoshi

2017-01-01

Objectives: The primary objective was to investigate the effects of continuous typing on median nerve changes at the carpal tunnel region at two different keyboard slopes (0° and 20°). The secondary objective was to investigate the differences in wrist kinematics and the changes in wrist anthropometric measurements when typing at the two different keyboard slopes. Methods: Fifteen healthy right-handed young men were recruited. A randomized sequence of the conditions (control, typing I, and typing II) was assigned to each participant. Wrist anthropometric measurements, wrist kinematics data collection and ultrasound examination to the median nerve was performed at designated time block. Results: Typing activity and time block do not cause significant changes to the wrist anthropometric measurements. The wrist measurements remained similar across all the time blocks in the three conditions. Subsequently, the wrist extensions and ulnar deviations were significantly higher in both the typing I and typing II conditions than in the control condition for both wrists (p<0.05). Additionally, the median nerve cross-sectional area (MNCSA) significantly increased in both the typing I and typing II conditions after the typing task than before the typing task. The MNCSA significantly decreased in the recovery phase after the typing task. Conclusions: This study demonstrated the immediate changes in the median nerve after continuous keyboard typing. Changes in the median nerve were greater during typing using a keyboard tilted at 20° than during typing using a keyboard tilted at 0°. The main findings suggest wrist posture near to neutral position caused lower changes of the median nerve. PMID:28701627

Impact of keyboard typing on the morphological changes of the median nerve.

PubMed

Yeap Loh, Ping; Liang Yeoh, Wen; Nakashima, Hiroki; Muraki, Satoshi

2017-09-28

The primary objective was to investigate the effects of continuous typing on median nerve changes at the carpal tunnel region at two different keyboard slopes (0° and 20°). The secondary objective was to investigate the differences in wrist kinematics and the changes in wrist anthropometric measurements when typing at the two different keyboard slopes. Fifteen healthy right-handed young men were recruited. A randomized sequence of the conditions (control, typing I, and typing II) was assigned to each participant. Wrist anthropometric measurements, wrist kinematics data collection and ultrasound examination to the median nerve was performed at designated time block. Typing activity and time block do not cause significant changes to the wrist anthropometric measurements. The wrist measurements remained similar across all the time blocks in the three conditions. Subsequently, the wrist extensions and ulnar deviations were significantly higher in both the typing I and typing II conditions than in the control condition for both wrists (p<0.05). Additionally, the median nerve cross-sectional area (MNCSA) significantly increased in both the typing I and typing II conditions after the typing task than before the typing task. The MNCSA significantly decreased in the recovery phase after the typing task. This study demonstrated the immediate changes in the median nerve after continuous keyboard typing. Changes in the median nerve were greater during typing using a keyboard tilted at 20° than during typing using a keyboard tilted at 0°. The main findings suggest wrist posture near to neutral position caused lower changes of the median nerve.

The possible impact of advanced glycation end products on pregnancy outcome in women with diabetes mellitus type 1.

PubMed

Pertynska-Marczewska, Magdalena; Cypryk, Katarzyna

2017-09-01

Diabetes mellitus (DM) is a group of metabolic disorders of carbohydrate metabolism in which glucose is underutilized, resulting in hyperglycemia. Reproductive impairment in poorly controlled diabetes mellitus type 1 (T1DM) results from a combined effect of insulin deficiency and hyperglycemia that disrupt the functioning of metabolic signals participating in the regulation of the reproductive system. Good metabolic control as a result of intensive insulin therapy has a great impact on the fertility and childbearing possibilities in the T1DM females. Advanced glycation end products (AGEs) are formed by nonenzymatic modification of proteins, lipids, and nucleic acids by glucose. The formation and accumulation of AGEs are known to progress at an accelerated rate in diabetes. AGEs either act on the pro-inflammatory cell surface receptors called RAGE or bind to the circulating anti-inflammatory sRAGE that prevents activation of cell-surface RAGE by AGEs and other proinflammatory ligands. Pregnancy has been found to induce a significant increase in RAGE protein levels in both myometrium and omental vasculature. This review will focus on the role of AGEs and RAGE in pregnancy complicated by DM type 1 as well as ways to reduce the rate of congenital malformations in the offspring of diabetic type 1 women.

Diabetes MILES--Australia (management and impact for long-term empowerment and success): methods and sample characteristics of a national survey of the psychological aspects of living with type 1 or type 2 diabetes in Australian adults

PubMed Central

2012-01-01

Background Successful management of diabetes requires attention to the behavioural, psychological and social aspects of this progressive condition. The Diabetes MILES (Management and Impact for Long-term Empowerment and Success) Study is an international collaborative. Diabetes MILES--Australia, the first Diabetes MILES initiative to be undertaken, was a national survey of adults living with type 1 or type 2 diabetes in Australia. The aim of this study was to gather data that will provide insights into how Australians manage their diabetes, the support they receive and the impact of diabetes on their lives, as well as to use the data to validate new diabetes outcome measures. Methods/design The survey was designed to include a core set of self-report measures, as well as modules specific to diabetes type or management regimens. Other measures or items were included in only half of the surveys. Cognitive debriefing interviews with 20 participants ensured the survey content was relevant and easily understood. In July 2011, the survey was posted to 15,000 adults (aged 18-70 years) with type 1 or type 2 diabetes selected randomly from the National Diabetes Services Scheme (NDSS) database. An online version of the survey was advertised nationally. A total of 3,338 eligible Australians took part; most (70.4%) completed the postal survey. Respondents of both diabetes types and genders, and of all ages, were adequately represented in both the postal and online survey sub-samples. More people with type 2 diabetes than type 1 diabetes took part in Diabetes MILES--Australia (58.8% versus 41.2%). Most respondents spoke English as their main language, were married/in a de facto relationship, had at least a high school education, were occupied in paid work, had an annual household income > $AUS40,000, and lived in metropolitan areas. Discussion A potential limitation of the study is the under-representation of respondents from culturally and linguistically diverse backgrounds

Study on the Effect of the Impact Location and the Type of Hammer Tip on the Frequency Response Function (FRF) in Experimental Modal Analysis of Rectangular Plates

NASA Astrophysics Data System (ADS)

Mali, K. D.; Singru, P. M.

2018-03-01

In this work effect of the impact location and the type of hammer tip on the frequency response function (FRF) is studied. Experimental modal analysis of rectangular plates is carried out for this purpose by using impact hammer, accelerometer and fast Fourier transform (FFT) analyzer. It is observed that the impulse hammer hit location has, no effect on the eigenfrequency, yet a difference in amplitude of the eigenfrequencies is obtained. The effect of the hammer tip on the pulse and the force spectrum is studied for three types of tips metal, plastic and rubber. A solid rectangular plate was excited by using these tips one by one in three different tests. It is observed that for present experimental set up plastic tip excites the useful frequency range.

Vehicle impact simulation for curb and barrier design : volume 1, impact simulation procedures.

DOT National Transportation Integrated Search

1998-10-01

The objectives of this study were to perform computer simulations of vehicle-curb and vehicle-berm impacts, to characterize : the behavior of a wide range of vehicle types after such impacts, and to produce design and evaluation trajectory data for u...

Petrography of impact glasses and melt breccias from the El'gygytgyn impact structure, Russia

NASA Astrophysics Data System (ADS)

Pittarello, Lidia; Koeberl, Christian

2013-07-01

The El'gygytgyn impact structure, 18 km in diameter and 3.6 Ma old, in Arctic Siberia, Russia, is the only impact structure on Earth mostly excavated in acidic volcanic rocks. The Late Cretaceous volcanic target includes lavas, tuffs, and ignimbrites of rhyolitic, dacitic, and andesitic composition, and local occurrence of basalt. Although the ejecta blanket around the crater is nearly completely eroded, bomb-shaped impact glasses, redeposited after the impact event, occur in lacustrine terraces within the crater. Here we present detailed petrographic descriptions of newly collected impact glass-bearing samples. The observed features contribute to constrain the formation of the melt and its cooling history within the framework of the impact process. The collected samples can be grouped into two types, characterized by specific features: (1) "pure" glasses, containing very few clasts or new crystals and which were likely formed during the early stages of cratering and (2) a second type, which represents composite samples with impact melt breccia lenses embedded in silicate glass. These mixed samples probably resulted from inclusion of unmelted impact debris during ejection and deposition. After deposition the glassy portions continued to deform, whereas the impact melt breccia inclusions that probably had already cooled down behaved as rigid bodies in the flow.

Impact of Modifiable Risk Factors on B-type Natriuretic Peptide and Cardiac Troponin T Concentrations

PubMed Central

Srivastava, Pratyaksh K.; Pradhan, Aruna D.; Cook, Nancy R.; Ridker, Paul M.; Everett, Brendan M.

2015-01-01

Alcohol use, physical activity, diet, and cigarette smoking are modifiable cardiovascular risk factors that have a substantial impact on the risk of myocardial infarction, stroke, and cardiovascular death. We hypothesized that these behaviors may alter concentrations of cardiac troponin, a marker of myocyte injury, and B-type natriuretic peptide, a marker of myocyte stress. Both markers have shown strong association with adverse cardiovascular outcomes. In 519 women with no evidence of cardiovascular disease, we measured circulating concentrations of cardiac troponin T, using a high-sensitivity assay (hsTnT), and the amino-terminal fragment of B-type natriuretic peptide (NT-proBNP). We used logistic regression to determine if these behaviors were associated with detectable hsTnT (>3 ng/L) or with NT-proBNP in the highest quartile (≥127.3 ng/L). The median (Q1-Q3) NT-proBNP of the cohort was 68.8 (40.3–127.3), and 30.8% (160/519) of the cohort had detectable circulating hsTnT. In adjusted models, women who drank 1–6 drinks per week had lower odds of having a detectable hsTnT (0.58, 95% CI: 0.34–0.96) and lower odds of having an elevated NT-proBNP (OR 0.55, 95% CI 0.32–0.96). We were subsequently able to validate the results for B-type natriuretic peptide in a large independent cohort. In conclusion, our results suggest that regular alcohol consumption is associated with lower concentrations of hsTnT and NT-proBNP, two cardiovascular biomarkers associated with cardiovascular risk, and raise the hypothesis that the beneficial effects of alcohol consumption may be mediated by direct effects on the myocardium. PMID:26739393

Type 1 Diabetes in Young Adulthood

PubMed Central

Monaghan, Maureen; Helgeson, Vicki; Wiebe, Deborah

2015-01-01

Type 1 diabetes has traditionally been studied as a chronic illness of childhood. However, young adulthood is a critical time for the development and integration of lifelong diabetes management skills, and research is starting to identify unique challenges faced by youth with diabetes as they age into adulthood. Most young adults experience multiple transitions during this unstable developmental period, including changes in lifestyle (e.g., education, occupation, living situation), changes in health care, and shifting relationships with family members, friends, and intimate others. Young adults with type 1 diabetes must navigate these transitions while also assuming increasing responsibility for their diabetes care and overall health. Despite these critical health and psychosocial concerns, there is a notable lack of evidence-based clinical services and supports for young adults with type 1 diabetes. We review relevant evolving concerns for young adults with type 1 diabetes, including lifestyle considerations, health care transitions, psychosocial needs, and changes in supportive networks, and how type 1 diabetes impacts and is impacted by these key developmental considerations. Specific avenues for intervention and future research are offered. PMID:25901502

Impact of insulin treatment in diabetic macular edema therapy in type 2 diabetes.

PubMed

Matsuda, Simone; Tam, Tiffany; Singh, Rishi P; Kaiser, Peter K; Petkovsek, Daniel; Zanella, Maria Teresa; Ehlers, Justis P

2015-02-01

To evaluate the impact of insulin therapy on the outcomes of diabetic macular edema (DME) treatment with vascular endothelial growth factor (VEGF) inhibitors in people with type 2 diabetes. A retrospective consecutive case series of 95 patients with type 2 diabetes and DME who were treated with anti-VEGF therapy. We examined 2 cohorts: patients taking only oral antidiabetic agents and patients on insulin therapy. The main outcome measures were change in visual acuity and change in central subfield macular thickness measured by spectral-domain optical coherence tomography. The additional variables analyzed included glycated hemoglobin (A1C), creatinine, blood pressure and body mass index and their correlations with clinical findings. Both groups had a statistically significant improvement in visual acuity (oral antidiabetic agents group: 20/61 to 20/49, p=0.003; insulin therapy group: 20/76 to 20/56, p=0.005). There was no difference between groups at initial or 12-month examination (p=0.239 and p=0.489, respectively). From an anatomic standpoint, central subfield macular thickness also improved significantly in both groups: from 454.7 μm to 354.9 μm (p<0.001) in the oral antidiabetic agents group and from 471.5 μm to 368.4 μm (p<0.001) in the insulin therapy group. Again, there was no significant difference between groups at initial or 12-month follow-up examinations (p=0.586 and p=0.591, respectively). Mean A1C levels remained relatively stable during the follow up in both groups. Anti-VEGF therapy is a useful treatment for DME. This study suggests that chronic insulin therapy, compared with oral antidiabetic agents, does not modify the anatomic or functional effectiveness of DME treatment. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Structures of the E46K Mutant-Type α-Synuclein Protein and Impact of E46K Mutation on the Structures of the Wild-Type α-Synuclein Protein

PubMed Central

2013-01-01

The E46K genetic missense mutation of the wild-type α-synuclein protein was recently identified in a family of Spanish origin with hereditary Parkinson’s disease. Detailed understanding of the structures of the monomeric E46K mutant-type α-synuclein protein as well as the impact of the E46K missense mutation on the conformations and free energy landscapes of the wild-type α-synuclein are required for gaining insights into the pathogenic mechanism of Parkinson’s disease. In this study, we use extensive parallel tempering molecular dynamics simulations along with thermodynamic calculations to assess the secondary and tertiary structural properties as well as the conformational preferences of the monomeric wild-type and E46K mutant-type α-synuclein proteins in an aqueous solution environment. We also present the residual secondary structure component conversion stabilities with dynamics using a theoretical strategy, which we most recently developed. To the best of our knowledge, this study presents the first detailed comparison of the structural and thermodynamic properties of the wild-type and E46K mutant-type α-synuclein proteins in an aqueous solution environment at the atomic level with dynamics. We find that the E46K mutation results not only in local but also in long-range changes in the structural properties of the wild-type α-synuclein protein. The mutation site shows a significant decrease in helical content as well as a large increase in β-sheet structure formation upon E46K mutation. In addition, the β-sheet content of the C-terminal region increases significantly in the E46K mutant-type αS in comparison to the wild-type αS. Our theoretical strategy developed to assess the thermodynamic preference of secondary structure transitions indicates that this shift in secondary structure is the result of a decrease in the thermodynamic preference of turn to helix conversions while the coil to β-sheet preference increases for these residues. Long

Impact of pioglitazone and bradykinin type 1 receptor antagonist on type 2 diabetes in high-fat diet-fed C57BL/6J mice.

PubMed

El Akoum, S; Haddad, Y; Couture, R

2017-09-01

Type 2 diabetes (T2D) is a major complication of obesity and a leading cause of morbidity and mortality. Antagonizing bradykinin type 1 receptor (B1R) improved body and tissue fat mass and reversed vascular and adipose tissue inflammation in a rat model of insulin resistance. This study aimed at evaluating further the role of B1R in a mouse model of T2D by comparing the antidiabetic and anti-inflammatory effects of the B1R antagonist SSR240612 (SSR) in adipose tissue with those of pioglitazone (TZD), an activator of peroxisome proliferator-activated receptor gamma. C57BL/6J mice were fed with high-fat diet (HFD) or standard diet (control) for 20 weeks. Yet, during the last 4 weeks, HFD-fed mice were administered SSR and TZD (10 mg kg -1  d -1 each) as monotherapy or combined therapy subcutaneously. The impact of treatments was measured on metabolic hormones levels (ELISA), adipose tissue inflammatory status and the expression of candidate genes involved in T2D (quantitative real-time polymerase chain reaction and western blot). SSR240612 and TZD treatments improved hyperglycaemia, hyperinsulinaemia, insulin resistance, adipose tissue inflammation (expression of B1R, chemokine ligand 2, F4/80 and tumour necrosis factor) and modulated adipogenesis (peroxisome proliferator-activated receptor gamma, adipocytes' protein 2 and CD40 expressions) in HFD-fed mice. Yet, SSR was more effective than TZD to reduce visceral fat mass and resistin. TZD/SSR combined treatment had an additive effect to improve insulin sensitivity and glucose intolerance. Bradykinin type 1 receptor antagonism could represent a promising therapeutic tool in combination with TZD for the treatment of T2D, obesity and insulin resistance.

Contact stresses modeling at the Panda-type fiber single-layer winding and evaluation of their impact on the fiber optic properties

NASA Astrophysics Data System (ADS)

Lesnikova, Yu I.; Smetannikov, O. Yu; Trufanov, A. N.; Trufanov, N. A.

2017-02-01

The impact of contact transverse forces on the birefringence of the single-mode polarization-maintaining Panda-type fiber is numerically modeled. It has been established that with a single-row power winding on a cylindrical mandrel, the fiber tension at winding is the principal factor that influences birefringence. When coiling the fiber based on the local defect microbending, the birefringence at the microbending point differs from that of the free fiber by 1.3%.

Type of mask may impact on continuous positive airway pressure adherence in apneic patients.

PubMed

Borel, Jean Christian; Tamisier, Renaud; Dias-Domingos, Sonia; Sapene, Marc; Martin, Francis; Stach, Bruno; Grillet, Yves; Muir, Jean François; Levy, Patrick; Series, Frederic; Pepin, Jean-Louis

2013-01-01

In obstructive sleep apnea patients (OSA), continuous positive airway pressure (CPAP) adherence is crucial to improve symptoms and cardiometabolic outcomes. The choice of mask may influence CPAP adherence but this issue has never been addressed properly. To evaluate the impact of nasal pillows, nasal and oronasal masks on CPAP adherence in a cohort of OSA. Newly CPAP treated OSA participating in "Observatoire Sommeil de la Fédération de Pneumologie", a French national prospective cohort, were included between March 2009 and December 2011. Anthropometric data, medical history, OSA severity, sleepiness, depressive status, treatment modalities (auto-CPAP versus fixed pressure, pressure level, interface type, use of humidifiers) and CPAP-related side effects were included in multivariate analysis to determine independent variables associated with CPAP adherence. 2311 OSA (age = 57(12) years, apnea+hypopnea index = 41(21)/h, 29% female) were included. Nasal masks, oronasal masks and nasal pillows were used by 62.4, 26.2 and 11.4% of the patients, respectively. In univariate analysis, oronasal masks and nasal pillows were associated with higher risk of CPAP non-adherence. CPAP non-adherence was also associated with younger age, female gender, mild OSA, gastroesophageal reflux, depression status, low effective pressure and CPAP-related side effects. In multivariate analysis, CPAP non-adherence was associated with the use of oronasal masks (OR = 2.0; 95%CI = 1.6; 2.5), depression, low effective pressure, and side effects. As oronasal masks negatively impact on CPAP adherence, a nasal mask should be preferred as the first option. Patients on oronasal masks should be carefully followed.

Type of Mask May Impact on Continuous Positive Airway Pressure Adherence in Apneic Patients

PubMed Central

Borel, Jean Christian; Tamisier, Renaud; Dias-Domingos, Sonia; Sapene, Marc; Martin, Francis; Stach, Bruno; Grillet, Yves; Muir, Jean François; Levy, Patrick; Series, Frederic; Pepin, Jean-Louis

2013-01-01

Rationale In obstructive sleep apnea patients (OSA), continuous positive airway pressure (CPAP) adherence is crucial to improve symptoms and cardiometabolic outcomes. The choice of mask may influence CPAP adherence but this issue has never been addressed properly. Objective To evaluate the impact of nasal pillows, nasal and oronasal masks on CPAP adherence in a cohort of OSA. Methods Newly CPAP treated OSA participating in “Observatoire Sommeil de la Fédération de Pneumologie”, a French national prospective cohort, were included between March 2009 and December 2011. Anthropometric data, medical history, OSA severity, sleepiness, depressive status, treatment modalities (auto-CPAP versus fixed pressure, pressure level, interface type, use of humidifiers) and CPAP-related side effects were included in multivariate analysis to determine independent variables associated with CPAP adherence. Results 2311 OSA (age = 57(12) years, apnea+hypopnea index = 41(21)/h, 29% female) were included. Nasal masks, oronasal masks and nasal pillows were used by 62.4, 26.2 and 11.4% of the patients, respectively. In univariate analysis, oronasal masks and nasal pillows were associated with higher risk of CPAP non-adherence. CPAP non-adherence was also associated with younger age, female gender, mild OSA, gastroesophageal reflux, depression status, low effective pressure and CPAP-related side effects. In multivariate analysis, CPAP non-adherence was associated with the use of oronasal masks (OR = 2.0; 95%CI = 1.6; 2.5), depression, low effective pressure, and side effects. Conclusion As oronasal masks negatively impact on CPAP adherence, a nasal mask should be preferred as the first option. Patients on oronasal masks should be carefully followed. PMID:23691209

Lunar highland rock types: Their implications for impact-induced fractionation

NASA Technical Reports Server (NTRS)

Phinney, W. C.; Warner, J. L.; Simonds, C. H.

1977-01-01

Lunar rocks may be classified into three major groups: (1) coarse-grained igneous rocks, (2) fine-grained igneous rocks, and (3) breccias. Group 1 is interpreted as primitive lunar crustal rocks that display various degrees of crushing and/or annealing. Group 2 is interpreted as volcanic rocks. Group 3 is interpreted as resulting from impacts on the lunar surface and is subdivided on the basis of matrix textures into fragmental breccias, crystalline breccias that have been annealed, and crystalline breccias with igneous matrices. A synthesis of the data concerning lunar highlands polymict breccias compels the prediction that the breccias should have homogeneous matrices from rock to rock within regions of the highlands of limited size where impact mixing has been efficient and extensive. But the returned breccias, even from one landing site, display a wide range in composition. This incompatibility between prediction and observation is a paradox that may be resolved by a process that acts after impact mixing to cause a differentiation of the breccia compositions. Partial melting of the local average crustal composition (as modeled by the average soil composition for each site) and separation of melt and residue in ejecta and/or fall-back blankets are compatible with the reviewed data and may resolve the paradox.

Impacts of Different Types of Measurements on Estimating Unsaturatedflow Parameters

NASA Astrophysics Data System (ADS)

Shi, L.

2015-12-01

This study evaluates the value of different types of measurements for estimating soil hydraulic parameters. A numerical method based on ensemble Kalman filter (EnKF) is presented to solely or jointly assimilate point-scale soil water head data, point-scale soil water content data, surface soil water content data and groundwater level data. This study investigates the performance of EnKF under different types of data, the potential worth contained in these data, and the factors that may affect estimation accuracy. Results show that for all types of data, smaller measurements errors lead to faster convergence to the true values. Higher accuracy measurements are required to improve the parameter estimation if a large number of unknown parameters need to be identified simultaneously. The data worth implied by the surface soil water content data and groundwater level data is prone to corruption by a deviated initial guess. Surface soil moisture data are capable of identifying soil hydraulic parameters for the top layers, but exert less or no influence on deeper layers especially when estimating multiple parameters simultaneously. Groundwater level is one type of valuable information to infer the soil hydraulic parameters. However, based on the approach used in this study, the estimates from groundwater level data may suffer severe degradation if a large number of parameters must be identified. Combined use of two or more types of data is helpful to improve the parameter estimation.

Impact of Storybook Type on Kindergarteners' Storybook Comprehension

ERIC Educational Resources Information Center

Kotaman, Hüseyin; Balci, Asli

2017-01-01

The purpose of this study was to examine impact of non-realistic and realistic storybooks on kindergarteners' storybook listening comprehension. One hundred and three kindergarteners ranging in age from 49 to 71 months, with a mean age of 62.08 months (SD = 4.97) from three public kindergartens participated in the study. Participants listened to…

Impact of dental caries on quality of life among preschool children: emphasis on the type of tooth and stages of progression.

PubMed

Ramos-Jorge, Joana; Alencar, Bruna Mota; Pordeus, Isabela Almeida; Soares, Maria Eliza da Consolação; Marques, Leandro Silva; Ramos-Jorge, Maria Letícia; Paiva, Saul Martins

2015-04-01

The aim of this cross-sectional study was to evaluate the impact of dental caries on the quality of life of preschool children and their parents/caretakers, with an emphasis on the type of tooth and stage of progression. A randomly selected sample of preschool children, 3-5 yrs of age, underwent an oral examination for the assessment of dental caries using the International Caries Detection and Assessment System II (ICDAS II) criteria. Parents/caretakers answered two questionnaires, one on the oral health-related quality of life (OHRQoL) of the child [the Early Childhood Oral Health Impact Scale (ECOHIS)], and the other on the socio-economic characteristics of the family. Statistical analyses were performed using the chi-square test, Kruskal-Wallis test, Mann-Whitney U-test, and Poisson regression. A total of 451 preschool children participated in the study. The majority of carious lesions exhibited severe decay (60.6%) and were found in both anterior (incisors/canines) and posterior (molars) teeth. The final Poisson model revealed negative impacts on quality of life from more advanced stages of dental caries, both in incisors/canines and molars. Child's age and household income were also associated with impact on quality of life. Carious lesions in more advanced stages of progression in anterior and posterior teeth were associated with a negative impact on the quality of life of preschool children. © 2014 Eur J Oral Sci.

Air-Pollution and Cardiometabolic Diseases (AIRCMD): A Prospective Study Investigating the Impact of Air Pollution Exposure and Propensity for Type II Diabetes

PubMed Central

Sun, Zhichao; Mukherjee, Bhramar; Brook, Robert D.; Gatts, Geoffrey A.; Yang, Fumo; Fan, Zhongjie; Brook, Jeffrey R.; Sun, Qinghua; Rajagopalan, Sanjay

2015-01-01

There is a paucity of prospective cohort studies investigating the impact of environmental factors on the development of cardiometabolic (CM) disorders like Type II diabetes (T2DM). The objective of the Air-Pollution and Cardiometabolic Diseases (AIRCMD) study is to investigate the impact of personal level air pollution measures [personal black carbon (BC)/sulfate measures] and ambient fine particulate matter [(PM2.5)/NO2] levels on propensity to Type II diabetes in Beijing, China. Subjects with metabolic syndrome will undergo 4 repeated study visits within each season over a 1-year period following an initial screening visit. At each study visit, subjects will be monitored for sub-acute exposure to personal and ambient measures of air-pollution exposure and will undergo a series of functional CM outcomes. The primary endpoints include independent associations between integrated 5-day mean exposure to PM2.5 and BC and homeostasis model assessment of insulin resistance (HOMA-IR) measures, 24-hour mean diastolic and mean arterial pressure and endothelial-dependent vasodilatation. The secondary endpoints will explore the mechanistic explanation for a causal relationship between exposures and propensity for Type II diabetes and will include additional functional outcomes such as arterial compliance, heart rate variability and plasma adipokines. The novel aspects of the study include the launch of infrastructure for future translational investigations in highly polluted urbanized environments and the creation of novel methodologies for linking personalized exposure measurements with functional CM outcomes. We believe that AIRCMD will allow for unprecedented new investigations into the association between environmental risk factors and CM disorders. PMID:23182147

The cost-effectiveness and budget impact of stepwise addition of bolus insulin in the treatment of type 2 diabetes: evaluation of the FullSTEP trial.

PubMed

Saunders, Rhodri; Lian, Jean; Karolicki, Boris; Valentine, William

2014-12-01

Abstract Background and aims: Intensification of basal insulin-only therapy in type 2 diabetes is often achieved through addition of bolus insulin 3-times daily. The FullSTEP trial demonstrated that stepwise addition (SWA) of bolus insulin aspart was non-inferior to full basal-bolus (FBB) therapy and reduced the rate of hypoglycemia. Here the cost-effectiveness and budget impact of SWA is evaluated. Cost-effectiveness and budget impact models were developed to assess the cost and quality-of-life (QoL) implications of intensification using SWA compared with FBB in the US setting. At assessment, SWA patients added one bolus dose to their current regimen if the HbA1c target was not met. SWA patients reaching three bolus doses used FBB event rates. Outcomes were evaluated at trial end and projected annually up to 5 years. Models captured hypoglycemic events, the proportion meeting HbA1c target, and self-measured blood glucose. Event rates and QoL utilities were taken from trial data and published literature. Costs were evaluated from a healthcare-payer perspective, reported in 2013 USD, and discounted (like clinical outcomes) at 3.5% annually. This analysis applies to patients with HbA1c 7.0-9.0% and body mass index <40 kg/m(2). SWA was associated with improved QoL and reduced costs compared with FBB. Improvement in QoL and cost reduction were driven by lower rates of hypoglycemia. Sensitivity analyses showed that outcomes were most influenced by the cost of bolus insulin and QoL impact of symptomatic hypoglycemia. Budget impact analysis estimated that, by moving from FBB to SWA, a health plan with 77,000 patients with type 2 diabetes, of whom 7.8% annually intensified to basal-bolus therapy, would save USD 1304 per intensifying patient over the trial period. SWA of bolus insulin should be considered a beneficial and cost-saving alternative to FBB therapy for the intensification of treatment in type 2 diabetes.

Impact of switching crop type on water and solute fluxes in deep vadose zone

NASA Astrophysics Data System (ADS)

Turkeltaub, T.; Kurtzman, D.; Russak, E. E.; Dahan, O.

2015-12-01

Switching crop type and consequently changing irrigation and fertilization regimes lead to alterations in deep percolation and solute concentrations of pore water. Herein, observations from the deep vadose zone and model simulations demonstrate the changes in water, chloride, and nitrate fluxes under a commercial greenhouse following the change from tomato to lettuce cropping. The site, located above a phreatic aquifer, was monitored for 5 years. A vadose-zone monitoring system was implemented under the greenhouse and provided continuous data on both temporal variations in water content and chemical composition of the pore water at multiple depths in the deep vadose zone (up to 20 m). Following crop switching, a significant reduction in chloride concentration and dramatic increase in nitrate were observed across the unsaturated zone. The changes in chemical composition of the vadose-zone pore water appeared as sequential breakthroughs across the unsaturated zone, initiating at land surface and propagating down toward the water table. Today, 3 years after switching the crops, penetration of the impact exceeds 10 m depth. Variations in the isotopic composition of nitrate (18O and 15N) in water samples obtained from the entire vadose zone clearly support a fast leaching process and mobilization of solutes across the unsaturated zone following the change in crop type. Water flow and chloride transport models were calibrated to observations acquired during an enhanced infiltration experiment. Forward simulation runs were performed with the calibrated models, constrained to tomato and lettuce cultivation regimes as surface boundary conditions. Predicted chloride and nitrate concentrations were in agreement with the observed concentrations. The simulated water drainage and nitrogen leaching implied that the observed changes are an outcome of recommended agricultural management practices.

Lithium in tektites and impact glasses: Implications for sources, histories and large impacts

NASA Astrophysics Data System (ADS)

Magna, T.; Deutsch, A.; Mezger, K.; Skála, R.; Seitz, H.-M.; Mizera, J.; Řanda, Z.; Adolph, L.

2011-04-01

Lithium (Li) abundances and isotope compositions were determined in a representative suite of tektites (moldavites, Muong Nong-type tektites and an australite, Ivory Coast tektites and bediasites), impact-related glasses (Libyan Desert Glass, zhamanshinites and irghizites), a glass fragment embedded in the suevite from the Ries impact crater and sedimentary materials in order to test a possible susceptibility of Li to fractionation during hypervelocity impact events and to de-convolve links to their potential parental sources. The overall data show a large spread in Li abundance (4.7-58 ppm Li) and δ 7Li values (-3.2‰ to 26.0‰) but individual groups of tektites and impact glasses have distinctive Li compositions. Most importantly, any significant high-temperature Li isotope fractionation can be excluded by comparing sedimentary lithologies from central Europe with moldavites. Instead, we suggest that Li isotope compositions in tektites and impact-related glasses are probably diagnostic of the precursor materials and their pre-impact geological histories. The Muong Nong-type tektites and australite specimen are identical in terms of Li concentrations and δ 7Li and we tentatively endorse their common origin in a single impact event. Evidence for low-temperature Rayleigh fractionation, which must have operated prior to impact-induced melting and solidification, is provided for a subset of Muong Nong-type tektites. Although Li isotope variations in most tektites are broadly similar to those of the upper continental crust, Libyan Desert Glass carries high δ 7Li ⩾24.7‰, which appears to mirror the previous fluvial history of parental material that was perhaps deposited in lacustrine environment or coastal seawater. Lithium isotopes in impact-related glasses from the Zhamanshin crater define a group distinct from all other samples and point to melting of chemically less evolved mafic lithologies, which is also consistent with their major and trace element

Impact of poor glycemic control of type 2 diabetes mellitus on serum prostate-specific antigen concentrations in men.

PubMed

Atalay, Hasan Anıl; Akarsu, Murat; Canat, Lutfi; Ülker, Volkan; Alkan, İlter; Ozkuvancı, Unsal

2017-09-01

To evaluate the impact of poor glycemic control of type 2 diabetes mellitus (T2DM) on serum prostate-specific antigen (PSA) concentrations in men. We performed a prospective analysis of 215 consecutive patients affected by erectile dysfunction (ED). ED was evaluated using the IIEF-5 questionnaire and the poor glycemic control (PGC) of T2DM was assessed according to the HbA1c criteria (International Diabetes Federation). Patients were divided into PGC group (HbA1c ≥ 7%) and control group (CG) (HbA1c < 6%). Correlations between serum HbA1c levels and various variables were evaluated and multivariate logistic regression analyses were carried out to identify variables for PGC. We compared 110 cases to 105 controls men ranging from 44 to 81 years of age, lower PSA concentrations were observed in men with PGC (PGC mean PSA: 0.9 ng/dl, CG mean PSA: 2.1 ng/dl, p < 0.001). Also mean prostate volume was 60% was smaller among men with PGC compared with men with CG (PGC mean prostate volume: 26 ml, CG prostate volume: 43 ml, p < 0.001). A strong negative correlation was found between serum HbA1c levels and serum PSA (p < 0.001 and r = -0.665) concentrations in men with PGC. We also found at the multivariate logistic regression model that PSA, prostate volume and peak systolic velocity were independent predictors of PGC. Our results suggest that there is significant impact of PGC on serum PSA levels in T2DM. Poor glycemic control of type 2 diabetes was associated with lower serum PSA levels and smaller prostate volumes.

Impact of HIV and Type 2 diabetes on Gut Microbiota Diversity, Tryptophan Catabolism and Endothelial Dysfunction.

PubMed

Hoel, Hedda; Hove-Skovsgaard, Malene; Hov, Johannes R; Gaardbo, Julie Christine; Holm, Kristian; Kummen, Martin; Rudi, Knut; Nwosu, Felix; Valeur, Jørgen; Gelpi, Marco; Seljeflot, Ingebjørg; Ueland, Per Magne; Gerstoft, Jan; Ullum, Henrik; Aukrust, Pål; Nielsen, Susanne Dam; Trøseid, Marius

2018-04-30

HIV infection and type 2 diabetes are associated with altered gut microbiota, chronic inflammation, and increased cardiovascular risk. We aimed to investigate the combined effect of these diseases on gut microbiota composition and related metabolites, and a potential relation to endothelial dysfunction in individuals with HIV-infection only (n = 23), diabetes only (n = 16) or both conditions (n = 21), as well as controls (n = 24). Fecal microbiota was analyzed by Illumina sequencing of the 16 S rRNA gene. Markers of endothelial dysfunction (asymmetric dimethylarginine [ADMA]), tryptophan catabolism (kynurenine/tryptophan [KT]-ratio), and inflammation (neopterin) were measured by liquid chromatography-tandem mass spectrometry. The combination of HIV and type 2 diabetes was associated with reduced gut microbiota diversity, increased plasma KT-ratio and neopterin. Microbial genes related to tryptophan metabolism correlated with KT-ratio and low alpha diversity, in particular in HIV-infected with T2D. In multivariate analyses, KT-ratio associated with ADMA (β = 4.58 [95% CI 2.53-6.63], p < 0.001), whereas microbiota composition per se was not associated with endothelial dysfunction. Our results indicate that tryptophan catabolism may be related to endothelial dysfunction, with a potentially detrimental interaction between HIV and diabetes. The potential contribution of gut microbiota and the impact for cardiovascular risk should be further explored in prospective studies powered for clinical end points.

Assessing the environmental impact of phenanthrene in different types of land use based on the binding characteristics with dissolved organic matter.

PubMed

Chen, Xiao-Meng; Zhao, Yue; Ma, Ying-Ying; Zhu, Long-Ji; Yang, Tian-Xue; Wei, Zi-Min; Dong, Ying-Li; Wei, Qing-Bin

2018-01-01

The binding characteristics of phenanthrene with dissolved organic matter (DOM) were studied by the excitation emission matrix fluorescence spectroscopy with parallel factor analysis in four types of land use which derived from forest (F), meadow (M), cropland (C), and greenhouse (G). The results showed that the humification degree and binding characteristics of phenanthrene with DOM were distinct differences in the four soils. The binding capacities of humic-like components with phenanthrene were stronger than those of protein-like components. The log K derived from the Stern-Volmer equation significantly correlated with the humification degree of DOM (p < 0.05) in different types of land use. Besides, correlation analysis demonstrated that the potential binding index (Fk) obtained from the modified Stern-Volmer model was a more accurate parameter to describe the combination degree of DOM with phenanthrene than log K, which presented a decrease order of C > F > M > G. Therefore, the environmental impact of phenanthrene in different types of land use could be assessed deeply based on the Fk and DOM concentration. Copyright © 2017 Elsevier Inc. All rights reserved.

The Type and Impact of Evidence Review Group Exploratory Analyses in the NICE Single Technology Appraisal Process.

PubMed

Carroll, Christopher; Kaltenthaler, Eva; Hill-McManus, Daniel; Scope, Alison; Holmes, Michael; Rice, Stephen; Rose, Micah; Tappenden, Paul; Woolacott, Nerys

2017-06-01

As part of the UK National Institute for Health and Care Excellence (NICE) single technology appraisal process, independent evidence review groups (ERGs) critically appraise a company's submission relating to a specific technology and indication. To explore the type of additional exploratory analyses conducted by ERGs and their impact on the recommendations made by NICE. The 100 most recently completed single technology appraisals with published guidance were selected for inclusion. A content analysis of relevant documents was undertaken to identify and extract relevant data, and narrative synthesis was used to rationalize and present these data. The types of exploratory analysis conducted in relation to companies' models were fixing errors, addressing violations, addressing matters of judgment, and the provision of a new, ERG-preferred base case. Ninety-three of the 100 ERG reports contained at least one of these analyses. The most frequently reported type of analysis in these 93 ERG reports related to the category "Matters of judgment," which was reported in 83 reports (89%). At least one of the exploratory analyses conducted and reported by an ERG is mentioned in 97% of NICE appraisal consultation documents and 94% of NICE final appraisal determinations, and had a clear influence on recommendations in 72% of appraisal consultation documents and 47% of final appraisal determinations. These results suggest that the additional analyses undertaken by ERGs in the appraisal of company submissions are highly influential in the policy-making and decision-making process. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Impact of Bicycle Route Type on Exposure to Traffic-Related Air Pollution

PubMed Central

MacNaughton, Piers; Melly, Steven; Vallarino, Jose; Adamkiewicz, Gary; Spengler, John D.

2017-01-01

Cyclists are exposed to traffic-related air pollution (TRAP) during their commutes due to their proximity to vehicular traffic. Two of the main components of TRAP are black carbon (BC) and nitrogen dioxide (NO2), which have both been causally associated with increased mortality. To assess the impact of cyclists’ exposure to TRAP, a battery-powered mobile monitoring station was designed to sample air pollutants along five bike routes in Boston, Massachusetts. The bike routes were categorized into three types: bike paths, which are separated from vehicle traffic; bike lanes, which are adjacent to traffic; and designated bike lanes, which are shared traffic lanes for buses and cyclists. Bike lanes were found to have significantly higher concentrations of BC and NO2 than bike paths in both adjusted and unadjusted generalized linear models. Higher concentrations were observed in designated bike lanes than bike paths; however, this association was only significant for NO2. After adjusting for traffic density, background concentration, and proximity to intersections, bike lanes were found to have concentrations of BC and NO2 that were approximately 33% higher than bike paths. Distance from the road, vegetation barriers, and reduced intersection density appear to influence these variations. These findings suggest that cyclists can reduce their exposure to TRAP during their commute by using bike paths preferentially over bike lanes regardless of the potential increase of traffic near these routes. PMID:24840278

Longitudinal impact of IBS-type symptoms on disease activity, healthcare utilization, psychological health, and quality of life in inflammatory bowel disease.

PubMed

Gracie, David J; Hamlin, P John; Ford, Alexander C

2018-05-01

The impact of irritable bowel syndrome (IBS)-type symptoms on the natural history of inflammatory bowel disease (IBD) is uncertain. We aimed to address this in a longitudinal study of secondary care patients. Longitudinal disease activity was defined by disease flare, escalation of medical therapy, hospitalization, or intestinal resection. The number of investigations performed and clinics attended determined healthcare utilization. Psychological well-being and quality of life were assessed using validated questionnaires. These outcomes were compared over a minimum period of 2 years between patients reporting IBS-type symptoms and patients with quiescent disease, occult inflammation, and active disease at baseline. In 360 IBD patients, there were no differences in longitudinal disease activity between patients with IBS-type symptoms and patients with quiescent disease or occult inflammation. Disease flare and escalation of medical therapy was more common in patients with active disease than in patients with IBS-type symptoms (hazard ratio (HR) = 3.16; 95% confidence interval (CI) 1.93-5.19 and HR = 3.24; 95% CI 1.98-5.31, respectively). A greater number of investigations were performed in patients with IBS-type symptoms than quiescent disease (P = 0.008), but not compared with patients with occult inflammation or active disease. Anxiety, depression, and somatization scores at follow up were higher, and quality-of-life scores lower, in patients with IBS-type symptoms when compared with patients with quiescent disease, but were similar to patients with active disease. IBS-type symptoms in IBD were associated with increased healthcare utilization, psychological comorbidity, reduced quality of life, but not adverse disease activity outcomes during extended follow-up.

Testing versus guessing blood glucose values: impact on self-care behaviors in type 2 diabetes.

PubMed

Pettus, Jeremy; Stenger, Patricia; Schachner, Holly C; Dunne, Nancy; Parkes, Joan Lee; Pardo, Scott; Edelman, Steven V

2014-09-01

To assess differences between estimated blood glucose values and those measured on a blood glucose meter and the impact on self-care behavior in type 2 diabetes. Subjects ≥18 years with type 2 diabetes (N = 297) attending a Taking Control of Your Diabetes conference were asked questions about diabetes management and to estimate their current blood glucose. Study staff tested subjects' blood glucose on a meter. After seeing the result, subjects were again asked questions on diabetes management. NCT01453413. The percentage of subject blood glucose estimations that were outside ISO 15197:2003 accuracy criteria (>±15 mg/dL or >±20% of meter glucose values). Nearly half (46%) of subjects estimated blood glucose values outside ISO 15197:2003 accuracy criteria. Time since last blood glucose test, time since last meal, testing frequency, and A1C did not have an effect on differences between estimated blood glucose values and meter results. In the questionnaire before blood glucose testing, most subjects strongly agreed, agreed, or neither agreed nor disagreed that 'I make decisions about my diabetes, such as my food intake or my insulin dose even when I do not test my blood sugar' (71%) and 'My body tells me without testing if my blood sugar is low or high' (77%). After blood glucose testing, 99% of subjects strongly agreed, agreed, or neither agreed nor disagreed that 'Knowing my blood sugar by checking could help me make different diabetes decisions'. Self-monitoring of blood glucose is an important component of diabetes self-management. Testing rather than guessing blood glucose values is important to obtain accurate results and inform people with type 2 diabetes to make effective, appropriate diabetes management decisions. A potential limitation of this study is that the subject population may not be representative of the general population of people with diabetes; however, the conference setting may attract a more motivated population, which could

Impact of music type on motor coordination task performance among introverted and extroverted students.

PubMed

Jamshidzad, Maryam; Maghsoudipour, Maryam; Zakerian, Seyed Abolfazl; Bakhshi, Enayatollah; Coh, Paul

2018-06-26

People are interested in music. In this study, we assessed the impact of music type on objective performance. We distributed 64 medical science students in Tehran into four groups: Iranian pop music, traditional music, Mozart's classical music and control groups. All participants performed the two-arm coordination test once without music and once with music (except for the control group), with an interval of 1 week. In the music groups, music was playing during the performance of the test. Participants were categorized as either introverted or extroverted and were distributed equally in the groups. There was a significant decrease of test time in the second trial, observed in all music groups, and no significant difference identified in the control group. The traditional music group had less difference of mean time compared to the pop music group. The differences in the traditional and classical groups were not significantly different. In the music groups, both extroverted and introverted students decreased their test time significantly after music intervention, but extroverted students decreased more. Listening to music would enhance the speed of performance. Music with a higher tempo, such as pop music, increased the speed more.

Impact of Haemophilus influenzae type b conjugate vaccine on bacterial meningitis in the Dominican Republic.

