Advance directives as autonomy enhancers: reality or myth?

OpenAIRE

Navarro Michel, Mónica

2015-01-01

In the last few decades there has been a wealth of literature and legislation on advance directives. As you all know, it is an instrument by which a person can express their wishes as regards what treatment they should be given or, more to the point, not to be given, when he is in a situation when he can not do so himself. Regulations in the western world seem to promote advance directives as a way to enhance patient¿s autonomy in the context of human rights, and the media has presen...

Medicare and Medicaid programs; advance directives--HCFA. Final rule.

Science.gov (United States)

1995-06-27

This final rule responds to public comments on the March 6, 1992 interim final rule with comment period that amended the Medicare and Medicaid regulations governing provider agreements and contracts to establish requirements for States, hospitals, nursing facilities, skilled nursing facilities, providers of home health care or personal care services, hospice programs and managed care plans concerning advance directives. An advance directive is a written instruction, such as a living will or durable power of attorney for health care, recognized under State law, relating to the provision of health care when an individual's condition makes him or her unable to express his or her wishes. The intent of the advance directives provisions is to enhance an adult individual's control over medical treatment decisions. This rule confirms the interim final rule with several minor changes based on our review and consideration of public comments.

Ceramic thermal wind sensor based on advanced direct chip attaching package

International Nuclear Information System (INIS)

Zhou Lin; Qin Ming; Chen Shengqi; Chen Bei

2014-01-01

An advanced direct chip attaching packaged two-dimensional ceramic thermal wind sensor is studied. The thermal wind sensor chip is fabricated by metal lift-off processes on the ceramic substrate. An advanced direct chip attaching (DCA) packaging is adopted and this new packaged method simplifies the processes of packaging further. Simulations of the advanced DCA packaged sensor based on computational fluid dynamics (CFD) model show the sensor can detect wind speed and direction effectively. The wind tunnel testing results show the advanced DCA packaged sensor can detect the wind direction from 0° to 360° and wind speed from 0 to 20 m/s with the error less than 0.5 m/s. The nonlinear fitting based least square method in Matlab is used to analyze the performance of the sensor. (semiconductor devices)

[Advance directives in clinical practice : Living will, healthcare power of attorney and care directive].

Science.gov (United States)

Hack, J; Buecking, B; Lopez, C L; Ruchholtz, S; Kühne, C A

2017-06-01

In clinical practice, situations continuously occur in which medical professionals and family members are confronted with decisions on whether to extend or limit treatment for severely ill patients in end of life treatment decisions. In these situations, advance directives are helpful tools in decision making according to the wishes of the patient; however, not every patient has made an advance directive and in our experience medical staff as well as patients are often not familiar with these documents. The purpose of this article is therefore to explain the currently available documents (e.g. living will, healthcare power of attorney and care directive) and the possible (legal) applications and limitations in the routine clinical practice.

African Cultural Concept of Death and the Idea of Advance Care Directives.

Science.gov (United States)

Ekore, Rabi Ilemona; Lanre-Abass, Bolatito

2016-01-01

An advance care directive is a person's oral or written instructions about his or her future medical care, if he or she becomes unable to communicate. It may be in written or oral form. Africans ordinarily do not encourage the contemplation of death or any discussion about their own or their loved ones' death. According to the African belief system, life does not end with death, but continues in another realm. Becoming an ancestor after death is a desirable goal of every individual, a feat which cannot be achieved if an individual asks for an unnatural death by attempting to utilize advance care directives. Advance care directives are considered to be too individualistic for communitarian societies such as Africa. Coupled with the communitarian nature of African societies are issues such as lack of awareness of advance directives, fear of death and grief, and the African cultural belief system, which are potential barriers to the utilization of advance care directives in the African setting. Hence, the need for culture sensitivity which makes it imperative that patient's family and loved ones are carried along as far as possible, without compromising the autonomy of the patient in question when utilizing advance care directives.

Effect of the Contents in Advance Directives on Individuals' Decision-Making.

Science.gov (United States)

Park, Jae Yoon; Lim, Chi-Yeon; Puurveen, Gloria; Kim, Do Yeun; Lee, Jae Hang; Do, Han Ho; Kim, Kyung Soo; Yoo, Kyung Don; Kim, Hyo Jin; Kim, Yunmi; Shin, Sung Joon

2018-01-01

Completing an advance directive offers individuals the opportunity to make informed choices about end-of-life care. However, these decisions could be influenced in different ways depending on how the information is presented. We randomly presented 185 participants with four distinct types of advance directive: neutrally framed (as reference), negatively framed, religiously framed, and a combination. Participants were asked which interventions they would like to receive at the end of life. Between 60% and 70% of participants responded "accept the special interventions" on the reference form. However, the majority (70%-90%) chose "refuse the interventions" on the negative form. With respect to the religious form, 70% to 80% chose "not decided yet." Participants who refused special life-sustaining treatments were older, female, and with better prior knowledge about advance directives. Our findings imply that the specific content of advance directives could affect decision-making with regard to various interventions for end-of-life care.

Advance directives: the clinical nurse specialist as a change agent.

Science.gov (United States)

Meehan, Karen Anne

2009-01-01

The purpose of this article is to describe the impact the clinical nurse specialist (CNS) has on the advance directive process within the cardiac surgery patient population. As a change agent, the CNS needs to be able to increase the number of advance directives obtained and increase the provision of dignified, self-directed, quality patient care. With requirements from The Joint Commission and the Patient Self-determination Act, the change in process must take place to ensure that healthcare professionals are doing all they can do to carry out a patient's wishes. The 6-Source Influencer Model is applied to a case study to illustrate the role of the CNS as a change agent. Following this model, the CNS can facilitate lasting institutional change in the advance directive process. Based on the example, it is possible that a CNS can act as a change agent for other patient populations within the healthcare setting.

Did you seek assistance for writing your advance directive? A qualitative study.

Science.gov (United States)

Becker, Matthias; Jaspers, Birgit; King, Claudius; Radbruch, Lukas; Voltz, Raymond; Nauck, Friedemann

2010-11-01

the completion of an advanced directive is paired with a high degree of self-responsibility of the signatory. It requires anticipation of probably complex medical situations. In the literature, the family physician is often seen as the most important person for advice when writing an advance directive. But little is known about whether or not patients want to involve medical advisors and to what extent physicians are willing to give advice. The aim of this study was to analyse whether or not individuals approached advisors for the completion of their advance directive, whom they chose and which reasons were given for seeking or foregoing assistance. semi-structured interviews with healthy individuals, chronically ill individuals and patients in palliative care including questions associated with advice for completing an advance directive (8/2008-7/2009). age 55-70 years and advance directive ≥ 3 months old. The interviews were fully transcribed according to standard transcription rules and analysed applying an inductive category development. interviews were conducted with 53 probands (healthy n = 20, chronically ill n = 17, palliative care patients n = 16); 18 probands were male. Mean age was 63.2 ± 4.4 years (range 55-70 years). Professional advice was sought by 12 probands (physician = 2, nurse = 1, lawyer/notary = 8, self-employed advisor = 1), another 8 probands included family members. In 17 cases, the physician knew the proband's advance directive, 36 probands never told their doctor about its existence. Categories of reasons for seeking or foregoing advice were trust/lack of trust, autonomy, rejection and financial considerations. information about the medical implications concerning patient preferences for end-of-life care seems not to be the main focus of interest when individuals write an advance directive. Autonomy and trust into notarially certified documents seem to be more important matters. If family physicians want to have a role in their

Geysers advanced direct contact condenser research

Energy Technology Data Exchange (ETDEWEB)

Henderson, J.; Bahning, T.; Bharathan, D.

1997-12-31

The first geothermal application of the Advanced Direct Contact Condenser (ADCC) technology developed by the National Renewable Energy Laboratory (NREL) is now operational and is being tested at The Geysers Power Plant Unit 11. This major research effort is being supported through the combined efforts of NREL, The Department of Energy (DOE), and Pacific Gas and Electric (PG&E). NREL and PG&E have entered into a Cooperative Research And Development Agreement (CRADA) for a project to improve the direct-contact condenser performance at The Geysers Power Plant. This project is the first geothermal adaptation of an advanced condenser design developed for the Ocean Thermal Energy Conversion (OTEC) systems. PG&E expects this technology to improve power plant performance and to help extend the life of the steam field by using steam more efficiently. In accordance with the CRADA, no money is transferred between the contracting parties. In this case the Department of Energy is funding NREL for their efforts in this project and PG&E is contributing funds in kind. Successful application of this technology at The Geysers will provide a basis for NREL to continue to develop this technology for other geothermal and fossil power plant systems.

Challenges to implementation of advance directives of will in hospital practice.

Science.gov (United States)

Cogo, Silvana Bastos; Lunardi, Valéria Lerch; Quintana, Alberto Manuel; Girardon-Perlini, Nara Marilene Oliveira; Silveira, Rosemary Silva da

2016-01-01

to understand the difficulties and limitations in the implementation of advance directives of will in the hospital context. qualitative, exploratory and descriptive study conducted by means of semi-structured interviews with nurses, resident physicians and family caregivers. The data were analyzed by using discursive textual analysis based on the framework of bioethics principles. the following categories emerged: Terminality as an expression of loss and cure as an option for care; concerns about legal implications; advance directives of will demand patient autonomy and proper communication. limitations and difficulties in practice of advance directives of will from the perspective of the participants show, apart from countless conflicts and dilemmas regarding end-of life matters, that impending death experiences obstruct patients' wishes.

Advance Directives and Powers of Attorney in Intensive Care Patients.

Science.gov (United States)

de Heer, Geraldine; Saugel, Bernd; Sensen, Barbara; Rübsteck, Charlotte; Pinnschmidt, Hans O; Kluge, Stefan

2017-06-05

Advance directives and powers of attorney are increasingly common, yet data on their use in clinical situations remain sparse. In this single center cross-sectional study, we collected data by questionnaire from 1004 intensive care patients in a university hospital. The frequencies of advance directives and powers of attorney were determined, and the factors affecting them were studied with multivariate logistic regression analysis. Usable data were obtained from 998 patients. 51.3% stated that they had prepared a document of at least one of these two kinds. Among them, 39.6% stated that they had given the relevant document(s) to the hospital, yet such documents were present in the patient's hospital record for only 23%. 508 patients stated their reasons for preparing an advance directive or a power of attorney: the most common reason (48%) was the fear of being at other people's mercy, of the lack of self-determination, or of medical overtreatment. The most important factors associated with a patient's statement that he/she had prepared such a document were advanced age (advance directive: 1.022 [1.009; 1.036], p = 0.001; power of attorney: 1.027 [1.014; 1.040], padvance directive: 1.622 [1.138; 2.311], padvance directives and 44.1% of the powers of attorney that were present in the hospital records were poorly interpretable because of the incomplete filling-out of preprinted forms. Half of the patients who did not have such a document had already thought of preparing one, but had not yet done so. For patients hospitalized in intensive care units, there should be early discussion about the presence or absence of documents of these kinds and early evaluation of the patient's concrete wishes in critical situations. Future studies are needed to determine how best to assure that these documents will be correctly prepared and then given over to hospital staff so that they can take their place in the patient's record.

Joint crisis plans and psychiatric advance directives in German psychiatric practice.

Science.gov (United States)

Radenbach, Katrin; Falkai, Peter; Weber-Reich, Traudel; Simon, Alfred

2014-05-01

This study explores the attitude of German psychiatrists in leading positions towards joint crisis plans and psychiatric advance directives. This topic was examined by contacting 473 medical directors of German psychiatric hospitals and departments. They were asked to complete a questionnaire developed by us. That form contained questions about the incidence and acceptance of joint crisis plans and psychiatric advance directives and previous experiences with them. 108 medical directors of psychiatric hospitals and departments responded (response rate: 22.8%). Their answers demonstrate that in their hospitals these documents are rarely used. Among the respondents, joint crisis plans are more accepted than psychiatric advance directives. There is a certain uncertainty when dealing with these instruments. Our main conclusion is that German psychiatry needs an intensified discussion on the use of instruments for patients to constitute procedures for future critical psychiatric events. For this purpose it will be helpful to collect more empirical data. Furthermore, the proposal of joint crisis plans in psychiatric hospitals and departments should be discussed as well as the possibility of consulting an expert during the preparation of a psychiatric advance directive.

Perspectives of Korean Patients, Families, Physicians and Nurses on Advance Directives

Directory of Open Access Journals (Sweden)

Jia Lee, PhD, RN

2010-12-01

Conclusions: There were many differences in the perspectives of patients, families, physicians and nurses on advance directives. End-of-life care decisions should take the wishes of patients into account, and that such decisions should therefore be made before the patients lose the capacity to make them. To make well-informed decisions regarding future care, patients and families must be fully educated about advance directives and expected outcomes.

Recent Advances in High-Performance Direct Methanol Fuel Cells

Science.gov (United States)

Narayanan, S. R.; Chun, W.; Valdez, T. I.; Jeffries-Nakamura, B.; Frank, H.; Surumpudi, S.; Halpert, G.; Kosek, J.; Cropley, C.; La Conti, A. B.;

Canadian advanced life support capacities and future directions

Science.gov (United States)

Bamsey, M.; Graham, T.; Stasiak, M.; Berinstain, A.; Scott, A.; Vuk, T. Rondeau; Dixon, M.

2009-07-01

Canada began research on space-relevant biological life support systems in the early 1990s. Since that time Canadian capabilities have grown tremendously, placing Canada among the emerging leaders in biological life support systems. The rapid growth of Canadian expertise has been the result of several factors including a large and technically sophisticated greenhouse sector which successfully operates under challenging climatic conditions, well planned technology transfer strategies between the academic and industrial sectors, and a strong emphasis on international research collaborations. Recent activities such as Canada's contribution of the Higher Plant Compartment of the European Space Agency's MELiSSA Pilot Plant and the remote operation of the Arthur Clarke Mars Greenhouse in the Canadian High Arctic continue to demonstrate Canadian capabilities with direct applicability to advanced life support systems. There is also a significant latent potential within Canadian institutions and organizations with respect to directly applicable advanced life support technologies. These directly applicable research interests include such areas as horticultural management strategies (for candidate crops), growth media, food processing, water management, atmosphere management, energy management, waste management, imaging, environment sensors, thermal control, lighting systems, robotics, command and data handling, communications systems, structures, in-situ resource utilization, space analogues and mission operations. With this background and in collaboration with the Canadian aerospace industry sector, a roadmap for future life support contributions is presented here. This roadmap targets an objective of at least 50% food closure by 2050 (providing greater closure in oxygen, water recycling and carbon dioxide uptake). The Canadian advanced life support community has chosen to focus on lunar surface infrastructure and not low Earth orbit or transit systems (i.e. microgravity

22 CFR 72.30 - Provisions in a will or advanced directive regarding disposition of remains.

Science.gov (United States)

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Provisions in a will or advanced directive... Decreased United States Citizen Or National § 72.30 Provisions in a will or advanced directive regarding disposition of remains. United States state law regarding advance directives, deaths and estates include...

Advance directives and outcomes of surrogate decision making before death.

Science.gov (United States)

Silveira, Maria J; Kim, Scott Y H; Langa, Kenneth M

2010-04-01

Recent discussions about health care reform have raised questions regarding the value of advance directives. We used data from survey proxies in the Health and Retirement Study involving adults 60 years of age or older who had died between 2000 and 2006 to determine the prevalence of the need for decision making and lost decision-making capacity and to test the association between preferences documented in advance directives and outcomes of surrogate decision making. Of 3746 subjects, 42.5% required decision making, of whom 70.3% lacked decision-making capacity and 67.6% of those subjects, in turn, had advance directives. Subjects who had living wills were more likely to want limited care (92.7%) or comfort care (96.2%) than all care possible (1.9%); 83.2% of subjects who requested limited care and 97.1% of subjects who requested comfort care received care consistent with their preferences. Among the 10 subjects who requested all care possible, only 5 received it; however, subjects who requested all care possible were far more likely to receive aggressive care as compared with those who did not request it (adjusted odds ratio, 22.62; 95% confidence interval [CI], 4.45 to 115.00). Subjects with living wills were less likely to receive all care possible (adjusted odds ratio, 0.33; 95% CI, 0.19 to 0.56) than were subjects without living wills. Subjects who had assigned a durable power of attorney for health care were less likely to die in a hospital (adjusted odds ratio, 0.72; 95% CI, 0.55 to 0.93) or receive all care possible (adjusted odds ratio, 0.54; 95% CI, 0.34 to 0.86) than were subjects who had not assigned a durable power of attorney for health care. Between 2000 and 2006, many elderly Americans needed decision making near the end of life at a time when most lacked the capacity to make decisions. Patients who had prepared advance directives received care that was strongly associated with their preferences. These findings support the continued use of advance

Paramedics experiences and expectations concerning advance directives: a prospective, questionnaire-based, bi-centre study.

Science.gov (United States)

Taghavi, Mahmoud; Simon, Alfred; Kappus, Stefan; Meyer, Nicole; Lassen, Christoph L; Klier, Tobias; Ruppert, David B; Graf, Bernhard M; Hanekop, Gerd G; Wiese, Christoph H R

2012-10-01

Advance directives and palliative crisis cards are means by which palliative care patients can exert their autonomy in end-of-life decisions. To examine paramedics' attitudes towards advance directives and end-of-life care. Questionnaire-based investigation using a self-administered survey instrument. Paramedics of two cities (Hamburg and Goettingen, Germany) were included. Participants were questioned as to (1) their attitudes about advance directives, (2) their clinical experiences in connection with end-of-life situations (e.g. resuscitation), (3) their suggestions in regard to advance directives, 'Do not attempt resuscitation' orders and palliative crisis cards. Questionnaires were returned by 728 paramedics (response rate: 81%). The majority of paramedics (71%) had dealt with advance directives and end-of-life decisions in emergency situations. Most participants (84%) found that cardiopulmonary resuscitation in end-of-life patients is not useful and 75% stated that they would withhold cardiopulmonary resuscitation in the case of legal possibility. Participants also mentioned that more extensive discussion of legal aspects concerning advance directives should be included in paramedic training curricula. They suggested that palliative crisis cards should be integrated into end-of-life care. Decision making in prehospital end-of-life care is a challenge for all paramedics. The present investigation demonstrates that a dialogue bridging emergency medical and palliative care issues is necessary. The paramedics indicated that improved guidelines on end-of-life decisions and the termination of cardiopulmonary resuscitation in palliative care patients may be essential. Participants do not feel adequately trained in end-of-life care and the content of advance directives. Other recent studies have also demonstrated that there is a need for training curricula in end-of-life care for paramedics.

Immunotherapy for advanced melanoma: future directions.

Science.gov (United States)

Valpione, Sara; Campana, Luca G

2016-02-01

As calculated by the meta-analysis of Korn et al., the prognosis of metastatic melanoma in the pretarget and immunological therapy era was poor, with a median survival of 6.2 and a 1-year life expectancy of 25.5%. Nowadays, significant advances in melanoma treatment have been gained, and immunotherapy is one of the promising approaches to get to durable responses and survival improvement. The aim of the present review is to highlight the recent innovations in melanoma immunotherapy and to propose a critical perspective of the future directions of this enthralling oncology subspecialty.

Protecting prisoners' autonomy with advance directives: ethical dilemmas and policy issues.

Science.gov (United States)

Andorno, Roberto; Shaw, David M; Elger, Bernice

2015-02-01

Over the last decade, several European countries and the Council of Europe itself have strongly supported the use of advance directives as a means of protecting patients' autonomy, and adopted specific norms to regulate this matter. However, it remains unclear under which conditions those regulations should apply to people who are placed in correctional settings. The issue is becoming more significant due to the increasing numbers of inmates of old age or at risk of suffering from mental disorders, all of whom might benefit from using advance directives. At the same time, the closed nature of prisons and the disparate power relationships that characterise them mean that great caution must be exercised to prevent care being withdrawn or withheld from inmates who actually want to receive it. This paper explores the issue of prisoners' advance directives in the European context, starting with the position enshrined in international and European law that prisoners retain all their human rights, except the right to liberty, and are therefore entitled to self-determination regarding health care decisions.

Health literacy: a study of internet-based information on advance directives.

Science.gov (United States)

Stuart, Peter

2017-11-28

The aim of this study was to evaluate the quality and value of web-based information on advance directives. Internet-based information on advance directives was selected because, if it is inaccurate or difficult to understand, patients risk making decisions about their care that may not be followed in practice. Two validated health information evaluation tools, the Suitability Assessment of Materials and DISCERN, and a focus group were used to assess credibility, user orientation and effectiveness. Only one of the 34 internet-based information items on advance directives reviewed fulfilled the study criteria and 30% of the sites were classed as unreadable. In terms of learning and informing, 79% of the sites were considered unsuitable. Using health literacy tools to evaluate internet-based health information highlights that often it is not at a functional literacy level and neither informs nor empowers users to make independent and valid healthcare decisions. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

[Can the vascular specialist improve patient awareness about advanced directives?].

Science.gov (United States)

Sanson, H; Priollet, P

2016-05-01

In France, the Leonetti law, adopted on April 22, 2005, stipulates the regulations concerning advanced directives. This is a patient's right that is not well known and rarely applied. In 2015, a new law project was thus presented in which the French National Authority for Health recommended that doctors, including all specialists, bring up the subject, especially during consultation. To evaluate the vascular specialist's possibility to mention the topic of advanced directives during consultations. A single and non-interventional prospective study conducted with the help of patients who consulted a private practitioner vascular specialist: recurrent patients regularly consulting a private practitioner vascular specialist were included. First-time consultants, minors and patients to whom it was not adapted to speak about the subject were not included. Between July 27 and September 23, 2015, 159 consecutive patients were examined. Fifty-five first-time consultants and four patients for whom the interview was unsuitable were excluded. In all, 100 patients were questioned. None of them refused to talk about the subject. Women made up a majority of the population (63 %) with an average age of 67 years (23-97). The principal diagnostics were common to vascular medicine consultations: deep vein thrombosis (20 %), peripheral arterial disease (15 %), varicose veins (11 %), lymphedema (11 %) and leg ulcers (9 %). Thirteen percent of the people had a history of cancer. Half of the patients had had follow-ups for over 10 years. The average time devoted to discussing the topic was 12minutes (5-40). Only 22 % of the patients declared having been familiar with advance directives. Once informed however, 78 % chose to write up an adapted form: 36 % with the help of their doctor and 42 % with a doctor and a relative. Seventy-three percent of the consultants thought that talking about the advance directives would reinforce the confidence link between the doctor and the

Direct electroplating of plastic for advanced electrical applications

DEFF Research Database (Denmark)

Islam, Aminul; Hansen, Hans Nørgaard; Tang, Peter Torben

2017-01-01

Electrodeposition or electroplating is predominantly applied to metallic components. Electroplating of plastics is possible in some cases where an initial electroless plating layer of nickel or copper is made to provide a conductive surface on the plastic part. This paper proposes a method...... for direct electroplating of plastic eliminating the need for slow and expensive processes like electroless metal deposition, PVD coating, painting with conductive inks etc. The results obtained from the test demonstrate the potential of direct electroplating of plastic to enhance the electrical conductivity...... and the use of electroplated plastics for advanced applications like Moulded Interconnect Devices (MIDs)....

Direct Cardiac Reprogramming: Advances in Cardiac Regeneration

Directory of Open Access Journals (Sweden)

Olivia Chen

2015-01-01

Full Text Available Heart disease is one of the lead causes of death worldwide. Many forms of heart disease, including myocardial infarction and pressure-loading cardiomyopathies, result in irreversible cardiomyocyte death. Activated fibroblasts respond to cardiac injury by forming scar tissue, but ultimately this response fails to restore cardiac function. Unfortunately, the human heart has little regenerative ability and long-term outcomes following acute coronary events often include chronic and end-stage heart failure. Building upon years of research aimed at restoring functional cardiomyocytes, recent advances have been made in the direct reprogramming of fibroblasts toward a cardiomyocyte cell fate both in vitro and in vivo. Several experiments show functional improvements in mouse models of myocardial infarction following in situ generation of cardiomyocyte-like cells from endogenous fibroblasts. Though many of these studies are in an early stage, this nascent technology holds promise for future applications in regenerative medicine. In this review, we discuss the history, progress, methods, challenges, and future directions of direct cardiac reprogramming.

Older adult opinions of "advance driving directives".

Science.gov (United States)

Betz, Marian E; Lowenstein, Steven R; Schwartz, Robert

2013-01-01

Discussions about driving cessation are difficult. "Advance driving directives" (ADDs), like advance directives for end-of-life care, would allow drivers to designate someone to help make driving decisions for them in the future. It is not known if older drivers support the concept of ADDs. Cross-sectional study of a convenience sample of English-speaking drivers (55+ years) at 2 independent living facilities and 2 community centers who completed anonymous surveys. Of 168 participants, 80% were female; the median age was 76.5 years (range = 56-93 years). Most (74%) drove daily or almost daily, and 7% reported a crash in the past year. Few had spoken with someone about driving safety (5%) or their wishes when driving skills decline (21%). Of the few who had discussed this topic, 83% had spoken with a family member; only 17% had spoken with a health care provider. However, participants were open to driving discussions, and 54% said they would be willing to complete an ADD if recommended. Of these, 79% said it was "likely" or "very likely" they would comply with the directive in the future. Most (73%) supported mandatory, age-based retesting; the median recommended testing age suggested was 80 years. More participants thought the driver (71%), a family member (61%), or a physician (59%) should determine license revocation for an unsafe driver, rather than the department of motor vehicles (32%). Many older drivers may be open to discussing their driving plans with physicians and family members. ADDs may facilitate these discussions in the present and help define driving-related wishes in the future.

Law on advance health care directives: a medical perspective.

Science.gov (United States)

Di Luca, A; Del Rio, A; Bosco, M; Di Luca, N M

2018-01-01

The paper's authors aim to elaborate on law 22 dicembre 2017, n. 219 , designed to regulate informed consent practices and advance health care directives", which has sparked a passionate debate centered on the substantial innovation achieved over the past decades in bio-medical science and at the same time, the noteworthy accomplishments made in enforcing human and personal rights. Within the paper, article three is delved into, which covers the creation of the so-called DAT ("Disposizioni anticipate di trattamento", advance health care directives), by which patients, in light of possible future incapacity to choose, can express their convictions and decisions on how to be treated and their consent or dissent to undergo treatments and procedures, including artificial nutrition and hydration. The authors peruse the new law's provisions through a medical perspective, and observe how they are heavily tilted towards patient choice, thus making doctors little more than mere tools of such decisions.

Japanese citizens' attitude toward end-of-life care and advance directives: A qualitative study for members of medical cooperatives.

Science.gov (United States)

Hirayama, Yoko; Otani, Takashi; Matsushima, Masato

2017-12-01

Japanese citizens are interested in choosing their own end-of-life care, but few have created their own advance directive. This study examined changes among Japanese citizens' attitudes toward end-of-life care and advance directives and explored factors that affected these attitudes. We conducted five focus groups with 48 participants in 2009 and 2010. All participants were members of health cooperatives in Tokyo. We identified many barriers and reasons for creating and writing down advance directives. Experience caring for dying people and having a serious disease affected attitudes toward advance directives. Some participants changed their attitude toward end-of-life care by writing their own advance directive. When someone is writing advance directives, asking about his/her past experience of caring may be helpful. And learning about or filling out advance directives may help to break down resistance to using these documents.

Recent advances in severe accident technology - direct containment heating in advanced light water reactors

International Nuclear Information System (INIS)

Fontana, M.H.

1993-01-01

The issues affecting high-pressure melt ejection (HPME) and the consequential containment pressurization from direct containment heating (DCH), as they affect advanced light water reactors (ALWRs), specifically advanced pressurized water reactors (APWRs), were reviewed by the U.S. Department of Energy Advanced Reactor Severe Accident Program (ARSAP). Recommendations from ARSAP regarding the design of APWRs to minimize DCH are embodied within the Electric Power Research Institute ALWR Utility Requirements Document, which specifies (a) a large, strong containment; (b) an in-containment refueling water storage tank; (c) a reactor cavity configuration that minimizes energy transport to the containment atmosphere; and (d) a reactor coolant system depressurization system. Experimental and analytical efforts, which have focused on current-generation plants, and analyses for APWRs were reviewed. Although DCH is a subject of continuous research and considerable uncertainties remain, it is the judgment of the ARSAP that reactors complying with the recommended design requirements would have a low probability of early containment failure due to HPME and DCH

A Korean perspective on developing a global policy for advance directives.

Science.gov (United States)

Kim, Soyoon; Hahm, Ki-Hyun; Park, Hyoung Wook; Kang, Hyun Hee; Sohn, Myongsei

2010-03-01

Despite the wide and daunting array of cross-cultural obstacles that the formulation of a global policy on advance directives will clearly pose, the need is equally evident. Specifically, the expansion of medical services driven by medical tourism, just to name one important example, makes this issue urgently relevant. While ensuring consistency across national borders, a global policy will have the additional and perhaps even more important effect of increasing the use of advance directives in clinical settings and enhancing their effectiveness within each country, regardless of where that country's state of the law currently stands. One cross-cultural issue that may represent a major obstacle in formulating, let alone applying, a global policy is whether patient autonomy as the underlying principle for the use of advance directives is a universal norm or a construct of western traditions that must be reconciled with alternative value systems that may place lesser significance on individual choice. A global policy, at a minimum, must emphasize respect for patient autonomy, provision of medical information, limits to the obligations for physicians, and portability. And though the development of a global policy will be no easy task, active engagement in close collaboration with the World Health Organization can make it possible.

Advance Directives among Nursing Home Residents with Mild, Moderate, and Advanced Dementia.

Science.gov (United States)

Tjia, Jennifer; Dharmawardene, Marisa; Givens, Jane L

2018-01-01

To describe prevalence and content of AD documentation among NH residents by dementia stage. The prevalence of advance directives (ADs) among nursing home (NH) residents with mild, moderate, and advanced dementia remains unclear. Population-based, cross-sectional study of all licensed NHs in five U.S. states. Subjects included all long-stay (>90 day) NH residents with dementia, aged ≥65 years, and a Cognitive Performance Scale (CPS) score ≥1 from the 2007 to 2008 Minimum Data Set 2.0 (n = 180,621). Dementia severity was classified as follows: mild (CPS 1-2), moderate (CPS 3-4), and advanced (CPS 5-6). ADs were defined as the presence of a living will, do-not-resuscitate order, do-not-hospitalize order, medication restriction, or feeding restriction). Overall, 59% of residents had any AD and 17% had a living will. Prevalence of any AD increased by dementia severity: mild (51.2%), moderate (58.2%), and advanced (61.5%) (p will was associated with higher education (≥high school graduate vs. some high school or less) and being married. While dementia severity was associated with greater likelihood of having documented any AD, almost 4 in 10 residents with dementia lacked any AD. Effective outreach may focus efforts on subgroups with lower odds of any AD or living wills, including non-white, less educated, and unmarried NH residents. A greater understanding of how such factors impact care planning will help to address barriers to patient-centered care for this population.

Psychiatric Advance Directives in India: What will the future hold?

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Ratnam, Ashutosh; Rudra, Abhijit; Chatterjee, K; Das, R C

2015-08-01

Psychiatric Advance Directives (PADs) have been incorporated into India's Mental Health Care Bill, 2013. This is the first time any form of Advance Directive stands to receive legal sanction in India. PADs have numerous theoretical and empirically tenable therapeutic and financial advantages. Western experiences have shown high acceptance for the concept among psychiatric patients, and illustrated that most stable patients with severe mental illness retain the capacity to frame PADs consistent with community practice standards. However active psychopathology does impair this capacity, and therein, current subjective assessments of competence performed by Physicians without objective instruments are often inaccurate. Though PADs champion patient autonomy, when applied and studied, they have shown little significant advantage-there is currently not enough data to support evidence-based universal recommendations for PADs. PADs as incorporated into the Mental Health Care Bill model on existing Western statutes, and though many of the strengths of earlier systems have been subsumed, so have several of the shortcomings. The risks, benefits and applicability of PADs in India are complicated by the social re-calibration of patient autonomy, mental-healthcare delivery system weaknesses, and the relatively peripheral role the Psychiatrist is mandated to play in the entire advance directive process. Treating patients within the framework of their pre-stated wishes will be a much more intricate and arduous task than most of modern Psychiatric practice in India, but the difficulties, obstacles and inevitable failures encountered will provide evidence of the delivery system's weaknesses and thereby contribute to its strength. Copyright © 2015 Elsevier B.V. All rights reserved.

Are advance directives helpful for good end of life decision making: a cross sectional survey of health professionals.

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Peicius, Eimantas; Blazeviciene, Aurelija; Kaminskas, Raimondas

2017-06-05

This paper joins the debate over changes in the role of health professionals when applying advance directives to manage the decision-making process at the end of life care. Issues in relation to advance directives occur in clinical units in Lithuania; however, it remains one of the few countries in the European Union (EU) where the discussion on advance directives is not included in the health-care policy-making agenda. To encourage the discussion of advance directives, a study was designed to examine health professionals' understanding and preferences related to advance directives. In addition, the study sought to explore the views of health care professionals of the application of Advance Directives (AD) in clinical practice in Lithuania. A cross-sectional survey was conducted by interviewing 478 health professionals based at major health care centers in Kaunas district, Lithuania. The design of the study included the use of a questionnaire developed for this study and validated by a pilot study. The collected data were analyzed using standard descriptive statistical methods. The analysis of knowledge about AD revealed some statistically significant differences when comparing the respondents' profession and gender. The analysis also indicated key emerging themes among respondents including tranquility of mind, the longest possible life expectancy and freedom of choice. Further, the study findings revealed that more than half of the study participants preferred to express their will while alive by using advance directives. The study findings revealed a low level of knowledge on advance directives among health professionals. Most health professionals agreed that AD's improved end-of-life decision making while the majority of physicians appreciated AD as the best tool for sharing responsibilities in clinical practice in Lithuania. More physicians than nurses preferred the presence of advance directives to support their decision making in end-of-life situations.

Technological advances in site-directed spin labeling of proteins.

Science.gov (United States)

Hubbell, Wayne L; López, Carlos J; Altenbach, Christian; Yang, Zhongyu

2013-10-01

Molecular flexibility over a wide time range is of central importance to the function of many proteins, both soluble and membrane. Revealing the modes of flexibility, their amplitudes, and time scales under physiological conditions is the challenge for spectroscopic methods, one of which is site-directed spin labeling EPR (SDSL-EPR). Here we provide an overview of some recent technological advances in SDSL-EPR related to investigation of structure, structural heterogeneity, and dynamics of proteins. These include new classes of spin labels, advances in measurement of long range distances and distance distributions, methods for identifying backbone and conformational fluctuations, and new strategies for determining the kinetics of protein motion. Copyright © 2013 Elsevier Ltd. All rights reserved.

The implementation of psychiatric advance directives: Experiences from a Dutch crisis card initiative.

NARCIS (Netherlands)

van der Ham, A.J.; Voskes, Y.; van Kempen, N.; Broerse, J.E.W.; Widdershoven, G.A.

2013-01-01

Objective: The crisis card is a specific form of psychiatric advance directive, documenting mental clients' treatment preferences in advance of a potential psychiatric crisis. In this paper, we aim to provide insight into implementation issues surrounding the crisis card. Method: A Dutch crisis-card

Approximately One In Three US Adults Completes Any Type Of Advance Directive For End-Of-Life Care.

Science.gov (United States)

Yadav, Kuldeep N; Gabler, Nicole B; Cooney, Elizabeth; Kent, Saida; Kim, Jennifer; Herbst, Nicole; Mante, Adjoa; Halpern, Scott D; Courtright, Katherine R

2017-07-01

Efforts to promote the completion of advance directives implicitly assume that completion rates of these documents, which help ensure care consistent with people's preferences in the event of incapacity, are undesirably low. However, data regarding completion of advance directives in the United States are inconsistent and of variable quality. We systematically reviewed studies published in the period 2011-16 to determine the proportion of US adults with a completed living will, health care power of attorney, or both. Among the 795,909 people in the 150 studies we analyzed, 36.7 percent had completed an advance directive, including 29.3 percent with living wills. These proportions were similar across the years reviewed. Similar proportions of patients with chronic illnesses (38.2 percent) and healthy adults (32.7 percent) had completed advance directives. The findings provide benchmarks for gauging future policies and practices designed to motivate completion of advance directives, particularly among those people most likely to benefit from having these documents on record. Project HOPE—The People-to-People Health Foundation, Inc.

Online, directed journaling in community health advanced practice nursing clinical education.

Science.gov (United States)

Daroszewski, Ellen Beth; Kinser, Anita G; Lloyd, Susan L

2004-04-01

The sharing of experiences in advanced practice nursing clinical courses allows for application of core principals to different facets of practice, with the potential to promote discussions beyond the course objectives, create opportunities for mentoring, foster critical thinking, and facilitate change and socialization into advanced practice. A pilot test of online, directed journaling, an innovative sharing and reflection strategy, was incorporated in a two-quarter community health advanced practice nursing clinical course in an attempt to enhance clinical learning. Six female graduate nursing students completed the journaling. A 10-item evaluation measure demonstrated that the online journaling strategy was highly effective and valuable for the students. An assessment of the journaling entries found multiple examples of discussion, mentoring, critical thinking, and socialization. Innovative online strategies should become the standard for sharing in advanced practice nursing education.

[Advance directives, a tool to humanize care].

Science.gov (United States)

Olmari-Ebbing, M; Zumbach, C N; Forest, M I; Rapin, C H

2000-07-01

The relationship between the patient and a medical care giver is complex specially as it implies to the human, juridical and practical points of view. It depends on legal and deontological considerations, but also on professional habits. Today, we are confronted to a fundamental modification of this relationship. Professional guidelines exist, but are rarely applied and rarely taught in universities. However, patients are eager to move from a paternalistic relationship to a true partnership, more harmonious and more respectful of individual values ("value based medicine"). Advance directives give us an opportunity to improve our practices and to provide care consistent with the needs and wishes of each patient.

Physician attitudes toward advanced directives: a literature review of variables impacting on physicians attitude toward advance directives.

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Coleman, Albert M E

2013-11-01

To review physician's attitudes as well as the variables that may impact on physicians' attitude toward advance directives (ADs). Literature review of 17 published articles, covering the period 1989 to 2011. Physicians overall have a positive attitude toward patients' AD. However, other factors affect this "general positive attitude." These factors influence the attitude-behavior relationship of physicians, and hence their actual practice in relation to patients' AD. The findings from this review are of importance in explaining the differences in the attitude of physicians toward AD and their compliance. This raises the issue of consideration of other ethical paradigms/theories in the clinical context other than the framework of "principlism-"based autonomy, on which AD leans on. This is important in light of the pluralism of ethical theories.

Advance directives in english and French law: different concepts, different values, different societies.

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Horn, Ruth Judith

2014-03-01

In Western societies advance directives are widely recognised as important means to extend patient self-determination under circumstances of incapacity. Following other countries, England and France have adopted legislation aiming to clarify the legal status of advance directives. In this paper, I will explore similarities and differences in both sets of legislation, the arguments employed in the respective debates and the socio-political structures on which these differences are based. The comparison highlights how different legislations express different concepts emphasising different values accorded to the duty to respect autonomy and to protect life, and how these differences are informed by different socio-political contexts. Furthermore each country associates different ethical concerns with ADs which raise doubts about whether these directives are a theoretical idea which is hardly applicable in practice.

From Advance Euthanasia Directive to Euthanasia: Stable Preference in Older People?

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Bolt, Eva E; Pasman, H Roeline W; Deeg, Dorly J H; Onwuteaka-Philipsen, Bregje D

2016-08-01

To determine whether older people with advance directive for euthanasia (ADEs) are stable in their advance desire for euthanasia in the last years of life, how frequently older people with an ADE eventually request euthanasia, and what factors determine this. Mortality follow-back study nested in a cohort study. The Netherlands. Proxies of deceased members of a cohort representative of Dutch older people (n = 168) and a cohort of people with advance directives (n = 154). Data from cohort members (possession of ADE) combined with after-death proxy information on cohort members' last 3 months of life. Multiple logistic regression analysis was performed on determinants of a euthanasia request in individuals with an ADE. Response rate was 65%. One hundred forty-two cohort members had an ADE at baseline. Three months before death, 87% remained stable in their desire for euthanasia; 47% eventually requested euthanasia (vs 6% without an ADE), and 16% died after euthanasia. People with an ADE were more likely to request euthanasia if they worried about loss of dignity. The majority of older adults who complete an ADE will have a stable preference over time, but an advance desire for euthanasia does not necessarily result in a euthanasia request. Writing an ADE may reflect a person's need for reassurance that they can request euthanasia in the future. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Relationship of social support and decisional conflict to advance directives attitude in Korean older adults: A community-based cross-sectional study.

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Lee, JuHee; Jung, Dukyoo; Choi, MoonKi

2016-01-01

The aim of this study was to clarify the relationship between social support, decisional conflict, and attitude towards advance directives, and determine whether decisional conflict mediates the relation between social support and advance directives attitude among older adults in South Korea. In total, 209 community-based older adults (mean age, 74.82 years) participated in this cross-sectional study. Demographic characteristics, self-perceived health status, social support, decisional conflict, and advance directives attitude were investigated via a structured questionnaire. Data analysis was carried out using Pearson's correlation and path analyses. The mean score of advance directives attitude was 48.01 (range, 35-61). Decisional conflict and social support were both significantly related to advance directives attitude (P conflict was a mediator between social support and advance directives attitudes. The results confirmed the importance of social support for reducing decisional conflict and encouraging positive attitudes toward advance directives. Future studies are needed to support the development of culturally sensitive educational approaches regarding advance directives for older adults in Korea. © 2015 The Authors. Japan Journal of Nursing Science © 2015 Japan Academy of Nursing Science.

Strategic directions and actions for advanced practice nursing in China

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Martha N. Hill

2017-01-01

Full Text Available There is a need and opportunity for China to develop education and practice innovations given that advance practice nurses (APNs improve health care and outcomes. The China Medical Board (CMB China Nursing Network (CCNN began planning for an Advanced Nursing Practice Program for education and career development that will facilitate CCNN's contributions to meeting national nursing policy priorities. This paper presents the discussion, recommendations and action plans developed at the inaugural planning meeting on June 26, 2015 at Fudan University in Shanghai. The recommendations are: Develop standards for advanced nursing practice; Develop Master's level curricula based on the standards; Commence pilot projects across a number of University affiliated hospitals; and Prepare clinical tutors and faculty. The strategic directions and actions are: Develop a clinical career ladder system; Expand the nursing role from hospital to community; and Build a specialty nurse accreditation system.

A multimedia intervention on cardiopulmonary resuscitation and advance directives.

Science.gov (United States)

Yamada, R; Galecki, A T; Goold, S D; Hogikyan, R V

1999-09-01

To assess the effects of a multimedia educational intervention about advance directives (ADs) and cardiopulmonary resuscitation (CPR) on the knowledge, attitude and activity toward ADs and life-sustaining treatments of elderly veterans. Prospective randomized controlled, single blind study of educational interventions. General medicine clinic of a university-affiliated Veterans Affairs Medical Center (VAMC). One hundred seventeen Veterans, 70 years of age or older, deemed able to make medical care decisions. The control group (n = 55) received a handout about ADs in use at the VAMC. The experimental group (n = 62) received the same handout, with an additional handout describing procedural aspects and outcomes of CPR, and they watched a videotape about ADs. Patients' attitudes and actions toward ADs, CPR and life-sustaining treatments were recorded before the intervention, after it, and 2 to 4 weeks after the intervention through self-administered questionnaires. Only 27.8% of subjects stated that they knew what an AD is in the preintervention questionnaire. This proportion improved in both the experimental and control (87.2% experimental, 52.5% control) subject groups, but stated knowledge of what an AD is was higher in the experimental group (odds ratio = 6.18, p CPR. This improved after the intervention in the experimental group (OR = 4.27, p =.004), but did not persist at follow-up. In the postintervention questionnaire, few subjects in either group stated that they discussed CPR or ADs with their physician on that day (OR = 0.97, p = NS). We developed a convenient means of educating elderly male patients regarding CPR and advance directives that improved short-term knowledge but did not stimulate advance care planning.

Effect of an End-of-Life Planning Intervention on the completion of advance directives in homeless persons: a randomized trial.

Science.gov (United States)

Song, John; Ratner, Edward R; Wall, Melanie M; Bartels, Dianne M; Ulvestad, Nancy; Petroskas, Dawn; West, Melissa; Weber-Main, Anne Marie; Grengs, Leah; Gelberg, Lillian

2010-07-20

Few interventions have focused on improving end-of-life care for underserved populations, such as homeless persons. To determine whether homeless persons will complete a counseling session on advance care planning and fill out a legal advance directive designed to assess care preferences and preserve the dignity of marginalized persons. Prospective, single-blind, randomized trial comparing self-guided completion of an advance directive with professionally assisted advance care planning. (ClinicalTrials.gov registration number: NCT00546884) 8 sites serving homeless persons in Minneapolis, Minnesota. 262 homeless persons recruited between November 2007 and August 2008. Minimal, self-guided intervention consisting of advance directive forms and written educational information versus a one-on-one advance planning intervention consisting of counseling and completing an advance directive with a social worker. Rate of advance directive completion, assessed by inspection of completed documents. The overall completion rate for advance directives was 26.7% (95% CI, 21.5% to 32.5%), with a higher rate in the counselor-guided group (37.9%) than in the self-guided group (12.8%) (CI of adjusted difference, 15.3 to 34.3 percentage points). This difference persisted across all sites and most subgroups. The advance directive's 4 clinical scenarios found a preference for surrogate decision making in 29% to 34% of written responses. Sampling was limited to a more stable subset of the homeless population in Minneapolis and may have been subject to selection bias. Modest compensation to complete the preintervention survey could have influenced participants to complete advance directives. Both a simple and complex intervention successfully engaged a diverse sample of homeless persons in advance care planning. One-on-one assistance significantly increased the completion rate. Homeless persons can respond to an intervention to plan for end-of-life care and can express specific preferences

The moral courage of nursing students who complete advance directives with homeless persons.

Science.gov (United States)

Nash, Woods; Mixer, Sandra J; McArthur, Polly M; Mendola, Annette

2016-11-01

Homeless persons in the United States have disproportionately high rates of illness, injury, and mortality and tend to believe that the quality of their end-of-life care will be poor. No studies were found as to whether nurses or nursing students require moral courage to help homeless persons or members of any other demographic complete advance directives. We hypothesized that baccalaureate nursing students require moral courage to help homeless persons complete advance directives. Moral courage was defined as a trait of a person or an action that overcomes fears or other challenges to achieve something of great moral worth. The hypothesis was investigated through a qualitative descriptive study. Aside from the pre-selection of a single variable to study (i.e. moral courage), our investigation was a naturalistic inquiry with narrative hues insofar as it attended to specific words and phrases in the data that were associated with that variable. A total of 15 baccalaureate nursing students at a public university in the United States responded to questionnaires that sought to elicit fears and other challenges that they both expected to experience and actually experienced while helping homeless persons complete advance directives at a local, non-profit service agency. The study was approved by the Internal Review Board of the authors' university, and each participant signed an informed consent form, which stated that the study involved no reasonably foreseeable risks and that participation was voluntary. Before meeting with homeless persons, participants reported that they expected to experience two fears and a challenge: fear of behaving in ways that a homeless person would deem inappropriate, fear of discussing a homeless person's dying and death, and the challenge of adequately conveying the advance directive's meaning and accurately recording a homeless person's end-of-life wishes. In contrast, after their meetings with homeless persons, relatively few participants

Advance care planning in 21st century Australia: a systematic review and appraisal of online advance care directive templates against national framework criteria.

Science.gov (United States)

Luckett, Tim; Bhattarai, Priyanka; Phillips, Jane; Agar, Meera; Currow, David; Krastev, Yordanka; Davidson, Patricia M

2015-11-01

A drive to promote advance care planning at a population level has led to a proliferation of online advance care directive (ACD) templates but little information to guide consumer choice. The current study aimed to appraise the quality of online ACD templates promoted for use in Australia. A systematic review of online Australian ACD templates was conducted in February 2014. ACD templates were identified via Google searches, and quality was independently appraised by two reviewers against criteria from the 2011 report A National Frameworkfor Advance Care Directives. Bias either towards or against future medical treatment was assessed using criteria designed to limit subjectivity. Fourteen online ACD templates were included, all of which were available only in English. Templates developed by Southern Cross University best met the framework criteria. One ACD template was found to be biased against medical treatment--the Dying with Dignity Victoria Advance Healthcare Directive. More research is needed to understand how online resources can optimally elicit and record consumers' individual preferences for future care. Future iterations of the framework should address online availability and provide a simple rating system to inform choice and drive quality improvement.

[Psychiatric advance directives and the role of autonomy].

Science.gov (United States)

Ambrosini, Daniel L; Crocker, Anne G

2009-01-01

Although psychiatric advance directives (PADs) are grounded in the ethics of autonomy, the relationship between the two is unclear. PADs are legal documents that allow individuals with mental illness to record their treatment preferences should they become incompetent in the future. The relationship between autonomy and PADs has been discussed in ethical, legal, and philosophical terms, but has not been clearly operationalized for clinical purposes. Autonomy is a fundamental ethical value that includes having the independence from outside controlling influences and the mental capacity to direct one's personal actions. Individuals with mental illness sometimes require assistance to understand their ethical and legal rights with respect to autonomous choice, and professional stakeholders need education regarding the importance of autonomy for clinical practice. Competency to consent to treatment is the mental prerequisite that ensures individuals with mental illness are able to complete PADs with insight, whereas autonomy is the value that empowers individuals to work towards their recovery.

"It's like playing with your destiny": Bosnian immigrants' views of advance directives and end-of-life decision-making.

Science.gov (United States)

Searight, H Russell; Gafford, Jennifer

2005-07-01

Patient autonomy is a primary value in US health care. It is assumed that patients want to be fully and directly informed about serious health conditions and want to engage in advance planning about medical care at the end-of-life. Written advance directives and proxy decision-makers are vehicles to promote autonomy when patients are no longer able to represent their wishes. Cross-cultural studies have raised questions about the universal acceptance of these health care values among all ethnicities. In the current investigation, Bosnian immigrants were interviewed about their views of physician-patient communication, advance directives, and locus of decision-making in serious illness. Many of the respondents indicated that they did not want to be directly informed of a serious illness. There was an expressed preference for physician- or family-based health care decisions. Advance directives and formally appointed proxies were typically seen as unnecessary and inconsistent with many respondents' personal values. The findings suggest that the value of individual autonomy and control over the health care decisions may not be applicable to cultures with a collectivist orientation.

The role of advance directives in end-of-life decisions in Austria: survey of intensive care physicians.

Science.gov (United States)

Schaden, Eva; Herczeg, Petra; Hacker, Stefan; Schopper, Andrea; Krenn, Claus G

2010-10-21

Currently, intensive care medicine strives to define a generally accepted way of dealing with end-of-life decisions, therapy limitation and therapy discontinuation.In 2006 a new advance directive legislation was enacted in Austria. Patients may now document their personal views regarding extension of treatment. The aim of this survey was to explore Austrian intensive care physicians' experiences with and their acceptance of the new advance directive legislation two years after enactment (2008). Under the aegis of the OEGARI (Austrian Society of Anaesthesiology, Resuscitation and Intensive Care) an anonymised questionnaire was sent to the medical directors of all intensive care units in Austria. The questions focused on the physicians' experiences regarding advance directives and their level of knowledge about the underlying legislation. There were 241 questionnaires sent and 139 were turned, which was a response rate of 58%. About one third of the responders reported having had no experience with advance directives and only 9 directors of intensive care units had dealt with more than 10 advance directives in the previous two years. Life-supporting measures, resuscitation, and mechanical ventilation were the predominantly refused therapies, wishes were mainly expressed concerning pain therapy. A response rate of almost 60% proves the great interest of intensive care professionals in making patient-oriented end-of-life decisions. However, as long as patients do not make use of their right of co-determination, the enactment of the new law can be considered only a first important step forward.

Prevalence of advanced adenomas in small and diminutive colon polyps using direct measurement of size.

Science.gov (United States)

Tsai, Franklin C; Strum, Williamson B

2011-08-01

Most studies reporting polyp size use visual estimates. Determining the prevalence of advanced histology based on direct measurement of polyp size may help guide the management of polyps found at optical colonoscopy (OC) and CT colonography (CTC). We designed a large, prospective study to assess the prevalence of advanced adenomas based on direct measurement of polyp size by a certified pathologists' assistant as reported in the pathology report. Patients between 40 and 89 years of age who presented for screening colonoscopy were included in our study. Advanced adenomas were defined as ≥10 mm or ≥25% villous features, high grade dysplasia or cancer. Polyps were divided by size into three groups: diminutive (≤5 mm), small (6-9 mm) and large (≥10 mm). If more than one adenoma was present, the most advanced was used for analysis. We evaluated 6,905 consecutive patients referred for colonoscopy between January 2005 and December 2006. Of the 4,967 who met the inclusion criteria, the mean age was 58.8 and consisted of 59% women. Overall, 930 (18.7%) had an adenoma; 248 (5%) were advanced adenomas including 8 (0.16%) cancers. Of 89 polyps≥10 mm, 76 (85%) had advanced histology; of 247 polyps 6-9 mm, 67 (27%) were advanced; of 1,025 polyps ≤5 mm, 105 (10%) were advanced. Thus, 172 of 248 (69%) patients with advanced adenomas had small or diminutive adenomas. Our data indicate the majority (69%) of advanced adenomas are advanced adenomas (10%). These findings may help guide the management of sub-centimeter colon polyps found by OC or CTC.

Advanced materials for alternative fuel capable directly fired heat engines

Energy Technology Data Exchange (ETDEWEB)

Fairbanks, J.W.; Stringer, J. (eds.)

1979-12-01

The first conference on advanced materials for alternative fuel capable directly fired heat engines was held at the Maine Maritime Academy, Castine, Maine. It was sponsored by the US Department of Energy, (Assistant Secretary for Fossil Energy) and the Electric Power Research Institute, (Division of Fossil Fuel and Advanced Systems). Forty-four papers from the proceedings have been entered into EDB and ERA and one also into EAPA; three had been entered previously from other sources. The papers are concerned with US DOE research programs in this area, coal gasification, coal liquefaction, gas turbines, fluidized-bed combustion and the materials used in these processes or equipments. The materials papers involve alloys, ceramics, coatings, cladding, etc., and the fabrication and materials listing of such materials and studies involving corrosion, erosion, deposition, etc. (LTN)

What explains racial differences in the use of advance directives and attitudes toward hospice care?

Science.gov (United States)

Johnson, Kimberly S; Kuchibhatla, Maragatha; Tulsky, James A

2008-10-01

Cultural beliefs and values are thought to account for differences between African Americans and whites in the use of advance directives and beliefs about hospice care, but few data clarify which beliefs and values explain these differences. Two hundred five adults aged 65 and older who received primary care in the Duke University Health System were surveyed. The survey included five scales: Hospice Beliefs and Attitudes, Preferences for Care, Spirituality, Healthcare System Distrust, and Beliefs About Dying and Advance Care Planning. African Americans were less likely than white subjects to have completed an advance directive (35.5% vs 67.4%, Pconflict with the goals of palliative care, and distrust the healthcare system. In multivariate analyses, none of these factors alone completely explained racial differences in possession of an advance directive or beliefs about hospice care, but when all of these factors were combined, race was no longer a significant predictor of either of the two outcomes. These findings suggest that ethnicity is a marker of common cultural beliefs and values that, in combination, influence decision-making at the end of life. This study has implications for the design of healthcare delivery models and programs that provide culturally sensitive end-of-life care to a growing population of ethnically diverse older adults.

Survey of the general public's attitudes toward advance directives in Japan: How to respect patients' preferences

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Kai Ichiro

2006-10-01

Full Text Available Abstract Background Japanese people have become increasingly interested in the expression and enhancement of their individual autonomy in medical decisions made regarding medical treatment at and toward the end of life. However, while many Western countries have implemented legislation that deals with patient autonomy in the case of terminal illness, no such legislation exists in Japan. The rationale for this research is based on the need to investigate patient's preferences regarding treatment at the end of life in order to re-evaluate advance directives policy and practice. Methods We conducted a cross-sectional survey with 418 members of the general middle-aged and senior adults (aged between 40 and 65 in Tokyo, Japan. Respondents were asked about their attitudes toward advance directives, and preferences toward treatment options. Results Over 60% of respondents agreed that it is better to express their wishes regarding advance directives (treatment preferences in writing, appointment of proxy for care decision making, appointment of legal administrator of property, stating preferences regarding disposal of one's property and funeral arrangements but less than 10% of them had already done so. About 60% of respondents in this study preferred to indicate treatment preferences in broad rather than concrete terms. Over 80% would like to decide treatment preferences in consultation with others (22.2% with their proxy, 11.0% with the doctor, and 47.8% with both their proxy and the doctor. Conclusion This study revealed that many Japanese people indicate an interest in undertaking advance directives. This study found that there is a range of preferences regarding how advance directives are undertaken, thus it is important to recognize that any processes put into place should allow flexibility in order to best respect patients' wishes and autonomy.

The role of advance directives in end-of-life decisions in Austria: survey of intensive care physicians

Directory of Open Access Journals (Sweden)

Schopper Andrea

2010-10-01

Full Text Available Abstract Background Currently, intensive care medicine strives to define a generally accepted way of dealing with end-of-life decisions, therapy limitation and therapy discontinuation. In 2006 a new advance directive legislation was enacted in Austria. Patients may now document their personal views regarding extension of treatment. The aim of this survey was to explore Austrian intensive care physicians' experiences with and their acceptance of the new advance directive legislation two years after enactment (2008. Methods Under the aegis of the OEGARI (Austrian Society of Anaesthesiology, Resuscitation and Intensive Care an anonymised questionnaire was sent to the medical directors of all intensive care units in Austria. The questions focused on the physicians' experiences regarding advance directives and their level of knowledge about the underlying legislation. Results There were 241 questionnaires sent and 139 were turned, which was a response rate of 58%. About one third of the responders reported having had no experience with advance directives and only 9 directors of intensive care units had dealt with more than 10 advance directives in the previous two years. Life-supporting measures, resuscitation, and mechanical ventilation were the predominantly refused therapies, wishes were mainly expressed concerning pain therapy. Conclusion A response rate of almost 60% proves the great interest of intensive care professionals in making patient-oriented end-of-life decisions. However, as long as patients do not make use of their right of co-determination, the enactment of the new law can be considered only a first important step forward.

The Texas Advanced Directive Law: Unfinished Business.

Science.gov (United States)

Kapottos, Michael; Youngner, Stuart

2015-01-01

The Texas Advance Directive Act allows physicians and hospitals to overrule patient or family requests for futile care. Purposefully not defining futility, the law leaves its determination in specific cases to an institutional process. While the law has received several criticisms, it does seem to work constructively in the cases that come to the review process. We introduce a new criticism: While the law has been justified by an appeal to professional values such as avoiding harm to patients, avoiding the provision of unseemly care, and good stewardship of medical resources, it is applied incompletely. It allows physicians and institutional committees to refuse "futile" treatments desired by patients and families while at the same time providing no way of regulating physicians who recommend or even push "futile" treatments in similar cases. In this sense, the TADA is incomplete on its own terms.

Psychiatric advance directives in Australian mental-health legislation.

Science.gov (United States)

Ouliaris, Calina; Kealy-Bateman, Warren

2017-12-01

Following the recent widespread reform of mental-health legislation in Australia, psychiatric advance directives (PADs) have now been incorporated in four jurisdictions. We contextualise the potential role for PADs within the Australian legal framework and note their varying introduction across jurisdictions, with a focus on progressive legislation in the Australian Capital Territory (ACT). The formal recognition of PADs effectively shifts the trajectory of mental-health law towards a stronger recognition of consumer autonomy, albeit to varying degrees across jurisdictions. The most inspiring of these changes may be seen in the ACT Act, where an innovative framing of PAD provisions creates a safe space for clinicians and patients to engage, build therapeutic alliances and develop appropriate frameworks for further change.

Hospital policies on life-sustaining treatments and advance directives in Canada.

OpenAIRE

Rasooly, I; Lavery, J V; Urowitz, S; Choudhry, S; Seeman, N; Meslin, E M; Lowy, F H; Singer, P A

1994-01-01

OBJECTIVE: To determine the prevalence and content of hospital policies on life-sustaining treatments (cardiopulmonary resuscitation [CPR], mechanical ventilation, dialysis, artificial nutrition and hydration, and antibiotic therapy for life-threatening infections) and advance directives in Canada. DESIGN: Cross-sectional mailed survey. SETTING: Canada. PARTICIPANTS: Chief executive officers or their designates at public general hospitals. MAIN OUTCOME MEASURES: Information regarding the exis...

Advance directives as a tool to respect patients' values and preferences: discussion on the case of Alzheimer's disease.

Science.gov (United States)

Porteri, Corinna

2018-02-20

The proposal of the new criteria for the diagnosis of Alzheimer's disease (AD) based on biomarker data is making possible a diagnosis of AD at the mild cognitive impairment (MCI) or predementia/prodromal- stage. Given the present lack of effective treatments for AD, the opportunity for the individuals to personally take relevant decisions and plan for their future before and if cognitive deterioration occurs is one the main advantages of an early diagnosis. Advance directives are largely seen as an effective tool for planning medical care in the event the subject becomes incompetent. Nevertheless, their value has been questioned with regard to people with dementia by scholars who refer to the arguments of personal identity and of patient's changing interests before and after the onset of dementia. In this paper, I discuss the value of advance directives in Alzheimer's disease and other kind of dementia. Despite critics, I argue that advance directives are especially advisable in dementia and provide reasons in favor of their promotion at an early stage of the disease as a valuable tool to respect patients' values and preferences on medical treatment, including participation in research and end of life decisions. I mainly support advance directives that include both decisions regarding health care and the appointment of an attorney in fact. I conclude that patients with AD at a prodromal or early stage should be offered the opportunity to execute an advance directive, and that not to honor a demented individual's directive would be an unacceptable form of discrimination towards those patients.

Directions for advanced use of nuclear power in century XXI

International Nuclear Information System (INIS)

Walter, C.E.

1999-01-01

Nuclear power can provide a significant contribution to electricity generation and meet other needs of the world and the US during the next century provided that certain directions are taken to achieve its public acceptance. These directions include formulation of projections of population, energy consumption, and energy resources over a responsible period of time. These projections will allow assessment of cumulative effects on the environment and on fixed resources. Use of fossil energy resources in a century of growing demand for energy must be considered in the context of long-term environmental damage and resource depletion. Although some question the validity of these consequences, they can be mitigated by use of advanced fast reactor technology. It must be demonstrated that nuclear power technology is safe, resistant to material diversion for weapon use, and economical. An unbiased examination of all the issues related to energy use, especially of electricity, is an essential direction to take

Status and future directions for advanced accelerator research - conventional and non-conventional collider concepts

International Nuclear Information System (INIS)

Siemann, R.H.

1997-01-01

The relationship between advanced accelerator research and future directions for particle physics is discussed. Comments are made about accelerator research trends in hadron colliders, muon colliders, and e + 3 - linear colliders

Recovery Act: Advanced Direct Methanol Fuel Cell for Mobile Computing

Energy Technology Data Exchange (ETDEWEB)

Fletcher, James H. [University of North Florida; Cox, Philip [University of North Florida; Harrington, William J [University of North Florida; Campbell, Joseph L [University of North Florida

2013-09-03

ABSTRACT Project Title: Recovery Act: Advanced Direct Methanol Fuel Cell for Mobile Computing PROJECT OBJECTIVE The objective of the project was to advance portable fuel cell system technology towards the commercial targets of power density, energy density and lifetime. These targets were laid out in the DOE’s R&D roadmap to develop an advanced direct methanol fuel cell power supply that meets commercial entry requirements. Such a power supply will enable mobile computers to operate non-stop, unplugged from the wall power outlet, by using the high energy density of methanol fuel contained in a replaceable fuel cartridge. Specifically this project focused on balance-of-plant component integration and miniaturization, as well as extensive component, subassembly and integrated system durability and validation testing. This design has resulted in a pre-production power supply design and a prototype that meet the rigorous demands of consumer electronic applications. PROJECT TASKS The proposed work plan was designed to meet the project objectives, which corresponded directly with the objectives outlined in the Funding Opportunity Announcement: To engineer the fuel cell balance-of-plant and packaging to meet the needs of consumer electronic systems, specifically at power levels required for mobile computing. UNF used existing balance-of-plant component technologies developed under its current US Army CERDEC project, as well as a previous DOE project completed by PolyFuel, to further refine them to both miniaturize and integrate their functionality to increase the system power density and energy density. Benefits of UNF’s novel passive water recycling MEA (membrane electrode assembly) and the simplified system architecture it enabled formed the foundation of the design approach. The package design was hardened to address orientation independence, shock, vibration, and environmental requirements. Fuel cartridge and fuel subsystems were improved to ensure effective fuel

Competence to Complete Psychiatric Advance Directives: Effects of Facilitated Decision Making

Science.gov (United States)

Swanson, Jeffrey W.; Appelbaum, Paul S.; Swartz, Marvin S.; Ferron, Joelle; Van Dorn, Richard A.; Wagner, H. Ryan

2013-01-01

Psychiatric advance directives (PADs) statutes presume competence to complete these documents, but the range and dimensions of decisional competence among people who actually complete PADs is unknown. This study examines clinical and neuropsychological correlates of performance on a measure to assess competence to complete PADs and investigates the effects of a facilitated PAD intervention on decisional capacity. N = 469 adults with psychotic disorders were interviewed at baseline and then randomly assigned to either a control group in which they received written materials about PADs or to an intervention group in which they were offered an opportunity to meet individually with a trained facilitator to create a PAD. At baseline, domains on the Decisional Competence Assessment Tool for PADs (DCAT-PAD) were most strongly associated with IQ, verbal memory, abstract thinking, and psychiatric symptoms. At one-month follow-up, participants in the intervention group showed more improvement on the DCAT-PAD than controls, particularly among participants with pre-morbid IQ estimates below the median of 100. The results suggest that PAD facilitation is an effective method to boost competence of cognitively-impaired clients to write PADs and make treatment decisions within PADs, thereby maximizing the chances their advance directives will be valid. PMID:17294136

Nurses' knowledge of advance directives and perceived confidence in end-of-life care: a cross-sectional study in five countries.

LENUS (Irish Health Repository)

Coffey, Alice

2016-01-28

Nurses\\' knowledge regarding advance directives may affect their administration and completion in end-of-life care. Confidence among nurses is a barrier to the provision of quality end-of-life care. This study investigated nurses\\' knowledge of advance directives and perceived confidence in end-of-life care, in Hong Kong, Ireland, Israel, Italy and the USA using a cross-sectional descriptive design (n = 1089). In all countries, older nurses and those who had more professional experience felt more confident managing patients\\' symptoms at end-of-life and more comfortable stopping preventive medications at end-of-life. Nurses in the USA reported that they have more knowledge and experience of advance directives compared with other countries. In addition, they reported the highest levels of confidence and comfort in dealing with end-of-life care. Although legislation for advance directives does not yet exist in Ireland, nurses reported high levels of confidence in end-of-life care.

Toolboxes for cyanobacteria: Recent advances and future direction.

Science.gov (United States)

Sun, Tao; Li, Shubin; Song, Xinyu; Diao, Jinjin; Chen, Lei; Zhang, Weiwen

2018-05-03

Photosynthetic cyanobacteria are important primary producers and model organisms for studying photosynthesis and elements cycling on earth. Due to the ability to absorb sunlight and utilize carbon dioxide, cyanobacteria have also been proposed as renewable chassis for carbon-neutral "microbial cell factories". Recent progresses on cyanobacterial synthetic biology have led to the successful production of more than two dozen of fuels and fine chemicals directly from CO 2 , demonstrating their potential for scale-up application in the future. However, compared with popular heterotrophic chassis like Escherichia coli and Saccharomyces cerevisiae, where abundant genetic tools are available for manipulations at levels from single gene, pathway to whole genome, limited genetic tools are accessible to cyanobacteria. Consequently, this significant technical hurdle restricts both the basic biological researches and further development and application of these renewable systems. Though still lagging the heterotrophic chassis, the vital roles of genetic tools in tuning of gene expression, carbon flux re-direction as well as genome-wide manipulations have been increasingly recognized in cyanobacteria. In recent years, significant progresses on developing and introducing new and efficient genetic tools have been made for cyanobacteria, including promoters, riboswitches, ribosome binding site engineering, clustered regularly interspaced short palindromic repeats/CRISPR-associated nuclease (CRISPR/Cas) systems, small RNA regulatory tools and genome-scale modeling strategies. In this review, we critically summarize recent advances on development and applications as well as technical limitations and future directions of the genetic tools in cyanobacteria. In addition, toolboxes feasible for using in large-scale cultivation are also briefly discussed. Copyright © 2018 Elsevier Inc. All rights reserved.

Advance directives from haematology departments: the patient's freedom of choice and communication with families. A qualitative analysis of 35 written documents.

Science.gov (United States)

Trarieux-Signol, S; Bordessoule, D; Ceccaldi, J; Malak, S; Polomeni, A; Fargeas, J B; Signol, N; Pauliat, H; Moreau, S

2018-01-02

In France, advance directives are favourably perceived by most of the population, although the drafting rate is low. This ambivalence is challenging because advance directives are meant to promote the autonomy and freedom of choice of patients. The purpose of this study was to analyse the content of advance directives written by patients suffering from malignant haemopathies to better understand how patients put them into practice. These could be relevant as early as the initial diagnosis of haematological malignancies because of the uncertain course of the disease. This was a multicentre, qualitative, descriptive study. The advance directives written by patients with malignant haemopathies treated in one of the six French hospital departments were included in the study from 01/06/2008 to 15/04/2016. A thematic analysis of the advance directives was performed by two researchers: a senior haematologist and a research assistant. The median age of the patients was 69. Most were women (sex ratio: 0.59), living as a couple (57%), with lymphoid pathologies (66%), who were still alive two years after the instructions were written (63%) and had nominated a health care proxy (88.6%). Free texts (62.9%) were richer in content than pre-defined forms. The advance directives were used in three ways: for a purely legal purpose, to focus on medical treatments or actions, or to communicate a message to the family. Three main themes emerged: (1) refusal of medical treatment (100%), in which patients express refusal of life-sustaining care (97.1%). The actual treatments or the moment when they should be limited or stopped were not always mentioned in detail. (2) A desire for effective pain relief to avoid suffering (57.1%) and (3) messages for their family (34.3%), such as funeral arrangements (17.1%) and messages of love or trust (14.3%). Patients who write advance directives are not necessarily at the end of their lives. Their content mainly conveys treatment wishes, although

Direct vessel inclined injection system for reduction of emergency core coolant direct bypass in advanced reactors

International Nuclear Information System (INIS)

Yoon, Sang H.; Lee, Jong G.; Suh, Kune Y.

2006-01-01

Multidimensional thermal hydraulics in the APR1400 (Advanced Power Reactor 1400 MWe) downcomer during a large-break loss-of-coolant accident (LBLOCA) plays a pivotal role in determining the capability of the safety injection system. APR1400 adopts the direct vessel injection (DVI) method for more effective core penetration of the emergency core cooling (ECC) water than the cold leg injection (CLI) method in the OPR1000 (Optimized Power Reactor 1000 MWe). The DVI method turned out to be prone to occasionally lack in efficacious delivery of ECC to the reactor core during the reflood phase of a LBLOCA, however. This study intends to demonstrate a direct vessel inclined injection (DVII) method, one of various ideas with which to maximize the ECC core penetration and to minimize the direct bypass through the break during the reflood phase of a LBLOCA. The 1/7 scaled down THETA (Transient Hydrodynamics Engineering Test Apparatus) tests show that a vertical inclined nozzle angle of the DVII system increases the downward momentum of the injected ECC water by reducing the degree of impingement on the reactor downcomer, whereby lessening the extent of the direct bypass through the break. The proposed method may be combined with other innovative measures with which to ensure an enough thermal margin in the core during the course of a LBLOCA in APR1400

Advance Directives for End-of-Life Care and the Role of Health Education Specialists: Applying the Theory of Reasoned Action

Science.gov (United States)

Tremethick, Mary Jane; Johnson, Maureen K.; Carter, Mary R.

2011-01-01

Quality end-of-life care is subjective and based on individual values and beliefs. An advance directive provides a legal means of communicating these values and beliefs, as well as preferences in regards to end-of-life care when an individual is no longer able to make his or her desires known. In many nations, advance directives are underused…

Advance directives for euthanasia in dementia: do law-based opportunities lead to more euthanasia?

NARCIS (Netherlands)

de Boer, M.E.; Dröes, R.M.; Jonker, C.; Eefsting, J.A.; Hertogh, C.M.P.M.

2010-01-01

Objective: To obtain insight into current practices regarding compliance with advance directives for euthanasia (ADEs) in cases of incompetent patients with dementia in Dutch nursing homes, in light of the legal possibility offered by the new euthanasia law to perform euthanasia in these cases.

A critical review of advance directives in Germany: attitudes, use and healthcare professionals’ compliance

NARCIS (Netherlands)

Evans, N.; Bausewein, C.; Meñaca, A.; Andrew, E.V.W.; Higginson, I.J.; Harding, R.; Pool, R.; Gysels, M.

2012-01-01

Objective Recent legal changes in Germany make non-compliance with advance directives (ADs) a criminal offence. This article assesses the evidence on attitudes towards, use of, and physician compliance with ADs in Germany. Methods Critical review: studies on ADs, identified from a systematic review

Advancements in the development of a directional-position sensing fast neutron detector using acoustically tensioned metastable fluids

Energy Technology Data Exchange (ETDEWEB)

Archambault, Brian C. [Sagamore Adams Laboratories, Lafayette, IN (United States); Webster, Jeffrey A.; Grimes, Thomas F.; Fischer, Kevin F.; Hagen, Alex R. [School of Nuclear Engineering, Purdue University, 400 Central Avenue, West Lafayette, IN 47907 (United States); Taleyakhan, Rusi P., E-mail: rusi@purdue.edu [Sagamore Adams Laboratories, Lafayette, IN (United States); School of Nuclear Engineering, Purdue University, 400 Central Avenue, West Lafayette, IN 47907 (United States)

2015-06-01

Advancements in the development of a direction and position sensing fast neutron detector which utilizes the directional acoustic tensioned metastable fluid detector (D-ATMFD) are described. The resulting D-ATMFD sensor is capable of determining the direction of neutron radiation with a single compact detector versus use of arrays of detectors in conventional directional systems. Directional neutron detection and source positioning offer enhanced detection speeds in comparison to traditional proximity searching; including enabling determination of the neutron source shape, size, and strength in near real time. This paper discusses advancements that provide the accuracy and precision of ascertaining directionality and source localization information utilizing enhanced signal processing-cum-signal analysis, refined computational algorithms, and on-demand enlargement capability of the detector sensitive volume. These advancements were accomplished utilizing experimentation and theoretical modeling. Benchmarking and qualifications studies were successfully conducted with random and fission based special nuclear material (SNM) neutron sources ({sup 239}Pu–Be and {sup 252}Cf). These results of assessments have indicated that the D-ATMFD compares well in technical performance with banks of competing directional fast neutron detector technologies under development worldwide, but it does so with a single detector unit, an unlimited field of view, and at a significant reduction in both cost and size while remaining completely blind to common background (e.g., beta-gamma) radiation. Rapid and direct SNM neutron source imaging with two D-ATMFD sensors was experimentally demonstrated, and furthermore, validated via multidimensional nuclear particle transport simulations utilizing MCNP-PoliMi. Characterization of a scaled D-ATMFD based radiation portal monitor (RPM) as a cost-effective and efficient {sup 3}He sensor replacement was performed utilizing MCNP-PoliMi simulations

What explains racial differences in the use of advance directives and attitudes toward hospice care?

OpenAIRE

Johnson, Kimberly S.; Kuchibhatla, Maragatha; Tulsky, James A.

2008-01-01

Cultural beliefs and values are thought to account for differences between African Americans and Whites in the use of advance directives and beliefs about hospice care. However, little data clarifies which beliefs and values explain these differences.

Advances in directed monooxygenase evolution : from diversity generation and flow cytometry screening to tailor-made monooxygenases

OpenAIRE

Ruff, Anna Joëlle

2012-01-01

Directed Evolution became a powerful tool for proteins engineers to generate tailor-made biocatalyst. Directed protein evolution consist of the following three consecutive main steps, which are performed in iterative cycles; Step 1 the gene diversity generation, Step 2 the screening for improved variants and Step 3 the isolation of gene encoding for improved proteins. In this thesis, methodological advancements in the two key steps of the directed evolution, the diversity generation (SeSaM me...

Consciousness in humans and non-human animals: recent advances and future directions.

Science.gov (United States)

Boly, Melanie; Seth, Anil K; Wilke, Melanie; Ingmundson, Paul; Baars, Bernard; Laureys, Steven; Edelman, David B; Tsuchiya, Naotsugu

2013-10-31

This joint article reflects the authors' personal views regarding noteworthy advances in the neuroscience of consciousness in the last 10 years, and suggests what we feel may be promising future directions. It is based on a small conference at the Samoset Resort in Rockport, Maine, USA, in July of 2012, organized by the Mind Science Foundation of San Antonio, Texas. Here, we summarize recent advances in our understanding of subjectivity in humans and other animals, including empirical, applied, technical, and conceptual insights. These include the evidence for the importance of fronto-parietal connectivity and of "top-down" processes, both of which enable information to travel across distant cortical areas effectively, as well as numerous dissociations between consciousness and cognitive functions, such as attention, in humans. In addition, we describe the development of mental imagery paradigms, which made it possible to identify covert awareness in non-responsive subjects. Non-human animal consciousness research has also witnessed substantial advances on the specific role of cortical areas and higher order thalamus for consciousness, thanks to important technological enhancements. In addition, much progress has been made in the understanding of non-vertebrate cognition relevant to possible conscious states. Finally, major advances have been made in theories of consciousness, and also in their comparison with the available evidence. Along with reviewing these findings, each author suggests future avenues for research in their field of investigation.

Apollo-L2, an advanced fuel tokamak reactor utilizing direct conversion

International Nuclear Information System (INIS)

Emmert, G.A.; Kulcinski, G.L.; Blanchard, J.P.; El-Guebaly, L.A.; Khater, H.Y.; Santarius, J.F.; Sawan, M.E.; Sviatoslavsky, I.N.; Wittenberg, L.J.; Witt, R.J.

1989-01-01

A scoping study of a tokamak reactor fueled by a D- 3 He plasma is presented. The Apollo D- 3 He tokamak capitalizes on recent advances in high field magnets (20 T) and utilizes rectennas to convert the synchrotron radiation directly to electricity. The low neutron wall loading (0.1 MW/m 2 ) permits a first wall lasting the life of the plant and enables the reactor to be classified as inherently safe. The cost of electricity is less than that from a similar power level DT reactor. 10 refs., 1 fig., 4 tabs

Responses of advanced directives by Jehovah's Witnesses on a gynecologic oncology service

Directory of Open Access Journals (Sweden)

Nagarsheth NP

2014-12-01

Full Text Available Nimesh P Nagarsheth,1,2 Nikhil Gupta,3 Arpeta Gupta,4 Erin Moshier,5 Herbert Gretz,1 Aryeh Shander6 1Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center, New York, NY, USA; 2Englewood Hospital and Medical Center, Englewood, NJ, USA; 3Department of Urology, North Shore – Long Island Jewish Health Service, New Hyde Park, NY, USA; 4Department of Endocrinology, Diabetes and Metabolism, St Luke's Hospital of Kansas City, Kansas City, MO, 5Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center, New York, NY, USA; 6Department of Anesthesiology, Englewood Hospital and Medical Center, Englewood, NJ, USA Objectives: To review the responses of advance directives signed by Jehovah's Witness patients prior to undergoing surgery at a gynecologic oncology service. Study design: A retrospective chart review of gynecologic oncology patients undergoing surgery at a bloodless surgery center from 1998–2007 was conducted. Demographic, pathologic, and clinical data were recorded. The proportion of patients who accepted and refused various blood-derived products was determined and was compared to previously published results from a similar study of labor and delivery unit patients. Results: No gynecologic oncology patients agreed to accept transfusions of whole blood, red cells, white cells, platelets, or plasma under any circumstance, whereas 9.8% of pregnant patients accepted transfusion (P=0.0385. However, 98% of gynecologic oncology patients agreed to accept some blood products, including fractions such as albumin, immunoglobulins, and clotting factors, while only 39% of pregnant patients agreed (P<0.0001. In addition, all gynecologic oncology patients (100% accepted intraoperative hemodilution, compared to 55% of pregnant patients (P<0.0001. Conclusion: Our results confirm the commonly held belief

Characteristics of Patients With Existing Advance Directives: Evaluating Motivations Around Advance Care Planning.

Science.gov (United States)

Genewick, Joanne E; Lipski, Dorothy M; Schupack, Katherine M; Buffington, Angela L H

2018-04-01

Although 80% of patients endorse an advance directive (AD), less than 35% of American adults have a documented AD. Much research has been done on barriers to creating ADs; however, there is a paucity of research addressing motivations for creating ADs. Previous research has identified 4 categories of influence for engaging in advance care planning (ACP). This study aimed to quantify the influence of these 4 motivating categories in creating an AD. Participants included 238 adults with documented ADs. Participants completed an 11-item questionnaire addressing 1 of the 4 hypothesized categories of influence in addressing ACP: concern for self; concern for others; expectations about the impact of ACP; and anecdotes, stories, and experiences. Principle component analysis yielded 2 factors representing dignity and personal control (intrinsic factors) and societal and familial influence (extrinsic factors). Intrinsic factors were the primary and most influential motivating factors among participants. A regression analysis of individual motivating factors showed that prior to age 50, the desire to provide guidance about personal preferences for end-of-life care significantly predicted the creation of an AD, whereas after age 50, the urging of family members significantly predicted the creation of an AD. Results indicated that intrinsic factors were the most influential motivator among participants of all ages. Extrinsic factors appeared to be less influential in the decision to create an AD. Motivating factors were also found to vary by age. These results may help physicians be more targeted in discussions surrounding ADs, thus saving time, which physicians identify as the main barrier in engaging in such discussions, while meeting patients' wishes for their physicians to bring up the topic of ADs.

African Cultural Concept of Death and the Idea of Advance Care Directives

OpenAIRE

Ekore, Rabi Ilemona; Lanre-Abass, Bolatito

2016-01-01

An advance care directive is a person's oral or written instructions about his or her future medical care, if he or she becomes unable to communicate. It may be in written or oral form. Africans ordinarily do not encourage the contemplation of death or any discussion about their own or their loved ones? death. According to the African belief system, life does not end with death, but continues in another realm. Becoming an ancestor after death is a desirable goal of every individual, a feat wh...

[Ethical issues in the practice of advance directives, living wills, and self-determination in end of life care].

Science.gov (United States)

Fang, Hui-Feng; Jhing, Huei-Yu; Lin, Chia-Chin

2009-02-01

The Hospice-Palliative Care Act, enacted in Taiwan in 2000, was designed to respect the end of life medical wishes of patients with incurable illnesses, safeguard the rights of these patients, and provide clinical guidelines for healthcare workers responsible to provide end of life care. Self-determination is a core element of human dignity. Advance directive documents include a living will, and durable power of attorney for healthcare. This article reviews current issues and ethical dilemmas with regard to advance directives. Patients, family members, and clinicians may require better education on the Hospice-Palliative Care Act in order to respect more appropriately patient end of life medical care wishes.

Wild orangutan males plan and communicate their travel direction one day in advance.

Directory of Open Access Journals (Sweden)

Carel P van Schaik

Full Text Available The ability to plan for the future beyond immediate needs would be adaptive to many animal species, but is widely thought to be uniquely human. Although studies in captivity have shown that great apes are capable of planning for future needs, it is unknown whether and how they use this ability in the wild. Flanged male Sumatran orangutans (Pongo abelii emit long calls, which females use to maintain earshot associations with them. We tested whether long calls serve to communicate a male's ever-changing predominant travel direction to facilitate maintaining these associations. We found that the direction in which a flanged male emits his long calls predicts his subsequent travel direction for many hours, and that a new call indicates a change in his main travel direction. Long calls given at or near the night nest indicate travel direction better than random until late afternoon on the next day. These results show that male orangutans make their travel plans well in advance and announce them to conspecifics. We suggest that such a planning ability is likely to be adaptive for great apes, as well as in other taxa.

Factors affecting long-term-care residents' decision-making processes as they formulate advance directives.

Science.gov (United States)

Lambert, Heather C; McColl, Mary Ann; Gilbert, Julie; Wong, Jiahui; Murray, Gale; Shortt, Samuel E D

2005-10-01

The purpose of this study was to describe factors contributing to the decision-making processes of elderly persons as they formulate advance directives in long-term care. This study was qualitative, based on grounded theory. Recruitment was purposive and continued until saturation was reached. Nine residents of a long-term-care facility were interviewed by use of a semistructured format. Open and axial coding of interview transcripts were carried out and the factors contributing to the decision process were defined. Elders based their decisions primarily on information gathered from personal experiences with death and illness. They obtained very little information from professionals or the media. Major factors considered by elders as they weighed information included spiritual, emotional, and social considerations. The factors considered during the decision-making process were oriented more toward the individual's experiences and less on contributions from objective sources than anticipated. Decision making for advance directives is a highly personalized process. The approach of health professionals when assisting with end-of-life decision making should be planned with these contributing factors in mind, so that the services offered to the individuals in this population best meet their needs.

Advanced Methods for Direct Ink Write Additive Manufacturing

Energy Technology Data Exchange (ETDEWEB)

Compel, W. S. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Lewicki, J. P. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

2018-01-24

Lawrence Livermore National Laboratory is one of the world’s premier labs for research and development of additive manufacturing processes. Out of these many processes, direct ink write (DIW) is arguably one of the most relevant for the manufacture of architected polymeric materials, components and hardware. However, a bottleneck in this pipeline that has largely been ignored to date is the lack of advanced software implementation with respect to toolpath execution. There remains to be a convenient, automated method to design and produce complex parts that is user-friendly and enabling for the realization of next generation designs and structures. For a material to be suitable as a DIW ink it must possess the appropriate rheological properties for this process. Most importantly, the material must exhibit shear-thinning in order to extrude through a print head and have a rapid recovery of its static shear modulus. This makes it possible for the extrudate to be self-supporting upon exiting the print head. While this and other prerequisites narrow the scope of ‘offthe- shelf’ printable materials directly amenable to DIW, the process still tolerates a wide range of potential feedstock materials. These include metallic alloys, inorganic solvent borne dispersions, polymeric melts, filler stabilized monomer compositions, pre-elastomeric feedstocks and thermoset resins each of which requires custom print conditions tailored to the individual ink. As such, an ink perfectly suited for DIW may be prematurely determined to be undesirable for the process if printed under the wrong conditions. Defining appropriate print conditions such as extrusion rate, layer height, and maximum bridge length is a vital first step in validating an ink’s DIW capability.

Racial and Ethnic Differences in Advance Directive Possession: Role of Demographic Factors, Religious Affiliation, and Personal Health Values in a National Survey of Older Adults.

Science.gov (United States)

Huang, Ivy A; Neuhaus, John M; Chiong, Winston

2016-02-01

Black and Hispanic older Americans are less likely than white older Americans to possess advance directives. Understanding the reasons for this racial and ethnic difference is necessary to identify targets for future interventions to improve advance care planning in these populations. The aim of the study was to evaluate whether racial and ethnic differences in advance directive possession are explained by other demographic factors, religious characteristics, and personal health values. A general population survey was conducted in a nationally representative sample using a web-enabled survey panel of American adults aged 50 and older (n = 2154). In a sample of older Americans, white participants are significantly more likely to possess advance directives (44.0%) than black older Americans (24.0%, p personal health values. These findings support targeted efforts to mitigate racial disparities in access to advance care planning.

Advanced direct liquefaction concepts for PETC generic units. Final report, Phase I

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-03-01

The Advanced Concepts for Direct Coal Liquefaction program was initiated by the Department of Energy in 1991 to develop technologies that could significantly reduce the cost of producing liquid fuels by the direct liquefaction of coal. The advanced 2-stage liquefaction technology that was developed at Wilsonville over the past 10 years has contributed significantly toward decreasing the cost of producing liquids from coal to about $33/bbl. It remains, however, the objective of DOE to further reduce this cost to a level more competitive with petroleum based products. This project, among others, was initiated to investigate various alternative approaches to develop technologies that might ultimately lead to a 25 % reduction in cost of product. In this project a number of novel concepts were investigated, either individually or in a coupled configuration that had the potential to contribute toward meeting the DOE goal. The concepts included mature technologies or ones closely related to them, such as coal cleaning by oil agglomeration, fluid coking and distillate hydrotreating and dewaxing. Other approaches that were either embryonic or less developed were chemical pretreatment of coal to remove oxygen, and dispersed catalyst development for application in the 2-stage liquefaction process. This report presents the results of this project. It is arranged in four sections which were prepared by participating organizations responsible for that phase of the project. A summary of the overall project and the principal results are given in this section. First, however, an overview of the process economics and the process concepts that were developed during the course of this program is presented.

41 CFR 302-10.301 - May I receive an advance of funds when payment is made directly to the carrier by my agency?

Science.gov (United States)

2010-07-01

... PRIMARY RESIDENCE Advance of Funds § 302-10.301 May I receive an advance of funds when payment is made directly to the carrier by my agency? No, your agency will not authorize you an advance of funds when it... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false May I receive an advance...