PubMed

Lee, Ellen H; Corcino, Miriam; Moore, Arelis; Garib, Zacarias; Peña, Chabela; Sánchez, Jacqueline; Fernández, Josefina; Feris-Iglesias, Jesús M; Flannery, Brendan

2008-09-01

Widespread use of Haemophilus influenzae type b (Hib) vaccines has dramatically reduced the burden of Hib disease throughout the Americas. Few studies have evaluated the impact of Hib vaccination on non-culture-confirmed disease. This study analyzed trends in probable bacterial meningitis before and after the introduction of Hib vaccine in the Dominican Republic and estimated vaccine effectiveness against Hib meningitis. Meningitis cases among children < 5 years of age were identified from admission records of the main pediatric hospital in Santo Domingo during 1998-2004. Laboratory criteria were used to classify meningitis cases with probable bacterial etiology; confirmed cases had positive bacterial culture or antigen detection in cerebrospinal fluid. Cumulative incidence rates of confirmed and probable bacterial meningitis were calculated for children living in the National District. Confirmed cases of Hib meningitis were enrolled in a case-control study with age- and neighborhood-matched control children to calculate vaccine effectiveness. Before vaccine introduction, annual rates of meningitis with probable bacterial etiology were 49 cases per 100 000 children < 5 years old; Hib accounted for 60% of confirmed bacterial cases. During 2002-2004, after vaccine introduction, annual rates of probable bacterial meningitis were 65% lower at 16 cases per 100 000, and Hib accounted for 26% of confirmed cases. Rates of Hib meningitis and probable bacterial meningitis with no determined etiology declined by 13 and 17 cases per 100 000, respectively. Introduction of Hib vaccine substantially reduced the incidence of confirmed and probable bacterial meningitis in the Dominican Republic. The estimated impact of Hib vaccination was twice as great when non-culture-confirmed disease was included.

Economic impact of compliance to treatment with antidiabetes medication in type 2 diabetes mellitus: a review paper.

PubMed

Breitscheidel, L; Stamenitis, S; Dippel, F-W; Schöffski, O

2010-03-01

Suboptimal compliance and failure to persist with antidiabetes therapies are of potential economic significance. The present research aims to describe the impact of poor compliance and persistence with antidiabetes medications on the cost of healthcare or its components for patients with type 2 diabetes mellitus (T2DM). Literature search was conducted in PubMed for relevant articles published in the period between 1 January 2000 and 30 April 2009. Thus, it is possible that relevant articles not listed in PubMed, but available in other databases are not included in the current review. Studies describing economic consequence of compliance and/or persistence with pharmaceutical antidiabetes treatment were identified. The variability in the studies reviewed was high, making it extremely difficult to make a comparison between them. Of 449 articles corresponding to the primary search algorithm, 12 studies (all conducted in USA) fulfilled the inclusion criteria regarding the economic impact of compliance and/or persistence with treatment on the overall cost of T2DM care or its components. Compliance was assessed via medication possession ratio (MPR) in ten studies, where it ranged from 0.52 to 0.93 depending on regimen. Persistence was assessed in one study. Mean total annual costs per T2DM patient varied between the studies, ranging from $4570 to $17338. In seven studies, medication compliance was inversely associated with total healthcare costs, while in four other studies inverse associations between medication compliance and hospitalisation costs were reported. In one study increased adherence did not change overall healthcare costs. Improved compliance may lead to reductions of the total healthcare costs in T2DM, Further research is needed in countries other than the US to assess impact of compliance and persistence to pharmacotherapy on T2DM costs in country-specific settings.

Impact of childhood obesity on employers.

PubMed

Sepulveda, Martin-J; Tait, Fan; Zimmerman, Edward; Edington, Dee

2010-01-01

The impact of childhood obesity on the workplace is not well understood. A study conducted for one large employer indicated that average per capita health insurance claims costs were as high as $2,907 in 2008 for an obese child and $10,789 for a child with type II diabetes. The average claims cost for children with type II diabetes actually exceeded the level of the average claims cost for adults with type II diabetes ($8,844). This paper reviews the evidence on the impact of childhood obesity on employers and discusses opportunities for business engagement-including two current examples of activities involving employers.

The impact of diabetes self-management education on glucose management and empowerment in ethnic Armenians with type 2 diabetes.

PubMed

Naccashian, Zarmine

2014-01-01

The purpose of this study was to investigate the impact of diabetes self-management education on glycemic control and perceptions of empowerment in Armenian American immigrants diagnosed with type 2 diabetes. A quasi-experimental pre and post design was used to investigate the impact of using education on self-management as measured by A1C levels and empowerment scores. Nine hours of diabetes self-management education classes were offered in the Armenian language to 75 clients at 2 adult health day care centers over 6 weeks. The participants were mostly first-generation Armenian immigrants aged 65 years and older. A1C results, the 8-item Diabetes Empowerment Scale (DES), and the 15-item Armenian Ethnic Orientation Questionnaire-Revised (AEOQ-R) were used to determine the impact of education on self-care management. After institutional review board approval was obtained, 75 participants completed the study. A paired t test indicated that the postintervention mean A1C level was significantly lower than the preintervention mean A1C level. The postintervention mean DES score was significantly greater than the preintervention mean DES score. No mediating effects of age, gender, acculturation, and number of years with the disease were identified for either A1C or DES score. The findings demonstrate the efficacy of the diabetes self-management education classes in improving diabetes self-care management skills. © 2014 The Author(s).

Estimation of the economic and health impact of complications of type 2 diabetes mellitus in the autonomous community of Madrid (Spain).

PubMed

Arrieta, Francisco; Rubio-Terrés, Carlos; Rubio-Rodríguez, Darío; Magaña, Ana; Piñera, Marbella; Iglesias, Pedro; Nogales, Pedro; Calañas, Alfonso; Novella, Blanca; Botella-Carretero, José Ignacio; Debán, Carlos; Zamarrón, Isabel; Mora, Gustavo; Balsa, José Antonio; Vázquez, Clotilde

2014-04-01

To estimate the economic and health impact of chronic complications (macrovascular and microvascular) of type 2 diabetes mellitus (T2DM) in the autonomous community of Madrid (Spain) (ACM). The number of expected complications was obtained from a descriptive, cross-sectional study on a cohort of 3,268 patients with T2DM from the ACM. Cost of complications (€, 2012) was assessed both at hospitals and in primary care. The number of medical visits in primary care and drug treatment for complications were collected by a panel of 21 physicians experienced in treatment of T2DM. Population and epidemiological data and healthcare costs were obtained from Spanish sources. Univariate sensitivity analyses were performed. It is estimated that there are 390,944 patients with T2DM in the ACM, and that they experience 172,406 and 212,283 macrovascular and microvascular complications respectively during their lifetimes. Mean cost of T2DM complications per patient is estimated at € 4,121.54 (66% due to macrovascular complications). The economic impact of T2DM complications in the ACM would be € 1,611 million (1,065 and 545 millions from macrovascular and microvascular complications respectively). The economic impact would range from € 1,249 and 2.509 million euro depending on T2DM prevalence. Complications of T2DM have a great health and economic impact in ACM. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

Regulating assisted reproductive technologies in Victoria: the impact of changing policy concerning the accessibility of in vitro fertilisation for preimplantation tissue-typing.

PubMed

Smith, Malcolm K

2012-06-01

On 1 January 2010, the Assisted Reproductive Treatment Act 2008 (Vic) came into force. The legislation was the outcome of a detailed review and consultation process undertaken by the Victorian Law Reform Commission. Arguably, the change to the regulatory framework represents a significant shift in policy compared to previous regulatory approaches on this topic in Victoria. This article considers the impact of the new legislation on eligibility for reproductive treatments, focusing on the accessibility of such services for the purpose of creating a "saviour sibling". It also highlights the impact of the Victorian regulatory body's decision to abolish its regulatory policies on preimplantation genetic diagnosis and preimplantation tissue-typing, concluding that the regulatory approach in relation to these latter issues is similar to other Australian jurisdictions where such practices are not addressed by a statutory framework.

Psychological impact of screening for type 2 diabetes: controlled trial and comparative study embedded in the ADDITION (Cambridge) randomised controlled trial.

PubMed

Eborall, Helen C; Griffin, Simon J; Prevost, A Toby; Kinmonth, Ann-Louise; French, David P; Sutton, Stephen

2007-09-08

To quantify the psychological impact of primary care based stepwise screening for type 2 diabetes. Controlled trial and comparative study embedded in a randomised controlled trial. 15 practices (10 screening, five control) in the ADDITION (Cambridge) trial in the east of England. 7380 adults (aged 40-69) in the top fourth for risk of having undiagnosed type 2 diabetes (6416 invited for screening, 964 controls). Invited for screening for type 2 diabetes or not invited (controls), incorporating a comparative study of subgroups of screening attenders. Attenders completed questionnaires after a random blood glucose test and at 3-6 months and 12-15 months later. Controls were sent questionnaires at corresponding time points. Non-attenders were sent questionnaires at 3-6 months and 12-15 months. State anxiety (Spielberger state anxiety inventory), anxiety and depression (hospital anxiety and depression scale), worry about diabetes, and self rated health. No significant differences were found between the screening and control participants at any time-for example, difference in means (95% confidence intervals) for state anxiety after the initial blood glucose test was -0.53, -2.60 to 1.54, at 3-6 months was 1.51 (-0.17 to 3.20), and at 12-15 months was 0.57, -1.11 to 2.24. After the initial test, compared with participants who screened negative, those who screened positive reported significantly poorer general health (difference in means -0.19, -0.25 to -0.13), higher state anxiety (0.93, -0.02 to 1.88), higher depression (0.32, 0.08 to 0.56), and higher worry about diabetes (0.25, 0.09 to 0.41), although effect sizes were small. Small but significant trends were found for self rated health across the screening subgroups at 3-6 months (P=0.047) and for worry about diabetes across the screen negative groups at 3-6 months and 12-15 months (P=0.001). Screening for type 2 diabetes has limited psychological impact on patients. Implementing a national screening programme based

Impact of type 2 diabetes mellitus on recurrent myocardial infarction in China.

PubMed

Li, Wentao; Li, Muwei; Gao, Chuanyu; Wang, Xianpei; Qi, Datun; Liu, Jun; Jin, Qiangsong

2016-11-01

To evaluate the influence of type 2 diabetes mellitus on the long-term outcomes of Chinese patients with previous myocardial infarction, we studied 864 patients with previous myocardial infarction, including 251 with type 2 diabetes mellitus and 613 without type 2 diabetes mellitus, over a median follow-up time of 2.9 years. The type 2 diabetes mellitus patients were subdivided into 95 insulin-treated diabetes mellitus and 156 non-insulin-treated diabetes mellitus subjects. The crude incidences (per 1000 patient-years) in the type 2 diabetes mellitus subjects versus the non-type 2 diabetes mellitus subjects were 43.7 versus 25.1 for recurrent myocardial infarction, 68.7 versus 28.3 for all-cause death and 99.8 versus 49.9 for the composite end point (i.e. recurrent myocardial infarction or all-cause death). Cox regression analysis showed that the adjusted hazard ratios for recurrent myocardial infarction, all-cause death and their combination were 1.67 (95% confidence interval: 1.06-2.74), 1.90 (1.25-2.90) and 1.72 (1.23-2.40), respectively. Significant associations were also observed between insulin treatment and all-cause death. Our findings suggested that type 2 diabetes mellitus is an independent risk factor for recurrent myocardial infarction, all-cause death and the composite end point among previous myocardial infarction patients. © The Author(s) 2016.

Characterizing backcountry camping impacts in Great Smoky Mountains National Park

USGS Publications Warehouse

Leung, Y.-F.; Marion, J.L.

1999-01-01

This investigates resource impacts on backcounty campsites in the Great Smoky Mountains National Park, USA. Study objectives were to enhance our understanding of camping impacts and to improve campsite impact assessment procedures by means of multivariate techniques. Three-hundred and eight campsites at designated backcountry campgrounds, and 69 additional unofficial campsites were assessed. Factor analysis of 195 established campsites on eight impact indicator variables revealed three dimensions of campsite impact: area disturbance, soil and groundcover damage, and tree-related damage. Four distinctive backcountry campsite types were identified, three of which were derived from cluster analyses of factor scores. These four backcountry campsite types characterize the intensity and areal extent of resource impacts, and they vary in locational and environmental attributes. At an aggregate level, different campsite types contributed unequally to the cumulative level of impact. The dimensional structure and typology developed in this study demonstrates that campsite impacts can be viewed and examined holistically with the use of multivariate methods. Implications for assessment procedures, management and further research are discussed.

Type 1, type 2 and gestational diabetes mellitus differentially impact placental pathologic characteristics of uteroplacental malperfusion.

PubMed

Huynh, Jennifer; Yamada, Jessica; Beauharnais, Catherine; Wenger, Julia B; Thadhani, Ravi I; Wexler, Deborah; Roberts, Drucilla J; Bentley-Lewis, Rhonda

2015-10-01

During a pregnancy complicated by diabetes, the placenta undergoes a number of functional and structural pathologic changes. However, differences across studies may reflect pathophysiologic differences of diabetes types under investigation. We examined placental pathology from women ages 18-40 years with self-identified race/ethnicity; singleton, live births; and type 1 (T1DM; n = 36), type 2 (T2DM; n = 37), or gestational diabetes mellitus (GDM; n = 126). Clinical data were abstracted from medical records. Placental diagnoses were independently re-reviewed by a perinatal pathologist. Multivariable analyses adjusting for race, gestational weight gain, gestational age, and systolic blood pressure were conducted. Women with T1DM compared with either T2DM or GDM had higher gestational weight gain (mean ± SD, T1DM vs. T2DM: 28.5 ± 12.4 vs. 20.5 ± 13.4 kg, p = 0.03; or GDM: 21.3 ± 12.7 kg, p = 0.009) and insulin use (T2DM: 100.0% vs. 85.3%, p = 0.02; or GDM: 4.0%, p < 0.001). Women with T1DM compared with either T2DM or GDM also had a similarly lower prevalence of placental infarcts in univariate analyses; however, these findings did not remain significant after multivariable adjustment. Also, placentas from women with T2DM compared to GDM had higher rates of decidual vasculopathy when excluding women with preeclampsia (10.3 vs. 1.6%, p = 0.049) and diffuse chorangiosis (62.2 vs. 32.5%, p < 0.001) but a lower rate of villous immaturity (10.8 vs. 90.5%, p = 0.007) after full adjustment. Placental vasculopathic abnormalities differ by maternal diabetes type, potentially reflecting underlying pathophysiologic mechanisms. Further research on placental pathology and metabolic derangements is warranted. Copyright © 2015 Elsevier Ltd. All rights reserved.

Impact gages for detecting meteoroid and other orbital debris impacts on space vehicles.

NASA Technical Reports Server (NTRS)

Mastandrea, J. R.; Scherb, M. V.

1973-01-01

Impacts on space vehicles have been simulated using the McDonnell Douglas Aerophysics Laboratory (MDAL) Light-Gas Guns to launch particles at hypervelocity speeds into scaled space structures. Using impact gages and a triangulation technique, these impacts have been detected and accurately located. This paper describes in detail the various types of impact gages (piezoelectric PZT-5A, quartz, electret, and off-the-shelf plastics) used. This description includes gage design and experimental results for gages installed on single-walled scaled payload carriers, multiple-walled satellites and space stations, and single-walled full-scale Delta tank structures. A brief description of the triangulation technique, the impact simulation, and the data acquisition system are also included.

Biodiversity impact assessment (BIA+) - methodological framework for screening biodiversity.

PubMed

Winter, Lisa; Pflugmacher, Stephan; Berger, Markus; Finkbeiner, Matthias

2018-03-01

For the past 20 years, the life cycle assessment (LCA) community has sought to integrate impacts on biodiversity into the LCA framework. However, existing impact assessment methods still fail to do so comprehensively because they quantify only a few impacts related to specific species and regions. This paper proposes a methodological framework that will allow LCA practitioners to assess currently missing impacts on biodiversity on a global scale. Building on existing models that seek to quantify the impacts of human activities on biodiversity, the herein proposed methodological framework consists of 2 components: a habitat factor for 14 major habitat types and the impact on the biodiversity status in those major habitat types. The habitat factor is calculated by means of indicators that characterize each habitat. The biodiversity status depends on parameters from impact categories. The impact functions, relating these different parameters to a given response in the biodiversity status, rely on expert judgments. To ensure the applicability for LCA practitioners, the components of the framework can be regionalized on a country scale for which LCA inventory data is more readily available. The weighting factors for the 14 major habitat types range from 0.63 to 1.82. By means of area weighting of the major habitat types in a country, country-specific weighting factors are calculated. In order to demonstrate the main part of the framework, examples of impact functions are given for the categories "freshwater eutrophication" and "freshwater ecotoxicity" in 1 major habitat type. The results confirm suitability of the methodological framework. The major advantages are the framework's user-friendliness, given that data can be used from LCA databases directly, and the complete inclusion of all levels of biodiversity (genetic, species, and ecosystem). It is applicable for the whole world and a wide range of impact categories. Integr Environ Assess Manag 2018;14:282-297. �

Impact of early psychosocial factors (childhood socioeconomic factors and adversities) on future risk of type 2 diabetes, metabolic disturbances and obesity: a systematic review

PubMed Central

2010-01-01

Background Psychological factors and socioeconomic status (SES) have a notable impact on health disparities, including type 2 diabetes risk. However, the link between childhood psychosocial factors, such as childhood adversities or parental SES, and metabolic disturbances is less well established. In addition, the lifetime perspective including adult socioeconomic factors remains of further interest. We carried out a systematic review with the main question if there is evidence in population- or community-based studies that childhood adversities (like neglect, traumata and deprivation) have considerable impact on type 2 diabetes incidence and other metabolic disturbances. Also, parental SES was included in the search as risk factor for both, diabetes and adverse childhood experiences. Finally, we assumed that obesity might be a mediator for the association of childhood adversities with diabetes incidence. Therefore, we carried out a second review on obesity, applying a similar search strategy. Methods Two systematic reviews were carried out. Longitudinal, population- or community-based studies were included if they contained data on psychosocial factors in childhood and either diabetes incidence or obesity risk. Results We included ten studies comprising a total of 200,381 individuals. Eight out of ten studies indicated that low parental status was associated with type 2 diabetes incidence or the development of metabolic abnormalities. Adjustment for adult SES and obesity tended to attenuate the childhood SES-attributable risk but the association remained. For obesity, eleven studies were included with a total sample size of 70,420 participants. Four out of eleven studies observed an independent association of low childhood SES on the risk for overweight and obesity later in life. Conclusions Taken together, there is evidence that childhood SES is associated with type 2 diabetes and obesity in later life. The database on the role of psychological factors such as

Impacts of different types of measurements on estimating unsaturated flow parameters

NASA Astrophysics Data System (ADS)

Shi, Liangsheng; Song, Xuehang; Tong, Juxiu; Zhu, Yan; Zhang, Qiuru

2015-05-01

This paper assesses the value of different types of measurements for estimating soil hydraulic parameters. A numerical method based on ensemble Kalman filter (EnKF) is presented to solely or jointly assimilate point-scale soil water head data, point-scale soil water content data, surface soil water content data and groundwater level data. This study investigates the performance of EnKF under different types of data, the potential worth contained in these data, and the factors that may affect estimation accuracy. Results show that for all types of data, smaller measurements errors lead to faster convergence to the true values. Higher accuracy measurements are required to improve the parameter estimation if a large number of unknown parameters need to be identified simultaneously. The data worth implied by the surface soil water content data and groundwater level data is prone to corruption by a deviated initial guess. Surface soil moisture data are capable of identifying soil hydraulic parameters for the top layers, but exert less or no influence on deeper layers especially when estimating multiple parameters simultaneously. Groundwater level is one type of valuable information to infer the soil hydraulic parameters. However, based on the approach used in this study, the estimates from groundwater level data may suffer severe degradation if a large number of parameters must be identified. Combined use of two or more types of data is helpful to improve the parameter estimation.

Impact of hydrocarbon type, concentration and weathering on its biodegradability in soil.

PubMed

Maletić, Snežana P; Dalmacija, Božo D; Rončević, Srđan D; Agbaba, Jasmina R; Perović, Svetlana D Ugarčina

2011-01-01

The objective of this research was to investigate the impact of the hydrocarbon type and concentration, as well as the total effect of the natural weathering process to hydrocarbon biodegradability in sandy soil and the environment. In this experiment, sandy soil was separately contaminated with 0.5%, 1.0%, 2.0% and 3.5% of diesel and crude oils. Oil contaminated soil was taken from the Oil Refinery dumping sites after 9 years of weathering, and its concentration was adjusted to the above-mentioned levels. The biodegradation process was monitored by measuring CO(2), evolution rate, hydrocarbon degradation rate and dehydrogenase activity. The favourable concentration ranges for the soil contaminated with diesel oil were 1.0%, with concentrations at about 2.0% causing slightly adverse effects to CO(2) production which was overcome after 2 weeks, and with 3.5% diesel oil causing significant toxicity. For soil contaminated with crude oil, 2.0% was found to be optimum for effective biodegradation, with 3.5% crude oil also causing adverse effects to CO(2) production, although less so than the same concentration of diesel oil. No adverse effect was obtained for any concentration of the weathered oil, as after the weathering process, the remaining contaminants in the soil were mostly poorly degradable constituents like asphaltenes, resins etc. It has been proposed that such residual material from oil degradation is analogous to, and can even be regarded as, humic material. Due to its inert characteristics, insolubility and similarity to humic materials it is unlikely to be environmentally hazardous.

Instructional Coach Weighs 3 Types of Data to Get Triple-Strength Feedback

ERIC Educational Resources Information Center

Boehle, Monica

2014-01-01

This article describes three types of data that can impact how instructional coaches face the challenges in measuring the impact of their work with teachers on student learning. Descriptions of the three types of data--"shifts in teacher reflective tendencies," "the use of student performance as an indicator of success," and…

Impact of academic facility type and volume on post-surgical outcomes following diagnosis of glioblastoma.

PubMed

Hauser, Alan; Dutta, Sunil W; Showalter, Timothy N; Sheehan, Jason P; Grover, Surbhi; Trifiletti, Daniel M

2018-01-01

To identify if facility type and/or facility volume impact overall survival (OS) following diagnosis of glioblastoma (GBM). We also sought to compare early post-surgical outcomes based on these factors. The National Cancer Database was queried for patients with GBM diagnosed from 2004 to 2013 with known survival. Patients were grouped based on facility type and facility volume. Multivariable analyses were performed to investigate factors associated OS following diagnosis and Chi-square tests were used to compare early post-surgical outcomes. 89,839 patients met inclusion criteria. Factors associated with improved OS on multivariable analysis included younger patient age, female gender, race, lower comorbidity score, higher performance score, smaller tumor size, unifocal tumors, MGMT hypermethylation, fully resected tumors, radiotherapy, and chemotherapy (each p < .001). Also, OS was improved among patients treated at centers averaging at least 30.2 cases per year (HR 0.948, compared to <7.4 cases/year, p < .001), and patients treated at Academic/Research programs had improved survival compared to those treated at Comprehensive Community Cancer programs (HR 1.069, p < .001) and Integrated Network Cancer programs (HR 1.126, p < .001). Similarly, Academic/Research programs and high volume centers demonstrated improved 30- and 90-day morality as well as 30-day readmission rates (p < .001). This study suggests that patients treated in Academic/Research programs and high patient-volume centers have increased survival and more favorable early-postsurgical outcomes. The extent to which differences in patient populations, socioeconomic factors, and/or provider expertise play into this cause will be areas of future research. Copyright © 2017 Elsevier Ltd. All rights reserved.

Impact of vasomotion type on prognosis of coronary artery spasm induced by acetylcholine provocation test of left coronary artery.

PubMed

Lee, Eun Mi; Choi, Man Ho; Seo, Hong Seog; Kim, Hyun Ki; Kim, Nam-Ho; Choi, Cheol Ung; Kim, Jin Won; Lim, Hong Euy; Kim, Eung Ju; Rha, Seung-Woon; Park, Chang Gyu; Oh, Dong Joo

2017-02-01

The impact of vasomotion types on long-term clinical outcomes in patients with coronary artery spasm (CAS) induced by the acetylcholine provocation test (ACH-test) remains unclear. We evaluated 4644 consecutive patients with typical resting chest pain (CP), but no angiographically significant coronary artery lesion (<50% stenosis), who underwent an ACH-test. According to their vasomotor response, patients were categorized into four types: normal vasomotion (no CP, no ischemic electrocardiographic changes, and no vasoconstriction), microvascular spasm (CP with <75% vasoconstriction but with CP relief after nitroglycerin infusion), epicardial spasm (CP with ≥75% vasoconstriction), and ACH-test inconclusive (vasoconstriction and/or electrocardiographic changes, but no CP). We investigated CP recurrence requiring follow-up angiography and major adverse cardiovascular events (MACEs) during 5 years. CP recurred in 7.9% of patients and was more frequent in abnormal vasomotion types (normal vasomotion, microvascular spasm, epicardial spasm, and inconclusive type: 5.4%, 9.8%, 10.9%, and 8.2%, respectively, log-rank p = 0.009). In multivariate analysis adjusted for medication use after the ACH-test, vasomotion subtype was not an independent predictor, whereas male sex, fixed lesion on baseline angiography, and medications including calcium channel blockers (CCBs), nitrates, and statins were independent positive predictors for recurrent CP. Alcohol consumption at the initial interview was a negative predictor. MACEs were observed in 1.6%, and the incidence was similar among subtypes (p = 0.421). Recurrent CP and long-term outcomes are independent of vasomotion subtypes, but long-term use of CCBs, nitrates, and statins is a significant predictor for recurrent CP. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Impacts of Return-to-Work Type and Period on Job Retention in Workers with Occupational Injuries and Diseases

PubMed Central

2017-01-01

Background Despite the necessity of job retention in achieving return-to-work (RTW) goals, many workers leave their jobs after returning to work. The objective of this study was to examine the impacts of RTW type and period on job retention in Korean workers with occupational injuries and diseases. Methods Data were derived from the Panel Study of Worker's Compensation Insurance, including data from 2,000 systemically sampled workers who had finished recuperation in 2012; three waves of survey data were included in the analyses. Workers who returned to work (n = 1,610) were included in the analysis of the relationship between RTW type and job retention, and 664 workers who returned to their original workplaces were included in the analysis of the relationship between RTW period and job retention. The participants completed a questionnaire, and administrative data were provided by workers' compensation insurance. Results A Cox proportional-hazards regression analysis showed an increased hazard ratio (HR) for non-retention of 2.66 (95% confidence interval, 2.11–3.35) in reemployed workers compared to that in workers returning to their original workplaces. Among workers returning to their original workplaces, HRs for non-retention were increased in workers with a RTW period of 13–24 months (3.03 [1.52–6.04]) and > 24 months (5.33 [2.14–13.25]) compared to workers with a RTW period of ≤ 3 months. Conclusion RTW type and period were significantly related to job retention, suggesting that policies for promoting job retention rate should be implemented. PMID:29215811

Impacts of Return-to-Work Type and Period on Job Retention in Workers with Occupational Injuries and Diseases.

PubMed

Jeong, Inchul; Park, Jae Bum; Kim, Hyoung Ryoul; Yoon, Jin Ha; Won, Jong Uk; Roh, Jaehoon

2018-01-01

Despite the necessity of job retention in achieving return-to-work (RTW) goals, many workers leave their jobs after returning to work. The objective of this study was to examine the impacts of RTW type and period on job retention in Korean workers with occupational injuries and diseases. Data were derived from the Panel Study of Worker's Compensation Insurance, including data from 2,000 systemically sampled workers who had finished recuperation in 2012; three waves of survey data were included in the analyses. Workers who returned to work (n = 1,610) were included in the analysis of the relationship between RTW type and job retention, and 664 workers who returned to their original workplaces were included in the analysis of the relationship between RTW period and job retention. The participants completed a questionnaire, and administrative data were provided by workers' compensation insurance. A Cox proportional-hazards regression analysis showed an increased hazard ratio (HR) for non-retention of 2.66 (95% confidence interval, 2.11-3.35) in reemployed workers compared to that in workers returning to their original workplaces. Among workers returning to their original workplaces, HRs for non-retention were increased in workers with a RTW period of 13-24 months (3.03 [1.52-6.04]) and > 24 months (5.33 [2.14-13.25]) compared to workers with a RTW period of ≤ 3 months. RTW type and period were significantly related to job retention, suggesting that policies for promoting job retention rate should be implemented. © 2018 The Korean Academy of Medical Sciences.

Colorful Impact Ejecta from Hargraves Crater

NASA Image and Video Library

2017-05-08

The collision that created Hargraves Crater impacted into diverse bedrock lithologies of ancient Mars; the impact ejecta is a rich mix of rock types with different colors and textures, as seen by NASA Mars Reconnaissance Orbiter. The crater is named after Robert Hargraves who discovered and studied meteorite impacts on the Earth. https://photojournal.jpl.nasa.gov/catalog/PIA21609

Low blow Charpy impact of silicon carbides

NASA Technical Reports Server (NTRS)

Abe, H.; Chandan, H. C.; Bradt, R. C.

1978-01-01

The room-temperature impact resistance of several commercial silicon carbides was examined using an instrumented pendulum-type machine and Charpy-type specimens. Energy balance compliance methods and fracture toughness approaches, both applicable to other ceramics, were used for analysis. The results illustrate the importance of separating the machine and the specimen energy contributions and confirm the equivalence of KIc and KId. The material's impact energy was simply the specimen's stored elastic strain energy at fracture.

The Relation Between Inflation in Type-I and Type-II Error Rate and Population Divergence in Genome-Wide Association Analysis of Multi-Ethnic Populations.

PubMed

Derks, E M; Zwinderman, A H; Gamazon, E R

2017-05-01

Population divergence impacts the degree of population stratification in Genome Wide Association Studies. We aim to: (i) investigate type-I error rate as a function of population divergence (F ST ) in multi-ethnic (admixed) populations; (ii) evaluate the statistical power and effect size estimates; and (iii) investigate the impact of population stratification on the results of gene-based analyses. Quantitative phenotypes were simulated. Type-I error rate was investigated for Single Nucleotide Polymorphisms (SNPs) with varying levels of F ST between the ancestral European and African populations. Type-II error rate was investigated for a SNP characterized by a high value of F ST . In all tests, genomic MDS components were included to correct for population stratification. Type-I and type-II error rate was adequately controlled in a population that included two distinct ethnic populations but not in admixed samples. Statistical power was reduced in the admixed samples. Gene-based tests showed no residual inflation in type-I error rate.

Impact cratering calculations

NASA Technical Reports Server (NTRS)

Ahrens, Thomas J.; Okeefe, J. D.; Smither, C.; Takata, T.

1991-01-01

In the course of carrying out finite difference calculations, it was discovered that for large craters, a previously unrecognized type of crater (diameter) growth occurred which was called lip wave propagation. This type of growth is illustrated for an impact of a 1000 km (2a) silicate bolide at 12 km/sec (U) onto a silicate half-space at earth gravity (1 g). The von Misses crustal strength is 2.4 kbar. The motion at the crater lip associated with this wave type phenomena is up, outward, and then down, similar to the particle motion of a surface wave. It is shown that the crater diameter has grown d/a of approximately 25 to d/a of approximately 4 via lip propagation from Ut/a = 5.56 to 17.0 during the time when rebound occurs. A new code is being used to study partitioning of energy and momentum and cratering efficiency with self gravity for finite-sized objects rather than the previously discussed planetary half-space problems. These are important and fundamental subjects which can be addressed with smoothed particle hydrodynamic (SPH) codes. The SPH method was used to model various problems in astrophysics and planetary physics. The initial work demonstrates that the energy budget for normal and oblique impacts are distinctly different than earlier calculations for silicate projectile impact on a silicate half space. Motivated by the first striking radar images of Venus obtained by Magellan, the effect of the atmosphere on impact cratering was studied. In order the further quantify the processes of meteor break-up and trajectory scattering upon break-up, the reentry physics of meteors striking Venus' atmosphere versus that of the Earth were studied.

Capacitor-type micrometeoroid detectors

NASA Technical Reports Server (NTRS)

Wortman, J. J.; Griffis, D. P.; Bryan, S. R.; Kinard, W.

1986-01-01

The metal oxide semiconductor (MOS) capacitor micrometeroid detector consists of a thin dielectric capacitor fabricated on a silicon wafer. In operation, the device is charged to a voltage level sufficiently near breakdown that micrometeoroid impacts will cause dielectric deformation or heating and subsequent arc-over at the point of impact. Each detector is capable of recording multiple impacts because of the self-healing characteristics of the device. Support instrumentation requirements consist of a voltage source and pulse counters that monitor the pulse of recharging current following every impact. An investigation has been conducted in which 0.5 to 5 micron diameter carbonized iron spheres traveling at velocities of 4 to 10 Km/sec were impacted on to detectors with either a dielectric thickness of 0.4 or 1.0 micron. This study demonstrated that an ion microprobe tuned to sufficiently high resolution can detect Fe remaining on the detector after the impact. Furthermore, it is also possible to resolve Fe ion images free of mass interferences from Si, for example, giving its spatial distribution after impact. Specifically this technique has shown that significant amounts of impacting particles remain in the crater and near it which can be analyzed for isotopic content. Further testing and calibration could lead to quantitive analysis. This study has shown that the capacitor type micrometeroid detector is capable of not only time and flux measurements but can also be used for isotopic analysis.

Urinary incontinence in Emirati women with diabetes mellitus type 2: prevalence, risk factors and impact on life.

PubMed

Bani-issa, Wegdan; Fakhry, Randa; Al Momani, Fida

2013-11-01

To evaluate prevalence, risk factors for urinary incontinence and its impact on lives of Emirati women with diabetes mellitus type 2 (DM2). Risk factors examined were age, parity, history of urinary tract infections, body mass index (BMI) and DM2 duration. Incontinence is a known complication of DM2 with impact on women's lives. Less is known about incontinence problem among Emirati women with DM2. A cross-sectional survey design using probability sampling approach was employed to assess urinary incontinence in Emirati women with DM2. A total of 300 women with DM2, aged 20-65 years, were recruited from six healthcare centres. Data were collected over an 18-month period. A standardised incontinence questionnaire was used to assess type and frequency of incontinence within the past 12 months. Presence of weekly incontinence was the main outcome. Of the 300 women, 188 (63%) reported any incontinence, of which 48% had at least weekly episode. Both stress (n = 154, 51·3%) and urge (n = 181, 60·3%) were reported by participants, with 48 (31·1%) reporting at least weekly stress and 85 (46·9%) expressing at least weekly urge incontinence. Diabetes duration was a significant risk factor for any, stress and urge incontinence followed by age for only any and stress incontinence. BMI was a risk factor for urge incontinence. Women perceived incontinence as bothersome, disturbing their social activities and daily prayers. The prevalence of incontinence in Emirati women with DM2 is higher than that reported by women in other cultures. Risk factors identified were DM2 duration, age and obesity. Emirati women found incontinence to be a bothersome problem influencing their daily lives and prayers. Nurses in general practice should be alert to the incontinence problem by considering it as part of the routine diabetes evaluation of women, especially of those with longer duration of diabetes, obese and older. Cultural knowledge, sensitivity and individualised treatment plans need

Psychological impacts from expectation of worsening conditions and obstacles to life planning are affected by glycemic control, self-reported symptoms, and drug therapy in patients with type 2 diabetes mellitus.

PubMed

Nakao, Motoyuki; Hara, Yoriko; Ishihara, Yoko

2016-05-01

It is important to reduce psychological stresses for glycemic control in diabetes. We investigated the factors affecting psychological impact, which was involved in the disease conditions in 378 patients with type 2 diabetes mellitus. Patients' self-assessed symptoms and four subscales of psychological impacts on diabetes - impact from diabetes (S1), anxiety from having a chronic disease (S2), expectation of worsening conditions (S3) and obstacles to life planning (S4) - were analyzed. Significant odds ratios (ORs) were found for sex and age in S1, age and glycemic control in S2, glycemic control in S3, disease duration and glycemic control in S4, and number of symptoms in S1-S4. Scores of S1 and S2 in women were lower than those in men, and decreased age-dependently. Significant ORs for the number of symptoms in S3 and S4 were greater than in S1 and S2. ORs increased markedly for patients under oral hypoglycemic agent therapy in S4 and insulin therapy in S1-S4 when compared with ORs for lifestyle therapy alone. The psychological impact of type 2 diabetes involved a priori factors dependent on sex and aging in the subscales of current anxieties and impact, and a posteriori factors, such as disease duration, glycemic control and treatment methods, in the subscales of expectation of worsening conditions and obstacles to life planning.

Impact of sleep behavior on glycemic control in type 1 diabetes: the role of social jetlag.

PubMed

Larcher, Sandra; Gauchez, Anne-Sophie; Lablanche, Sandrine; Pépin, Jean-Louis; Benhamou, Pierre-Yves; Borel, Anne-Laure

2016-11-01

Sleep behavior is changing toward shorter sleep duration and a later chronotype. It results in a sleep debt that is acquitted on work-free days, inducing a small but recurrent sleep misalignment each week, referred to as "social jetlag". These sleep habits could affect health through misalignment with circadian rhythms. The primary objective is to address the impact of sleep behavior on glycemic control, assessed by HbA1c, in patients with type 1 diabetes, independently of other lifestyle or sleep-related factors. The secondary objective is to address whether circadian phase affects glycemic control. In total, 80 adult patients with type 1 diabetes (46% female) were included in a clinical cohort study. Sleep behavior was addressed objectively by a 7-day actimetry, lifestyle by questionnaires, sleep breathing disorders by nocturnal oximetry and circadian phase by dim light melatonin onset (DLMO). Univariate analyses showed that chronotype (r = 0.23, P = 0.042) and social jetlag (r = 0.30, P = 0.008) were significantly associated with HbA1c. In multivariable analysis, social jetlag was the only sleep habit independently associated with HbA1c (β = 0.012 (0.006; 0.017), P < 0.001). HbA1c was lower in patients with a social jetlag below versus above the median (7.7% (7.1-8.7) and 8.7% (7.6-9.8), P = 0.011). DLMO was not associated with HbA1c. However, the later the DLMO, the worse the sleep efficiency (r = -0.41, P < 0.001) and fragmentation index (r = 0.35, P = 0.005). Social jetlag, a small but recurrent circadian misalignment, is associated with worse glycemic control in type 1 diabetes, whereas circadian phase is not. Further intervention studies should address the potential improvement of glycemic control by correcting social jetlag. © 2016 European Society of Endocrinology.

The nature of organic records in impact excavated rocks on Mars

NASA Astrophysics Data System (ADS)

Montgomery, W.; Bromiley, G. D.; Sephton, M. A.

2016-08-01

Impact ejected rocks are targets for life detection missions to Mars. The Martian subsurface is more favourable to organic preservation than the surface owing to an attenuation of radiation and physical separation from oxidising materials with increasing depth. Impact events bring materials to the surface where they may be accessed without complicated drilling procedures. On Earth, different assemblages of organic matter types are derived from varying depositional environments. Here we assess whether these different types of organic materials can survive impact events without corruption. We subjected four terrestrial organic matter types to elevated pressures and temperatures in piston-cylinder experiments followed by chemical characterisation using whole-rock pyrolysis-gas chromatography-mass spectrometry. Our data reveal that long chain hydrocarbon-dominated organic matter (types I and II; mainly microbial or algal) are unresistant to pressure whereas aromatic hydrocarbon-dominated organic matter types (types III and IV; mainly land plant, metamorphosed or degraded, displaying some superficial chemical similarities to abiotic meteoritic organic matter) are relatively resistant. This suggests that the impact excavated record of potential biology on Mars will be unavoidably biased, with microbial organic matter underrepresented while metamorphosed, degraded or abiotic meteoritic organic matter types will be selectively preserved.

The nature of organic records in impact excavated rocks on Mars.

PubMed

Montgomery, W; Bromiley, G D; Sephton, M A

2016-08-05

Impact ejected rocks are targets for life detection missions to Mars. The Martian subsurface is more favourable to organic preservation than the surface owing to an attenuation of radiation and physical separation from oxidising materials with increasing depth. Impact events bring materials to the surface where they may be accessed without complicated drilling procedures. On Earth, different assemblages of organic matter types are derived from varying depositional environments. Here we assess whether these different types of organic materials can survive impact events without corruption. We subjected four terrestrial organic matter types to elevated pressures and temperatures in piston-cylinder experiments followed by chemical characterisation using whole-rock pyrolysis-gas chromatography-mass spectrometry. Our data reveal that long chain hydrocarbon-dominated organic matter (types I and II; mainly microbial or algal) are unresistant to pressure whereas aromatic hydrocarbon-dominated organic matter types (types III and IV; mainly land plant, metamorphosed or degraded, displaying some superficial chemical similarities to abiotic meteoritic organic matter) are relatively resistant. This suggests that the impact excavated record of potential biology on Mars will be unavoidably biased, with microbial organic matter underrepresented while metamorphosed, degraded or abiotic meteoritic organic matter types will be selectively preserved.

The Impact of Insects in the Northern Hardwoods Type

Treesearch

H. J. Macaloney

1966-01-01

The northern hardwoods type occupies about 16 percent -- 8.2 million acres -- of the commercial forest land in the Lake States. The timber has high unit values and represents about 42 percent of the total value of all the commercial forest in the region. Increasing values and markets for northern hardwoods in recent years have stressed the need for better quality in...

Impact of type of calcineurin inhibitor on post-transplant tuberculosis: Single-center study from India.

PubMed

Agarwal, Sanjay K; Bhowmik, Dipankar; Mahajan, Sandeep; Bagchi, Soumita

2017-02-01

Tuberculosis (TB) is an important cause of morbidity and mortality in renal transplant recipients. Immunosuppressive drugs are one of the most important risk factor for post-transplant tuberculosis (PTTB). A paucity of data exists about the impact of the type of calcineurin inhibitor on PTTB. In this retrospective study, all adult patients on calcineurin inhibitor-based immunosuppression were included. Patients receiving TB chemoprophylaxis were excluded. Diabetes, duration of dialysis, hepatitis B and C, past treated TB, induction therapy, type of antimetabolite, acute rejection, new onset of diabetes after renal transplantation (RT) (NODAT) and cytomegalovirus (CMV) were analyzed in tacrolimus (Tac) and cyclosporine (CsA) groups. Primary outcome was incidence of TB and secondary outcomes were timeline of development of TB after RT and pattern of TB in the two groups. Of the 1664 patients included, 582 patients received CsA-based immunosuppression while 1082 received Tac-based immunosuppression. Duration of dialysis, positive tuberculin skin test, use of induction, mycophenolate mofetil use, CMV infection, and NODAT were significantly more, and hepatitis B infection, past treated TB, and acute rejection episodes were significantly less in the Tac group. At the end of follow-up, incidence of TB in the Tac group was significantly less than in the CsA group (6.1% vs 19.9%, P<.001). Mean time for development of TB after RT was similar in both the groups and nodal and disseminated TB were more common in the Tac group. In conclusion, our study shows that use of Tac as compared to CsA significantly decreases incidence of PTTB. Time of infection since transplant was similar in both the groups. However, nodal and disseminated TB were more common in the Tac group. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Impact of bromocriptine-QR therapy on cardiovascular outcomes in type 2 diabetes mellitus subjects on metformin.

PubMed

Chamarthi, Bindu; Ezrokhi, Michael; Rutty, Dean; Cincotta, Anthony H

2016-11-01

Type 2 diabetes mellitus (T2DM) is associated with a substantially increased risk of cardiovascular disease (CVD). Bromocriptine-QR (B-QR), a quick release sympatholytic dopamine D 2 receptor agonist, is a FDA-approved therapy for T2DM which may provide CVD risk reduction. Metformin is considered to be an agent with a potential cardioprotective benefit. This large placebo controlled clinical study assessed the impact of B-QR addition to existing metformin therapy on CVD outcomes in T2DM subjects. 1791 subjects (1208 B-QR; 583 placebo) on metformin ± another anti-diabetes therapy at baseline derived from the Cycloset Safety Trial, a 12-month, randomized, multicenter, placebo-controlled, double-blind study in T2DM, were included in this study. The primary CVD endpoint evaluated was treatment impact on CVD event rate, prespecified as a composite of time to first myocardial infarction, stroke, coronary revascularization, or hospitalization for unstable angina/congestive heart failure. Impact on glycemic control was evaluated as a secondary analysis. The composite CVD end point occurred in 16/1208 B-QR treated (1.3%) and 18/583 placebo treated (3.1%) subjects resulting in a 55% CVD hazard risk reduction (intention-to-treat, Cox regression analysis; HR: 0.45 [0.23-0.88], p = 0.028). Kaplan-Meier curves demonstrated a significantly lower cumulative incidence rate of the CVD endpoint in the B-QR treatment group (Log-Rank p = 0.017). In subjects with poor glycemic control (HbA1c ≥ 7.5) at baseline, B-QR therapy relative to placebo resulted in a significant mean %HbA1c reduction of -0.59 at week 12 and -0.51 at week 52 respectively (p < 0.001 for both) and a 10 fold higher percent of subjects achieving HbA1c goal of ≤7% by week 52 (B-QR 30%, placebo 3%; p = 0.003). These findings suggest that in T2DM subjects on metformin, BQR therapy may represent an effective strategy for reducing CVD risk. Cycloset Safety Trial registration: ClinicalTrials.gov Identifier

The magnitude of impact damage on LDEF materials

NASA Technical Reports Server (NTRS)

Allbrooks, Martha; Atkinson, Dale

1992-01-01

The purpose of this report is to document the magnitude and types of impact damage to materials and systems on the LDEF. This report will provide insights which permit NASA and industry space-systems designers to more rapidly identify potential problems and hazards in placing a spacecraft in low-Earth orbit (LEO). This report is structured to provide (1) a background on LDEF, (2) an introduction to the LEO meteoroid and debris environments, and (3) descriptions of the types of damage caused by impacts into structural materials, and contamination caused by spallation and ejecta from impact events.