Advanced health biotechnologies in Thailand: redefining policy directions.

Science.gov (United States)

Velasco, Román Pérez; Chaikledkaew, Usa; Myint, Chaw Yin; Khampang, Roongnapa; Tantivess, Sripen; Teerawattananon, Yot

2013-01-02

Thailand faces a significant burden in terms of treating and managing degenerative and chronic diseases. Moreover, incidences of rare diseases are rising. Many of these-such as diabetes, cancer, and inherited inborn metabolic diseases-have no definite treatments or cure. Meanwhile, advanced health biotechnology has been found, in principle, to be an effective solution for these health problems. Qualitative approaches were employed to analyse the current situation and examine existing public policies related to advanced health biotechnologies in Thailand. The results of this analysis were then used to formulate policy recommendations. Our research revealed that the system in Thailand in relation to advanced health biotechnologies is fragmented, with multiple unaddressed gaps, underfunding of research and development (R&D), and a lack of incentives for the private sector. In addition, there are no clear definitions of advanced health biotechnologies, and coverage pathways are absent. Meanwhile, false advertising and misinformation are prevalent, with no responsible bodies to actively and effectively provide appropriate information and education (I&E). The establishment of a specialised institution to fill the gaps in this area is warranted. The development and implementation of a comprehensive national strategic plan related to advanced health biotechnologies, greater investment in R&D and I&E for all stakeholders, collaboration among agencies, harmonisation of reimbursement across public health schemes, and provision of targeted I&E are specifically recommended.

Public Opinion Regarding Financial Incentives to Engage in Advance Care Planning and Complete Advance Directives.

Science.gov (United States)

Auriemma, Catherine L; Chen, Lucy; Olorunnisola, Michael; Delman, Aaron; Nguyen, Christina A; Cooney, Elizabeth; Gabler, Nicole B; Halpern, Scott D

2017-09-01

The Centers for Medicare & Medicaid Services (CMS) recently instituted physician reimbursements for advance care planning (ACP) discussions with patients. To measure public support for similar programs. Cross-sectional online and in-person surveys. English-speaking adults recruited at public parks in Philadelphia, Pennsylvania, from July to August 2013 and online through survey sampling international Web-based recruitment platform in July 2015. Participants indicated support for 6 programs designed to increase advance directive (AD) completion or ACP discussion using 5-point Likert scales. Participants also indicated how much money (US$0-US$1000) was appropriate to incentivize such behaviors, compared to smoking cessation or colonoscopy screening. We recruited 883 participants: 503 online and 380 in-person. The status quo of no systematic approach to motivate AD completion was supported by 67.0% of participants (63.9%-70.1%). The most popular programs were paying patients to complete ADs (58.0%; 54.5%-61.2%) and requiring patients to complete ADs or declination forms for health insurance (54.1%; 50.8%-57.4%). Participants more commonly supported paying patients to complete ADs than paying physicians whose patients complete ADs (22.6%; 19.8%-25.4%) or paying physicians who document ACP discussions (19.1%; 16.5%-21.7%; both P < .001). Participants supported smaller payments for AD completion and ACP than for obtaining screening colonoscopies or stopping smoking. Americans view payments for AD completion or ACP more skeptically than for other health behaviors and prefer that such payments go to patients rather than physicians. The current CMS policy of reimbursing physicians for ACP conversations with patients was the least preferred of the programs evaluated.

Advanced health biotechnologies in Thailand: redefining policy directions

Directory of Open Access Journals (Sweden)

Velasco Román Pérez

2013-01-01

Full Text Available Abstract Background Thailand faces a significant burden in terms of treating and managing degenerative and chronic diseases. Moreover, incidences of rare diseases are rising. Many of these—such as diabetes, cancer, and inherited inborn metabolic diseases—have no definite treatments or cure. Meanwhile, advanced health biotechnology has been found, in principle, to be an effective solution for these health problems. Methods Qualitative approaches were employed to analyse the current situation and examine existing public policies related to advanced health biotechnologies in Thailand. The results of this analysis were then used to formulate policy recommendations. Results Our research revealed that the system in Thailand in relation to advanced health biotechnologies is fragmented, with multiple unaddressed gaps, underfunding of research and development (R&D, and a lack of incentives for the private sector. In addition, there are no clear definitions of advanced health biotechnologies, and coverage pathways are absent. Meanwhile, false advertising and misinformation are prevalent, with no responsible bodies to actively and effectively provide appropriate information and education (I&E. The establishment of a specialised institution to fill the gaps in this area is warranted. Conclusion The development and implementation of a comprehensive national strategic plan related to advanced health biotechnologies, greater investment in R&D and I&E for all stakeholders, collaboration among agencies, harmonisation of reimbursement across public health schemes, and provision of targeted I&E are specifically recommended.

Advance euthanasia directives: a controversial case and its ethical implications.

Science.gov (United States)

Miller, David Gibbes; Dresser, Rebecca; Kim, Scott Y H

2018-03-03

Authorising euthanasia and assisted suicide with advance euthanasia directives (AEDs) is permitted, yet debated, in the Netherlands. We focus on a recent controversial case in which a Dutch woman with Alzheimer's disease was euthanised based on her AED. A Dutch euthanasia review committee found that the physician performing the euthanasia failed to follow due care requirements for euthanasia and assisted suicide. This case is notable because it is the first case to trigger a criminal investigation since the 2002 Dutch euthanasia law was enacted. Thus far, only brief descriptions of the case have been reported in English language journals and media. We provide a detailed description of the case, review the main challenges of preparing and applying AEDs for persons with dementia and briefly assess the adequacy of the current oversight system governing AEDs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Engaging Patients With Advance Directives Using an Information Visualization Approach.

Science.gov (United States)

Woollen, Janet; Bakken, Suzanne

2016-01-01

Despite the benefits of advance directives (AD) to patients and care providers, they are often not completed due to lack of patient awareness. The purpose of the current article is to advocate for creation and use of an innovative information visualization (infovisual) as a health communication tool aimed at improving AD dissemination and engagement. The infovisual would promote AD awareness by encouraging patients to learn about their options and inspire contemplation and conversation regarding their end-of-life (EOL) journey. An infovisual may be able to communicate insights that are often communicated in words, but are much more powerfully communicated by example. Furthermore, an infovisual could facilitate vivid understanding of options and inspire the beginning of often difficult conversations among care providers, patients, and loved ones. It may also save clinicians time, as care providers may be able to spend less time explaining details of EOL care options. Use of an infovisual could assist in ensuring a well-planned EOL journey. Copyright 2016, SLACK Incorporated.

The efficacy of self-directed modules for clinical learning: advanced competencies in entry-level physical therapy education.

Science.gov (United States)

Peck, Kirk; Paschal, Karen; Black, Lisa; Nelson, Kelly

2014-01-01

Prior to graduation, students often express an interest to advance clinical and professional skills in teaching, research, administration, and various niche practice areas. The acquisition of advanced education in selected areas of practice is believed to improve employment opportunities, accelerate career advancement including eligibility for professional certifications, and contribute to personal satisfaction in the profession. The purpose of this paper is to (1) describe an innovative model of education, the Directed Practice Experience (DPE) elective, that incorporates a student-initiated learning process designed to achieve student-identified professional goals, and (2) report the outcomes for graduates who have completed the DPE in an entry-level program in physical therapy education. Students who met select criteria were eligible to complete a DPE. Applicants designed a 4- to 6-week clinical education experience consisting of stated rationale for personal and professional growth, examples of leadership and service, and self-directed objectives that are beyond entry-level expectations as measured by the revised Physical Therapist Clinical Performance Instrument, version 2006. Twenty-six students have completed DPEs since 2005. Fifty percent resulted in new academic partnerships. At least 25% of graduates now serve as clinical instructors for the entry-level program. Those who participated in DPEs have also completed post-graduate residencies, attained ABPTS Board certifications, authored peer-reviewed publications, and taught in both PT and residency programs. The DPE model allows qualified students to acquire advanced personal skills and knowledge prior to graduation in areas of professional practice that exceed entry-level expectations. The model is applicable to all CAPTE accredited physical therapy education programs and is especially beneficial for academic programs desiring to form new community partnerships for student clinical education.

Advance Health Care Directives and “Public Guardian”: The Italian Supreme Court Requests the Status of Current and Not Future Inability

Directory of Open Access Journals (Sweden)

Francesco Paolo Busardò

2014-01-01

Full Text Available Advance health care decisions animate an intense debate in several European countries, which started more than 20 years ago in the USA and led to the adoption of different rules, based on the diverse legal, sociocultural and philosophical traditions of each society. In Italy, the controversial issue of advance directives and end of life’s rights, in the absence of a clear and comprehensive legislation, has been over time a subject of interest of the Supreme Court. Since 2004 a law introduced the “Public Guardian,” aiming to provide an instrument of assistance to the person lacking in autonomy because of an illness or incapacity. Recently, this critical issue has once again been brought to the interest of the Supreme Court, which passed a judgment trying to clarify the legislative application of the appointment of the Guardian in the field of advance directives.

Facilitation of Psychiatric Advance Directives by Peers and Clinicians on Assertive Community Treatment Teams.

Science.gov (United States)

Easter, Michele M; Swanson, Jeffrey W; Robertson, Allison G; Moser, Lorna L; Swartz, Marvin S

2017-07-01

Psychiatric advance directives (PADs) provide a legal mechanism for competent adults to document care preferences and authorize a surrogate to make treatment decisions. In a controlled research setting, an evidence-based intervention, the facilitated psychiatric advance directive (FPAD), was previously shown to overcome most barriers to PAD completion. This study examined implementation of the FPAD intervention in usual care settings as delivered by peer support specialists and nonpeer clinicians on assertive community treatment (ACT) teams. A total of 145 ACT consumers were randomly assigned, within teams, to FPAD with facilitation by either a peer (N=71) or a clinician (N=74). Completion rates and PAD quality were compared with the previous study's standard and across facilitator type. Logistic regression was used to estimate effects on the likelihood of PAD completion. The completion rate of 50% in the intent-to-treat sample (N=145) was somewhat inferior to the prior standard (61%), but the rate of 58% for the retained sample (those who completed a follow-up interview, N=116) was not significantly different from the standard. Rates for peers and clinicians did not differ significantly from each other for either sample. PAD quality was similar to that achieved in the prior study. Four consumer variables predicted completion: independent living status, problematic substance use, length of time served by the ACT team, and no perceived unmet need for hospitalization in crisis. Peers and clinicians can play a crucial role in increasing the number of consumers with PADs, an important step toward improving implementation of PADs in mental health care.

Fluctuating capacity and advance decision-making in Bipolar Affective Disorder - Self-binding directives and self-determination.

Science.gov (United States)

Gergel, Tania; Owen, Gareth S

2015-01-01

For people with Bipolar Affective Disorder, a self-binding (advance) directive (SBD), by which they commit themselves to treatment during future episodes of mania, even if unwilling, can seem the most rational way to deal with an imperfect predicament. Knowing that mania will almost certainly cause enormous damage to themselves, their preferred solution may well be to allow trusted others to enforce treatment and constraint, traumatic though this may be. No adequate provision exists for drafting a truly effective SBD and efforts to establish such provision are hampered by very valid, but also paralysing ethical, clinical and legal concerns. Effectively, the autonomy and rights of people with bipolar are being 'protected' through being denied an opportunity to protect themselves. From a standpoint firmly rooted in the clinical context and experience of mania, this article argues that an SBD, based on a patient-centred evaluation of capacity to make treatment decisions (DMC-T) and grounded within the clinician-patient relationship, could represent a legitimate and ethically coherent form of self-determination. After setting out background information on fluctuating capacity, mania and advance directives, this article proposes a framework for constructing such an SBD, and considers common objections, possible solutions and suggestions for future research. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

The Knowing-Doing Gap in Advance Directives in Asian Americans: The Role of Education and Acculturation.

Science.gov (United States)

Jang, Yuri; Park, Nan Sook; Chiriboga, David A; Radhakrishnan, Kavita; Kim, Miyong T

2017-11-01

The purposes of the present study were (1) to explore the completion rate of advance directives (ADs) in a sample of Asian Americans and (2) to examine the direct and moderating effects of knowledge of AD, education, and acculturation in predicting AD completion. Education and acculturation were conceptualized as moderators in the link between knowledge and completion of ADs. Using data from 2609 participants in the 2015 Asian American Quality of Life survey (aged 18-98), logistic regression analyses on AD completion were conducted, testing both direct and moderating effects. The overall AD completion rate in sample was about 12%. The AD knowledge and acculturation independently predicted AD completion. No direct effect of education was found; however, it interacted with AD knowledge. The AD knowledge was more likely to be translated into completion in the group with higher education. The AD completion rate observed in the present sample of Asian Americans was much lower than that of the US general population (26%-36%). The interactive role of education helps to explain the gap between AD knowledge and completion and suggests intervention strategies.

Dříve vyslovená přání (advance directives). Právní a etické úvahy

Czech Academy of Sciences Publication Activity Database

Doležal, Adam

2017-01-01

Roč. 7, č. 2 (2017), s. 1-15 ISSN 1804-8137 Institutional support: RVO:68378122 Keywords : advance directives * living will * euthanasia Subject RIV: AG - Legal Sciences OBOR OECD: Law http://www.ilaw.cas.cz/medlawjournal/index.php/medlawjournal/article/view/141

Directions in advanced reactor technology

International Nuclear Information System (INIS)

Golay, M.W.

1990-01-01

Successful nuclear power plant concepts must simultaneously performance in terms of both safety and economics. To be attractive to both electric utility companies and the public, such plants must produce economical electric energy consistent with a level of safety which is acceptable to both the public and the plant owner. Programs for reactor development worldwide can be classified according to whether the reactor concept pursues improved safety or improved economic performance as the primary objective. When improved safety is the primary goal, safety enters the solution of the design problem as a constraint which restricts the set of allowed solutions. Conversely, when improved economic performance is the primary goal, it is allowed to be pursued only to an extent which is compatible with stringent safety requirements. The three major reactor coolants under consideration for future advanced reactor use are water, helium and sodium. Reactor development programs focuses upon safety and upon economics using each coolant are being pursued worldwide. These programs are discussed

Advanced Gasoline Turbocharged Direction Injection (GTDI) Engine Development

Energy Technology Data Exchange (ETDEWEB)

Wagner, Terrance [Ford Motor Co., Dearborn, MI (United States)

2015-12-31

This program was undertaken in response to US Department of Energy Solicitation DE-FOA-0000079, resulting in a cooperative agreement with Ford and MTU to demonstrate improvement of fuel efficiency in a vehicle equipped with an advanced GTDI engine. Ford Motor Company has invested significantly in GTDI engine technology as a cost effective, high volume, fuel economy solution, marketed globally as EcoBoost technology. Ford envisions additional fuel economy improvement in the medium and long term by further advancing EcoBoost technology. The approach for the project was to engineer a comprehensive suite of gasoline engine systems technologies to achieve the project objectives, and to progressively demonstrate the objectives via concept analysis / computer modeling, single-cylinder and multi-cylinder engine testing on engine dynamometer, and vehicle level testing on chassis rolls.

Future directions for resuscitation research. V. Ultra-advanced life support.

Science.gov (United States)

Tisherman, S A; Vandevelde, K; Safar, P; Morioka, T; Obrist, W; Corne, L; Buckman, R F; Rubertsson, S; Stephenson, H E; Grenvik, A; White, R J

1997-06-01

Standard external cardiopulmonary resuscitation (SECPR) frequently produces very low perfusion pressures, which are inadequate to achieve restoration of spontaneous circulation (ROSC) and intact survival, particularly when the heart is diseased. Ultra-advanced life support (UALS) techniques may allow support of vital organ systems until either the heart recovers or cardiac repair or replacement is performed. Closed-chest emergency cardiopulmonary bypass (CPB) provides control of blood flow, pressure, composition and temperature, but has so far been applied relatively late. This additional low-flow time may preclude conscious survival. An easy, quick method for vessel access and a small preprimed system that could be taken into the field are needed. Open-chest CPR (OCCPR) is physiologically superior to SECPR, but has also been initiated too late in prior studies. Its application in the field has recently proven feasible. Variations of OCCPR, which deserve clinical trials inside and outside hospitals, include 'minimally invasive direct cardiac massage' (MIDCM), using a pocket-size plunger-like device inserted via a small incision and 'direct mechanical ventricular actuation' (DMVA), using a machine that pneumatically drives a cup placed around the heart. Other novel UALS approaches for further research include the use of an aortic balloon catheter to improve coronary and cerebral blood flow during SECPR, aortic flush techniques and a double-balloon aortic catheter that could allow separate perfusion (and cooling) of the heart, brain and viscera for optimal resuscitation of each. Decision-making, initiation of UALS methods and diagnostic evaluations must be rapid to maximize the potential for ROSC and facilitate decision-making regarding long-term circulatory support versus withdrawal of life support for hopeless cases. Research and development of UALS techniques needs to be coordinated with cerebral resuscitation research.

A New Option for the Reconstruction of Primary or Recurrent Ischial Pressure Sores: Hamstring-Adductor Magnus Muscle Advancement Flap and Direct Closure.

Science.gov (United States)

Burm, Jin Sik; Hwang, Jungil; Lee, Yung Ki

2018-04-01

Owing to the high recurrence rates of ischial pressure sores, surgeons should consider the possibility of future secondary flap surgery during flap selection. The purpose of this article is to present a new surgical option for the reconstruction of primary or recurrent ischial pressure sores using a simple hamstring-adductor magnus advancement flap and direct closure. After horizontal fusiform skin excision, complete bursa excision and ischiectomy were performed. The tenomuscular origin of the adductor magnus and the conjoined tenomuscular origin of the biceps femoris long head and semitendinosus were isolated and completely detached from the inferior border of the ischial tuberosity. They were then advanced in a cephalad direction without detachment of the distal tendon or muscle and securely affixed to the sacrotuberous ligament. The wound was directly closed without further incision or dissection. Twelve ischial pressure sores (6 primary and 6 recurrent; 12 patients) were surgically corrected. The follow-up period was 12 to 65 months. All patients healed successfully without early postoperative complications, such as hematoma, seroma, infection, wound dehiscence, or partial necrosis. Late complications included wound disruption 5 weeks after surgery that spontaneously healed in 1 case and recurrence 3 years later in another case. The new surgical option presented herein, which involves hamstring-adductor magnus advancement flap and direct closure, is a simple and reliable method for providing sufficient muscle bulk to fill the dead space and proper padding to the bone stump while preserving the main vascular perforators and pedicles as well as future surgical options.

Defending to the Four Directions Evolving Uechi-ryu’s Hojoundo Exercises for Advanced Students

Directory of Open Access Journals (Sweden)

Ihor Rymaruk

2012-07-01

Full Text Available This article introduces “Defending to the Four Directions,” techniques that add challenge to Uechi-ryu while incorporating and building upon the traditional katas which have formed the basis of the style. Making changes within a style’s training methods just to be different without any other purpose is of little value and actually destructive to the system. This article describes a meaningful and realistic addition to the practice of hojoundo, the formal exercises incorporating basic movements. “Defending to the Four Directions” is intended for advanced students who have mastered Uechi-ryu’s foundamentals. In addition, the practice is well-suited for adaptation and adoption into other martial art styles.

Automated Ecological Assessment of Physical Activity: Advancing Direct Observation.

Science.gov (United States)

Carlson, Jordan A; Liu, Bo; Sallis, James F; Kerr, Jacqueline; Hipp, J Aaron; Staggs, Vincent S; Papa, Amy; Dean, Kelsey; Vasconcelos, Nuno M

2017-12-01

Technological advances provide opportunities for automating direct observations of physical activity, which allow for continuous monitoring and feedback. This pilot study evaluated the initial validity of computer vision algorithms for ecological assessment of physical activity. The sample comprised 6630 seconds per camera (three cameras in total) of video capturing up to nine participants engaged in sitting, standing, walking, and jogging in an open outdoor space while wearing accelerometers. Computer vision algorithms were developed to assess the number and proportion of people in sedentary, light, moderate, and vigorous activity, and group-based metabolic equivalents of tasks (MET)-minutes. Means and standard deviations (SD) of bias/difference values, and intraclass correlation coefficients (ICC) assessed the criterion validity compared to accelerometry separately for each camera. The number and proportion of participants sedentary and in moderate-to-vigorous physical activity (MVPA) had small biases (within 20% of the criterion mean) and the ICCs were excellent (0.82-0.98). Total MET-minutes were slightly underestimated by 9.3-17.1% and the ICCs were good (0.68-0.79). The standard deviations of the bias estimates were moderate-to-large relative to the means. The computer vision algorithms appeared to have acceptable sample-level validity (i.e., across a sample of time intervals) and are promising for automated ecological assessment of activity in open outdoor settings, but further development and testing is needed before such tools can be used in a diverse range of settings.

Automated Ecological Assessment of Physical Activity: Advancing Direct Observation

Directory of Open Access Journals (Sweden)

Jordan A. Carlson

2017-12-01

Full Text Available Technological advances provide opportunities for automating direct observations of physical activity, which allow for continuous monitoring and feedback. This pilot study evaluated the initial validity of computer vision algorithms for ecological assessment of physical activity. The sample comprised 6630 seconds per camera (three cameras in total of video capturing up to nine participants engaged in sitting, standing, walking, and jogging in an open outdoor space while wearing accelerometers. Computer vision algorithms were developed to assess the number and proportion of people in sedentary, light, moderate, and vigorous activity, and group-based metabolic equivalents of tasks (MET-minutes. Means and standard deviations (SD of bias/difference values, and intraclass correlation coefficients (ICC assessed the criterion validity compared to accelerometry separately for each camera. The number and proportion of participants sedentary and in moderate-to-vigorous physical activity (MVPA had small biases (within 20% of the criterion mean and the ICCs were excellent (0.82–0.98. Total MET-minutes were slightly underestimated by 9.3–17.1% and the ICCs were good (0.68–0.79. The standard deviations of the bias estimates were moderate-to-large relative to the means. The computer vision algorithms appeared to have acceptable sample-level validity (i.e., across a sample of time intervals and are promising for automated ecological assessment of activity in open outdoor settings, but further development and testing is needed before such tools can be used in a diverse range of settings.

Regulation of advance directives in Italy: a bad law in the making.

Science.gov (United States)

Gristina, Giuseppe Renato; Martin, Erica; Ranieri, Vito Marco

2012-11-01

The Advance Directives (ADs) have been adopted in many countries to defend patients' autonomy. In Italy, the role of ADs has recently been the subject of heated debate involving political parties and the Roman Catholic Church. In February 2009, the conservative government coalition presented a bill of law on this issue. It has been passed by the Low Chamber and is now being discussed in the Senate. The purpose of the article is to highlight any possible bill's contradiction with Italian Constitution, Italian Code of Medical Ethics (ICME), and Oviedo Convention contents, relevant for intensivists. Analysis of bill's content in the light of Italian Constitution, ICME, Oviedo Convention articles and in comparison with French legislation regarding end of life (Leonetti law). In the Authors' point of view the bill's articles -limit the moral and judicial importance of four main issues as informed consent, permanent incapacity, artificial nutrition/hydration, and withdraw/withhold treatments. In the Authors' opinion the ADs must represent informed preferences made freely by patients within the relationship with their physicians, as part of an advance care planning. When this relationship develops in accordance with the ICME rules, it contains all of the ethical/professional dimensions to legitimate right choices in each case. The law should draw inspiration from ICME principles, assigning them a juridical power, acknowledging their validity in legitimating end-of-life decisions, and defining a framework of juridical legitimacy for these decisions without infringing on patients' right to autonomy with prescriptions on the care.

Advanced Direct-Drive Generator for Improved Availability of Oscillating Wave Surge Converter Power Generation Systems Final Technical Report

Energy Technology Data Exchange (ETDEWEB)

Englebretson, Steven [ABB Inc., Cary, NC (United States); Ouyang, Wen [ABB Inc., Cary, NC (United States); Tschida, Colin [ABB Inc., Cary, NC (United States); Carr, Joseph [ABB Inc., Cary, NC (United States); Ramanan, V.R. [ABB Inc., Cary, NC (United States); Johnson, Matthew [Texas A& M Univ., College Station, TX (United States); Gardner, Matthew [Texas A& M Univ., College Station, TX (United States); Toliyat, Hamid [Texas A& M Univ., College Station, TX (United States); Staby, Bill [Resolute Marine Energy, Inc., Boston, MA (United States); Chertok, Allan [Resolute Marine Energy, Inc., Boston, MA (United States); Hazra, Samir [ABB Inc., Cary, NC (United States); Bhattacharya, Subhashish [ABB Inc., Cary, NC (United States)

2017-05-13

This report summarizes the activities conducted under the DOE-EERE funded project DE-EE0006400, where ABB Inc. (ABB), in collaboration with Texas A&M’s Advanced Electric Machines & Power Electronics (EMPE) Lab and Resolute Marine Energy (RME) designed, derisked, developed, and demonstrated a novel magnetically geared electrical generator for direct-drive, low-speed, high torque MHK applications The project objective was to investigate a novel and compact direct-drive electric generator and its system aspects that would enable elimination of hydraulic components in the Power Take-Off (PTO) of a Marine and Hydrokinetic (MHK) system with an oscillating wave surge converter (OWSC), thereby improving the availability of the MHK system. The scope of this project was limited to the development and dry lab demonstration of a low speed generator to enable future direct drive MHK systems.

Are written advance directives helpful to guide end-of-life therapy in the intensive care unit? A retrospective matched-cohort study.

Science.gov (United States)

Hartog, Christiane S; Peschel, Ilka; Schwarzkopf, Daniel; Curtis, J Randall; Westermann, Isabella; Kabisch, Bjoern; Pfeifer, Ruediger; Guenther, Albrecht; Michalsen, Andrej; Reinhart, Konrad

2014-02-01

The purpose of the study was to determine whether treatment preferences in patients' advance directives (ADs) are associated with life-supporting treatments received during end-of-life care in the intensive care unit (ICU). This is a retrospective cohort study, including patients who died in 4 ICUs of a university hospital in Germany. Patients with ADs were matched with 2 patients each without ADs using propensity scores. Sixty-four (13%) of 477 patients had ADs, written a median of 109 weeks before admission. Five categories of applicability conditions were identified, most of them difficult to interpret in the ICU (eg, "advanced brain impairment" or "imminent death"). Advance directives contained a number of treatment refusals. Specifically, 63 of 64 refused "life-sustaining measures." Compared to patients without ADs, patients with ADs were less likely to receive cardiopulmonary resuscitation (9% vs 23%, P = .029) and more likely to have do-not-resuscitate orders (77% vs 56%, P = .007). Therapy-limiting decisions and ICU length of stay did not differ between those with or without ADs. Patients with ADs are less likely to receive cardiopulmonary resuscitation but otherwise receive similar life-sustaining treatments compared to matched patients without ADs. More research is needed to explore reasons for potential noncompliance with patient preferences. © 2013.

Advanced directions of peaceful applications of nuclear energy in the Republic of Azerbaijan

International Nuclear Information System (INIS)

Garibov, A.A.

2006-01-01

Full text: Application of nuclear energy is actual during last years due to depletion of organic sources of row materials. Therefore, each country develops the programs on peaceful application of nuclear energy and using alternative as well as other energy sources on the basis of the analysis of fuel-energy balance and energy demand state. The Republic of Azerbaijan has huge hydrocarbon resources and alternative energy sources. However, taking into account the fact that hydrocarbon resources can cover increasing energy demand at maximum 50-60 years and renewable energy sources can not meet large energy demand during near future then the discovering of advanced ways on peaceful application of nuclear energy is of great importance. Since the seventies of the twentieth century, wide spectrum of scientific researches on the discovering advanced ways on peaceful application of nuclear energy are carried out in the Republic of Azerbaijan. Among them it is necessary to mark the following directions: radiation modification of the properties of polymers, absorbents, catalysts, metals and alloys, semiconductors, dielectrics, ferroelectrics and various devices; radiation oil-chemistry processes; radiation polymerization; radiation-heterogeneous processes; atomic-hydrogen energy; scientific problems of radiation safety and nuclear security; discovering possibilities for using radiation technologies in the solution of environmental problems; radiation sciences of materials and radiation physics; radiation biology and medicine; application of isotope sources in medicine; application of isotope in oil-gas industry; application of isotope sources in radiography and different fields of technique

Impact of a stay in the intensive care unit on the preparation of Advance Directives: Descriptive, exploratory, qualitative study.

Science.gov (United States)

Andreu, Pascal; Dargent, Auguste; Large, Audrey; Meunier-Beillard, Nicolas; Vinault, Sandrine; Leiva-Rojas, Uriel; Ecarnot, Fiona; Prin, Sébastien; Charles, Pierre-Emmanuel; Fournel, Isabelle; Rigaud, Jean-Philippe; Quenot, Jean-Pierre

2018-04-01

Our objective was to assess, through a qualitative, exploratory study, the thought processes of patients regarding the formulation of advance directives (AD) after a stay in the ICU. The study was conducted from May to July 2016 using telephone interviews performed by four senior ICU physicians. Inclusion criteria were: patients discharged from ICU to home>3 months earlier. Semi-directive interviews with patients focused on 5 main points surrounding AD. In total, among 159 eligible patients, data from 94 (59%) were available for analysis. Among all those interviewed, 83.5% had never heard of "advance directives". Only 2% had executed AD before ICU admission, and 7% expressed a desire to prepare AD further to their ICU stay. Among the barriers to preparation of AD, lack of information was the main reason cited for not executing AD. Patients noted the following in their AD: withdrawal of life-support in case of vegetative/minimally conscious state or when there is no longer any hope, in case of uncontrollable pain, and if impossible to wean from mechanical ventilation. The ideal time to engage patients in these discussions is most likely well before an acute health event occurs, although this warrants further investigation both before and after ICU admissions. Copyright © 2017 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

Study of the standard direct costs of various techniques of advanced endoscopy. Comparison with surgical alternatives.

Science.gov (United States)

Loras, Carme; Mayor, Vicenç; Fernández-Bañares, Fernando; Esteve, Maria

2018-03-12

The complexity of endoscopy has carried out an increase in cost that has a direct effect on the healthcare systems. However, few studies have analyzed the cost of advanced endoscopic procedures (AEP). To carry out a calculation of the standard direct costs of AEP, and to make a financial comparison with their surgical alternatives. Calculation of the standard direct cost in carrying out each procedure. An endoscopist detailed the time, personnel, materials, consumables, recovery room time, stents, pathology and medication used. The cost of surgical procedures was the average cost recorded in the hospital. Thirty-eight AEP were analyzed. The technique showing lowest cost was gastroscopy + APC (€116.57), while that with greatest cost was ERCP with cholangioscopy + stent placement (€5083.65). Some 34.2% of the procedures registered average costs of €1000-2000. In 57% of cases, the endoscopic alternative was 2-5 times more cost-efficient than surgery, in 31% of cases indistinguishable or up to 1.4 times more costly. Standard direct cost of the majority of AEP is reported using a methodology that enables easy application in other centers. For the most part, endoscopic procedures are more cost-efficient than the corresponding surgical procedure. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Advancements in high-power high-brightness laser bars and single emitters for pumping and direct diode application

Science.gov (United States)

An, Haiyan; Jiang, Ching-Long J.; Xiong, Yihan; Zhang, Qiang; Inyang, Aloysius; Felder, Jason; Lewin, Alexander; Roff, Robert; Heinemann, Stefan; Schmidt, Berthold; Treusch, Georg

2015-03-01

We have continuously optimized high fill factor bar and packaging design to increase power and efficiency for thin disc laser system pump application. On the other hand, low fill factor bars packaged on the same direct copper bonded (DCB) cooling platform are used to build multi-kilowatt direct diode laser systems. We have also optimized the single emitter designs for fiber laser pump applications. In this paper, we will give an overview of our recent advances in high power high brightness laser bars and single emitters for pumping and direct diode application. We will present 300W bar development results for our next generation thin disk laser pump source. We will also show recent improvements on slow axis beam quality of low fill factor bar and its application on performance improvement of 4-5 kW TruDiode laser system with BPP of 30 mm*mrad from a 600 μm fiber. Performance and reliability results of single emitter for multiemitter fiber laser pump source will be presented as well.

A phase I, dose-escalation study of TB-403, a monoclonal antibody directed against PlGF, in patients with advanced solid tumours

DEFF Research Database (Denmark)

Lassen, U; Nielsen, D L; Sørensen, M

2012-01-01

BACKGROUND: TB-403 (RO 5323441), a humanised monoclonal antibody, is a novel antiangiogenesis agent directed against placental growth factor. The safety, pharmacokinetics (PK), and antitumour activity of TB-403 were assessed in a phase I, dose-escalation study in patients with advanced solid...

Advanced DVI for ECC direct bypass mitigation

International Nuclear Information System (INIS)

Kwon, Tae-Soon; Song, Chul-Hwa; Baek, Won-Pil

2009-01-01

An ECC direct bypass fraction during a late reflood phase of a LBLOCA is strongly dependent on the characteristics of the cross flow and the geometrical configuration of a DVI in the downcomer of a pressurized light water reactor. The important design parameters of a DVI are the elevation, the azimuthal angle, and the separator to prevent a steam-water interaction. An ECC sub-channel to separate or to isolate an ECC water from a high-speed cross flow is one of the important design features to mitigate the ECC bypass phenomena. A dual core barrel cylinder as an ECC flow separator is located between a reactor vessel and a core barrel outer wall in the downcomer annulus. A new narrow gap between the core barrel and the additional dual core barrel plays the role of a downward ECC flow channel or an ECC flow separator in a high-speed cross flow field of the downcomer annulus. The flow zone around a broken cold leg in the downcomer annulus has the role of a high ECC direct bypass due to a strong suction force while the wake zone of a hot leg has the role of an ECC penetration. Thus, the relative azimuthal angle of the DVI nozzle from the broken cold leg is an important design parameter. A large azimuthal angle from a cold leg to a hot leg needs to avoid a high suction flow zone when an ECC water is being injected. The other enhancing mechanism of an ECC penetration is a grooved core barrel which has small rectangular-shaped grooves vertically arranged on the core barrel wall of the reactor vessel downcomer annulus. These grooves have the role for a generation of a vortex induced by a high-speed cross flow. Since the stagnant flow in a lateral direction and rotational vortex provides the pulling force of an ECC drop or film to flow down into the lower downcomer annulus by gravity, the ECC direct bypass fraction is reduced when compared to the current design of a smoothed wall. An open channel of grooves generates a stagnant vortex, while a closed channel of grooves

[Advance directives in prehospital emergency treatment : prospective questionnaire-based analysis].

Science.gov (United States)

Brokmann, J C; Grützmann, T; Pidun, A K; Groß, D; Rossaint, R; Beckers, S K; May, A T

2014-01-01

The handling of advance directives (AD) in prehospital emergency treatment in Germany is characterized by instability. In the project "Advance directives in preclinical emergency medical aid" ("Patientenverfügungen in der präklinischen Notfallmedizin") the frequency and quality of ADs in emergency situations was investigated. The aim of this study was to fill the gaps in research and to collate data on how consideration of the self-determination of patients in emergency situations can be optimized. Over a period of 12 months from December 2007 to December 2008 a questionnaire was included in the emergency documentation of the medical emergency service in Aachen. Emergency patients were asked by emergency physicians to provide an AD and the quantitative as well as qualitative features of these ADs were examined. Furthermore, the study recorded what kinds of problems occurred with ADs in emergency situations and what measures were needed to correct this deficiency. The reactions of patients were documented on a numeral rating scale with a score of 1 reflecting a negative and 10 reflecting a positive reaction. In the 12-month period emergency doctors recorded 1,321 missions and after application of the exclusion criteria (e.g. missing signature, incomplete documentation and late delivery) 1,047 documented questionnaires were available for the analysis. A total of 127 out of 1,047 emergency patients provided an AD, 44 had a durable power of attorney and 27 had appointed a legal representative for healthcare. Of the emergency patients 20 had a legal attendant and 43 out of the 127 ADs could be presented to the emergency team during the emergency mission. The emergency team often encountered difficulties regarding the handling of the ADs due to the time factor and unclear wording. The latter included the following problems: misleading formulation (19.1 %), difficulty with the complexity (14.9 %) and contradicting information (4 %). Only 29 (61.7 %) of the

Development of advanced direct perception displays for nuclear power plants to enhance monitoring, control and fault management

International Nuclear Information System (INIS)

Jones, B.; Shaheen, S.; Moray, N.; Sanderson, P.; Reising, D.V.

1993-01-01

With recent theoretical and empirical research in basic and applied psychology, human factors, and engineering, it is now sufficient to define an integrated approach to the deign of advanced displays for present and future nuclear power plants. Traditionally, the conventional displays have shown operators the individual variables on gauges, meters, strip charts, etc. This design approach requires the operators to mentally integrate the separately displayed variables and determine the implications for the plant state. This traditional approach has been known as the single-sensor-single-indicator display design and it places an intolerable amount of mental workload on operators during transients and abnormal conditions. This report discusses a new alternative approach which is the use of direct perception interfaces. Direct perception a interfaces display the underlying physical and system constraints of the situation in a directly perceptual way, such that the viewer need not reason about what is seen to identify system states, but can identify the state of the system perceptually. It is expected that displays which show the dynamics of fundamental physical laws should better support operator decisions and diagnoses of plant states. The purpose of this research project is to develop a suite of direct perception displays for PWR nuclear power plant operations

Planning for Advanced Cancer

Science.gov (United States)

Find out what issues need to be addressed when dealing with an advanced or metastatic cancer diagnosis. Completing advance directives, looking at health insurance, organizing records and documents, and looking at the meanings in your life are some of the things to think about.

Usefulness of questionnaires on advance directives in haemodialysis units.

Science.gov (United States)

Jornet, Angel Rodríguez; Castellanos, Loreley Ana Betancourt; Contador, Maria Isabel Bolós; Morera, Juan Carlos Oliva; López, José Antonio Ibeas

2017-10-01

As renal replacement therapy has become universal practice in medicine, there is a need to consider whether this treatment is suitable for elderly people. These patients have high comorbidity and may require dialysis withdrawal in certain clinical circumstances. Advance directives (ADs) drawn up by patients facilitate treatment-related decisions if they lose cognitive capacity. Questionnaires dealing with possible extreme clinical circumstances can thus help clinicians and relatives reach pertinent decisions in such cases. We studied the usefulness of questionnaires on ADs in patients who started periodic haemodialysis over a period of 10 years. Telephone interviews were conducted to assess satisfaction level among relatives/representatives of deceased patients who had been advised to limit therapeutic efforts in certain clinical situations. The questionnaire was assessed using a six-factor degree of satisfaction. Four hundred and forty-three questionnaires were distributed over a period of 10 years. A total of 41.3% of patients stated that they wished to limit therapeutic efforts in the serious clinical situations presented; 37.9% refused to complete the questionnaire; 14.7% expressed their wishes without any written confirmation; and 6.1% expressed their wish to continue on dialysis in all situations. Two hundred and twenty-four patients had died by the study end date. The cause of death in 20.2% was scheduled dialysis withdrawal. Representatives reported an extremely high degree of satisfaction with the questionnaire (94.7%). Younger people, however, were more reluctant to consider and answer questionnaires on ADs. Questionnaires on ADs are a useful tool in daily nephrology practice and should be distributed to those patients willing to consider the limitation of therapeutic efforts in extreme clinical circumstances. In general terms, these questionnaires should be given to all elderly patients. © The Author 2017. Published by Oxford University Press on

Advances in direct oxidation methanol fuel cells

Science.gov (United States)

Surampudi, S.; Narayanan, S. R.; Vamos, E.; Frank, H.; Halpert, G.; Laconti, Anthony B.; Kosek, J.; Prakash, G. K. Surya; Olah, G. A.

1993-01-01

Fuel cells that can operate directly on fuels such as methanol are attractive for low to medium power applications in view of their low weight and volume relative to other power sources. A liquid feed direct methanol fuel cell has been developed based on a proton exchange membrane electrolyte and Pt/Ru and Pt catalyzed fuel and air/O2 electrodes, respectively. The cell has been shown to deliver significant power outputs at temperatures of 60 to 90 C. The cell voltage is near 0.5 V at 300 mA/cm(exp 2) current density and an operating temperature of 90 C. A deterrent to performance appears to be methanol crossover through the membrane to the oxygen electrode. Further improvements in performance appear possible by minimizing the methanol crossover rate.

Radiation-induced erectile dysfunction: Recent advances and future directions

Directory of Open Access Journals (Sweden)

Javed Mahmood, PhD

2016-07-01

Full Text Available Prostate cancer is one of the most prevalent cancers and the second leading cause of cancer-related deaths in men in the United States. A large number of patients undergo radiation therapy (RT as a standard care of treatment; however, RT causes erectile dysfunction (radiation-induced erectile dysfunction; RiED because of late side effects after RT that significantly affects quality of life of prostate cancer patients. Within 5 years of RT, approximately 50% of patients could develop RiED. Based on the past and current research findings and number of publications from our group, the precise mechanism of RiED is under exploration in detail. Recent investigations have shown prostate RT induces significant morphologic arterial damage with aberrant alterations in internal pudendal arterial tone. Prostatic RT also reduces motor function in the cavernous nerve which may attribute to axonal degeneration may contributing to RiED. Furthermore, the advances in radiogenomics such as radiation induced somatic mutation identification, copy number variation and genome-wide association studies has significantly facilitated identification of biomarkers that could be used to monitoring radiation-induced late toxicity and damage to the nerves; thus, genomic- and proteomic-based biomarkers could greatly improve treatment and minimize arterial tissue and nerve damage. Further, advanced technologies such as proton beam therapy that precisely target tumor and significantly reduce off-target damage to vital organs and healthy tissues. In this review, we summarize recent advances in RiED research and novel treatment modalities for RiED. We also discuss the possible molecular mechanism involved in the development of RiED in prostate cancer patients. Further, we discuss various readily available methods as well as novel strategies such as stem cell therapies, shockwave therapy, nerve grafting with tissue engineering, and nutritional supplementations might be used to

Recent Advances and Future Directions for Quality Engineering

DEFF Research Database (Denmark)

Vining, Geoff; Kulahci, Murat; Pedersen, Søren

2015-01-01

The origins of quality engineering are in manufacturing, where quality engineers apply basic statistical methodologies to improve the quality and productivity of products and processes. In the past decade, people have discovered that these methodologies are effective for improving almost any type...... of system or process, such as financial, health care, and supply chains. This paper begins with a review of key advances and trends within quality engineering over the past decade. The second part uses the first part as a foundation to outline new application areas for the field. It also discusses how...

Impact of Integrated Care Model (ICM) on Direct Medical Costs in Management of Advanced Chronic Obstructive Pulmonary Disease (COPD).

Science.gov (United States)

Bandurska, Ewa; Damps-Konstańska, Iwona; Popowski, Piotr; Jędrzejczyk, Tadeusz; Janowiak, Piotr; Świętnicka, Katarzyna; Zarzeczna-Baran, Marzena; Jassem, Ewa

2017-06-12

BACKGROUND Chronic obstructive pulmonary disease (COPD) is a commonly diagnosed condition in people older than 50 years of age. In advanced stage of this disease, integrated care (IC) is recommended as an optimal approach. IC allows for holistic and patient-focused care carried out at the patient's home. The aim of this study was to analyze the impact of IC on costs of care and on demand for medical services among patients included in IC. MATERIAL AND METHODS The study included 154 patients diagnosed with advanced COPD. Costs of care (general, COPD, and exacerbations-related) were evaluated for 1 year, including 6-months before and after implementing IC. The analysis included assessment of the number of medical procedures of various types before and after entering IC and changes in medical services providers. RESULTS Direct medical costs of standard care in advanced COPD were 886.78 EUR per 6 months. Costs of care of all types decreased after introducing IC. Changes in COPD and exacerbation-related costs were statistically significant (p=0.012492 and p=0.017023, respectively). Patients less frequently used medical services for respiratory system and cardiovascular diseases. Similarly, the number of hospitalizations and visits to emergency medicine departments decreased (by 40.24% and 8.5%, respectively). The number of GP visits increased after introducing IC (by 7.14%). CONCLUSIONS The high costs of care in advanced COPD indicate the need for new forms of effective care. IC caused a decrease in costs and in the number of hospitalization, with a simultaneous increase in the number of GP visits.

General survey of Korean advanced technology

International Nuclear Information System (INIS)

1984-05-01

This book includes advanced technology, world trend of advanced technology, technological innovation study for strengthening international competitiveness, patterns of Korea industrialization and its causes, structures of Korea electronic equipment and development direction, middle and long-term prospects of home appliance, the world of computer, current situation and prospect of robot industry, homework for strengthening international competitiveness of machine industry, direction for rationalization of materials industry, current situations of technical textile, future technology of developed countries, and trend of Korea technological activities.