The impact of insulin therapy and attitudes towards insulin intensification among adults with type 2 diabetes: A qualitative study.

PubMed

Holmes-Truscott, Elizabeth; Browne, Jessica L; Speight, Jane

2016-08-01

As type 2 diabetes (T2DM) is a progressive chronic condition, regular clinical review and treatment intensification are critical for prevention of long-term complications. Our aim was to explore the personal impact of insulin therapy, both positive and negative consequences, and attitudes towards future insulin intensification. Twenty face-to-face interviews were conducted, and transcripts were analysed using thematic inductive analysis. Eligible participants were adults with T2DM, using insulin injections for <4years. Participants were mostly men (n=13, 65%), (median (range)) aged 65 (43-76) years, living with T2DM for 11.5 (2-27) years. Five themes emerged regarding the consequences (positive and negative) of insulin therapy, including: physical impact, personal control, emotional well-being, freedom/flexibility, (concerns about) others' reactions. Increased inconvenience and the perceived seriousness of using fast-acting insulin were both reported as barriers to future insulin intensification, despite most participants being receptive to the idea of administering additional injections. Positive and negative experiences of insulin therapy were reported by adults with T2DM and most were receptive to insulin intensification despite reported barriers. These findings may inform clinical interactions with people with T2DM and interventions to promote receptiveness to insulin initiation and intensification. Copyright © 2016 Elsevier Inc. All rights reserved.

Personal and Relationship Challenges of Adults With Type 1 Diabetes

PubMed Central

Trief, Paula M.; Sandberg, Jonathan G.; Dimmock, Jacqueline A.; Forken, Patricia J.; Weinstock, Ruth S.

2013-01-01

OBJECTIVE Little is known about the psychosocial challenges of adults living with type 1 diabetes or its impact on partner relationships. This qualitative study was undertaken to gain better understanding of these issues. RESEARCH DESIGN AND METHODS Four focus groups were held, two with adult type 1 diabetic patients (n = 16) and two with partners (n = 14). Two broad questions were posed: “What are the emotional and interpersonal challenges you have experienced because you have (your partner has) type 1 diabetes?” and “How does the fact that you have (your partner has) type 1 diabetes affect your relationship with your partner, positively and/or negatively?” Sessions were recorded and transcribed, and analyzed by a team of four researchers, using constant comparative methods to identify core domains and concepts. RESULTS Four main domains were identified: 1) impact of diabetes on the relationship, including level of partner involvement, emotional impact of diabetes on the relationship, and concerns about child-rearing; 2) understanding the impact of hypoglycemia; 3) stress of potential complications; and 4) benefits of technology. Themes suggest that, although partner involvement varies (very little to significant), there exists significant anxiety about hypoglycemia and future complications and sources of conflict that may increase relationship stress. Partner support is highly valued, and technology has a positive influence. CONCLUSIONS Adults with type 1 diabetes face unique emotional and interpersonal challenges. Future research should focus on gaining a better understanding of how they cope and the effect of psychosocial stressors and coping on adherence, quality of life, and glycemic control. PMID:23474590

Compliance with Requests by Children with Autism: The Impact of Sentence Type

ERIC Educational Resources Information Center

Kissine, Mikhail; De Brabanter, Philippe; Leybaert, Jacqueline

2012-01-01

This study assesses the extent to which children with autism understand requests performed with grammatically non-imperative sentence types. Ten children with autism were videotaped in naturalistic conditions. Four grammatical sentence types were distinguished: imperative, declarative, interrogative and sub-sentential. For each category, the…

IMPACT OF GLUCOSE MANAGEMENT TEAM ON OUTCOMES OF HOSPITALIZARON IN PATIENTS WITH TYPE 2 DIABETES ADMITTED TO THE MEDICAL SERVICE.

PubMed

Wang, Yunjiao J; Seggelke, Stacey; Hawkins, R Matthew; Gibbs, Joanna; Lindsay, Mark; Hazlett, Ingrid; Low Wang, Cecilia C; Rasouli, Neda; Young, Kendra A; Draznin, Boris

2016-12-01

To improve glycemic control of hospitalized patients with diabetes and hyperglycemia, many medical centers have established dedicated glucose management teams (GMTs). However, the impact of these specialized teams on clinical outcomes has not been evaluated. We conducted a retrospective study of 440 patients with type 2 diabetes admitted to the medical service for cardiac or infection-related diagnosis. The primary endpoint was a composite outcome of several well-recognized markers of morbidity, consisting of: death during hospitalization, transfer to intensive care unit, initiation of enteral or parenteral nutrition, line infection, new in-hospital infection or infection lasting more than 20 days of hospitalization, deep venous thrombosis or pulmonary embolism, rise in plasma creatinine, and hospital re-admissions. Medical housestaff managed the glycemia in 79% of patients (usual care group), while the GMT managed the glycemia in 21% of patients (GMT group). The primary outcome was similar between cohorts (0.95 events per patient versus 0.99 events per patient in the GMT and usual care cohorts, respectively). For subanalysis, the subjects in both groups were stratified into those with average glycemia of <180 mg/dL versus those with glycemia >180 mg/dL. We found a significant beneficial impact of glycemic management by the GMT on the composite outcome in patients with average glycemia >180 mg/dL during their hospital stay. The number of patients who met primary outcome was significantly higher in the usual care group (40 of 83 patients, 48%) than in the GMT-treated cohort (8 of 33 patients, 25.7%) (P<.02). Our data suggest that GMTs may have an important role in managing difficult-to-control hyperglycemia in the inpatient setting. BG = blood glucose GMT = glucose management team HbA1c = hemoglobin A1c ICU = intensive care unit POC = point of care T2D = type 2 diabetes.

The Impact of an Internet-Based Self-Management Intervention (HeLP-Diabetes) on the Psychological Well-Being of Adults with Type 2 Diabetes: A Mixed-Method Cohort Study.

PubMed

Hofmann, Megan; Dack, Charlotte; Barker, Chris; Murray, Elizabeth

2016-01-01

This mixed-method study assessed the impact of an internet-based, self-management intervention ("HeLP-Diabetes") on the psychological well-being of adults with type 2 diabetes. Nineteen participants were recruited from 3 general practices. Data were collected at baseline and at 6 weeks follow-up. Access to HeLP-Diabetes was associated with a significant decrease in participants' diabetes-related distress (Z = 2.04, p = 0.04, and d = 0.28). No significant differences were found in emotional distress or self-efficacy. The qualitative data found that participants reported improvements including increased self-efficacy and support, better management of low mood, greater diabetes awareness, and taking the condition more seriously. Participants also reported making improvements to their eating habits, exercise routine, and medical management. Some negative experiences associated with using the intervention were mentioned including feelings of guilt for not using the intervention as suggested or not making any behavioral changes, as well as technical and navigational frustrations with the intervention. Internet-based self-management interventions may have the potential to decrease diabetes-related distress in people with type 2 diabetes. The qualitative data also suggests internet interventions can positively impact both psychological and behavioural outcomes of adults with type 2 diabetes.

The Impact of an Internet-Based Self-Management Intervention (HeLP-Diabetes) on the Psychological Well-Being of Adults with Type 2 Diabetes: A Mixed-Method Cohort Study

PubMed Central

Hofmann, Megan; Dack, Charlotte; Barker, Chris; Murray, Elizabeth

2016-01-01

This mixed-method study assessed the impact of an internet-based, self-management intervention (“HeLP-Diabetes”) on the psychological well-being of adults with type 2 diabetes. Nineteen participants were recruited from 3 general practices. Data were collected at baseline and at 6 weeks follow-up. Access to HeLP-Diabetes was associated with a significant decrease in participants' diabetes-related distress (Z = 2.04, p = 0.04, and d = 0.28). No significant differences were found in emotional distress or self-efficacy. The qualitative data found that participants reported improvements including increased self-efficacy and support, better management of low mood, greater diabetes awareness, and taking the condition more seriously. Participants also reported making improvements to their eating habits, exercise routine, and medical management. Some negative experiences associated with using the intervention were mentioned including feelings of guilt for not using the intervention as suggested or not making any behavioral changes, as well as technical and navigational frustrations with the intervention. Internet-based self-management interventions may have the potential to decrease diabetes-related distress in people with type 2 diabetes. The qualitative data also suggests internet interventions can positively impact both psychological and behavioural outcomes of adults with type 2 diabetes. PMID:26682226

Impact of porcine circovirus type 2 (PCV2) vaccination on boar semen quality and quantity using two different vaccines.

PubMed

Caspari, K; Henning, H; Schreiber, F; Maass, P; Gössl, R; Schaller, C; Waberski, D

2014-09-01

Porcine circovirus type-2 (PCV2) is widespread in domestic pig populations. It can be shed with boar semen, but the role boars have in epidemiology is still unclear. Vaccinating boars against PCV2 can reduce disease and virus load in semen, but may have unwanted side effects, that is, impairment of spermatogenesis. Therefore, the aim of this study was to investigate the effect and impact of two different PCV2 vaccines on boar semen quality and quantity. Healthy normospermic Large White boars in three groups of 12 each were vaccinated with either Circovac, Ingelvac CircoFLEX, or received NaCl. Eight ejaculates were collected starting 1 week after vaccination and assessed for quantitative traits. In general, sperm quantity and quality parameters did not change due to the vaccination (P > 0.05). Only DNA integrity between the Circovac and control group was P < 0.05 but remained at a low level (<2%). One boar showed clinical signs with body temperature up to 39.9 °C and went off feed. For this animal, a clear relation between vaccination, fever period, and impaired sperm quality could be observed. The results indicate that both vaccines did not have a major impact on sperm quality or quantity. Therefore, vaccination of boars against PCV2 seems to be feasible. However, one boar treated with the oil-based vaccine showed a temporarily impaired semen quality after elevated body temperature after vaccination. Thus, possible systemic reactions and the subsequent impact on sperm quality should be taken into account when choosing a PCV2 vaccine for boars. Copyright © 2014 Elsevier Inc. All rights reserved.

Load assumptions for the landing impact of seaplanes

NASA Technical Reports Server (NTRS)

Taub, Josef

1931-01-01

The formula for the impact of floats must include the enlargement factor itself as well as the type of enlargement. The latter is preferably characterized by the change in surface loading. It is shown that the enlargement of a small seaplane generally results in a changed float (or boat) loading as well as wing loading. The conditions of starting stipulate the retention of the float loading when changing from single-float (boat) to twin-float arrangement. This contingency is followed by an increased impact factor in the twin-float type against the otherwise equivalent single-float type.

The nature of organic records in impact excavated rocks on Mars

PubMed Central

Montgomery, W.; Bromiley, G. D.; Sephton, M. A.

2016-01-01

Impact ejected rocks are targets for life detection missions to Mars. The Martian subsurface is more favourable to organic preservation than the surface owing to an attenuation of radiation and physical separation from oxidising materials with increasing depth. Impact events bring materials to the surface where they may be accessed without complicated drilling procedures. On Earth, different assemblages of organic matter types are derived from varying depositional environments. Here we assess whether these different types of organic materials can survive impact events without corruption. We subjected four terrestrial organic matter types to elevated pressures and temperatures in piston-cylinder experiments followed by chemical characterisation using whole-rock pyrolysis-gas chromatography-mass spectrometry. Our data reveal that long chain hydrocarbon-dominated organic matter (types I and II; mainly microbial or algal) are unresistant to pressure whereas aromatic hydrocarbon-dominated organic matter types (types III and IV; mainly land plant, metamorphosed or degraded, displaying some superficial chemical similarities to abiotic meteoritic organic matter) are relatively resistant. This suggests that the impact excavated record of potential biology on Mars will be unavoidably biased, with microbial organic matter underrepresented while metamorphosed, degraded or abiotic meteoritic organic matter types will be selectively preserved. PMID:27492071

Impacts of sodium-glucose co-transporter type 2 inhibitors on central blood pressure.

PubMed

Takenaka, Tsuneo; Ohno, Yoichi; Suzuki, Hiromichi

2018-03-01

To assess the effects of sodium-glucose co-transporter type 2 inhibitors on central blood pressure, an important determinant of cardiovascular events. Canagliflozin, Empagliflozin or Luseogliflozin was given for 102 type 2 diabetic patients with hypertension and nephropathy. Central blood pressure was evaluated by radial tonometry. Clinical parameters were followed for 6 months. Three differing sodium-glucose co-transporter type 2 inhibitors similarly reduced brachial and central blood pressures, casual blood sugar, haemoglobin A1c, estimated glomerular filtration rate and albuminuria without significant changes in pulse rate and lipid profiles. Central systolic blood pressure was associated with the decreases in albuminuria by sodium-glucose co-transporter type 2 inhibitors. Comparable influences of various sodium-glucose co-transporter type 2 inhibitors on central blood pressure suggest class effects.

Driver Mortality in Paired Side Impact Collisions Due to Incompatible Vehicle Types

PubMed Central

Crandall, C.S.

2003-01-01

Using a matched case control design, this study measured the mortality associated with paired passenger car-sport utility vehicle side impact (‘T-bone’) collisions using FARS data. Survival versus fatal outcome within the matched crash pairs was measured with matched pair odds ratios. Conditional logistic regression adjusted for multiple effects. Overall, passenger car drivers experienced greater mortality than did SUV drivers, regardless if they were in the struck or striking vehicle (odds ratio: 10.0; 95% confidence interval: 7.9, 12.5). Differential mortality persisted after adjustment for confounders. Efforts should be sought to improve passenger car side impact crashworthiness and to reduce SUV aggressivity. PMID:12941243

First-phase insulin secretion has limited impact on postprandial glycemia in subjects with type 2 diabetes: correlations between hyperglycemic glucose clamp and meal test.

PubMed

Rave, Klaus; Sidharta, Patricia N; Dingemanse, Jasper; Heinemann, Lutz; Roggen, Kerstin

2010-02-01

Lack of first-phase insulin (INS) secretion is regarded as causative for high postprandial glucose excursions in subjects with type 2 diabetes. We aimed to determine the impact of early INS secretion on postprandial glycemia. Twenty subjects with type 2 diabetes (age 54 +/- 8 years, body mass index 28.7 +/- 2.7 kg/m(2) [mean +/- SD]) underwent a hyperglycemic glucose clamp and a meal test twice separated by a washout period of 4 weeks. Multiple regression analysis was used to identify determinants of postprandial glycemia. During hyperglycemic glucose clamps eight subjects showed a preserved first-phase INS secretion (P1+), whereas 12 subjects showed none (P1-). Both subject groups differed in fasting blood glucose (BG) (116 +/- 7 vs. 147 +/- 31 mg/dL, P = 0.011) and glycosylated hemoglobin (6.0 +/- 0.4 vs. 6.7 +/- 0.8, P = 0.041). Total INS secretory response during glucose clamps was higher in P1+ than P1- (INS-area under the concentration vs. time curve [AUC](0-120 min) 6.7 +/- 2.7 vs. 3.2 +/- 2.1 mU.min/mL; P = 0.006). During meal tests, however, INS-AUC(0-120 min) was similar between P1+ and P1-, whereas early INS secretion was still different (INS-AUC(0-60 min) 3.9 +/- 1.8 vs. 2.1 +/- 1.0 mU.min/mL; P = 0.031). Despite higher INS-AUC(0-60 min) in P1+, early postprandial BG was comparable between groups (BG-AUC(0-60 min) 1.5 +/- 0.5 vs. 1.6 +/- 0.6 g.min/dL; difference not significant). Multiple regression analyses showed no impact of first-phase INS secretion on postprandial glycemia, either in P1+ or in P1-. Nevertheless, in P1-, but not in P1+, postprandial glycemia was negatively correlated with INS sensitivity (R(2) = 0.83, P < 0.001). This study, correlating results of hyperglycemic glucose clamps with meal tests, shows that a preserved first-phase INS secretion has only a limited impact on postprandial glucose excursions in a group of subjects in early-stage type 2 diabetes.

Note: Heated flyer-plate impact system

NASA Astrophysics Data System (ADS)

Dolan, D. H.; Seagle, C. T.; Ao, T.; Hacking, R. G.

2014-07-01

A technique for launching heated flyer plates was developed on a single-stage gas gun. This type of impact creates a well-posed mechanical state and a tunable thermal state, which is useful for calibrating dynamic temperature measurements. Proof-of-principle thermoreflectance measurements were performed using this technique. Since the target remains at room temperature until the moment of impact, heated flyers avoid differential expansion and annealing issues, allowing novel impact experiments to be performed.

Note: Heated flyer-plate impact system.

PubMed

Dolan, D H; Seagle, C T; Ao, T; Hacking, R G

2014-07-01

A technique for launching heated flyer plates was developed on a single-stage gas gun. This type of impact creates a well-posed mechanical state and a tunable thermal state, which is useful for calibrating dynamic temperature measurements. Proof-of-principle thermoreflectance measurements were performed using this technique. Since the target remains at room temperature until the moment of impact, heated flyers avoid differential expansion and annealing issues, allowing novel impact experiments to be performed.

Impact of Environmental Factors and Biological Soil Crust Types on Soil Respiration in a Desert Ecosystem

PubMed Central

Feng, Wei; Zhang, Yuqing; Jia, Xin; Wu, Bin; Zha, Tianshan; Qin, Shugao; Wang, Ben; Shao, Chenxi; Liu, Jiabin; Fa, Keyu

2014-01-01

The responses of soil respiration to environmental conditions have been studied extensively in various ecosystems. However, little is known about the impacts of temperature and moisture on soils respiration under biological soil crusts. In this study, CO2 efflux from biologically-crusted soils was measured continuously with an automated chamber system in Ningxia, northwest China, from June to October 2012. The highest soil respiration was observed in lichen-crusted soil (0.93±0.43 µmol m−2 s−1) and the lowest values in algae-crusted soil (0.73±0.31 µmol m−2 s−1). Over the diurnal scale, soil respiration was highest in the morning whereas soil temperature was highest in the midday, which resulted in diurnal hysteresis between the two variables. In addition, the lag time between soil respiration and soil temperature was negatively correlated with the soil volumetric water content and was reduced as soil water content increased. Over the seasonal scale, daily mean nighttime soil respiration was positively correlated with soil temperature when moisture exceeded 0.075 and 0.085 m3 m−3 in lichen- and moss-crusted soil, respectively. However, moisture did not affect on soil respiration in algae-crusted soil during the study period. Daily mean nighttime soil respiration normalized by soil temperature increased with water content in lichen- and moss-crusted soil. Our results indicated that different types of biological soil crusts could affect response of soil respiration to environmental factors. There is a need to consider the spatial distribution of different types of biological soil crusts and their relative contributions to the total C budgets at the ecosystem or landscape level. PMID:25050837

The impact of flavour, device type and warning messages on youth preferences for electronic nicotine delivery systems: evidence from an online discrete choice experiment.

PubMed

Shang, Ce; Huang, Jidong; Chaloupka, Frank J; Emery, Sherry L

2017-11-02

To examine the impact of flavour, device type and health warning messages on youth preference for electronic nicotine delivery systems (ENDS), and to provide evidence and data to inform the Food and Drug Administration's potential regulatory actions on ENDS. An online discrete choice experiment was conducted in September 2015. Each participant was given nine choice sets and asked to choose one out of two alternative ENDS products, with varying characteristics in three attributes (flavour, device type and warning message). The impact of the attributes on the probability of choosing ENDS was analysed using conditional and nested logit regressions, controlling for individual sociodemographic characteristics and current smoking status. A general population sample of 515 participants (50 ever-users and 465 never-users of ENDS) aged 14-17 years were recruited to complete the experiment using an online panel. Fruit/sweets/beverage flavours significantly increase the probability of choosing ENDS among youth (p<0.01 for never-users and <0.1 for ever-users) and flavour has the most pronounced impact among three attributes. Among never-users, menthol flavour also increases (p<0.05) the probability of choosing ENDS compared with tobacco flavour. Vaping devices that are modifiable, compared with cigarette-like e-cigarettes, increase (p<0.05) the probability of choosing ENDS among adolescent never-users. Warning messages reduce (p<0.01) the probability of choosing ENDS among never-users. Restricting fruit/sweets/beverage flavours in ENDS, regulating modifiable vaping devices and adopting strong health warning messages may reduce the uptake of ENDS among youth. © 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.

The modulation of tumor vessel permeability by thalidomide and its impacts on different types of targeted drug delivery systems in a sarcoma mouse model.

PubMed

Wang, Dan; Fu, Jijun; Shi, Yujie; Peng, Dong; Yuan, Lan; He, Bing; Dai, Wenbing; Zhang, Hua; Wang, Xueqing; Tian, Jie; Zhang, Qiang

2016-09-28

The transport of nanocarriers is supposed to be based on EPR effect which is affected by diverse factors, so the modulation of EPR effect seems very significant for nanocarriers including targeted drug delivery systems (TDDSs). Besides, it is extremely unclear how the EPR effect impacts the fate of different types of TDDSs. To make the most advantage of EPR effect for TDDSs, it is definitely necessary to clarify these key issues. Here, we construct and characterize various TDDSs, including sterically-stabilized liposomes (SSL), RGD functionalized SSL (RGD-SSL) and novel 7PEP functionalized SSL (7PEP-SSL), loaded with doxorubicin (DOX), DIR or DID. Here, we modulate the permeability of tumor vessels by thalidomide (THD) in a sarcoma-bearing EPR mouse model via monitoring endogenous deoxygenated hemoglobin in circulation, and then we confirm the effect of THD on tumor vessel permeability by vessel density, vessel maturity, VEGF expression and so on. Importantly, we investigate and find the impacts of EPR effect on the antitumor efficacy, in vivo distribution and intratumoral microdistribution of the three TDDSs. Interestingly, the EPR effects affect different TDDSs differently. The elevated EPR effect enhances the tumor accumulation of SSL and RGD-SSL but fails to increase their efficacy. The RGD-SSL exhibits the best efficacy with the least fluctuation, demonstrating the advantage of angiogenesis targeted systems. 7PEP-SSL seems the biggest beneficiary of EPR effect, suggesting the significance of EPR modulation for cells targeted systems. Generally, this study demonstrates the feasibility of modulating EPR effect bidirectionally by THD as well as the impacts of EPR effect on different type of testing TDDSs based on this animal model. It certainly provides novel insight into the design and potential use of TDDSs. Copyright © 2016 Elsevier B.V. All rights reserved.

Impact of a structured multicomponent educational intervention program on metabolic control of patients with type 2 diabetes.

PubMed

do Rosário Pinto, Maria; Parreira, Pedro Miguel Dinis Santos; Basto, Marta Lima; Dos Santos Mendes Mónico, Lisete

2017-12-15

Diabetes is one of the most common metabolic disorders, with a high prevalence of patients with poor metabolic control. Worldwide, evidence highlights the importance of developing and implementing educational interventions that can reduce this burden. The main objective of this study was to analyse the impact of a lifestyle centred intervention on glycaemic control of poorly controlled type 2 diabetic patients, followed in a Community Care Centre. A type 2 experimental design was conducted over 6 months, including 122 adults with HbA1c ≥ 7.5%, randomly allocated into Experimental group (EG) or Control Group (CG). EG patients attended a specific Educational Program while CG patients frequented usual care. Personal and health characterization variables, clinical metrics and self-care activities were measured before and after the implementation of the intervention. Analysis was done by comparing gains between groups (CG vs EG) through differential calculations (post minus pre-test results) and Longitudinal analysis. Statistical differences were obtained between groups for HbA1c and BMI: EG had a decrease in 11% more (effect-size r2 = .11) than CG for HbA1c (p < .001) and 4% more (effect-size r2 = .04) in BMI (p < .05). When controlling for socioeconomic characteristics and comorbidities that showed to be associated to each parameter in pre-test, from pre to post-test only EG participants significantly decreased HbA1c [Wilks' ʎ = .702; F(1,57) = 24.16; p < .001; ηp2 = .298; observed power = .998]; BMI values [Wilks' ʎ = .900; F(1,59) = 6.57; p = .013; ηp2 = .100; observed power = .713]; systolic Blood pressure [Wilks' ʎ = .735; F(1,61) = 21.94; p < .001; ηp2 = .265; observed power = .996] and diastolic Blood pressure [Wilks' ʎ = .795; F(1,59) = 15.20; p < .001; ηp2 = .205; observed power = .970]. The impact of a structured multicomponent educational

The impact crater as a habitat: effects of impact processing of target materials.

PubMed

Cockell, Charles S; Osinski, Gordon R; Lee, Pascal

2003-01-01

Impact structures are a rare habitat on Earth. However, where they do occur they can potentially have an important influence on the local ecology. Some of the types of habitat created in the immediate post-impact environment are not specific to the impact phenomenon, such as hydrothermal systems and crater lakes that can be found, for instance, in post-volcanic environments, albeit with different thermal characteristics than those associated with impact. However, some of the habitats created are specifically linked to processes of impact processing. Two examples of how impact processing of target materials has created novel habitats that improve the opportunities for colonization are found in the Haughton impact structure in the Canadian High Arctic. Impact-shocked rocks have become a habitat for endolithic microorganisms, and large, impact-shattered blocks of rock are used as resting sites by avifauna. However, some materials produced by an impact, such as melt sheet rocks, can make craters more biologically depauperate than the area surrounding them. Although there are no recent craters with which to study immediate post-impact colonization, these data yield insights into generalized mechanisms of how impact processing can influence post-impact succession. Because impact events are one of a number of processes that can bring localized destruction to ecosystems, understanding the manner in which impact structures are recolonized is of ecological interest. Impact craters are a universal phenomenon on solid planetary surfaces, and so they are of potential biological relevance on other planetary surfaces, particularly Mars.

The impact crater as a habitat: effects of impact processing of target materials

NASA Technical Reports Server (NTRS)

Cockell, Charles S.; Osinski, Gordon R.; Lee, Pascal

2003-01-01

Impact structures are a rare habitat on Earth. However, where they do occur they can potentially have an important influence on the local ecology. Some of the types of habitat created in the immediate post-impact environment are not specific to the impact phenomenon, such as hydrothermal systems and crater lakes that can be found, for instance, in post-volcanic environments, albeit with different thermal characteristics than those associated with impact. However, some of the habitats created are specifically linked to processes of impact processing. Two examples of how impact processing of target materials has created novel habitats that improve the opportunities for colonization are found in the Haughton impact structure in the Canadian High Arctic. Impact-shocked rocks have become a habitat for endolithic microorganisms, and large, impact-shattered blocks of rock are used as resting sites by avifauna. However, some materials produced by an impact, such as melt sheet rocks, can make craters more biologically depauperate than the area surrounding them. Although there are no recent craters with which to study immediate post-impact colonization, these data yield insights into generalized mechanisms of how impact processing can influence post-impact succession. Because impact events are one of a number of processes that can bring localized destruction to ecosystems, understanding the manner in which impact structures are recolonized is of ecological interest. Impact craters are a universal phenomenon on solid planetary surfaces, and so they are of potential biological relevance on other planetary surfaces, particularly Mars.

Mandatory and Self-citation; Types, Reasons, Their Benefits and Disadvantages.

PubMed

Hemmat Esfe, Mohammad; Wongwises, Somchai; Asadi, Amin; Karimipour, Arash; Akbari, Mohammad

2015-12-01

This paper defines and discusses two important types of citations, self-citation and mandatory citation, in engineering journals. Citation can be classified in three categories: optional; semi-mandatory; and mandatory. There are some negative and positive impacts for the authors' paper and journals' reputation if mandatory citation of a paper or set of papers is requested. These effects can be different based on the recommended papers for citing in the new research. Mandatory citation has various types discussed in this paper. Self-citation and its reasons and impacts are also discussed in the present study.

Research of the relationship of pedestrian injury to collision speed, car-type, impact location and pedestrian sizes using human FE model (THUMS Version 4).

PubMed

Watanabe, Ryosuke; Katsuhara, Tadasuke; Miyazaki, Hiroshi; Kitagawa, Yuichi; Yasuki, Tsuyoshi

2012-10-01

Injuries in car to pedestrian collisions are affected by various factors such as the vehicle body type, pedestrian body size and impact location as well as the collision speed. This study aimed to investigate the influence of such factors taking a Finite Element (FE) approach. A total of 72 collision cases were simulated using three different vehicle FE models (Sedan, SUV, Mini-Van), three different pedestrian FE models (AM50, AF05, AM95), assuming two different impact locations (center and the corner of the bumper) and at four different collision speeds (20, 30, 40 and 50 km/h). The impact kinematics and the responses of the pedestrian model were validated against those in the literature prior to the simulations. The relationship between the collision speed and the predicted occurrence of head and chest injuries was examined for each case, analyzing the impact kinematics of the pedestrian against the vehicle body and resultant loading to the head and the chest. Strain based indicators were used in the simulation model to estimate skeletal injury (bony fracture) and soft tissue (brain and internal organs) injury. The study results primarily showed that the injury risk became higher with the collision speed, but was also affected by the combination of the factors such as the pedestrian size and the impact location. The study also discussed the injury patterns and trends with respect to the factors examined. In all of the simulated conditions, the model did not predict any severe injury at a collision speed of 20 km/h.

Fiber composite fan blade impact improvement

NASA Technical Reports Server (NTRS)

Graff, J.; Stoltze, L.; Varholak, E. M.

1976-01-01

The improved foreign object damage resistance of a metal matrix advanced composite fan blade was demonstrated. The fabrication, whirl impact test and subsequent evaluation of nine advanced composite fan blades of the "QCSEE" type design were performed. The blades were designed to operate at a tip speed of 282 m/sec. The blade design was the spar/shell type, consisting of a titanium spar and boron/aluminum composite airfoils. The blade retention was designed to rock on impact with large birds, thereby reducing the blade bending stresses. The program demonstrated the ability of the blades to sustain impacts with up to 681 g slices of birds at 0.38 rad with little damage (only 1.4 percent max weight loss) and 788 g slices of birds at 0.56 rad with only 3.2 percent max weight loss. Unbonding did not exceed 1.1 percent of the post-test blade area during any of the tests. All blades in the post-test condition were judged capable of operation in accordance with the FAA guidelines for medium and large bird impacts.

The impact of fasting during Ramadan on the glycemic control of patients with type 2 diabetes mellitus.

PubMed

Sahin, S B; Ayaz, T; Ozyurt, N; Ilkkilic, K; Kirvar, A; Sezgin, H

2013-10-01

Millions of Muslims fast from dawn until dusk during the annual Islamic holy month of Ramadan. Most of the studies evaluating biochemical changes in diabetic patients during Ramadan showed little changes in the glycemic control. In this study, our aim was to assess the impact of fasting during Ramadan on glycemic control in patients with type 2 diabetes. We examined 122 patients with type 2 diabetes (82 female, 40 male, age 56.93 ± 9.57 years) before and after the Ramadan. 66.4% of the patients were treated with oral antidiabetic (OAD) alone, 6.5% with a combination of insulin plus OAD and 19.7% with insulin alone. 88 of 122 patients fasted during Ramadan (26.98 ± 5.93 days). Weight, body mass index (BMI), waist circumference, blood pressure, fasting plasma glucose (FPG), postprandial glucose (PPG), fructosamine, HbA1c, fasting insulin and lipid parameters were measured. The frequencies of both severe hyperglycemia and hypoglycemia were higher in the fasting group, but the difference was not significant (p=0.18). Weight, BMI, waist circumference, blood pressure, FPG (143.38 ± 52.04 vs. 139.31 ± 43.47 mg/dl) PPG (213.40 ± 98.56 vs. 215.66+109.31 mg/dl), fructosamine (314.18 ± 75.40 vs. 314.49 ± 68.36 µmol/l), HbA1c (6.33 ± 0.98 vs. 6.22 ± 0.92%) and fasting insulin (12.61 ± 8.94 vs. 10.51 ± 6.26 µU/ml) were unchanged in patients who fasted during Ramadan. Microalbuminuria significantly decreased during Ramadan (132.85 ± 197.11 vs. 45.03 ± 73.11 mg/dl). In this study, we concluded that fasting during Ramadan did not worsen the glycemic control of patients with type 2 diabetes. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.

The Impact of Patient-Centered versus Didactic Education Programs in Chronic Patients by Severity: The Case of Type 2 Diabetes Mellitus.

PubMed

Windrum, Paul; García-Goñi, Manuel; Coad, Holly

2016-06-01

Education leads to better health-related decisions and protective behaviors, being especially important for patients with chronic conditions. Self-management education programs have been shown to be beneficial for patients with different chronic conditions and to have a higher impact on health outcomes than does didactic education. To investigate improvements in glycemic control (measured by glycated hemoglobin A1c) in patients with type 2 diabetes mellitus. Our comparative trial involved one group of patients receiving patient-centered education and another receiving didactic education. We dealt with selection bias issues, estimated the different impact of both programs, and validated our analysis using quantile regression techniques. We found evidence of better mean glycemic control in patients receiving the patient-centered program, which engaged better patients. Nevertheless, that differential impact is nonmonotonic. Patients initially at the healthy range at the patient-centered program maintained their condition better. Patients close to, but not within, the healthy range benefited equally from attending either program. Patients with very high glycemic level benefited significantly more from attending the patient-centered program. Finally, patients with the worst initial glycemic control (far from the healthy range) improved equally their diabetic condition, regardless of which program they attended. Different patients are sensitive to different categories of education programs. The optimal, cost-effective design of preventative programs for patients with chronic conditions needs to account for the different impact in different "patient categories." This implies stratifying patients and providing the appropriate preventative education program, or looking for alternative policy implementations for unresponsive patients who have the most severe condition and are the most costly. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research

Fuel Consumption and Fire Emissions Estimates in Siberia: Impact of Vegetation Types, Meteorological Conditions, Forestry Practices and Fire Regimes

NASA Astrophysics Data System (ADS)

Kukavskaya, Elena; Conard, Susan; Ivanova, Galina; Buryak, Ludmila; Soja, Amber; Zhila, Sergey

2015-04-01

Boreal forests play a crucial role in carbon budgets with Siberian carbon fluxes and pools making a major contribution to the regional and global carbon cycle. Wildfire is the main ecological disturbance in Siberia that leads to changes in forest species composition and structure and in carbon storage, as well as direct emissions of greenhouse gases and aerosols to the atmosphere. At present, the global scientific community is highly interested in quantitative and accurate estimates of fire emissions. Little research on wildland fuel consumption and carbon emission estimates has been carried out in Russia until recently. From 2000 to 2007 we conducted a series of experimental fires of varying fireline intensity in light-coniferous forest of central Siberia to obtain quantitative and qualitative data on fire behavior and carbon emissions due to fires of known behavior. From 2009 to 2013 we examined a number of burned logged areas to assess the potential impact of forest practices on fire emissions. In 2013-2014 burned areas in dark-coniferous and deciduous forests were examined to determine fuel consumption and carbon emissions. We have combined and analyzed the scarce data available in the literature with data obtained in the course of our long-term research to determine the impact of various factors on fuel consumption and to develop models of carbon emissions for different ecosystems of Siberia. Carbon emissions varied drastically (from 0.5 to 40.9 tC/ha) as a function of vegetation type, weather conditions, anthropogenic effects and fire behavior characteristics and periodicity. Our study provides a basis for better understanding of the feedbacks between wildland fire emissions and changing anthropogenic disturbance patterns and climate. The data obtained could be used by air quality agencies to calculate local emissions and by managers to develop strategies to mitigate negative smoke impacts on the environmentand human health.

Impacts of precipitation seasonality and ecosystem types on evapotranspiration in the Yukon River Basin, Alaska

USGS Publications Warehouse

Yuan, W.; Liu, S.; Liu, H.; Randerson, J.T.; Yu, G.; Tieszen, L.L.

2010-01-01

Evapotranspiration (ET) is the largest component of water loss from terrestrial ecosystems; however, large uncertainties exist when estimating the temporal and spatial variations of ET because of concurrent shifts in the magnitude and seasonal distribution of precipitation as well as differences in the response of ecosystem ET to environmental variabilities. In this study, we examined the impacts of precipitation seasonality and ecosystem types on ET quantified by eddy covariance towers from 2002 to 2004 in three ecosystems (grassland, deciduous broadleaf forest, and evergreen needleleaf forest) in the Yukon River Basin, Alaska. The annual precipitation changed greatly in both magnitude and seasonal distribution through the three investigated years. Observations and model results showed that ET was more sensitive to precipitation scarcity in the early growing season than in the late growing season, which was the direct result of different responses of ET components to precipitation in different seasons. The results demonstrated the importance of seasonal variations of precipitation in regulating annual ET and overshadowing the function of annual precipitation. Comparison of ET among ecosystems over the growing season indicated that ET was largest in deciduous broadleaf, intermediate in evergreen needleleaf, and lowest in the grassland ecosystem. These ecosystem differences in ET were related to differences in successional stages and physiological responses.

Differences in the prevalence and impact of risk factors for general recidivism between different types of juveniles who have committed sexual offenses (JSOs) and juveniles who have committed nonsexual offenses (NSOs).

PubMed

van der Put, Claudia E; van Vugt, Eveline S; Stams, Geert Jan J M; Deković, Maja; van der Laan, Peter H

2013-02-01

To date, there is surprisingly little research on differences in the prevalence and impact of risk factors for general recidivism between juveniles who have committed sexual offenses (JSO) and juveniles who have committed nonsexual offenses (NSO). Therefore, we examined differences in the prevalence and impact of dynamic risk factors for general delinquency between youth with nonsexual offenses (NSO, n = 504), youth with misdemeanor sexual offenders (MSO, n = 136), youth with felony sexual offenders (FSO, n = 116) and youth with offenses against much younger children (CSO, n = 373). The sample consisted of boys with a mean age of 15.3 years (SD = 1.5). The prevalence of dynamic risk factors for general delinquency was significantly lower in JSOs than in NSOs. More serious sexual offenses were associated with a lower prevalence of dynamic risk factors. In contrast, the impact of most dynamic risk factors on general recidivism proved to be significantly larger among JSOs compared to NSOs. The relative importance of the dynamic risk factors varied for each type of JSO, resulting in differences in the dynamic risk profiles of the various types of JSOs.

Evidence-based practice implementation: the impact of public versus private sector organization type on organizational support, provider attitudes, and adoption of evidence-based practice.

PubMed

Aarons, Gregory A; Sommerfeld, David H; Walrath-Greene, Christine M

2009-12-31

The goal of this study is to extend research on evidence-based practice (EBP) implementation by examining the impact of organizational type (public versus private) and organizational support for EBP on provider attitudes toward EBP and EBP use. Both organization theory and theory of innovation uptake and individual adoption of EBP guide the approach and analyses in this study. We anticipated that private sector organizations would provide greater levels of organizational support for EBPs leading to more positive provider attitudes towards EBPs and EBP use. We also expected attitudes toward EBPs to mediate the association of organizational support and EBP use. Participants were mental health service providers from 17 communities in 16 states in the United States (n = 170). Path analyses were conducted to compare three theoretical models of the impact of organization type on organizational support for EBP and of organizational support on provider attitudes toward EBP and EBP use. Consistent with our predictions, private agencies provided greater support for EBP implementation, and staff working for private agencies reported more positive attitudes toward adopting EBPs. Organizational support for EBP partially mediated the association of organization type on provider attitudes toward EBP. Organizational support was significantly positively associated with attitudes toward EBP and EBP use in practice. This study offers further support for the importance of organizational context as an influence on organizational support for EBP and provider attitudes toward adopting EBP. The study demonstrates the role organizational support in provider use of EBP in practice. This study also suggests that organizational support for innovation is a malleable factor in supporting use of EBP. Greater attention should be paid to organizational influences that can facilitate the dissemination and implementation of EBPs in community settings.

Utility Sector Impacts of Reduced Electricity Demand

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

Coughlin, Katie

2014-12-01

This report presents a new approach to estimating the marginal utility sector impacts associated with electricity demand reductions. The method uses publicly available data and provides results in the form of time series of impact factors. The input data are taken from the Energy Information Agency's Annual Energy Outlook (AEO) projections of how the electric system might evolve in the reference case, and in a number of side cases that incorporate different effciency and other policy assumptions. The data published with the AEO are used to define quantitative relationships between demand-side electricity reductions by end use and supply-side changes tomore » capacity by plant type, generation by fuel type and emissions of CO2, Hg, NOx and SO2. The impact factors define the change in each of these quantities per unit reduction in site electricity demand. We find that the relative variation in these impacts by end use is small, but the time variation can be significant.« less

Impact of Age and Antibody Type on Progression From Single to Multiple Autoantibodies in Type 1 Diabetes Relatives.

PubMed

Bosi, Emanuele; Boulware, David C; Becker, Dorothy J; Buckner, Jane H; Geyer, Susan; Gottlieb, Peter A; Henderson, Courtney; Kinderman, Amanda; Sosenko, Jay M; Steck, Andrea K; Bingley, Polly J

2017-08-01

Islet autoantibodies are markers of type 1 diabetes, and an increase in number of autoantibodies detected during the preclinical phase predicts progression to overt disease. To refine the effect of age in relation to islet antibody type on progression from single to multiple autoantibodies in relatives of people with type 1 diabetes. We examined 994 relatives with normal glucose tolerance who were positive for a single autoantibody, followed prospectively in the TrialNet Pathway to Prevention. Antibodies to glutamic acid decarboxylase (GADA), insulin (IAA), insulinoma-associated antigen 2, and zinc transporter 8 and islet cell antibodies were tested every 6 to 12 months. The primary outcome was confirmed development of multiple autoantibodies. Age was categorized as <8 years, 8 to 11 years, 12 to 17 years, and ≥18 years, and optimal age breakpoints were identified by recursive partitioning analysis. After median follow-up of 2 years, 141 relatives had developed at least one additional autoantibodies. Five-year risk was inversely related to age, but the pattern differed by antibody type: Relatives with GADA showed a gradual decrease in risk over the four age groups, whereas relatives with IAA showed a sharp decrease above age 8 years. Recursive partitioning analysis identified age breakpoints at 14 years in relatives with GADA and at 4 years in relatives with IAA. In relatives with IAA, spread of islet autoimmunity is largely limited to early childhood, whereas immune responses initially directed at glutamic acid decarboxylase can mature over a longer period. These differences have important implications for monitoring these patients and for designing prevention trials. Copyright © 2017 Endocrine Society

Impact of three-phase bone scintigraphy on the diagnosis and treatment of complex regional pain syndrome type I or reflex sympathetic dystrophy.

PubMed

Shehab, Dia; Elgazzar, Abdelhamid; Collier, B David; Naddaf, Sleiman; Al-Jarallah, Khalid; Omar, Abdelmoneim; Al-Mutairy, Moudi

2006-01-01

To determine the impact of three-phase bone scintigraphy (TPBS) on the diagnosis and management of complex regional pain syndrome type I (CRPSI) or reflex sympathetic dystrophy (RSD). Twenty consecutive patients with a recent clinical evidence of CRPSI were referred for TPBS as part of their routine management plan. All patients underwent neurological examinations with special attention to the evaluation of clinical features of vasomotor, sudomotor, motor and sensory dysfunction. Patients were followed prospectively. When both the clinical and TPBS results supported the diagnosis of CRPSI, patients were started on treatment. Of the 20 patients, TPBS supported the diagnosis of RSD in 9 who were treated with steroids and physiotherapy. Complete follow-up was available for 7 of them and all had a satisfactory response to treatment. For the remaining 11 patients RSD was diagnosed clinically but not confirmed by TPBS. On follow-up there was no evidence that TPBS failed to identify RSD in these 11 patients. The results indicate that TPBS confirmed the clinical diagnosis of RSD, and, more importantly, had a significant impact on its management.

Impact of Haemophilus influenzae type b vaccination on the incidence of invasive Haemophilus influenzae disease in France, 15 years after its introduction.

PubMed

Georges, S; Lepoutre, A; Dabernat, H; Levy-Bruhl, D

2013-09-01

We assessed the impact of Haemophilus influenzae type b (Hib) vaccination, introduced in France in early 1993, on the incidence of invasive Haemophilus influenzae (Hi) disease up to 2008.The incidence of Hi meningitis fell from 0·9/100000 in 1991–1992 to 0·09/100 000 in 1996–2008,with a marked decline (96%) in children aged <5 years, including infants aged <3 months, from 12 to 0·4 /100 000. The incidence of invasive Hi disease also decreased in children aged <15 years from 6 to 0·7 /100 000, remained stable in the 15–64 years age group at about 0·5/100 000,and increased slightly from 2·0 to 2·4 /100 000 in persons aged >64 years. No emergence of non-encapsulated or encapsulated non-vaccine serotypes was observed. These findings confirm the major direct impact of Hib vaccination on the incidence of Hi invasive disease in children and the indirect benefit of vaccination for infants too young to be vaccinated.

The influence of sampling interval on the accuracy of trail impact assessment

USGS Publications Warehouse

Leung, Y.-F.; Marion, J.L.

1999-01-01

Trail impact assessment and monitoring (IA&M) programs have been growing in importance and application in recreation resource management at protected areas. Census-based and sampling-based approaches have been developed in such programs, with systematic point sampling being the most common survey design. This paper examines the influence of sampling interval on the accuracy of estimates for selected trail impact problems. A complete census of four impact types on 70 trails in Great Smoky Mountains National Park was utilized as the base data set for the analyses. The census data were resampled at increasing intervals to create a series of simulated point data sets. Estimates of frequency of occurrence and lineal extent for the four impact types were compared with the census data set. The responses of accuracy loss on lineal extent estimates to increasing sampling intervals varied across different impact types, while the responses on frequency of occurrence estimates were consistent, approximating an inverse asymptotic curve. These findings suggest that systematic point sampling may be an appropriate method for estimating the lineal extent but not the frequency of trail impacts. Sample intervals of less than 100 m appear to yield an excellent level of accuracy for the four impact types evaluated. Multiple regression analysis results suggest that appropriate sampling intervals are more likely to be determined by the type of impact in question rather than the length of trail. The census-based trail survey and the resampling-simulation method developed in this study can be a valuable first step in establishing long-term trail IA&M programs, in which an optimal sampling interval range with acceptable accuracy is determined before investing efforts in data collection.

On the relationship between the snowflake type aloft and the surface precipitation types at temperatures near 0 °C

NASA Astrophysics Data System (ADS)

Sankaré, Housseyni; Thériault, Julie M.

2016-11-01

Winter precipitation types can have major consequences on power outages, road conditions and air transportation. The type of precipitation reaching the surface depends strongly on the vertical temperature of the atmosphere, which is often composed of a warm layer aloft and a refreezing layer below it. A small variation of the vertical structure can lead to a change in the type of precipitation near the surface. It has been shown in previous studies that the type of precipitation depends also on the precipitation rate, which is directly linked to the particle size distribution and that a difference as low as 0.5 °C in the vertical temperature profile could change the type of precipitation near the surface. Given the importance of better understanding the formation of winter precipitation type, the goal of this study is to assess the impact of the snowflake habit aloft on the type of precipitation reaching the surface when the vertical temperature is near 0 °C. To address this, a one dimensional cloud model coupled with a bulk microphysics scheme was used. Four snowflake types (dendrite, bullet, column and graupel) have been added to the scheme. The production of precipitation at the surface from these types of snow has been compared to available observations. The results showed that the thickness of the snow-rain transition is four times deeper when columns and graupel only fall through the atmosphere compared to dendrites. Furthermore, a temperature of the melting layer that is three (four) times warmer is required to completely melt columns and graupel (dendrites). Finally, the formation of freezing rain is associated with the presence of lower density snowflakes (dendrites) aloft compared to the production of ice pellets (columns). Overall, this study demonstrated that the type of snowflakes has an impact on the type of precipitation reaching the surface when the temperature is near 0 °C.

Two types of Cassie-to-Wenzel wetting transitions on superhydrophobic surfaces during drop impact.

PubMed

Lee, Choongyeop; Nam, Youngsuk; Lastakowski, Henri; Hur, Janet I; Shin, Seungwon; Biance, Anne-Laure; Pirat, Christophe; Kim, Chang-Jin C J; Ybert, Christophe

2015-06-21

Despite the fact that superhydrophobic surfaces possess useful and unique properties, their practical application has remained limited by durability issues. Among those, the wetting transition, whereby a surface gets impregnated by the liquid and permanently loses its superhydrophobicity, certainly constitutes the most limiting aspect under many realistic conditions. In this study, we revisit this so-called Cassie-to-Wenzel transition (CWT) under the broadly encountered situation of liquid drop impact. Using model hydrophobic micropillar surfaces of various geometrical characteristics and high speed imaging, we identify that CWT can occur through different mechanisms, and at different impact stages. At early impact stages, right after contact, CWT occurs through the well established dynamic pressure scenario of which we provide here a fully quantitative description. Comparing the critical wetting pressure of surfaces and the theoretical pressure distribution inside the liquid drop, we provide not only the CWT threshold but also the hardly reported wetted area which directly affects the surface spoiling. At a later stage, we report for the first time to our knowledge, a new CWT which occurs during the drop recoil toward bouncing. With the help of numerical simulations, we discuss the mechanism underlying this new transition and provide a simple model based on impulse conservation which successfully captures the transition threshold. By shedding light on the complex interaction between impacting water drops and surface structures, the present study will facilitate designing superhydrophobic surfaces with a desirable wetting state during drop impact.

The impact of a disease management programme for type 2 diabetes on health-related quality of life: multilevel analysis of a cluster-randomised controlled trial.

PubMed

Panisch, Sigrid; Johansson, Tim; Flamm, Maria; Winkler, Henrike; Weitgasser, Raimund; Sönnichsen, Andreas C

2018-01-01

Type 2 diabetes is a chronic disease associated with poorer health outcomes and decreased health related quality of life (HRQoL). The aim of this analysis was to explore the impact of a disease management programme (DMP) in type 2 diabetes on HRQoL. A multilevel model was used to explain the variation in EQ-VAS. A cluster-randomized controlled trial-analysis of the secondary endpoint HRQoL. Our study population were general practitioners and patients in the province of Salzburg. The DMP "Therapie-Aktiv" was implemented in the intervention group, and controls received usual care. Outcome measure was a change in EQ-VAS after 12 months. For comparison of rates, we used Fisher's Exact test; for continuous variables the independent T test or Welch test were used. In the multilevel modeling, we examined various models, continuously adding variables to explain the variation in the dependent variable, starting with an empty model, including only the random intercept. We analysed random effects parameters in order to disentangle variation of the final EQ-VAS. The EQ-VAS significantly increased within the intervention group (mean difference 2.19, p = 0.005). There was no significant difference in EQ-VAS between groups (mean difference 1.00, p = 0.339). In the intervention group the improvement was more distinct in women (2.46, p = 0.036) compared to men (1.92, p = 0.063). In multilevel modeling, sex, age, family and work circumstances, any macrovascular diabetic complication, duration of diabetes, baseline body mass index and baseline EQ-VAS significantly influence final EQ-VAS, while DMP does not. The final model explains 28.9% (EQ-VAS) of the total variance. Most of the unexplained variance was found on patient-level (95%) and less on GP-level (5%). DMP "Therapie-Aktiv" has no significant impact on final EQ-VAS. The impact of DMPs in type 2 diabetes on HRQoL is still unclear and future programmes should focus on patient specific needs and predictors in

Obstructive Sleep Apnoea and Type 2 Diabetes.

PubMed

Tahrani, Abd A; Ali, Asad

2014-02-01

With the growing prevalence of obesity, the burden of type 2 diabetes is increasing. Obstructive sleep apnoea (OSA) is a very common medical condition that is associated with increased risk of cardiovascular disease and mortality. Obesity is a common risk factor for OSA and type 2 diabetes and hence it is not surprising that OSA and type 2 diabetes are interlinked. OSA has been shown to be an independent risk factor for the development of incident pre-diabetes/type 2 diabetes. OSA is also associated with worse glycaemic control and vascular disease in patients with type 2 diabetes. However, evidence for the benefits of OSA treatment in patients with type 2 diabetes is still lacking. The aim of this article is to provide an overview of OSA, the relationships between OSA and dysglycaemia and the impact of OSA in patients with type 2 diabetes, highlighting recent advances in the field.

The Human Respiratory Syncytial Virus Nonstructural Protein 1 Regulates Type I and Type II Interferon Pathways*

PubMed Central

Hastie, Marcus L.; Headlam, Madeleine J.; Patel, Nirav B.; Bukreyev, Alexander A.; Buchholz, Ursula J.; Dave, Keyur A.; Norris, Emma L.; Wright, Cassandra L.; Spann, Kirsten M.; Collins, Peter L.; Gorman, Jeffrey J.

2012-01-01

Respiratory syncytial viruses encode a nonstructural protein (NS1) that interferes with type I and III interferon and other antiviral responses. Proteomic studies were conducted on human A549 type II alveolar epithelial cells and type I interferon-deficient Vero cells (African green monkey kidney cells) infected with wild-type and NS1-deficient clones of human respiratory syncytial virus to identify other potential pathway and molecular targets of NS1 interference. These analyses included two-dimensional differential gel electrophoresis and quantitative Western blotting. Surprisingly, NS1 was found to suppress the induction of manganese superoxide dismutase (SOD2) expression in A549 cells and to a much lesser degree Vero cells in response to infection. Because SOD2 is not directly inducible by type I interferons, it served as a marker to probe the impact of NS1 on signaling of other cytokines known to induce SOD2 expression and/or indirect effects of type I interferon signaling. Deductive analysis of results obtained from cell infection and cytokine stimulation studies indicated that interferon-γ signaling was a potential target of NS1, possibly as a result of modulation of STAT1 levels. However, this was not sufficient to explain the magnitude of the impact of NS1 on SOD2 induction in A549 cells. Vero cell infection experiments indicated that NS1 targeted a component of the type I interferon response that does not directly induce SOD2 expression but is required to induce another initiator of SOD2 expression. STAT2 was ruled out as a target of NS1 interference using quantitative Western blot analysis of infected A549 cells, but data were obtained to indicate that STAT1 was one of a number of potential targets of NS1. A label-free mass spectrometry-based quantitative approach is proposed as a means of more definitive identification of NS1 targets. PMID:22322095

[Impact of the positive appraisal of care on quality of life, purpose in life, and will to continue care among Japanese family caregivers of older adults: analysis by kinship type].

PubMed

Yamamoto-Mitani, Noriko; Ishigaki, Kazuko; Kuniyoshi, Midori; Kawahara-Maekawa, Noriko; Hasegawa, Kiyomi; Hayashi, Kunihiko; Sugishita, Chieko

2002-07-01

The impact of positive appraisal of care (PAC) on the caregiver's quality of life (QL), sense of purpose in life (sense of ikigai) and will to continue care was examined. Data were collected from 322 Japanese family caregivers of older adults who were using visiting nursing services through 21 facilities in the Tokyo metropolitan area, and the prefectures of Shizuoka, Mie and Okinawa. The data were grouped by kinship type (husband or son, wife, daughter or daughter-in-law) and analyzed separately. From the multiple regression and logistic regression analyses, the following results were derived: 1) The PAC was not related to the physical QL regardless of the relationship type; 2) The relationship depended upon the relationship type: only the PAC was related to the mental QL among husband and son caregivers, both the PAC and the negative appraisal of care (NAC) were important among wives, only the NAC among daughters, and none of them among daughters-in-law; 3) Both the PAC and NAC were related to the sense of ikigai in all caregiver types except among husband and son caregivers, which showed no relationship between the NAC and sense of ikigai; 4) Both the PAC and NAC were related to will to continue care among son and husband caregivers, whereas only the PAC was among wives and daughters-in-law. Only the NAC was related among daughters. However, the difference across kinship type seems minimal for will to continue care. Understanding the PAC among family caregivers may be important in order to better assist them to improve their mental QL or sense of ikigai as well as to predict their continuation of caregiving at home. The impact of PAC varies depending on the kinship type, and it should be assessed separately with reference to this pariable to develop plans for appropriate assistance.

Regional variations in cancer survival: Impact of tumour stage, socioeconomic status, comorbidity and type of treatment in Norway.

PubMed

Skyrud, Katrine Damgaard; Bray, Freddie; Eriksen, Morten Tandberg; Nilssen, Yngvar; Møller, Bjørn

2016-05-01

Cancer survival varies by place of residence, but it remains uncertain whether this reflects differences in tumour, patient and treatment characteristics (including tumour stage, indicators of socioeconomic status (SES), comorbidity and information on received surgery and radiotherapy) or possibly regional differences in the quality of delivered health care. National population-based data from the Cancer Registry of Norway were used to identify cancer patients diagnosed in 2002-2011 (n = 258,675). We investigated survival from any type of cancer (all cancer sites combined), as well as for the six most common cancers. The effect of adjusting for prognostic factors on regional variations in cancer survival was examined by calculating the mean deviation, defined by the mean absolute deviation of the relative excess risks across health services regions. For prostate cancer, the mean deviation across regions was 1.78 when adjusting for age and sex only, but decreased to 1.27 after further adjustment for tumour stage. For breast cancer, the corresponding mean deviations were 1.34 and 1.27. Additional adjustment for other prognostic factors did not materially change the regional variation in any of the other sites. Adjustment for tumour stage explained most of the regional variations in prostate cancer survival, but had little impact for other sites. Unexplained regional variations after adjusting for tumour stage, SES indicators, comorbidity and type of treatment in Norway may be related to regional inequalities in the quality of cancer care. © 2015 UICC.

Impact of human T cell leukemia virus type 1 in living donor liver transplantation.

PubMed

Yoshizumi, T; Shirabe, K; Ikegami, T; Kayashima, H; Yamashita, N; Morita, K; Masuda, T; Hashimoto, N; Taketomi, A; Soejima, Y; Maehara, Y

2012-06-01

Human T cell leukemia virus type 1 (HTLV-1) is an endemic retrovirus in southwestern Japan, which causes adult T cell leukemia (ATL) or HTLV-1 associated myelopathy in a minority of carriers. Here, we investigated the impact of HTLV-1 status in living donor liver transplantation (LDLT). Twenty-six of 329 (7.9%) HTLV-1 carriers underwent primary LDLT. One recipient negative for HTLV-1 before LDLT received a graft from an HTLV-1 positive donor. Eight donors were HTLV-1 positive. Twenty-seven recipients (13 male and 14 female; mean age 52.5 years) were reviewed retrospectively. ATL developed in four recipients who ultimately died. The intervals between LDLT and ATL development ranged from 181 to 1315 days. Of the four ATL recipients, two received grafts from HTLV-1 positive donors and two from negative donors. The 1-, 3- and 5-year HTLV-1 carrier survival rates were 91.3%, 78.3% and 66.3%, respectively. Fulminant hepatic failure as a pretransplant diagnosis and a pretransplant MELD score ≥ 15 was identified as risk factors for ATL development in this study (p = 0.001 and p = 0.041, respectively). In conclusion, LDLT can be performed for HTLV-1 positive recipients. However, when fulminant hepatic failure is diagnosed, LDLT should not be performed until further studies have revealed the mechanisms of ATL development. © Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.

Does footwear type impact the number of steps required to reach gait steady state?: an innovative look at the impact of foot orthoses on gait initiation.

PubMed

Najafi, Bijan; Miller, Daniel; Jarrett, Beth D; Wrobel, James S

2010-05-01

Many studies have attempted to better elucidate the effect of foot orthoses on gait dynamics. To our knowledge, most previous studies exclude the first few steps of gait and begin analysis at steady state walking. These unanalyzed steps of gait may contain important information about the dynamic and complex processes required to achieve equilibrium for a given gait velocity. The purpose of this study was to quantify gait initiation and determine how many steps were required to reach steady state walking under three footwear conditions: barefoot, habitual shoes, and habitual shoes with a prefabricated foot orthoses. Fifteen healthy subjects walked 50m at habitual speed in each condition. Wearing habitual shoes with the prefabricated orthoses enabled subjects to reach steady state walking in fewer steps (3.5 steps+/-2.0) compared to the barefoot condition (5.2 steps+/-3.0; p=0.02) as well as compared to the habitual shoes condition (4.7 steps+/-1.6; p=0.05). Interestingly, the subjects' dynamic medial-lateral balance was significantly improved (22%, p<0.05) by using foot orthoses compared to other footwear conditions. These findings suggest that foot orthoses may help individuals reach steady state more quickly and with a better dynamic balance in the medial-lateral direction, independent of foot type. The findings of this pilot study may open new avenues for objectively assessing the impact of prescription footwear on dynamic balance and spatio-temporal parameters of gait. Further work to better assess the impact of foot orthoses on gait initiation in patients suffering from gait and instability pathologies may be warranted. Copyright 2010 Elsevier B.V. All rights reserved.

On impact testing of subsize Charpy V-notch type specimens

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

Mikhail, A.S.; Nanstad, R.K.

1994-12-31

The potential for using subsize specimens to determine the actual properties of reactor pressure vessel steels is receiving increasing attention for improved vessel condition monitoring that could be beneficial for light-water reactor plant-life extension. This potential is made conditional upon, on the one hand, by the possibility of cutting samples of small volume from the internal surface of the pressure vessel for determination of actual properties of the operating pressure vessel. The plant-life extension will require supplemental surveillance data that cannot be provided by the existing surveillance programs. Testing of subsize specimens manufactured from broken halves of previously tested surveillancemore » Charpy V-notch (CVN) specimens offers an attractive means of extending existing surveillance programs. Using subsize CVN type specimens requires the establishment of a specimen geometry that is adequate to obtain a ductile-to-brittle transition curve similar to that obtained from full-size specimens. This requires the development of a correlation of transition temperature and upper-shelf toughness between subsize and full-size specimens. The present study was conducted under the Heavy-Section Steel Irradiation Program. Different published approaches to the use of subsize specimens were analyzed and five different geometries of subsize specimens were selected for testing and evaluation. The specimens were made from several types of pressure vessel steels with a wide range of yield strengths, transition temperatures, and upper-shelf energies (USEs). Effects of specimen dimensions, including depth, angle, and radius of notch have been studied. The correlation of transition temperature determined from different types of subsize specimens and the full-size specimen is presented. A new procedure for transforming data from subsize specimens was developed and is presented.« less

Prosecuting Child Sexual Abuse: The Importance of Evidence Type

ERIC Educational Resources Information Center

Walsh, Wendy A.; Jones, Lisa M.; Cross, Theodore P.; Lippert, Tonya

2010-01-01

Corroborating evidence has been associated with a decrease in children's distress during the court process, yet few studies have empirically examined the impact of evidence type on prosecution rates. This study examined the types of evidence and whether charges were filed in a sample of child sexual abuse cases (n = 329). Cases with a child…

Apennine Front revisited - Diversity of Apollo 15 highland rock types

NASA Technical Reports Server (NTRS)

Lindstrom, Marilyn M.; Marvin, Ursula B.; Vetter, Scott K.; Shervais, John W.

1988-01-01

The Apollo 15 landing site is geologically the most complex of the Apollo sites, situated at a mare-highland interface within the rings of two of the last major basin-forming impacts. Few of the Apollo 15 samples are ancient highland rocks derived from the early differentiation of the moon, or impact melts from major basin impacts. Most of the samples are regolith breccias containing abundant clasts of younger volcanic mare and KREEP basalts. The early geologic evolution of the region can be understood only by examining the small fragments of highland rocks found in regolith breccias and soils. Geochemical and petrologic studies of clasts and matrices of three impact melt breccias and four regolith breccias are presented. Twelve igneous and metamorphic rocks show extreme diversity and include a new type of ferroan norite. Twenty-five samples of highland impact melt are divided into groups based on composition. These impact melts form nearly a continuum over more than an order of magnitude in REE concentrations. This continuum may result from both major basin impacts and younger local events. Highland rocks from the Apennine Front include most of the highland rock types found at all of the other sites. An extreme diversity of highland rocks is a fundamental characteristic of the Apennine Front and is a natural result of its complex geologic evolution.

Simulation of different types of ENSO impacts on South Asian Monsoon in CCSM4

NASA Astrophysics Data System (ADS)

Islam, Siraj ul; Tang, Youmin

2017-02-01

It has been found in observation that there are different types of influences of El Nino Southern Oscillation (ENSO) on the South Asian Monsoon (SAM). A correct description and representation of these teleconnections is critical for climate models to simulate and predict SAM. In this study, we examine these teleconnections in NCAR CAM4 and CCSM4 models, including the strength and weakness of these models in preserving different types of ENSO-SAM relationships. By using observational and simulation dataset, the composite analysis, based on specific selection criteria, is performed for both SAM rainfall and the eastern equatorial Pacific sea surface temperature (SST) anomalies. Anomalous SAM rainfall is characterized in three different types i.e. the indirect influence of the SST anomalies of preceding winter (DJF-only), direct influence of the SST anomalies of concurrent summer (JJAS-only) and the combined influence of both preceding winter and concurrent summer (DJF&JJAS). The analysis reveals that CAM4 uncoupled simulation can reasonably well reproduce the anomalous SAM rainfall in DJF-only and DJF&JJAS types whereas the model fails to simulate the anomalous rainfall in the JJAS-only type. The better performance of CAM4, particularly in DJF&JJAS type, comes from its realistic simulation of moisture content and thermal contrast. Its failure to preserve the ENSO-SAM relationship of JJAS-only type is due to the absence of ENSO induced warming in Northern Indian Ocean via atmospheric circulation which is indirectly linked to the lack of air-sea coupling. The role of Indian Ocean in controlling the ENSO-SAM teleconnections of the DJF&JJAS type is further investigated using CAM4 sensitivity experiments. It is found that in absence of Indian Ocean SST, the anomalous SAM summer rainfall suppresses in the DJF&JJAS type, suggesting the important modulation by Indian Ocean SST probably through the preceding winter equatorial Pacific SST forcing and the atmospheric

Features and impacts of five multidisciplinary community-university research partnerships.

PubMed

King, Gillian; Servais, Michelle; Forchuk, Cheryl; Chalmers, Heather; Currie, Melissa; Law, Mary; Specht, Jacqueline; Rosenbaum, Peter; Willoughby, Teena; Kertoy, Marilyn

2010-01-01

Despite the increasing number of multidisciplinary community-university research partnerships designed to address real-world issues, little is known about their nature. This article describes the features and impacts of five research partnerships addressing health or social service issues, which constituted a convenience sample from the province of Ontario, Canada. The article describes their characteristics, ways of operating, outputs, types of requests received from community members and mid-term impacts. Requests directed to partnerships were tracked over a 10-month period in 2003 to 2004, using a research contact checklist, and 174 community members later completed an impact questionnaire capturing perceptions of the impacts of the partnerships on personal knowledge and research skill development, organisational/group access to and use of information, and community and organisational development. The data indicated that partnerships had similar priorities and magnitudes of mid-term impacts, yet differed in the scope of their partnering, realm of intended influence and the number of mechanisms used to engage and communicate with target audiences. The partnerships produced different types of outputs and received different types of requests from community members. The findings inform researchers about partnership diversity and help to establish more realistic expectations about the magnitude of partnerships' impacts.

BeiDou inter-satellite-type bias evaluation and calibration for mixed receiver attitude determination.

PubMed

Nadarajah, Nandakumaran; Teunissen, Peter J G; Raziq, Noor

2013-07-22

The Chinese BeiDou system (BDS), having different types of satellites, is an important addition to the ever growing system of Global Navigation Satellite Systems (GNSS). It consists of Geostationary Earth Orbit (GEO) satellites, Inclined Geosynchronous Satellite Orbit (IGSO) satellites and Medium Earth Orbit (MEO) satellites. This paper investigates the receiver-dependent bias between these satellite types, for which we coined the name "inter-satellite-type bias" (ISTB), and its impact on mixed receiver attitude determination. Assuming different receiver types may have different delays/biases for different satellite types, we model the differential ISTBs among three BeiDou satellite types and investigate their existence and their impact on mixed receiver attitude determination. Our analyses using the real data sets from Curtin's GNSS array consisting of different types of BeiDou enabled receivers and series of zero-baseline experiments with BeiDou-enabled receivers reveal the existence of non-zero ISTBs between different BeiDou satellite types. We then analyse the impact of these biases on BeiDou-only attitude determination using the constrained (C-)LAMBDA method, which exploits the knowledge of baseline length. Results demonstrate that these biases could seriously affect the integer ambiguity resolution for attitude determination using mixed receiver types and that a priori correction of these biases will dramatically improve the success rate.

BeiDou Inter-Satellite-Type Bias Evaluation and Calibration for Mixed Receiver Attitude Determination

PubMed Central

Nadarajah, Nandakumaran; Teunissen, Peter J. G.; Raziq, Noor

2013-01-01

The Chinese BeiDou system (BDS), having different types of satellites, is an important addition to the ever growing system of Global Navigation Satellite Systems (GNSS). It consists of Geostationary Earth Orbit (GEO) satellites, Inclined Geosynchronous Satellite Orbit (IGSO) satellites and Medium Earth Orbit (MEO) satellites. This paper investigates the receiver-dependent bias between these satellite types, for which we coined the name “inter-satellite-type bias” (ISTB), and its impact on mixed receiver attitude determination. Assuming different receiver types may have different delays/biases for different satellite types, we model the differential ISTBs among three BeiDou satellite types and investigate their existence and their impact on mixed receiver attitude determination. Our analyses using the real data sets from Curtin's GNSS array consisting of different types of BeiDou enabled receivers and series of zero-baseline experiments with BeiDou-enabled receivers reveal the existence of non-zero ISTBs between different BeiDou satellite types. We then analyse the impact of these biases on BeiDou-only attitude determination using the constrained (C-)LAMBDA method, which exploits the knowledge of baseline length. Results demonstrate that these biases could seriously affect the integer ambiguity resolution for attitude determination using mixed receiver types and that a priori correction of these biases will dramatically improve the success rate. PMID:23881141

Obstructive Sleep Apnoea and Type 2 Diabetes

PubMed Central

Ali, Asad

2014-01-01

Abstract With the growing prevalence of obesity, the burden of type 2 diabetes is increasing. Obstructive sleep apnoea (OSA) is a very common medical condition that is associated with increased risk of cardiovascular disease and mortality. Obesity is a common risk factor for OSA and type 2 diabetes and hence it is not surprising that OSA and type 2 diabetes are interlinked. OSA has been shown to be an independent risk factor for the development of incident pre-diabetes/type 2 diabetes. OSA is also associated with worse glycaemic control and vascular disease in patients with type 2 diabetes. However, evidence for the benefits of OSA treatment in patients with type 2 diabetes is still lacking. The aim of this article is to provide an overview of OSA, the relationships between OSA and dysglycaemia and the impact of OSA in patients with type 2 diabetes, highlighting recent advances in the field. PMID:29872463

Fiber typing in aging muscle.

PubMed

Purves-Smith, Fennigje M; Sgarioto, Nicolas; Hepple, Russell T

2014-04-01

It is accepted widely that fast-twitch muscle fibers are preferentially impacted in aging muscle, yet we hypothesize that this is not valid when aging muscle atrophy becomes severe. In this review, we summarize the evidence of fiber type-specific effect in aging muscle and the potential confounding roles of fibers coexpressing multiple myosin heavy-chain isoforms and their histochemical identification.

Twin pregnancy among women with pregestational type 1 or type 2 diabetes mellitus.

PubMed

González González, Nieves L; González Dávila, Enrique; Goya, Maria; Vega, Begoña; Hernández Suarez, Mercedes; Bartha, Jose L

2014-07-01

To assess the impact of twin versus singleton pregnancy on obstetric and perinatal outcomes among women with pregestational diabetes mellitus (DM). Multicenter retrospective cohort study of women with pregestational DM and twin or singleton pregnancy, conducted in Spain during 2005-2010. Each group included 63 women (type 1 DM, n=39; type 2 DM, n=24). Of 269 565 deliveries, 68 (0.025%) were twins of mothers with pregestational DM, with 28/63 (44.4%) conceptions achieved with assisted reproduction technology. Among women with type 1 DM, hypertensive complications were more common among those with twins than among controls (13% versus 3%, P=0.02); the rate of preterm birth was higher (69% versus 15%, P<0.001); and the rate of admission to the neonatal intensive care unit was higher (51% versus 21%, P=0.005). Twin pregnancy was an independent risk factor for adverse perinatal outcomes regardless of the type of diabetes. Twin pregnancy in women with either type of DM dramatically increased the risk of perinatal morbidity. In mothers with type 1 DM, twin pregnancy was more often associated with hypertensive complications than singleton pregnancy. Transfer of more than one embryo should be avoided if ART is needed in a woman with DM. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Characteristics and Impact Factors of Renal Threshold for Glucose Excretion in Patients with Type 2 Diabetes Mellitus.

PubMed

Yue, Xiao Dan; Wang, Jing Yu; Zhang, Xin Rong; Yang, Ju Hong; Shan, Chun Yan; Zheng, Miao Yan; Ren, Hui Zhu; Zhang, Yi; Yang, Shao Hua; Guo, Zhen Hong; Chang, Bai; Chang, Bao Cheng

2017-04-01

Sodium glucose co-transporter 2 (SGLT-2) inhibitors are newly developed but promising medicine for type 2 diabetes. However, patients with a different renal threshold for glucose excretion (RT(G)) may have a different reaction to this medicine. Therefore, the objective of this study was to investigate the characteristics of RT(G) and its impact factors in patients with type 2 diabetes mellitus (T2DM). The clinical and laboratory data of 36 healthy individuals and 168 in-hospital patients with T2DM were collected and analyzed, RT(G) was calculated using blood glucose (BG) measured by dynamic BG monitoring, urinary glucose excretion (UGE) and estimated glomerular filtration rate (eGFR). The characteristics of RT(G) were investigated. The risk factors for high RT(G) were analyzed using non-conditional logistic regression analysis. Our results found that RT(G) of the T2DM group was higher than that of the healthy individuals (P < 0.05); and 22.22% from the healthy individuals group but 58.33% from the T2DM group had high RT(G). Age, duration of diabetes, body mass index (BMI), and homeostasis model assessment insulin resistance index (HOMA-IR) were independently associated with high RT(G) (P < 0.05). Further stratified analysis revealed that RT(G) in T2DM patients increased with age, duration of diabetes, and BMI. In conclusion, RT(G) is increased in patients with T2DM, especially in those with longer diabetic duration, higher BMI, and those who are older. Therefore, these patients may be more sensitive to SGLT-2 inhibitors. © 2017 The Korean Academy of Medical Sciences.

Measuring the impact of methodological research: a framework and methods to identify evidence of impact.

PubMed

Brueton, Valerie C; Vale, Claire L; Choodari-Oskooei, Babak; Jinks, Rachel; Tierney, Jayne F

2014-11-27

Providing evidence of impact highlights the benefits of medical research to society. Such evidence is increasingly requested by research funders and commonly relies on citation analysis. However, other indicators may be more informative. Although frameworks to demonstrate the impact of clinical research have been reported, no complementary framework exists for methodological research. Therefore, we assessed the impact of methodological research projects conducted or completed between 2009 and 2012 at the UK Medical Research Council Clinical Trials Unit Hub for Trials Methodology Research Hub, with a view to developing an appropriate framework. Various approaches to the collection of data on research impact were employed. Citation rates were obtained using Web of Science (http://www.webofknowledge.com/) and analyzed descriptively. Semistructured interviews were conducted to obtain information on the rates of different types of research output that indicated impact for each project. Results were then pooled across all projects. Finally, email queries pertaining to methodology projects were collected retrospectively and their content analyzed. Simple citation analysis established the citation rates per year since publication for 74 methodological publications; however, further detailed analysis revealed more about the potential influence of these citations. Interviews that spanned 20 individual research projects demonstrated a variety of types of impact not otherwise collated, for example, applications and further developments of the research; release of software and provision of guidance materials to facilitate uptake; formation of new collaborations and broad dissemination. Finally, 194 email queries relating to 6 methodological projects were received from 170 individuals across 23 countries. They provided further evidence that the methodologies were impacting on research and research practice, both nationally and internationally. We have used the information

Oral findings in patients with mucolipidosis type III.

PubMed

Cavalcante, Weber Céo; Santos, Luciano Cincurá Silva; Dos Santos, Josiane Nascimento; de Vasconcellos, Sara Juliana de Abreu; de Azevedo, Roberto Almeida; Dos Santos, Jean Nunes

2012-01-01

Mucolipidosis type III is a rare, autosomal recessive disorder, which is part of a group of storage diseases as a result of inborn error of lysosomal enzyme metabolism. It is characterized by the gradual onset of signs and symptoms affecting the physical and mental development as well as visual changes, heart, skeletal and joint. Although oral findings associated with mucolipidosis type II have been extensively reported, there is a shortage of information on mucolipidosis type III. This paper presents radiological and histological findings of multiple radiolucent lesions associated with impacted teeth in the jaw of a 16 year-old youngster with mucolipidosis type III.

Impact of landform and type of land use on soils developed over granite in the monsoonal climate of North-East India

NASA Astrophysics Data System (ADS)

Prokop, Paweł; Kruczkowska, Bogusława; Jones Syiemlieh, Hiambok; Bucała, Anna

2016-04-01

Soil properties are determined by the factors such climate, organisms, topography, geology, and time. Despite human activity will be recognized as part of biotic factors or distinct from other organisms it change soil directly or indirectly by changing both soil morphology and the underlying soil-forming processes. Thus it is difficult to distinguish soil properties modified only due to human impact. A small hilly catchment (3.9 km2) at an altitude of 1750-1800 m a.s.l. was selected for the investigation of landform and land use impact on soil properties. The climate is monsoonal with 14oC of mean annual temperature and 2400 mm of mean annual rainfall. The catchment is underlain by deeply weathered (up to 20 m) granite with abundant corestones embedded in sandy grus. Soils have been classified as sandy-loam and silty-loam Ultisols. Site has relatively uniform climate and parent material, so that a large proportion of the local soil variation can be attributed to landforms and land use changes within them. Thirty soil samples from topsoil (depth up to10 cm) were analysed from two landforms: flat ridge and the middle part of 150 m length slope (15o) with three types of land use: natural deciduous forest, cultivated land (potatoes, cabbage) and 20-years old pine forest on former cultivated land. Physical (texture, bulk density) and chemical (pH, C, N, P, K, CEC) soil properties were analysed. Significant differences between the means of soil properties were identified using the t-statistics, with a level of probability of 5%. Impact of landform on topsoil properties was visible under all three land use types. Soil under natural deciduous forest on flat ridge has statistically significant less sand, higher content of C and N in comparison to soil profile localized on slope. The differences between ridge and slope under pine forest and cultivated land were limited to some chemical properties such content of C, N and CEC, while statistically significant differences in

Detailed Modeling of the DART Spacecraft Impact into Didymoon

NASA Astrophysics Data System (ADS)

Weaver, R.; Gisler, G.

2017-12-01

In this presentation we will model the impact of the DART spacecraft into the target Didymoon. Most previous modeling of this impact has used full density aluminum spheres with a mass of 300 kg or more recently 500 kg. Many of the published scaling laws for crater size and diameter as well as ejecta modeling assume this type of impactor. The actual spacecraft for the DART impact is not solid and does not contain a solid dedicated kinetic impactor. The spacecraft is considered the impactor. Since the spacecraft is significantly larger ( 100 x 100 x 200 cm) in size than a full density aluminum sphere (radius 35 cm) the resulting impact dynamics will be quite different. Here we model both types of impact and compare the results of the simulation for crater size, crater depth and ejecta. This allows for a comparison of the momentum enhancement factor, beta. Suggestions for improvement of the spacecraft design will be given.

Osmium-Isotope and Platinum-Group-Element Systematics of Impact-Melt Rocks, Chesapeake Bay Impact Structure, Virginia, USA

NASA Technical Reports Server (NTRS)

Lee, Seung Ryeol; Wright Horton, J., Jr.; Walker, Richard J.

2005-01-01

Osmium (Os) isotopes and platinum-group elements (PGEs) are useful for geochemically identifying a meteoritic component within impact structures, because meteorites are typically characterized by low (187)Os/(188)Os ratios and high PGE concentrations. In contrast, most types of crustal target rocks have high radiogenic Os and very low PGE concentrations. We have examined Os isotope and PGE systematics of impact-melt rocks and pre-impact target rocks from a 2004 test hole in the late Eocene Chesapeake Bay impact structure and from nearby coreholes. Our goal is to determine the proportion of the projectile component in the melt rock Additional information is included in the original extended abstract.

Demographics, Velocity Distributions, and Impact Type as Predictors of AIS 4+ Head Injuries in Motor Vehicle Crashes

PubMed Central

Yoganandan, Narayan; Fitzharris, Michael; Pintar, Frank A.; Stemper, Brian D.; Rinaldi, James; Maiman, Dennis J.; Fildes, Brian N.

2011-01-01

The objective of the study was to determine differences between the United States-based NASS and CIREN and Australia-based ANCIS databases in occupant-, crash-, and vehicle-related parameters for AIS 4+ head injuries in motor vehicle crashes. Logistic regression analysis was performed to examine roles of the change in velocity (DV), crash type (frontal, far-side, nearside, rear impact), seatbelt use, and occupant position, gender, age, stature, and body mass in cranial traumas. Belted and unbelted non-ejected occupant (age >16 years) data from 1997–2006 were used for the NASS and CIREN datasets, and 2000–2010 for ANCIS. Vehicle model year, and occupant position and demographics including body mass index (BMI) data were obtained. Injuries were coded using AIS 1990–1998 update. Similarities were apparent across all databases: mean demographics were close to the mid-size anthropometry, mean BMI was in the normal to overweight range, and representations of extreme variations were uncommon. Side impacts contributed to over one-half of the ensemble, implying susceptibility to head trauma in this mode. Odds of sustaining head injury increased by 4% per unit increase in DV (OR: 1.04, 95% CI: 1.03–1.04, p<0.001; adjusted for other variables); one-half for belted compared to unbelted occupants (OR: 0.48, 95% CI: 0.37–0.61, p<0.001); nearside, then far-side had significantly higher odds than frontal, and no difference by gender or position (front-left, front-right). Similar crash- and occupant-related outcomes from the two continents indicate a worldwide need to revise the translation acceleration-based head injury criterion to include the angular component in an appropriate format for improved injury assessment and mitigation. PMID:22105402

Lunar Meteorite Dhofar 026: A Second-Generation Impact Melt

NASA Astrophysics Data System (ADS)

Cohen, B. A.; Taylor, L. A.; Nazarov, M.

2001-03-01

Petrology and mineral-chemistry of lunar highlands meteorite Dhofar 026 show that it is a crystalline impact melt of FAN-type material. Crystalline spherules within the meteorite are earlier impact melt fragments derived from a basaltic precursor.

Impact of using a non-diabetes-specific risk calculator on eligibility for statin therapy in type 2 diabetes.

PubMed

Price, H C; Coleman, R L; Stevens, R J; Holman, R R

2009-03-01

The aim of this study was to investigate the impact of using a non-diabetes-specific cardiovascular disease (CVD) risk calculator to determine eligibility for statin therapy according to current UK National Institute for Health and Clinical Excellence (NICE) guidelines for those patients with type 2 diabetes who are at an increased risk of CVD (10 year risk >or=20%). The 10 year CVD risks were estimated using the UK Prospective Diabetes Study (UKPDS) Risk Engine and the Framingham equation for 4,025 patients enrolled in the Lipids in Diabetes Study who had established type 2 diabetes and LDL-cholesterol <4.1 mmol/l. The mean (SD) age of the patients was 60.7 (8.6) years, blood pressure 141/83 (17/10) mmHg and the total cholesterol:HDL-cholesterol ratio was 3.9 (1.0). The median (interquartile range) diabetes duration was 6 (3-11) years and the HbA(1c) level was 8.0% (7.2-9.0%). The cohort comprised 65% men, 91% whites, 4% Afro-Caribbeans, 5% Asian Indians and 15% current smokers. More patients were classified as being at high risk by the UKPDS Risk Engine (65%) than by the Framingham CVD equation (63%) (p < 0.0001). The Framingham CVD equation classified fewer men and people aged <50 years old as high risk (p < 0.0001). There was no difference between the UKPDS Risk Engine and Framingham classification of women at high risk (p = 0.834). These results suggest that the use of Framingham-derived rather than UKPDS Risk Engine-derived CVD risk estimates would deny about one in 25 patients statin therapy when applying current NICE guidelines. Thus, under these guidelines the choice of CVD risk calculator is important when assessing CVD risk in patients with type 2 diabetes, particularly for the identification of the relatively small proportion of younger people who require statin therapy.

Impact of clinical status and salivary conditions on xerostomia and oral health-related quality of life of adolescents with type 1 diabetes mellitus.

PubMed

Busato, Ivana Maria Saes; Ignácio, Sérgio Aparecido; Brancher, João Armando; Moysés, Simone Tetu; Azevedo-Alanis, Luciana Reis

2012-02-01

To investigate the influence of clinical status and salivary conditions on the presence of xerostomia on adolescents with and without type 1 diabetes mellitus (DM1), and further to investigate the influence of clinical status, salivary conditions and xerostomia on oral health-related quality of life (OHQoL) of those with DM1. A cross-sectional study was performed on 102 adolescents, 51 with DM1 and 51 nondiabetics. Xerostomia was detected by asking a question about the sensation of having 'dry mouth', and Oral Health Impact Profile-14 was used to measure the impact of xerostomia on OHQoL. The clinical status was assessed by using decayed, missing or filled and Community Periodontal indices, and by evaluating oral manifestations; and the following salivary conditions were evaluated: stimulated salivary flow, pH, buffer capacity, total protein, amylase, urea, calcium, and glucose salivary concentrations. Multiple logistic regression analysis was used to evaluate the influence of clinical status and salivary conditions on xerostomia and the impact of xerostomia on the OHQoL of adolescents with DM1. Clinical status and salivary conditions was shown to have no influence on the presence of xerostomia. Bivariate (P = 0.00) and logistic regression (P = 0.01) analysis showed a significant association between DM1 and xerostomia. Logistic regression analysis showed association between xerostomia (P = 0.00) and OHQoL, and caries experience (P = 0.03) and OHQoL. DM1 showed to be predictive of a high prevalence of xerostomia in adolescents. Caries experience and xerostomia showed to have a negative impact on the OHQoL of adolescents with DM1. © 2011 John Wiley & Sons A/S.

The Impact of Novel Technologies on the Environment Throughout History

NASA Astrophysics Data System (ADS)

Ilyinskii, P.

Several known historical processes or events, especially those with a manifest environmental impact will be assessed from a technological standpoint. Recent technological advances made results of technological intervention into the nature much more rapid than before and therefore the assessment of prior experiences is both helpful and necessary. Three types of consequences of technological intervention are discerned: (1) ‘slow progressors’, i.e., such risks that accumulate throughout substantial time spans and are not instantaneously obvious, and those of (2) intermediate and (3) immediate impact. The capacity to reverse the negative consequences of each type of intervention inversely correlates with their manifestation speed. Specifically, the events of the third type often result from the ‘interaction with the absolutely unknown’ often need to be remedied in an urgent manner. Each of these types of environmental impacts will be illustrated with a known historical event. It is likely that the same three types of negative consequences will be seen in the nearest future upon the development and utilization of novel bio-organical and biotechnological products. These risks will be also discussed in a historical perspective.

Development of a Kelp-type Structure Module in a Coastal Ocean Model to Assess the Hydrodynamic Impact of Seawater Uranium Extraction Technology

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

Wang, Taiping; Khangaonkar, Tarang; Long, Wen

2014-02-07

In recent years, with the rapid growth of global energy demand, the interest in extracting uranium from seawater for nuclear energy has been renewed. While extracting seawater uranium is not yet commercially viable, it serves as a “backstop” to the conventional uranium resources and provides an essentially unlimited supply of uranium resource. With recent advances in seawater uranium extraction technology, extracting uranium from seawater could be economically feasible when the extraction devices are deployed at a large scale (e.g., several hundred km2). There is concern however that the large scale deployment of adsorbent farms could result in potential impacts tomore » the hydrodynamic flow field in an oceanic setting. In this study, a kelp-type structure module was incorporated into a coastal ocean model to simulate the blockage effect of uranium extraction devices on the flow field. The module was quantitatively validated against laboratory flume experiments for both velocity and turbulence profiles. The model-data comparison showed an overall good agreement and validated the approach of applying the model to assess the potential hydrodynamic impact of uranium extraction devices or other underwater structures in coastal oceans.« less

Budget impact of continuous subcutaneous insulin infusion therapy in patients with type 1 diabetes who experience severe recurrent hypoglycemic episodes in Spain.

PubMed

Giménez, Marga; Elías, Isabel; Álvarez, María; Quirós, Carmen; Conget, Ignacio

Hypoglycemia is one of the most common complications to achieve a good metabolic control, and has been listed by several scientific associations as a common indication to start treatment with continuous subcutaneous insulin infusion (CSII). Use of CSII is still residual in Spain as compared to neighbouring countries, and cost of acquisition cost is one of the main reasons. This study estimates the budget impact of treatment with CSII, as compared to multiple daily insulin injections, of patients with type 1 diabetes mellitus who experience recurrent severe hypoglycemia episodes from the National Healthcare System perspective. Budget impact was based on a retrospective, observational study evaluating the efficacy of CSII in patients with type 1 diabetes mellitus conducted at Hospital Clínic i Universitari in Barcelona, where one of the main indications for switching to CSII were recurrent severe hypoglycemia episodes. The mean number of annual episodes was 1.33 in the two years prior to CSII start and 0.08 in the last two years of follow up (p=0.003). Costs of treatment and major hypoglycemic events over a four-year period were considered. Costs were taken from different Spanish data sources and expressed in € of 2016. Treatment with CSII increased costs by €9,509 per patient as compared to multiple daily insulin injections (€11,902-€2,393). Cost associated to severe hypoglycemic events decreased by €19,330 per patient treated with CSIII (€1,371-€20,701). Results suggest mean total savings of €9,821 per patient during the four-year study period. The higher costs associated to CSII therapy may be totally offset by the severe hypoglycemic events prevented. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

Budget impact analysis of vaccination against Haemophilus influenzae type b as a part of a Pentavalent vaccine in the childhood immunization schedule of Iran.