Motivations, aims and communication around advance directives A mixed-methods study into the perspective of their owners and the influence of a current illness

NARCIS (Netherlands)

van Wijmen, M.P.S.; Pasman, H.R.W.; Widdershoven, G.A.M.; Onwuteaka-Philipsen, B.D.

2014-01-01

Objective: What are motivations of owners of an advance directive (AD) to draft an AD, what do they aim for with their AD and do they communicate about their AD? Methods: Written questionnaires were sent to a cohort of people owning different types of ADs (n= 5768). A purposive sample of people

Optimally setting up directed searches for continuous gravitational waves in Advanced LIGO O1 data

Science.gov (United States)

Ming, Jing; Papa, Maria Alessandra; Krishnan, Badri; Prix, Reinhard; Beer, Christian; Zhu, Sylvia J.; Eggenstein, Heinz-Bernd; Bock, Oliver; Machenschalk, Bernd

2018-02-01

In this paper we design a search for continuous gravitational waves from three supernova remnants: Vela Jr., Cassiopeia A (Cas A) and G347.3. These systems might harbor rapidly rotating neutron stars emitting quasiperiodic gravitational radiation detectable by the advanced LIGO detectors. Our search is designed to use the volunteer computing project Einstein@Home for a few months and assumes the sensitivity and duty cycles of the advanced LIGO detectors during their first science run. For all three supernova remnants, the sky positions of their central compact objects are well known but the frequency and spin-down rates of the neutron stars are unknown which makes the searches computationally limited. In a previous paper we have proposed a general framework for deciding on what target we should spend computational resources and in what proportion, what frequency and spin-down ranges we should search for every target, and with what search setup. Here we further expand this framework and apply it to design a search directed at detecting continuous gravitational wave signals from the most promising three supernova remnants identified as such in the previous work. Our optimization procedure yields broad frequency and spin-down searches for all three objects, at an unprecedented level of sensitivity: The smallest detectable gravitational wave strain h0 for Cas A is expected to be 2 times smaller than the most sensitive upper limits published to date, and our proposed search, which was set up and ran on the volunteer computing project Einstein@Home, covers a much larger frequency range.

Lightning Radio Source Retrieval Using Advanced Lightning Direction Finder (ALDF) Networks

Science.gov (United States)

Koshak, William J.; Blakeslee, Richard J.; Bailey, J. C.

1998-01-01

A linear algebraic solution is provided for the problem of retrieving the location and time of occurrence of lightning ground strikes from an Advanced Lightning Direction Finder (ALDF) network. The ALDF network measures field strength, magnetic bearing and arrival time of lightning radio emissions. Solutions for the plane (i.e., no Earth curvature) are provided that implement all of tile measurements mentioned above. Tests of the retrieval method are provided using computer-simulated data sets. We also introduce a quadratic planar solution that is useful when only three arrival time measurements are available. The algebra of the quadratic root results are examined in detail to clarify what portions of the analysis region lead to fundamental ambiguities in source location. Complex root results are shown to be associated with the presence of measurement errors when the lightning source lies near an outer sensor baseline of the ALDF network. In the absence of measurement errors, quadratic root degeneracy (no source location ambiguity) is shown to exist exactly on the outer sensor baselines for arbitrary non-collinear network geometries. The accuracy of the quadratic planar method is tested with computer generated data sets. The results are generally better than those obtained from the three station linear planar method when bearing errors are about 2 deg. We also note some of the advantages and disadvantages of these methods over the nonlinear method of chi(sup 2) minimization employed by the National Lightning Detection Network (NLDN) and discussed in Cummins et al.(1993, 1995, 1998).

Advance care planning in CKD/ESRD: an evolving process.

Science.gov (United States)

Holley, Jean L

2012-06-01

Advance care planning was historically considered to be simply the completion of a proxy (health care surrogate designation) or instruction (living will) directive that resulted from a conversation between a patient and his or her physician. We now know that advance care planning is a much more comprehensive and dynamic patient-centered process used by patients and families to strengthen relationships, achieve control over medical care, prepare for death, and clarify goals of care. Some advance directives, notably designated health care proxy documents, remain appropriate expressions of advance care planning. Moreover, although physician orders, such as do-not-resuscitate orders and Physician Orders for Life-Sustaining Treatment, may not be strictly defined as advance directives, their completion, when appropriate, is an integral component of advance care planning. The changing health circumstances and illness trajectory characteristic of ESRD mandate that advance care planning discussions adapt to a patient's situation and therefore must be readdressed at appropriate times and intervals. The options of withholding and withdrawing dialysis add ESRD-specific issues to advance care planning in this population and are events each nephrologist will at some time confront. Advance care planning is important throughout the spectrum of ESRD and is a part of nephrology practice that can be rewarding to nephrologists and beneficial to patients and their families.

Applying Precision Medicine and Immunotherapy Advances from Oncology to Host-Directed Therapies for Infectious Diseases.

Science.gov (United States)

Mahon, Robert N; Hafner, Richard

2017-01-01

To meet the challenges of increasing antimicrobial resistance, the infectious disease community needs innovative therapeutics. Precision medicine and immunotherapies are transforming cancer therapeutics by targeting the regulatory signaling pathways that are involved not only in malignancies but also in the metabolic and immunologic function of the tumor microenvironment. Infectious diseases target many of the same regulatory pathways as they modulate host metabolic functions for their own nutritional requirements and to impede host immunity. These similarities and the advances made in precision medicine and immuno-oncology that are relevant for the current development of host-directed therapies (HDTs) to treat infectious diseases are discussed. To harness this potential, improvements in drug screening methods and development of assays that utilize the research tools including high throughput multiplexes already developed by oncology are essential. A multidisciplinary approach that brings together immunologists, infectious disease specialists, and oncologists will be necessary to fully develop the potential of HDTs.

Advance Directive in End of Life Decision-Making among the Yoruba of South-Western Nigeria.

Science.gov (United States)

Jegede, Ayodele Samuel; Adegoke, Olufunke Olufunsho

2016-11-01

End-of-life decision making is value-laden within the context of culture and bioethics. Also, ethics committee role is difficult to understand on this, thus need for ethnomethodological perspective in an expanding bioethical age. Anthropological approach was utilized to document Yoruba definition and perspective of death, cultural beliefs about end-of-life decision making, factors influencing it and ethics committee role. Interviews were conducted among selected Yoruba resident in Akinyele LGA, Oyo State, Nigeria. Content analytical approach was used for data analysis. Yoruba culture, death is socially constructed having spiritual, physical and social significance. Relationship between the dying and significant others influences decision making. Hierarchy of authority informs implementing traditional advance directive. Socialization, gender, patriarchy, religious belief and tradition are major considerations in end-of-life decision making. Awareness, resource allocation and advocacy are important ethics committees' roles. Further research into cultural diversity of end-of-life decision making will strengthen ethical practice in health care delivery.

A call to improve practice concerning cultural sensitivity in advance directives: a review of the literature.

Science.gov (United States)

Zager, B Sue; Yancy, Margaret

2011-12-01

The Patient Self Determination Act of 1990 mandates healthcare providers (HCP) to speak with patients about end-of-life preferences and advance directives (AD). HCP work with patients of varying cultures, and standard ADs do not address cultural differences. In order to understand various cultural beliefs, cultural sensitivity is important especially when discussing advance care planning (ACP). Individuals from differing ethnic backgrounds are likely to turn to their traditional norms of practice when ill or treatment choices must be made. An AD that addresses varying cultural values and beliefs was sought. A comprehensive review of the literature was conducted. Articles selected for review included qualitative and quantitative studies. The evidence was evaluated and synthesized for information related to cultural sensitivity and ADs. Three common themes emerged related to ACP discussions and culture. Healthcare provider awareness, communication, and education concerning cultural differences and ACP assisted in meeting the needs for end-of-life planning in the current era of increased globalization. Education for HCP on cultural differences and how to lead discussions promoted ACP. ADs are an essential part of health care and promote patient-centered care. (HCP) should be able to recognize differing cultural values and beliefs in order to initiate conversations about end of life. Initiating conversations about ACP can be facilitated by using open-ended questions that respect the values and beliefs of various cultures. Copyright ©2011 Sigma Theta Tau International.

Advanced direct liquefaction concepts for PETC generic units

Energy Technology Data Exchange (ETDEWEB)

1992-04-01

In the Advance Coal Liquefaction Concept Proposal (ACLCP) carbon monoxide (CO) and water have been proposed as the primary reagents in the pretreatment process. The main objective of this project is to develop a methodology for pretreating coal under mild conditions based on a combination of existing processes which have shown great promise in liquefaction, extraction and pyrolysis studies. The aim of this pretreatment process is to partially depolymerise the coal, eliminate oxygen and diminish the propensity for retograde reactions during subsequent liquefaction. The desirable outcome of the CO pretreatment step should be: (1) enhanced liquefaction activity and/or selectivity toward products of higher quality due to chemical modification of the coal structure; (2) cleaner downstream products; (3) overall improvement in operability and process economics.

La perspectiva de las personas mayores sobre el testamento vital Elders´perspective about Advance Directives

Directory of Open Access Journals (Sweden)

Inés Mª Barrio Cantalejo

2006-06-01

Full Text Available Antecedentes. La popularización del testamento vital (TV exige conocer la perspectiva que sobre él tienen sus potenciales usuarios. Cualquier intento de generalizar el TV sin evaluar cómo será recibido por las personas mayores está condenado al fracaso. Objetivo: Explorar la perspectiva de los mayores sobre el testamento vital. Diseño: Estudio cualitativo. 40 personas mayores, usuarios de 3 Centros de Salud y 1 Residencia Asistida de Madrid, se reunieron en 5 grupos de discusión en abril de 2004. Participantes: 14 mediadores captaron a 2-3 participantes cada uno. Se consideró que edad y residencia en medio familiar o institucional son las variables que más diferencian la elaboración de los discursos sobre el TV. Se utilizaron, pues, como criterios de segmentación, buscando heterogeneidad entre grupos y homogeneidad y heterogeneidad intragrupal. La saturación se consideró cuando las ideas expresadas resultaron recurrentes. Resultados: 4 ideas se extraen de los datos: 1 los mayores prefieren la planificación anticipada de decisiones al TV. 2 Su opinión sobre el TV se asocia a la vivencia singular de otros eventos en el final de la vida. 3 Conceden un papel relevante a la familia. 4 Desean conducir su propia vida, pero "sin papeles escritos". Conclusiones. La implementación del TV a través de una estrategia educativa e institucional se beneficiará si consideramos la perspectiva de la población mayor española sobre el TV.Background: The introduction of advance directives (AD require to examine the perspective their potential users have about. Any public policy about the implementation of ADs adressed to elders will fall if their perspective is unknown. Objective: To examine the elders' perspective about advance directives. Methods: Qualitative study. 40 elders, users of 3 Primary Health Care Center, and of 1 Nursing Home from Madrid. 5 focus groups were organized in 2004 April. Participants: 14 providers recruited 2

ADVANCED SULFUR CONTROL CONCEPTS

Energy Technology Data Exchange (ETDEWEB)

Apostolos A. Nikolopoulos; Santosh K. Gangwal; William J. McMichael; Jeffrey W. Portzer

2003-01-01

Conventional sulfur removal in integrated gasification combined cycle (IGCC) power plants involves numerous steps: COS (carbonyl sulfide) hydrolysis, amine scrubbing/regeneration, Claus process, and tail-gas treatment. Advanced sulfur removal in IGCC systems involves typically the use of zinc oxide-based sorbents. The sulfides sorbent is regenerated using dilute air to produce a dilute SO{sub 2} (sulfur dioxide) tail gas. Under previous contracts the highly effective first generation Direct Sulfur Recovery Process (DSRP) for catalytic reduction of this SO{sub 2} tail gas to elemental sulfur was developed. This process is currently undergoing field-testing. In this project, advanced concepts were evaluated to reduce the number of unit operations in sulfur removal and recovery. Substantial effort was directed towards developing sorbents that could be directly regenerated to elemental sulfur in an Advanced Hot Gas Process (AHGP). Development of this process has been described in detail in Appendices A-F. RTI began the development of the Single-step Sulfur Recovery Process (SSRP) to eliminate the use of sorbents and multiple reactors in sulfur removal and recovery. This process showed promising preliminary results and thus further process development of AHGP was abandoned in favor of SSRP. The SSRP is a direct Claus process that consists of injecting SO{sub 2} directly into the quenched coal gas from a coal gasifier, and reacting the H{sub 2}S-SO{sub 2} mixture over a selective catalyst to both remove and recover sulfur in a single step. The process is conducted at gasifier pressure and 125 to 160 C. The proposed commercial embodiment of the SSRP involves a liquid phase of molten sulfur with dispersed catalyst in a slurry bubble-column reactor (SBCR).

Experimental investigation of a directionally enhanced DHX concept for high temperature Direct Reactor Auxiliary Cooling Systems

International Nuclear Information System (INIS)

Hughes, Joel T.; Blandford, Edward D.

2016-01-01

Highlights: • A novel directional heat exchanger design has been developed. • Hydrodynamic tests have been performed on the proposed design. • Heat transfer performance is inferred by hydrodynamic results. • Results are discussed and future work is suggested. - Abstract: The use of Direct Reactor Auxiliary Cooling Systems (DRACSs) as a safety-related decay heat removal system for advanced reactors has developed historically through the Sodium Fast Reactor (SFR) community. Beginning with the EBR-II, DRACSs have been utilized in a large number of past and current SFR designs. More recently, the DRACS has been adopted for Fluoride Salt-Cooled High-Temperature Reactors (FHRs) for similar decay heat removal functions. In this paper we introduce a novel directionally enhanced DRACS Heat Exchanger (DHX) concept. We present design options for optimizing such a heat exchanger so that shell-side heat transfer is enhanced in one primary coolant flow direction and degraded in the opposite coolant flow direction. A reduced-scale experiment investigating the hydrodynamics of a directionally enhanced DHX was built and the data collected is presented. The concept of thermal diodicity is expanded to heat exchanger technologies and used as performance criteria for evaluating design options. A heat exchanger that can perform as such would be advantageous for use in advanced reactor concepts where primary coolant flow reversal is expected during Loss-of-Forced-Circulation (LOFC) accidents where the ability to circulate coolant is compromised. The design could also find potential use in certain advanced Sodium Fast Reactor (SFR) designs utilizing fluidic diode concepts.

Experimental investigation of a directionally enhanced DHX concept for high temperature Direct Reactor Auxiliary Cooling Systems

Energy Technology Data Exchange (ETDEWEB)

Hughes, Joel T.; Blandford, Edward D., E-mail: edb@unm.edu

2016-07-15

Highlights: • A novel directional heat exchanger design has been developed. • Hydrodynamic tests have been performed on the proposed design. • Heat transfer performance is inferred by hydrodynamic results. • Results are discussed and future work is suggested. - Abstract: The use of Direct Reactor Auxiliary Cooling Systems (DRACSs) as a safety-related decay heat removal system for advanced reactors has developed historically through the Sodium Fast Reactor (SFR) community. Beginning with the EBR-II, DRACSs have been utilized in a large number of past and current SFR designs. More recently, the DRACS has been adopted for Fluoride Salt-Cooled High-Temperature Reactors (FHRs) for similar decay heat removal functions. In this paper we introduce a novel directionally enhanced DRACS Heat Exchanger (DHX) concept. We present design options for optimizing such a heat exchanger so that shell-side heat transfer is enhanced in one primary coolant flow direction and degraded in the opposite coolant flow direction. A reduced-scale experiment investigating the hydrodynamics of a directionally enhanced DHX was built and the data collected is presented. The concept of thermal diodicity is expanded to heat exchanger technologies and used as performance criteria for evaluating design options. A heat exchanger that can perform as such would be advantageous for use in advanced reactor concepts where primary coolant flow reversal is expected during Loss-of-Forced-Circulation (LOFC) accidents where the ability to circulate coolant is compromised. The design could also find potential use in certain advanced Sodium Fast Reactor (SFR) designs utilizing fluidic diode concepts.

Advance Directives of Will (Living Will: Ethical and Legal Implications Based on the Principle of Dignity of Human Person

Directory of Open Access Journals (Sweden)

Maria Aparecida Alkimim

2016-12-01

Full Text Available This paper, with methodology of philosophical, bibliographical and documentary research intends to apply the principle of dignity of human person to the vicissitudes around the advance directives of will, to the ethical aspects disciplined by the Code of Medical Ethics, as well as to what regards the legal aspects, involving the Federal Constitution, the Civil Code, the Code of Medical Ethics and the Resolution 1995/2012 (CFM. The principle of dignity of human person along with the consequent application in the principles of bioethics is considered in a personalistic perspective. This kind of approach is indicative of the interdisciplinarity of bioethics.

Advanced TCA BAckplane Tester

CERN Document Server

Oltean, Alexandra Dana; PGNet2005

2005-01-01

The “Advanced Telecom Computing Architecture” (AdvancedTCA) is a modular standard chassis based system designed to support the needs of carrier class telecommunication applications. It is defined by a set of industry standards under the direction of the PICMG group. One early deployment of the standard technology has been a 10 Gigabit Ethernet switch developed in the framework of the EU funded ESTA project. In order to study the practical aspects of high speed Ethernet switching at 10 Gigabit and above and to validate the signal integrity of the AdvancedTCA backplane, we developed a Backplane Tester. This system is able to run pseudo-random bit sequence (PRBS) traffic at 3.125 Gbps over every link on the AdvancedTCA backplane simultaneously, and to monitor any possible connectivity failure immediately in terms of the link and slot positions inside the chassis. In this paper, we describe the design and the practical architectural hardware and software aspects of the AdvancedTCA Backplane Tester. We also pr...

Advanced practice nursing role delineation in acute and critical care: application of the strong model of advanced practice.

Science.gov (United States)

Mick, D J; Ackerman, M H

2000-01-01

This purpose of this study was to differentiate between the roles of clinical nurse specialists and acute care nurse practitioners. Hypothesized blending of the clinical nurse specialist and acute care nurse practitioner roles is thought to result in an acute care clinician who integrates the clinical skills of the nurse practitioner with the systems knowledge, educational commitment, and leadership ability of the clinical nurse specialist. Ideally, this role blending would facilitate excellence in both direct and indirect patient care. The Strong Model of Advanced Practice, which incorporates practice domains of direct comprehensive care, support of systems, education, research, and publication and professional leadership, was tested to search for practical evidence of role blending. This descriptive, exploratory, pilot study included subjects (N = 18) solicited from an academic medical center and from an Internet advanced practice listserv. Questionnaires included self-ranking of expertise in practice domains, as well as valuing of role-related tasks. Content validity was judged by an expert panel of advanced practice nurses. Analyses of descriptive statistics revealed that clinical nurse specialists, who had more experience both as registered nurses and in the advanced practice nurse role, self-ranked their expertise higher in all practice domains. Acute care nurse practitioners placed higher importance on tasks related to direct comprehensive care, including conducting histories and physicals, diagnosing, and performing diagnostic procedures, whereas clinical nurse specialists assigned greater importance to tasks related to education, research, and leadership. Levels of self-assessed clinical expertise as well as valuing of role-related tasks differed among this sample of clinical nurse specialists and acute care nurse practitioners. Groundwork has been laid for continuing exploration into differentiation in advanced practice nursing roles. As the clinical

Advanced Parkinson’s disease effect on goal-directed and habitual processes involved in visuomotor associative learning

Directory of Open Access Journals (Sweden)

Fadila eHadj-Bouziane

2013-01-01

Full Text Available The present behavioral study readdresses the question of habit learning in Parkinson's disease. Patients were early onset, non-demented, dopa-responsive, candidates for surgical treatment, similar to those we found earlier as suffering greater dopamine depletion in the putamen than in the caudate nucleus. The task was the same conditional associative learning task as that used previously in monkeys and healthy humans to unveil the striatum involvement in habit learning. Sixteen patients and 20 age- and education-matched healthy control subjects learned sets of 3 visuo-motor associations between complex patterns and joystick displacements during two testing sessions separated by a few hours. We distinguished errors preceding versus following the first correct response to compare patients' performance during the earliest phase of learning dominated by goal-directed actions with that observed later on, when responses start to become habitual. The disease significantly retarded both learning phases, especially in patients under sixty years of age. However, only the late phase deficit was disease severity-dependent and persisted on the second testing session. These findings provide the first corroboration in Parkinson patients of two ideas well-established in the animal literature. The first is the idea that associating visual stimuli to motor acts is a form of habit learning that engages the striatum. It is confirmed here by the global impairment in visuo-motor learning induced by Parkinson's disease. The second idea is that goal-directed behaviors are predominantly caudate-dependent whereas habitual responses are primarily putamen-dependent. At the advanced Parkinson's disease stages tested here, dopamine depletion is greater in the putamen than in the caudate nucleus. Accordingly, the late phase of learning corresponding to the emergence of habitual responses was more vulnerable to the disease than the early phase dominated by goal-directed

Proceedings of the advanced research and technology development direct utilization, instrumentation and diagnostics contractors' review meeting

Energy Technology Data Exchange (ETDEWEB)

Geiling, D.W. (USDOE Morgantown Energy Technology Center, WV (USA)); Goldberg, P.M. (eds.) (USDOE Pittsburgh Energy Technology Center, PA (USA))

1990-01-01

The 1990 Advanced Research and Technology Development (AR TD) Direct Utilization, and Instrumentation and Diagnostics Contractors Review Meeting was held September 16--18, 1990, at the Hyatt at Chatham Center in Pittsburgh, PA. The meeting was sponsored by the US Department of Energy (DOE), Office of Fossil Energy, and the Pittsburgh and Morgantown Energy Technology Centers. Each year the meeting provides a forum for the exchange of information among the DOE AR TD contractors and interested parties. This year's meeting was hosted by the Pittsburgh Energy Technology Center and was attended by 120 individuals from industry, academia, national laboratories, and other governmental agencies. Papers were presented on research addressing coal surface, science, devolatilization and combustion, ash behavior, emission controls for gases particulates, fluid bed combustion and utilization in diesels and turbines. Individual reports are processed separately for the data bases.

Fast wave direct electron heating in advanced inductive and ITER baseline scenario discharges in DIII-D

Energy Technology Data Exchange (ETDEWEB)

Pinsker, R. I.; Jackson, G. L.; Luce, T. C.; Politzer, P. A. [General Atomics, PO Box 85608, San Diego, California 92186-5608 (United States); Austin, M. E. [University of Texas at Austin, Austin, Texas 78712 (United States); Diem, S. J.; Kaufman, M. C.; Ryan, P. M. [Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831 (United States); Doyle, E. J.; Zeng, L. [University of California Los Angeles, Los Angeles, California 90095 (United States); Grierson, B. A.; Hosea, J. C.; Nagy, A.; Perkins, R.; Solomon, W. M.; Taylor, G. [Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543 (United States); Maggiora, R.; Milanesio, D. [Politecnico di Torino, Dipartimento di Elettronica, Torino (Italy); Porkolab, M. [Massachusetts Institute of Technology, Cambridge, Massachusetts 02139 (United States); Turco, F. [Columbia University, New York, New York 10027 (United States)

2014-02-12

Fast Wave (FW) heating and electron cyclotron heating (ECH) are used in the DIII-D tokamak to study plasmas with low applied torque and dominant electron heating characteristic of burning plasmas. FW heating via direct electron damping has reached the 2.5 MW level in high performance ELMy H-mode plasmas. In Advanced Inductive (AI) plasmas, core FW heating was found to be comparable to that of ECH, consistent with the excellent first-pass absorption of FWs predicted by ray-tracing models at high electron beta. FW heating at the ∼2 MW level to ELMy H-mode discharges in the ITER Baseline Scenario (IBS) showed unexpectedly strong absorption of FW power by injected neutral beam (NB) ions, indicated by significant enhancement of the D-D neutron rate, while the intended absorption on core electrons appeared rather weak. The AI and IBS discharges are compared in an effort to identify the causes of the different response to FWs.

Education of advanced practice nurses in Canada.

Science.gov (United States)

Martin-Misener, Ruth; Bryant-Lukosius, Denise; Harbman, Patricia; Donald, Faith; Kaasalainen, Sharon; Carter, Nancy; Kilpatrick, Kelley; DiCenso, Alba

2010-12-01

In Canada, education programs for the clinical nurse specialist (CNS) and nurse practitioner (NP) roles began 40 years ago. NP programs are offered in almost all provinces. Education for the CNS role has occurred through graduate nursing programs generically defined as providing preparation for advanced nursing practice. For this paper, we drew on pertinent sections of a scoping review of the literature and key informant interviews conducted for a decision support synthesis on advanced practice nursing to describe the following: (1) history of advanced practice nursing education in Canada, (2) current status of advanced practice nursing education in Canada, (3) curriculum issues, (4) interprofessional education, (5) resources for education and (6) continuing education. Although national frameworks defining advanced nursing practice and NP competencies provide some direction for education programs, Canada does not have countrywide standards of education for either the NP or CNS role. Inconsistency in the educational requirements for primary healthcare NPs continues to cause significant problems and interferes with inter-jurisdictional licensing portability. For both CNSs and NPs, there can be a mismatch between a generalized education and specialized practice. The value of interprofessional education in facilitating effective teamwork is emphasized. Recommendations for future directions for advanced practice nursing education are offered.

Degradation mechanism of alachlor during direct ozonation and O(3)/H(2)O(2) advanced oxidation process.

Science.gov (United States)

Qiang, Zhimin; Liu, Chao; Dong, Bingzhi; Zhang, Yalei

2010-01-01

The degradation of alachlor by direct ozonation and advanced oxidation process O(3)/H(2)O(2) was investigated in this study with focus on identification of degradation byproducts. The second-order reaction rate constant between ozone and alachlor was determined to be 2.5+/-0.1M(-1)s(-1) at pH 7.0 and 20 degrees C. Twelve and eight high-molecular-weight byproducts (with the benzene ring intact) from alachlor degradation were identified during direct ozonation and O(3)/H(2)O(2), respectively. The common degradation byproducts included N-(2,6-diethylphenyl)-methyleneamine, 8-ethyl-3,4-dihydro-quinoline, 8-ethyl-quinoline, 1-chloroacetyl-2-hydro-3-ketone-7-acetyl-indole, 2-chloro-2',6'-diacetyl-N-(methoxymethyl)acetanilide, 2-chloro-2'-acetyl-6'-ethyl-N-(methoxymethyl)-acetanilide, and two hydroxylated alachlor isomers. In direct ozonation, four more byproducts were also identified including 1-chloroacetyl-2,3-dihydro-7-ethyl-indole, 2-chloro-2',6'-ethyl-acetanilide, 2-chloro-2',6'-acetyl-acetanilide and 2-chloro-2'-ethyl-6'-acetyl-N-(methoxymethyl)-acetanilide. Degradation of alachlor by O(3) and O(3)/H(2)O(2) also led to the formation of low-molecular-weight byproducts including formic, acetic, propionic, monochloroacetic and oxalic acids as well as chloride ion (only detected in O(3)/H(2)O(2)). Nitrite and nitrate formation was negligible. Alachlor degradation occurred via oxidation of the arylethyl group, N-dealkylation, cyclization and cleavage of benzene ring. After O(3) or O(3)/H(2)O(2) treatment, the toxicity of alachlor solution examined by the Daphnia magna bioassay was slightly reduced. 2009 Elsevier Ltd. All rights reserved.

Effect of the PREPARE Website vs an Easy-to-Read Advance Directive on Advance Care Planning Documentation and Engagement Among Veterans: A Randomized Clinical Trial.

Science.gov (United States)

Sudore, Rebecca L; Boscardin, John; Feuz, Mariko A; McMahan, Ryan D; Katen, Mary T; Barnes, Deborah E

2017-08-01

Documentation rates of patients' medical wishes are often low. It is unknown whether easy-to-use, patient-facing advance care planning (ACP) interventions can overcome barriers to planning in busy primary care settings. To compare the efficacy of an interactive, patient-centered ACP website (PREPARE) with an easy-to-read advance directive (AD) to increase planning documentation. This was a comparative effectiveness randomized clinical trial from April 2013 to July 2016 conducted at multiple primary care clinics at the San Francisco VA Medical Center. Inclusion criteria were age of a least 60 years; at least 2 chronic and/or serious conditions; and 2 or more primary care visits; and 2 or more additional clinic, hospital, or emergency room visits in the last year. Participants were randomized to review PREPARE plus an easy-to-read AD or the AD alone. There were no clinician and/or system-level interventions or education. Research staff were blinded for all follow-up measurements. The primary outcome was new ACP documentation (ie, legal forms and/or discussions) at 9 months. Secondary outcomes included patient-reported ACP engagement at 1 week, 3 months, and 6 months using validated surveys of behavior change process measures (ie, 5-point knowledge, self-efficacy, readiness scales) and action measures (eg, surrogate designation, using a 0-25 scale). We used intention-to-treat, mixed-effects logistic and linear regression, controlling for time, health literacy, race/ethnicity, baseline ACP, and clustering by physician. The mean (SD) age of 414 participants was 71 (8) years, 38 (9%) were women, 83 (20%) had limited literacy, and 179 (43%) were nonwhite. No participant characteristic differed significantly among study arms at baseline. Retention at 6 months was 90%. Advance care planning documentation 6 months after enrollment was higher in the PREPARE arm vs the AD-alone arm (adjusted 35% vs 25%; odds ratio, 1.61 [95% CI, 1.03-2.51]; P = .04). PREPARE also resulted

Prevalence of use of advance directives, health care proxy, legal guardian, and living will in 512 patients hospitalized in a cardiac care unit/intensive care unit in 2 community hospitals.

Science.gov (United States)

Kumar, Anil; Aronow, Wilbert S; Alexa, Margelusa; Gothwal, Ritu; Jesmajian, Stephen; Bhushan, Bharat; Gaba, Praveen; Catevenis, James

2010-04-30

The prevalence of use of any advance directives was 26% in 112 patients hospitalized in a cardiac care unit (CCU)/intensive care unit (ICU) in an academic medical center. We investigated in 2 community hospitals the prevalence of use of advance directives (AD), health care proxy (HCP), legal guardian (LG), and living will (LW) in 512 patients hospitalized in a CCU/ ICU approached for AD and HCP. The use of AD was 22%, of HCP was 19%, of LG was 16%, and of LW was 5%. The use of AD was 22%, of HCP was 19%, of LG was 16%, and of LW was 5% in patients hospitalized in a CCU/ICU. Educational programs on use of AD and of HCP need to be part of cardiovascular training programs and of cardiovascular continuing medical education.

NATO Advanced Study Institute on Advanced Physical Oceanographic Numerical Modelling

CERN Document Server

1986-01-01

This book is a direct result of the NATO Advanced Study Institute held in Banyuls-sur-mer, France, June 1985. The Institute had the same title as this book. It was held at Laboratoire Arago. Eighty lecturers and students from almost all NATO countries attended. The purpose was to review the state of the art of physical oceanographic numerical modelling including the parameterization of physical processes. This book represents a cross-section of the lectures presented at the ASI. It covers elementary mathematical aspects through large scale practical aspects of ocean circulation calculations. It does not encompass every facet of the science of oceanographic modelling. We have, however, captured most of the essence of mesoscale and large-scale ocean modelling for blue water and shallow seas. There have been considerable advances in modelling coastal circulation which are not included. The methods section does not include important material on phase and group velocity errors, selection of grid structures, advanc...

Preschool life skills: Recent advancements and future directions.

Science.gov (United States)

Fahmie, Tara A; Luczynski, Kevin C

2018-01-01

Over the past decade, researchers have replicated and extended research on the preschool life skills (PLS) program developed by Hanley, Heal, Tiger, and Ingvarsson (2007). This review summarizes recent research with respect to maximizing skill acquisition, improving generality, evaluating feasibility and acceptability, and testing predictions of the initial PLS study. For each area, we suggest directions for future research. © 2018 Society for the Experimental Analysis of Behavior.

ARIES-AT: An advanced tokamak, advanced technology fusion power plant

International Nuclear Information System (INIS)

Najmabadi, F.; Jardin, S.C.; Tillack, M.; Waganer, L.M.

2001-01-01

The ARIES-AT study was initiated to assess the potential of high-performance tokamak plasmas together with advanced technology in a fusion power plant. Several avenues were pursued in order to arrive at plasmas with a higher β and better bootstrap alignment compared to ARIES-RS that led to plasmas with higher β N and β. Advanced technologies that are examined in detail include: (1) Possible improvements to the overall system by using high-temperature superconductors, (2) Innovative SiC blankets that lead to a high thermal cycle efficiency of ∼60%; and (3) Advanced manufacturing techniques which aim at producing near-finished products directly from raw material, resulting in low-cost, and reliable components. The 1000-MWe ARIES-AT design has a major radius of 5.4 m, minor radius of 1.3 M, a toroidal β of 9.2% (β N =6.0) and an on-axis field of 5.6 T. The plasma current is 13 MA and the current drive power is 24 MW. The ARIES-AT study shows that the combination of advanced tokamak modes and advanced technology leads to attractive fusion power plant with excellent safety and environmental characteristics and with a cost of electricity (5c/kWh), which is competitive with those projected for other sources of energy. (author)

Advanced SEM imaging

International Nuclear Information System (INIS)

Joy, D. C.; Newbury, D. E.

1998-01-01

The scanning electron microscope (SEM) represents the most promising tool for metrology, defect review, and for the analysis of ULSI structures, but both fundamental problems such as electron-solid interactions, and practical considerations such as electron-optical constraints, are now setting a limit to performance. This paper examines the directions in which an advanced SEM might be developed to overcome these constraints. The SEM also offers considerable promise as a tool for the high spatial resolution X-ray microanalysis, especially for those situations where a thin cross-section is not practical and first surface analysis is required. The ways in which this capability can be incorporated in an advanced SEM are examined

Advanced SEM imaging

International Nuclear Information System (INIS)

Joy, D.C.; Newbury, D.E.; Newbury, D.E.

1998-01-01

The scanning electron microscope (SEM) represents the most promising tool for metrology, defect review, and for the analysis of ULSI structures, but both fundamental problems such as electron-solid interactions, and practical considerations such as electron-optical constraints, are now setting a limit to performance. This paper examines the directions in which an advanced SEM might be developed to overcome these constraints. The SEM also offers considerable promise as a tool for the high spatial resolution X-ray microanalysis, especially for those situations where a thin cross-section is not practical and first surface analysis is required. The ways in which this capability can be incorporated in an advanced SEM are examined. copyright 1998 American Institute of Physics

Advanced control of direct-driven PMSG generator in wind turbine system

Directory of Open Access Journals (Sweden)

Gajewski Piotr

2016-12-01

Full Text Available The paper presents the advanced control system of the wind energy conversion with a variable speed wind turbine. The considered system consists of a wind turbine with the permanent magnet synchronous generator (PMSG, machine side converter (MSC, grid side converter (GSC and control circuits. The mathematical models of a wind turbine system, the PMSG generator and converters have been described. The control algorithms of the converter systems based on the methods of vector control have been applied. In the advanced control system of the machine side converter the optimal MPPT control method has been used. Additionally the pitch control scheme is included in order to achieve the limitation of maximum power and to prevent mechanical damage of the wind turbine. In the control system of the grid side converter the control of active and reactive power has been applied with the application of Voltage Oriented Control (VOC. The performance of the considered wind energy system has been studied by digital simulation. The results of simulation studies confirmed the good effectiveness of the considered wind turbine system and very good performance of the proposed methods of vector control and control systems.

Nuclear imaging: Advances and trends

International Nuclear Information System (INIS)

Herk, G. van

1986-01-01

In this article, nuclear imaging instruments that are likely to be of interest to the nuclear medicine community of developing countries are emphasized. The advances, trends, developments, and future directions in the field of nuclear imaging are mentioned

Advanced exhaust nozzle technology

Energy Technology Data Exchange (ETDEWEB)

Glidewell, R J; Warburton, R E

1981-01-01

Recent developments in turbine engine exhaust nozzle technology include nonaxisymmetric nozzles, thrust reversing, and thrust vectoring. Trade studies have been performed to determine the impact of these developments on the thrust-to-weight ratio and specific fuel consumption of an advanced high performance, augmented turbofan engine. Results are presented in a manner which provides an understanding of the sources and magnitudes of differences in the basic elements of nozzle internal performance and weight as they relate to conventional, axisymmetric nozzle technology. Conclusions are presented and recommendations are made with regard to future directions of advanced development and demonstration. 5 refs.

Advanced solid state batteries

Energy Technology Data Exchange (ETDEWEB)

Levasseur, A; Delmas, C; Menetrier, M; Hagenmuller, P

1984-01-01

Direct electrochemical storage of electricity is attractive because of its adaptability to vehicle traction as well as to stationary applications. Important advancements are necessary to improve primary or secondary batteries so far used. The aim of this study was to develop and to characterize materials for the next generation of advanced, rechargeable solid state batteries for vehicle transport and stationary storage applications. One of the best electricity storage systems was the lithium/intercalation compound secondary battery, though up to now the behavior of liquid organic electrolytes did not allow for good recycling in such systems. The research program for these batteries is described.

Directional Limits on Persistent Gravitational Waves from Advanced LIGO's First Observing Run.

Science.gov (United States)

Abbott, B P; Abbott, R; Abbott, T D; Abernathy, M R; Acernese, F; Ackley, K; Adams, C; Adams, T; Addesso, P; Adhikari, R X; Adya, V B; Affeldt, C; Agathos, M; Agatsuma, K; Aggarwal, N; Aguiar, O D; Aiello, L; Ain, A; Ajith, P; Allen, B; Allocca, A; Altin, P A; Ananyeva, A; Anderson, S B; Anderson, W G; Appert, S; Arai, K; Araya, M C; Areeda, J S; Arnaud, N; Arun, K G; Ascenzi, S; Ashton, G; Ast, M; Aston, S M; Astone, P; Aufmuth, P; Aulbert, C; Avila-Alvarez, A; Babak, S; Bacon, P; Bader, M K M; Baker, P T; Baldaccini, F; Ballardin, G; Ballmer, S W; Barayoga, J C; Barclay, S E; Barish, B C; Barker, D; Barone, F; Barr, B; Barsotti, L; Barsuglia, M; Barta, D; Bartlett, J; Bartos, I; Bassiri, R; Basti, A; Batch, J C; Baune, C; Bavigadda, V; Bazzan, M; Beer, C; Bejger, M; Belahcene, I; Belgin, M; Bell, A S; Berger, B K; Bergmann, G; Berry, C P L; Bersanetti, D; Bertolini, A; Betzwieser, J; Bhagwat, S; Bhandare, R; Bilenko, I A; Billingsley, G; Billman, C R; Birch, J; Birney, R; Birnholtz, O; Biscans, S; Biscoveanu, A S; Bisht, A; Bitossi, M; Biwer, C; Bizouard, M A; Blackburn, J K; Blackman, J; Blair, C D; Blair, D G; Blair, R M; Bloemen, S; Bock, O; Boer, M; Bogaert, G; Bohe, A; Bondu, F; Bonnand, R; Boom, B A; Bork, R; Boschi, V; Bose, S; Bouffanais, Y; Bozzi, A; Bradaschia, C; Brady, P R; Braginsky, V B; Branchesi, M; Brau, J E; Briant, T; Brillet, A; Brinkmann, M; Brisson, V; Brockill, P; Broida, J E; Brooks, A F; Brown, D A; Brown, D D; Brown, N M; Brunett, S; Buchanan, C C; Buikema, A; Bulik, T; Bulten, H J; Buonanno, A; Buskulic, D; Buy, C; Byer, R L; Cabero, M; Cadonati, L; Cagnoli, G; Cahillane, C; Calderón Bustillo, J; Callister, T A; Calloni, E; Camp, J B; Campbell, W; Canepa, M; Cannon, K C; Cao, H; Cao, J; Capano, C D; Capocasa, E; Carbognani, F; Caride, S; Casanueva Diaz, J; Casentini, C; Caudill, S; Cavaglià, M; Cavalier, F; Cavalieri, R; Cella, G; Cepeda, C B; Cerboni Baiardi, L; Cerretani, G; Cesarini, E; Chamberlin, S J; Chan, M; Chao, S; Charlton, P; Chassande-Mottin, E; Cheeseboro, B D; Chen, H Y; Chen, Y; Cheng, H-P; Chincarini, A; Chiummo, A; Chmiel, T; Cho, H S; Cho, M; Chow, J H; Christensen, N; Chu, Q; Chua, A J K; Chua, S; Chung, S; Ciani, G; Clara, F; Clark, J A; Cleva, F; Cocchieri, C; Coccia, E; Cohadon, P-F; Colla, A; Collette, C G; Cominsky, L; Constancio, M; Conti, L; Cooper, S J; Corbitt, T R; Cornish, N; Corsi, A; Cortese, S; Costa, C A; Coughlin, E; Coughlin, M W; Coughlin, S B; Coulon, J-P; Countryman, S T; Couvares, P; Covas, P B; Cowan, E E; Coward, D M; Cowart, M J; Coyne, D C; Coyne, R; Creighton, J D E; Creighton, T D; Cripe, J; Crowder, S G; Cullen, T J; Cumming, A; Cunningham, L; Cuoco, E; Dal Canton, T; Danilishin, S L; D'Antonio, S; Danzmann, K; Dasgupta, A; Da Silva Costa, C F; Dattilo, V; Dave, I; Davier, M; Davies, G S; Davis, D; Daw, E J; Day, B; Day, R; De, S; DeBra, D; Debreczeni, G; Degallaix, J; De Laurentis, M; Deléglise, S; Del Pozzo, W; Denker, T; Dent, T; Dergachev, V; De Rosa, R; DeRosa, R T; DeSalvo, R; Devenson, J; Devine, R C; Dhurandhar, S; Díaz, M C; Di Fiore, L; Di Giovanni, M; Di Girolamo, T; Di Lieto, A; Di Pace, S; Di Palma, I; Di Virgilio, A; Doctor, Z; Dolique, V; Donovan, F; Dooley, K L; Doravari, S; Dorrington, I; Douglas, R; Dovale Álvarez, M; Downes, T P; Drago, M; Drever, R W P; Driggers, J C; Du, Z; Ducrot, M; Dwyer, S E; Edo, T B; Edwards, M C; Effler, A; Eggenstein, H-B; Ehrens, P; Eichholz, J; Eikenberry, S S; Essick, R C; Etienne, Z; Etzel, T; Evans, M; Evans, T M; Everett, R; Factourovich, M; Fafone, V; Fair, H; Fairhurst, S; Fan, X; Farinon, S; Farr, B; Farr, W M; Fauchon-Jones, E J; Favata, M; Fays, M; Fehrmann, H; Fejer, M M; Fernández Galiana, A; Ferrante, I; Ferreira, E C; Ferrini, F; Fidecaro, F; Fiori, I; Fiorucci, D; Fisher, R P; Flaminio, R; Fletcher, M; Fong, H; Forsyth, S S; Fournier, J-D; Frasca, S; Frasconi, F; Frei, Z; Freise, A; Frey, R; Frey, V; Fries, E M; Fritschel, P; Frolov, V V; Fulda, P; Fyffe, M; Gabbard, H; Gadre, B U; Gaebel, S M; Gair, J R; Gammaitoni, L; Gaonkar, S G; Garufi, F; Gaur, G; Gayathri, V; Gehrels, N; Gemme, G; Genin, E; Gennai, A; George, J; Gergely, L; Germain, V; Ghonge, S; Ghosh, Abhirup; Ghosh, Archisman; Ghosh, S; Giaime, J A; Giardina, K D; Giazotto, A; Gill, K; Glaefke, A; Goetz, E; Goetz, R; Gondan, L; González, G; Gonzalez Castro, J M; Gopakumar, A; Gorodetsky, M L; Gossan, S E; Gosselin, M; Gouaty, R; Grado, A; Graef, C; Granata, M; Grant, A; Gras, S; Gray, C; Greco, G; Green, A C; Groot, P; Grote, H; Grunewald, S; Guidi, G M; Guo, X; Gupta, A; Gupta, M K; Gushwa, K E; Gustafson, E K; Gustafson, R; Hacker, J J; Hall, B R; Hall, E D; Hammond, G; Haney, M; Hanke, M M; Hanks, J; Hanna, C; Hannam, M D; Hanson, J; Hardwick, T; Harms, J; Harry, G M; Harry, I W; Hart, M J; Hartman, M T; Haster, C-J; Haughian, K; Healy, J; Heidmann, A; Heintze, M C; Heitmann, H; Hello, P; Hemming, G; Hendry, M; Heng, I S; Hennig, J; Henry, J; Heptonstall, A W; Heurs, M; Hild, S; Hoak, D; Hofman, D; Holt, K; Holz, D E; Hopkins, P; Hough, J; Houston, E A; Howell, E J; Hu, Y M; Huerta, E A; Huet, D; Hughey, B; Husa, S; Huttner, S H; Huynh-Dinh, T; Indik, N; Ingram, D R; Inta, R; Isa, H N; Isac, J-M; Isi, M; Isogai, T; Iyer, B R; Izumi, K; Jacqmin, T; Jani, K; Jaranowski, P; Jawahar, S; Jiménez-Forteza, F; Johnson, W W; Jones, D I; Jones, R; Jonker, R J G; Ju, L; Junker, J; Kalaghatgi, C V; Kalogera, V; Kandhasamy, S; Kang, G; Kanner, J B; Karki, S; Karvinen, K S; Kasprzack, M; Katsavounidis, E; Katzman, W; Kaufer, S; Kaur, T; Kawabe, K; Kéfélian, F; Keitel, D; Kelley, D B; Kennedy, R; Key, J S; Khalili, F Y; Khan, I; Khan, S; Khan, Z; Khazanov, E A; Kijbunchoo, N; Kim, Chunglee; Kim, J C; Kim, Whansun; Kim, W; Kim, Y-M; Kimbrell, S J; King, E J; King, P J; Kirchhoff, R; Kissel, J S; Klein, B; Kleybolte, L; Klimenko, S; Koch, P; Koehlenbeck, S M; Koley, S; Kondrashov, V; Kontos, A; Korobko, M; Korth, W Z; Kowalska, I; Kozak, D B; Krämer, C; Kringel, V; Królak, A; Kuehn, G; Kumar, P; Kumar, R; Kuo, L; Kutynia, A; Lackey, B D; Landry, M; Lang, R N; Lange, J; Lantz, B; Lanza, R K; Lartaux-Vollard, A; Lasky, P D; Laxen, M; Lazzarini, A; Lazzaro, C; Leaci, P; Leavey, S; Lebigot, E O; Lee, C H; Lee, H K; Lee, H M; Lee, K; Lehmann, J; Lenon, A; Leonardi, M; Leong, J R; Leroy, N; Letendre, N; Levin, Y; Li, T G F; Libson, A; Littenberg, T B; Liu, J; Lockerbie, N A; Lombardi, A L; London, L T; Lord, J E; Lorenzini, M; Loriette, V; Lormand, M; Losurdo, G; Lough, J D; Lousto, C O; Lovelace, G; Lück, H; Lundgren, A P; Lynch, R; Ma, Y; Macfoy, S; Machenschalk, B; MacInnis, M; Macleod, D M; Magaña-Sandoval, F; Majorana, E; Maksimovic, I; Malvezzi, V; Man, N; Mandic, V; Mangano, V; Mansell, G L; Manske, M; Mantovani, M; Marchesoni, F; Marion, F; Márka, S; Márka, Z; Markosyan, A S; Maros, E; Martelli, F; Martellini, L; Martin, I W; Martynov, D V; Mason, K; Masserot, A; Massinger, T J; Masso-Reid, M; Mastrogiovanni, S; Matas, A; Matichard, F; Matone, L; Mavalvala, N; Mazumder, N; McCarthy, R; McClelland, D E; McCormick, S; McGrath, C; McGuire, S C; McIntyre, G; McIver, J; McManus, D J; McRae, T; McWilliams, S T; Meacher, D; Meadors, G D; Meidam, J; Melatos, A; Mendell, G; Mendoza-Gandara, D; Mercer, R A; Merilh, E L; Merzougui, M; Meshkov, S; Messenger, C; Messick, C; Metzdorff, R; Meyers, P M; Mezzani, F; Miao, H; Michel, C; Middleton, H; Mikhailov, E E; Milano, L; Miller, A L; Miller, A; Miller, B B; Miller, J; Millhouse, M; Minenkov, Y; Ming, J; Mirshekari, S; Mishra, C; Mitra, S; Mitrofanov, V P; Mitselmakher, G; Mittleman, R; Moggi, A; Mohan, M; Mohapatra, S R P; Montani, M; Moore, B C; Moore, C J; Moraru, D; Moreno, G; Morriss, S R; Mours, B; Mow-Lowry, C M; Mueller, G; Muir, A W; Mukherjee, Arunava; Mukherjee, D; Mukherjee, S; Mukund, N; Mullavey, A; Munch, J; Muniz, E A M; Murray, P G; Mytidis, A; Napier, K; Nardecchia, I; Naticchioni, L; Nelemans, G; Nelson, T J N; Neri, M; Nery, M; Neunzert, A; Newport, J M; Newton, G; Nguyen, T T; Nielsen, A B; Nissanke, S; Nitz, A; Noack, A; Nocera, F; Nolting, D; Normandin, M E N; Nuttall, L K; Oberling, J; Ochsner, E; Oelker, E; Ogin, G H; Oh, J J; Oh, S H; Ohme, F; Oliver, M; Oppermann, P; Oram, Richard J; O'Reilly, B; O'Shaughnessy, R; Ottaway, D J; Overmier, H; Owen, B J; Pace, A E; Page, J; Pai, A; Pai, S A; Palamos, J R; Palashov, O; Palomba, C; Pal-Singh, A; Pan, H; Pankow, C; Pannarale, F; Pant, B C; Paoletti, F; Paoli, A; Papa, M A; Paris, H R; Parker, W; Pascucci, D; Pasqualetti, A; Passaquieti, R; Passuello, D; Patricelli, B; Pearlstone, B L; Pedraza, M; Pedurand, R; Pekowsky, L; Pele, A; Penn, S; Perez, C J; Perreca, A; Perri, L M; Pfeiffer, H P; Phelps, M; Piccinni, O J; Pichot, M; Piergiovanni, F; Pierro, V; Pillant, G; Pinard, L; Pinto, I M; Pitkin, M; Poe, M; Poggiani, R; Popolizio, P; Post, A; Powell, J; Prasad, J; Pratt, J W W; Predoi, V; Prestegard, T; Prijatelj, M; Principe, M; Privitera, S; Prodi, G A; Prokhorov, L G; Puncken, O; Punturo, M; Puppo, P; Pürrer, M; Qi, H; Qin, J; Qiu, S; Quetschke, V; Quintero, E A; Quitzow-James, R; Raab, F J; Rabeling, D S; Radkins, H; Raffai, P; Raja, S; Rajan, C; Rakhmanov, M; Rapagnani, P; Raymond, V; Razzano, M; Re, V; Read, J; Regimbau, T; Rei, L; Reid, S; Reitze, D H; Rew, H; Reyes, S D; Rhoades, E; Ricci, F; Riles, K; Rizzo, M; Robertson, N A; Robie, R; Robinet, F; Rocchi, A; Rolland, L; Rollins, J G; Roma, V J; Romano, J D; Romano, R; Romie, J H; Rosińska, D; Rowan, S; Rüdiger, A; Ruggi, P; Ryan, K; Sachdev, S; Sadecki, T; Sadeghian, L; Sakellariadou, M; Salconi, L; Saleem, M; Salemi, F; Samajdar, A; Sammut, L; Sampson, L M; Sanchez, E J; Sandberg, V; Sanders, J R; Sassolas, B; Sathyaprakash, B S; Saulson, P R; Sauter, O; Savage, R L; Sawadsky, A; Schale, P; Scheuer, J; Schlassa, S; Schmidt, E; Schmidt, J; Schmidt, P; Schnabel, R; Schofield, R M S; Schönbeck, A; Schreiber, E; Schuette, D; Schutz, B F; Schwalbe, S G; Scott, J; Scott, S M; Sellers, D; Sengupta, A S; Sentenac, D; Sequino, V; Sergeev, A; Setyawati, Y; Shaddock, D A; Shaffer, T J; Shahriar, M S; Shapiro, B; Shawhan, P; Sheperd, A; Shoemaker, D H; Shoemaker, D M; Siellez, K; Siemens, X; Sieniawska, M; Sigg, D; Silva, A D; Singer, A; Singer, L P; Singh, A; Singh, R; Singhal, A; Sintes, A M; Slagmolen, B J J; Smith, B; Smith, J R; Smith, R J E; Son, E J; Sorazu, B; Sorrentino, F; Souradeep, T; Spencer, A P; Srivastava, A K; Staley, A; Steinke, M; Steinlechner, J; Steinlechner, S; Steinmeyer, D; Stephens, B C; Stevenson, S P; Stone, R; Strain, K A; Straniero, N; Stratta, G; Strigin, S E; Sturani, R; Stuver, A L; Summerscales, T Z; Sun, L; Sunil, S; Sutton, P J; Swinkels, B L; Szczepańczyk, M J; Tacca, M; Talukder, D; Tanner, D B; Tao, D; Tápai, M; Taracchini, A; Taylor, R; Theeg, T; Thomas, E G; Thomas, M; Thomas, P; Thorne, K A; Thrane, E; Tippens, T; Tiwari, S; Tiwari, V; Tokmakov, K V; Toland, K; Tomlinson, C; Tonelli, M; Tornasi, Z; Torrie, C I; Töyrä, D; Travasso, F; Traylor, G; Trifirò, D; Trinastic, J; Tringali, M C; Trozzo, L; Tse, M; Tso, R; Turconi, M; Tuyenbayev, D; Ugolini, D; Unnikrishnan, C S; Urban, A L; Usman, S A; Vahlbruch, H; Vajente, G; Valdes, G; van Bakel, N; van Beuzekom, M; van den Brand, J F J; Van Den Broeck, C; Vander-Hyde, D C; van der Schaaf, L; van Heijningen, J V; van Veggel, A A; Vardaro, M; Varma, V; Vass, S; Vasúth, M; Vecchio, A; Vedovato, G; Veitch, J; Veitch, P J; Venkateswara, K; Venugopalan, G; Verkindt, D; Vetrano, F; Viceré, A; Viets, A D; Vinciguerra, S; Vine, D J; Vinet, J-Y; Vitale, S; Vo, T; Vocca, H; Vorvick, C; Voss, D V; Vousden, W D; Vyatchanin, S P; Wade, A R; Wade, L E; Wade, M; Walker, M; Wallace, L; Walsh, S; Wang, G; Wang, H; Wang, M; Wang, Y; Ward, R L; Warner, J; Was, M; Watchi, J; Weaver, B; Wei, L-W; Weinert, M; Weinstein, A J; Weiss, R; Wen, L; Weßels, P; Westphal, T; Wette, K; Whelan, J T; Whiting, B F; Whittle, C; Williams, D; Williams, R D; Williamson, A R; Willis, J L; Willke, B; Wimmer, M H; Winkler, W; Wipf, C C; Wittel, H; Woan, G; Woehler, J; Worden, J; Wright, J L; Wu, D S; Wu, G; Yam, W; Yamamoto, H; Yancey, C C; Yap, M J; Yu, Hang; Yu, Haocun; Yvert, M; Zadrożny, A; Zangrando, L; Zanolin, M; Zendri, J-P; Zevin, M; Zhang, L; Zhang, M; Zhang, T; Zhang, Y; Zhao, C; Zhou, M; Zhou, Z; Zhu, S J; Zhu, X J; Zucker, M E; Zweizig, J

2017-03-24

We employ gravitational-wave radiometry to map the stochastic gravitational wave background expected from a variety of contributing mechanisms and test the assumption of isotropy using data from the Advanced Laser Interferometer Gravitational Wave Observatory's (aLIGO) first observing run. We also search for persistent gravitational waves from point sources with only minimal assumptions over the 20-1726 Hz frequency band. Finding no evidence of gravitational waves from either point sources or a stochastic background, we set limits at 90% confidence. For broadband point sources, we report upper limits on the gravitational wave energy flux per unit frequency in the range F_{α,Θ}(f)<(0.1-56)×10^{-8}    erg cm^{-2} s^{-1} Hz^{-1}(f/25  Hz)^{α-1} depending on the sky location Θ and the spectral power index α. For extended sources, we report upper limits on the fractional gravitational wave energy density required to close the Universe of Ω(f,Θ)<(0.39-7.6)×10^{-8}  sr^{-1}(f/25  Hz)^{α} depending on Θ and α. Directed searches for narrowband gravitational waves from astrophysically interesting objects (Scorpius X-1, Supernova 1987 A, and the Galactic Center) yield median frequency-dependent limits on strain amplitude of h_{0}<(6.7,5.5,  and  7.0)×10^{-25}, respectively, at the most sensitive detector frequencies between 130-175 Hz. This represents a mean improvement of a factor of 2 across the band compared to previous searches of this kind for these sky locations, considering the different quantities of strain constrained in each case.

[Advance directives in Italy: a goal not yet reached but already passed?].

Science.gov (United States)

Riccioni, Luigi; Gristina, Giuseppe

2015-10-01

The advance directives (ADs) have been adopted in many countries to defend patients' autonomy. In Italy, in the past, this topic gave rise to a heated debate involving philosophers, theologians, and politicians. In 2009, the government presented a bill of law on ADs firmly criticized from a scientific, moral and juridical point of view because the bill's content is against the principles of Italian Constitution, Italian Code of Medical Ethics, Oviedo Convention, and official statements of many scientific societies. Although the bill has passed the Low Chamber it lies, even since, in the Senate, lacking in regard any agreement among the political parties. The purpose of this article is to highlight that, in our country, patients, relatives and doctors deserve a law not only related to the specific topic of ADs, but - as in other European countries (Germany, Spain, France, UK) - aimed to deal with the complex issue of end of life care as a whole. This law should take into account the sound evidence existing in regard to the four fundamental principles supporting the best scientific and ethical approaches to the end of life issues: shared decision making process between doctors and patients/relatives; rejection of dying process marked by the suffering; withholding/withdrawing futile treatments together with palliative sedation as two crucial contributions to suppress the patient suffering and pain; clear-cut difference between these clinical/ethical options and euthanasia. At the same time, this law should be able to provide physicians with a legal coverage to make all the clinical and ethical decisions more and more complex because of the continuous evolution of medical science on one hand, and the impressive development of biotechnology on the other hand.

Microwave and particle beam sources and directed energy concepts

International Nuclear Information System (INIS)

Brandt, H.E.

1989-01-01

This book containing the proceedings of the SPIE on microwave and particle beam sources and directed energy concepts. Topics covered include: High power microwave sources, Direct energy concepts, Advanced accelerators, and Particle beams

Advance Directives

Science.gov (United States)

... Data Conducting Clinical Trials Statistical Tools and Data Terminology Resources NCI Data Catalog Cryo-EM NCI's Role ... Withholding food and fluids Organ and tissue donation Medical Power of Attorney This is a document that ...

Advance directives or living wills: reflections of general practitioners ...

African Journals Online (AJOL)

Background: Living wills have long been associated with end-of-life care. This study explored the promotion of living wills by general practitioners (GPs) and frail care nursing coordinators who were directly involved in the care of the elderly in Howick, KwaZulu-Natal. The study also explored their views regarding the pro ...

Study of Advanced Propulsion Systems for Small Transport Aircraft Technology (STAT) Program

Science.gov (United States)

Baerst, C. F.; Heldenbrand, R. W.; Rowse, J. H.

1981-01-01

Definitions of takeoff gross weight, performance, and direct operating cost for both a 30 and 50 passenger airplane were established. The results indicate that a potential direct operating cost benefit, resulting from advanced technologies, of approximately 20 percent would be achieved for the 1990 engines. Of the numerous design features that were evaluated, only maintenance-related items contributed to a significant decrease in direct operating cost. Recommendations are made to continue research and technology programs for advanced component and engine development.

Sigma Team for Advanced Actinide Recycle FY2015 Accomplishments and Directions

Energy Technology Data Exchange (ETDEWEB)

Moyer, Bruce A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2015-09-30

noncomplexing aqueous solution and submission of this scientific breakthrough as a paper in Science; The first-ever co-crystallization of Am(VI) with UO₂(NO₃)₂ ∙ 6H₂O, opening the door to a new approach for separating hexavalent actinides as a group; Results showing that three potentially problematic metals will not present risk in ALSEP; Improvement in ALSEP contactor stripping kinetics to acceptable performance; A comparison of centrifugal contactors vs mixer-settlers showing the former performs better in ALSEP stripping; Synthesis of new mixed N,O-donor extractants with enhanced solubility and strength for selective trivalent actinide extraction; Development of computational methods showing promise in prediction of the selectivity of new extractants for trivalent actinides vs lanthanides; An order-of-magnitude improvement in aqueous Am/Eu complexation selectivity of an alternative macrocyclic stripping agent for ALSEP, potentially enabling an option for an Am product stream free from both Ln and Cm. An alternative aqueous combination of dipicolinate complexant and malonate buffer that may present options for ALSEP and TALSPEAK (Trivalent Actinide-Lanthanide Separations by Phosphorus-reagent Extraction from Aqueous Komplexes) type separations. The ALSEP concept is advancing toward a benchtop flowsheet demonstration planned for FY 2016, and a bench-scale test bed at Idaho National Laboratory (INL) will be employed to demonstrate at least one tandem Am oxidation and separation concept. This report outlines the goals of the STAAR, significance of achieving these goals, STAAR organization around the above aims and questions, recent highlights, and future directions. The report also includes a listing of publications, reports, patents, and dissertations.

The factors impacted to local contractor from Foreign Direct Investment in advancing economic hub development in Iskandar Malaysia

Science.gov (United States)

Syafiq Salim, Muhamad; Zakaria, Rozana; Aminuddin, Eeydzah; Hamid, Abdul Rahim Abdul; Abdullah, Redzuan; Shahzaib Khan, Jam

2018-04-01

Iskandar Malaysia is an advanced economic hub which is rapidly growing in the State of Johor. It has been an attractive place for Foreign Direct Investment (FDI) to invest. Many sectors are affected by the presence of FDI including the construction sector. This paper highlights the investigation on the effects of FDI to the local contractor in the Iskandar Malaysia Development. In this study, a questionnaire survey was carried out to gain the information on problems from internal factors and external factors that caused the limitation on involvement in FDI project by local contractors. 73 numbers of local contractor registered under CIDB in class G5, G6 and G7 are the respondents. Frequency analysis and Average Index Analysis are used for the results. This study provides the factors that impacted local construction players in Iskandar Malaysia Development. This study has portrayed that FDI plays a vital and significant role in spearheading the active involvement of local contractors in an urban sustainable development.

Performance of direct and iterative algorithms on an optical systolic processor

Science.gov (United States)

Ghosh, A. K.; Casasent, D.; Neuman, C. P.

1985-11-01

The frequency-multiplexed optical linear algebra processor (OLAP) is treated in detail with attention to its performance in the solution of systems of linear algebraic equations (LAEs). General guidelines suitable for most OLAPs, including digital-optical processors, are advanced concerning system and component error source models, guidelines for appropriate use of direct and iterative algorithms, the dominant error sources, and the effect of multiple simultaneous error sources. Specific results are advanced on the quantitative performance of both direct and iterative algorithms in the solution of systems of LAEs and in the solution of nonlinear matrix equations. Acoustic attenuation is found to dominate iterative algorithms and detector noise to dominate direct algorithms. The effect of multiple spatial errors is found to be additive. A theoretical expression for the amount of acoustic attenuation allowed is advanced and verified. Simulations and experimental data are included.

Recent advances on Zeolite modification for direct alcohol fuel cells (DAFCs)

Science.gov (United States)

Makertihartha, I. G. B. N.; Zunita, M.; Rizki, Z.; Dharmawijaya, P. T.

2017-03-01

The increase of energy demand and global warming issues has driven studies of alternative energy sources. The polymer electrolyte membrane fuel cell (PEMFC) can be an alternative energy source by (partially) replacing the use of fossil fuel which is in line with the green technology concept. However, the usage of hydrogen as a fuel has several disadvantages mainly transportation and storage related to its safety aspects. Recently, alcohol has gained attention as an energy source for fuel cell application, namely direct alcohol fuel cell (DAFC). Among alcohols, high-mass energy density methanol and ethanol are widely used as direct methanol fuel cell (DMFC) and direct ethanol fuel cell (DEFC), respectively. Currently, the performance of DMFC is still rudimentary. Furthermore, the use of ethanol gives some additional privileges such as non-toxic property, renewable, ease of production in great quantity by the fermentation of sugar-containing raw materials. Direct alcohol fuel cell (DAFC) still has weakness in the low proton conductivity and high alcohol crossover. Therefore, to increase the performance of DAFC, modification using zeolite has been performed to improve proton conductivity and decrease alcohol crossover. Zeolite also has high thermal resistance properties, thereby increasing DAFC performance. This paper will discuss briefly about modification of catalyst and membrane for DAFC using zeolite. Zeolite modification effect on fuel cell performance especially proton conductivity and alcohol crossover will be presented in detail.

Practical and Ethical Aspects of Advance Research Directives for Research on Healthy Aging: German and Israeli Professionals' Perspectives.

Science.gov (United States)

Werner, Perla; Schicktanz, Silke

2018-01-01

Healthy aging is the development and maintenance of optimal cognitive, social and physical well-being, and function in older adults. Preventing or minimizing disease is one of the main ways of achieving healthy aging. Dementia is one of the most prevalent and life-changing diseases of old age. Thus, dementia prevention research is defined as one of the main priorities worldwide. However, conducting research with persons who lack the capacity to give consent is a major ethical issue. Our study attempts to explore if and how advance research directives (ARDs) may be used as a future tool to deal with the ethical and practical issues in dementia research. We conducted focus groups and in-depth interviews with German and Israeli professional stakeholders from the fields of gerontology, ethics, medical law, psychiatry, neurology and policy advice ( n  = 16), and analyzed the main topics discussed regarding cross-national similarities and controversies within the groups, as well as across the two national contexts. While both countries are in the midst of a developmental process and have recognized the importance and need for ARD as a tool for expanding healthy aging, Germany is in a more advanced stage than Israel because of the EU regulation process, which indicates the influence of international harmonization on these research-related ethical issues. Consensual themes within the qualitative material were identified: the need for a broader debate on ARD, the ethical importance of autonomy and risk-benefit assessment for ARD implementation, the role of the proxy and the need for the differentiation of types of dementia research. Controversies and dilemmas aroused around themes such as the current role of IRBs in each country, the need for limits, and how to guaranty safeguarding and control. Implementing a new tool is a step-by-step procedure requiring a thorough understanding of the current state of knowledge as well as of the challenges and hurdles ahead. As long

Practical and Ethical Aspects of Advance Research Directives for Research on Healthy Aging: German and Israeli Professionals’ Perspectives

Directory of Open Access Journals (Sweden)

Perla Werner

2018-04-01

Full Text Available BackgroundHealthy aging is the development and maintenance of optimal cognitive, social and physical well-being, and function in older adults. Preventing or minimizing disease is one of the main ways of achieving healthy aging. Dementia is one of the most prevalent and life-changing diseases of old age. Thus, dementia prevention research is defined as one of the main priorities worldwide. However, conducting research with persons who lack the capacity to give consent is a major ethical issue.ObjectiveOur study attempts to explore if and how advance research directives (ARDs may be used as a future tool to deal with the ethical and practical issues in dementia research.MethodWe conducted focus groups and in-depth interviews with German and Israeli professional stakeholders from the fields of gerontology, ethics, medical law, psychiatry, neurology and policy advice (n = 16, and analyzed the main topics discussed regarding cross-national similarities and controversies within the groups, as well as across the two national contexts.ResultsWhile both countries are in the midst of a developmental process and have recognized the importance and need for ARD as a tool for expanding healthy aging, Germany is in a more advanced stage than Israel because of the EU regulation process, which indicates the influence of international harmonization on these research-related ethical issues. Consensual themes within the qualitative material were identified: the need for a broader debate on ARD, the ethical importance of autonomy and risk–benefit assessment for ARD implementation, the role of the proxy and the need for the differentiation of types of dementia research. Controversies and dilemmas aroused around themes such as the current role of IRBs in each country, the need for limits, and how to guaranty safeguarding and control.DiscussionImplementing a new tool is a step-by-step procedure requiring a thorough understanding of the current state of knowledge

Default options in advance directives: study protocol for a randomised clinical trial

Science.gov (United States)

Gabler, Nicole B; Cooney, Elizabeth; Small, Dylan S; Troxel, Andrea B; Arnold, Robert M; White, Douglas B; Angus, Derek C; Loewenstein, George; Volpp, Kevin G; Bryce, Cindy L; Halpern, Scott D

2016-01-01

Introduction Although most seriously ill Americans wish to avoid burdensome and aggressive care at the end of life, such care is often provided unless patients or family members specifically request otherwise. Advance directives (ADs) were created to provide opportunities to set limits on aggressive care near life's end. This study tests the hypothesis that redesigning ADs such that comfort-oriented care is provided as the default, rather than requiring patients to actively choose it, will promote better patient-centred outcomes. Methods and analysis This multicentre trial randomises seriously ill adults to receive 1 of 3 different ADs: (1) a traditional AD that requires patients to actively choose their goals of care or preferences for specific interventions (eg, feeding tube insertion) or otherwise have their care guided by their surrogates and the prevailing societal default toward aggressive care; (2) an AD that defaults to life-extending care and receipt of life-sustaining interventions, enabling patients to opt out from such care; or (3) an AD that defaults to comfort care, enabling patients to opt into life-extending care. We seek to enrol 270 patients who return complete, legally valid ADs so as to generate sufficient power to detect differences in the primary outcome of hospital-free days (days alive and not in an acute care facility). Secondary outcomes include hospital and intensive care unit admissions, costs of care, hospice usage, decision conflict and satisfaction, quality of life, concordance of preferences with care received and bereavement outcomes for surrogates of patients who die. Ethics and dissemination This study has been approved by the Institutional Review Boards at all trial centres, and is guided by a data safety and monitoring board and an ethics advisory board. Study results will be disseminated using methods that describe the results in ways that key stakeholders can best understand and implement. Trial registration number NCT02017548

1996 Laboratory directed research and development annual report

Energy Technology Data Exchange (ETDEWEB)

Meyers, C.E.; Harvey, C.L.; Lopez-Andreas, L.M.; Chavez, D.L.; Whiddon, C.P. [comp.

1997-04-01

This report summarizes progress from the Laboratory Directed Research and Development (LDRD) program during fiscal year 1996. In addition to a programmatic and financial overview, the report includes progress reports from 259 individual R&D projects in seventeen categories. The general areas of research include: engineered processes and materials; computational and information sciences; microelectronics and photonics; engineering sciences; pulsed power; advanced manufacturing technologies; biomedical engineering; energy and environmental science and technology; advanced information technologies; counterproliferation; advanced transportation; national security technology; electronics technologies; idea exploration and exploitation; production; and science at the interfaces - engineering with atoms.

A model for emergency department end-of-life communications after acute devastating events--part I: decision-making capacity, surrogates, and advance directives.

Science.gov (United States)

Limehouse, Walter E; Feeser, V Ramana; Bookman, Kelly J; Derse, Arthur

2012-09-01

Making decisions for a patient affected by sudden devastating illness or injury traumatizes a patient's family and loved ones. Even in the absence of an emergency, surrogates making end-of-life treatment decisions may experience negative emotional effects. Helping surrogates with these end-of-life decisions under emergent conditions requires the emergency physician (EP) to be clear, making medical recommendations with sensitivity. This model for emergency department (ED) end-of-life communications after acute devastating events comprises the following steps: 1) determine the patient's decision-making capacity; 2) identify the legal surrogate; 3) elicit patient values as expressed in completed advance directives; 4) determine patient/surrogate understanding of the life-limiting event and expectant treatment goals; 5) convey physician understanding of the event, including prognosis, treatment options, and recommendation; 6) share decisions regarding withdrawing or withholding of resuscitative efforts, using available resources and considering options for organ donation; and 7) revise treatment goals as needed. Emergency physicians should break bad news compassionately, yet sufficiently, so that surrogate and family understand both the gravity of the situation and the lack of long-term benefit of continued life-sustaining interventions. EPs should also help the surrogate and family understand that palliative care addresses comfort needs of the patient including adequate treatment for pain, dyspnea, or anxiety. Part I of this communications model reviews determination of decision-making capacity, surrogacy laws, and advance directives, including legal definitions and application of these steps; Part II (which will appear in a future issue of AEM) covers communication moving from resuscitative to end-of-life and palliative treatment. EPs should recognize acute devastating illness or injuries, when appropriate, as opportunities to initiate end-of-life discussions and to

Advanced Clothing System

Science.gov (United States)

Broyan, James; Orndoff, Evelyne

2014-01-01

The goal of the Advanced Clothing System (ACS) is to use advanced commercial off-the-shelf fibers and antimicrobial treatments with the goal of directly reducing the mass and volume of a logistics item. The current clothing state-of-the-art on the International Space Station (ISS) is disposable, mostly cotton-based, clothing with no laundry provisions. Each clothing article has varying use periods and will become trash. The goal is to increase the length of wear of the clothing to reduce the logistical mass and volume. The initial focus has been exercise clothing since the use period is lower. Various ground studies and an ISS technology demonstration have been conducted to evaluate clothing preference and length of wear. The analysis indicates that use of ACS selected garments (e.g. wool, modacrylic, polyester) can increase the breakeven point for laundry to 300 days.

The Advanced LIGO timing system

International Nuclear Information System (INIS)

Bartos, Imre; Factourovich, Maxim; Marka, Szabolcs; Marka, Zsuzsa; Raics, Zoltan; Bork, Rolf; Heefner, Jay; Schwinberg, Paul; Sigg, Daniel

2010-01-01

Gravitational wave detection using a network of detectors relies upon the precise time stamping of gravitational wave signals. The relative arrival times between detectors are crucial, e.g. in recovering the source direction, an essential step in using gravitational waves for multi-messenger astronomy. Due to the large size of gravitational wave detectors, timing at different parts of a given detector also needs to be highly synchronized. In general, the requirement toward the precision of timing is determined such that, upon detection, the deduced (astro-) physical results should not be limited by the precision of timing. The Advanced LIGO optical timing distribution system is designed to provide UTC-synchronized timing information for the Advanced LIGO detectors that satisfies the above criterium. The Advanced LIGO timing system has modular structure, enabling quick and easy adaptation to the detector frame as well as possible changes or additions of components. It also includes a self-diagnostics system that enables the remote monitoring of the status of timing. After the description of the Advanced LIGO timing system, several tests are presented that demonstrate its precision and robustness.

Some new directions in system transient simulation

International Nuclear Information System (INIS)

Ransom, V.H.

1986-01-01

The current research in system transient simulation at the Idaho National Engineering Laboratory (INEL) is summarized in this paper and three new directions that are emerging from this work are discussed. The new directions are: development of an Advanced Thermal Hydraulic Energy Network Analyzer (ATHENA) having new modeling capability, use of expert systems for enhancing simulation methods, and the trend to individual workstations for simulation

Sports Tournament Predictions Using Direct Manipulation

OpenAIRE

Vuillemot , Romain; Perin , Charles

2016-01-01

An advanced interface for sports tournament predictions uses direct manipulation to allow users to make nonlinear predictions. Unlike previous interface designs, the interface helps users focus on their prediction tasks by enabling them to first choose a winner and then fill out the rest of the bracket. In real-world tests of the proposed interface (for the 2014 FIFA World Cup tournament and 2015/2016 UEFA Champions League), the authors validated the use of direct manipulation as an alternati...

7 CFR 1484.57 - Will FAS make advance payments to a Cooperator?

Science.gov (United States)

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Will FAS make advance payments to a Cooperator? 1484... large cost item. FAS will provide this type of advance expense payment in lieu of direct payments by FAS... to protect FAS' financial interests. FAS will not make any special advance payment to a Cooperator...

Networked Airborne Communications Using Adaptive Multi Beam Directional Links

Science.gov (United States)

2016-03-05

Networked Airborne Communications Using Adaptive Multi-Beam Directional Links R. Bruce MacLeod Member, IEEE, and Adam Margetts Member, IEEE MIT...provide new techniques for increasing throughput in airborne adaptive directional net- works. By adaptive directional linking, we mean systems that can...techniques can dramatically increase the capacity in airborne networks. Advances in digital array technology are beginning to put these gains within reach

Advance statements in the new Victorian Mental Health Act.

Science.gov (United States)

Saraf, Sudeep

2015-06-01

There is growing recognition of the utility of advance statements in the area of mental health. The definition of advance statements and procedure for making and varying advance statements under the Victorian legislation is described. The implications for psychiatrists, mental health tribunals and the process should the psychiatrist vary their decision from that made in the advance statement are discussed. Advance statements being enshrined in legislation is another step in the direction of recovery-oriented service provision for persons with mental illness. The challenge for services will be to develop systems and processes that promote increased uptake of these instruments to empower persons with mental illness to participate in their treatment. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Implementation of an advanced hybrid MPC-PID control system using PAT tools into a direct compaction continuous pharmaceutical tablet manufacturing pilot plant.

Science.gov (United States)

Singh, Ravendra; Sahay, Abhishek; Karry, Krizia M; Muzzio, Fernando; Ierapetritou, Marianthi; Ramachandran, Rohit

2014-10-01

It is desirable for a pharmaceutical final dosage form to be manufactured through a quality by design (QbD)-based approach rather than a quality by testing (QbT) approach. An automatic feedback control system coupled with PAT tools that is part of the QbD paradigm shift, has the potential to ensure that the pre-defined end product quality attributes are met in a time and cost efficient manner. In this work, an advanced hybrid MPC-PID control architecture coupled with real time inline/online monitoring tools and principal components analysis (PCA) based additional supervisory control layer has been proposed for a continuous direct compaction tablet manufacturing process. The advantages of both MPC and PID have been utilized in a hybrid scheme. The control hardware and software integration and implementation of the control system has been demonstrated using feeders and blending unit operation of a continuous tablet manufacturing pilot plant and an NIR based PAT tool. The advanced hybrid MPC-PID control scheme leads to enhanced control loop performance of the critical quality attributes in comparison to a regulatory (e.g. PID) control scheme indicating its potential to improve pharmaceutical product quality. Copyright © 2014 Elsevier B.V. All rights reserved.

NATO Advanced Research Workshop on Molecular Engineering for Advanced Materials

CERN Document Server

Schaumburg, Kjeld

1995-01-01

An important aspect of molecular engineering is the `property directed' synthesis of large molecules and molecular assemblies. Synthetic expertise has advanced to a state which allows the assembly of supramolecules containing thousands of atoms using a `construction kit' of molecular building blocks. Expansion in the field is driven by the appearance of new building blocks and by an improved understanding of the rules for joining them in the design of nanometer-sized devices. Another aspect is the transition from supramolecules to materials. At present no single molecule (however large) has been demonstrated to function as a device, but this appears to be only a matter of time. In all of this research, which has a strongly multidisciplinary character, both existing and yet to be developed analytical techniques are and will remain indispensable. All this and more is discussed in Molecular Engineering for Advanced Materials, which provides a masterly and up to date summary of one of the most challenging researc...

Multiaxial ratcheting with advanced kinematic and directional distortional hardening rules

Czech Academy of Sciences Publication Activity Database

Feigenbaum, H. P.; Dugdale, J.; Dafalias, Y.F.; Kourousis, K. I.; Plešek, Jiří

2012-01-01

Roč. 49, č. 22 (2012), s. 3063-3076 ISSN 0020-7683 R&D Projects: GA MŠk(CZ) ME10024 Institutional research plan: CEZ:AV0Z20760514 Keywords : plasticity * directional distortional hardening * thermodynamics Subject RIV: JJ - Other Materials Impact factor: 1.871, year: 2012 http://www.sciencedirect.com/science/article/pii/S0020768312002612

Mirror Advanced Reactor Study (MARS)

International Nuclear Information System (INIS)

Logan, B.G.

1983-01-01

Progress in a two year study of a 1200 MWe commercial tandem mirror reactor (MARS - Mirror Advanced Reactor Study) has reached the point where major reactor system technologies are identified. New design features of the magnets, blankets, plug heating systems and direct converter are described. With the innovation of radial drift pumping to maintain low plug density, reactor recirculating power fraction is reduced to 20%. Dominance of radial ion and impurity losses into the halo permits gridless, circular direct converters to be dramatically reduced in size. Comparisons of MARS with the Starfire tokamak design are made

Advanced Air Transportation Technologies Project, Final Document Collection

Science.gov (United States)

Mogford, Richard H.; Wold, Sheryl (Editor)

2008-01-01

This CD ROM contains a compilation of the final documents of the Advanced Air Transportation Technologies (AAIT) project, which was an eight-year (1996 to 2004), $400M project managed by the Airspace Systems Program office, which was part of the Aeronautics Research Mission Directorate at NASA Headquarters. AAIT focused on developing advanced automation tools and air traffic management concepts that would help improve the efficiency of the National Airspace System, while maintaining or enhancing safety. The documents contained in the CD are final reports on AAIT tasks that serve to document the project's accomplishments over its eight-year term. Documents include information on: Advanced Air Transportation Technologies, Autonomous Operations Planner, Collaborative Arrival Planner, Distributed Air/Ground Traffic Management Concept Elements 5, 6, & 11, Direct-To, Direct-To Technology Transfer, Expedite Departure Path, En Route Data Exchange, Final Approach Spacing Tool - (Active and Passive), Multi-Center Traffic Management Advisor, Multi Center Traffic Management Advisor Technology Transfer, Surface Movement Advisor, Surface Management System, Surface Management System Technology Transfer and Traffic Flow Management Research & Development.

High Torque, Direct Drive Electric Motor, Phase II

Data.gov (United States)

National Aeronautics and Space Administration — Bear Engineering proposes to advance the development of an innovative high torque, low speed, direct drive motor in order to meet NASA's requirements for such...

Sciences of geodesy I advances and future directions

CERN Document Server

Xu, Guochang

2010-01-01

This series of reference books describes sciences of different elds in and around geodesy with independent chapters. Each chapter covers an individual eld and describes the history, theory, objective, technology, development, highlights of research and applications. In addition, problems as well as future directions are discussed. The subjects of this reference book include Absolute and Relative Gravimetry, Adaptively Robust Kalman Filters with Applications in Navigation, Airborne Gravity Field Determination, Analytic Orbit Theory, Deformation and Tectonics, Earth Rotation, Equivalence of GPS Algorithms and its Inference, Marine Geodesy, Satellite Laser Ranging, Superconducting Gravimetry and Synthetic Aperture Radar Interferometry. These are individual subjects in and around geodesy and are for the rst time combined in a unique book which may be used for teaching or for learning basic principles of many subjects related to geodesy. The material is suitable to provide a general overview of geodetic sciences f...

Advanced transport aircraft technology

Energy Technology Data Exchange (ETDEWEB)

Winblade, R L

1980-06-01

Various elements of the NASA aircraft energy efficiency program are described. Regarding composite structures, the development of three secondary and three medium-primary components to validate structural and fabrication technology is discussed. In laminar flow control, the design of advanced airfoils having large regions of supercritical flow with features which simplify laminarization are considered. Emphasis is placed on engine performance improvement, directed at developing advanced components to reduce fuel consumption in current production engines, and engine diagnostics aimed at identifying the sources and causes of performance deterioration in high-bypass turbofan engines. In addition, the results of propeller aerodynamic and acoustic tests have substantiated the feasibility of achieving the propeller efficiency goal of 80% and confirmed that the effect of blade sweep on reducing propeller source noise was 5-6 dB.

Technology Transfer, Foreign Direct Investment and International Trade

OpenAIRE

Leonard K. Cheng

2000-01-01

By developing a Ricardian trade model that features technology transfer via foreign direct investment (FDI), we show that technology transfer via multinational enterprises (MNEs) increases world output and trade in goods and services. When there are many goods a continuous reduction in the cost of technology transfer will cause increasingly more technologically advanced goods to go through the product cycle, i.e., goods initially produced in the advanced North are later produced in the backwa...

Current status and future potential for advanced volume reduction technologies

International Nuclear Information System (INIS)

Rutland, L.; Naughton, M.D.; Papaiya, N.C.

1984-01-01

With escalating costs for disposal of low-level radioactive waste (LLW) from nuclear power plants, and the possibility of unavailability of disposal space, some nuclear power utilities responded by commiting to implementing advanced volume reduction (VR) systems. This paper presents recent experience to implement advanced volume reduction technologies; their performance and typical operating and capital costs. This experience in the light of current economic conditions may enable us to predict the direction that future advanced VR technology commitments is taking

Direct energy recovery from helium ion beams by a beam direct converter with secondary electron suppressors

International Nuclear Information System (INIS)

Yoshikawa, K.; Yamamoto, Y.; Toku, H.; Kobayashi, A.; Okazaki, T.

1989-01-01

A 5-yr study of beam direct energy conversion was performed at the Kyoto University Institute of Atomic Energy to clarify the essential features of direct energy recovery from monoenergetic ion beams so that the performance characteristics of energy recovery can be predicted reasonably well by numerical calculations. The study used an improved version of an electrostatically electron-suppressed beam direct converter. Secondary electron suppressor grids were added, and a helium ion beam was used with typical parameters of 15.4 keV, 90 mA, and 100 ms. This paper presents a comparison of experimental results with numerical results by the two-dimensional Kyoto University Advanced Dart (KUAD) code, including evaluation of atomic processes

Preparing Children to Look at Pictures: Advance Descriptions Direct Attention and Facilitate Active Processing

Science.gov (United States)

Carr, Thomas H.; And Others

1977-01-01

The effect of three different kinds of advance descriptions on recognition memory for component information from pictures was measured for 72 first-grade children. All descriptions resulted in higher retention of all components than viewing without description. (Author/JMB)

Advanced differential quadrature methods

CERN Document Server

Zong, Zhi

2009-01-01

Modern Tools to Perform Numerical DifferentiationThe original direct differential quadrature (DQ) method has been known to fail for problems with strong nonlinearity and material discontinuity as well as for problems involving singularity, irregularity, and multiple scales. But now researchers in applied mathematics, computational mechanics, and engineering have developed a range of innovative DQ-based methods to overcome these shortcomings. Advanced Differential Quadrature Methods explores new DQ methods and uses these methods to solve problems beyond the capabilities of the direct DQ method.After a basic introduction to the direct DQ method, the book presents a number of DQ methods, including complex DQ, triangular DQ, multi-scale DQ, variable order DQ, multi-domain DQ, and localized DQ. It also provides a mathematical compendium that summarizes Gauss elimination, the Runge-Kutta method, complex analysis, and more. The final chapter contains three codes written in the FORTRAN language, enabling readers to q...

Design concepts and advanced manipulator development for nuclear fuel cycle facilities

International Nuclear Information System (INIS)

Feldman, M.J.

1985-01-01

In the Fuel Recycle Division, Consolidated Fuel Reprocessing Program at the Oak Ridge National Laboratory, a comprehensive remote systems development program has existed for the past seven years. The new remote technology under development is expected to significantly improve remote operations by extending the range of tasks accomplished by remote means and increasing the efficiency of remote work undertaken. The application of advanced manipulation is viewed as an essential part of a series of design directions whose sum describes a somewhat unique blend of old and new technology. A design direction based upon the Teletec concept is explained and recent progress in the development of an advanced servomanipulator-based maintenance concept is summarized to show that a new generation of remote systems is feasible through advanced technology. 14 refs., 14 figs

Sustainability assessment of advanced wastewater treatment technologies

DEFF Research Database (Denmark)

Høibye, Linda; Clauson-Kaas, Jes; Wenzel, Henrik

2008-01-01

, which includes technical, economical and environmental aspects. The technical and economical assessment is performed on 5 advanced treatment technologies: sand filtration, ozone treatment, UV exclusively for disinfection of pathogenic microorganisms, membrane bioreactor (MBR) and UV in combination......As a consequence of the EU Water Framework Directive more focus is now on discharges of hazardous substances from wastewater treatment plants and sewers. Thus, many municipalities in Denmark may have to adopt to future advanced treatment technologies. This paper describes a holistic assessment...... with advanced oxidation. The technical assessment is based on 12 hazardous substances comprising heavy metals, organic pollutants, endocrine disruptors as well as pathogenic microorganisms. The environmental assessment is performed by life cycle assessment (LCA) comprising 9 of the specific hazardous substances...

Applications of Advanced Electromagnetics Components and Systems

CERN Document Server

Kouzaev, Guennadi A

2013-01-01

This text, directed to the microwave engineers and Master and PhD students, is on the use of electromagnetics to the development and design of advanced integrated components distinguished by their extended field of applications. The results of hundreds of authors scattered in numerous journals and conference proceedings are carefully reviewed and classed.  Several chapters are to refresh the knowledge of readers in advanced electromagnetics. New techniques are represented by compact electromagnetic–quantum equations which can be used in modeling of microwave-quantum integrated circuits of future In addition, a topological method to the boundary value problem analysis is considered with the results and examples.  One extended chapter is for the development and design of integrated components for extended bandwidth applications, and the technology and electromagnetic issues of silicon integrated transmission lines, transitions, filters, power dividers, directional couplers, etc are considered. Novel prospec...

Delineating advanced practice nursing in New Zealand: a national survey.