PubMed

Teimouri, Fatemeh; Kebriaeezadeh, Abbas; Zahraei, Seyed Mohsen; Gheiratian, MohammadMahdi; Nikfar, Shekoufeh

2017-01-14

Health decision makers need to know the impact of the development of a new intervention on the public health and health care costs so that they can plan for economic and financial objectives. The aim of this study was to determine the budget impact of adding Haemophilus influenzae type b (Hib) as a part of a Pentavalent vaccine (Hib-HBV-DTP) to the national childhood immunization schedule of Iran. An excel-based model was developed to determine the costs of including the Pentavalent vaccine in the national immunization program (NIP), comparing the present schedule with the previous one (including separate DTP and hepatitis B vaccines). The total annual costs included the cost of vaccination (the vaccine and syringe) and the cost of Hib treatment. The health outcome was the estimated annual cases of the diseases. The net budget impact was the difference in the total annual cost between the two schedules. Uncertainty about the vaccine effectiveness, vaccination coverage, cost of the vaccine, and cost of the diseases were handled through scenario analysis. The total cost of vaccination during 5 years was $18,060,463 in the previous program and $67,774,786 in the present program. Inclusion of the Pentavalent vaccine would increase the vaccination cost about $49 million, but would save approximately $6 million in the healthcare costs due to reduction of disease cases and treatment costs. The introduction of the Pentavalent vaccine resulted in a net increase in the healthcare budget expenditure across all scenarios from $43.4 million to $50.7 million. The results of this study showed that the inclusion of the Pentavalent vaccine in the NIP of Iran had a significant impact on the health care budget and increased the financial burden on the government. Budget impact of including Pentavalent vaccine in the national immunization schedule of Iranᅟ.

The impact of type 1 diabetes and diabetic polyneuropathy on muscle strength and fatigability.

PubMed

Orlando, Giorgio; Balducci, Stefano; Bazzucchi, Ilenia; Pugliese, Giuseppe; Sacchetti, Massimo

2017-06-01

Although it is widely accepted that diabetic polyneuropathy (DPN) is linked to a marked decline in neuromuscular performance, information on the possible impact of type 1 diabetes (T1D) on muscle strength and fatigue remains unclear. The purpose of this study was to investigate the effects of T1D and DPN on strength and fatigability in knee extensor muscles. Thirty-one T1D patients (T1D), 22 T1D patients with DPN (DPN) and 23 matched healthy control participants (C) were enrolled. Maximal voluntary contraction (MVC) and endurance time at an intensity level of 50% of the MVC were assessed at the knee extensor muscles with an isometric dynamometer. Clinical characteristics of diabetic patients were assessed by considering a wide range of vascular and neurological parameters. DPN group had lower knee extensor muscles strength than T1D (-19%) and the C group (-37.5%). T1D group was 22% weaker when compared to the C group. Lower body muscle fatigability of DPN group was 22 and 45.5% higher than T1D and C group, respectively. T1D group possessed a higher fatigability (29.4%) compared to C group. A correlation was found between motor and sensory nerve conduction velocity and muscle strength and fatigability. Patients with T1D are characterised by both a higher fatigability and a lower muscle strength, which are aggravated by DPN. Our data suggest that factors other than nervous damage play a role in the pathogenesis of such defect.

Energy and Economic Impacts of Projected Freight Transportation Improvements

DOT National Transportation Integrated Search

1977-05-01

This study examines current and future energy impacts for each major freight mode, by commodity, and, in many cases, by vehicle types. It also discusses potential economic impacts of these anticipated changes. The study is limited to intercity freigh...

Finite element analyses of railroad tank car head impacts

DOT National Transportation Integrated Search

2008-09-24

This paper describes engineering analyses of a railroad : tank car impacted at its head by a rigid punch. This type of : collision, referred to as a head impact, is examined using : dynamic, nonlinear finite element analysis (FEA). : Commercial softw...

Modeling Drought Impact Occurrence Based on Climatological Drought Indices for Europe

NASA Astrophysics Data System (ADS)

Stagge, J. H.; Kohn, I.; Tallaksen, L. M.; Stahl, K.

2014-12-01

Meteorological drought indices are often assumed to accurately characterize the severity of a drought event; however, these indices do not necessarily reflect the likelihood or severity of a particular type of drought impact experienced on the ground. In previous research, this link between index and impact was often estimated based on thresholds found by experience, measured using composite indices with assumed weighting schemes, or defined based on very narrow impact measures, using either a narrow spatial extent or very specific impacts. This study expands on earlier work by demonstrating the feasibility of relating user-provided impact reports to the climatological drought indices SPI and SPEI by logistic regression. The user-provided drought impact reports are based on the European Drought Impact Inventory (EDII, www.geo.uio.no/edc/droughtdb/), a newly developed online database that allows both public report submission and querying the more than 4,000 reported impacts spanning 33 European countries. This new tool is used to quantify the link between meteorological drought indices and impacts focusing on four primary impact types, spanning agriculture, energy and industry, public water supply, and freshwater ecosystem across five European countries. Statistically significant climate indices are retained as predictors using step-wise regression and used to compare the most relevant drought indices and accumulation periods for different impact types and regions. Agricultural impacts are explained best by 2-12 month anomalies, with 2-3 month anomalies found in predominantly rain-fed agricultural regions, and anomalies greater than 3 months related to agricultural management practices. Energy and industry impacts, related to hydropower and energy cooling water in these countries, respond to longer accumulated precipitation anomalies (6-12 months). Public water supply and freshwater ecosystem impacts are explained by a more complex combination of short (1-3 month

Comparing impacts between formal and informal recreational trails.

PubMed

Pickering, Catherine Marina; Norman, Patrick

2017-05-15

Globally there are hundreds of thousands of kilometres of recreational trails traversing natural areas of high conservation value: but what are their impacts and do impacts differ among trails? We compared the effects of four common types of recreational trails [(1) narrow and (2) medium width informal bare earth trails and (3) gravel and (4) tarmac/concrete formal trails] on vegetation adjacent to trails in a high conservation value plant community that is popular for mountain biking and hiking in Australia. Plant species composition was recorded in quadrats along the edge of the four types of trails and in control sites away from trails. Vegetation cover, the cover of individual growth forms, and species richness along the edges of all four types of trails were similar to the controls, although the wider trails affected plant composition, with the tarmac and gravel trails favouring different species. With very few comparative studies, more research is required to allow managers and researchers to directly compare differences in the severity and types of impacts on vegetation among trails. In the meantime, limiting damage to vegetation on the edge of hardened trails during construction, use and maintenance is important, and hardening trails may not always be appropriate. Copyright © 2016. Published by Elsevier Ltd.

Assessing the impact of climate change on flood types in the Austrian and French Alps using the stochastic weather generator TripleM and rainfall-runoff modeling

NASA Astrophysics Data System (ADS)

Breinl, Korbinian; Turkington, Thea

2017-04-01

We developed a new methodology for classifying flood types, which appears to be particularly suitable for climate change impact studies. Climate change is not only expected to change the magnitude and frequency of Alpine floods but also the types of floods. The distribution of existing flood types may change and new flood types may develop. A shift away from solely focusing on the magnitude and frequency of floods in flood hazard assessment and disaster risk management towards the causal types of floods is required as the types and therefore also timing and characteristics of floods will have implications on both the local social and ecological systems. The flood types are classified using k-means clustering of temperature and precipitation indicators, capturing differences in rainfall amounts, antecedent rainfall, snow-cover, and the day of the year. In a first step, we used the open-source multi-site weather generator TripleM coupled with the fast conceptual rainfall-runoff model HBV to extrapolate the observed discharge time series and generate a large inventory of different types of observed flood events and flood types. The weather generator was then parameterized based on projections of rainfall and temperature to simulate future flood types and events. We selected four climate projections (mild dry, mild wet, warm dry and warm wet conditions) from a set of 15, which originated from the EURO-CORDEX dataset. We worked in two catchments in the Austrian and French Alps that have been affected by floods in the past: the medium-sized Salzach catchment in Austria, which is dominated by rainfall driven flooding during the summer and autumn period, and the small Ubaye catchment in the Southern French Alps, which is dominated by rain-on-snow floods in the spring period. The analysis of the simulated future flood types shows clear changes in the distribution and characteristics of flood types in both study areas under the different climate projections examined.

The Potential for Altmetrics to Measure Other Types of Impact in Scientific Production: Academic and Social Impact Dynamics in Social Media and Networks

ERIC Educational Resources Information Center

Maricato, João de Melo; Vilan Filho, Jayme Leiro

2018-01-01

Introduction: Altmetrics is an area under construction, with a potential to study the impacts of academic products from social media data. It is believed that altmetrics can capture social and academic impacts, going beyond measures obtained using bibliometric and scientometric indicators. This research aimed to analyse aspects, characteristics…

Impact of a community-based exercise programme on physical fitness in middle-aged and older patients with type 2 diabetes.

PubMed

Mendes, Romeu; Sousa, Nelson; Themudo-Barata, José; Reis, Victor

2016-01-01

Physical fitness is related to all-cause mortality, quality of life and risk of falls in patients with type 2 diabetes. This study aimed to analyse the impact of a long-term community-based combined exercise program (aerobic+resistance+agility/balance+flexibility) developed with minimum and low-cost material resources on physical fitness in middle-aged and older patients with type 2 diabetes. This was a non-experimental pre-post evaluation study. Participants (N=43; 62.92±5.92 years old) were engaged in a community-based supervised exercise programme (consisting of combined aerobic, resistance, agility/balance and flexibility exercises; three sessions per week; 70min per session) of 9 months' duration. Aerobic fitness (6-Minute Walk Test), muscle strength (30-Second Chair Stand Test), agility/balance (Timed Up and Go Test) and flexibility (Chair Sit and Reach Test) were assessed before (baseline) and after the exercise intervention. Significant improvements in the performance of the 6-Minute Walk Test (Δ=8.20%, p<0.001), 30-Second Chair Stand Test (Δ=28.84%, p<0.001), Timed Up and Go Test (Δ=14.31%, p<0.001), and Chair Sit and Reach Test (Δ=102.90%, p<0.001) were identified between baseline and end-exercise intervention time points. A long-term community-based combined exercise programme, developed with low-cost exercise strategies, produced significant benefits in physical fitness in middle-aged and older patients with type 2 diabetes. This supervised group exercise programme significantly improved aerobic fitness, muscle strength, agility/balance and flexibility, assessed with field tests in community settings. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

Under the radar: mitigating enigmatic ecological impacts.

PubMed

Raiter, Keren G; Possingham, Hugh P; Prober, Suzanne M; Hobbs, Richard J

2014-11-01

Identifying the deleterious ecological effects of developments, such as roads, mining, and urban expansion, is essential for informing development decisions and identifying appropriate mitigation actions. However, there are many types of ecological impacts that slip 'under the radar' of conventional impact evaluations and undermine the potential for successful impact mitigation (including offsets). These 'enigmatic' impacts include those that are small but act cumulatively; those outside of the area directly considered in the evaluation; those not detectable with the methods, paradigms, or spatiotemporal scales used to detect them; those facilitated, but not directly caused, by development; and synergistic impact interactions. Here, we propose a framework for conceptualising enigmatic impacts and discuss ways to address them. Copyright © 2014 Elsevier Ltd. All rights reserved.

Shuttle Hypervelocity Impact Database

NASA Technical Reports Server (NTRS)

Hyde, James L.; Christiansen, Eric L.; Lear, Dana M.

2011-01-01

With three missions outstanding, the Shuttle Hypervelocity Impact Database has nearly 3000 entries. The data is divided into tables for crew module windows, payload bay door radiators and thermal protection system regions, with window impacts compromising just over half the records. In general, the database provides dimensions of hypervelocity impact damage, a component level location (i.e., window number or radiator panel number) and the orbiter mission when the impact occurred. Additional detail on the type of particle that produced the damage site is provided when sampling data and definitive analysis results are available. Details and insights on the contents of the database including examples of descriptive statistics will be provided. Post flight impact damage inspection and sampling techniques that were employed during the different observation campaigns will also be discussed. Potential enhancements to the database structure and availability of the data for other researchers will be addressed in the Future Work section. A related database of returned surfaces from the International Space Station will also be introduced.

Differential Impact of Homelessness on Glycemic Control in Veterans with Type 2 Diabetes Mellitus.

PubMed

Axon, R Neal; Gebregziabher, Mulugeta; Dismuke, Clara E; Hunt, Kelly J; Yeager, Derik; Ana, Elizabeth J Santa; Egede, Leonard E

2016-11-01

Veterans with evidence of homelessness have high rates of mental health and substance abuse disorders, but chronic medical conditions such as diabetes are also prevalent. We aimed to determine the impact of homelessness on glycemic control in patients with type 2 diabetes mellitus. Longitudinal analysis of a retrospective cohort. A national cohort of 1,263,906 Veterans with type 2 diabetes. Subjects with evidence of homelessness were identified using a combination of diagnostic and administrative codes. Odds for poor glycemic control using hemoglobin A1C (HbA1C) cutoff values of 8 % and 9 %. Homeless defined as a score based on the number of indicator variables for homelessness within a veterans chart. Veterans with evidence of homelessness had a significantly greater annual mean HbA1C ≥ 8 (32.6 % vs. 20.43 %) and HbA1C ≥ 9 (21.4 % vs. 9.9 %), tended to be younger (58 vs. 67 years), were more likely to be non-Hispanic black (39.1 %), divorced (43 %) or never married (34 %), to be urban dwelling (88.8 %), and to have comorbid substance abuse (46.7 %), depression (42.3 %), psychoses (39.7 %), liver disease (18.8 %), and fluid/electrolyte disorders (20.4 %), relative to non-homeless veterans (all p < 0.0001). Homelessness was modeled as an ordinal variable that scored the number of times a homelessness indicator was found in the Veterans medical record. We observed a significant interaction between homelessness and race/ethnicity on the odds of poor glycemic control. Homelessness, across all racial-ethnic groups, was associated with increased odds of uncontrolled diabetes at a cut-point of 8 % and 9 % for hemoglobin A1C ; however, the magnitude of the association was greater in non-Hispanic whites [8 %, OR 1.55 (1.47;1.63)] and Hispanics [8 %, OR 2.11 (1.78;2.51)] than in non-Hispanic blacks [8 %, OR 1.22 (1.15;1.28)]. Homelessness is a significant risk factor for uncontrolled diabetes in Veterans, especially among non-Hispanic white

Multiple educational programs improves glycemic control, quality of life with diminishing the impact of diabetes in poorly controlled type 1 diabetics.

PubMed

Vyas, Chintan; Dalal, Lopa; Talaviya, Praful; Saboo, Banshi

2017-12-01

The aim of present study was to assess the outcomes of multiple educational programs on glycemic control, quality of life and impact of diabetes in poorly controlled Type 1 Diabetic patients. A 12 months diabetes education programs were conducted every week for first one month then followed by every 3 months with follow up on improvement of HbA1c and QOL in T1D patients (n=54). Clinical characteristics were recorded at baseline visit. The QOL was evaluated by 15 set DQOL questionnaires in 40 consecutive patients at baseline, 3, 6 and 12 months after education programs. The HbA1c level (%) was evaluated at same time point. Decrease in DQOL score was reported as improvement in QOL. The rate of patients response to educational programs was noted 74.07% (n=40) at end of the study (12 months). The prevalence of T1D was reported higher in men than in women. The overall DQOL score and HbA1c% level was significantly (P<0.05) decreased at 3, 6 and 12 months after educational programs. Patients exhibited greater satisfaction and diminished impact of diabetes after educational programs was observed after 3 months and it was continue up to end of study. The frequencies of self-monitoring of blood glucose were increased. Numbers of hypoglycemic and DKA events were decreased after educational programs when compared to baseline. Results of study revealed that the appropriate education and counseling diminish impact of diabetes, improve QOL and help to achieve desired glycemic (HbA1c) level in poorly control T1D patients. Copyright © 2017. Published by Elsevier Ltd.

Modern clinical management helps reducing the impact of type 1 diabetes in children.

PubMed

Scaramuzza, Andrea E; Zuccotti, Gian Vincenzo

2015-08-01

Type 1 diabetes care may be very costly not only in terms of money but also in terms of psychological and therapeutic acceptance and compliance. Recently, a lot of new technologies have been introduced in the care of patients with type 1 diabetes that should allow them to achieve an improvement in glycemic control, quality of life and above all prevent long-term complications. Combining continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion (CSII) provides a more useful tool for patients with type 1 diabetes, the sensor-augmented pump (SAP). The aim of the present review is to explore SAP efficacy and safety in young patients with type 1 diabetes. SAP demonstrated increased efficacy in lowering glycated hemoglobin when compared either to multiple daily injections or CSII alone. Its efficacy is positively associated with CGM use, baseline HbA1c and patients' age. According to currently available evidence, SAP seems sufficiently safe, effective and beneficial in improving glycemic control in pediatric patients with type 1 diabetes. Moreover, encouraging results using semi-closed loop systems are emerging, paving the way toward a fully automated artificial pancreas. As pediatric diabetologists we have the duty to offer our patients the best therapeutic option currently available, supported by evidence, to help them gain the best results with the fewest adverse effects (hypoglycemia and/or diabetic ketoacidosis), better if chomping a little piece of dark chocolate. Copyright © 2015 Elsevier Ltd. All rights reserved.

An Assessment of Regional Variations in Martian Modified Impact Crater Morphology

NASA Astrophysics Data System (ADS)

Craddock, Robert A.; Bandeira, Lourenço.; Howard, Alan D.

2018-03-01

Impact craters on Mars have been extensively modified by ancient geologic processes that may have included rainfall and surface runoff, snow and ice, denudation by lava flows, burial by eolian material, or others. Many of these processes can leave distinct signatures on the morphometry of the modified impact crater as well as the surrounding landscape. To look for signs of potential regional differences in crater modification processes, we conducted an analysis of different morphometric parameters related to modified impact craters located in the Margaritifer Sinus, Sinus Sabaeus, Iapygia, Mare Tyrrhenum, Aeolis, and Eridania quadrangles, including depth, crater wall slope, crater floor slope, the curvature between the interior wall and the crater floor slope, and the curvature between the interior wall and surrounding landscape. A Welch's t test analysis comparing these parameters shows that fresh impact craters (Type 4) have consistent morphologies regardless of their geographic location examined in this study, which is not unexpected. Modified impact craters both in the initial (Type 3) and terminal stages (Type 1) of modification also have statistically consistent morphologies. This would suggest that the processes that operated in the late Noachian were globally ubiquitous, and that modified craters eventually reached a stable crater morphology. However, craters preserved in advanced (but not terminal) stages of modification (Type 2) have morphologies that vary across the quadrangles. It is possible that these variations reflect spatial differences in the types and intensity of geologic processes that operated during the Noachian, implying that the ancient climate also varied across regions.

The Impact of Sleep Debt on Excess Adiposity and Insulin Sensitivity in Patients with Early Type 2 Diabetes Mellitus

PubMed Central

Arora, Teresa; Chen, Mimi Z.; Cooper, Ashley R.; Andrews, Rob C.; Taheri, Shahrad

2016-01-01

Study Objectives: We examined cross-sectional and prospective associations between sleep debt and adiposity measures, as well as homeostatic model assessment-insulin resistance (HOMA-IR) in early type 2 diabetes. Methods: Prospective data analysis from participants of a randomized controlled trial based on an intensive lifestyle intervention (usual care, diet, or diet and physical activity). Data were collected at baseline, 6 months, and 12 months post-intervention. The study was performed across five secondary care centers in the United Kingdom. Patients (n = 593) with a recent diagnosis of type 2 diabetes were recruited. Objective height and weight were ascertained for obesity status (body mass index [BMI]; ≥ 30 kg/m2), waist circumference (cm) for central adiposity, and fasting blood samples drawn to examine insulin resistance (IR). Seven-day sleep diaries were used to calculate weekday sleep debt at baseline, calculated as average weekend sleep duration minus average weekday sleep duration. Results: At baseline, compared to those without weekday sleep debt, those with weekday sleep debt were 72% more likely to be obese (OR = 1.72 [95% CI:1.03–2.88]). At six months, weekday sleep debt was significantly associated with obesity and IR after adjustment, OR = 1.90 (95% CI:1.10–3.30), OR = 2.07 (95% CI:1.02–4.22), respectively. A further increase at 12 months was observed for sleep debt with obesity and IR: OR = 2.10 (95% CI:1.14–3.87), OR = 3.16 (95% CI:1.38–7.24), respectively. For every 30 minutes of weekday sleep debt, the risk of obesity and IR at 12 months increased by 18% and 41%, respectively. Conclusions: Sleep debt resulted in long-term metabolic disruption, which may promote the progression of type 2 diabetes in newly diagnosed patients. Sleep hygiene/education could be an important factor for future interventions to target early diabetes. Citation: Arora T, Chen MZ, Cooper AR, Andrews RC, Taheri S. The impact of sleep debt on excess adiposity

The Impact of Patient Education on Anthropometric, Lipidemic, and Glycemic Parameters Among Patients With Poorly Controlled Type II Diabetes Mellitus: A 3-Month Prospective Single-Center Turkish Study.

PubMed

Cander, Soner; Gul, Ozen Oz; Gul, Cuma B; Keles, Saadet B; Yavas, Sibel; Ersoy, Canan

2014-12-01

This study evaluated the impact of patient education on adherence to a diabetes care plan (e.g., anthropometric, lipidemic, and glycemic parameters) among adults with type II diabetes mellitus without adequate glycemic control. A total of 61 ambulatory adults with type II diabetes mellitus (mean age: 53.6 ± 8.2 years, 70.5% female) were evaluated for anthropometrics, duration of diabetes mellitus, type of anti-diabetic treatment, blood biochemistry, and glycemic parameters in this 3-month prospective observational single-center study. During the course of the study, participants demonstrated a significant decrease in body weight and fat percentage and HbA1c (p < .001 for each). None of the factors evaluated was a significant determinant for glycemic parameters. These findings revealed that adults with type II diabetes mellitus who received education on adherence to routine self-monitoring of blood glucose, standard diabetic diet, and an exercise program delivered by certified diabetes educators had better glycemic control and significant decrease in body weight and fat percentage over a 3-month monitoring period. Copyright 2014, SLACK Incorporated.

Trail impacts and trail impact management related to ecotourism visitation at Torres del Paine National Park, Chile

USGS Publications Warehouse

Farrell, T.A.; Marion, J.L.

2002-01-01

Ecotourism and protected area visitation in Central and South America are largely dependent upon a relatively undisturbed quality of natural resources. However, visitation may impact vegetation, soil, water and wildlife resources, and degrade visitor facilities such as recreation sites and trails. Findings are reported from trail impact research conducted at Torres del Paine National Park in Patagonia, Chile. The frequency and magnitude of selected trail impacts and the relative effect of the amount of use, vegetation type, trail position and trail grade are investigated. Findings differed from previous studies in that amount of use was significantly related to both trail width increases and trail erosion. Management actions to minimize trail impacts are offered.

The Impact of Social Media on College Students

ERIC Educational Resources Information Center

Mastrodicasa, Jeanna; Metellus, Paul

2013-01-01

There are numerous ways, positive and negative, in which social media impact college students. Understanding sheer volume of time and the type of activities for which college students use social networking sites is crucial for higher education administrators. Researchers have begun to empirically examine impacts on students' well-being and have…

Introduction of Haemophilus influenzae type B conjugate vaccine into routine immunization in Ghana and its impact on bacterial meningitis in children younger than five years.

PubMed

Renner, Lorna Awo; Newman, Mercy J; Ahadzie, Lawson; Antwi-Agyei, Kwadwo Odei; Eshetu, Messeret

2007-04-01

This report shows the impact of a pentavalent vaccine that includes Haemophilus influenzae type b (Hib) conjugate vaccine on bacterial meningitis in children younger than 5 years in Ghana. A review of the first 3 years of a pediatric bacterial meningitis surveillance program, started in August 2001 in Accra, Ghana, was undertaken. There was a significant reduction, P = 0.042 and 0.017, in percentage of purulent meningitis in children younger than 1 year, comparing the first year when the vaccine was introduced, to the second and third years, respectively.

Respiratory Protection Performance: Impact of Helmet Integration

DTIC Science & Technology

2016-09-01

ECBC-TR-1418 RESPIRATORY PROTECTION PERFORMANCE: IMPACT OF HELMET INTEGRATION Daniel J. Barker Corey M. Grove RESEARCH AND TECHNOLOGY...REPORT TYPE Final 3. DATES COVERED (From - To) Sep 2015 – Mar 2016 4. TITLE AND SUBTITLE Respiratory Protection Performance: Impact of Helmet...integrated helmet respirator on respiratory protection effectiveness as compared with a helmet and respirator worn in a traditional nonintegrated

Thoracolumbar spine fractures in frontal impact crashes.

PubMed

Pintar, Frank A; Yoganandan, Narayan; Maiman, Dennis J; Scarboro, Mark; Rudd, Rodney W

2012-01-01

There is currently no injury assessment for thoracic or lumbar spine fractures in the motor vehicle crash standards throughout the world. Compression-related thoracolumbar fractures are occurring in frontal impacts and yet the mechanism of injury is poorly understood. The objective of this investigation was to characterize these injuries using real world crash data from the US-DOT-NHTSA NASS-CDS and CIREN databases. Thoracic and lumbar AIS vertebral body fracture codes were searched for in the two databases. The NASS database was used to characterize population trends as a function of crash year and vehicle model year. The CIREN database was used to examine a case series in more detail. From the NASS database there were 2000-4000 occupants in frontal impacts with thoracic and lumbar vertebral body fractures per crash year. There was an increasing trend in incidence rate of thoracolumbar fractures in frontal impact crashes as a function of vehicle model year from 1986 to 2008; this was not the case for other crash types. From the CIREN database, the thoracolumbar spine was most commonly fractured at either the T12 or L1 level. Major, burst type fractures occurred predominantly at T12, L1 or L5; wedge fractures were most common at L1. Most CIREN occupants were belted; there were slightly more females involved; they were almost all in bucket seats; impact location occurred approximately half the time on the road and half off the road. The type of object struck also seemed to have some influence on fractured spine level, suggesting that the crash deceleration pulse may be influential in the type of compression vector that migrates up the spinal column. Future biomechanical studies are required to define mechanistically how these fractures are influenced by these many factors.

The asymmetric impact of global warming on US drought types and distributions in a large ensemble of 97 hydro-climatic simulations

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

Huang, Shengzhi; Leng, Guoyong; Huang, Qiang

Projection of future drought is often involved large uncertainties from climate models, emission scenarios as well as drought definitions. In this study, we investigate changes in future droughts in the conterminous United States based on 97 1/8 degree hydro-climate model projections. Instead of focusing on a specific drought type, we investigate changes in meteorological, agricultural, and hydrological drought as well as the concurrences. Agricultural and hydrological droughts are projected to become more frequent with increase in global mean temperature, while less meteorological drought is expected. Changes in drought intensity scale linearly with global temperature rises under RCP8.5 scenario, indicating themore » potential feasibility to derive future drought severity given certain global warming amount under this scenario. Changing pattern of concurrent droughts generally follows that of agricultural and hydrological droughts. Under the 1.5 °C warming target as advocated in recent Paris agreement, several hot spot regions experiencing highest droughts are identified. Extreme droughts show similar patterns but with much larger magnitude than the climatology. In conclusion, this study highlights the distinct response of droughts of various types to global warming and the asymmetric impact of global warming on drought distribution resulting in a much stronger influence on extreme drought than on mean drought.« less

The asymmetric impact of global warming on US drought types and distributions in a large ensemble of 97 hydro-climatic simulations

DOE PAGES

Huang, Shengzhi; Leng, Guoyong; Huang, Qiang; ...

2017-07-19

Projection of future drought is often involved large uncertainties from climate models, emission scenarios as well as drought definitions. In this study, we investigate changes in future droughts in the conterminous United States based on 97 1/8 degree hydro-climate model projections. Instead of focusing on a specific drought type, we investigate changes in meteorological, agricultural, and hydrological drought as well as the concurrences. Agricultural and hydrological droughts are projected to become more frequent with increase in global mean temperature, while less meteorological drought is expected. Changes in drought intensity scale linearly with global temperature rises under RCP8.5 scenario, indicating themore » potential feasibility to derive future drought severity given certain global warming amount under this scenario. Changing pattern of concurrent droughts generally follows that of agricultural and hydrological droughts. Under the 1.5 °C warming target as advocated in recent Paris agreement, several hot spot regions experiencing highest droughts are identified. Extreme droughts show similar patterns but with much larger magnitude than the climatology. In conclusion, this study highlights the distinct response of droughts of various types to global warming and the asymmetric impact of global warming on drought distribution resulting in a much stronger influence on extreme drought than on mean drought.« less

The asymmetric impact of global warming on US drought types and distributions in a large ensemble of 97 hydro-climatic simulations.

PubMed

Huang, Shengzhi; Leng, Guoyong; Huang, Qiang; Xie, Yangyang; Liu, Saiyan; Meng, Erhao; Li, Pei

2017-07-19

Projection of future drought is often involved large uncertainties from climate models, emission scenarios as well as drought definitions. In this study, we investigate changes in future droughts in the conterminous United States based on 97 1/8 degree hydro-climate model projections. Instead of focusing on a specific drought type, we investigate changes in meteorological, agricultural, and hydrological drought as well as the concurrences. Agricultural and hydrological droughts are projected to become more frequent with increase in global mean temperature, while less meteorological drought is expected. Changes in drought intensity scale linearly with global temperature rises under RCP8.5 scenario, indicating the potential feasibility to derive future drought severity given certain global warming amount under this scenario. Changing pattern of concurrent droughts generally follows that of agricultural and hydrological droughts. Under the 1.5 °C warming target as advocated in recent Paris agreement, several hot spot regions experiencing highest droughts are identified. Extreme droughts show similar patterns but with much larger magnitude than the climatology. This study highlights the distinct response of droughts of various types to global warming and the asymmetric impact of global warming on drought distribution resulting in a much stronger influence on extreme drought than on mean drought.

Impact damage resistance of composite fuselage structure, part 2

NASA Technical Reports Server (NTRS)

Dost, Ernest F.; Finn, Scott R.; Murphy, Daniel P.; Huisken, Amy B.

1993-01-01

The strength of laminated composite materials may be significantly reduced by foreign object impact induced damage. An understanding of the damage state is required in order to predict the behavior of structure under operational loads or to optimize the structural configuration. Types of damage typically induced in laminated materials during an impact event include transverse matrix cracking, delamination, and/or fiber breakage. The details of the damage state and its influence on structural behavior depend on the location of the impact. Damage in the skin may act as a soft inclusion or affect panel stability, while damage occurring over a stiffener may include debonding of the stiffener flange from the skin. An experiment to characterize impact damage resistance of fuselage structure as a function of structural configuration and impact threat was performed. A wide range of variables associated with aircraft fuselage structure such as material type and stiffener geometry (termed, intrinsic variables) and variables related to the operating environment such as impactor mass and diameter (termed, extrinsic variables) were studied using a statistically based design-of-experiments technique. The experimental design resulted in thirty-two different 3-stiffener panels. These configured panels were impacted in various locations with a number of impactor configurations, weights, and energies. The results obtained from an examination of impacts in the skin midbay and hail simulation impacts are documented. The current discussion is a continuation of that work with a focus on nondiscrete characterization of the midbay hail simulation impacts and discrete characterization of impact damage for impacts over the stiffener.

Energy Cost Impact of Non-Residential Energy Code Requirements

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

Zhang, Jian; Hart, Philip R.; Rosenberg, Michael I.

2016-08-22

The 2012 International Energy Conservation Code contains 396 separate requirements applicable to non-residential buildings; however, there is no systematic analysis of the energy cost impact of each requirement. Consequently, limited code department budgets for plan review, inspection, and training cannot be focused on the most impactful items. An inventory and ranking of code requirements based on their potential energy cost impact is under development. The initial phase focuses on office buildings with simple HVAC systems in climate zone 4C. Prototype building simulations were used to estimate the energy cost impact of varying levels of non-compliance. A preliminary estimate of themore » probability of occurrence of each level of non-compliance was combined with the estimated lost savings for each level to rank the requirements according to expected savings impact. The methodology to develop and refine further energy cost impacts, specific to building type, system type, and climate location is demonstrated. As results are developed, an innovative alternative method for compliance verification can focus efforts so only the most impactful requirements from an energy cost perspective are verified for every building and a subset of the less impactful requirements are verified on a random basis across a building population. The results can be further applied in prioritizing training material development and specific areas of building official training.« less

Impact properties of geopolymeric concrete: a state-of-the-art review

NASA Astrophysics Data System (ADS)

Fang, Chi; Xie, Jianhe; Zhang, Bingxue; Yuan, Bing; Wang, Chonghao

2018-01-01

The application of geopolymer instead of cement in construction engineering provides an effective way to achieve sustainable development. A large number of studies have shown that geopolymeric concrete (GC) has excellent static performance. However, there are relatively few studies on the dynamic performance of GC which is of dominate importance in cases such as explosion, earthquake and other impact loads. This paper presents a brief review of recent research on the impact properties of GC, in order to facilitate the research development in this field. The effects of strain rate, fiber type, alkali type, elevated temperature, water environment and flow state on the impact resistance performance of GC were analysed. Research findings revealed that GC exhibited better impact properties than ordinary Portland concrete (OPC).

Food impaction after expandable metal stent placement: experience in 1,360 patients with esophageal and upper gastrointestinal tract obstruction.

PubMed

Song, Min; Song, Ho-Young; Kim, Jin Hyoung; Park, Jung-Hoon; Jung, Hwoon-Yong; Kim, Jong-Hoon; Kim, Sung-Bae

2011-09-01

To retrospectively evaluate the incidence, predictive factors, and interventional management of food impaction after expandable metallic stent placement in patients with obstruction of the esophagus or upper gastrointestinal tract caused by benign or malignant disease. Between March 1993 and March 2010, 1,360 patients (1,029 men, 331 women; age range, 21-89 y; mean age, 61 y) underwent fluoroscopically guided stent placement for dysphagia caused by esophageal or gastrointestinal tract strictures. Five types of covered expandable metal stents were used, including four types of esophageal stents (types A-D) and one type of gastroduodenal stent (type E), with types A, B, C, D, and E stents used in 180, 60, 90, 432, and 598 patients, respectively. Multivariate analysis was performed to evaluate factors predictive of food impaction. Food impaction occurred in 41 of 1,360 patients (3.0%). The food impaction rates for types A, B, C, D, and E stents were 0.6%, 1.7%, 1.1%, 3.2%, and 4.0%, respectively. Multivariate analysis showed that stent length was an independent predictor of food impaction (odds ratio, 0.839; P = .012). Of the 41 patients with food impaction, 23 underwent endoscopic management, 12 underwent fluoroscopically guided management, and six did not require management because impacted food spontaneously passed through the stent. The overall food impaction rate was 3.0%, with multiple logistic regression analysis showing that shorter stent length was the only significant predictor of food impaction. Food impaction can be managed by endoscopic or fluoroscopically guided removal or placement of a second stent. Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.

Researchers of Color, Fame, and Impact.

PubMed

Zárate, Michael A; Hall, Gordon Nagayama; Plaut, Victoria C

2017-11-01

Fame and eminence, as traditionally measured, limit the definition of impact to the publication world. We add two types of impact to the traditional measures of fame and eminence. Many of the traditional measures of fame or eminence are based on social-network connections, whereby individuals appoint other people to positions of eminence. Editorial boards are one specific example. Eminence is also limited to number of publications, for example, with little regard for the impact of those publications at the societal level. In addition to the dominant measures of eminence, societal impact broadens the definition of impact to reflect real-world changes. Two examples include mentoring, which is rarely mentioned as a criterion for eminence, and policy value, such as when research influences important public policy. These additions are discussed in reference to the general underrepresentation of researchers of color in academia.

Decision-making in diabetes mellitus type 1.

PubMed

Rustad, James K; Musselman, Dominique L; Skyler, Jay S; Matheson, Della; Delamater, Alan; Kenyon, Norma S; Cáceda, Ricardo; Nemeroff, Charles B

2013-01-01

Decreased treatment adherence in patients with diabetes mellitus type 1 (type 1 DM) may reflect impairments in decision-making and underlying associated deficits in working memory and executive functioning. Other factors, including comorbid major depression, may also interfere with decision-making. The authors sought to review the clinically relevant characteristics of decision-making in type 1 DM by surveying the literature on decision-making by patients with type 1 DM. Deficiencies in decision-making in patients with type 1 DM or their caregivers contribute to treatment nonadherence and poorer metabolic control. Animal models of type 1 DM reveal deficits in hippocampal-dependent memory tasks, which are reversible with insulin. Neurocognitive studies of patients with type 1 DM reveal lowered performance on ability to apply knowledge to solve problems in a new situation and acquired scholarly knowledge, psychomotor efficiency, cognitive flexibility, visual perception, speed of information-processing, and sustained attention. Other factors that might contribute to poor decision-making in patients with type 1 DM, include "hypoglycemia unawareness" and comorbid major depression (given its increased prevalence in type 1 DM). Future studies utilizing novel treatment strategies to help patients with type 1 DM make better decisions about their disease may improve their glycemic control and quality of life, while minimizing the impact of end-organ disease.

Comorbid Anxiety and Depression and Their Impact on Cardiovascular Disease in Type 2 Diabetes: The Fremantle Diabetes Study Phase II.

PubMed

Bruce, David G; Davis, Wendy A; Dragovic, Milan; Davis, Timothy M E; Starkstein, Sergio E

2016-10-01

The aims were to determine whether anxious depression, defined by latent class analysis (LCA), predicts cardiovascular outcomes in type 2 diabetes and to compare the predictive power of anxious depression with Diagnostic & Statistical Manual Versions IV and 5 (DSM-IV/5) categories of depression and generalized anxiety disorder (GAD). Prospective observational study of 1,337 type 2 participants. Baseline assessment with the 9-item Patient Health Questionnaire and the GAD Scale; LCA-defined groups with minor or major anxious depression based on anxiety and depression symptoms. Cox modeling used to compare the independent impact of: (1) LCA anxious depression, (2) DSM-IV/5 depression, (3) GAD on incident cardiovascular events and deaths after 4 years. LCA minor and major anxious depression was present in 21.9 and 7.8% of participants, respectively, DSM-IV/5 minor and major depression in 6.2 and 6.1%, respectively, and GAD in 4.8%. There were 110 deaths, 31 cardiovascular deaths, and 199 participants had incident cardiovascular events. In adjusted models, minor anxious depression (Hazard ratio (95% confidence intervals): 1.70 (1.15-2.50)) and major anxious depression (1.90 (1.11-3.25)) predicted incident cardiovascular events and major anxious depression also predicted cardiovascular mortality (4.32 (1.35-13.86)). By comparison, incident cardiovascular events were predicted by DSM-IV/5 major depression (2.10 (1.22-3.62)) only and cardiovascular mortality was predicted by both DSM-IV/5 major depression (3.56 (1.03-12.35)) and GAD (5.92 (1.84-19.08)). LCA-defined anxious depression is more common than DSM-IV/5 categories and is a strong predictor of cardiovascular outcomes in type 2 diabetes. These data suggest that this diagnostic scheme has predictive validity and clinical relevance. © 2016 Wiley Periodicals, Inc.

Sleep duration and its impact on adherence in adolescents with type 1 diabetes mellitus.

PubMed

McDonough, Ryan J; Clements, Mark A; DeLurgio, Stephen A; Patton, Susana R

2017-06-01

Adherence to the type 1 diabetes (T1D) regimen, while predictive of glycemic control, decreases during adolescence. For adolescents, attaining adequate sleep is an additional challenge. This study evaluates the impact of sleep on adherence in teens with T1D. Forty-five adolescents aged 12-18 yr, with T1D for at least 6 months while on insulin pump therapy. Adolescents logged their sleep on a written diary for 2 wk. Corresponding insulin pump/glucometer downloads as well as sleep habit questionnaires were also obtained. Data from 20 girls and 25 boys, with a mean age of 15 ± 1.6 yr and mean glycated hemoglobin of 8.7 ± 1.1% (72 mmol/mol), were analyzed. Overall, average sleep was 8.6 ± 0.9 h per night. Sleep durations were compared to the next day's frequency of self-monitored blood glucose (SMBG) and total daily insulin bolus frequency. Associations were found between sleep duration and youths' SMBG and insulin bolus frequencies (p < 0.03 and p < 0.001, respectively). Specifically, a 15- and 20-min increase in sleep was associated with one additional SMBG check and one additional insulin bolus, respectively. Analyses suggest an associated increase in T1D self-management behaviors in youths with increased sleep duration. These findings highlight the importance of assessing sleep in clinical practice, and encourage further research to examine effective strategies to address sleep hygiene as part of routine diabetes management. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Interactive multi-mode blade impact analysis

NASA Technical Reports Server (NTRS)

Alexander, A.; Cornell, R. W.

1978-01-01

The theoretical methodology used in developing an analysis for the response of turbine engine fan blades subjected to soft-body (bird) impacts is reported, and the computer program developed using this methodology as its basis is described. This computer program is an outgrowth of two programs that were previously developed for the purpose of studying problems of a similar nature (a 3-mode beam impact analysis and a multi-mode beam impact analysis). The present program utilizes an improved missile model that is interactively coupled with blade motion which is more consistent with actual observations. It takes into account local deformation at the impact area, blade camber effects, and the spreading of the impacted missile mass on the blade surface. In addition, it accommodates plate-type mode shapes. The analysis capability in this computer program represents a significant improvement in the development of the methodology for evaluating potential fan blade materials and designs with regard to foreign object impact resistance.

Impact of Genetic Testing and Family Health History Based Risk Counseling on Behavior Change and Cognitive Precursors for Type 2 Diabetes.

PubMed

Wu, R Ryanne; Myers, Rachel A; Hauser, Elizabeth R; Vorderstrasse, Allison; Cho, Alex; Ginsburg, Geoffrey S; Orlando, Lori A

2017-02-01

Family health history (FHH) in the context of risk assessment has been shown to positively impact risk perception and behavior change. The added value of genetic risk testing is less certain. The aim of this study was to determine the impact of Type 2 Diabetes (T2D) FHH and genetic risk counseling on behavior and its cognitive precursors. Subjects were non-diabetic patients randomized to counseling that included FHH +/- T2D genetic testing. Measurements included weight, BMI, fasting glucose at baseline and 12 months and behavioral and cognitive precursor (T2D risk perception and control over disease development) surveys at baseline, 3, and 12 months. 391 subjects enrolled of which 312 completed the study. Behavioral and clinical outcomes did not differ across FHH or genetic risk but cognitive precursors did. Higher FHH risk was associated with a stronger perceived T2D risk (p Kendall  < 0.001) and with a perception of "serious" risk (p Kendall  < 0.001). Genetic risk did not influence risk perception, but was correlated with an increase in perception of "serious" risk for moderate (p Kendall  = 0.04) and average FHH risk subjects (p Kendall  = 0.01), though not for the high FHH risk group. Perceived control over T2D risk was high and not affected by FHH or genetic risk. FHH appears to have a strong impact on cognitive precursors of behavior change, suggesting it could be leveraged to enhance risk counseling, particularly when lifestyle change is desirable. Genetic risk was able to alter perceptions about the seriousness of T2D risk in those with moderate and average FHH risk, suggesting that FHH could be used to selectively identify individuals who may benefit from genetic risk testing.

Assessing Man’s Impact on Wetlands,

DTIC Science & Technology

1980-12-01

AD-A94 652 ARMY MILITARY PERSONNEL CENTER ALEXANDRIA VA F/S 8/6 ASSESSZNG MAN’S IMPACT ON WE LANDS,(U) UNCLASSIFIED 0 GALLOWAY 1 A uhuhfuhfhumEIliE...EElliE mrhhmhhhhEEohE mmmmmmmmm Assessing Mns Impact on Wetlands By G.E. Galloway rpp fo f A.l - 5 UN RI pulcto N-RI7-3 D 1 i ILI ’!UNt’ Sea Grant...TITLE (and Subtitle) - - 5. TYPE OF REPORT & PERIOD COVERED /Assessing Man’s Impact on Wetlands December 1980 6. PERFORMING ORG. REPORT NUMBER 7- AU HOR

Chemical, thermal and impact processing of asteroids

NASA Technical Reports Server (NTRS)

Scott, E. R. D.; Taylor, G. J.; Newsom, H. E.; Herbert, F.; Zolensky, M.

1989-01-01

The geological effects of impacts, heating, melting, core formation, and aqueous alteration on asteroids are reviewed. A review of possible heat sources appears to favor an important role for electrical induction heating. The effects of each geologic process acting individually and in combination with others, are considered; it is concluded that there is much evidence for impacts during alteration, metamorphism and melting. These interactions vastly increased the geologic diversity of the asteroid belt. Subsequent impacts of cool asteroids did not reduce this diversity. Instead new rock types were created by mixing, brecciation and minor melting.

Protection against impact with the ground using wearable airbags.