Science.gov (United States)

Carryer, J; Wilkinson, J; Towers, A; Gardner, G

2018-03-01

A variety of advanced practice nursing roles and titles have proliferated in response to the changing demands of a population characterized by increasing age and chronic illness. Whilst similarly identified as advanced practice roles, they do not share a common practice profile, educational requirements or legislative direction. The lack of clarity limits comparative research that can inform policy and health service planning. To identify advanced practice roles within nursing titles employed in New Zealand and practice differences between advanced practice and other roles. Replicating recent Australian research, 3255 registered nurses/nurse practitioners in New Zealand completed the amended Advanced Practice Delineation survey tool. The mean domain scores of the predominant advanced practice position were compared with those of other positions. Differences between groups were explored using one-way ANOVA and post hoc between group comparisons. Four nursing position bands were identified: nurse practitioner, clinical nurse specialist, domain-specific and registered nurse. Significant differences between the bands were found on many domain scores. The nurse practitioner and clinical nurse specialist bands had the most similar practice profiles, nurse practitioners being more involved in direct care and professional leadership. Similar to the position of clinical nurse consultant in Australia, those practicing as clinical nurse specialists were deemed to reflect the threshold for advanced practice nursing. The results identified different practice patterns for the identified bands and distinguish the advanced practice nursing roles. By replicating the Australian study of Gardener et al. (2016), this NZ paper extends the international data available to support more evidence-based nursing workforce planning and policy development. © 2017 International Council of Nurses.

Qualitative research in rehabilitation science: opportunities, challenges, and future directions.

Science.gov (United States)

VanderKaay, Sandra; Moll, Sandra E; Gewurtz, Rebecca E; Jindal, Pranay; Loyola-Sanchez, Adalberto; Packham, Tara L; Lim, Chun Y

2018-03-01

Qualitative research has had a significant impact within rehabilitation science over time. During the past 20 years the number of qualitative studies published per year in Disability and Rehabilitation has markedly increased (from 1 to 54). In addition, during this period there have been significant changes in how qualitative research is conceptualized, conducted, and utilized to advance the field of rehabilitation. The purpose of this article is to reflect upon the progress of qualitative research within rehabilitation to date, to explicate current opportunities and challenges, and to suggest future directions to continue to strengthen the contribution of qualitative research in this field. Relevant literature searches were conducted in electronic data bases and reference lists. Pertinent literature was examined to identify current opportunities and challenges for qualitative research use in rehabilitation and to identify future directions. Six key areas of opportunity and challenge were identified: (a) paradigm shifts, (b) advancements in methodology, (c) emerging technology, (d) advances in quality evaluation, (e) increasing popularity of mixed methods approaches, and (f) evolving approaches to knowledge translation. Two important future directions for rehabilitation are posited: (1) advanced training in qualitative methods and (2) engaging qualitative communities of research. Qualitative research is well established in rehabilitation and has an important place in the continued growth of this field. Ongoing development of qualitative researchers and methods are essential. Implications for Rehabilitation Qualitative research has the potential to improve rehabilitation practice by addressing some of the most pervasive concerns in the field such as practitioner-client interaction, the subjective and lived experience of disability, and clinical reasoning and decision making. This will serve to better inform those providing rehabilitation services thereby benefiting

High satisfaction and low decisional conflict with advance care planning among chronically ill patients with advanced chronic obstructive pulmonary disease or heart failure using an online decision aid: A pilot study.

Science.gov (United States)

Van Scoy, Lauren J; Green, Michael J; Dimmock, Anne Ef; Bascom, Rebecca; Boehmer, John P; Hensel, Jessica K; Hozella, Joshua B; Lehman, Erik B; Schubart, Jane R; Farace, Elana; Stewart, Renee R; Levi, Benjamin H

2016-09-01

Many patients with chronic illnesses report a desire for increased involvement in medical decision-making. This pilot study aimed to explore how patients with exacerbation-prone disease trajectories such as advanced heart failure or chronic obstructive pulmonary disease experience advance care planning using an online decision aid and to compare whether patients with different types of exacerbation-prone illnesses had varied experiences using the tool. Pre-intervention questionnaires measured advance care planning knowledge. Post-intervention questionnaires measured: (1) advance care planning knowledge; (2) satisfaction with tool; (3) decisional conflict; and (4) accuracy of the resultant advance directive. Comparisons were made between patients with heart failure and chronic obstructive pulmonary disease. Over 90% of the patients with heart failure (n = 24) or chronic obstructive pulmonary disease (n = 25) reported being "satisfied" or "highly satisfied" with the tool across all satisfaction domains; over 90% of participants rated the resultant advance directive as "very accurate." Participants reported low decisional conflict. Advance care planning knowledge scores rose by 18% (p < 0.001) post-intervention. There were no significant differences between participants with heart failure and chronic obstructive pulmonary disease. Patients with advanced heart failure and chronic obstructive pulmonary disease were highly satisfied after using an online advance care planning decision aid and had increased knowledge of advance care planning. This tool can be a useful resource for time-constrained clinicians whose patients wish to engage in advance care planning. © The Author(s) 2016.

Visual perception of dynamic properties: cue heuristics versus direct-perceptual competence.

Science.gov (United States)

Runeson, S; Juslin, P; Olsson, H

2000-07-01

Constructivist and Gibsonian approaches disagree over the possibility of direct perceptual use of advanced information. A trenchant instance concerns visual perception of underlying dynamic properties as specified by kinematic patterns of events. For the paradigmatic task of discrimination of relative mass in observed collisions, 2 mathematical models are developed, 1 model representing a direct, invariant-based approach, and 1 representing a cue-heuristic approach. The models enable a critical experimental design with distinct predictions concerning performance data and confidence ratings. Although pretraining results were mixed, the invariant-based model was empirically confirmed after a minimal amount of training: Competence entails the use of advanced kinematic information in a direct-perceptual ("sensory") mode of apprehension, in contrast to beginners' use of simpler cues in an inferential ("cognitive") mode.

Advanced supersonic technology and its implications for the future

Science.gov (United States)

Driver, C.

1979-01-01

A brief overview of the NASA Supersonic Cruise Research (SCR) program is presented. The SCR program has identified significant improvements in the areas of aerodynamics, structures, propulsion, noise reduction, takeoff and landing procedures, and advanced configuration concepts. These improvements tend to overcome most of the problems which led to the cancellation of the National SST program. They offer the promise of an advanced SST family of aircraft which are environmentally acceptable, have flexible range-payload capability, and are economically viable. The areas of technology addressed by the SCR program have direct application to advanced military aircraft and to supersonic executive aircraft.

Advances in solar photoelectro-Fenton: Decolorization and mineralization of the Direct Yellow 4 diazo dye using an autonomous solar pre-pilot plant

International Nuclear Information System (INIS)

Garcia-Segura, Sergi; Brillas, Enric

2014-01-01

Highlights: • Assessment of an autonomous solar pre-pilot plant for solar photoelectro-Fenton. • Total decolorization and 96-97% mineralization for solutions of Direct Yellow 4 diazo dye at pH 3.0. • More rapid dye decay and mineralization at 0.50 mmol dm −3 Fe 2+ and maximum current of 5.0 A. • 11 aromatics, 22 hydroxylated derivatives and 9 carboxylic acids detected as intermediates. • Release of NH 4 + and SO 4 2− as main inorganic ions. - Abstract: Here, an overview on the advances in solar photoelectro-Fenton (SPEF) is initially presented to show that it is the more potent electrochemical advanced oxidation process based on Fenton's reaction chemistry to remove organic pollutants from waters, due to the synergistic action of generated hydroxyl radicals and solar irradiation. As a novel advance for SPEF, an autonomous solar pre-pilot plant is proposed to make an energetically inexpensive process that can be viable at industrial level. The plant of 10 dm 3 capacity contained a Pt/air-diffusion cell with 90.2 cm 2 electrode area, coupled to a solar compound parabolic collectors (CPCs) photoreactor of 1.57 dm 3 irradiation volume and to a solar photovoltaic panel that provides a maximum average current of 5.0 A. The oxidation ability of this plant was assessed by studying the degradation of Direct Yellow 4 (DY4) diazo dye, which involved the predominant destruction of organics by ·OH formed from Fenton's reaction between H 2 O 2 generated at the cathode and added Fe 2+ , along with the photolysis of Fe(III)-carboxylate complexes with sunlight in the CPCs photoreactor. The effect of Fe 2+ and dye contents as well as current on decolorization rate, substrate decay and mineralization rate was examined. About 96-97% mineralization was rapidly attained using 0.50 mmol dm −3 Fe 2+ and up to 0.32 mmol dm −3 DY4 at 5.0 A. The DY4 decay always obeyed a pseudo-first-order kinetics. Eleven aromatic products, twenty two hydroxylated derivatives

Brief Timelapse on Dendrimer Chemistry: Advances, Limitations, and Expectations

KAUST Repository

Ornelas, Catia

2015-01-01

, with a critical analysis on the expectations, limitations, advances, current challenges and future directions. Dendrimer timelapse demonstrates constant evolution in dendrimer chemistry enabling their application in nanomedicine, protein mimic, catalysis

Experimental study of deceleration process of traveling wave direct energy converter for advanced fusion

International Nuclear Information System (INIS)

Takeno, Hormasa; Yamamoto, Takayoshi; Takada, Kousuke; Yasaka, Yasuyoshi

2007-01-01

Advanced fusion is attractive in the view point of utilization of high efficiency direct energy conversion from fusion produced ions. Deuterium-helium-3 reaction is the most possible, however, the energy of created fast proton is so enormous that conventional electro-static converters cannot be applied. Use of a traveling wave direct energy converter (TWDEC), the principle of which was inverse process of a linear accelerator, was proposed for recovering energy of the fast protons. In order to realize the TWDEC, the authors are continuing experimental study by employing a small-scale simulator. A TWDEC consists of a modulator and a decelerator. Fast proton beam extracted from a reactor is introduced in the modulator where radio frequency (RF) electrostatic field modulate the beam velocity, and hence, the protons are bunched and density-modulated in the downstream. The density-modulated protons flow into the decelerator where a number of electrodes connected to a transmission circuit are axially aligned. The flowing protons induce RF current which creates RF traveling voltage on the electrodes. The RF traveling field between aligned electrodes decelerates the protons, thus their energy is recovered into RF power. In this paper, deceleration process of TWDEC is experimentally examined. In our experimental simulator, because of the small beam current, the induced potential, i.e. the deceleration field is so weak that the beam cannot be decelerated. Thus, we examined the process by dividing into two: one was induction of the deceleration field by the modulated beam, which was called as passive decelerator. The other was energy recovery through interaction between the deceleration field and the modulated beam. In this latter experiment, the deceleration field was supplied externally, and we called this as active decelerator. As for the active decelerator mode, we performed higher beam energy experiment than previous one. As the beam energy increases, the divergence of

Knowledge of advance directive and perceptions of end-of-life care in Chinese-American elders: The role of acculturation.

Science.gov (United States)

Gao, Xiang; Sun, Fei; Ko, Eunjeong; Kwak, Jung; Shen, Huei-Wern

2015-12-01

This study aimed to describe knowledge of an advance directive (AD) and preferences regarding end-of-life (EoL) care communication, decision making, and designation of surrogates in Chinese-American elders and to examine the role of acculturation variables in AD awareness. Survey data were collected through face-to-face interviews on a sample of 385 Chinese-American elders aged 55 or above living in the Phoenix metropolitan area. The choice of language (Mandarin, Cantonese, or English) and place of interview (senior apartments, Chinese senior centers, or homes) was at the respondent's preference. Hierarchical logistic regression analysis was employed to examine the influence of acculturation variables on AD awareness. Some 21% of participants had heard about ADs, and only 10% had completed one. Elders with higher acculturation levels (OR = 1.04, p Acculturation levels influence awareness of an AD, and family values are crucial in EoL care decision making. Cultural factors should be considered in designing and delivering appropriate programs to promote knowledge of EoL care among Chinese-American elders and their families.

FY 2007 Progress Report for Advanced Combustion Engine Technologies

Energy Technology Data Exchange (ETDEWEB)

None, None

2007-12-01

Advanced combustion engines have great potential for achieving dramatic energy efficiency improvements in light-duty vehicle applications, where it is suited to both conventional and hybrid- electric powertrain configurations. Light-duty vehicles with advanced combustion engines can compete directly with gasoline engine hybrid vehicles in terms of fuel economy and consumer-friendly driving characteristics; also, they are projected to have energy efficiencies that are competitive with hydrogen fuel cell vehicles when used in hybrid applications.Advanced engine technologies being researched and developed by the Advanced Combustion Engine R&D Sub-Program will also allow the use of hydrogen as a fuel in ICEs and will provide an energy-efficient interim hydrogen-based powertrain technology during the transition to hydrogen/fuelcell-powered transportation vehicles.

MARS: Mirror Advanced Reactor Study

International Nuclear Information System (INIS)

Logan, B.G.

1984-01-01

A recently completed two-year study of a commercial tandem mirror reactor design [Mirror Advanced Reactor Study (MARS)] is briefly reviewed. The end plugs are designed for trapped particle stability, MHD ballooning, balanced geodesic curvature, and small radial electric fields in the central cell. New technologies such as lithium-lead blankets, 24T hybrid coils, gridless direct converters and plasma halo vacuum pumps are highlighted

Laser amplitude stabilization for advanced interferometric gravitational wave detectors

International Nuclear Information System (INIS)

Barr, B W; Strain, K A; Killow, C J

2005-01-01

We present results of experiments into the stabilization of the amplitude of Nd:YAG lasers for use in advanced gravitational wave detectors. By feeding back directly to the pump-diode driving current we achieved shot-noise-limited stabilization at frequencies up to several kHz with some residual noise at lower frequencies (sub ∼100 Hz). The method used is applicable to higher powered laser systems planned for advanced interferometric gravitational wave detectors

Laboratory directed research and development annual report: 2005

International Nuclear Information System (INIS)

2006-01-01

This report summarizes progress from the Laboratory Directed Research and Development (LDRD) program during fiscal year 2005 for Sandia National Laboratories. In addition to a programmatic and financial overview, the report includes progress reports from 410 individual R and D projects in 19 categories. The categories and subheadings are: Science, Technology and Engineering (Advanced Components and Certification Engineering; Advanced Manufacturing; Biotechnology; Chemical and Earth Sciences; Computational and Information Sciences; Electronics and Photonics; Engineering Sciences; Materials Science and Technology; Pulsed Power Sciences and High Energy Density Sciences; Science and Technology Strategic Objectives); Mission Technologies (Energy and Infrastructure Assurance; Homeland Security; Military Technologies and Applications; Nonproliferation and Assessments; Grand Challanges); and Corporate Objectives (Advanced Concepts; Seniors' Council; University Collaborations)

Advanced dementia pain management protocols.

Science.gov (United States)

Montoro-Lorite, Mercedes; Canalias-Reverter, Montserrat

Pain management in advanced dementia is complex because of neurological deficits present in these patients, and nurses are directly responsible for providing interventions for the evaluation, management and relief of pain for people suffering from this health problem. In order to facilitate and help decision-makers, pain experts recommend the use of standardized protocols to guide pain management, but in Spain, comprehensive pain management protocols have not yet been developed for advanced dementia. This article reflects the need for an integrated management of pain in advanced dementia. From the review and analysis of the most current and relevant studies in the literature, we performed an approximation of the scales for the determination of pain in these patients, with the observational scale PAINAD being the most recommended for the hospital setting. In addition, we provide an overview for comprehensive management of pain in advanced dementia through the conceptual framework «a hierarchy of pain assessment techniques by McCaffery and Pasero» for the development and implementation of standardized protocols, including a four-phase cyclical process (evaluation, planning/performance, revaluation and recording), which can facilitate the correct management of pain in these patients. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Faculty Development for Advancing Community Engagement in Higher Education: Current Trends and Future Directions

Science.gov (United States)

Welch, Marshall; Plaxton-Moore, Star

2017-01-01

This research involved the conduct of a conceptual review of 28 refereed journal articles and a survey of campus centers for community engagement staff to identify salient features and trends of existing faculty development programming designed to advance service-learning and community engagement in higher education. Results of this investigation…

Laboratory directed research and development program, FY 1996

International Nuclear Information System (INIS)

1997-02-01

The Ernest Orlando Lawrence Berkeley National Laboratory (Berkeley Lab) Laboratory Directed Research and Development Program FY 1996 report is compiled from annual reports submitted by principal investigators following the close of the fiscal year. This report describes the projects supported and summarizes their accomplishments. It constitutes a part of the Laboratory Directed Research and Development (LDRD) program planning and documentation process that includes an annual planning cycle, projection selection, implementation, and review. The Berkeley Lab LDRD program is a critical tool for directing the Laboratory's forefront scientific research capabilities toward vital, excellent, and emerging scientific challenges. The program provides the resources for Berkeley Lab scientists to make rapid and significant contributions to critical national science and technology problems. The LDRD program also advances the Laboratory's core competencies, foundations, and scientific capability, and permits exploration of exciting new opportunities. Areas eligible for support include: (1) Work in forefront areas of science and technology that enrich Laboratory research and development capability; (2) Advanced study of new hypotheses, new experiments, and innovative approaches to develop new concepts or knowledge; (3) Experiments directed toward proof of principle for initial hypothesis testing or verification; and (4) Conception and preliminary technical analysis to explore possible instrumentation, experimental facilities, or new devices

Laboratory Directed Research and Development Program FY98

Energy Technology Data Exchange (ETDEWEB)

Hansen, T. [ed.; Chartock, M.

1999-02-05

The Ernest Orlando Lawrence Berkeley National Laboratory (LBNL or Berkeley Lab) Laboratory Directed Research and Development Program FY 1998 report is compiled from annual reports submitted by principal investigators following the close of the fiscal year. This report describes the supported projects and summarizes their accomplishments. It constitutes a part of the Laboratory Directed Research and Development (LDRD) program planning and documentation process that includes an annual planning cycle, projection selection, implementation, and review. The LBNL LDRD program is a critical tool for directing the Laboratory's forefront scientific research capabilities toward vital, excellent, and emerging scientific challenges. The program provides the resources for LBNL scientists to make rapid and significant contributions to critical national science and technology problems. The LDRD program also advances LBNL's core competencies, foundations, and scientific capability, and permits exploration of exciting new opportunities. All projects are work in forefront areas of science and technology. Areas eligible for support include the following: Advanced study of hypotheses, concepts, or innovative approaches to scientific or technical problems; Experiments and analyses directed toward ''proof of principle'' or early determination of the utility of new scientific ideas, technical concepts, or devices; and Conception and preliminary technical analyses of experimental facilities or devices.

Laboratory directed research and development program, FY 1996

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-02-01

The Ernest Orlando Lawrence Berkeley National Laboratory (Berkeley Lab) Laboratory Directed Research and Development Program FY 1996 report is compiled from annual reports submitted by principal investigators following the close of the fiscal year. This report describes the projects supported and summarizes their accomplishments. It constitutes a part of the Laboratory Directed Research and Development (LDRD) program planning and documentation process that includes an annual planning cycle, projection selection, implementation, and review. The Berkeley Lab LDRD program is a critical tool for directing the Laboratory`s forefront scientific research capabilities toward vital, excellent, and emerging scientific challenges. The program provides the resources for Berkeley Lab scientists to make rapid and significant contributions to critical national science and technology problems. The LDRD program also advances the Laboratory`s core competencies, foundations, and scientific capability, and permits exploration of exciting new opportunities. Areas eligible for support include: (1) Work in forefront areas of science and technology that enrich Laboratory research and development capability; (2) Advanced study of new hypotheses, new experiments, and innovative approaches to develop new concepts or knowledge; (3) Experiments directed toward proof of principle for initial hypothesis testing or verification; and (4) Conception and preliminary technical analysis to explore possible instrumentation, experimental facilities, or new devices.

The advanced controls program at Oak Ridge National Laboratory

International Nuclear Information System (INIS)

Knee, H.E.; White, J.D.

1990-01-01

The Oak Ridge National Laboratory (ORNL), under sponsorship of the US Department of Energy (DOE), is conducting research that will lead to advanced, automated control of new liquid-metal-reactor (LMR) nuclear power plants. Although this program of research (entitled the ''Advanced Controls Program'') is focused on LMR technology, it will be capable of providing control design, test, and qualification capability for other advanced reactor designs (e.g., the advanced light water reactor [ALWR] and high temperature gas-cooled reactor [HTGR] designs), while also benefiting existing nuclear plants. The Program will also have applicability to complex, non-nuclear process control environments (e.g., petrochemical, aerospace, etc.). The Advanced Controls Program will support capabilities throughout the entire plant design life cycle, i.e., from the initial interactive first-principle dynamic model development for the process, systems, components, and instruments through advanced control room qualification. The current program involves five principal areas of research activities: (1) demonstrations of advanced control system designs, (2) development of an advanced controls design environment, (3) development of advanced control strategies, (4) research and development (R ampersand D) in human-system integration for advanced control system designs, and (5) testing and validation of advanced control system designs. Discussion of the research in these five areas forms the basis of this paper. Also included is a description of the research directions of the program. 8 refs

ADVANCED TECHNOLOGIES OF ELECTRONIC EDUCATIONAL SYSTEMS DEVELOPMENT

Directory of Open Access Journals (Sweden)

M. Shishkina

2011-11-01

Full Text Available Actual problems and contradictions of electronic educational systems development are described: availability of education, quality of educational services; individualization of education; exposures and advantages in using of computer technology; standardization of technologies and resources. Tendencies of their solution in the view of development of new advanced technologies of e-education are specified. The essence and advantages of using the cloud computing technologies as a new platform of distributed learning are specified. Advanced directions of cloud-based data usage in executive system of education are declared: access management, content management, asset management, communications management.

Expectations of a business rescue plan: international directives for ...

African Journals Online (AJOL)

Expectations of a business rescue plan: international directives for Chapter 6 implementation. ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search ... Preliminary analysis of business rescue plans suggested that a significant ...

Motivations, aims and communication around advance directives: a mixed-methods study into the perspective of their owners and the influence of a current illness.

Science.gov (United States)

van Wijmen, Matthijs P S; Pasman, H Roeline W; Widdershoven, Guy A M; Onwuteaka-Philipsen, Bregje D

2014-06-01

What are motivations of owners of an advance directive (AD) to draft an AD, what do they aim for with their AD and do they communicate about their AD? Written questionnaires were sent to a cohort of people owning different types of ADs (n=5768). A purposive sample of people suffering from an illness was selected from the cohort for an in-depth interview (n=29). About half of our population had no direct motivation to draft their AD. Most mentioned motivation for the other half was an illness of a family member or friend. Many different and specific aims for drafting an AD were mentioned. An often mentioned more general aim in people with different ADs was to prevent unnecessary lengthening of life or treatment (14-16%). Most respondents communicated about having an AD with close-ones (63-88%) and with their GP (65-79%). In the interviews people gave vivid examples of experiences of what they hoped to prevent at the end of life. Some mentioned difficulties foreseeing the future and gave examples of response shift. ADs can give directions to caregivers about what people want at the end of life. ADs have to be discussed in detail by their owners and caregivers, since owners often have specific aims with their AD. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Integrated Application of Active Controls (IAAC) technology to an advanced subsonic transport project: Current and advanced act control system definition study

Science.gov (United States)

1982-01-01

The Current and Advanced Technology ACT control system definition tasks of the Integrated Application of Active Controls (IAAC) Technology project within the Energy Efficient Transport Program are summarized. The systems mechanize six active control functions: (1) pitch augmented stability; (2) angle of attack limiting; (3) lateral/directional augmented stability; (4) gust load alleviation; (5) maneuver load control; and (6) flutter mode control. The redundant digital control systems meet all function requirements with required reliability and declining weight and cost as advanced technology is introduced.

The ARIES-AT advanced tokamak, Advanced technology fusion power plant

International Nuclear Information System (INIS)

Najmabadi, Farrokh; Abdou, A.; Bromberg, L.

2006-01-01

The ARIES-AT study was initiated to assess the potential of high-performance tokamak plasmas together with advanced technology in a fusion power plant and to identifying physics and technology areas with the highest leverage for achieving attractive and competitive fusion power in order to guide fusion R and D. The 1000-MWe ARIES-AT design has a major radius of 5.2 m, a minor radius of 1.3 m, a toroidal β of 9.2% (β N = 5.4) and an on-axis field of 5.6 T. The plasma current is 13 MA and the current-drive power is 35 MW. The ARIES-AT design uses the same physics basis as ARIES-RS, a reversed-shear plasma. A distinct difference between ARIES-RS and ARIES-AT plasmas is the higher plasma elongation of ARIES-AT (κ x = 2.2) which is the result of a 'thinner' blanket leading to a large increase in plasma β to 9.2% (compared to 5% for ARIES-RS) with only a slightly higher β N . ARIES-AT blanket is a simple, low-pressure design consisting of SiC composite boxes with a SiC insert for flow distribution that does not carry any structural load. The breeding coolant (Pb-17Li) enters the fusion core from the bottom, and cools the first wall while traveling in the poloidal direction to the top of the blanket module. The coolant then returns through the blanket channel at a low speed and is superheated to ∼1100 deg. C. As most of the fusion power is deposited directly into the breeding coolant, this method leads to a high coolant outlet temperature while keeping the temperature of the SiC structure as well as interface between SiC structure and Pb-17Li to about 1000 deg. C. This blanket is well matched to an advanced Brayton power cycle, leading to an overall thermal efficiency of ∼59%. The very low afterheat in SiC composites results in exceptional safety and waste disposal characteristics. All of the fusion core components qualify for shallow land burial under U.S. regulations (furthermore, ∼90% of components qualify as Class-A waste, the lowest level). The ARIES

Directed Self-Assembly of Nanodispersions

Energy Technology Data Exchange (ETDEWEB)

Furst, Eric M [University of Delaware

2013-11-15

Directed self-assembly promises to be the technologically and economically optimal approach to industrial-scale nanotechnology, and will enable the realization of inexpensive, reproducible and active nanostructured materials with tailored photonic, transport and mechanical properties. These new nanomaterials will play a critical role in meeting the 21st century grand challenges of the US, including energy diversity and sustainability, national security and economic competitiveness. The goal of this work was to develop and fundamentally validate methods of directed selfassembly of nanomaterials and nanodispersion processing. The specific aims were: 1. Nanocolloid self-assembly and interactions in AC electric fields. In an effort to reduce the particle sizes used in AC electric field self-assembly to lengthscales, we propose detailed characterizations of field-driven structures and studies of the fundamental underlying particle interactions. We will utilize microscopy and light scattering to assess order-disorder transitions and self-assembled structures under a variety of field and physicochemical conditions. Optical trapping will be used to measure particle interactions. These experiments will be synergetic with calculations of the particle polarizability, enabling us to both validate interactions and predict the order-disorder transition for nanocolloids. 2. Assembly of anisotropic nanocolloids. Particle shape has profound effects on structure and flow behavior of dispersions, and greatly complicates their processing and self-assembly. The methods developed to study the self-assembled structures and underlying particle interactions for dispersions of isotropic nanocolloids will be extended to systems composed of anisotropic particles. This report reviews several key advances that have been made during this project, including, (1) advances in the measurement of particle polarization mechanisms underlying field-directed self-assembly, and (2) progress in the

Direct Numerical Simulations of Statistically Stationary Turbulent Premixed Flames

KAUST Repository

Im, Hong G.; Arias, Paul G.; Chaudhuri, Swetaprovo; Uranakara, Harshavardhana A.

2016-01-01

Direct numerical simulations (DNS) of turbulent combustion have evolved tremendously in the past decades, thanks to the rapid advances in high performance computing technology. Today’s DNS is capable of incorporating detailed reaction mechanisms

When lithography meets self-assembly: a review of recent advances in the directed assembly of complex metal nanostructures on planar and textured surfaces

Science.gov (United States)

Hughes, Robert A.; Menumerov, Eredzhep; Neretina, Svetlana

2017-07-01

One of the foremost challenges in nanofabrication is the establishment of a processing science that integrates wafer-based materials, techniques, and devices with the extraordinary physicochemical properties accessible when materials are reduced to nanoscale dimensions. Such a merger would allow for exacting controls on nanostructure positioning, promote cooperative phenomenon between adjacent nanostructures and/or substrate materials, and allow for electrical contact to individual or groups of nanostructures. With neither self-assembly nor top-down lithographic processes being able to adequately meet this challenge, advancements have often relied on a hybrid strategy that utilizes lithographically-defined features to direct the assembly of nanostructures into organized patterns. While these so-called directed assembly techniques have proven viable, much of this effort has focused on the assembly of periodic arrays of spherical or near-spherical nanostructures comprised of a single element. Work directed toward the fabrication of more complex nanostructures, while still at a nascent stage, has nevertheless demonstrated the possibility of forming arrays of nanocubes, nanorods, nanoprisms, nanoshells, nanocages, nanoframes, core-shell structures, Janus structures, and various alloys on the substrate surface. In this topical review, we describe the progress made in the directed assembly of periodic arrays of these complex metal nanostructures on planar and textured substrates. The review is divided into three broad strategies reliant on: (i) the deterministic positioning of colloidal structures, (ii) the reorganization of deposited metal films at elevated temperatures, and (iii) liquid-phase chemistry practiced directly on the substrate surface. These strategies collectively utilize a broad range of techniques including capillary assembly, microcontact printing, chemical surface modulation, templated dewetting, nanoimprint lithography, and dip-pen nanolithography and

Analisis Tingkat Motivasi Siswa Dalam Pembelajaran IPA Model Advance Organizer Berbasis Proyek

Directory of Open Access Journals (Sweden)

Tasiwan -

2014-04-01

Full Text Available atur kemajuan (advance organizer berbasis proyek. Sampel penelitian dipilih secara acak. Pada kelas  eksperimen diterapkan model pembelajaran advance organizer berbasis proyek sedangkan pada kelas kontrol diterapkan pembelajaran langsung (direct instruction tanpa advance organizer. Sebelum pembelajaran di kelas, siswa eksperimen dikelompokkan menjadi 8 kelompok yang terdiri atas 4 – 5 siswa. Setiap kelompok ditugaskan untuk merealisasikan proyek bel listrik, rangkaian arus seri – paralel, dan tuas. Produk proyek digunakan dalam pembelajaran dikelas sebagai advance organizer. Data diperoleh melalui observasi partisipatif, penilaian produk, peta konsep, laporan eksperimen, dan angket. Instrumen motivasi menggunakan skala motivasi ARCS. Hasil penelitian menunjukkan bahwa kelas eksperimen memiliki tingkat motivasi lebih baik dalam aspek perhatian, relevansi, kepercayaan diri, dan kepuasan pembelajaran dengan rata – rata tingkat motivasi sebesar 77,20, sedangkan tanpa advance organizer berbasis proyek sebesar 71,10. Disarankan siswa diberikan kemandirian penuh dalam proyek. This study was conducted to analyze the level of student motivation in learning science through models of advance organizer  based project . Samples were selected at random . In the experimental class advance organizer applied learning model based on a class project while learning control direct instruction without advance organizer . Prior learning in the classroom , students are grouped into 8 experimental groups consisting of 4-5 students . Each group was assigned a project to realize an electric bell , the circuit current series - parallel , and lever . Products used in a learning class project as advance organizer . The data obtained through participant observation , assessment product , concept maps , experimental reports , and questionnaires . Motivation instrument using ARCS motivation scale . Results showed that the experimental class had better motivation level

Advances and Research Directions in Data-Warehousing Technology

Directory of Open Access Journals (Sweden)

Mukesh Mohania

1999-11-01

Full Text Available Information is one of the most valuable assets of an organisation and when used properly can assist in intelligent decision making that can significantly improve the functioning of an organisation. Data Warehousing is a recent technology that allows information to be easily and efficiently accessed for decision-making activities by collecting data from many operational, legacy and possibly heterogeneous data sources. On-Line Analytical Processing (OLAP tools are well-suited for complex data analysis, such as multi-dimensional data analysis, and to assist in decision support activities while data mining tools take the process one step further and actively search the data for patterns and hidden knowledge in the data held in the warehouse. Many organisations are building, or are planning to develop, a data warehouse for their operational and decision support needs. In this paper, we present an overview of data warehousing, multi-dimensional databases, OLAP and data mining technology and discuss the directions of current research in the area. We also discuss recent developments in data warehouse modelling, view selection and maintenance, indexing schemes, parallel query processing and data mining issues. A number of technical issues for exploratory research are presented and possible solutions are also discussed.

Fully integrated biochip platforms for advanced healthcare.

Science.gov (United States)

Carrara, Sandro; Ghoreishizadeh, Sara; Olivo, Jacopo; Taurino, Irene; Baj-Rossi, Camilla; Cavallini, Andrea; de Beeck, Maaike Op; Dehollain, Catherine; Burleson, Wayne; Moussy, Francis Gabriel; Guiseppi-Elie, Anthony; De Micheli, Giovanni

2012-01-01

Recent advances in microelectronics and biosensors are enabling developments of innovative biochips for advanced healthcare by providing fully integrated platforms for continuous monitoring of a large set of human disease biomarkers. Continuous monitoring of several human metabolites can be addressed by using fully integrated and minimally invasive devices located in the sub-cutis, typically in the peritoneal region. This extends the techniques of continuous monitoring of glucose currently being pursued with diabetic patients. However, several issues have to be considered in order to succeed in developing fully integrated and minimally invasive implantable devices. These innovative devices require a high-degree of integration, minimal invasive surgery, long-term biocompatibility, security and privacy in data transmission, high reliability, high reproducibility, high specificity, low detection limit and high sensitivity. Recent advances in the field have already proposed possible solutions for several of these issues. The aim of the present paper is to present a broad spectrum of recent results and to propose future directions of development in order to obtain fully implantable systems for the continuous monitoring of the human metabolism in advanced healthcare applications.

Fusion advanced studies Torus

International Nuclear Information System (INIS)

2007-01-01

The successful development of ITER and DEMO scenarios requires preparatory activities on devices that are smaller than ITER, sufficiently flexible and capable of investigating the peculiar physics of burning plasma conditions. The aim of the Fusion Advanced Studies Torus (FAST) proposal [2.1] (formerly FT3 [2.2]) is to show that the preparation of ITER scenarios and the development of new expertise for the DEMO design and RD can be effectively implemented on a new facility. FAST will a) operate with deuterium plasmas, thereby avoiding problems associated with tritium, and allow investigation of nonlinear dynamics (which are important for understanding alpha particle behaviour in burning plasmas) by using fast ions accelerated by heating and current drive systems; b) work in a dimensionless parameter range close to that of ITER; c) test technical innovative solutions, such as full-tungsten plasma-facing components and an advanced liquid metal divertor target for the first wall/divertor, directly relevant for ITER and DEMO; d) exploit advanced regimes with a much longer pulse duration than the current diffusion time; e) provide a test bed for ITER and DEMO diagnostics; f) provide an ideal framework for model and numerical code benchmarks, their verification and validation in ITER/ DEMO-relevant plasma conditions

The cultural context of patient's autonomy and doctor's duty: passive euthanasia and advance directives in Germany and Israel.

Science.gov (United States)

Schicktanz, Silke; Raz, Aviad; Shalev, Carmel

2010-11-01

The moral discourse surrounding end-of-life (EoL) decisions is highly complex, and a comparison of Germany and Israel can highlight the impact of cultural factors. The comparison shows interesting differences in how patient's autonomy and doctor's duties are morally and legally related to each other with respect to the withholding and withdrawing of medical treatment in EoL situations. Taking the statements of two national expert ethics committees on EoL in Israel and Germany (and their legal outcome) as an example of this discourse, we describe the similarity of their recommendations and then focus on the differences, including the balancing of ethical principles, what is identified as a problem, what social role professionals play, and the influence of history and religion. The comparison seems to show that Israel is more restrictive in relation to Germany, in contrast with previous bioethical studies in the context of the moral and legal discourse regarding the beginning of life, in which Germany was characterized as far more restrictive. We reflect on the ambivalence of the cultural reasons for this difference and its expression in various dissenting views on passive euthanasia and advance directives, and conclude with a comment on the difficulty in classifying either stance as more or less restrictive.

Advance care planning with individuals experiencing homelessness: Literature review and recommendations for public health practice.

Science.gov (United States)

Hubbell, Sarah A

2017-09-01

Vulnerable populations in the United States experience disparities in access to advance care planning and may have significant unmet health care needs at the end of life, including unrelieved suffering. People who are homeless have increased morbidity and mortality risks, yet lack opportunities to communicate end-of-life preferences. This paper includes a narrative literature review of advance care planning interventions and qualitative investigations into end-of-life concerns among people experiencing homelessness. Trials of clinician-guided interventions with homeless individuals demonstrated effectiveness in achieving advance directive completion and surrogate decision-maker designation. End-of-life concerns among homeless persons included fears of dying alone, dying unnoticed, or remaining unidentified after death. Research participants also reported concerns regarding burial and notification of family members. Public health practitioners should facilitate advance care planning for people who are homeless by providing opportunities for education and discussion on care options and advance directives. © 2017 Wiley Periodicals, Inc.

Construction of a Direct Water-Injected Two-Stroke Engine for Phased Direct Fuel Injection-High Pressure Charging Investigations

Science.gov (United States)

Somsel, James P.

1998-01-01

The development of a water injected Orbital Combustion Process (OCP) engine was conducted to assess the viability of using the powerplant for high altitude NASA aircraft and General Aviation (GA) applications. An OCP direct fuel injected, 1.2 liter, three cylinder, two-stroke engine has been enhanced to independently inject water directly into the combustion chamber. The engine currently demonstrates low brake specific fuel consumption capability and an excellent power to weight ratio. With direct water injection, significant improvements can be made to engine power, to knock limits/ignition advance timing, and to engine NO(x) emissions. The principal aim of the testing was to validate a cyclic model developed by the Systems Analysis Branch at NASA Ames Research Center. The work is a continuation of Ames' investigations into a Phased Direct Fuel Injection Engine with High Pressure Charging (PDFI-ITPC).

Spatial Policy оf Exporting Direct Investments: Features оf China

Directory of Open Access Journals (Sweden)

Alina Nikolaevna Novopashina

2014-03-01

Full Text Available In recent years, China has shown rapid growth in volumes of foreign direct investment (FDI, which is the consequence of implementing policy. However, the structure of FDI does not correspond to the government-supported areas. Existing theoretical and empirical studies don’t reveal the causes of China’s FDI. Results of the regression analysis (based on panel data for 2003-2010 prove that the most attractive for Chinese investors were countries with following features: 1 rich in mineral resources, 2 possessing advanced technologies, 3 higher than in China income levels, 4 geographic proximity to China and 5 foreign trade openness. Furthermore, features of the current institutional environment in China affect the directions of foreign direct investment. Investors from PRC direct FDI in developing countries which have low quality of institutions as well as China. Investing in these countries is primarily aimed at getting access to their mineral resources and consumer markets. As for investing in developed countries, the reason is acquisition of advanced technologies which they possess. Directions of FDI in these countries, on the contrary, are determined by the high quality of institutions

Engaging Men and Boys in Advancing Women's Agency : Where We Stand and New Directions

OpenAIRE

Fleming, Paul J.; Barker, Gary; McCleary-Sills, Jennifer; Morton, Matthew

2013-01-01

Despite advances in gender equality, women and girls still face disadvantages and limits on their agency. Men and boys can be key stakeholders and allies to increase women's agency. This paper focuses on examining men's attitudes and behaviors related to gender equality and violence perpetration to better understand how to engage men and boys as. It uses data collected from men and women f...

Direct Problems and Inverse Problems in Biometric Systems

OpenAIRE

Mihailescu Marius Iulian

2013-01-01

The article purpose is to describe the two sides of biometrics technologies, direct problems and inverse problems. The advance that we face today in field of Information Technology makes Information Security an inseparable part. The authentication has a huge role when we deal about security. The problems that can appear in implementing and developing biometrics systems is raising many problems, and one of the goal of this article is to focus on direct and inverse problems which is a new and c...

Sports Tournament Predictions Using Direct Manipulation.

Science.gov (United States)

Vuillemot, Romain; Perin, Charles

2016-01-01

An advanced interface for sports tournament predictions uses direct manipulation to allow users to make nonlinear predictions. Unlike previous interface designs, the interface helps users focus on their prediction tasks by enabling them to first choose a winner and then fill out the rest of the bracket. In real-world tests of the proposed interface (for the 2014 FIFA World Cup tournament and 2015/2016 UEFA Champions League), the authors validated the use of direct manipulation as an alternative to widgets. Using visitor interaction logs, they were able to determine the strategies people use to perform predictions and identify potential areas of improvement for further prediction interfaces.

Large-Scale Direct-Writing of Aligned Nanofibers for Flexible Electronics.

Science.gov (United States)

Ye, Dong; Ding, Yajiang; Duan, Yongqing; Su, Jiangtao; Yin, Zhouping; Huang, Yong An

2018-05-01

Nanofibers/nanowires usually exhibit exceptionally low flexural rigidities and remarkable tolerance against mechanical bending, showing superior advantages in flexible electronics applications. Electrospinning is regarded as a powerful process for this 1D nanostructure; however, it can only be able to produce chaotic fibers that are incompatible with the well-patterned microstructures in flexible electronics. Electro-hydrodynamic (EHD) direct-writing technology enables large-scale deposition of highly aligned nanofibers in an additive, noncontact, real-time adjustment, and individual control manner on rigid or flexible, planar or curved substrates, making it rather attractive in the fabrication of flexible electronics. In this Review, the ground-breaking research progress in the field of EHD direct-writing technology is summarized, including a brief chronology of EHD direct-writing techniques, basic principles and alignment strategies, and applications in flexible electronics. Finally, future prospects are suggested to advance flexible electronics based on orderly arranged EHD direct-written fibers. This technology overcomes the limitations of the resolution of fabrication and viscosity of ink of conventional inkjet printing, and represents major advances in manufacturing of flexible electronics. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Key Advances in the Systemic Therapy for Soft tissue Sarcomas: Current Status and Future Directions

Directory of Open Access Journals (Sweden)

Neelesh Soman

2013-10-01

Full Text Available Soft tissue sarcomas (STS represent a heterogeneous group of diverse neoplasms of mesenchymal origin. Once relapsed from standard therapy, STS patients have limited treatment options especially those that present with advanced or metastatic disease. In this review article, we highlight recent clinical data that led to the US Food and Drug Administration (FDA approval of pazopanib (Votrient® for STS and regorafenib (Stivarga®, BAY 73-4506 in gastrointestinal stromal tumours. We also review ongoing safety/efficacy data for trabectedin (Yondelis®, ET-743, and data from clinical studies of ridaforolimus (AP23573; MK-8669 and palifosfamide (ZIO-201. We provide a list of some promising ongoing trials in soft tissue sarcomas including first line studies of TH-302 and trabectedin. Finally, our article delves into recent advances in our understanding of the molecular pathogenesis of STS and novel therapies that might be explored as treatment options for specific STS histologies.

Status of advanced bremsstrahlung converters

International Nuclear Information System (INIS)

Halbleib, J.A.

1980-01-01

This paper is an attempt to review the somewhat ill-defined area of advanced converter research in a more or less chronological fashion. Section 2 reviews the early B/sub z/ work that was motivated by the CASINO project. More recent work makes liberal use of technology from ICF research using REBs is discussed in Sec. 3. Section 4 discusses possible directions for future research, some of which are being actively pursued at Sandia National Laboratories (SNL) and elsewhere

Computational Intelligence Paradigms in Advanced Pattern Classification

CERN Document Server

Jain, Lakhmi

2012-01-01

This monograph presents selected areas of application of pattern recognition and classification approaches including handwriting recognition, medical image analysis and interpretation, development of cognitive systems for image computer understanding, moving object detection, advanced image filtration and intelligent multi-object labelling and classification. It is directed to the scientists, application engineers, professors, professors and students will find this book useful.

First VESF School on Advanced Detectors for Gravitational Waves

CERN Document Server

Advanced Interferometers and the Search for Gravitational Waves

2014-01-01

The search for gravitational radiation with optical interferometers is gaining momentum worldwide. Beside the VIRGO and GEO gravitational wave observatories in Europe and the two LIGOs in the United States, which have operated successfully during the past decade, further observatories are being completed (KAGRA in Japan) or planned (ILIGO in India). The sensitivity of the current observatories, although spectacular, has not allowed direct discovery of gravitational waves. The advanced detectors (Advanced LIGO and Advanced Virgo), at present in the development phase, will improve sensitivity by a factor of 10, probing the universe up to 200 Mpc for signal from inspiraling binary compact stars. This book covers all experimental aspects of the search for gravitational radiation with optical interferometers. Every facet of the technological development underlying the evolution of advanced interferometers is thoroughly described, from configuration to optics and coatings, and from thermal compensation to suspensio...

An update on current management of advanced renal cell cancer, biomarkers, and future directions

OpenAIRE

Zhi, Wanqing Iris; Kim, Jenny J.