PubMed

Fukaya, Kiyoshi; Uchida, Mitsuya

2008-01-01

Incidental falls from heights, falls on the same level caused by slipping or tripping, and falls from wheelchair overturns are commonplace phenomena, associated with serious injuries from impact with the ground. A wearable airbag device is a countermeasure applicable to all these types of incidents. Three types of wearable airbag systems were developed and evaluated: for protection against falls from heights (Type-1), against wheelchair overturns (Type-2), and against falls on the same level (Type-3). The systems consist of an airbag, sensor, inflator, and jacket. The sensor detects the fall and the airbag inflates to protect the user. Fall tests using dummies with/without the airbags demonstrated the effectiveness of these devices. In the experiments with system Type-1, for fall heights of less than 2m, the airbags reduced the impact acceleration, and the Head Injury Criterion (HIC) values were under 1,000, the auto-crash test requirement. However, there are limits to the amount of protection afforded: in Type-1, the airbag can protect only the back of the head.; in Types-2 and 3, the fall height of the center of gravity is lower than 2m, and there is some margin of extra protective resource, which can be used to extend the protected area.

Dynamical and collisional evolution of Halley-type comets

NASA Astrophysics Data System (ADS)

van der Helm, E.; Jeffers, S. V.

2012-03-01

The number of observed Halley-type comets is hundreds of times less than predicted by models (Levison, H.F., Dones, L., Duncan, M.J. [2001]. Astron. J. 121, 2253-2267). In this paper we investigate the impact of collisions with planetesimals on the evolution of Halley-type comets. First we compute the dynamical evolution of a sub-set of 21 comets using the MERCURY integrator package over 100 Myr. The dynamical lifetime is determined to be of the order of 105-106 years in agreement with previous work. The collisional probability of Halley-type comets colliding with known asteroids, a simulated population of Kuiper-belt objects, and planets, is calculated using a modified, Öpik-based collision code. Our results show that the catastrophic disruption of the cometary nucleus has a very low probability of occurring, and disruption through cumulative minor impacts is concluded to be negligible. The dust mantle formed from ejected material falling back to the comet’s surface is calculated to be less than a few centimeters thick, which is insignificant compared to the mantle formed by volatile depletion, while planetary encounters were found to be a negligible disruption mechanism.

Aircraft type influence on contrail properties

NASA Astrophysics Data System (ADS)

Jeßberger, P.; Voigt, C.; Schumann, U.; Sölch, I.; Schlager, H.; Kaufmann, S.; Petzold, A.; Schäuble, D.; Gayet, J.-F.

2013-05-01

The investigation of the impact of aircraft parameters on contrail properties helps to better understand the climate impact from aviation. Yet, in observations, it is a challenge to separate aircraft and meteorological influences on contrail formation. During the CONCERT campaign in November 2008, contrails from 3 Airbus passenger aircraft of type A319-111, A340-311 and A380-841 were probed at cruise under similar meteorological conditions with in-situ instruments on board the DLR research aircraft Falcon. Within the 2 min old contrails detected near ice saturation, we find similar effective diameters Deff (5.2-5.9 μm), but differences in particle number densities nice (162-235 cm-3) and in vertical contrail extensions (120-290 m), resulting in large differences in contrail optical depths τ (0.25-0.94). Hence larger aircraft produce optically thicker contrails. Based on the observations, we apply the EULAG-LCM model with explicit ice microphysics and in addition the Contrail and Cirrus Prediction model CoCiP to calculate the aircraft type impact on young contrails under identical meteorological conditions. The observed increase in τ for heavier aircraft is confirmed by the models, yet for generally smaller τ. An aircraft dependence of climate relevant contrail properties persists during contrail lifetime, adding importance to aircraft dependent model initialization. We finally derive an analytical relationship between contrail, aircraft and meteorological parameters. Near ice saturation, contrail width × τ scales linearly with fuel flow rate as confirmed by observations. For higher saturation ratios approximations from theory suggest a non-linear increase in the form (RHI-1)2/3. Summarized our combined results could help to more accurately assess the climate impact from aviation using an aircraft dependent contrail parameterization.

Aircraft type influence on contrail properties

NASA Astrophysics Data System (ADS)

Jeßberger, P.; Voigt, C.; Schumann, U.; Sölch, I.; Schlager, H.; Kaufmann, S.; Petzold, A.; Schäuble, D.; Gayet, J.-F.

2013-12-01

The investigation of the impact of aircraft parameters on contrail properties helps to better understand the climate impact from aviation. Yet, in observations, it is a challenge to separate aircraft and meteorological influences on contrail formation. During the CONCERT campaign in November 2008, contrails from 3 Airbus passenger aircraft of types A319-111, A340-311 and A380-841 were probed at cruise under similar meteorological conditions with in situ instruments on board DLR research aircraft Falcon. Within the 2 min-old contrails detected near ice saturation, we find similar effective diameters Deff (5.2-5.9 μm), but differences in particle number densities nice (162-235 cm-3) and in vertical contrail extensions (120-290 m), resulting in large differences in contrail optical depths τ at 550 nm (0.25-0.94). Hence larger aircraft produce optically thicker contrails. Based on the observations, we apply the EULAG-LCM model with explicit ice microphysics and, in addition, the Contrail and Cirrus Prediction (CoCiP) model to calculate the aircraft type impact on young contrails under identical meteorological conditions. The observed increase in τ for heavier aircraft is confirmed by the models, yet for generally smaller τ. CoCiP model results suggest that the aircraft dependence of climate-relevant contrail properties persists during contrail lifetime, adding importance to aircraft-dependent model initialization. We finally derive an analytical relationship between contrail, aircraft and meteorological parameters. Near ice saturation, contrail width × τ scales linearly with the fuel flow rate, as confirmed by observations. For higher relative humidity with respect to ice (RHI), the analytical relationship suggests a non-linear increase in the form (RHI-12/3. Summarized, our combined results could help to more accurately assess the climate impact from aviation using an aircraft-dependent contrail parameterization.

Impact of chronotype and time perspective on the processing of scripts.

PubMed

Nowack, Kati; van der Meer, Elke

2014-05-01

Little is known about the impact of temporal orientation (chronotype; time perspective) on cognitive performance. This study adopted a psychophysiological approach to explore how chronotype (morningness-eveningness) and time perspective (present; future) influence time succession as another aspect of psychological time that is entailed within script knowledge. In a temporal judgment task, participants decided which of the two presented sub-events (e.g., get new batteries-set right time on alarm clock) comes earlier (or later) within a given script (e.g., changing batteries in an alarm clock). Behavioral and pupillary data suggest a differential impact of chronotype and time perspective on script knowledge and cognitive performance. The impact of time perspective on the processing of temporal information entailed in script knowledge appears linked to match or mismatch conditions between a strong focus on future outcomes associated with future time perspective and the task of identifying either the later (future-oriented) or the earlier (past-oriented) sub-event. Concerning the chronotype, evening types process items in which chronological time succession is violated (i.e., reversely presented items) more accurately than morning types. Indexed by pupillary data, the impact of chronotype may relate to more general cognitive abilities. The psychophysiological data derived in this study suggests that evening types typically outperform morning types in various measures such working memory capacity and verbal intelligence simply because they invest more cognitive resources than morning types. Copyright © 2014 Elsevier B.V. All rights reserved.

Comparative Analysis of Head Impact in Contact and Collision Sports

PubMed Central

Reynolds, Bryson B.; Patrie, James; Henry, Erich J.; Goodkin, Howard P.; Broshek, Donna K.; Wintermark, Max

2017-01-01

Abstract As concerns about head impact in American football have grown, similar concerns have started to extend to other sports thought to experience less head impact, such as soccer and lacrosse. However, the amount of head impact experienced in soccer and lacrosse is relatively unknown, particularly compared with the substantial amount of data from football. This pilot study quantifies and compares head impact from four different types of sports teams: college football, high school football, college soccer, and college lacrosse. During the 2013 and 2014 seasons, 61 players wore mastoid patch accelerometers to quantify head impact during official athletic events (i.e., practices and games). In both practices and games, college football players experienced the most or second-most impacts per athletic event, highest average peak resultant linear and rotational acceleration per impact, and highest cumulative linear and rotational acceleration per athletic event. For average peak resultant linear and rotational acceleration per individual impact, college football was followed by high school football, then college lacrosse, and then college soccer, with similar trends in both practices and games. In the four teams under study, college football players experienced a categorically higher burden of head impact. However, for cumulative impact burden, the high school football cohort was not significantly different from the college soccer cohort. The results suggest that head impact in sport substantially varies by both the type of sport (football vs. soccer vs. lacrosse) and level of play (college vs. high school). PMID:27541183

Frequency and location of head impact exposures in individual collegiate football players.

PubMed

Crisco, Joseph J; Fiore, Russell; Beckwith, Jonathan G; Chu, Jeffrey J; Brolinson, Per Gunnar; Duma, Stefan; McAllister, Thomas W; Duhaime, Ann-Christine; Greenwald, Richard M

2010-01-01

Measuring head impact exposure is a critical step toward understanding the mechanism and prevention of sport-related mild traumatic brain (concussion) injury, as well as the possible effects of repeated subconcussive impacts. To quantify the frequency and location of head impacts that individual players received in 1 season among 3 collegiate teams, between practice and game sessions, and among player positions. Cohort study. Collegiate football field. One hundred eighty-eight players from 3 National Collegiate Athletic Association football teams. Participants wore football helmets instrumented with an accelerometer-based system during the 2007 fall season. The number of head impacts greater than 10 g and location of the impacts on the player's helmet were recorded and analyzed for trends and interactions among teams (A, B, or C), session types, and player positions using Kaplan-Meier survival curves. The total number of impacts players received was nonnormally distributed and varied by team, session type, and player position. The maximum number of head impacts for a single player on each team was 1022 (team A), 1412 (team B), and 1444 (team C). The median number of head impacts on each team was 4.8 (team A), 7.5 (team B), and 6.6 (team C) impacts per practice and 12.1 (team A), 14.6 (team B), and 16.3 (team C) impacts per game. Linemen and linebackers had the largest number of impacts per practice and per game. Offensive linemen had a higher percentage of impacts to the front than to the back of the helmet, whereas quarterbacks had a higher percentage to the back than to the front of the helmet. The frequency of head impacts and the location on the helmet where the impacts occur are functions of player position and session type. These data provide a basis for quantifying specific head impact exposure for studies related to understanding the biomechanics and clinical aspects of concussion injury, as well as the possible effects of repeated subconcussive impacts in

Impact melt breccias at the Apollo 17 landing site

NASA Technical Reports Server (NTRS)

Ryder, Graham

1992-01-01

Impact melt breccias are by far the most common highland rock type collected on the Apollo 17 mission. They tend to be fine grained, with virtually no clast-free impact melt rocks having been identified. All the highland boulders sampled are impact melt breccia, with the possible exception of one South Massif boulder that might have a friable matrix (but nonetheless consists dominantly of impact melt) and a shocked igneous norite boulder from the North Massif. The impact melt breccias were originally described as metaclastic, but their melt origin became apparent as work progressed. Chemical compositions appear to allow natural groupings of the impact melt breccias. Various groupings of the impact melt breccias are discussed.

Restrictions on surgical resident shift length does not impact type of medical errors.

PubMed

Anderson, Jamie E; Goodman, Laura F; Jensen, Guy W; Salcedo, Edgardo S; Galante, Joseph M

2017-05-15

In 2011, resident duty hours were restricted in an attempt to improve patient safety and resident education. With the goal of reducing fatigue, shorter shift length leads to more patient handoffs, raising concerns about adverse effects on patient safety. This study seeks to determine whether differences in duty-hour restrictions influence types of errors made by residents. This is a nested retrospective cohort study at a surgery department in an academic medical center. During 2013-14, standard 2011 duty hours were in place for residents. In 2014-15, duty-hour restrictions at the study site were relaxed ("flexible") with no restrictions on shift length. We reviewed all morbidity and mortality submissions from July 1, 2013-June 30, 2015 and compared differences in types of errors between these periods. A total of 383 patients experienced adverse events, including 59 deaths (15.4%). Comparing standard versus flexible periods, there was no difference in mortality (15.7% versus 12.6%, P = 0.479) or complication rates (2.6% versus 2.5%, P = 0.696). There was no difference in types of errors between periods (P = 0.050-0.808). The most number of errors were due to cognitive failures (229, 59.6%), whereas the fewest number of errors were due to team failure (127, 33.2%). By subset, technical errors resulted in the highest number of errors (169, 44.1%). There were no differences between types of errors of cases that were nonelective, at night, or involving residents. Among adverse events reported in this departmental surgical morbidity and mortality, there were no differences in types of errors when resident duty hours were less restrictive. Copyright © 2017 Elsevier Inc. All rights reserved.

The Types and Effects of Peer Native Speakers' Feedback on CMC

ERIC Educational Resources Information Center

Diez-Bedmar, Maria Belen; Perez-Paredes, Pascual

2012-01-01

Online collaborative writing tasks are frequently undertaken in forums and wikis. Variation between these two communication modes has yet to be examined, particularly type of feedback and its effects. We investigated the type of feedback and the impact of English native-speakers' feedback on Spanish peers' discourse restructuring in the context of…

Economic Impacts of a Wide Area Release of Anthrax

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

Judd, Kathleen S.; Olson, Jarrod; Stein, Steven L.

2009-05-29

This analysis explores economic impacts that might result from a wide-area release of anthrax. The intent is not to provide a quantitative analysis of such a disaster, but to: 1. Define the general categories of economic impacts that the region should be concerned about; and, 2. Explore what types of private sector businesses or industries, if any, may have the greatest impact on speeding the economic recovery of the region.

Evaluating for impact: what type of data can assist a health promoting school approach?

PubMed

Joyce, Andrew; Dabrowski, Anna; Aston, Ruth; Carey, Gemma

2017-04-01

There is debate within the health promoting school (HPS) movement on whether schools should monitor health behaviour outcomes as part of an evaluation or rely more on process type measures, such as changes to school policies and the physical and social environment which yield information about (in)effective implementation. The debate is often framed around ideological considerations of the role of schools and there is little empirical work on how these indicators of effective implementation can influence change at a policy and practice level in real world settings. Information has potentially powerful effects in motivating a change process, but this will vary according to the type of information and the type of organizational culture into which it is presented. The current predominant model relies on process data, policy and environmental audit monitoring and benchmarking approaches, and there is little evidence of whether this engages school communities. Theoretical assertions on the importance of monitoring data to motivate change need to be empirically tested and, in doing so, we can learn which types of data influence adoption of HPS in which types of school and policy contexts. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Damage characterization of E-glass and C-glass fibre polymer composites after high velocity impact

NASA Astrophysics Data System (ADS)

Razali, N.; Sultan, M. T. H.; Cardona, F.; Jawaid, M.

2017-12-01

The purpose of this work is to identify impact damage on glass fibre reinforced polymer composite structures after high velocity impact. In this research, Type C-glass (600 g/m2) and Type E-glass (600 g/m2) were used to fabricate Glass Fibre-Reinforced Polymer composites (GFRP) plates. The panels were fabricated using a vacuum bagging and hot bounder method. Single stage gas gun (SSGG) was used to do the testing and data acquisition system was used to collect the damage data. Different types of bullets and different pressure levels were used for the experiment. The obtained results showed that the C-glass type of GFRP experienced more damage in comparison to E-glass type of materials based on the amount of energy absorbed on impact and the size of the damage area. All specimens underwent a partial fibre breakage but the laminates were not fully penetrated by the bullets. This indicated that both types of materials have high impact resistance even though the applied pressures of the gas gun were on the high range. We concluded that within the material specifications of the laminates including the type of glass fibre reinforcement and the thickness of the panels, those composite materials are safe to be applied in structural and body armour applications as an alternative to more expensive materials such as Kevlar and type S-glass fibre based panels.

AC loss modelling and experiment of two types of low-inductance solenoidal coils

NASA Astrophysics Data System (ADS)

Liang, Fei; Yuan, Weijia; Zhang, Min; Zhang, Zhenyu; Li, Jianwei; Venuturumilli, Sriharsha; Patel, Jay

2016-11-01

Low-inductance solenoidal coils, which usually refer to the nonintersecting type and the braid type, have already been employed to build superconducting fault current limiters because of their fast recovery and low inductance characteristics. However, despite their usage there is still no systematical simulation work concerning the AC loss characteristics of the coils built with 2G high temperature superconducting tapes perhaps because of their complicated structure. In this paper, a new method is proposed to simulate both types of coils with 2D axisymmetric models solved by H formulation. Following the simulation work, AC losses of both types of low inductance solenoidal coils are compared numerically and experimentally, which verify that the model works well in simulating non-inductive coils. Finally, simulation works show that pitch has significant impact to AC loss of both types of coils and the inter-layer separation has different impact to the AC loss of braid type of coil in case of different applied currents. The model provides an effective tool for the design optimisation of SFCLs built with non-inductive solenoidal coils.

Decreasing the Burden of Type 2 Diabetes in South Africa: The Impact of Taxing Sugar-Sweetened Beverages

PubMed Central

Manyema, Mercy; Veerman, J. Lennert; Chola, Lumbwe; Tugendhaft, Aviva; Labadarios, Demetre; Hofman, Karen

2015-01-01

Introduction Type 2 diabetes poses an increasing public health burden in South Africa (SA) with obesity as the main driver of the epidemic. Consumption of sugar sweetened beverages (SSBs) is linked to weight gain and reducing SSB consumption may significantly impact the prevalence of obesity and related diseases. We estimated the effect of a 20% SSB tax on the burden of diabetes in SA. Methods and Findings We constructed a life table-based model in Microsoft Excel (2010). Consumption data from the 2012 SA National Health and Nutrition Examination Survey, previously published own- and cross-price elasticities of SSBs and energy balance equations were used to estimate changes in daily energy intake and its projected impact on BMI arising from increased SSB prices. Diabetes relative risk and prevalent years lived with disability estimates from the Global Burden of Disease Study and modelled disease epidemiology estimates from a previous study were used to estimate the effect of the BMI changes on diabetes burden. Diabetes cost estimates were obtained from the South African Council for Medical Schemes. Over 20 years, a 20% SSB tax could reduce diabetes incident cases by 106 000 in women (95% uncertainty interval (UI) 70 000–142 000) and by 54 000 in men (95% UI: 33 000–80 000); and prevalence in all adults by 4.0% (95% UI: 2.7%-5.3%). Cumulatively over twenty years, approximately 21 000 (95% UI: 14 000–29 000) adult T2DM-related deaths, 374 000 DALYs attributed to T2DM (95% UI: 299 000–463 000) and over ZAR10 billion T2DM healthcare costs (95% UI: ZAR6.8–14.0 billion) equivalent to USD860 million (95% UI: USD570 million–USD1.2 billion) may be averted. Conclusion Fiscal policy on SSBs has the potential to mitigate the diabetes epidemic in South Africa and contribute to the National Department of Health goals stated in the National NCD strategic plan. PMID:26575644

Decreasing the Burden of Type 2 Diabetes in South Africa: The Impact of Taxing Sugar-Sweetened Beverages.

PubMed

Manyema, Mercy; Veerman, J Lennert; Chola, Lumbwe; Tugendhaft, Aviva; Labadarios, Demetre; Hofman, Karen

2015-01-01

Type 2 diabetes poses an increasing public health burden in South Africa (SA) with obesity as the main driver of the epidemic. Consumption of sugar sweetened beverages (SSBs) is linked to weight gain and reducing SSB consumption may significantly impact the prevalence of obesity and related diseases. We estimated the effect of a 20% SSB tax on the burden of diabetes in SA. We constructed a life table-based model in Microsoft Excel (2010). Consumption data from the 2012 SA National Health and Nutrition Examination Survey, previously published own- and cross-price elasticities of SSBs and energy balance equations were used to estimate changes in daily energy intake and its projected impact on BMI arising from increased SSB prices. Diabetes relative risk and prevalent years lived with disability estimates from the Global Burden of Disease Study and modelled disease epidemiology estimates from a previous study were used to estimate the effect of the BMI changes on diabetes burden. Diabetes cost estimates were obtained from the South African Council for Medical Schemes. Over 20 years, a 20% SSB tax could reduce diabetes incident cases by 106 000 in women (95% uncertainty interval (UI) 70 000-142 000) and by 54 000 in men (95% UI: 33 000-80 000); and prevalence in all adults by 4.0% (95% UI: 2.7%-5.3%). Cumulatively over twenty years, approximately 21 000 (95% UI: 14 000-29 000) adult T2DM-related deaths, 374 000 DALYs attributed to T2DM (95% UI: 299 000-463 000) and over ZAR10 billion T2DM healthcare costs (95% UI: ZAR6.8-14.0 billion) equivalent to USD860 million (95% UI: USD570 million-USD1.2 billion) may be averted. Fiscal policy on SSBs has the potential to mitigate the diabetes epidemic in South Africa and contribute to the National Department of Health goals stated in the National NCD strategic plan.

The Impact of Chronotype on Melatonin Levels Among Shift Workers

PubMed Central

Bhatti, Parveen; Mirick, Dana K.; Davis, Scott

2015-01-01

Objectives The association between shift work and cancer, which is thought to be mediated by effects on circulating melatonin levels, may be modified by chronotype (i.e. the inherent preference for activity in the morning or the evening); however, few studies have examined the potential impact of chronotype on the carcinogenic effects of shift work. The authors analyzed the impact of chronotype on previously reported differences in melatonin levels among healthcare workers that exclusively worked night or day shifts. Methods The cross-sectional study included 664 men and women (310 day shift and 354 night shift workers) from which urine samples were collected throughout work and sleep periods and were assayed for 6-sulfatoxymelatonin. Participants also completed the Composite Scale of Morningness, a questionnaire used to assess chronotype. Results Among both morning and evening-type night shift workers, 6-sulfatoxymelatonin levels were constitutively lower during daytime sleep, nighttime sleep and night work compared to dayshift workers during nighttime sleep. However, morning-type shift workers consistently showed 6-sulfatoxymelatonin levels that were closer to levels in day shift workers than did evening-type night shift workers. Differences in 6-sulfatoxymelatonin levels between morning-type and evening-type night shift workers relative to day shift workers were statistically significant in every instance (p < 0.05). Conclusion These results suggest that morning-type night shift workers may be better able to maintain a ‘normal’ circadian pattern of melatonin production as compared to evening-type night shift workers. The impact of this chronotype effect on cancer risk among shift workers requires further study. PMID:24399070

The impact of chronotype on melatonin levels among shift workers.

PubMed

Bhatti, Parveen; Mirick, Dana K; Davis, Scott

2014-03-01

The association between shift work and cancer, which is thought to be mediated by effects on circulating melatonin levels, may be modified by chronotype (ie, the inherent preference for activity in the morning or the evening); however, few studies have examined the potential impact of chronotype on the carcinogenic effects of shift work. The authors analysed the impact of chronotype on previously reported differences in melatonin levels among healthcare workers that exclusively worked night or day shifts. The cross-sectional study included 664 men and women (310 day shift and 354 night shift workers) from which urine samples were collected throughout work and sleep periods and were assayed for 6-sulfatoxymelatonin. Participants also completed the Composite Scale of Morningness, a questionnaire used to assess chronotype. Among both morning and evening-type night shift workers, 6-sulfatoxymelatonin levels were constitutively lower during daytime sleep, night-time sleep and night work compared with day shift workers during night-time sleep. However, morning-type night shift workers consistently showed 6-sulfatoxymelatonin levels that were closer to levels in day shift workers than did evening-type night shift workers. Differences in 6-sulfatoxymelatonin levels between morning-type and evening-type night shift workers relative to day shift workers were statistically significant in every instance (p<0.05). These results suggest that morning-type night shift workers may be better able to maintain a 'normal' circadian pattern of melatonin production as compared with evening-type night shift workers. The impact of this chronotype effect on cancer risk among shift workers requires further study.

Comparing the Ecological Impacts of Wind and Oil & Gas Development: A Landscape Scale Assessment

PubMed Central

Jones, Nathan F.; Pejchar, Liba

2013-01-01

Energy production in the United States is in transition as the demand for clean and domestic power increases. Wind energy offers the benefit of reduced emissions, yet, like oil and natural gas, it also contributes to energy sprawl. We used a diverse set of indicators to quantify the ecological impacts of oil, natural gas, and wind energy development in Colorado and Wyoming. Aerial imagery was supplemented with empirical data to estimate habitat loss, fragmentation, potential for wildlife mortality, susceptibility to invasion, biomass carbon lost, and water resources. To quantify these impacts we digitized the land-use footprint within 375 plots, stratified by energy type. We quantified the change in impacts per unit area and per unit energy produced, compared wind energy to oil and gas, and compared landscapes with and without energy development. We found substantial differences in impacts between energy types for most indicators, although the magnitude and direction of the differences varied. Oil and gas generally resulted in greater impacts per unit area but fewer impacts per unit energy compared with wind. Biologically important and policy-relevant outcomes of this study include: 1) regardless of energy type, underlying land-use matters and development in already disturbed areas resulted in fewer total impacts; 2) the number and source of potential mortality varied between energy types, however, the lack of robust mortality data limits our ability to use this information to estimate and mitigate impacts; and 3) per unit energy produced, oil and gas extraction was less impactful on an annual basis but is likely to have a much larger cumulative footprint than wind energy over time. This rapid evaluation of landscape-scale energy development impacts could be replicated in other regions, and our specific findings can help meet the challenge of balancing land conservation with society’s demand for energy. PMID:24312296

Comparing the ecological impacts of wind and oil & gas development: a landscape scale assessment.

PubMed

Jones, Nathan F; Pejchar, Liba

2013-01-01

Energy production in the United States is in transition as the demand for clean and domestic power increases. Wind energy offers the benefit of reduced emissions, yet, like oil and natural gas, it also contributes to energy sprawl. We used a diverse set of indicators to quantify the ecological impacts of oil, natural gas, and wind energy development in Colorado and Wyoming. Aerial imagery was supplemented with empirical data to estimate habitat loss, fragmentation, potential for wildlife mortality, susceptibility to invasion, biomass carbon lost, and water resources. To quantify these impacts we digitized the land-use footprint within 375 plots, stratified by energy type. We quantified the change in impacts per unit area and per unit energy produced, compared wind energy to oil and gas, and compared landscapes with and without energy development. We found substantial differences in impacts between energy types for most indicators, although the magnitude and direction of the differences varied. Oil and gas generally resulted in greater impacts per unit area but fewer impacts per unit energy compared with wind. Biologically important and policy-relevant outcomes of this study include: 1) regardless of energy type, underlying land-use matters and development in already disturbed areas resulted in fewer total impacts; 2) the number and source of potential mortality varied between energy types, however, the lack of robust mortality data limits our ability to use this information to estimate and mitigate impacts; and 3) per unit energy produced, oil and gas extraction was less impactful on an annual basis but is likely to have a much larger cumulative footprint than wind energy over time. This rapid evaluation of landscape-scale energy development impacts could be replicated in other regions, and our specific findings can help meet the challenge of balancing land conservation with society's demand for energy.

Maltreatment type and behaviors: does listening matter?

PubMed

Merritt, Darcey H; Snyder, Susan M

2014-12-01

This article presents an exploratory assessment of whether children's perceptions of caseworker support (e.g. feeling listened to) moderates the relationship between the type of maltreatment and problematic behaviors. Relying on data collected for the National Survey of Child and Adolescent Well-Being (NSCAW I), this research measures how often children felt listened to by their caseworkers and the effect on the relationship between two types of maltreatment (e.g. physical abuse and neglect) and problematic child behaviors. Results indicate that whereas children reported feeling listened to most of the time, there are significant differences in the probabilities of problematic behavior scores between physically abused and neglected children according to how often they felt listened to. With the exception of those children who felt listened to all of the time, physically abused children have a higher probability of problematic behaviors than neglected children. Comparisons between the two maltreatment types indicate a greater impact of listening on physically abused children across the continuum of feeling listened to (e.g. never to all of the time), than for neglected children, except for at the highest level of listening, as results indicate a small, but significant difference indicating neglected children are more positively impacted by listening than physically abused kids. Implications for practice are that children's perceptions of support from caseworkers may influence behavioral outcomes differently according to maltreatment type. Additionally, these findings encourage the inclusion of children's perspectives regarding the relationships they have with caseworkers. Copyright © 2014. Published by Elsevier Ltd.

Classification of Baltic Sea ice types by airborne multifrequency microwave radiometer

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

Kurvonen, L.; Hallikainen, M.

An airborne multifrequency radiometer (24, 34, 48, and 94 GHz, vertical polarization) was used to investigate the behavior of the brightness temperature of different sea ice types in the Gulf of Bothnia (Baltic Sea). The measurements and the main results of the analysis are presented. The measurements were made in dry and wet conditions (air temperature above and below 0 C). The angle of incidence was 45{degree} in all measurements. The following topics are evaluated: (a) frequency dependency of the brightness temperature of different ice types, (b) the capability of the multifrequency radiometer to classify ice types for winter navigationmore » purposes, and (c) the optimum measurement frequencies for mapping sea ice. The weather conditions had a significant impact on the radiometric signatures of some ice types (snow-covered compact pack ice and frost-covered new ice); the impact was the highest at 94 GHz. In all cases the overall classification accuracy was around 90% (the kappa coefficient was from 0.86 to 0.96) when the optimum channel combination (24/34 GHz and 94 GHz) was used.« less

Technical support document: Energy conservation standards for consumer products: Dishwashers, clothes washers, and clothes dryers including: Environmental impacts; regulatory impact analysis

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

Not Available

1990-12-01

The Energy Policy and Conservation Act as amended (P.L. 94-163), establishes energy conservation standards for 12 of the 13 types of consumer products specifically covered by the Act. The legislation requires the Department of Energy (DOE) to consider new or amended standards for these and other types of products at specified times. This Technical Support Document presents the methodology, data and results from the analysis of the energy and economic impacts of standards on dishwashers, clothes washers, and clothes dryers. The economic impact analysis is performed in five major areas: An Engineering Analysis, which establishes technical feasibility and product attributesmore » including costs of design options to improve appliance efficiency. A Consumer Analysis at two levels: national aggregate impacts, and impacts on individuals. The national aggregate impacts include forecasts of appliance sales, efficiencies, energy use, and consumer expenditures. The individual impacts are analyzed by Life-Cycle Cost (LCC), Payback Periods, and Cost of Conserved Energy (CCE), which evaluate the savings in operating expenses relative to increases in purchase price; A Manufacturer Analysis, which provides an estimate of manufacturers' response to the proposed standards. Their response is quantified by changes in several measures of financial performance for a firm. An Industry Impact Analysis shows financial and competitive impacts on the appliance industry. A Utility Analysis that measures the impacts of the altered energy-consumption patterns on electric utilities. A Environmental Effects analysis, which estimates changes in emissions of carbon dioxide, sulfur oxides, and nitrogen oxides, due to reduced energy consumption in the home and at the power plant. A Regulatory Impact Analysis collects the results of all the analyses into the net benefits and costs from a national perspective. 47 figs., 171 tabs. (JF)« less

Jointly characterizing epigenetic dynamics across multiple human cell types

PubMed Central

An, Lin; Yue, Feng; Hardison, Ross C

2016-01-01

Advanced sequencing technologies have generated a plethora of data for many chromatin marks in multiple tissues and cell types, yet there is lack of a generalized tool for optimal utility of those data. A major challenge is to quantitatively model the epigenetic dynamics across both the genome and many cell types for understanding their impacts on differential gene regulation and disease. We introduce IDEAS, an integrative and discriminative epigenome annotation system, for jointly characterizing epigenetic landscapes in many cell types and detecting differential regulatory regions. A key distinction between our method and existing state-of-the-art algorithms is that IDEAS integrates epigenomes of many cell types simultaneously in a way that preserves the position-dependent and cell type-specific information at fine scales, thereby greatly improving segmentation accuracy and producing comparable annotations across cell types. PMID:27095202

Impacts of future changes in weather condition on U.S. transportation

NASA Astrophysics Data System (ADS)

Ashfaq, M.; Pagan, B. R.; Bonds, B. W.; Rastogi, D.

2016-12-01

High-resolution near-term climate projections suggest an intensification of the regional hydrological cycle over the U.S., leading to stronger and more frequent precipitation events. Increase in precipitation extremes is driven by both warm season convection driven rainstorms and frontal based cold season snowstorms. Results also indicate that future warming is driven more by hot extremes, as decrease in cold extremes is three times less than increase in hot extremes. While projected changes may likely impact the transportation system across the U.S., accurate estimation of such impacts requires knowledge of changes in precipitation types (rain, snow, ice, freezing rain). Here we apply four commonly used precipitation typing algorithms to determine different types of precipitation in an 11-memebr high-resolution (18 km) climate projections dataset that covers 40 years (1966-2005) in the baseline and 40 years (2011-2050) in the future period under Representative Concentration Pathway 8.5. The results are compared with the NARR-based precipitation classification in the historical period at the county level. Documented weather related county level fatal crash data for the CONUS and non-fatal crash data for selected states in the eastern half of the U.S. is compiled to develop the historical baseline for the impact of weather conditions on transportation. Further analysis is carried out to understand the ability of an ensemble of high-resolution simulations to produce different precipitation types in the baseline period, potential changes in the occurrence of each type of weather condition in the future period and that how such changes may impact road conditions, vehicle crashes and human fatalities. Additional analysis will also be explored to understand the impact of changes in winter weather conditions on the cost associated with road maintenance.

Safety and metabolic impact of Ramadan fasting in children and adolescents with type 1 diabetes.

PubMed

El-Hawary, Amany; Salem, Nanees; Elsharkawy, Ashraf; Metwali, Abdelhameed; Wafa, Alaa; Chalaby, Nehad; El-Gilany, Abelhady; Abo-Elmagd, Megahed; El-Ziny, Magdy

2016-05-01

Annually, many children and adolescents with type 1 diabetes mellitus (T1DM) insist on fasting for Ramadan despite being exempted and despite knowing all the risks. We aimed to assess the safety and metabolic impact of Ramadan fasting in children with T1DM using different insulin regimens. Children with T1DM who choose to fast during Ramadan 1434/2013 (29 days) were recruited 3 months before Ramadan. They received pre-Ramadan intensive education. Three insulin regimens were included; Regimen-I (regular insulin/NPH); Regimen-II (regular insulin/insulin glargine) and Regimen-III (premixed insulin). Changes in weight, insulin dose, HbA1c, fructosamine and lipid profile were evaluated. Out of total 53 patients (24 male), 28 patients (52.8%) completed Ramadan fasting (fasting group). The remaining 25 patients were included in (broke-fasting group). Positive correlation between fructosamine changes and number of days fasted during Ramadan. Significant decrease in post-Ramadan fructosamine (<0.001) and increase in post-Ramadan total cholesterol and low density lipoprotein (LDL) levels were detected within fasting, broke-fasting and insulin regimen groups. Significant higher blood glucose at three time points, pre-Iftar, pre-Sohur and midday in Regimen-I compared to Regimen-II and Regimen-III (p=0.004). Fasting during Ramadan is feasible and is associated with significant improvement in fructosamine level in children with T1DM using different insulin regimens. Mandatory consideration to the quality and quantity of food offered to patients with T1DM during Ramadan to guard against adverse changes in lipid profile.

The impact of human immunodeficiency virus-related diseases on pigmented skin types.

PubMed

Ameen, M

2013-10-01

Infection with human immunodeficiency virus (HIV) remains a significant problem globally. Early diagnosis and treatment with antiretroviral drugs has considerably improved health outcomes and decreased disease-related morbidity. HIV infection is associated with a wide range of skin disorders enabling dermatologists to diagnose HIV as well as associated opportunistic infections early in the course of disease. Despite concerted efforts by international health organizations to limit disease incidence, the prevalence of HIV infection remains high and is highest in sub-Saharan Africa. The diagnosis of HIV-related skin diseases is challenging as immunosuppression often results in atypical disease presentation. In addition, the clinical presentation will vary in pigmented skin types. The aim of this article is to describe disease variation in pigmented skin types. © 2013 The Author BJD © 2013 British Association of Dermatologists.

Impact of Type II Spicules into the Corona

NASA Astrophysics Data System (ADS)

Martinez-Sykora, Juan; De Pontieu, Bart; Carlsson, Mats; Hansteen, Viggo H.; Pereira, Tiago M. D.

2017-08-01

In the lower solar atmosphere, the chromosphere is permeated by jets, in which plasma is propelled at speeds of 50-150 km/s into the Sun’s atmosphere or corona. Although these spicules may play a role in heating the million-degree corona and are associated with Alfvén waves that help drive the solar wind, their generation remains mysterious. We implemented in the radiative MHD Bifrost code the effects of partial ionization using the generalized Ohm’s law. This code also solves the full MHD equations with non-grey and non-LTE radiative transfer and thermal conduction along magnetic field lines. The ion-neutral collision frequency is computed using recent studies that improved the estimation of the cross sections under chromospheric conditions (Vranjes & Krstic 2013). Self-consistently driven jets (spicules type II) in magnetohydrodynamic simulations occur ubiquitously when magnetic tension is confined and transported upwards through interactions between ions and neutrals, and impulsively released to drive flows, heat plasma, generate Alfvén waves, and may play an important role in maintaining the substructure of loop fans. This mechanism explains how spicular plasma can be heated to millions of degrees and how Alfvén waves are generated in the chromosphere.

High Energy Wide Area Blunt Impact on Composite Aircraft Structures

NASA Astrophysics Data System (ADS)

DeFrancisci, Gabriela K.

The largest source of damage to commercial aircraft is caused by accidental contact with ground service equipment (GSE). The cylindrical bumper typically found on GSE distributes the impact load over a large contact area, possibly spanning multiple internal structural elements (frame bays) of a stiffened-skin fuselage. This type of impact can lead to damage that is widespread and difficult to detect visually. To address this problem, monolithic composite panels of various size and complexity have been modeled and tested quasi-statically and dynamically. The experimental observations have established that detectability is dependent on the impact location and immediately-adjacent internal structure of the panel, as well as the impactor geometry and total deformation of the panel. A methodology to model and predict damage caused by wide area blunt impact events was established, which was then applied to more general cases that were not tested in order to better understand the nature of this type of impact event and how it relates to the final damage state and visual detectability.

Impact of habitat type on forage quality of seedling oak leaves in central Wisconsin

Treesearch

Michael Demchik

2014-01-01

The objectives of this study were to determine if relative feed value or crude protein in seedling oak leaves was different between three central Wisconsin habitat type groupings. Seedling oak leaves of two species were collected from oak sites that represented either fully stocked or understocked conditions from three possible habitat type groupings: (1) Acer...

[The medical social aspects of childhood traumatism accounting the family type].

PubMed

2012-01-01

In the Russian Federation the childhood traumatism is considered as one of progressing social dangers. The interest in studying the impact of family type on childhood morbidity formation is increased during last years. The family is a fundamental principle of mechanisms of public health formation. The questionnaire poll of parents of children suffered from traumas provides the data concerning the medical social risk factors impacting the level of childhood traumatism. The one of the most important prevention measures is the impact on the family.

Evaluation of life cycle impacts of intersection control type selection [final report].

DOT National Transportation Integrated Search

2016-05-05

The methodology provided in this report provides guidance for NCDOT conversions of twoway : stop controlled intersections to other intersection types to enhance the effective allocation of : public funds. The findings of this project have been inc...

"…Part of My Identity": The Impact of Self-Management on the Sense of Self of Young Women With Type 1 Diabetes.

PubMed

Clausi, Laura; Schneider, Margaret

The purpose of this study was to explore the lived experiences of young women with type 1 diabetes and the ways in which their self-management of their illness may influence their perceived sense of self. Semistructured interviews were conducted with 7 women aged 18 to 22 years who had been formally given a diagnosis of type 1 diabetes. Interviews were audiotaped and transcribed verbatim, and subsequent member checks were completed. Returned member checks and transcriptions were then analyzed using a form of thematic analysis. Three main themes emerged from the data including (1) "I just want to be more free, I guess"; (2) "It's just, like another part of me"; and (3) "I just kind of want to be normal, like I don't even have diabetes." A number of subthemes within each theme were also identified. Findings indicated that many aspects of the young women's day-to-day illness management routine impacted the way in which they viewed themselves. Key aspects that were identified by these women included issues with wanting to feel more free in terms of how they self-manage, trying to stay positive, and wanting to be normal, yet feeling as though they are still different from their peers.

A Comparison of Quasi-Static Indentation to Low-Velocity Impact

NASA Technical Reports Server (NTRS)

Nettles, A. T.; Douglas, M. J.

2000-01-01

A static test method for modeling low-velocity foreign object impact events to composites would prove to be very beneficial to researchers since much more data can be obtained from a static test than from an impact test. In order to examine if this is feasible, a series of static indentation and low-velocity impact tests were carried out and compared. Square specimens of many sizes and thicknesses were utilized to cover the array of types of low velocity impact events. Laminates with a pi/4 stacking sequence were employed since this is by far the most common type of engineering laminate. Three distinct flexural rigidities -under two different boundary conditions were tested in order to obtain damage ranging from that due to large deflection to contact stresses and levels in-between to examine if the static indentation-impact comparisons are valid under the spectrum of damage modes that can be experienced. Comparisons between static indentation and low-velocity impact tests were based on the maximum applied transverse load. The dependent parameters examined included dent depth, back surface crack length, delamination area, and to a limited extent, load-deflection behavior. Results showed that no distinct differences could be seen between the static indentation tests and the low-velocity impact tests, indicating that static indentation can be used to represent a low-velocity impact event.

Origin of orbital debris impacts on LDEF's trailing surfaces

NASA Technical Reports Server (NTRS)

Kessler, Donald J.

1993-01-01

A model was developed to determine the origin of orbital impacts measured on the training surfaces of LDEF. The model calculates the expected debris impact crater distribution around LDEF as a function of debris orbital parameters. The results show that only highly elliptical, low inclination orbits could be responsible for these impacts. The most common objects left in this type of orbit are orbital transfer stages used by the U.S. and ESA to place payloads into geosynchronous orbit. Objects in this type of orbit are difficult to catalog by the U.S. Space Command; consequently there are independent reasons to believe that the catalog does not adequately represent this population. This analysis concludes that the relative number of cataloged objects with highly elliptical, low inclination orbits must be increased by a factor of 20 to be consistent with the LDEF data.

An experimental study of non-destructive testing on glass fibre reinforced polymer composites after high velocity impact event

NASA Astrophysics Data System (ADS)

Razali, N.; Sultan, M. T. H.; Cardona, F.

2016-10-01

A non-destructive testing method on Glass Fibre Reinforced Polymer (GFRP) after high velocity impact event using single stage gas gun (SSGG) is presented. Specimens of C- type and E-type fibreglass reinforcement, which were fabricated with 6mm, 8mm, 10mm and 12mm thicknesses and size 100 mm x 100 mm, were subjected to a high velocity impact with three types of bullets: conical, hemispherical and blunt at various gas gun pressure levels from 6 bar to 60 bar. Visual observation techniques using a lab microscope were used to determine the infringed damage by looking at the crack zone. Dye penetrants were used to inspect the area of damage, and to evaluate internal and external damages on the specimens after impact. The results from visual analysis of the impacted test laminates were discussed and presented. It was found that the impact damage started with induced delamination, fibre cracking and then failure, simultaneously with matrix cracking and breakage, and finally followed by the fibres pulled out. C-type experienced more damaged areas compared to E-type of GFRP.

Impact of specific language impairment and type of school on different language subsystems.

PubMed

Puglisi, Marina Leite; Befi-Lopes, Debora Maria

2016-01-01

This study aimed to explore quantitative and qualitative effects of type of school and specific language impairment (SLI) on different language abilities. 204 Brazilian children aged from 4 to 6 years old participated in the study. Children were selected to form three groups: 1) 63 typically developing children studying in private schools (TDPri); 2) 102 typically developing children studying in state schools (TDSta); and 39 children with SLI studying in state schools (SLISta). All individuals were assessed regarding expressive vocabulary, number morphology and morphosyntactic comprehension. All language subsystems were vulnerable to both environmental (type of school) and biological (SLI) effects. The relationship between the three language measures was exactly the same to all groups: vocabulary growth correlated with age and with the development of morphological abilities and morphosyntactic comprehension. Children with SLI showed atypical errors in the comprehension test at the age of 4, but presented a pattern of errors that gradually resembled typical development. The effect of type of school was marked by quantitative differences, while the effect of SLI was characterised by both quantitative and qualitative differences.

Impact-initiated damage thresholds in composites

NASA Technical Reports Server (NTRS)

Sharma, A. V.

1980-01-01

An experimental investigation was conducted to study the effect of low velocity projectile impact on the sandwich-type structural components. The materials used in the fabrication of the impact surface were graphite-, Kevlar-, and boron-fibers with appropriate epoxy matrices. The testing of the specimens was performed at moderately low- and high-temperatures as well as at room temperature to assess the impact-initiated strength degradation of the laminates. Eleven laminates with different stacking sequences, orientations, and thicknesses were tested. The low energy projectile impact is considered to simulate the damage caused by runway debris, dropping of the hand tools during servicing, etc., on the secondary aircraft structures fabricated with the composite materials. The results show the preload and the impact energy combinations necessary to cause catastrophic failures in the laminates tested. A set of faired curves indicating the failure thresholds is shown separately for the tension- and compression-loaded laminates. The specific-strengths and -moduli for the various laminates tested are also given.

Melt in the impact breccias from the Eyreville drill cores, Chesapeake Bay impact structure, USA

NASA Astrophysics Data System (ADS)

Bartosova, Katerina; Hecht, Lutz; Koeberl, Christian; Libowitzky, Eugen; Reimold, Wolf Uwe

2011-03-01

The center of the 35.3 Ma Chesapeake Bay impact structure (85 km diameter) was drilled during 2005/2006 in an ICDP-0USGS drilling project. The Eyreville drill cores include polymict impact breccias and associated rocks (1397-01551 m depth). Tens of melt particles from these impactites were studied by optical and electron microscopy, electron microprobe, and microRaman spectroscopy, and classified into six groups: m1—clear or brownish melt, m2—brownish melt altered to phyllosilicates, m3—colorless silica melt, m4—melt with pyroxene and plagioclase crystallites, m5—dark brown melt, and m6—melt with globular texture. These melt types have partly overlapping major element abundances, and large compositional variations due to the presence of schlieren, poorly mixed melt phases, partly digested clasts, and variable crystallization and alteration. The different melt types also vary in their abundance with depth in the drill core. Based on the chemical data, mixing calculations were performed to determine possible precursors of these melt particles. The calculations suggest that most melt types formed mainly from the thick sedimentary section of the target sequence (mainly the Potomac Formation), but an additional crystalline basement (schist/gneiss) precursor is likely for the most abundant melt types m2 and m5. Sedimentary rocks with compositions similar to those of the melt particles are present among the Eyreville core samples. Therefore, sedimentary target rocks were the main precursor of the Eyreville melt particles. However, the composition of the melt particles is not only the result of the precursor composition but also the result of changes during melting and solidification, as well as postimpact alteration, which must also be considered. The variability of the melt particle compositions reflects the variety of target rocks and indicates that there was no uniform melt source. Original heterogeneities, resulting from melting of different target rocks

Rare high-impact disease variants: properties and identifications.

PubMed

Park, Leeyoung; Kim, Ju Han

2016-03-21

Although many genome-wide association studies have been performed, the identification of disease polymorphisms remains important. It is now suspected that many rare disease variants induce the association signal of common variants in linkage disequilibrium (LD). Based on recent development of genetic models, the current study provides explanations of the existence of rare variants with high impacts and common variants with low impacts. Disease variants are neither necessary nor sufficient due to gene-gene or gene-environment interactions. A new method was developed based on theoretical aspects to identify both rare and common disease variants by their genotypes. Common disease variants were identified with relatively small odds ratios and relatively small sample sizes, except for specific situations in which the disease variants were in strong LD with a variant with a higher frequency. Rare disease variants with small impacts were difficult to identify without increasing sample sizes; however, the method was reasonably accurate for rare disease variants with high impacts. For rare variants, dominant variants generally showed better Type II error rates than recessive variants; however, the trend was reversed for common variants. Type II error rates increased in gene regions containing more than two disease variants because the more common variant, rather than both disease variants, was usually identified. The proposed method would be useful for identifying common disease variants with small impacts and rare disease variants with large impacts when disease variants have the same effects on disease presentation.

Impact damage resistance of composite fuselage structure, part 1

NASA Technical Reports Server (NTRS)

Dost, E. F.; Avery, W. B.; Ilcewicz, L. B.; Grande, D. H.; Coxon, B. R.

1992-01-01

The impact damage resistance of laminated composite transport aircraft fuselage structures was studied experimentally. A statistically based designed experiment was used to examine numerous material, laminate, structural, and extrinsic (e.g., impactor type) variables. The relative importance and quantitative measure of the effect of each variable and variable interactions on responses including impactor dynamic response, visibility, and internal damage state were determined. The study utilized 32 three-stiffener panels, each with a unique combination of material type, material forms, and structural geometry. Two manufacturing techniques, tow placement and tape lamination, were used to build panels representative of potential fuselage crown, keel, and lower side-panel designs. Various combinations of impactor variables representing various foreign-object-impact threats to the aircraft were examined. Impacts performed at different structural locations within each panel (e.g., skin midbay, stiffener attaching flange, etc.) were considered separate parallel experiments. The relationship between input variables, measured damage states, and structural response to this damage are presented including recommendations for materials and impact test methods for fuselage structure.

Evaluating the landscape impact of renewable energy plants

NASA Astrophysics Data System (ADS)

Ioannidis, Romanos; Koutsoyiannis, Demetris

2017-04-01

Different types of renewable energy have been on an ongoing competition with each other. There has been a lot of research comparing the most common types of renewable energy plants in relation with their efficiency, cost and environmental impact. However, few papers so far have attempted to analyse their impact on landscape and there has never been in depth research on which type of renewable energy causes the least impact on the natural, cultural and aesthetic characteristics of a landscape. This seems to be a significant omission given the vast areas of land already covered with renewable energy plants and the worldwide plans for many more renewable energy projects in the future. Meanwhile, the low aesthetic quality of renewable energy plants has already been an obstacle to their further development, with several relevant examples from countries such as Spain and the Netherlands. There have even been cases where aesthetic degradation is the primary or even the single argument of the opposition to proposed plants. In any case, the aesthetic design and the integration of renewable energy plants into the landscape should really be important design parameters if we plan those projects to truly be sustainable and to be considered complete works of engineering. To initiate dialogue over those aspects of renewable energy, we provide a first comparison on hydro, solar and wind energy. To materialize this comparison, we use data from existing dams, photovoltaic and wind farms. Initially, the average area per MW covered by each type of energy plant is calculated and then evaluated qualitatively from a landscape-impact perspective. Although the area affected is comparable in these three cases, the analysis of the data suggests that dams offer a considerable amount of advantages compared to the other two types of plants. This conclusion arises from the fact that dams, whose basic impact to the landscape is the creation of an artificial lake, contribute much less to the

Impact Testing for Materials Science at NASA - MSFC

NASA Technical Reports Server (NTRS)

Sikapizye, Mitch

2010-01-01

The Impact Testing Facility (ITF) at NASA - Marshall Space Flight Center is host to different types of guns used to study the effects of high velocity impacts. The testing facility has been and continues to be utilized for all NASA missions where impact testing is essential. The Facility has also performed tests for the Department of Defense, other corporations, as well as universities across the nation. Current capabilities provided by Marshall include ballistic guns, light gas guns, exploding wire gun, and the Hydrometeor Impact Gun. A new plasma gun has also been developed which would be able to propel particles at velocities of 20km/s. This report includes some of the guns used for impact testing at NASA Marshall and their capabilities.

Frequency and Location of Head Impact Exposures in Individual Collegiate Football Players

PubMed Central

Crisco, Joseph J.; Fiore, Russell; Beckwith, Jonathan G.; Chu, Jeffrey J.; Brolinson, Per Gunnar; Duma, Stefan; McAllister, Thomas W.; Duhaime, Ann-Christine; Greenwald, Richard M.

2010-01-01

Abstract Context: Measuring head impact exposure is a critical step toward understanding the mechanism and prevention of sport-related mild traumatic brain (concussion) injury, as well as the possible effects of repeated subconcussive impacts. Objective: To quantify the frequency and location of head impacts that individual players received in 1 season among 3 collegiate teams, between practice and game sessions, and among player positions. Design: Cohort study. Setting: Collegiate football field. Patients or Other Participants: One hundred eighty-eight players from 3 National Collegiate Athletic Association football teams. Intervention(s): Participants wore football helmets instrumented with an accelerometer-based system during the 2007 fall season. Main Outcome Measure(s): The number of head impacts greater than 10g and location of the impacts on the player's helmet were recorded and analyzed for trends and interactions among teams (A, B, or C), session types, and player positions using Kaplan-Meier survival curves. Results: The total number of impacts players received was nonnormally distributed and varied by team, session type, and player position. The maximum number of head impacts for a single player on each team was 1022 (team A), 1412 (team B), and 1444 (team C). The median number of head impacts on each team was 4.8 (team A), 7.5 (team B), and 6.6 (team C) impacts per practice and 12.1 (team A), 14.6 (team B), and 16.3 (team C) impacts per game. Linemen and linebackers had the largest number of impacts per practice and per game. Offensive linemen had a higher percentage of impacts to the front than to the back of the helmet, whereas quarterbacks had a higher percentage to the back than to the front of the helmet. Conclusions: The frequency of head impacts and the location on the helmet where the impacts occur are functions of player position and session type. These data provide a basis for quantifying specific head impact exposure for studies related to

Asteroids from a Martian Mega Impact

NASA Astrophysics Data System (ADS)

Kohler, Susanna

2018-04-01

Like evidence left at a crime scene, the mineral olivine may be the clue that helps scientists piece together Marss possibly violent history. Could a long-ago giant impact have flung pieces of Mars throughout our inner solar system? Two researchers from the Tokyo Institute of Technology in Japan are on the case.A Telltale MineralOlivine, a mineral that is common in Earths subsurface but weathers quickly on the surface. Olivine is a major component of Marss upper mantle. [Wilson44691]Olivine is a major component of the Martian upper mantle, making up 60% of this region by weight. Intriguingly, olivine turns up in other places in our solar system too for instance, in seven out of the nine known Mars Trojans (a group of asteroids of unknown origin that share Marss orbit), and in the rare A-type asteroids orbiting in the main asteroid belt.How did these asteroids form, and why are they so olivine-rich? An interesting explanation has been postulated: perhaps this olivine all came from the same place Mars as the result of a mega impact billions of years ago.Evidence for ImpactMars bears plenty of signs pointing to a giant impact in its past. The northern and sourthern hemispheres of Mars look very different, a phenomenon referred to as the Mars hemisphere dichotomy. The impact of a Pluto-sized body could explain the smooth Borealis Basin that covers the northern 40% of Marss surface.This high-resolution topographic map of Mars reveals the dichotomy between its northern and sourthern hemispheres. The smooth region in the northern hemisphere, the Borealis basin, may have been formed when a giant object impacted Mars billions of years ago. [NASA/JPL/USGS]Other evidence piles up: Marss orbit location, its rotation speed, the presence of its two moons all could be neatly explained by a large impact around 4 billion years ago. Could such an impact have also strewn debris from Marss mantle across the solar system?To test this theory, we need to determine if a mega impact is

Reducing food's environmental impacts through producers and consumers.

PubMed

Poore, J; Nemecek, T

2018-06-01

Food's environmental impacts are created by millions of diverse producers. To identify solutions that are effective under this heterogeneity, we consolidated data covering five environmental indicators; 38,700 farms; and 1600 processors, packaging types, and retailers. Impact can vary 50-fold among producers of the same product, creating substantial mitigation opportunities. However, mitigation is complicated by trade-offs, multiple ways for producers to achieve low impacts, and interactions throughout the supply chain. Producers have limits on how far they can reduce impacts. Most strikingly, impacts of the lowest-impact animal products typically exceed those of vegetable substitutes, providing new evidence for the importance of dietary change. Cumulatively, our findings support an approach where producers monitor their own impacts, flexibly meet environmental targets by choosing from multiple practices, and communicate their impacts to consumers. Copyright © 2018 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

The Impact of Bariatric Surgery on Type 2 Diabetes Mellitus and the Management of Hypoglycemic Events

PubMed Central

Kassem, Mahmoud Attia Mohamed; Durda, Michael Andrew; Stoicea, Nicoleta; Cavus, Omer; Sahin, Levent; Rogers, Barbara

2017-01-01

Recent studies discussed the benefit of bariatric surgery on obese patients diagnosed with type 2 diabetes mellitus (T2DM). Several factors play an essential role in predicting the impact of bariatric surgery on T2DM, such as ABCD score (age, BMI, C-peptide, and duration of the disease), HbA1c, and fasting blood glucose, incretins [glucagon-like peptide-1 (GLP-1) and gastric inhibitory peptide (GIP)]. DiaRem score known to include factors such as age, HbA1c, medication, and insulin usage used to predict the remission of T2DM, but it has some limitations. An extensive literature search was conducted on PubMed and Google Scholar using keywords such as gastric bypass, T2DM, bariatric surgery, GLP-1, GIP, and post bariatric hypoglycemia. Restrictive-malabsorptive procedures are most effective in treating T2DM patients based on changes induced in appetite through regulation of gastrointestinal hormones, with decreased hunger and increased satiation. We provide a review of bariatric surgery influence on T2DM and management of post-intervention hypoglycemic events. Post-bariatric surgery hypoglycemia is a serious complication especially when patients develop life-threatening neuroglycopenia with loss of consciousness and seizure. The avoidance of this adverse event may be achieved by strict dietary modification including a restriction on carbohydrates as well as foods with high glycemic index. Further research will provide more information on post-bariatric surgery hyperinsulinemic hypoglycemia pathophysiology and management. PMID:28298900

[Impact of hypoglycemic episodes on nerves conduction and auditory and visual evoked potentials in children with type 1 diabetes].

PubMed

Wysocka-Mincewicz, Marta; Trippenbach-Dulska, Hanna; Emeryk-Szajewska, Barbara; Zakrzewska-Pniewska, Beata; Kochanek, Krzysztof; Pańkowska, Ewa

2007-01-01

Hypoglycemia is an acute disturbance of energy, especially impacting the central nervous system, but direct influence on peripheral nervous function is not detected. The aim of the study was to establish the influence of hypoglycemic moderate and severe episodes on the function of peripheral nerves, hearing and visual pathway. 97 children with type 1 diabetes (mean age 15.4+/-2.16 years, mean duration of diabetes 8.11+/-2.9 years, mean HbA1c 8,58+/-1.06%), at least 10 years old and with at least 3 years duration of diabetes, were included to study. Nerve conduction studies, visual (VEP) and auditory (ABR) evoked potentials were performed with standard surface stimulating and recording techniques. Moderate hypoglycemic episodes were defined as events of low glycemia requiring help of another person but without loss of consciousness and/or convulsions but recurrent frequently in at least one year. Severe hypoglycemia was defined as events with loss of consciousness and/or convulsions. Univariate ANOVA tests of significance or H Kruskal-Wallis test were used, depending on normality of distribution. The subgroups with a history of hypoglycemic episodes had significant delay in all conduction parameters in the sural nerve (amplitude p<0.05, sensory latency p<0.05, and velocity p<0.005) and in motor potential amplitude of tibial nerve (p<0.005). In ABR wave III latency and interval I-III in subgroups with episodes of hypoglycemia (p<0,05) were significantly prolonged. In analyses of VEP parameters no differences were detected. The study showed influence of hypoglycemic episodes on function of all sural nerve parameters and tibial motor amplitude, and in ABR on wave III and interval I-III. Frequent moderate hypoglycemic episodes were strong risk factors for damage of the peripheral and central nervous systems, comparable with impact of several severe hypoglycemias.

Impact of exercise on diurnal and nocturnal markers of glycaemic variability and oxidative stress in obese individuals with type 2 diabetes or impaired glucose tolerance.

PubMed

Farabi, Sarah S; Carley, David W; Smith, Donald; Quinn, Lauretta

2015-09-01

We measured the effects of a single bout of exercise on diurnal and nocturnal oxidative stress and glycaemic variability in obese subjects with type 2 diabetes mellitus or impaired glucose tolerance versus obese healthy controls. Subjects (in random order) performed either a single 30-min bout of moderate-intensity exercise or remained sedentary for 30 min at two separate visits. To quantify glycaemic variability, standard deviation of glucose (measured by continuous glucose monitoring system) and continuous overlapping net glycaemic action of 1-h intervals (CONGA-1) were calculated for three 12-h intervals during each visit. Oxidative stress was measured by 15-isoprostane F(2t) levels in urine collections for matching 12-h intervals. Exercise reduced daytime glycaemic variability (ΔCONGA-1 = -12.62 ± 5.31 mg/dL, p = 0.04) and urinary isoprostanes (ΔCONGA-1 = -0.26 ± 0.12 ng/mg, p = 0.04) in the type 2 diabetes mellitus/impaired glucose tolerance group. Daytime exercise-induced change in urinary 15-isoprostane F(2t) was significantly correlated with both daytime standard deviation (r = 0.68, p = 0.03) and with subsequent overnight standard deviation (r = 0.73, p = 0.027) in the type 2 diabetes mellitus/impaired glucose tolerance group. Exercise significantly impacts the relationship between diurnal oxidative stress and nocturnal glycaemic variability in individuals with type 2 diabetes mellitus/impaired glucose tolerance. © The Author(s) 2015.

Comparison of Nanohole-Type and Nanopillar-Type Patterned Metallic Electrodes Incorporated in Organic Solar Cells

NASA Astrophysics Data System (ADS)

Wang, Wenyan; Cui, Yanxia; Fung, Kin Hung; Zhang, Ye; Ji, Ting; Hao, Yuying

2017-09-01

Both the nanohole- and nanopillar-type patterned metallic electrodes (PMEs) have been introduced in organic solar cells (OSCs) for improving device performances experimentally, but there is few work addressing the similarities and differences between them. In this theoretical work, we systematically compare the impact of the nanohole- and nanopillar-type PMEs on the performance of an OSC based on hybridized cavity resonances. By optimizing the geometrical parameters of each PME, we obtained an interesting result that the integrated absorption efficiencies in the active layer with different optimized PMEs are almost the same (both are equal to 82.4%), outperforming that of the planar control by 9.9%. Though the absorption enhancement spectra of the two different optimal devices are similar as well, the mechanisms of light trapping at the corresponding enhancement peaks are distinct from each other. In a comprehensive view, the nanopillar-type PME is suggested to be applied in the present system, since its optimal design has a moderate filling ratio, which is much easier to fabricate than its counterpart. This work could contribute to the development of high-efficiency OSCs.

Cumulative impacts on seabed habitats: an indicator for assessments of good environmental status.

PubMed

Korpinen, Samuli; Meidinger, Manuel; Laamanen, Maria

2013-09-15

The European seas are under anthropogenic pressures impacting the state of water quality, benthic habitats and species. The EU Marine Strategy Framework Directive (MSFD) requires the Member States to assess the impacts of pressures and make a programme of measures leading to good environmental status (GES) by 2020. This study presents a method for assessing the quantity and distribution of anthropogenic impacts on benthic habitats in the Baltic Sea by using spatial data of human pressures and benthic habitats. The southern sub-basins were more extensively impacted than the northern sub-basins. Over the entire sea area, deep sea habitats were more impacted than shallower infralittoral and circalittoral habitats. Sand and coarse sediments were the seabed types relatively most impacted in the Baltic Sea scale. A comparison against tentative thresholds for GES showed that in the sub-basin scale only one third of the habitat types was in GES. Copyright © 2013 Elsevier Ltd. All rights reserved.

Worse cardiac remodeling in response to pressure overload in type 2 diabetes mellitus.

PubMed

Gonçalves, N; Gomes-Ferreira, C; Moura, C; Roncon-Albuquerque, R; Leite-Moreira, A F; Falcão-Pires, I

2016-08-15

Diabetic cardiomyopathy is characterized by cardiac structural and functional abnormalities. Additionally, chronic pressure overload conditions are highly prevalent amongst diabetic population and this association leads to a more severe myocardial impairment. The differences in myocardial pathophysiology between type 1 and type 2 diabetes mellitus (DM) still remain to be clarified. Thus, we aimed to investigate biventricular structural and functional changes promoted by the two types of DM and the impact of concomitant chronic pressure overload. Wistar rats were injected with streptozotocin (Type 1 DM, T1DM) or fed with a hypercaloric diet (Type 2 DM, T2DM). Pressure overload was imposed in DM animals by aortic constriction and after 5weeks of DM the cardiac function and structure were evaluated. Both types of DM promoted hypertrophy, increased fibrosis and advanced glycation end-products deposition, in the two ventricles. Interestingly, the induced myocardial alterations were distinct. While T1DM stimulated a pronounced hypertrophy and extracellular matrix remodeling, T2DM induced functional impairment. The negative impact of the association of DM with aortic constriction was more pronounced in T2DM, promoting impaired function and increased stiffness, particularly in the right ventricle. Our study demonstrated that the two types of diabetes induce distinct cardiac alterations per se or when combined with chronic pressure overload. T1DM promoted a more extensive remodeling in cardiac structure while T2DM significantly impaired ventricular function. The impact of pressure overload was more notorious in T2DM as observed by worse myocardial remodeling, suggesting a higher susceptibility to the deleterious effects of chronic pressure overload, namely hypertension, among this diabetic population. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Clostridium botulinum type E occurs and grows in the alga Cladophora glomerata

USGS Publications Warehouse

Byappanahalli, M.N.; Whitman, R.L.

2009-01-01

In recent years, massive avian die-offs from Clostridium botulinum type E infection have occurred in the Sleeping Bear Dunes National Lakeshore (SLBE) area of Lake Michigan. These outbreaks have been coincidental with massive blooms of the green algae Cladophora, mostly Cladophora glomerata. We tested the hypothesis that Clostridium botulinum type E can grow under suitable conditions in these algal mats. In a lab mesocosm study, Cladophora from four outbreak-impacted beaches from SLBE were compared with four unimpacted beaches in the Milwaukee–Racine area for bontE gene of Clostridium botulinum. Frequency of the bontE gene was higher after incubation (25 °C for up to 6 weeks) of Cladophora from impacted vs. the unimpacted area. Since no type E gene was detected initially in Cladophora from any of the eight locations, we infer that the increased occurrence of type E gene arose from spore germination or vegetative Clostridium growth within the existing algal mats of SLBE. Moreover, we found that the congener Clostridium perfringens readily grows in mesocosms containing Cladophora.

Manual therapy in adults with tension-type headache: A systematic review.

PubMed

Cumplido-Trasmonte, C; Fernández-González, P; Alguacil-Diego, I M; Molina-Rueda, F

2018-03-07

Tension-type headache is the most common primary headache, with a high prevalence and a considerable socioeconomic impact. Manual physical therapy techniques are widely used in the clinical field to treat the symptoms associated with tension-type headache. This systematic review aims to determine the effectiveness of manual and non-invasive therapies in the treatment of patients with tension-type headache. We conducted a systematic review of randomised controlled trials in the following databases: Brain, PubMed, Web of Science, PEDro, Scopus, CINAHL, and Science Direct. Ten randomised controlled trials were included for analysis. According to these studies, manual therapy improves symptoms, increasing patients' well-being and improving the outcome measures analysed. Manual therapy has positive effects on pain intensity, pain frequency, disability, overall impact, quality of life, and craniocervical range of motion in adults with tension-type headache. None of the techniques was found to be superior to the others; combining different techniques seems to be the most effective approach. Copyright © 2018 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Venus - Impact Crater 'Jeanne

NASA Technical Reports Server (NTRS)

1991-01-01

This Magellan full-resolution image shows Jeanne crater, a 19.5 kilometer (12 mile) diameter impact crater. Jeanne crater is located at 40.0 degrees north latitude and 331.4 degrees longitude. The distinctive triangular shape of the ejecta indicates that the impacting body probably hit obliquely, traveling from southwest to northeast. The crater is surrounded by dark material of two types. The dark area on the southwest side of the crater is covered by smooth (radar-dark) lava flows which have a strongly digitate contact with surrounding brighter flows. The very dark area on the northeast side of the crater is probably covered by smooth material such as fine-grained sediment. This dark halo is asymmetric, mimicking the asymmetric shape of the ejecta blanket. The dark halo may have been caused by an atmospheric shock or pressure wave produced by the incoming body. Jeanne crater also displays several outflow lobes on the northwest side. These flow-like features may have formed by fine-grained ejecta transported by a hot, turbulent flow created by the arrival of the impacting object. Alternatively, they may have formed by flow of impact melt.

Impact of seasonal synoptic weather types on local PM10 concentrations in Bavaria/Germany: recent conditions and future projections

NASA Astrophysics Data System (ADS)

Weitnauer, Claudia; Beck, Christoph; Jacobeit, Jucundus

2015-04-01

It is a matter of common knowledge that local concentrations of PM10 (fine particles in the air with a medium diameter less than 10 μm) vary with the seasons in Europe. These concentrations are influenced on the one hand by the amount of natural and anthropogenic emissions and on the other hand by large-scale and local meteorological conditions. In Bavaria (part of southern Germany) as the target region of the present study, the PM10 concentrations are particularly high in winter time. One reason for this are increased particle emissions due to domestic heating and traffic load in December, January and February. As several studies in other European regions indicated, a distinct effect of the large-scale synoptic weather situation in winter on local PM10 concentrations should be considered as another reason. The main task of this study is to use seasonal synoptic weather types, which are optimized with respect to daily mean PM10 data at 16 Bavarian cities, and therefore are classified by using daily gridded NCEP/NCAR reanalysis data (2.5° x 2.5° horizontal resolution) for the recent period 1980 - 2011 over a Central European spatial domain, to describe the impact of the large-scale meteorological conditions on the local particle concentrations. The weather types are related to monthly PM10 indices by using different transfer techniques like direct synoptic downscaling, multiple regression and generalized linear models as well as random forests. The PM10 indices are determined by averaging daily to monthly data (PMmean) or by counting the daily exceedances of a particular threshold (> 50 μg/m3, PMe50). The generated transfer models are evaluated in calibration and validation periods using several forecast skills, for example the mean squared skill score (MSSS) or the Heidke Skill Score (HSS). The sufficiently performing models are then applied to weather types derived from future climate change scenarios of the global climate model ECHAM 6 for the IPCC scenarios

Regional economic impacts of Grand Canyon river runners.

PubMed

Hjerpe, Evan E; Kim, Yeon-Su

2007-10-01

Economic impact analysis (EIA) of outdoor recreation can provide critical social information concerning the utilization of natural resources. Outdoor recreation and other non-consumptive uses of resources are viewed as environmentally friendly alternatives to extractive-type industries. While outdoor recreation can be an appropriate use of resources, it generates both beneficial and adverse socioeconomic impacts on rural communities. The authors used EIA to assess the regional economic impacts of rafting in Grand Canyon National Park. The Grand Canyon region of northern Arizona represents a rural US economy that is highly dependent upon tourism and recreational expenditures. The purpose of this research is twofold. The first is to ascertain the previously unknown regional economic impacts of Grand Canyon river runners. The second purpose is to examine attributes of these economic impacts in terms of regional multipliers, leakage, and types of employment created. Most of the literature on economic impacts of outdoor recreation has focused strictly on the positive economic impacts, failing to illuminate the coinciding adverse and constraining economic impacts. Examining the attributes of economic impacts can highlight deficiencies and constraints that limit the economic benefits of recreation and tourism. Regional expenditure information was obtained by surveying non-commercial boaters and commercial outfitters. The authors used IMPLAN input-output modeling to assess direct, indirect, and induced effects of Grand Canyon river runners. Multipliers were calculated for output, employment, and income. Over 22,000 people rafted on the Colorado River through Grand Canyon National Park in 2001, resulting in an estimated $21,100,000 of regional expenditures to the greater Grand Canyon economy. However, over 50% of all rafting-related expenditures were not captured by the regional economy and many of the jobs created by the rafting industry are lower-wage and seasonal. Policy

Some design constraints required for the assembly of software components: The incorporation of atomic abstract types into generically structured abstract types

NASA Technical Reports Server (NTRS)

Johnson, Charles S.

1986-01-01

It is nearly axiomatic, that to take the greatest advantage of the useful features available in a development system, and to avoid the negative interactions of those features, requires the exercise of a design methodology which constrains their use. A major design support feature of the Ada language is abstraction: for data, functions processes, resources, and system elements in general. Atomic abstract types can be created in packages defining those private types and all of the overloaded operators, functions, and hidden data required for their use in an application. Generically structured abstract types can be created in generic packages defining those structured private types, as buildups from the user-defined data types which are input as parameters. A study is made of the design constraints required for software incorporating either atomic or generically structured abstract types, if the integration of software components based on them is to be subsequently performed. The impact of these techniques on the reusability of software and the creation of project-specific software support environments is also discussed.

Taylor impact of glass bars

NASA Astrophysics Data System (ADS)

Murray, Natalie; Bourne, Neil; Field, John

1997-07-01

Brar and Bless pioneeered the use of plate impact upon bars as a technique for investigating the 1D stress loading of glass. We wish to extend this technique by applying VISAR and embedded stress gauge measurements to a symmetrical version of the test. In this configuration two rods impact one upon the other in a symmetrical version of the Taylor test geometry in which the impact is perfectly rigid in the centre of mass frame. Previous work in the laboratory has characterised the three glass types (float, borosilicate and a high density lead glass). These experiments will identify the 1D stress failure mechanisms from high-speed photography and the stress and particle velocity histories will be interpreted in the light of these results. The differences in response of the three glasses will be highlighted.

The impact of the oxygen scavenger on the dose-rate dependence and dose sensitivity of MAGIC type polymer gels

NASA Astrophysics Data System (ADS)

Khan, Muzafar; Heilemann, Gerd; Kuess, Peter; Georg, Dietmar; Berg, Andreas

2018-03-01

Recent developments in radiation therapy aimed at more precise dose delivery along with higher dose gradients (dose painting) and more efficient dose delivery with higher dose rates e.g. flattening filter free (FFF) irradiation. Magnetic-resonance-imaging based polymer gel dosimetry offers 3D information for precise dose delivery techniques. Many of the proposed polymer gels have been reported to exhibit a dose response, measured as relaxation rate ΔR2(D), which is dose rate dependent. A lack of or a reduced dose-rate sensitivity is very important for dosimetric accuracy, especially with regard to the increasing clinical use of FFF irradiation protocols with LINACs at high dose rates. Some commonly used polymer gels are based on Methacrylic-Acid-Gel-Initiated-by-Copper (MAGIC). Here, we report on the dose sensitivity (ΔR2/ΔD) of MAGIC-type gels with different oxygen scavenger concentration for their specific dependence on the applied dose rate in order to improve the dosimetric performance, especially for high dose rates. A preclinical x-ray machine (‘Yxlon’, E  =  200 kV) was used for irradiation to cover a range of dose rates from low \\dot{D} min  =  0.6 Gy min-1 to high \\dot{D} max  =  18 Gy min-1. The dose response was evaluated using R2-imaging of the gel on a human high-field (7T) MR-scanner. The results indicate that all of the investigated dose rates had an impact on the dose response in polymer gel dosimeters, being strongest in the high dose region and less effective for low dose levels. The absolute dose rate dependence \\frac{(Δ R2/Δ D)}{Δ \\dot{D}} of the dose response in MAGIC-type gel is significantly reduced using higher concentrations of oxygen scavenger at the expense of reduced dose sensitivity. For quantitative dose evaluations the relative dose rate dependence of a polymer gel, normalized to its sensitivity is important. Based on this normalized sensitivity the dose rate sensitivity was reduced distinctly

PROBABILITY OF CME IMPACT ON EXOPLANETS ORBITING M DWARFS AND SOLAR-LIKE STARS

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

Kay, C.; Opher, M.; Kornbleuth, M., E-mail: ckay@bu.edu

2016-08-01

Solar coronal mass ejections (CMEs) produce adverse space weather effects at Earth. Planets in the close habitable zone of magnetically active M dwarfs may experience more extreme space weather than at Earth, including frequent CME impacts leading to atmospheric erosion and leaving the surface exposed to extreme flare activity. Similar erosion may occur for hot Jupiters with close orbits around solar-like stars. We have developed a model, Forecasting a CME's Altered Trajectory (ForeCAT), which predicts a CME's deflection. We adapt ForeCAT to simulate CME deflections for the mid-type M dwarf V374 Peg and hot Jupiters with solar-type hosts. V374 Peg'smore » strong magnetic fields can trap CMEs at the M dwarfs's Astrospheric Current Sheet, that is, the location of the minimum in the background magnetic field. Solar-type CMEs behave similarly, but have much smaller deflections and do not become trapped at the Astrospheric Current Sheet. The probability of planetary impact decreases with increasing inclination of the planetary orbit with respect to the Astrospheric Current Sheet: 0.5–5 CME impacts per day for M dwarf exoplanets, 0.05–0.5 CME impacts per day for solar-type hot Jupiters. We determine the minimum planetary magnetic field necessary to shield a planet's atmosphere from CME impacts. M dwarf exoplanets require values between tens and hundreds of Gauss. Hot Jupiters around a solar-type star, however, require a more reasonable <30 G. These values exceed the magnitude required to shield a planet from the stellar wind, suggesting that CMEs may be the key driver of atmospheric losses.« less

Impact of Disease Management Programs on HbA1c Values in Type 2 Diabetes Patients in Germany.

PubMed

Kostev, Karel; Rockel, Timo; Jacob, Louis

2017-01-01

The aim was to analyze the impact of disease management programs on HbA1c values in type 2 diabetes mellitus (T2DM) patients in Germany. This study included 9017 patients followed in disease management programs (DMPs) who started an antihyperglycemic treatment upon inclusion in a DMP. Standard care (SC) patients were included after individual matching (1:1) to DMP cases based on age, gender, physician (diabetologist versus nondiabetologist care), HbA1c values at baseline, and index year. The main outcome was the share of patients with HbA1c <7.5% or 6.5% after at least 6 months and less than 12 months of therapy in DMP and SC groups. Multivariate logistic regression models were fitted with HbA1c level as a dependent variable and the potential predictor (DMP versus SC). The mean age was 64.3 years and 54.7% of the patients were men. The mean HbA1c level at baseline was equal to 8.7%. In diabetologist practices, 64.7% of DMP patients and 55.1% of SC patients had HbA1c levels <7.5%, while 23.4% of DMP patients and 16.9% of SC patients had HbA1c levels <6.5% ( P values < .001). By comparison, in general practices, 72.4% of DMP patients and 65.7% of SC patients had HbA1c levels <7.5%, while 29.0% of DMP patients and 25.4% of SC patients had HbA1c levels <6.5% ( P values < .001). DMPs increased the likelihood of HbA1c levels lower than 7.5% or 6.5% after 6 months of therapy in both diabetologist and general care practices. The present study indicates that the enrollment of T2DM patients in DMPs has a positive impact on HbA1c values in Germany.

ELECTROPHORETIC MOBILITIES OF ESCHERICHIA COLI 0157:H7 AND WILD-TYPE ESCHERICHIA COLI STRAINS

EPA Science Inventory

The electrophoretic mobility (EPM) of a number of human-virulent and "wild-type" Escherichia coli strains in phosphate buffered water was measured. The impact of pH, ionic strength, cation type (valence) and concentration, and bacterial strain on the EPM was investigated. Resul...

Deterioration Types of Stones Used in Suleymaniye Mosque (Istanbul, Turkey)

NASA Astrophysics Data System (ADS)

Alptekin Bilen, Candan; Erisis, Sinem; Er, Selman; Yilmaz, Murat; Angi, Serkan; Tugrul, Atiye

2016-10-01

Suleymaniye Mosque located in the historic peninsula of Istanbul, is one of the most important monument of classical Ottoman Architecture. Different types of natural stones having varied lithological characteristics were used in the mosque. Chemical composition, mineralogical, petrographic characteristics and external conditions such as atmospheric effects, earthquake and human impacts have deteriorated these stones over time. The aim of this study is to investigate different natural stones and their deterioration types used in Suleymaniye Mosque. According to the results obtained, generally different types of granites, marbles, limestones, pudding stones, porphyry, serpentinite were used in Suleymaniye Mosque. Detachment, material loss, biological colonization, discoloration and deposits have been determined as a deterioration types on these stones.

Country logistics performance and disaster impact.

PubMed

Vaillancourt, Alain; Haavisto, Ira

2016-04-01

The aim of this paper is to deepen the understanding of the relationship between country logistics performance and disaster impact. The relationship is analysed through correlation analysis and regression models for 117 countries for the years 2007 to 2012 with disaster impact variables from the International Disaster Database (EM-DAT) and logistics performance indicators from the World Bank. The results show a significant relationship between country logistics performance and disaster impact overall and for five out of six specific logistic performance indicators. These specific indicators were further used to explore the relationship between country logistic performance and disaster impact for three specific disaster types (epidemic, flood and storm). The findings enhance the understanding of the role of logistics in a humanitarian context with empirical evidence of the importance of country logistics performance in disaster response operations. © 2016 The Author(s). Disasters © Overseas Development Institute, 2016.

Impact of educational outreach intervention on enhancing health care providers' knowledge about statin therapy prescribing in Malaysian patients with type 2 diabetes mellitus.

PubMed

Elnaem, Mohamed Hassan; Nik Mohamed, Mohamad Haniki; Zaman Huri, Hasniza; Azarisman, Shah M

2018-03-06

Previous research reported underutilization of statin therapy among patients with type 2 diabetes mellitus. Improving health care providers' awareness and understanding of the benefits and risks of statin treatment could be of assistance in optimizing the statin prescribing process. This study aimed to assess health care providers' knowledge related to statin therapy and the impact of educational outreach intervention based on the perceived knowledge. This was a cross-sectional study based on educational outreach intervention targeting physicians and pharmacists in 1 major tertiary hospital in the state of Pahang, Malaysia. Participants responded to a 12-item, validated questionnaire both prior to and after the outreach educational program. Two sessions were conducted separately for 2 cohorts of pharmacists and physicians. The knowledge scores prior to and after the educational intervention were calculated and compared using a paired-samples t-test. The response rate to both pre-and post-educational outreach questionnaires was 91% (40/44). Prior to the intervention, around 84% (n37) of the participants decided to initiate statin therapy for both pre-assessment clinical case scenarios; however, only 27% (n12) could state the clinical benefits of statin therapy. Forty-five percent (n20) could state the drug to drug interactions, and 52.3% (n23) could identify the statin therapy that can be given at any time day/evening. The educational outreach program increased participants' knowledge scores of 1.450 (95% CI, 0.918 to 1.982) point, P < .0005, which is statistically significant. Forty respondents (91%) were of the opinion that statin side effects are the most common cause of treatment discontinuation. This work demonstrated the impact of an educational outreach intervention on improving health care providers' knowledge and beliefs about statin therapy. This type of intervention is considered effective for short-term knowledge enhancement. Further research is needed

Modeling drop impacts on inclined flowing soap films

NASA Astrophysics Data System (ADS)

Basu, Saikat; Yawar, Ali; Concha, Andres; Bandi, Mahesh

2015-11-01

Small drops impinging on soap films flowing at an angle primarily exhibit three fundamental regimes of post-impact dynamics: (a) the drop bounces off the film surface, (b) it coalesces with the downstream flow, and (c) it pierces through the film. During impact, the drop deforms along with a simultaneous, almost elastic deformation of the film transverse to the stream direction. Hence, the governing dynamics for this interaction present the rare opportunity to explore the in-tandem effects of elasticity and hydrodynamics alike. In this talk, we outline the analytical framework to study the drop impact dynamics. The model assumes a deformable drop and a deformable three-dimensional soap film and invokes a parametric study to qualify the three mentioned impact types. The physical parameters include the impact angle, drop impact speed, and the diameters of the drop prior to and during impact when it deforms and spreads out. Our model system offers a path towards optimization of interactions between a spray and a flowing liquid.

Impact of the Central Polypurine Tract on the Kinetics of Human Immunodeficiency Virus Type 1 Vector Transduction

PubMed Central

Van Maele, Bénédicte; De Rijck, Jan; De Clercq, Erik; Debyser, Zeger

2003-01-01

Lentiviral vectors derived from human immunodeficiency virus type 1 (HIV-1) show great promise as gene carriers for future gene therapy. Insertion of a fragment containing the central polypurine tract (cPPT) in HIV-1 vector constructs is known to enhance transduction efficiency drastically, reportedly by facilitating the nuclear import of HIV-1 cDNA through a central DNA flap. We have studied the impact of the cPPT on the kinetics of HIV-1 vector transduction by real-time PCR. The kinetics of total HIV-1 DNA, two-long-terminal-repeat (2-LTR) circles, and, by an Alu-PCR, integrated proviral DNA were monitored. About 6 to 12 h after transduction, the total HIV-1 DNA reached a maximum level, followed by a steep decrease. The 2-LTR circles peaked after 24 to 48 h and were diluted upon cell division. Integration of HIV-1 DNA was first detected at 12 h postinfection. When HIV-1 vectors that contained the cPPT were used, DNA synthesis was similar but a threefold higher amount of 2-LTR circles was detected, confirming the impact on nuclear import. Moreover, a 10-fold increase in the amount of integrated DNA was observed in the presence of the cPPT. Only in the absence of the cPPT was a saturation in 2-LTR circle formation seen at a high multiplicity of infection, suggesting a role for the cPPT in overcoming a barrier to the nuclear import of HIV-1 DNA. A major effect of the central DNA flap on the juxtaposition of both LTRs is unlikely, since transduction with HIV-1 vectors containing ectopic cPPT fragments resulted in increased amounts of 2-LTR circles as well as integrated DNA. Inhibitors of transduction by cPPT-containing HIV vectors were also studied by real-time PCR. The reverse transcriptase inhibitor azidothymidine (AZT) and the nonnucleoside reverse transcriptase inhibitor α-APA clearly inhibited viral DNA synthesis, whereas integrase inhibitors such as the diketo acid L-708,906 and the pyranodipyrimidine V-165 specifically inhibited integration. PMID:12663775

Modeling the impact of hydromorphological alterations by dams and channelization on fish habitat.

NASA Astrophysics Data System (ADS)

Parasiewicz, Piotr; Suska, Katarzyna

2017-04-01

As a consequence of introduction of Water Framework Directive it has been discovered that hydromorphological pressures are one of the main causes of impact on aquatic fauna. However, the impact may vary depending on river type and fish community. To test this hypothesis, we modelled alterations of fish habitat on 6 river sections across Poland using MesoHABSIM approach. The original models of habitat for Target Fish Community were based on repeated field surveys in reference river sections, classified into four fish-ecological classes. Introducing to the models three hydromorphological modification types (damming, channelization and dredging) changed persistent habitat availability for the fish community. The change was measured with Habitat Stress Days Alteration index. Overall the modifications caused increase of habitat stress days, but impact varied depending on season, hydromorphologic river type and expected fish community.

Thermal and impact history of the H chondrite parent asteroid during metamorphism: Constraints from metallic Fe-Ni

NASA Astrophysics Data System (ADS)

Scott, Edward R. D.; Krot, Tatiana V.; Goldstein, Joseph I.; Wakita, Shigeru

2014-07-01

We have studied cloudy taenite, metallographic cooling rates, and shock effects in 30 H3-6 chondrites to elucidate the thermal and early impact history of the H chondrite parent body. We focused on H chondrites with old Ar-Ar ages (>4.4 Gyr) and unshocked and mildly shocked H chondrites, as strongly shocked chondrites with such old ages are very rare. Cooling rates for most H chondrites at 500 °C are 10-50 °C/Myr and do not decrease systematically with increasing petrologic type as predicted by the onion-shell model in which types 3-5 are arranged in concentric layers around a type 6 core. Some type 4 chondrites cooled slower than some type 6 chondrites and type 3 chondrites did not cool faster than other types, contrary to the onion-shell model. Cloudy taenite particle sizes, which range from 40 to 120 nm, are inversely correlated with metallographic cooling rates and show that the latter were not compromised by shock heating. The three H4 chondrites that were used to develop the onion-shell model, Ste. Marguerite, Beaver Creek, and Forest Vale, cooled through 500 °C at ⩾5000 °C/Myr. Our thermal modeling shows that these rates are 50× higher than could be achieved in a body that was heated by 26Al and cooled without disturbance by impact. Published Ar-Ar ages do not decrease systematically with increasing petrologic type but do correlate inversely with cloudy taenite particle size suggesting that impact mixing decreased during metamorphism. Metal and silicate compositions in regolith breccias show that impacts mixed material after metamorphism without causing significant heating. Impacts during metamorphism created Portales Valley and two other H6 chondrites with large metallic veins, excavated the fast-cooled H4 chondrites around 3-4 Myr after accretion, and mixed petrologic types. Metallographic data do not require catastrophic disruption by impact during cooling.

Plant Functional Type Shifts in Big Sagebrush Ecosystems: Impacts on Dryland Ecosystem Water Balance

NASA Astrophysics Data System (ADS)

Bogenschuetz, N. M.; Bearup, L. A.; Maxwell, R. M.; Santi, P. M.

2014-12-01

The mountain pine beetle (MPB), Dendroctonus ponderosae, has caused significant tree mortality within North America. Specifically, the MPB affects ponderosa pine and lodgepole pine forests within the Rocky Mountains with approximately 3.4 million acres of forest impacted over the past 20 years. The full impacts of such unprecedented tree mortality on hydrology and slope stability is not well understood. This work studies the affects of MPB infestation on slope instability. A large-scale statistical analysis of MPB and slope stability is combined with a more in-depth analysis of the factors that contribute to slope stability. These factors include: slope aspect, slope angle, root decay, regrowth and hydrologic properties, such as water table depth and soil moisture. Preliminary results show that MPB may affect a greater number of north- and east-facing slopes. This is in accordance with more water availability and a higher MPB impacted tree density on north-facing slopes which, in turn, could potentially increase the probability of slope failure. Root strength is predicted to decrease as the roots stop transpiring 3-4 years proceeding infestation. However, this effect on the hillslope is likely being counterbalanced by the regrowth of grasses, forbs, shrubs, and trees. In addition, the increase in water table height from the lack of transpiring trees is adding a driving force to the slopes. The combination of all these factors will be used in order to assess the effects of MPB tree mortality on slope stability.

Site impacts associated with biomass removals in lower Alabama

Treesearch

Emily A. Carter; John . Fulton; Brian J. Burton

2005-01-01

A study was initiated during summer 2003 to evaluate site impacts associated with conversion of a slash pine stand to long leaf pine. Site impacts were evaluated by placing 10 transects over a subsection of the harvest tract and classifying the type of soil surface disturbance every 3 meters. Bulk density, gravimetric water content and cone index were measured on...