2014-01-01

In the past decade, metastatic renal cell carcinoma (mRCC) treatment underwent significant advancement that resulted in an unprecedented improvement in the prognosis of this disease. This review will provide an updated review of currently approved treatment options, namely antiangiogenic and immunotherapy, as well as treatment guideline recommended by the National Comprehensive Cancer Network (NCCN). We will summarize studies ongoing in determining prognostic and predictive biomarkers in maxi...

Recent designs for advanced fusion reactor blankets

International Nuclear Information System (INIS)

Sze, D.K.

1994-06-01

A series of reactor design studies based on the Tokamak configuration have been carried out under the direction of Professor Robert Conn of UCLA. They are called ARIES-1 through 4 and PULSAR 1 and 2. The key mission of these studies is to evaluate the attractiveness of fusion assuming different degrees of advancement in either physics or engineering development. Also, the requirements of engineering and physics systems for a pulsed reactor were evaluated by the PULSAR design studies. This paper discusses the directions and conclusions of the blanket and related engineering systems for those design studies

Impact of the Distance of Maxillary Advancement on Horizontal Relapse After Orthognathic Surgery.

Science.gov (United States)

Fahradyan, Artur; Wolfswinkel, Erik M; Clarke, Noreen; Park, Stephen; Tsuha, Michaela; Urata, Mark M; Hammoudeh, Jeffrey A; Yamashita, Dennis-Duke R

2018-04-01

The maxillary horizontal relapse following Le Fort I advancement has been estimated to be 10% to 50%. This retrospective review examines the direct association between the amounts of maxillary advancement and relapse. We hypothesize that the greater the advancement, the greater the relapse amount. Patients with class III skeletal malocclusion underwent maxillary advancement with either a Le Fort I or a Le Fort I with simultaneous mandibular setback (bimaxillary surgery) from 2008 to 2015. Patients were assessed for a history of cleft lip or cleft palate. Patients with known syndromes were excluded. Cephalometric analysis was performed to compare surgical and postsurgical changes. Of 136 patients, 47.1% were males and 61.8% had a history of cleft. The mean surgery age was 18.9 (13.8-23) years and 53.7% underwent a bimaxillary procedure. A representative subgroup of 35 patients had preoperative, immediate postoperative, and an average of 1-year postoperative lateral cephalograms taken. The mean maxillary advancement was 6.3 mm and the horizontal relapse was 1.8 mm, indicating a 28.6% relapse. A history of cleft and amount of maxillary advancement were directly correlated, whereas bone grafting of the maxillary osteotomy sites was inversely correlated with the amount of relapse ( P < .05). Our data suggest positive correlation between amount of maxillary advancement and horizontal relapse as well as a positive correlation between history of cleft and horizontal relapse. Bone grafting of the maxillary osteotomy sites has a protective effect on the relapse.

AdvancED Flex 4

CERN Document Server

Tiwari, Shashank; Schulze, Charlie

2010-01-01

AdvancED Flex 4 makes advanced Flex 4 concepts and techniques easy. Ajax, RIA, Web 2.0, mashups, mobile applications, the most sophisticated web tools, and the coolest interactive web applications are all covered with practical, visually oriented recipes. * Completely updated for the new tools in Flex 4* Demonstrates how to use Flex 4 to create robust and scalable enterprise-grade Rich Internet Applications.* Teaches you to build high-performance web applications with interactivity that really engages your users.* What you'll learn Practiced beginners and intermediate users of Flex, especially

Advanced medical interventions in pleural disease

Directory of Open Access Journals (Sweden)

Rahul Bhatnagar

2016-06-01

Full Text Available The burden of a number of pleural diseases continues to increase internationally. Although many pleural procedures have historically been the domain of interventional radiologists or thoracic surgeons, in recent years, there has been a marked expansion in the techniques available to the pulmonologist. This has been due in part to both technological advancements and a greater recognition that pleural disease is an important subspecialty of respiratory medicine. This article summarises the important literature relating to a number of advanced pleural interventions, including medical thoracoscopy, the insertion and use of indwelling pleural catheters, pleural manometry, point-of-care thoracic ultrasound, and image-guided closed pleural biopsy. We also aim to inform the reader regarding the latest updates to more established procedures such as chemical pleurodesis, thoracentesis and the management of chest drains, drawing on contemporary data from recent randomised trials. Finally, we shall look to explore the challenges faced by those practicing pleural medicine, especially relating to training, as well as possible future directions for the use and expansion of advanced medical interventions in pleural disease.

Current status and prospect of therapy with advanced cancer

International Nuclear Information System (INIS)

Watari, Tsutomu

1979-01-01

Symtomatic or palliative therapy of the patients with advanced cancer must be directed to the relief of specific distressing symptoms caused by or associated with neoplasm. The radiotherapy must have a clear concepts of the potential accomplishments of other treatment modalities, such as neurosurgery, anesthesiology, chemotherapy, pharmacology and psychotherapy, so that he may use his own method in proper perspective. I discussed following is an list of contents in this papers. Relief of pain, Psychotherapy, SVC obstruction, Obstructive jaundice, Brain and lung metastasis, prevention of fracture, Skin metastasis, Liver metastasis and treatment of advanced pediaric tumor etc. For the future: 1) Establishment of Stage and Grade of advanced cancer. 2) Development of new chemotherapeutic drug and immunotherapy. 3) Combination of multidisciplinary team and multidisciplinary treatment. (author)

Energy Efficient Engine program advanced turbofan nacelle definition study

Science.gov (United States)

Howe, David C.; Wynosky, T. A.

1985-01-01

Advanced, low drag, nacelle configurations were defined for some of the more promising propulsion systems identified in the earlier Benefit/Cost Study, to assess the benefits associated with these advanced technology nacelles and formulate programs for developing these nacelles and low volume thrust reversers/spoilers to a state of technology readiness in the early 1990's. The study results established the design feasibility of advanced technology, slim line nacelles applicable to advanced technology, high bypass ratio turbofan engines. Design feasibility was also established for two low volume thrust reverse/spoiler concepts that meet or exceed the required effectiveness for these engines. These nacelle and thrust reverse/spoiler designs were shown to be applicable in engines with takeoff thrust sizes ranging from 24,000 to 60,000 pounds. The reduced weight, drag, and cost of the advanced technology nacelle installations relative to current technology nacelles offer a mission fuel burn savings ranging from 3.0 to 4.5 percent and direct operating cost plus interest improvements from 1.6 to 2.2 percent.

A osteogenesis distraction device enabling control of vertical direction for syndromic craniosynostosis.

Science.gov (United States)

Kobayashi, Shinji; Fukawa, Toshihiko; Hirakawa, Takashi; Maegawa, Jiro

2014-02-01

We have developed a hybrid facial osteogenesis distraction system that combines the advantages of external and internal distraction devices to enable control of both the distraction distance and vector. However, when the advanced maxilla has excessive clockwise rotation and shifts more downward vertically than planned, it might be impossible to pull it up to correct it. We invented devices attached to external distraction systems that can control the vertical vector of distraction to resolve this problem. The purpose of this article is to describe the result of utilizing the distraction system for syndromic craniosynostosis. In addition to a previously reported hybrid facial distraction system, the devices for controlling the vertical direction of the advanced maxilla were attached to the external distraction device. The vertical direction of the advanced maxilla can be controlled by adjustment of the spindle units. This system was used for 2 patients with Crouzon and Apert syndrome. The system enabled control of the vertical distance, with no complications during the procedures. As a result, the maxilla could be advanced into the planned position including overcorrection without excessive clockwise rotation of distraction. Our system can alter the cases and bring them into the planned position, by controlling the vertical vector of distraction. We believe that this system might be effective in infants with syndromic craniosynostosis as it involves 2 osteotomies and horizontal and vertical direction of elongation can be controlled.

Opinions about euthanasia and advanced dementia: a qualitative study among Dutch physicians and members of the general public.

Science.gov (United States)

Kouwenhoven, Pauline S C; Raijmakers, Natasja J H; van Delden, Johannes J M; Rietjens, Judith A C; van Tol, Donald G; van de Vathorst, Suzanne; de Graeff, Nienke; Weyers, Heleen A M; van der Heide, Agnes; van Thiel, Ghislaine J M W

2015-01-28

The Dutch law states that a physician may perform euthanasia according to a written advance euthanasia directive (AED) when a patient is incompetent as long as all legal criteria of due care are met. This may also hold for patients with advanced dementia. We investigated the differing opinions of physicians and members of the general public on the acceptability of euthanasia in patients with advanced dementia. In this qualitative study, 16 medical specialists, 19 general practitioners, 16 elderly physicians and 16 members of the general public were interviewed and asked for their opinions about a vignette on euthanasia based on an AED in a patient with advanced dementia. Members of the general public perceived advanced dementia as a debilitating and degrading disease. Physicians emphasized the need for direct communication with the patient when making decisions about euthanasia. Respondent from both groups acknowledged difficulties in the assessment of patients' autonomous wishes and the unbearableness of their suffering. Legally, an AED may replace direct communication with patients about their request for euthanasia. In practice, physicians are reluctant to forego adequate verbal communication with the patient because they wish to verify the voluntariness of patients' request and the unbearableness of suffering. For this reason, the applicability of AEDs in advanced dementia seems limited.

Advanced energy projects: FY 1987 research summaries

International Nuclear Information System (INIS)

1987-09-01

This report contains brief summaries of all projects active in the Division of Advanced Energy Projects during Fiscal Year 1987 (October 1, 1986-September 30, 1987). The intent of this compilation is to provide a convenient means for quickly acquainting an interested reader with the program in Advanced Energy Projects. More detailed information on research activities in a particular project may be obtained by contacting directly the principal investigator. Some projects will have reached the end of their contract periods by the time this book appears, and will, therefore, no longer be active. Those cases in which work was completed in FY '87 are indicated by the footnote: Project completed. The annual funding level of each project is shown

Advances in steam generator service technology

International Nuclear Information System (INIS)

Nair, B. R.; Bastin, J. J.

1997-01-01

This paper will discuss the most recent and innovative advances in the areas of pressurized water reactor (PWR) steam generator service technology. The paper will include detail of new products such as the Remotely Operated Service Arm (ROSA-III), laser welded sleeving, and laser welded Direct Tube Repair (DTR) - products and services that save utility costs, shorten outage durations, enhance plant performance and safety, and reduce radiation exposure. (author)

[Thalidomide teratogenicity and its direct target identification].

Science.gov (United States)

Ito, Takumi; Ando, Hideki; Handa, Hiroshi

2015-01-01

Half a century ago, thalidomide was developed as a sedative drug and was wildly used over 40 countries. However the drug has serious birth defects such as amelia and phocomelia. Now thalidomide is regarded as a clinically effective drug and used for the treatment of multiple myeloma under strict controls. The direct target of thalidomide had been a long-standing question. We identified cereblon as a primary direct target protein for thalidomide teratogenicity using new affinity bead technology in 2010. In this review, we introduce an overview of thalidomide teratogenicity, a story about how we identified cereblon, and recent advances in cereblon studies.

Directional Joint Bilateral Filter for Depth Images

Directory of Open Access Journals (Sweden)

Anh Vu Le

2014-06-01

Full Text Available Depth maps taken by the low cost Kinect sensor are often noisy and incomplete. Thus, post-processing for obtaining reliable depth maps is necessary for advanced image and video applications such as object recognition and multi-view rendering. In this paper, we propose adaptive directional filters that fill the holes and suppress the noise in depth maps. Specifically, novel filters whose window shapes are adaptively adjusted based on the edge direction of the color image are presented. Experimental results show that our method yields higher quality filtered depth maps than other existing methods, especially at the edge boundaries.

A puzzling aspect of the effect of advance notice on unemployment

DEFF Research Database (Denmark)

Addision, John; Blackburn, McKinley L.

1995-01-01

Displaced male workers with generous periods of advance notice tend to move directly into reemployment faster than their non-notified counterparts but once unemployed tend to escape from unemployment much more slowly. We examine three potential explanations for this puzzle associated with unemplo......Displaced male workers with generous periods of advance notice tend to move directly into reemployment faster than their non-notified counterparts but once unemployed tend to escape from unemployment much more slowly. We examine three potential explanations for this puzzle associated...... with unemployment insurance, the endogeneity of notice, and differential search intensity. Of these alternatives, the evidence suggests that it is the additional but less productive search time during the notice interval that creates the appearance of a puzzle....

Fully Integrated Biochip Platforms for Advanced Healthcare

Directory of Open Access Journals (Sweden)

Giovanni De Micheli

2012-08-01

Full Text Available Recent advances in microelectronics and biosensors are enabling developments of innovative biochips for advanced healthcare by providing fully integrated platforms for continuous monitoring of a large set of human disease biomarkers. Continuous monitoring of several human metabolites can be addressed by using fully integrated and minimally invasive devices located in the sub-cutis, typically in the peritoneal region. This extends the techniques of continuous monitoring of glucose currently being pursued with diabetic patients. However, several issues have to be considered in order to succeed in developing fully integrated and minimally invasive implantable devices. These innovative devices require a high-degree of integration, minimal invasive surgery, long-term biocompatibility, security and privacy in data transmission, high reliability, high reproducibility, high specificity, low detection limit and high sensitivity. Recent advances in the field have already proposed possible solutions for several of these issues. The aim of the present paper is to present a broad spectrum of recent results and to propose future directions of development in order to obtain fully implantable systems for the continuous monitoring of the human metabolism in advanced healthcare applications.

Ascertaining directionality information from incident nuclear radiation

Energy Technology Data Exchange (ETDEWEB)

Archambault, Brian C. [Purdue University (United States); Lapinskas, Joseph R. [QSA Global, Inc. (United States); Wang Jing; Webster, Jeffrey A. [Purdue University (United States); McDeavitt, Sean [Texas A and M University (United States); Taleyarkhan, Rusi P., E-mail: rusi@purdue.edu [Purdue University (United States)

2011-10-15

Highlights: > Use of tensioned metastable fluids for detection of fast neutron radiation. > Monitored neutrons with 100% gamma photon blindness capability. > Monitored direction of incoming neutron radiation from special nuclear material emissions. > Ascertained directionality of neutron source to within 30 deg. and with 80% confidence with 2000 detection events at rate of 30-40 per second. > Conducted successful blind test for determining source of neutrons from a hidden neutron emitting source. > Compared results with MCNP5-COMSOL based multi-physics model. - Abstract: Unprecedented capabilities for the detection of nuclear particles via tailored resonant acoustic systems such as the acoustic tensioned metastable fluid detection (ATMFD) systems were assessed for determining directionality of incoming fast neutrons. This paper presents advancements that expand on these accomplishments, thereby increasing the accuracy and precision of ascertaining directionality information utilizing enhanced signal processing-cum-signal analysis, refined computational algorithms, and on demand enlargement of the detector sensitive volume. Advances in the development of ATMFD systems were accomplished utilizing a combination of experimentation and theoretical modeling. Modeling methodologies include Monte-Carlo based nuclear particle transport using MCNP5 and multi-physics based assessments accounting for acoustic, structural, and electromagnetic coupling of the ATMFD system via COMSOL's multi-physics simulation platform. Benchmarking and qualification studies have been conducted with a 1 Ci Pu-Be neutron-gamma source. These results show that the specific ATMFD system used for this study can enable detection of directionality of incoming fast neutrons from the neutron source to within 30{sup o} with 80% confidence; this required {approx}2000 detection events which could be collected within {approx}50 s at a detection rate of {approx}30-40 per second. Blind testing was

Ascertaining directionality information from incident nuclear radiation

International Nuclear Information System (INIS)

Archambault, Brian C.; Lapinskas, Joseph R.; Wang Jing; Webster, Jeffrey A.; McDeavitt, Sean; Taleyarkhan, Rusi P.

2011-01-01

Highlights: → Use of tensioned metastable fluids for detection of fast neutron radiation. → Monitored neutrons with 100% gamma photon blindness capability. → Monitored direction of incoming neutron radiation from special nuclear material emissions. → Ascertained directionality of neutron source to within 30 deg. and with 80% confidence with 2000 detection events at rate of 30-40 per second. → Conducted successful blind test for determining source of neutrons from a hidden neutron emitting source. → Compared results with MCNP5-COMSOL based multi-physics model. - Abstract: Unprecedented capabilities for the detection of nuclear particles via tailored resonant acoustic systems such as the acoustic tensioned metastable fluid detection (ATMFD) systems were assessed for determining directionality of incoming fast neutrons. This paper presents advancements that expand on these accomplishments, thereby increasing the accuracy and precision of ascertaining directionality information utilizing enhanced signal processing-cum-signal analysis, refined computational algorithms, and on demand enlargement of the detector sensitive volume. Advances in the development of ATMFD systems were accomplished utilizing a combination of experimentation and theoretical modeling. Modeling methodologies include Monte-Carlo based nuclear particle transport using MCNP5 and multi-physics based assessments accounting for acoustic, structural, and electromagnetic coupling of the ATMFD system via COMSOL's multi-physics simulation platform. Benchmarking and qualification studies have been conducted with a 1 Ci Pu-Be neutron-gamma source. These results show that the specific ATMFD system used for this study can enable detection of directionality of incoming fast neutrons from the neutron source to within 30 o with 80% confidence; this required ∼2000 detection events which could be collected within ∼50 s at a detection rate of ∼30-40 per second. Blind testing was successfully

[Advance Directives in Family Practices: Results of a Survey of GP Patients on their Care Situation].

Science.gov (United States)

Schnakenberg, Rieke; Just, Johannes; Thiessen, Vitali; Puth, Marie-Therese; Bleckwenn, Markus; Weckbecker, Klaus

2017-07-26

Background Advance directives (AD) are an important tool for documentation of patients' wishes and are therefore recommended to the elderly as well as patients with chronic diseases. However, there is no standardized procedure in Germany and no guideline for counseling patients who wish to write an AD with or without health care proxy. The aim of this study was to evaluate the care situation concerning the ADs and the role of the primary care physician in drafting the document Method We conducted semi-structured interviews with patients in primary care in North Rhine-Westphalia using a cross-sectional study design. Result Most of the 154 patients who were interviewed (average age: 58 years; 52% female) suffered from chronic diseases (79%), and about one-third (32%) already had an AD. Fear of "loss of autonomy" was the main reason for preparing an AD. Patients without AD were generally not opposed to the concept and named procrastination (43%) as the main reason for not having prepared one. The chance for preparing an AD increased by the factor 1.08 per life-year (Odds ratio (OR): 1.08; CI: 1.04-1.11). Patients with AD mostly got advice via the internet (22%), their primary care physicians (12%) and relatives (12%). Most patients were satisfied with their AD. Conclusion The majority of primary care patients do not make use of ADs. The primary care physicians play an important role in counseling and should motivate patients to complete ADs. Here, the establishment of quality standards would be desirable in the future. © Georg Thieme Verlag KG Stuttgart · New York.

Multifunctional nanodiamonds in regenerative medicine: Recent advances and future directions.

Science.gov (United States)

Whitlow, Jonathan; Pacelli, Settimio; Paul, Arghya

2017-09-10

With recent advances in the field of nanomedicine, many new strategies have emerged for diagnosing and treating diseases. At the forefront of this multidisciplinary research, carbon nanomaterials have demonstrated unprecedented potential for a variety of regenerative medicine applications including novel drug delivery platforms that facilitate the localized and sustained release of therapeutics. Nanodiamonds (NDs) are a unique class of carbon nanoparticles that are gaining increasing attention for their biocompatibility, highly functional surfaces, optical properties, and robust physical properties. Their remarkable features have established NDs as an invaluable regenerative medicine platform, with a broad range of clinically relevant applications ranging from targeted delivery systems for insoluble drugs, bioactive substrates for stem cells, and fluorescent probes for long-term tracking of cells and biomolecules in vitro and in vivo. This review introduces the synthesis techniques and the various routes of surface functionalization that allow for precise control over the properties of NDs. It also provides an in-depth overview of the current progress made toward the use of NDs in the fields of drug delivery, tissue engineering, and bioimaging. Their future outlook in regenerative medicine including the current clinical significance of NDs, as well as the challenges that must be overcome to successfully translate the reviewed technologies from research platforms to clinical therapies will also be discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

Surface plasmon optics for biosensors with advanced sensitivity and throughput

International Nuclear Information System (INIS)

Toma, M.

2012-01-01

Plasmonic biosensors represent a rapidly advancing technology which enables rapid and sensitive analysis of target analytes. This thesis focuses on novel metallic and polymer structures for plasmonic biosensors based on surface plasmon resonance (SPR) and surface plasmon-enhanced fluorescence (SPF). It comprises four projects addressing key challenges concerning the enhancement of sensitivity and throughput. In the project 1, an advanced optical platform is developed which relies on reference-compensated angular spectroscopy of hydrogel-guided waves. The developed optical setup provides superior refractive index resolution of 1.2×10 -7 RIU and offers an attractive platform for direct detection of small analytes which cannot be analyzed by regular SPR biosensors. The project 2 carries out theoretical study of SPR imaging with advanced lateral resolution by utilizing Bragg scattered surface plasmons (BSSPs) on sub-wavelength metallic gratings. The results reveal that the proposed concept provides better lateral resolution and fidelity of the images. This feature opens ways for high-throughput SPR biosensors with denser arrays of sensing spots. The project 3 investigates surface plasmon coupled-emission from fluorophores in the vicinity of plasmonic Bragg-gratings. The experimental results provide leads on advancing the collection efficiency of fluorescence light by controlling the directions of fluorescence emission. This functionality can directly improve the sensitivity of fluorescence-based assays. In the last project 4, a novel sensing scheme with actively tuneable plasmonic structures is developed by employing thermo-responsive hydrogel binding matrix. The hydrogel film simultaneously serves as a large capacity binding matrix and provides means for actuating of surface plasmons through reversible swelling and collapsing of the hydrogel. This characteristic is suitable for multiplexing of sensing channels in fluorescence-based biosensor scheme (author)

Advance care planning: Beyond the living will.

Science.gov (United States)

Messinger-Rapport, Barbara J; Baum, Elizabeth E; Smith, Martin L

2009-05-01

For a variety of reasons, the most commonly used advance directive documents (eg, the living will) may not be very useful in many situations that older adults encounter. The durable power of attorney for health care is a more versatile document. We advocate focusing less on "signing away" certain interventions and more on clarifying the goals of care in the ambulatory setting.

FOREWORD: Focus on Advanced Ceramics Focus on Advanced Ceramics

Science.gov (United States)

Ohashi, Naoki

2011-06-01

Much research has been devoted recently to developing technologies for renewable energy and improving the efficiency of the processes and devices used in industry and everyday life. Efficient solutions have been found using novel materials such as platinum and palladium-based catalysts for car exhaust systems, samarium-cobalt and neodymium-iron-boron permanent magnets for electrical motors, and so on. However, their realization has resulted in an increasing demand for rare elements and in their deficit, the development of new materials based on more abundant elements and new functionalities of traditional materials. Moreover, increasing environmental and health concerns demand substitution of toxic or hazardous substances with nature-friendly alternatives. In this context, this focus issue on advanced ceramics aims to review current trends in ceramics science and technology. It is related to the International Conference on Science and Technology of Advanced Ceramics (STAC) held annually to discuss the emerging issues in the field of ceramics. An important direction of ceramic science is the collaboration between experimental and theoretical sciences. Recent developments in density functional theory and computer technology have enabled the prediction of physical and chemical properties of ceramics, thereby assisting the design of new materials. Therefore, this focus issue includes articles devoted to theory and advanced characterization techniques. As mentioned above, the potential shortage of rare elements is becoming critical to the industry and has resulted in a Japanese government initiative called the 'Ubiquitous Element Strategy'. This focus issue also includes articles related to this strategy and to the associated topics of energy conversion, such as phosphors for high-efficiency lighting and photocatalysts for solar-energy harvesting. We hope that this focus issue will provide a timely overview of current trends and problems in ceramics science and

Rejuvenating direct modulation and direct detection for modern optical communications

Science.gov (United States)

Che, Di; Li, An; Chen, Xi; Hu, Qian; Shieh, William

2018-02-01

High-speed transoceanic optical fiber transmission using direct modulation (DM) and direct detection (DD) was one of the most stirring breakthroughs for telecommunication in 1990s, which drove the internet as a global phenomenon. However, the later evolution of optical coherent communications in 2000s gradually took over the long-haul applications, due to its superior optical spectral efficiency. Nowadays, DM-DD systems are dominant mainly in cost- and power-sensitive short-reach applications, because of its natural characteristics-the simplicity. This paper reviews the recent advances of DM-DD transceivers from both hardware and signal processing perspectives. It introduces a variety of modified DM and/or DD systems for 3 application scenarios: very-short-reach interconnect with little fiber channel impact; single or a few spans of fiber transmission up to several hundred km; and distance beyond the 2nd scenario. Besides the DM-DD and multi-dimension DM-DD with polarization diversity, this paper focuses on how to rejuvenate traditional DM and DD technologies in order to bridge the transmission application gap between DM-DD and coherent transceivers, using technologies such as dispersion compensation, signal field recovery from the intensity-only DD receiver, and complex direct modulation with coherent detection. More than 30 years since the birth, DM and DD still hold indispensable roles in modern optical communications.

Advanced reactor development for non-electric applications

International Nuclear Information System (INIS)

Chang, M.H.; Kim, S.H.

1996-01-01

Advance in the nuclear reactor technology achieved through nuclear power programs carried out in the world has led nuclear communities to direct its attention to a better and peaceful utilization of nuclear energy in addition to that for power generation. The efforts for non-electric application of nuclear energy has been pursued in a limited number of countries in the world for their special needs. However, those needs and the associated efforts contributed largely to the development and practical realization of advanced reactors characterized by highly improved reactor safety and reliability by deploying the most up-to-date safety technologies. Due mainly to the special purpose of utilization, economic reasons and ease in implementation of new advanced technologies, small and medium reactors have become a major stream in the reactor developments for non-electric applications. The purpose of this paper is to provide, to the interested nuclear society, the overview of the development status and design characteristics of selected advanced nuclear reactors previously developed and/or currently under development specially for non-electric applications. Major design technologies employed in those reactors to enhance the reactor safety and reliability are reviewed to present the underlying principles of the design. Along with the overview, this paper also introduces a development program and major design characteristics of an advanced integral reactor (SMART) for co-generation purpose currently under conceptual development in Korea. (author)

Soil respiration in Mexico: Advances and future directions

Directory of Open Access Journals (Sweden)

Alejandro Cueva

2016-07-01

Full Text Available Soil respiration (RS is a CO2 efflux from the soil to the atmosphere defined as the sum of autotrophic (respiration by roots and mycorrhizae, and heterotrophic (respiration of microorganisms that decompose fractions of organic matter and of soil fauna respiration. Globally, RS is considered to be the second largest flux of C to the atmosphere. From published literature it is clear that its main controls are soil temperature, soil moisture, photosynthesis, organic matter inputs and soil biota composition. Despite its relevance in C cycle science, there have been only twenty eight studies in Mexico in the last decade where direct measurement of gas exchange was conducted in the field. These studies were held mostly in agricultural and forest ecosystems, in Central and Southern Mexico where mild subtropical conditions prevail. However, arid, semi-arid, tropical and wetland ecosystems may have an important role in Mexico’s CO2 emissions because of their extent and extensive land use changes. From the twenty eight studies, only two provided continuous measurements of RS with high temporal resolution, highlighting the need for long-term studies to evaluate the complex biophysical controls of this flux and associated processes over different ecological succession stages. We conclude that Mexico represents an important opportunity to understand its complex dynamics, in national and global context, as ecosystems in the country cover a wide range of climatic conditions. This is particularly important because deforestation and degradation of Mexican ecosystems is rapidly increasing along with expected changes in climate.

Omics Advances in Ecotoxicology.

Science.gov (United States)

Zhang, Xiaowei; Xia, Pu; Wang, Pingping; Yang, Jianghu; Baird, Donald J

2018-04-03

Toxic substances in the environment generate adverse effects at all levels of biological organization from the molecular level to community and ecosystem. Given this complexity, it is not surprising that ecotoxicologists have struggled to address the full consequences of toxic substance release at ecosystem level, due to the limits of observational and experimental tools to reveal the changes in deep structure at different levels of organization. -Omics technologies, consisting of genomics and ecogenomics, have the power to reveal, in unprecedented detail, the cellular processes of an individual or biodiversity of a community in response to environmental change with high sample/observation throughput. This represents a historic opportunity to transform the way we study toxic substances in ecosystems, through direct linkage of ecological effects with the systems biology of organisms. Three recent examples of -omics advance in the assessment of toxic substances are explored here: (1) the use of functional genomics in the discovery of novel molecular mechanisms of toxicity of chemicals in the environment; (2) the development of laboratory pipelines of dose-dependent, reduced transcriptomics to support high-throughput chemical testing at the biological pathway level; and (3) the use of eDNA metabarcoding approaches for assessing chemical effects on biological communities in mesocosm experiments and through direct observation in field monitoring. -Omics advances in ecotoxicological studies not only generate new knowledge regarding mechanisms of toxicity and environmental effect, improving the relevance and immediacy of laboratory toxicological assessment, but can provide a wholly new paradigm for ecotoxicology by linking ecological models to mechanism-based, systems biology approaches.

Using SpaceClaimTD Direct for Modeling Components with Complex Geometries for the Thermal Desktop-Based Advanced Stirling Radioisotope Generator Model

Science.gov (United States)

Fabanich, William A., Jr.

2014-01-01

SpaceClaim/TD Direct has been used extensively in the development of the Advanced Stirling Radioisotope Generator (ASRG) thermal model. This paper outlines the workflow for that aspect of the task and includes proposed best practices and lessons learned. The ASRG thermal model was developed to predict component temperatures and power output and to provide insight into the prime contractor's thermal modeling efforts. The insulation blocks, heat collectors, and cold side adapter flanges (CSAFs) were modeled with this approach. The model was constructed using mostly TD finite difference (FD) surfaces/solids. However, some complex geometry could not be reproduced with TD primitives while maintaining the desired degree of geometric fidelity. Using SpaceClaim permitted the import of original CAD files and enabled the defeaturing/repair of those geometries. TD Direct (a SpaceClaim add-on from CRTech) adds features that allowed the "mark-up" of that geometry. These so-called "mark-ups" control how finite element (FE) meshes are to be generated through the "tagging" of features (e.g. edges, solids, surfaces). These tags represent parameters that include: submodels, material properties, material orienters, optical properties, and radiation analysis groups. TD aliases were used for most tags to allow analysis to be performed with a variety of parameter values. "Domain-tags" were also attached to individual and groups of surfaces and solids to allow them to be used later within TD to populate objects like, for example, heaters and contactors. These tools allow the user to make changes to the geometry in SpaceClaim and then easily synchronize the mesh in TD without having to redefine the objects each time as one would if using TDMesher. The use of SpaceClaim/TD Direct helps simplify the process for importing existing geometries and in the creation of high fidelity FE meshes to represent complex parts. It also saves time and effort in the subsequent analysis.

Using SpaceClaim/TD Direct for Modeling Components with Complex Geometries for the Thermal Desktop-Based Advanced Stirling Radioisotope Generator Model

Science.gov (United States)

Fabanich, William

2014-01-01

SpaceClaim/TD Direct has been used extensively in the development of the Advanced Stirling Radioisotope Generator (ASRG) thermal model. This paper outlines the workflow for that aspect of the task and includes proposed best practices and lessons learned. The ASRG thermal model was developed to predict component temperatures and power output and to provide insight into the prime contractors thermal modeling efforts. The insulation blocks, heat collectors, and cold side adapter flanges (CSAFs) were modeled with this approach. The model was constructed using mostly TD finite difference (FD) surfaces solids. However, some complex geometry could not be reproduced with TD primitives while maintaining the desired degree of geometric fidelity. Using SpaceClaim permitted the import of original CAD files and enabled the defeaturing repair of those geometries. TD Direct (a SpaceClaim add-on from CRTech) adds features that allowed the mark-up of that geometry. These so-called mark-ups control how finite element (FE) meshes were generated and allowed the tagging of features (e.g. edges, solids, surfaces). These tags represent parameters that include: submodels, material properties, material orienters, optical properties, and radiation analysis groups. TD aliases were used for most tags to allow analysis to be performed with a variety of parameter values. Domain-tags were also attached to individual and groups of surfaces and solids to allow them to be used later within TD to populate objects like, for example, heaters and contactors. These tools allow the user to make changes to the geometry in SpaceClaim and then easily synchronize the mesh in TD without having to redefine these objects each time as one would if using TD Mesher.The use of SpaceClaim/TD Direct has helped simplify the process for importing existing geometries and in the creation of high fidelity FE meshes to represent complex parts. It has also saved time and effort in the subsequent analysis.

Where There's a Will: The Link Between Estate Planning and Disparities in Advance Care Planning by White and Black Older Adults.

Science.gov (United States)

Koss, Catheryn S; Baker, Tamara A

2018-03-01

Data from the Health and Retirement Study ( n = 6,946) were used to test whether differences in estate planning accounted for disparities in advance care planning between White and Black older adults. White participants were more likely to have advance directives after controlling for demographic, health, and financial variables. When estate planning was also controlled, the odds of having an advance directive were equal for White and Black participants. In contrast, Whites remained more likely to discuss end-of-life preferences after controlling for demographic, health, financial, and estate planning variables. White participants were almost four times as likely to have wills or trusts. Wealth, income, and home ownership were predictive of estate planning. Financial disparities contributed to lower rates of estate planning which in turn explained in large part why Black older adults were less likely to have advance directives but did not account for race disparities in advance care discussion.

Advances in endoscopic retrograde cholangiopancreatography for the treatment of cholangiocarcinoma.

Science.gov (United States)

Uppal, Dushant S; Wang, Andrew Y

2015-06-25

Cholangiocarcinoma (CCA) is a malignancy of the bile ducts that carries high morbidity and mortality. Patients with CCA typically present with obstructive jaundice, and associated complications of CCA include cholangitis and biliary sepsis. Endoscopic retrograde cholangiopancreatography (ERCP) is a valuable treatment modality for patients with CCA, as it enables internal drainage of blocked bile ducts and hepatic segments by using plastic or metal stents. While there remains debate as to if bilateral (or multi-segmental) hepatic drainage is required and/or superior to unilateral drainage, the underlying tenant of draining any persistently opacified bile ducts is paramount to good ERCP practice and good clinical outcomes. Endoscopic therapy for malignant biliary strictures from CCA has advanced to include ablative therapies via ERCP-directed photodynamic therapy (PDT) or radiofrequency ablation (RFA). While ERCP techniques cannot cure CCA, advancements in the field of ERCP have enabled us to improve upon the quality of life of patients with inoperable and incurable disease. ERCP-directed PDT has been used in lieu of brachytherapy to provide neoadjuvant local tumor control in patients with CCA who are awaiting liver transplantation. Lastly, mounting evidence suggests that palliative ERCP-directed PDT, and probably ERCP-directed RFA as well, offer a survival advantage to patients with this difficult-to-treat malignancy.

The Crosstalk between Tissue Engineering and Pharmaceutical Biotechnology: Recent Advances and Future Directions.

Science.gov (United States)

Pacheco, Daniela P; Reis, Rui L; Correlo, Vítor M; Marques, Alexandra P

2015-01-01

Tissue-engineered constructs made of biotechnology-derived materials have been preferred due to their chemical and physical composition, which offers both high versatility and a support to enclose/ incorporate relevant signaling molecules and/or genes known to therapeutically induce tissue repair. Herein, a critical overview of the impact of different biotechnology-derived materials, scaffolds, and recombinant signaling molecules over the behavior of cells, another element of tissue engineered constructs, as well its regulatory role in tissue regeneration and disease progression is given. Additionally, these tissue-engineered constructs evolved to three-dimensional (3D) tissue-like models that, as an advancement of two-dimensional standard culture methods, are expected to be a valuable tool in the field of drug discovery and pharmaceutical research. Despite the improved design and conception of current proposed 3D tissue-like models, advanced control systems to enable and accelerate streamlining and automation of the numerous labor-intensive steps intrinsic to the development of tissue-engineered constructs are still to be achieved. In this sense, this review intends to present the biotechnology- derived materials that are being explored in the field of tissue engineering to generate 3D tissue-analogues and briefly highlight their foremost breakthroughs in tissue regeneration and drug discovery. It also aims to reinforce that the crosstalk between tissue engineering and pharmaceutical biotechnology has been fostering the outcomes of tissue engineering approaches through the use of biotechnology-derived signaling molecules. Gene delivery/therapy is also discussed as a forefront area that represents another cross point between tissue engineering and pharmaceutical biotechnology, in which nucleic acids can be considered a "super pharmaceutical" to drive biological responses, including tissue regeneration.

Advanced information society (10)

Science.gov (United States)

Masuyama, Keiichi

Informationalization in Japan has spread among various fields of industrial and social life in wide and depth by drastic advancement in technology and networking. Looking at the change in industrial structure as well as international trend in information the Japanese Government regards the role of information and communication technology as infrastructure to be important, and is under the way of constructing various measures with ministries and agencies concerned with them. This paper describes how administrative agencies involved in information and communication such as Ministry of Postal Services, Ministry of International Trade and Industry cope with informationalization, and mentions future direction in information policies.

A directly cooled grating substrate for ALS [Advanced Light Source] undulator beam lines

International Nuclear Information System (INIS)

DiGennaro, R.; Swain, T.

1989-08-01

Design analyses using finite element methods are presented for thermal distortion of water-cooled diffraction grating substrates for a potential application at the LBL Advanced Light Source, demonstrating that refinements in cooling channel configuration and heat flux distribution can significantly reduce optical surface distortion with high heat loads. Using an existing grating substrate design, sensitivity of tangential slope errors due to thermal distortion is evaluated for a variety of thermal boundary conditions, including coolant flow rate and heat transfer film coefficients, surface illumination area and heat distribution profile, and location of the convection cooling surfaces adjacent to the heated region. 1 ref., 5 figs., 2 tabs

The impact of gendered organizational systems on women's career advancement.

Science.gov (United States)

O'Neil, Deborah A; Hopkins, Margaret M

2015-01-01

In this Perspective article we propose that in order to pave the way for women's career advancement into the senior ranks of organizations, attention must be directed at the systemic norms and structures that drive the gendered nature of the workplace. A focus on individual level issues, i.e., women lacking confidence and women opting out, detracts from the work that must be done at the organizational level in order to dismantle the system of pervasive, structural disadvantage facing women seeking to advance to senior leadership positions.

The use of direct geometry spectrometers in molecular spectroscopy

International Nuclear Information System (INIS)

Parker, Stewart F; Ramirez-Cuesta, Anibal J; Albers, Peter W; Lennon, David

2014-01-01

The advantages and disadvantages of the use of direct geometry spectrometers for molecular spectroscopy and catalysis studies are described. We show that both direct and indirect geometry INS spectrometers are important tools for the study of industrially relevant areas such as catalysis, proton conductors and gas separation. We propose a novel hybrid instrument, Cerberus, that would offer high sensitivity and high-to-reasonable resolution across the entire 'mid-infrared' spectral range that would effectively advance research in these areas

Laboratory directed research and development annual report 2004

International Nuclear Information System (INIS)

Not Available

2005-01-01

This report summarizes progress from the Laboratory Directed Research and Development (LDRD) program during fiscal year 2004. In addition to a programmatic and financial overview, the report includes progress reports from 352 individual R and D projects in 15 categories. The 15 categories are: (1) Advanced Concepts; (2) Advanced Manufacturing; (3) Biotechnology; (4) Chemical and Earth Sciences; (5) Computational and Information Sciences; (6) Differentiating Technologies; (7) Electronics and Photonics; (8) Emerging Threats; (9) Energy and Critical Infrastructures; (10) Engineering Sciences; (11) Grand Challenges; (12) Materials Science and Technology; (13) Nonproliferation and Materials Control; (14) Pulsed Power and High Energy Density Sciences; and (15) Corporate Objectives

Experimentation and evaluation of advanced integrated system concepts

Science.gov (United States)

Ross, M.; Garrigus, K.; Gottschalck, J.; Rinearson, L.; Longee, E.

1980-09-01

This final report examines the implementation of a time-phased test bed for experimentation and evaluation of advanced system concepts relative to the future Defense Switched Network (DSN). After identifying issues pertinent to the DSN, a set of experiments which address these issues are developed. Experiments are ordered based on their immediacy and relative importance to DSN development. The set of experiments thus defined allows requirements for a time phased implementation of a test bed to be identified, and several generic test bed architectures which meet these requirements are examined. Specific architecture implementations are costed and cost/schedule profiles are generated as a function of experimental capability. The final recommended system consists of two separate test beds: a circuit switch test bed, configured around an off-the-shelf commercial switch, and directed toward the examination of nearer term and transitional issues raised by the evolving DSN; and a packet/hybrid test bed, featuring a discrete buildup of new hardware and software modules, and directed toward examination of the more advanced integrated voice and data telecommunications issues and concepts.

The Economics of Academic Advancement Within Surgery.

Science.gov (United States)

Baimas-George, Maria; Fleischer, Brian; Korndorffer, James R; Slakey, Douglas; DuCoin, Christopher

The success of an academic surgeon's career is often viewed as directly related to academic appointment; therefore, the sequence of promotion is a demanding, rigorous process. This paper seeks to define the financial implication of academic advancement across different surgical subspecialties. Data was collected from the Association of American Medical College's 2015 report of average annual salaries. Assumptions included 30 years of practice, 5 years as assistant professor, and 10 years as associate professor before advancement. The base formula used was: (average annual salary) × (years of practice [30 years - fellowship/research years]) + ($50,000 × years of fellowship/research) = total adjusted lifetime salary income. There was a significant increase in lifetime salary income with advancement from assistant to associate professor in all subspecialties when compared to an increase from associate to full professor. The greatest increase in income from assistant to associate professor was seen in transplant and cardiothoracic surgery (35% and 27%, respectively). Trauma surgery and surgical oncology had the smallest increases of 8% and 9%, respectively. With advancement to full professor, the increase in lifetime salary income was significantly less across all subspecialties, ranging from 1% in plastic surgery to 8% in pediatric surgery. When analyzing the economics of career advancement in academic surgery, there is a substantial financial benefit in lifetime income to becoming an associate professor in all fields; whereas, advancement to full professor is associated with a drastically reduced economic benefit. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Recent advances in laser-driven neutron sources

Science.gov (United States)

Alejo, A.; Ahmed, H.; Green, A.; Mirfayzi, S. R.; Borghesi, M.; Kar, S.

2016-11-01

Due to the limited number and high cost of large-scale neutron facilities, there has been a growing interest in compact accelerator-driven sources. In this context, several potential schemes of laser-driven neutron sources are being intensively studied employing laser-accelerated electron and ion beams. In addition to the potential of delivering neutron beams with high brilliance, directionality and ultra-short burst duration, a laser-driven neutron source would offer further advantages in terms of cost-effectiveness, compactness and radiation confinement by closed-coupled experiments. Some of the recent advances in this field are discussed, showing improvements in the directionality and flux of the laser-driven neutron beams.

Recent Advances in Bioprinting and Applications for Biosensing

Directory of Open Access Journals (Sweden)

Andrew D. Dias

2014-04-01

Full Text Available Future biosensing applications will require high performance, including real-time monitoring of physiological events, incorporation of biosensors into feedback-based devices, detection of toxins, and advanced diagnostics. Such functionality will necessitate biosensors with increased sensitivity, specificity, and throughput, as well as the ability to simultaneously detect multiple analytes. While these demands have yet to be fully realized, recent advances in biofabrication may allow sensors to achieve the high spatial sensitivity required, and bring us closer to achieving devices with these capabilities. To this end, we review recent advances in biofabrication techniques that may enable cutting-edge biosensors. In particular, we focus on bioprinting techniques (e.g., microcontact printing, inkjet printing, and laser direct-write that may prove pivotal to biosensor fabrication and scaling. Recent biosensors have employed these fabrication techniques with success, and further development may enable higher performance, including multiplexing multiple analytes or cell types within a single biosensor. We also review recent advances in 3D bioprinting, and explore their potential to create biosensors with live cells encapsulated in 3D microenvironments. Such advances in biofabrication will expand biosensor utility and availability, with impact realized in many interdisciplinary fields, as well as in the clinic.

Environmental Barrier Coating Development for SiC/SiC Ceramic Matrix Composites: Recent Advances and Future Directions

Science.gov (United States)

Zhu, Dongming

2016-01-01

This presentation briefly reviews the SiC/SiC major environmental and environment-fatigue degradations encountered in simulated turbine combustion environments, and thus NASA environmental barrier coating system evolution for protecting the SiC/SiC Ceramic Matrix Composites for meeting the engine performance requirements. The presentation will review several generations of NASA EBC materials systems, EBC-CMC component system technologies for SiC/SiC ceramic matrix composite combustors and turbine airfoils, highlighting the temperature capability and durability improvements in simulated engine high heat flux, high pressure, high velocity, and with mechanical creep and fatigue loading conditions. This paper will also focus on the performance requirements and design considerations of environmental barrier coatings for next generation turbine engine applications. The current development emphasis is placed on advanced NASA candidate environmental barrier coating systems for SiC/SiC CMCs, their performance benefits and design limitations in long-term operation and combustion environments. The efforts have been also directed to developing prime-reliant, self-healing 2700F EBC bond coat; and high stability, lower thermal conductivity, and durable EBC top coats. Major technical barriers in developing environmental barrier coating systems, the coating integrations with next generation CMCs having the improved environmental stability, erosion-impact resistance, and long-term fatigue-environment system durability performance will be described. The research and development opportunities for turbine engine environmental barrier coating systems by utilizing improved compositions, state-of-the-art processing methods, and simulated environment testing and durability modeling will be briefly discussed.