Gender identity and adjustment: understanding the impact of individual and normative differences in sex typing.

PubMed

Lurye, Leah E; Zosuls, Kristina M; Ruble, Diane N

2008-01-01

The relationship among gender identity, sex typing, and adjustment has attracted the attention of social and developmental psychologists for many years. However, they have explored this issue with different assumptions and different approaches. Generally the approaches differ regarding whether sex typing is considered adaptive versus maladaptive, measured as an individual or normative difference, and whether gender identity is regarded as a unidimensional or multidimensional construct. In this chapter, we consider both perspectives and suggest that the developmental timing and degree of sex typing, as well as the multidimensionality of gender identity, be considered when examining their relationship to adjustment.

Gender Identity and Adjustment: Understanding the Impact of Individual and Normative Differences in Sex Typing

PubMed Central

Lurye, Leah E.; Zosuls, Kristina M.; Ruble, Diane N.

2009-01-01

The relationship among gender identity, sex typing, and adjustment has attracted the attention of social and developmental psychologists for many years. However, they have explored this issue with different assumptions and different approaches. Generally the approaches differ regarding whether sex typing is considered adaptive versus maladaptive, measured as an individual or normative difference, and whether gender identity is regarded as a unidimensional or multidimensional construct. In this chapter, we consider both perspectives and suggest that the developmental timing and degree of sex typing, as well as the multidimensionality of gender identity, be considered when examining their relationship to adjustment. PMID:18521861

Investigating the Impact of Peer Feedback in Foreign Language Writing

ERIC Educational Resources Information Center

Levi Altstaedter, Laura

2018-01-01

The present quasi-experimental study aimed at investigating the impact of trained and untrained peer feedback on students' written comment types and writing quality. Significant differences were found in terms of comment types provided: trained students provided a significantly higher number of comments focused on organization and content (global…

Wear resistance and mechanisms of composite hardfacings at abrasive impact erosion wear

NASA Astrophysics Data System (ADS)

Surzhenkov, A.; Viljus, M.; Simson, T.; Tarbe, R.; Saarna, M.; Casesnoves, F.

2017-05-01

Tungsten carbide based hardmetal containing sprayed and melted composite hardfacings are prospective for protection against abrasive wear. For selection of abrasive wear resistant hardfacings under intensive impact wear conditions, both mechanical properties (hardness, fracture toughness, etc.) and abrasive wear conditions (type of abrasive, impact velocity, etc.) should be considered. This study focuses on the wear (wear rate and mechanisms) of thick metal-matrix composite hardfacings with hardmetal (WC-Co) reinforcement produced by powder metallurgy technology. The influence of the hardmetal reinforcement type on the wear resistance at different abrasive impact erosion wear (AIEW) conditions was studied. An optimal reinforcement for various wear conditions is described. Based on wear mechanism studies, a mathematical model for wear prediction was drafted.

Gender Identity and Adjustment: Understanding the Impact of Individual and Normative Differences in Sex Typing

ERIC Educational Resources Information Center

Lurye, Leah E.; Zosuls, Kristina M.; Ruble, Diane N.

2008-01-01

The relationship among gender identity, sex typing, and adjustment has attracted the attention of social and developmental psychologists for many years. However, they have explored this issue with different assumptions and different approaches. Generally the approaches differ regarding whether sex typing is considered adaptive versus maladaptive,…

Cost effectiveness of self-monitoring of blood glucose (SMBG) for patients with type 2 diabetes and not on insulin: impact of modelling assumptions on recent Canadian findings.

PubMed

Tunis, Sandra L

2011-11-01

Canadian patients, healthcare providers and payers share interest in assessing the value of self-monitoring of blood glucose (SMBG) for individuals with type 2 diabetes but not on insulin. Using the UKPDS (UK Prospective Diabetes Study) model, the Canadian Optimal Prescribing and Utilization Service (COMPUS) conducted an SMBG cost-effectiveness analysis. Based on the results, COMPUS does not recommend routine strip use for most adults with type 2 diabetes who are not on insulin. Cost-effectiveness studies require many assumptions regarding cohort, clinical effect, complication costs, etc. The COMPUS evaluation included several conservative assumptions that negatively impacted SMBG cost effectiveness. Current objectives were to (i) review key, impactful COMPUS assumptions; (ii) illustrate how alternative inputs can lead to more favourable results for SMBG cost effectiveness; and (iii) provide recommendations for assessing its long-term value. A summary of COMPUS methods and results was followed by a review of assumptions (for trial-based glycosylated haemoglobin [HbA(1c)] effect, patient characteristics, costs, simulation pathway) and their potential impact. The UKPDS model was used for a 40-year cost-effectiveness analysis of SMBG (1.29 strips per day) versus no SMBG in the Canadian payer setting. COMPUS assumptions for patient characteristics (e.g. HbA(1c) 8.4%), SMBG HbA(1c) advantage (-0.25%) and costs were retained. As with the COMPUS analysis, UKPDS HbA(1c) decay curves were incorporated into SMBG and no-SMBG pathways. An important difference was that SMBG HbA(1c) benefits in the current study could extend beyond the initial simulation period. Sensitivity analyses examined SMBG HbA(1c) advantage, adherence, complication history and cost inputs. Outcomes (discounted at 5%) included QALYs, complication rates, total costs (year 2008 values) and incremental cost-effectiveness ratios (ICERs). The base-case ICER was $Can63 664 per QALY gained; approximately 56% of

AKAP79/150 impacts intrinsic excitability of hippocampal neurons through phospho-regulation of A-type K+ channel trafficking.

PubMed

Lin, Lin; Sun, Wei; Kung, Faith; Dell'Acqua, Mark L; Hoffman, Dax A

2011-01-26

Kv4.2, as the primary α-subunit of rapidly inactivating, A-type voltage-gated K(+) (Kv) channels expressed in hippocampal CA1 pyramidal dendrites, plays a critical role in regulating their excitability. Activity-dependent trafficking of Kv4.2 relies on C-terminal protein kinase A (PKA) phosphorylation. A-kinase-anchoring proteins (AKAPs) target PKA to glutamate receptor and ion channel complexes to allow for discrete, local signaling. As part of a previous study, we showed that AKAP79/150 interacts with Kv4.2 complexes and that the two proteins colocalize in hippocampal neurons. However, the nature and functional consequence of their interaction has not been previously explored. Here, we report that the C-terminal domain of Kv4.2 interacts with an internal region of AKAP79/150 that overlaps with its MAGUK (membrane-associated guanylate kinase)-binding domain. We show that AKAP79/150-anchored PKA activity controls Kv4.2 surface expression in heterologous cells and hippocampal neurons. Consistent with these findings, disrupting PKA anchoring led to a decrease in neuronal excitability, while preventing dephosphorylation by the phosphatase calcineurin resulted in increased excitability. These results demonstrate that AKAP79/150 provides a platform for dynamic PKA regulation of Kv4.2 expression, fundamentally impacting CA1 excitability.

Impact and residual fatigue behavior of ARALL and AS6/5245 composite materials

NASA Technical Reports Server (NTRS)

Johnson, W. S.

1986-01-01

Aramide fiber reinforced aluminum laminates (ARALL) represent a cross between resin matrix composites and metals. The purpose of this study was to evaluate the impact sensitivity of this concept. Two types of ARALL (7075 aluminum prestrained and 2024 aluminum not prestrained) were tested through static indentation and the results compared to sheet 2024-T3 and 7075-T6 aluminum alloys. A state-of-the-art composite (AS6/5245) was also tested and compared to the ARALL. Further, the two types of ARALL material and the composite were dynamically impacted at two energy levels and fatigue tested to determine residual fatigue strength. Both forms of the ARALL material had worse impact resistance than monolithic sheet aluminum. The ARALL material made with 2024-T3 aluminum had better impact resistance than did the laminates made with 7075-T6 aluminum. The ARALL materials are at least equal to the composite material in impact damage resistance and are better for impact detection. The composite material has higher residual fatigue strength after impact than the ARALL material and is 25 percent lighter. The prestraining of the ARALL greatly reduces the fatigue growth of impact damage.

Formation of Moon-Type Rocks by Multiple Impacts with Porous, Crystals and Glassy Soils

NASA Astrophysics Data System (ADS)

Miura, Yas.

2012-03-01

Lunar rocks are checked by two data of (a) density, porosity, and age; and (b) FeO, Ni, Co, and C contents and age. The results indicate that primordial FAN anorthosites are relatively brecciated on heterogeneous surface with multiple impact process.

Type I Error Inflation for Detecting DIF in the Presence of Impact

ERIC Educational Resources Information Center

DeMars, Christine E.

2010-01-01

In this brief explication, two challenges for using differential item functioning (DIF) measures when there are large group differences in true proficiency are illustrated. Each of these difficulties may lead to inflated Type I error rates, for very different reasons. One problem is that groups matched on observed score are not necessarily well…

Impact of a Serious Videogame Designed for Flexible Insulin Therapy on the Knowledge and Behaviors of Children with Type 1 Diabetes: The LUDIDIAB Pilot Study.

PubMed

Joubert, Michael; Armand, Coline; Morera, Julia; Tokayeva, Leyla; Guillaume, Aurore; Reznik, Yves

2016-02-01

Flexible (or functional) insulin therapy method is a self-management education approach for intensive insulin therapy in patients with type 1 diabetes. The serious game (or applied game) "L'Affaire Birman" ("Mr. Birman's File") (available at www.gluciweb.com ) was specifically designed as an educational tool for the flexible insulin therapy method. Its educational impact was evaluated in children with type 1 diabetes. This prospective multicenter pilot study evaluated the effect of this videogame on the therapeutic knowledge and behavior of children with type 1 diabetes. PedCarbQuiz (PCQ) and Diabetes Self-Management Profile (DSMP) questionnaires were used before (T0), immediately after (T1), and 6 months after (T2) the unstructured use of the videogame. The 38 children enrolled in the study were 42% boys and 58% girls; they had a mean age of 13.7 ± 2.1 years old, a diabetes duration of 6.0 ± 3.8 years, and hemoglobin A1c (HbA1c) levels of 8.5 ± 1.4% (69.4 ± 9.4 mmol/mol). The children connected to the game 3.3 ± 2.8 times during this 6-month study. Their PCQ score increased from 31.6 ± 4.9 at T0 to 36.0 ± 4.0 at T2 (P < 0.05). Two PCQ subscores also increased significantly: the insulin titration score at T1 and T2 and the carbohydrate quantification score at T2. Conversely, the DSMP score was not different at T0, T1, and T2 (59.1 ± 9.9, 60.2 ± 9.8, and 60.0 ± 10.0, respectively), and HbA1c levels also remained stable throughout the study (8.4 ± 1.3%, 8.4 ± 1.2%, and 8.5 ± 1.5% at T0, T1, and T2, respectively). Subgroup analysis found a greater impact of the game in children with poor glycemic control and low knowledge at baseline. Adherence to the game was rather low (half of the children played less than 2.5 bouts), but no criterion was found to be predictive of this low attractiveness. Nonsupervised usage of the serious game "L'Affaire Birman" was able to improve insulin titration and

Depression, anxiety and self-care behaviours of young adults with Type 2 diabetes: results from the International Diabetes Management and Impact for Long-term Empowerment and Success (MILES) Study.

PubMed

Browne, J L; Nefs, G; Pouwer, F; Speight, J

2015-01-01

Young adults with Type 2 diabetes have higher physical morbidity and mortality than other diabetes sub-groups, but differences in psychosocial outcomes have not yet been investigated. We sought to compare depression and anxiety symptoms and self-care behaviours of young adults with Type 2 diabetes with two matched control groups. Using cross-sectional survey data from the Australian and Dutch Diabetes Management and Impact for Long-term Empowerment and Success (MILES) studies, we matched 93 young adults (aged 18-39 years) with Type 2 diabetes (case group) with: (i) 93 older adults ( ≥ 40 years) with Type 2 diabetes (Type 2 diabetes control group; matched on country, gender, education, diabetes duration and insulin use) and (ii) 93 young adults with Type 1 diabetes (Type 1 diabetes control group; matched on country, gender, age and education). Groups were compared with regard to depression symptoms (nine-item Patient Health Questionnaire), anxiety symptoms (seven-item Generalised Anxiety Disorder questionnaire) and frequency of selected self-care behaviours (single item per behaviour). Participants in the case group had higher depression scores (Cohen's d = 0.40) and were more likely to have clinically meaningful depressive symptoms (Cramer's V = 0.23) than those in the Type 2 diabetes control group. Participants in the case group had statistically equivalent depression scores to the Type 1 diabetes control group. The groups did not differ in anxiety scores. Those in the case group were less likely than both control groups to take insulin as recommended (Cramer's V = 0.24-0.34), but there were no significant differences between the groups in oral medication-taking. The case group were less likely than the Type 2 diabetes control group to eat healthily (Cramer's V = 0.16), and less likely than the Type 1 diabetes control group to be physically active (Cramer's V = 0.15). Our results suggest that Type 2 diabetes is as challenging as Type 1 diabetes for young adults

The clinician factor: Personality characteristics of clinicians and their impact upon clinical outcomes in the management of children and adolescents with type 1 diabetes.

PubMed

Cameron, Fergus J; Russell, Ellyn; McCombe, Julia; O'Connell, Michele A; Skinner, Timothy

2018-06-01

The purpose of this study was to estimate clinician qualities that influence metabolic outcomes in youth with type 1 diabetes. Data were gathered over two 3 month periods in a large tertiary diabetes center (1500 patients, 8 clinicians) from patients with type 1 diabetes who received continuous care from each clinician. Data included sex, age, diabetes duration, insulin regimen, body mass index (BMI), insulin dose and episodes of severe hypoglycemia. Clinician data included target blood glucose levels, target glycated hemoglobin (HbA1c), Diabetes Attitude Scale and Big 5 Personality Inventory Scale. Mean HbA1c per clinician was the primary outcome variable. The 8 clinicians saw a total of 464 patients during the first time period, and 603 in the second time period. Lowest to highest mean HbA1c per clinician varied by 0.7%. There were small but statistically significant differences between clinicians with their patients' age at diagnosis, duration of diabetes, age, gender, treatment type and BMI SD score. After controlling for these differences, the clinician characteristics that were associated with lower mean HbA1c were having no lower limit in target HbA1c and being self-reportedly "less agreeable." The impact of these clinician attitudinal traits was equivalent to the combined effects of patient characteristics and treatment type. There was a significant variation in metabolic outcomes between treating clinicians. After controlling for patient clinical differences, clinician mean HbA1c was associated with lower limit in target HbA1c and being "less agreeable." Clinicians who were more demanding and dogmatic appeared to have better outcomes. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Environmental Impact Assessment in the marine environment: A comparison of legal frameworks

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

Guerra, Flávia, E-mail: f.c.diasguerra@vu.nl; Liga para a Protecção da Natureza, 1500-124 Lisboa; Grilo, Catarina

Environmental Impact Assessment (EIA) is a well-established practice in most developed countries, even though its application to projects in the marine environment is at a much earlier stage of development. We use the Portuguese example to address marine EIA legislation since its exclusive economic zone (EEZ) is currently the third largest in the European Union and its EIA legislation does not require various offshore activities with potentially negative environmental impacts to undergo EIA before being licensed. This paper aims to determine whether three types of projects implemented within Portuguese maritime zones – artificial reefs using sunken ships, hydrocarbon prospecting andmore » wave-energy generation – would benefit from application of an appropriately designed EIA. We have conducted a structured review of EIA legal provisions from seven other countries, and considered whether a full EIA was required for each project type. Consequently, 12 Environmental Impact Statements (EIS) have been compared to identify patterns of (dis)similarity across countries and project types. Additionally, we identified key descriptors and predicted impacts for each project type referred to in their EIS. The main conclusion is that ultimately all three projects would benefit from mandatory EIA in Portugal. This paper is relevant for countries with large maritime areas and underdeveloped marine EIA legislation, helping improve international policy-making relating to these three types of marine projects. - Highlights: • EIA is not mandatory for some project types developed in Portuguese maritime zones. • Artificial reefs, oil&gas prospecting and wave-energy licensing differ in 8 countries. • EIA should be mandatory in Portugal for artificial reefs and oil&gas prospecting. • However, an AEInc approach is enough for wave-energy projects in Portugal. • Findings could be extended to other EU countries with extensive maritime zones.« less

The impact of learned resourcefulness on quality of life in type II diabetic patients: a cross-sectional correlational study.

PubMed

Huang, Chiung-Yu; Perng, Shoa-Jen; Chen, Hisu-Fung; Lai, Chien-Yu

2008-12-01

It is well recognized that patients with diabetes encounter a host of daily self-care issues, including controlling blood sugar and preventing and managing complications, which impact significantly upon quality of life. Studies have indicated that learned resourcefulness has a potentially positive effect in dealing with psychosocial and health problems. The purpose of this study was to test the relationship between learned resourcefulness and quality of life in type II diabetic patients. The mediating and moderating effects of learned resourcefulness on the relationship between metabolic control and quality of life of diabetic patients was also examined. This cross-sectional and correlational study included a convenience sample of 131 type II diabetic patients recruited from three hospitals in southern Taiwan. Data were collected through questionnaires, which included the Rosenbaum's Self Control Schedule and World Health Organization's Quality of Life (Short Version). Multiple regression techniques were used to analyze outcome predictors. Study findings include identification of a mediating effect of learned resourcefulness between metabolic control and quality of life. While most DM patients were not satisfied with their health, we found that those with greater learned resourcefulness enjoyed a better quality of life. Learned resourcefulness, gender, and HbA1C explained 35.2% of variance in DM patient quality of life. Male diabetic patients enjoyed a better quality of life than females, even though levels of learned resourcefulness between the two groups were not significantly different. Results indicate that poor metabolic control of diabetic patients has a detrimental effect on quality of life, and when diabetic patients use more self-control skills, they may achieve better quality of life. Results suggest that nurses who use cognitive behavior coping strategies (resourcefulness) may help diabetic patients achieve better metabolic control and promote better

How Does Teacher Knowledge in Statistics Impact on Teacher Listening?

ERIC Educational Resources Information Center

Burgess, Tim

2012-01-01

For teaching statistics investigations at primary school level, teacher knowledge has been identified using a framework developed from a classroom based study. Through development of the framework, three types of teacher listening problems were identified, each of which had potential impact on the students' learning. The three types of problems…

Type-2 diabetes mellitus reduces cortical thickness and decreases oxidative metabolism in sensorimotor regions after stroke.

PubMed

Ferris, Jennifer K; Peters, Sue; Brown, Katlyn E; Tourigny, Katherine; Boyd, Lara A

2018-05-01

Individuals with type-2 diabetes mellitus experience poor motor outcomes after ischemic stroke. Recent research suggests that type-2 diabetes adversely impacts neuronal integrity and function, yet little work has considered how these neuronal changes affect sensorimotor outcomes after stroke. Here, we considered how type-2 diabetes impacted the structural and metabolic function of the sensorimotor cortex after stroke using volumetric magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS). We hypothesized that the combination of chronic stroke and type-2 diabetes would negatively impact the integrity of sensorimotor cortex as compared to individuals with chronic stroke alone. Compared to stroke alone, individuals with stroke and diabetes had lower cortical thickness bilaterally in the primary somatosensory cortex, and primary and secondary motor cortices. Individuals with stroke and diabetes also showed reduced creatine levels bilaterally in the sensorimotor cortex. Contralesional primary and secondary motor cortex thicknesses were negatively related to sensorimotor outcomes in the paretic upper-limb in the stroke and diabetes group such that those with thinner primary and secondary motor cortices had better motor function. These data suggest that type-2 diabetes alters cerebral energy metabolism, and is associated with thinning of sensorimotor cortex after stroke. These factors may influence motor outcomes after stroke.

The Empirical Analysis of Impact of Alliances on Airline Operations

NASA Technical Reports Server (NTRS)

Iatrou, Kostas; Alamdari, Fariba

2003-01-01

Airline alliances are dominating the current air transport industry with the largest carriers of the world belonging to one of the four alliance groupings - "Wings", Star Alliance, one world, SkyTeam - which represent 56% of world Revenue Passenger Kilometers. Although much research has been carried out to evaluate the impact of alliance membership on performance of airlines, it would be of interest to ascertain the degree of impact perceived by participating airlines in alliances. It is the purpose of this paper to gather the opinion of all the airlines, belonging to the four global alliance groupings on the impact alliances have had on their traffic and on their performance in general To achieve this, a comprehensive survey of the alliance management departments of airlines participating in the four global strategic alliances was carried out. With this framework the survey has examined which type of cooperation among carriers (FFP, Code Share, Strategic Alliance without antitrust immunity, Strategic Alliance with antitrust immunity) has produced the most positive impact on traffic and which type of route (short haul, long haul, hub-hub, hub-non hub, non hub-non hub) has been mostly affected. In addition, the respondent airlines quantified the effect alliances have had on specific areas of their operation, such as load factors, traffic, costs, revenue and fares. Their responses have been analysed under each global alliances grouping, under airline and under geographic region to establish which group, type of carrier and geographic region has benefited most. The results show that each of the four global alliances groupings has experienced different results according to the type of collaboration agreed amongst their member airlines.

Impact of a preconception counseling program for teens with type 1 diabetes (READY-Girls) on patient-provider interaction, resource utilization, and cost.

PubMed

Fischl, Andrea F Rodgers; Herman, William H; Sereika, Susan M; Hannan, Margaret; Becker, Dorothy; Mansfield, M Joan; Freytag, Linda L; Milaszewski, Kerry; Botscheller, Amanda N; Charron-Prochownik, Denise

2010-04-01

To evaluate the impact of a preconception counseling program tailored for teens with type 1 diabetes on cognitive, psychosocial, and behavioral outcomes and to assess its cost-effectiveness. A total of 88 teens with type 1 diabetes from two sites were randomized into the READY-Girls (Reproductive-health Education and Awareness of Diabetes in Youth for Girls) intervention (IG) (n = 43) or standard care (SC) (n = 45) groups. During three diabetes clinic visits, IG subjects viewed a two-part CD-ROM, read a book, and met with a nurse. Program effectiveness was measured by knowledge, attitudes, intentions, and behaviors regarding diabetes, pregnancy, sexuality, and preconception counseling. Assessments occurred at baseline, before and after viewing program materials, and at 9 months. Economic analyses included an assessment of resource utilization, direct medical costs, and a break-even cost analysis. Age range was 13.2-19.7 years (mean +/- SD 16.7 +/- 1.7 years); 6% (n = 5) were African American, and 24% (n = 21) were sexually active. Compared with baseline and SC subjects, IG subjects demonstrated a significant group-by-time interaction for benefit and knowledge of preconception counseling and reproductive health: increasing immediately after the first visit (P < 0.001) and being sustained for 9 months (P < 0.05 benefits; P < 0.001 knowledge). For IG subjects, preconception counseling barriers decreased over time (P < 0.001), and intention and initiation of preconception counseling and reproductive health discussions increased (P < 0.001). Costs of adverse reproductive outcomes are high. Direct medical costs of READY-Girls were low. READY-Girls was beneficial and effects were sustained for at least 9 months. This low-cost self-instructional program can potentially empower young women with type 1 diabetes to make well-informed reproductive health choices, adding little time burden or cost to their diabetes management.

A Budyko-type Model for Human Water Consumption

NASA Astrophysics Data System (ADS)

Lei, X.; Zhao, J.; Wang, D.; Sivapalan, M.

2017-12-01

With the expansion of human water footprint, water crisis is no longer only a conflict or competition for water between different economic sectors, but also increasingly between human and the environment. In order to describe the emergent dynamics and patterns of the interaction, a theoretical framework that encapsulates the physical and societal controls impacting human water consumption is needed. In traditional hydrology, Budyko-type models are simple but efficient descriptions of vegetation-mediated hydrologic cycle in catchments, i.e., the partitioning of mean annual precipitation into runoff and evapotranspiration. Plant water consumption plays a crucial role in the process. Hypothesized similarities between human-water and vegetation-water interactions, including water demand, constraints and system functioning, give the idea of corresponding Budyko-type framework for human water consumption at the catchment scale. Analogous to variables of Budyko-type models for hydrologic cycle, water demand, water consumption, environmental water use and available water are corresponding to potential evaporation, actual evaporation, runoff and precipitation respectively. Human water consumption data, economic and hydro-meteorological data for 51 human-impacted catchments and 10 major river basins in China are assembled to look for the existence of a Budyko-type relationship for human water consumption, and to seek explanations for the spread in the observed relationship. Guided by this, a Budyko-type analytical model is derived based on application of an optimality principle, that of maximum water benefit. The model derived has the same functional form and mathematical features as those that apply for the original Budyko model. Parameters of the new Budyko-type model for human consumption are linked to economic and social factors. The results of this paper suggest that the functioning of both social and hydrologic subsystems within catchment systems can be explored within

Toward a Theory of Psychological Type Congruence for Advertisers.

ERIC Educational Resources Information Center

McBride, Michael H.; And Others

Focusing on the impact of advertisers' persuasive selling messages on consumers, this paper discusses topics relating to the theory of psychological type congruence. Based on an examination of persuasion theory and relevant psychological concepts, including recent cognitive stability and personality and needs theory and the older concept of…

Columbia River System Operation Review : Final Environmental Impact Statement, Appendix J: Recreation.

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

Columbia River System Operation Review

1995-11-01

This Appendix J of the Final Environmental Impact Statement for the Columbia River System discusses impacts on the recreational activities in the region. Major sections include the following: scope and processes; recreation in the Columbia River Basin today - by type, location, participation, user characteristics, factors which affect usage, and managing agencies; recreation analysis procedures and methodology; and alternatives and their impacts.

Final Results of Shuttle MMOD Impact Database

NASA Technical Reports Server (NTRS)

Hyde, J. L.; Christiansen, E. L.; Lear, D. M.

2015-01-01

The Shuttle Hypervelocity Impact Database documents damage features on each Orbiter thought to be from micrometeoroids (MM) or orbital debris (OD). Data is divided into tables for crew module windows, payload bay door radiators and thermal protection systems along with other miscellaneous regions. The combined number of records in the database is nearly 3000. Each database record provides impact feature dimensions, location on the vehicle and relevant mission information. Additional detail on the type and size of particle that produced the damage site is provided when sampling data and definitive spectroscopic analysis results are available. Guidelines are described which were used in determining whether impact damage is from micrometeoroid or orbital debris impact based on the findings from scanning electron microscopy chemical analysis. Relationships assumed when converting from observed feature sizes in different shuttle materials to particle sizes will be presented. A small number of significant impacts on the windows, radiators and wing leading edge will be highlighted and discussed in detail, including the hypervelocity impact testing performed to estimate particle sizes that produced the damage.

Impact resistance of fiber composites

NASA Technical Reports Server (NTRS)

Chamis, C. C.; Sinclair, J. H.

1982-01-01

Stress-strain curves are obtained for a variety of glass fiber and carbon fiber reinforced plastics in dynamic tension, over the stress-strain range of 0.00087-2070/sec. The test method is of the one-bar block-to-bar type, using a rotating disk or a pendulum as the loading apparatus and yielding accurate stress-strain curves up to the breaking strain. In the case of glass fiber reinforced plastic, the tensile strength, strain to peak impact stress, total strain and total absorbed energy all increase significantly as the strain rate increases. By contrast, carbon fiber reinforced plastics show lower rates of increase with strain rate. It is recommended that hybrid composites incorporating the high strength and rigidity of carbon fiber reinforced plastic with the high impact absorption of glass fiber reinforced plastics be developed for use in structures subjected to impact loading.

Possible long-term decline in impact rates. 2. Lunar impact-melt data regarding impact history

NASA Astrophysics Data System (ADS)

Hartmann, William K.; Quantin, Cathy; Mangold, Nicolas

2007-01-01

Crater counts at lunar landing sites with measured ages establish a steep decline in cratering rate during the period ˜3.8 to ˜3.1 Gyr ago. Most models of the time dependence suggest a roughly constant impact rate (within factor ˜2) after about 3 Gyr ago, but are based on sparse data. Recent dating of impact melts from lunar meteorites, and Apollo glass spherules, clarifies impact rates from ˜3.2 to ˜2 Gyr ago or less. Taken together, these data suggest a decline with roughly 700 Myr half-life around 3 Gyr ago, and a slower decline after that, dropping by a factor ˜3 from about ˜2.3 Gyr ago until the present. Planetary cratering involved several phases with different time behaviors: (1) rapid sweep-up of most primordial planetesimals into planets in the first hundred Myr, (2) possible later effects of giant planet migration with enhanced cratering, (3) longer term sweep-up of leftover planetesimals, and finally (4) the present long-term "leakage" of asteroids from reservoirs such as the main asteroid belt and Kuiper belt. In addition, at any given point on the Moon, a pattern of "spikes" (sharp maxima of relatively narrow time width) will appear in the production rate of smaller craters (≲500 m?), not only from secondary debris from large primary lunar impacts at various distances from the point in question, but also from asteroid breakups dotted through Solar System history. The pattern of spikes varies according to type of sample being measured (i.e., glass spherules vs impact melts). For example, several data sets show an impact rate spike ˜470 Myr ago associated with the asteroid belt collision that produced the L chondrites (see Section 3.6 below). Such spikes should be less prominent in the production record of craters of D≳ few km. These phenomena affect estimates of planetary surfaces ages from crater counts, as discussed in a companion paper [Quantin, C., Mangold, N., Hartmann, W.K., Allemand, P., 2007. Icarus 186, 1-10]. Fewer impact melts and

Earth Impact Effects Program: Estimating the Regional Environmental Consequences of Impacts On Earth

NASA Astrophysics Data System (ADS)

Collins, G. S.; Melosh, H. J.; Marcus, R. A.

2009-12-01

The Earth Impact Effects Program (www.lpl.arizona.edu/impacteffects) is a popular web-based calculator for estimating the regional environmental consequences of a comet or asteroid impact on Earth. It is widely used, both by inquisitive members of the public as an educational device and by scientists as a simple research tool. It applies a variety of scaling laws, based on theory, nuclear explosion test data, observations from terrestrial and extraterrestrial craters and the results of small-scale impact experiments and numerical modelling, to quantify the principal hazards that might affect the people, buildings and landscape in the vicinity of an impact. The program requires six inputs: impactor diameter, impactor density, impact velocity prior to atmospheric entry, impact angle, and the target type (sedimentary rock, crystalline rock, or a water layer above rock), as well as the distance from the impact at which the environmental effects are to be calculated. The program includes simple algorithms for estimating the fate of the impactor during atmospheric traverse, the thermal radiation emitted by the impact plume (fireball) and the intensity of seismic shaking. The program also approximates various dimensions of the impact crater and ejecta deposit, as well as estimating the severity of the air blast in both crater-forming and airburst impacts. We illustrate the strengths and limitations of the program by comparing its predictions (where possible) against known impacts, such as Carancas, Peru (2007); Tunguska, Siberia (1908); Barringer (Meteor) crater, Arizona (ca 49 ka). These tests demonstrate that, while adequate for large impactors, the simple approximation of atmospheric entry in the original program does not properly account for the disruption and dispersal of small impactors as they traverse Earth's atmosphere. We describe recent improvements to the calculator to better describe atmospheric entry of small meteors; the consequences of oceanic impacts; and

Climbers' attitudes toward recreation resource impacts in the Adirondack Park

Treesearch

Christopher A. Monz; Katherine E. Smith; Leah Knickerbocker

2006-01-01

Climbers arriving at trailheads to popular climbing areas in Adirondack Park, NY were surveyed as to the types of resource impacts they found to be offensive. Climbers were also asked about their degree of concern regarding crowding, noise and management of climbing areas. Some resource impacts, such as damage to trees as a result of poor climbing practices, are...

Cold episodes in the Peruvian Central Andes: Composites, Types, and their Impacts over South America (1958-2014)

NASA Astrophysics Data System (ADS)

Sulca, J. C.; Vuille, M. F.; Roundy, P. E.; Trasmonte, G.; Silva, Y.; Takahashi, K.

2015-12-01

The Mantaro basin (MB) is located in the central Peruvian Andes. Occasionally, cold episodes are observed during austral summer (January-March), that strongly damage crops. However, little is known about the causes and impacts of such cold episodes. The main goal of this study is thus to characterize cold episodes in the MB and assess their large-scale circulation and teleconnections over South America (SA) during austral summer. To identify cold events in the MB daily minimum temperature (Tmin) for the period 1958-2014 from Huayao station, located within the MB was used. A cold episode is defined when daily minimum temperature drops below its 10-percentile for at least one day. Additionally, to study the sensitivity between physical mechanisms associated with cold episodes and temperature, cold episodes are classified in three groups: Weak cold episodes (7.5 ≤ Tmin ≤ 10 percentile), strong cold episodes (Tmin ≤ 2.5 percentile), but excluding the 9 coldest events (Tmin ≤ 0 ͦ C), henceforth referred to as extraordinary cold episodes. Several gridded reanalysis were used to characterize the large-scale circulation, cloud cover and rainfall over SA associated with these events. Weak and strong cold episodes in the MB are mainly associated with a weakening of the Bolivian High-Nordeste Low system by tropical-extratropical interactions. Both types of cold episodes are associated with westerly wind anomalies at mid- and upper-tropospheric levels aloft the Peruvian Central Andes, which inhibit the influx of humid air masses from the lowlands to the east and hence limit the development of cloud cover (e.g., positive OLR anomalies over MB). The resulting clear sky conditions cause nighttime temperatures to drop, leading to cold extremes below 10-percentile. Simultaneously, northeastern Brazil (NEB) registers negative OLR anomalies, strong convection and enhanced cloud cover because displacement of the South Atlantic Convergence Zone (SACZ) toward the northeast of

Impact of pharmaceutical care interventions on glycemic control and other health-related clinical outcomes in patients with type 2 diabetes: Randomized controlled trial.

PubMed

Wishah, Ruba A; Al-Khawaldeh, Omar A; Albsoul, Abla M

2015-01-01

The primary aim of this study was to evaluate the impact of pharmaceutical care interventions on glycemic control and other health-related clinical outcomes in patients with type 2 diabetes patients in Jordan. A randomized controlled clinical trial was conducted on 106 patients with uncontrolled type 2 diabetes seeking care in the diabetes clinics at Jordan University Hospital. Patients were randomly allocated into control and intervention group. The intervention group patients received pharmaceutical care interventions developed by the clinical pharmacist in collaboration with the physician while the control group patients received usual care without clinical pharmacist's input. Fasting blood glucose and HbA1c were measured at the baseline, at three months, and six months intervals for both intervention and control groups. After the six months follow-up, mean of HbA1c and FBS of the patients in the intervention group decreased significantly compared to the control group patients (P<0.05). Also, the results indicated that mean scores of patients' knowledge about medications, knowledge about diabetes and adherence to medications and diabetes self-care activities of the patients in the intervention group increased significantly compared to the control group (P<0.05). This study demonstrated an improvement in HbA1c, FBS, and lipid profile, in addition to self-reported medication adherence, diabetes knowledge, and diabetes self-care activities in patients with type 2 diabetes who received pharmaceutical care interventions. The results suggest the benefits of integrating clinical pharmacist services in multidisciplinary healthcare team and diabetes management in Jordan. Copyright © 2014 Diabetes India. Published by Elsevier Ltd. All rights reserved.

The Effect of Union Type on Work-Life Conflict in Five European Countries

ERIC Educational Resources Information Center

Kasearu, Kairi

2009-01-01

This paper explores the strategies for reconciling family and work in different union types. The focus here is on investigating how cohabiting and married individuals perceive the work-life conflict in different European countries. To test the union type impact on work-life balance in the context of different societal conditions, this paper draws…

Analyzing the impacts of three types of biochar on soil carbon fractions and physiochemical properties in a corn-soybean rotation.

PubMed

Sandhu, Saroop S; Ussiri, David A N; Kumar, Sandeep; Chintala, Rajesh; Papiernik, Sharon K; Malo, Douglas D; Schumacher, Thomas E

2017-10-01

Biochar is a solid material obtained when biomass is thermochemically converted in an oxygen-limited environment. In most previous studies, the impacts of biochar on soil properties and organic carbon (C) were investigated under controlled conditions, mainly laboratory incubation or greenhouse studies. This 2-year field study was conducted to evaluate the influence of biochar on selected soil physical and chemical properties and carbon and nitrogen fractions for two selected soil types (clay loam and a sandy loam soil) under a corn (Zea mays L.)-soybean (Glycine max L.) rotation. The three plant based biochar materials used for this study were corn stover (CS), ponderosa pine (Pinus ponderosa Lawson and C. Lawson) wood residue (PW), and switchgrass (Panicum virgatum L.) (SG). Data showed that CS and SG significantly increased the pH of acidic soil at the eroded landscape position but produced no significant change in soil pH at the depositional landscape position. The effects of biochar treatments on cold water extractable C (WSC) and nitrogen (WSN) fractions for the 0-7.5 cm depth were depended on biochar and soil type. Results suggested that alkaline biochars applied at 10 Mg ha -1 can increase the pH and WSC fraction of acidic sandy loam soil, but the 10 Mg ha -1 rate might be low to substantially improve physical properties and hot water extractable C and N fractions of soil. Application of higher rates of biochar and long-term monitoring is needed to quantify the benefits of biochar under field conditions on soils in different environmental conditions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Impact of lysine and liquid smoke as flavor enhancers on the quality of low-fat Bologna-type sausages with 50% replacement of NaCl by KCl.

PubMed

Dos Santos Alves, Larissa Aparecida Agostinho; Lorenzo, José Manuel; Gonçalves, Carlos Antonio Alvarenga; Dos Santos, Bibiana Alves; Heck, Rosane Teresinha; Cichoski, Alexandre José; Campagnol, Paulo Cezar Bastianello

2017-01-01

Low-fat Bologna-type sausages were produced with 50% of NaCl replaced by KCl and with addition of lysine and/or liquid smoke as flavor enhancers. The influence of sodium reduction on technological, physicochemical, and microbiological properties was determined. In addition, the sensory properties were evaluated using a Check all that apply questionnaire (CATA) and a consumer study. The partial replacement of NaCl by KCl did not have negative impacts on physicochemical, technological, and microbiological properties. However, the addition of KCl affected the sensory acceptance, as consumers identified by CATA questionnaire a reduction in salty taste and an increase in bitter, astringent, and metallic taste. The isolated or combined addition of lysine and liquid smoke reduced the sensory quality defects caused by the addition of KCl. Therefore, high quality low-fat Bologna-type sausages with sodium reduction close to 50% can be produced by replacing 50% NaCl by KCl and with addition of 1% lysine and/or 0.1% liquid smoke. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Impact of Different Types of Fathers on Family Climate in Young Adulthood: A Multi-perspective Longitudinal Study on 14 to 27 Year Olds and their Fathers].

PubMed

Escher, Fabian J; Seiffge-Krenke, Inge

2018-01-01

Impact of Different Types of Fathers on Family Climate in Young Adulthood: A Multi-perspective Longitudinal Study on 14 to 27 Year Olds and their Fathers In a 13 year longitudinal study, the influence of three types of fathers on the family climate was analyzed. In a sample of 213 subjects, their 169 fathers and their 210 mothers, the family environment ( Family Environment Scales) was examined when the subjects were young adults (M = 26.89, SD = 1.32). The results of the study point to significant changes in family climate in those young adults who described their father as increasingly negative (N = 28) or distant (N = 11) when in adolescence. These two groups showed a more negative family environment and greater differences between the perspectives of fathers and their young adult children than the group of young adults who described their father as normative (N = 174) when in adolescence. The highest discrepancies were described by young adults with a negative relationship with their father in adolescence. The findings show a long lasting importance of father-child interactions in adolescence.

Hypervelocity Impact Test Facility: A gun for hire

NASA Technical Reports Server (NTRS)

Johnson, Calvin R.; Rose, M. F.; Hill, D. C.; Best, S.; Chaloupka, T.; Crawford, G.; Crumpler, M.; Stephens, B.

1994-01-01

An affordable technique has been developed to duplicate the types of impacts observed on spacecraft, including the Shuttle, by use of a certified Hypervelocity Impact Facility (HIF) which propels particulates using capacitor driven electric gun techniques. The fully operational facility provides a flux of particles in the 10-100 micron diameter range with a velocity distribution covering the space debris and interplanetary dust particle environment. HIF measurements of particle size, composition, impact angle and velocity distribution indicate that such parameters can be controlled in a specified, tailored test designed for or by the user. Unique diagnostics enable researchers to fully describe the impact for evaluating the 'targets' under full power or load. Users regularly evaluate space hardware, including solar cells, coatings, and materials, exposing selected portions of space-qualified items to a wide range of impact events and environmental conditions. Benefits include corroboration of data obtained from impact events, flight simulation of designs, accelerated aging of systems, and development of manufacturing techniques.

Evaluating wilderness recreational opportunities: application of an impact matrix

USGS Publications Warehouse

Stohlgren, Thomas J.; Parsons, David J.

1992-01-01

An inventory of the severity and spatial distribution of wilderness campsite impacts in Sequoia and Kings Canyon National Parks identified a total of 273 distinct nodes of campsites or “management areas.” A campsite impact matrix was developed to evaluate management areas based on total impacts (correlated to the total area of campsite development) and the density, or concentration, of impacts relative to each area's potentially campable area. The matrix is used to quantify potential recreational opportunities for wilderness visitors in a spectrum from areas offering low impact-dispersed camping to those areas offering high impact-concentrated camping. Wilderness managers can use this type of information to evaluate use distribution patterns, identify areas to increase or decrease use, and to identify areas needing site-specific regulations (e.g., one-night camping limits) to preserve wilderness resources and guarantee outstanding opportunities for solitude.

Venus - Impact Crater Jeanne

NASA Image and Video Library

1996-11-20

This full-resolution image from NASA Magellan spacecraft shows Jeanne crater, a 19.5 kilometer (12 mile) diameter impact crater. Jeanne crater is located at 40.0 degrees north latitude and 331.4 degrees longitude. The distinctive triangular shape of the ejecta indicates that the impacting body probably hit obliquely, traveling from southwest to northeast. The crater is surrounded by dark material of two types. The dark area on the southwest side of the crater is covered by smooth (radar-dark) lava flows which have a strongly digitate contact with surrounding brighter flows. The very dark area on the northeast side of the crater is probably covered by smooth material such as fine-grained sediment. This dark halo is asymmetric, mimicking the asymmetric shape of the ejecta blanket. The dark halo may have been caused by an atmospheric shock or pressure wave produced by the incoming body. Jeanne crater also displays several outflow lobes on the northwest side. These flow-like features may have formed by fine-grained ejecta transported by a hot, turbulent flow created by the arrival of the impacting object. Alternatively, they may have formed by flow of impact melt. http://photojournal.jpl.nasa.gov/catalog/PIA00472

Atypical combinations and scientific impact.

PubMed

Uzzi, Brian; Mukherjee, Satyam; Stringer, Michael; Jones, Ben

2013-10-25

Novelty is an essential feature of creative ideas, yet the building blocks of new ideas are often embodied in existing knowledge. From this perspective, balancing atypical knowledge with conventional knowledge may be critical to the link between innovativeness and impact. Our analysis of 17.9 million papers spanning all scientific fields suggests that science follows a nearly universal pattern: The highest-impact science is primarily grounded in exceptionally conventional combinations of prior work yet simultaneously features an intrusion of unusual combinations. Papers of this type were twice as likely to be highly cited works. Novel combinations of prior work are rare, yet teams are 37.7% more likely than solo authors to insert novel combinations into familiar knowledge domains.

Impact Testing of Orbiter Thermal Protection System Materials

NASA Technical Reports Server (NTRS)

Kerr, Justin

2006-01-01

This viewgraph presentation reviews the impact testing of the materials used in designing the shuttle orbiter thermal protection system (TPS). Pursuant to the Columbia Accident Investigation Board recommendations a testing program of the TPS system was instituted. This involved using various types of impactors in different sizes shot from various sizes and strengths guns to impact the TPS tiles and the Leading Edge Structural Subsystem (LESS). The observed damage is shown, and the resultant lessons learned are reviewed.

Reassessment of the recombination parameters of chromium in n- and p-type crystalline silicon and chromium-boron pairs in p-type crystalline silicon

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

Sun, Chang, E-mail: chang.sun@anu.edu.au; Rougieux, Fiacre E.; Macdonald, Daniel

2014-06-07

Injection-dependent lifetime spectroscopy of both n- and p-type, Cr-doped silicon wafers with different doping levels is used to determine the defect parameters of Cr{sub i} and CrB pairs, by simultaneously fitting the measured lifetimes with the Shockley-Read-Hall model. A combined analysis of the two defects with the lifetime data measured on both n- and p-type samples enables a significant tightening of the uncertainty ranges of the parameters. The capture cross section ratios k = σ{sub n}/σ{sub p} of Cr{sub i} and CrB are determined as 3.2 (−0.6, +0) and 5.8 (−3.4, +0.6), respectively. Courtesy of a direct experimental comparison of the recombinationmore » activity of chromium in n- and p-type silicon, and as also suggested by modelling results, we conclude that chromium has a greater negative impact on carrier lifetimes in p-type silicon than n-type silicon with similar doping levels.« less

Audio versus Written Feedback: Exploring Learners' Preference and the Impact of Feedback Format on Students' Academic Performance

ERIC Educational Resources Information Center

Morris, Cecile; Chikwa, Gladson