Linear induction accelerator approach for advanced radiography

International Nuclear Information System (INIS)

Caporaso, G.J.

1997-05-01

Recent advances in induction accelerator technology make it possible to envision a single accelerator that can serve as an intense, precision multiple pulse x-ray source for advanced radiography. Through the use of solid-state modulator technology repetition rates on the order of 1 MHz can be achieved with beam pulse lengths ranging from 200 ns to 2 microsecs. By using fast kickers, these pulses may be sectioned into pieces which are directed to different beam lines so as to interrogate the object under study from multiple lines of sight. The ultimate aim is to do a time dependent tomographic reconstruction of a dynamic object. The technology to accomplish these objectives along with a brief discussion of the experimental plans to verify it will be presented

Sustainability assessment of advanced wastewater treatment technologies

DEFF Research Database (Denmark)

Høibye, Linda; Clauson-Kaas, Jes; Wenzel, Henrik

2007-01-01

, which includes technical, economic and environmental aspects. The technical and economic assessment is performed on 5 advanced treatment technologies: sand filtration, ozone treatment, UV exclusively for disinfection of pathogenic microorganisms, Membrane Bioreactor (MBR), and UV in combination......As a consequence of the EU Water Framwork Directive, more focus is now on discharges of hazardous substances from wastewater treatment plants and sewers. Thus, many municipalities in Denmark may have to adopt to future advenced treatment technologies. This paper describes a holistic assessment...... with advanced oxidation. The technical assessment is based on 12 hazardous substances comprising heavy metals, organic pollutants, endocrine disruptors as well as pathogenic microorganisms. The environmental assessment is performed by life cycle assessment (LCA) comprising 9 of the specific hazardous substances...

Pediatric advance care planning from the perspective of health care professionals: a qualitative interview study.

Science.gov (United States)

Lotz, Julia D; Jox, Ralf J; Borasio, Gian Domenico; Führer, Monika

2015-03-01

Pediatric advance care planning differs from the adult setting in several aspects, including patients' diagnoses, minor age, and questionable capacity to consent. So far, research has largely neglected the professionals' perspective. We aimed to investigate the attitudes and needs of health care professionals with regard to pediatric advance care planning. This is a qualitative interview study with experts in pediatric end-of-life care. A qualitative content analysis was performed. We conducted 17 semi-structured interviews with health care professionals caring for severely ill children/adolescents, from different professions, care settings, and institutions. Perceived problems with pediatric advance care planning relate to professionals' discomfort and uncertainty regarding end-of-life decisions and advance directives. Conflicts may arise between physicians and non-medical care providers because both avoid taking responsibility for treatment limitations according to a minor's advance directive. Nevertheless, pediatric advance care planning is perceived as helpful by providing an action plan for everyone and ensuring that patient/parent wishes are respected. Important requirements for pediatric advance care planning were identified as follows: repeated discussions and shared decision-making with the family, a qualified facilitator who ensures continuity throughout the whole process, multi-professional conferences, as well as professional education on advance care planning. Despite a perceived need for pediatric advance care planning, several barriers to its implementation were identified. The results remain to be verified in a larger cohort of health care professionals. Future research should focus on developing and testing strategies for overcoming the existing barriers. © The Author(s) 2014.

Implications of directed energy for SETI

Science.gov (United States)

Lubin, Philip

2016-09-01

We compute the detectability of directed-energy (DE) sources from distant civilizations that may exist. Recent advances in our own DE technology suggest that our eventual capabilities will radically enhance our capacity to broadcast our presence and hence allow us to ponder the reverse case of detection. We show that DE systems are detectable at vast distances, possibly across the entire horizon, which profoundly alters conceivable search strategies for extra-terrestrial, technologically-advanced civilizations. Even modest searches are extremely effective at detecting or constraining many civilization classes. A single civilization anywhere in our galaxy of comparable technological advancement to our own can be detected with near unity probability with a cluster of 0.1 m telescopes on Earth. A 1 m class telescope can detect a single civilization anywhere in the Andromeda galaxy. A search strategy is proposed using small Earth-based telescopes to observe 1012-1020 stellar and planetary systems. Such observations could address whether there exist other civilizations which are broadcasting with similar or more advanced DE capability. We show that such searches have near-unity probability of detecting comparably advanced civilizations anywhere in our galaxy within a few years, assuming the civilization: (1) adopts a simple "intelligent targeting" beacon strategy; (2) is beaconing at a wavelength we can detect; (3) broadcast the beacon long enough for the light to reach Earth now. In this blind-beacon, blind-search strategy, the civilization need not know where we are nor do we need to know where they are. The same basic strategy can be extended to extragalactic distances.

Advances in directional borehole radar data analysis and visualization

Science.gov (United States)

Smith, D.V.G.; Brown, P.J.

2002-01-01

The U.S. Geological Survey is developing a directional borehole radar (DBOR) tool for mapping fractures, lithologic changes, and underground utility and void detection. An important part of the development of the DBOR tool is data analysis and visualization, with the aim of making the software graphical user interface (GUI) intuitive and easy to use. The DBOR software system consists of a suite of signal and image processing routines written in Research Systems' Interactive Data Language (IDL). The software also serves as a front-end to many widely accepted Colorado School of Mines Center for Wave Phenomena (CWP) Seismic UNIX (SU) algorithms (Cohen and Stockwell, 2001). Although the SU collection runs natively in a UNIX environment, our system seamlessly emulates a UNIX session within a widely used PC operating system (MicroSoft Windows) using GNU tools (Noer, 1998). Examples are presented of laboratory data acquired with the prototype tool from two different experimental settings. The first experiment imaged plastic pipes in a macro-scale sand tank. The second experiment monitored the progress of an invasion front resulting from oil injection. Finally, challenges to further development and planned future work are discussed.

The advanced fuel cycle initiative: the future path for advanced spent fuel treatment and transmutation research in the United States

International Nuclear Information System (INIS)

Herczeg, J.W.

2003-01-01

The U. S. Department of Energy (DOE) has invested over USD 100 million in transmutation research and development over the past three years. The programme has evolved from an accelerator based transmutation programme to a multi-tier reactor and accelerator based programme. These changes have resulted in a significant re-focus of the research and development programme as well as a name change to reflect the new direction. The Advanced Accelerator Application (AAA) programme is now renamed the Advanced Fuel Cycle Initiative (AFCI). Research completed by the AAA programme in Fiscal Year 2002 points to a multi-phased AFCI Programme consisting of two elements that would be conducted in parallel as part of an integrated research effort: an intermediate-term technology element (AFCI Series One), which emphasises advanced technical enhancements to the current commercial nuclear power infrastructure; and a long term technology element (AFCI Series Two), which will require the introduction of next-generation nuclear energy systems to reduce the toxicity of nuclear waste. (author)

Center for Advanced Computational Technology

Science.gov (United States)

Noor, Ahmed K.

2000-01-01

The Center for Advanced Computational Technology (ACT) was established to serve as a focal point for diverse research activities pertaining to application of advanced computational technology to future aerospace systems. These activities include the use of numerical simulations, artificial intelligence methods, multimedia and synthetic environments, and computational intelligence, in the modeling, analysis, sensitivity studies, optimization, design and operation of future aerospace systems. The Center is located at NASA Langley and is an integral part of the School of Engineering and Applied Science of the University of Virginia. The Center has four specific objectives: 1) conduct innovative research on applications of advanced computational technology to aerospace systems; 2) act as pathfinder by demonstrating to the research community what can be done (high-potential, high-risk research); 3) help in identifying future directions of research in support of the aeronautical and space missions of the twenty-first century; and 4) help in the rapid transfer of research results to industry and in broadening awareness among researchers and engineers of the state-of-the-art in applications of advanced computational technology to the analysis, design prototyping and operations of aerospace and other high-performance engineering systems. In addition to research, Center activities include helping in the planning and coordination of the activities of a multi-center team of NASA and JPL researchers who are developing an intelligent synthesis environment for future aerospace systems; organizing workshops and national symposia; as well as writing state-of-the-art monographs and NASA special publications on timely topics.

The impact of gendered organizational systems on women's career advancement

Directory of Open Access Journals (Sweden)

Deborah Anne O'Neil

2015-06-01

Full Text Available In this Perspective article we propose that in order to pave the way for women's career advancement into the senior ranks of organizations, attention must be directed at the systemic norms and structures that drive the gendered nature of the workplace. A focus on individual level issues, i.e., women lacking confidence and women opting out, detracts from the work that must be done at the organizational level in order to dismantle the system of pervasive, structural disadvantage facing women seeking to advance to senior leadership positions.

Pressure Safety: Advanced Self-Study 30120

Energy Technology Data Exchange (ETDEWEB)

Glass, George [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2016-02-29

Pressure Safety Advance Self-Study (Course 30120) consists of an introduction, five modules, and a quiz. To receive credit in UTrain for completing this course, you must score 80% or better on the 15-question quiz (check UTrain). Directions for initiating the quiz are appended to the end of this training manual. This course contains several links to LANL websites. UTrain might not support active links, so please copy links into the address line in your browser.

Direct methods for limit and shakedown analysis of structures advanced computational algorithms and material modelling

CERN Document Server

Pisano, Aurora; Weichert, Dieter

2015-01-01

Articles in this book examine various materials and how to determine directly the limit state of a structure, in the sense of limit analysis and shakedown analysis. Apart from classical applications in mechanical and civil engineering contexts, the book reports on the emerging field of material design beyond the elastic limit, which has further industrial design and technological applications. Readers will discover that “Direct Methods” and the techniques presented here can in fact be used to numerically estimate the strength of structured materials such as composites or nano-materials, which represent fruitful fields of future applications.   Leading researchers outline the latest computational tools and optimization techniques and explore the possibility of obtaining information on the limit state of a structure whose post-elastic loading path and constitutive behavior are not well defined or well known. Readers will discover how Direct Methods allow rapid and direct access to requested information in...

Metabolic engineering of Bacillus subtilis fueled by systems biology: Recent advances and future directions.

Science.gov (United States)

Liu, Yanfeng; Li, Jianghua; Du, Guocheng; Chen, Jian; Liu, Long

By combining advanced omics technology and computational modeling, systems biologists have identified and inferred thousands of regulatory events and system-wide interactions of the bacterium Bacillus subtilis, which is commonly used both in the laboratory and in industry. This dissection of the multiple layers of regulatory networks and their interactions has provided invaluable information for unraveling regulatory mechanisms and guiding metabolic engineering. In this review, we discuss recent advances in the systems biology and metabolic engineering of B. subtilis and highlight current gaps in our understanding of global metabolism and global pathway engineering in this organism. We also propose future perspectives in the systems biology of B. subtilis and suggest ways that this approach can be used to guide metabolic engineering. Specifically, although hundreds of regulatory events have been identified or inferred via systems biology approaches, systematic investigation of the functionality of these events in vivo has lagged, thereby preventing the elucidation of regulatory mechanisms and further rational pathway engineering. In metabolic engineering, ignoring the engineering of multilayer regulation hinders metabolic flux redistribution. Post-translational engineering, allosteric engineering, and dynamic pathway analyses and control will also contribute to the modulation and control of the metabolism of engineered B. subtilis, ultimately producing the desired cellular traits. We hope this review will aid metabolic engineers in making full use of available systems biology datasets and approaches for the design and perfection of microbial cell factories through global metabolism optimization. Copyright © 2016 Elsevier Inc. All rights reserved.

Measuring the impact of the advanced practitioner role: a practical approach.

Science.gov (United States)

Neville, Lillian; Swift, Juliette

2012-04-01

This paper aims to illuminate difficulties in evaluating the advanced practitioner role and to offer a practical solution. The advanced practice role has been part of the workforce strategy in the Northwest of England since 2005. However capturing hard evidence of the impact of this role has been problematic. Current restrictions on resources require the provision of evidence of the value of roles and services. Critical analysis of literature has identified challenges in evaluating the advanced practice role. The case study design takes account of current policy initiatives, notably QIPP. There is no common approach to evaluating the role of advanced practitioners. The case study has the potential to be a useful tool to organise evidence of the impact of advanced practitioner roles. Advanced practitioners need to have appropriate knowledge and skills to provide evidence of the impact of their role. There is potential for this work to be applied to other roles across the NHS. Managers need to work in partnership with workforce planners and educationalists to support advanced practitioners to utilise their skills in methods of providing evidence that they do work of value. Clear strategic direction for advanced practitioners is advised as part of the workforce strategy. © 2012 Blackwell Publishing Ltd.

Advanced materials and coatings for energy conversion systems

Energy Technology Data Exchange (ETDEWEB)

St Pierre, George R. [Ohio State Univ., Materials Science and Engineering Dept., Columbus, OH (United States)

1997-12-31

Following an historical review of the development of high-temperature alloys for energy conversion systems including turbine engines, some of the current advances in single crystal materials, intermetallics, metal-matrix composites, and ceramic-matrix composites are discussed. Particular attention is directed at creep phenomena, fatigue properties and oxidation resistance. Included within the discussions is the current status of carbon/carbon composites as potential high-temperature engineering materials and the development of coating systems for thermal barrier and oxidation protection. The specific influences of combustion gas compositions, i.e., oxidation potential, sulfur, halides, etc. are discussed. A current list of eligible advanced materials and coatings systems is presented and assessed. Finally, the critical failure mechanism and life-prediction parameters for some of the new classes of advanced structural materials are elaborated with the view to achieving affordability and extended life with a high degree of reliability. Examples are drawn from a variety of energy conversion systems. (Author)

NATO Advanced Research Institute on Health Services Systems

CERN Document Server

Werff, Albert; Hirsch, Gary; Barnard, Keith

1984-01-01

The Advanced Research Institute on "Health Services Systems" was held under the auspices of the NATO Special Programme Panel on Systems Science as a part of the NATO Science Committee's continuous effort to promote the advancement of science through international cooperation. A special word is said in this respect supra by Pro­ fessor Checkland, Chairman of the Systems Science Panel. The Advanced Research Institute (ARI) was organized for the purpose of bringing together senior scientists to seek a consensus on the assessment of the present state of knowledge on the specific topic of "health services systems" and to present views and recom­ mendations for future health services research directions, which should be of value to both the scientific community and the people in charge of reorienting health services. The conference was structured so as to permit the assembly of a variety of complementary viewpoints through intensive group discussions to be the basis of this final report. Invitees were selected fr...

Advanced stratified charge rotary aircraft engine design study

Science.gov (United States)

Badgley, P.; Berkowitz, M.; Jones, C.; Myers, D.; Norwood, E.; Pratt, W. B.; Ellis, D. R.; Huggins, G.; Mueller, A.; Hembrey, J. H.

1982-01-01

A technology base of new developments which offered potential benefits to a general aviation engine was compiled and ranked. Using design approaches selected from the ranked list, conceptual design studies were performed of an advanced and a highly advanced engine sized to provide 186/250 shaft Kw/HP under cruise conditions at 7620/25,000 m/ft altitude. These are turbocharged, direct-injected stratified charge engines intended for commercial introduction in the early 1990's. The engine descriptive data includes tables, curves, and drawings depicting configuration, performance, weights and sizes, heat rejection, ignition and fuel injection system descriptions, maintenance requirements, and scaling data for varying power. An engine-airframe integration study of the resulting engines in advanced airframes was performed on a comparative basis with current production type engines. The results show airplane performance, costs, noise & installation factors. The rotary-engined airplanes display substantial improvements over the baseline, including 30 to 35% lower fuel usage.

Statistical mechanics of directed models of polymers in the square lattice

CERN Document Server

Rensburg, J V

2003-01-01

Directed square lattice models of polymers and vesicles have received considerable attention in the recent mathematical and physical sciences literature. These are idealized geometric directed lattice models introduced to study phase behaviour in polymers, and include Dyck paths, partially directed paths, directed trees and directed vesicles models. Directed models are closely related to models studied in the combinatorics literature (and are often exactly solvable). They are also simplified versions of a number of statistical mechanics models, including the self-avoiding walk, lattice animals and lattice vesicles. The exchange of approaches and ideas between statistical mechanics and combinatorics have considerably advanced the description and understanding of directed lattice models, and this will be explored in this review. The combinatorial nature of directed lattice path models makes a study using generating function approaches most natural. In contrast, the statistical mechanics approach would introduce...

Initial Efficacy Testing of an Autobiographical Memory Intervention on Advance Care Planning for Patients With Terminal Cancer.

Science.gov (United States)

Brohard, Cheryl

2017-11-01

To test the efficacy of a novel intervention to facilitate advance care planning.
. Exploratory, quasiexperimental pilot study with two independent groups.
. A large hospice located in the southwestern United States. 
. A convenience sample of 50 participants with terminal cancer enrolled in hospice.
. An autobiographical memory (ABM) intervention used the participants' experiences with cancer and end of life for the purpose of directing advance care planning.
. Two domains of advance care planning, decision making and communication, were measured in relation to 11 variables. The ABM intervention was nonthreatening, short in duration, and easily completed with participants as they recalled, without hesitation, specific personal memories of family and friends who had died and their advance care plans. The Mann-Whitney nonparametric test revealed that participants in the experimental group had a higher average rank than those in the control group for communicating the decision about antibiotics, as well as exhibited a trend toward significance for five other advance care planning variables.
. Findings showed that directive ABMs may be effective in influencing the decision making and communication of advance care planning for terminally ill patients with cancer.
. The current level of understanding about using the ABM intervention suggests that nurses can initiate an advance care planning conversation using this approach.

Research, development, demonstration, and early deployment policies for advanced-coal technology in China

International Nuclear Information System (INIS)

Zhao Lifeng; Gallagher, Kelly Sims

2007-01-01

Advanced-coal technologies will increasingly play a significant role in addressing China's multiple energy challenges. This paper introduces the current status of energy in China, evaluates the research, development, and demonstration policies for advanced-coal technologies during the Tenth Five-Year Plan, and gives policy prospects for advanced-coal technologies in the Eleventh Five-Year Plan. Early deployment policies for advanced-coal technologies are discussed and some recommendations are put forward. China has made great progress in the development of advanced-coal technologies. In terms of research, development, and demonstration of advanced-coal technologies, China has achieved breakthroughs in developing and demonstrating advanced-coal gasification, direct and indirect coal liquefaction, and key technologies of Integrated Gasification Combined Cycle (IGCC) and co-production systems. Progress on actual deployment of advanced-coal technologies has been more limited, in part due to insufficient supporting policies. Recently, industry chose Ultra Super Critical (USC) Pulverized Coal (PC) and Super Critical (SC) PC for new capacity coupled with pollution-control technology, and 300 MW Circulating Fluidized Bed (CFB) as a supplement

Advances in Modal Logic

DEFF Research Database (Denmark)

Modal logic is a subject with ancient roots in the western logical tradition. Up until the last few generations, it was pursued mainly as a branch of philosophy. But in recent years, the subject has taken new directions with connections to topics in computer science and mathematics. This volume...... is the proceedings of the conference of record in its fi eld, Advances in Modal Logic. Its contributions are state-of-the-art papers. The topics include decidability and complexity results for specifi c modal logics, proof theory of modal logic, logics for reasoning about time and space, provability logic, dynamic...... epistemic logic, and the logic of evidence....

A Unit on Hitler and Nazism for Advanced Students.

Science.gov (United States)

Williams, Elinor C.

1993-01-01

This unit on Hitler, the Third Reich, and its echoes in Germany today is based on original source material, such as "Mein Kampf," as well as more recent reports by those directly affected, such as Sichrovsky's "Schuldig Geboren." Teachers of advanced high school or college classes are introduced to some appropriate materials…

Laser direct writing of micro- and nano-scale medical devices

Science.gov (United States)

Gittard, Shaun D; Narayan, Roger J

2010-01-01

Laser-based direct writing of materials has undergone significant development in recent years. The ability to modify a variety of materials at small length scales and using short production times provides laser direct writing with unique capabilities for fabrication of medical devices. In many laser-based rapid prototyping methods, microscale and submicroscale structuring of materials is controlled by computer-generated models. Various laser-based direct write methods, including selective laser sintering/melting, laser machining, matrix-assisted pulsed-laser evaporation direct write, stereolithography and two-photon polymerization, are described. Their use in fabrication of microstructured and nanostructured medical devices is discussed. Laser direct writing may be used for processing a wide variety of advanced medical devices, including patient-specific prostheses, drug delivery devices, biosensors, stents and tissue-engineering scaffolds. PMID:20420557

The cultural context of patient’s autonomy and doctor’s duty: passive euthanasia and advance directives in Germany and Israel

Science.gov (United States)

Raz, Aviad; Shalev, Carmel

2010-01-01

The moral discourse surrounding end-of-life (EoL) decisions is highly complex, and a comparison of Germany and Israel can highlight the impact of cultural factors. The comparison shows interesting differences in how patient’s autonomy and doctor’s duties are morally and legally related to each other with respect to the withholding and withdrawing of medical treatment in EoL situations. Taking the statements of two national expert ethics committees on EoL in Israel and Germany (and their legal outcome) as an example of this discourse, we describe the similarity of their recommendations and then focus on the differences, including the balancing of ethical principles, what is identified as a problem, what social role professionals play, and the influence of history and religion. The comparison seems to show that Israel is more restrictive in relation to Germany, in contrast with previous bioethical studies in the context of the moral and legal discourse regarding the beginning of life, in which Germany was characterized as far more restrictive. We reflect on the ambivalence of the cultural reasons for this difference and its expression in various dissenting views on passive euthanasia and advance directives, and conclude with a comment on the difficulty in classifying either stance as more or less restrictive. PMID:20680469

Advancing palliative and end-of-life science in cardiorespiratory populations: The contributions of nursing science.

Science.gov (United States)

Grady, Patricia A

Nursing science has a critical role to inform practice, promote health, and improve the lives of individuals across the lifespan who face the challenges of advanced cardiorespiratory disease. Since 1997, the National Institute of Nursing Research (NINR) has focused attention on the importance of palliative and end-of-life care for advanced heart failure and advanced pulmonary disease through the publication of multiple funding opportunity announcements and by supporting a cadre of nurse scientists that will continue to address new priorities and future directions for advancing palliative and end-of-life science in cardiorespiratory populations. Published by Elsevier Inc.

Quality of dying in nursing home residents dying with dementia: does advanced care planning matter? A nationwide postmortem study.

Directory of Open Access Journals (Sweden)

An Vandervoort

Full Text Available Advance care planning is considered a central component of good quality palliative care and especially relevant for people who lose the capacity to make decisions at the end of life, which is the case for many nursing home residents with dementia. We set out to investigate to what extent (1 advance care planning in the form of written advance patient directives and verbal communication with patient and/or relatives about future care and (2 the existence of written advance general practitioner orders are related to the quality of dying of nursing home residents with dementia.Cross-sectional study of deaths (2010 using random cluster-sampling. Representative sample of nursing homes in Flanders, Belgium. Deaths of residents with dementia in a three-month period were reported; for each the nurse most involved in care, GP and closest relative completed structured questionnaires.We identified 101 deaths of residents with dementia in 69 nursing homes (58% response rate. A written advance patient directive was present for 17.5%, GP-orders for 56.7%. Controlling for socio-demographic/clinical characteristics in multivariate regression analyses, chances of having a higher mean rating of emotional well-being (less fear and anxiety on the Comfort Assessment in Dying with Dementia scale were three times higher with a written advance patient directive and more specifically when having a do-not-resuscitate order (AOR 3.45; CI,1.1-11 than for those without either (AOR 2.99; CI,1.1-8.3. We found no association between verbal communication or having a GP order and quality of dying.For nursing home residents with dementia there is a strong association between having a written advance directive and quality of dying. Where wishes are written, relatives report lower levels of emotional distress at the end of life. These results underpin the importance of advance care planning for people with dementia and beginning this process as early as possible.

38 CFR 17.32 - Informed consent and advance care planning.

Science.gov (United States)

2010-07-01

...) Definitions: Advance Directive. Specific written statements made by a patient who has decision-making capacity.... Decision-making capacity. The ability to understand and appreciate the nature and consequences of health... informed consent on behalf of a patient who lacks decision-making capacity. (b) Policy. Except as otherwise...

Advanced containment research for the Canadian Nuclear Fuel Waste Management Program

International Nuclear Information System (INIS)

Onofrei, M.; Mathew, P.M.; McKay, P.; Hosaluk, L.J.; Oscarson, D.W.

1986-09-01

This document outlines the program on the development of advanced containment systems for the disposal of used fuel in a vault deep in plutonic rock. Possible advanced containment concepts, the strategy adopted in selecting potential container materials, and experimental programs currently underway or planned are presented. Most effort is currently directed toward developing long-term containment systems based on non-metallic materials and massive metal containers. The use of additional independent barriers to extend the lifetime of simple containment systems is also being evaluated. 58 refs

National nuclear power planning of China and advanced reactor

International Nuclear Information System (INIS)

Qian Jihui

1990-01-01

The necessity of investigation on the trends of advanced reactor technology all over the world is elabrated while China is going to set up its long-term national nuclear power programme. In author's opinion, thermal reactor power plants will have a quite long period development in the next century and a new trend of second generation NPPs might emerge in the beginning of next century. These new generation advanced reactors are characterized with new design concepts based on the inherent or passive safety features. Among them, most promising ones are those of AP-600 and MHTGR. Chinese experts are paying special attention to and closely following these two directions

KNOWLEDGE UNDERSTANDING AND ADVANCED SEARCHING

Directory of Open Access Journals (Sweden)

R Vidya

2017-04-01

Full Text Available It’s a comprehensive fact that millions of people around the world surf the Internet for want of answers for their questions. Generally, the questions are asked in the form of Searching or direct questions which follow perfect ontological directions. It is important that the system understands the questions in the right sense and can provide the best answer for all the questions raised in the web forum. One such pragmatic method is required which is expected to provide optimum solution to achieve best answers for questions that not only percepts language but also follows perfect ontological information in accordance with the cyber law. This Proposed Model presents a new dynamic model called Knowledge Understanding and Advance Searching (KUAS that studies the importance of Smart Question Answering with other question answering engines like START and proves to give the optimal solution compared to them.

Advanced hybrid transient stability and EMT simulation for VSC-HVDC systems

NARCIS (Netherlands)

Van Der Meer, A.A.; Gibescu, M.; Van Der Meijden, M.A.M.M.; Kling, W.L.; Ferreira, J.A.

2015-01-01

This paper deals with advanced hybrid transient stability and electromagnetic-transient (EMT) simulation of combined ac/dc power systems containing large amounts of renewable energy sources interfaced through voltage-source converter-high-voltage direct current (VSC-HVDC). The concerning transient

Self-directed learning: Status of final-year students and perceptions ...

African Journals Online (AJOL)

Background. Self-directed learning (SDL) is the essential mechanism of lifelong learning, which, in turn, is required for medical professionals to maintain competency because of advancing technology and constantly evolving disease care and contexts. Yet, most Nigerian medical schools do not actively promote SDL skills ...

Assessing directed interactions from neurophysiological signals—an overview

International Nuclear Information System (INIS)

Lehnertz, Klaus

2011-01-01

The study of synchronization phenomena in coupled dynamical systems is an active field of research in many scientific disciplines including the neurosciences. Over the last decades, a number of time series analysis techniques have been proposed to capture both linear and nonlinear aspects of interactions. While most of these techniques allow one to quantify the strength of interactions, developments that resulted from advances in nonlinear dynamics and in information and synchronization theory aim at assessing directed interactions. Most of these techniques, however, assume the underlying systems to be at least approximately stationary and require a large number of data points to robustly assess directed interactions. Recent extensions allow assessing directed interactions from short and transient signals and are particularly suited for the analysis of evoked and event-related activity. (topical review)

The spatial patterns of directional phenotypic selection.

Science.gov (United States)

Siepielski, Adam M; Gotanda, Kiyoko M; Morrissey, Michael B; Diamond, Sarah E; DiBattista, Joseph D; Carlson, Stephanie M

2013-11-01

Local adaptation, adaptive population divergence and speciation are often expected to result from populations evolving in response to spatial variation in selection. Yet, we lack a comprehensive understanding of the major features that characterise the spatial patterns of selection, namely the extent of variation among populations in the strength and direction of selection. Here, we analyse a data set of spatially replicated studies of directional phenotypic selection from natural populations. The data set includes 60 studies, consisting of 3937 estimates of selection across an average of five populations. We performed meta-analyses to explore features characterising spatial variation in directional selection. We found that selection tends to vary mainly in strength and less in direction among populations. Although differences in the direction of selection occur among populations they do so where selection is often weakest, which may limit the potential for ongoing adaptive population divergence. Overall, we also found that spatial variation in selection appears comparable to temporal (annual) variation in selection within populations; however, several deficiencies in available data currently complicate this comparison. We discuss future research needs to further advance our understanding of spatial variation in selection. © 2013 John Wiley & Sons Ltd/CNRS.

The spatial patterns of directional phenotypic selection

KAUST Repository

Siepielski, Adam M.

2013-09-12

Local adaptation, adaptive population divergence and speciation are often expected to result from populations evolving in response to spatial variation in selection. Yet, we lack a comprehensive understanding of the major features that characterise the spatial patterns of selection, namely the extent of variation among populations in the strength and direction of selection. Here, we analyse a data set of spatially replicated studies of directional phenotypic selection from natural populations. The data set includes 60 studies, consisting of 3937 estimates of selection across an average of five populations. We performed meta-analyses to explore features characterising spatial variation in directional selection. We found that selection tends to vary mainly in strength and less in direction among populations. Although differences in the direction of selection occur among populations they do so where selection is often weakest, which may limit the potential for ongoing adaptive population divergence. Overall, we also found that spatial variation in selection appears comparable to temporal (annual) variation in selection within populations; however, several deficiencies in available data currently complicate this comparison. We discuss future research needs to further advance our understanding of spatial variation in selection. © 2013 John Wiley & Sons Ltd/CNRS.

Commentary on ``Future directions: Building technologies and design tools``

Energy Technology Data Exchange (ETDEWEB)

Quadrel, R.W.

1992-08-10

This paper presents a number of interesting and thought-provoking scenarios about the future use of advanced technology in the design and operation of commercial buildings. I will express my reactions in the following series of short paragraphs. These thoughts will, I hope, raise some new questions and offer fruitful directions for further exploration.

Delivering high-level food industry skills for future food security through Advanced Training Partnerships

OpenAIRE

Frazier, Richard A.

2013-01-01

The UK Biotechnology and Biological Sciences Research Council’s Advanced Training Partnerships initiative represents a significant investment in the provision of high-level skills for the UK food industry sector to address global food security from farm to fork. This paper summarises the background, aims and scope of the Advanced Training Partnerships, their development so far, and offers a view on future directions and evaluation of impact.

Integrated Flight and Propulsion Controls for Advanced Aircraft Configurations

Science.gov (United States)

Merrill, Walter; Garg, Sanjay

1995-01-01

The research vision of the NASA Lewis Research Center in the area of integrated flight and propulsion controls technologies is described. In particular the Integrated Method for Propulsion and Airframe Controls developed at the Lewis Research Center is described including its application to an advanced aircraft configuration. Additionally, future research directions in integrated controls are described.

The impact of gendered organizational systems on women’s career advancement

Science.gov (United States)

O’Neil, Deborah A.; Hopkins, Margaret M.

2015-01-01

In this Perspective article we propose that in order to pave the way for women’s career advancement into the senior ranks of organizations, attention must be directed at the systemic norms and structures that drive the gendered nature of the workplace. A focus on individual level issues, i.e., women lacking confidence and women opting out, detracts from the work that must be done at the organizational level in order to dismantle the system of pervasive, structural disadvantage facing women seeking to advance to senior leadership positions. PMID:26175708

Recent Advances in Computational Methods for Nuclear Magnetic Resonance Data Processing

KAUST Repository

Gao, Xin

2013-01-11

Although three-dimensional protein structure determination using nuclear magnetic resonance (NMR) spectroscopy is a computationally costly and tedious process that would benefit from advanced computational techniques, it has not garnered much research attention from specialists in bioinformatics and computational biology. In this paper, we review recent advances in computational methods for NMR protein structure determination. We summarize the advantages of and bottlenecks in the existing methods and outline some open problems in the field. We also discuss current trends in NMR technology development and suggest directions for research on future computational methods for NMR.

Photodynamic Therapy in Patients with Advanced Hilar Cholangiocarcinoma: Percutaneous Cholangioscopic Versus Peroral Transpapillary Approach.

Science.gov (United States)

Lee, Tae Yoon; Cheon, Young Koog; Shim, Chan Sup

2016-04-01

This study aimed to compare the clinical outcomes of patients with advanced hilar cholangiocarcinoma (CC) who underwent photodynamic therapy (PDT) with either percutaneous transhepatic cholangioscopy (PTCS) or endoscopic retrograde cholangiopancreatography (ERCP). PDT has been proposed as a promising therapy for treatment of unresectable hilar CC that is resistant to conventional standard treatment. However, few studies have compared the delivery methods of PDT in unresectable hilar CC patients. Thirty-seven adult patients with advanced hilar CC were included in this study. Twenty-four patients treated with PTCS-directed PDT and 13 patients treated with ERCP-directed PDT were analyzed retrospectively. The PTCS- and ERCP-directed PDT groups were comparable with respect to age, gender, health status, pretreatment bilirubin levels, Bismuth type, and hilar CC stage. The length of hospital stay differed significantly (p hilar CC. Lower pre-PDT bilirubin levels were associated with longer survival in all patients.

Advancing CANDU Technology Through R and D

International Nuclear Information System (INIS)

Torgerson, David F.

1993-01-01

CANDU reactors are evolving to meet future requirements using incremental changes as opposed to revolutionary design changes. The main elements for advancing the technology reducing capital and operating, increasing capacity factors, increasing passive safety, and enhancing fuel/fuel cycle flexibility. These elements are being addressed by carrying out research and development in the areas of safety, plant systems and components, heavy water production, information technology, fuel channels, and fuel/fuel cycle technology. In safety, the focus is on using the inherent features of CANDU to enhance passive or natural safety concepts, such as the use of the moderator as an effective heat sink, and the development of advanced fuels to improve critical heat flux and to reduce source terms. Plant systems and components work includes improvements to plant systems such as steam generators, heat exchangers, pump seals, and advanced control room technology. Heavy water processes are being developed that can be used with existing hydrogen production plants, or that can be used in a stand-alone mode. Information technology is being developed to cover all aspects of CANDU design, construction, and operation. Fuel channel improvements include elucidation and application of basic materials science for life extension, and the development of advanced non-destructive examination methods. Fuel and fuel cycle work is focusing on LWR/CANDU synergy, such as the use of recovered uranium and the direct use of spent PWR fuel in CANDU reactor, advanced fuels to improve burnup and economics (e. g., the joint AECB/KAERI Conflux program), and low void reactivity fuel to enhance passive safety. This paper gives an overview of some of the R and D supporting these activities, with particular emphasis on Alice's vision for advancing CANDU technology over the next 10 years

What Price Ethics: New Research Directions in Counselor Ethical Behavior

Science.gov (United States)

Paradise, Louis V.

1978-01-01

This paper briefly examines research on the ethical behavior of counselors, demonstrating that new directions in this area are needed, and that new research questions must be asked if significant information relating to counseling and ethics is to advance. Areas of inquiry and methods for investigation are suggested. (Author)

Direct-drive inertial confinement fusion: A review

Energy Technology Data Exchange (ETDEWEB)

Craxton, R. S.; Anderson, K. S.; Boehly, T. R.; Goncharov, V. N.; Harding, D. R.; Knauer, J. P.; McKenty, P. W.; Myatt, J. F.; Short, R. W.; Skupsky, S.; Theobald, W.; Collins, T. J. B.; Delettrez, J. A.; Hu, S. X.; Marozas, J. A.; Maximov, A. V.; Michel, D. T.; Radha, P. B.; Regan, S. P.; Sangster, T. C. [Laboratory for Laser Energetics, University of Rochester, Rochester, New York 14623-1299 (United States); and others

2015-11-15

direct-drive target concepts. Filamentation is largely suppressed by beam smoothing. Thermal transport modeling, important to the interpretation of experiments and to target design, has been found to be nonlocal in nature. Advances in shock timing and equation-of-state measurements relevant to direct-drive ICF are reported. Room-temperature implosions have provided an increased understanding of the importance of stability and uniformity. The evolution of cryogenic implosion capabilities, leading to an extensive series carried out on the 60-beam OMEGA laser [Boehly et al., Opt. Commun. 133, 495 (1997)], is reviewed together with major advances in cryogenic target formation. A polar-drive concept has been developed that will enable direct-drive–ignition experiments to be performed on the National Ignition Facility [Haynam et al., Appl. Opt. 46(16), 3276 (2007)]. The advantages offered by the alternative approaches of fast ignition and shock ignition and the issues associated with these concepts are described. The lessons learned from target-physics and implosion experiments are taken into account in ignition and high-gain target designs for laser wavelengths of 1/3 μm and 1/4 μm. Substantial advances in direct-drive inertial fusion reactor concepts are reviewed. Overall, the progress in scientific understanding over the past five decades has been enormous, to the point that inertial fusion energy using direct drive shows significant promise as a future environmentally attractive energy source.

Direct-drive inertial confinement fusion: A review

International Nuclear Information System (INIS)

Craxton, R. S.; Anderson, K. S.; Boehly, T. R.; Goncharov, V. N.; Harding, D. R.; Knauer, J. P.; McKenty, P. W.; Myatt, J. F.; Short, R. W.; Skupsky, S.; Theobald, W.; Collins, T. J. B.; Delettrez, J. A.; Hu, S. X.; Marozas, J. A.; Maximov, A. V.; Michel, D. T.; Radha, P. B.; Regan, S. P.; Sangster, T. C.

2015-01-01

direct-drive target concepts. Filamentation is largely suppressed by beam smoothing. Thermal transport modeling, important to the interpretation of experiments and to target design, has been found to be nonlocal in nature. Advances in shock timing and equation-of-state measurements relevant to direct-drive ICF are reported. Room-temperature implosions have provided an increased understanding of the importance of stability and uniformity. The evolution of cryogenic implosion capabilities, leading to an extensive series carried out on the 60-beam OMEGA laser [Boehly et al., Opt. Commun. 133, 495 (1997)], is reviewed together with major advances in cryogenic target formation. A polar-drive concept has been developed that will enable direct-drive–ignition experiments to be performed on the National Ignition Facility [Haynam et al., Appl. Opt. 46(16), 3276 (2007)]. The advantages offered by the alternative approaches of fast ignition and shock ignition and the issues associated with these concepts are described. The lessons learned from target-physics and implosion experiments are taken into account in ignition and high-gain target designs for laser wavelengths of 1/3 μm and 1/4 μm. Substantial advances in direct-drive inertial fusion reactor concepts are reviewed. Overall, the progress in scientific understanding over the past five decades has been enormous, to the point that inertial fusion energy using direct drive shows significant promise as a future environmentally attractive energy source

Proton exchange membrane materials for the advancement of direct methanol fuel-cell technology

Science.gov (United States)

Cornelius, Christopher J [Albuquerque, NM

2006-04-04

A new class of hybrid organic-inorganic materials, and methods of synthesis, that can be used as a proton exchange membrane in a direct methanol fuel cell. In contrast with Nafion.RTM. PEM materials, which have random sulfonation, the new class of materials have ordered sulfonation achieved through self-assembly of alternating polyimide segments of different molecular weights comprising, for example, highly sulfonated hydrophilic PDA-DASA polyimide segment alternating with an unsulfonated hydrophobic 6FDA-DAS polyimide segment. An inorganic phase, e.g., 0.5 5 wt % TEOS, can be incorporated in the sulfonated polyimide copolymer to further improve its properties. The new materials exhibit reduced swelling when exposed to water, increased thermal stability, and decreased O.sub.2 and H.sub.2 gas permeability, while retaining proton conductivities similar to Nafion.RTM.. These improved properties may allow direct methanol fuel cells to operate at higher temperatures and with higher efficiencies due to reduced methanol crossover.

Fairly direct hit. Advances in imaging of shotgun projectiles in MRI

Energy Technology Data Exchange (ETDEWEB)

Eggert, Sebastian [Kantonsspital Baden AG, Department of Radiology, Baden (Switzerland); University of Zurich, Institute of Forensic Medicine, Zurich (Switzerland); Kubik-Huch, Rahel A.; Peters, Alexander [Kantonsspital Baden AG, Department of Radiology, Baden (Switzerland); Klarhoefer, Markus [Siemens Healthcare, Zurich (Switzerland); Bolliger, Stephan A.; Thali, Michael J. [University of Zurich, Institute of Forensic Medicine, Zurich (Switzerland); Anderson, Suzanne [Kantonsspital Baden AG, Department of Radiology, Baden (Switzerland); University of Notre Dame Australia, Radiology, Sydney School of Medicine, Sydney, NSW (Australia); Froehlich, Johannes M. [Federal Institute of Technology, Pharmaceutical Sciences, Zurich (Switzerland)

2015-09-15

To investigate the magnetic properties of different types of projectiles and qualify the metal artefact reduction technique for diagnostic and/or forensic MRI. Ten different projectiles embedded in ordnance gelatine blocks underwent an in vitro 1.5-T MR study with seven sequences including a recently developed metal artefact reduction sequence (Advanced WARP) combining VAT (view-angle-tilting) and SEMAC (slice-encoding metal-artefact-correction). Resulting image quality (five-point scale: 1=best; 5=worst) was scored. Quantifiable magnetic characteristics were correlated with qualitative rating of the MR sequences and torque dislodgment. Metal artefact reduction sequence (median: 2.5) significantly (p < 0.001) improves depiction of projectiles in comparison to all other MR pulse sequences (median: 4.75). Images from diamagnetic composed bullets (median: 2) are much less disturbed compared to magnetic attracted ones (median: 5). Correlation (0.623) between deflection angle measurement (ferromagnetic mean 84.2 ; paramagnetic 62 ; diamagnetic mean 0 ) and median qualitative image quality was highly significant (p = 0.027). Torque dislodgement was distinct for elongated magnetic attracted projectiles. Significant improvement of MR imaging of projectiles using metal artefact reduction techniques has important implications for diagnostic/forensic work-up. The correlations between magnetic attraction force, deflection-angle results and image properties demonstrate that the MR safety of projectiles can be estimated with one of these methods. (orig.)

Fairly direct hit. Advances in imaging of shotgun projectiles in MRI

International Nuclear Information System (INIS)

Eggert, Sebastian; Kubik-Huch, Rahel A.; Peters, Alexander; Klarhoefer, Markus; Bolliger, Stephan A.; Thali, Michael J.; Anderson, Suzanne; Froehlich, Johannes M.

2015-01-01

To investigate the magnetic properties of different types of projectiles and qualify the metal artefact reduction technique for diagnostic and/or forensic MRI. Ten different projectiles embedded in ordnance gelatine blocks underwent an in vitro 1.5-T MR study with seven sequences including a recently developed metal artefact reduction sequence (Advanced WARP) combining VAT (view-angle-tilting) and SEMAC (slice-encoding metal-artefact-correction). Resulting image quality (five-point scale: 1=best; 5=worst) was scored. Quantifiable magnetic characteristics were correlated with qualitative rating of the MR sequences and torque dislodgment. Metal artefact reduction sequence (median: 2.5) significantly (p < 0.001) improves depiction of projectiles in comparison to all other MR pulse sequences (median: 4.75). Images from diamagnetic composed bullets (median: 2) are much less disturbed compared to magnetic attracted ones (median: 5). Correlation (0.623) between deflection angle measurement (ferromagnetic mean 84.2 ; paramagnetic 62 ; diamagnetic mean 0 ) and median qualitative image quality was highly significant (p = 0.027). Torque dislodgement was distinct for elongated magnetic attracted projectiles. Significant improvement of MR imaging of projectiles using metal artefact reduction techniques has important implications for diagnostic/forensic work-up. The correlations between magnetic attraction force, deflection-angle results and image properties demonstrate that the MR safety of projectiles can be estimated with one of these methods. (orig.)

Advanced Technologies for Design Information Verification

International Nuclear Information System (INIS)

Watkins, Michael L.; Sheen, David M.; Rose, Joseph L.; Cumblidge, Stephen E.

2009-01-01

This paper discusses several technologies that have the potential to enhance facilities design verification. These approaches have shown promise in addressing the challenges associated with the verification of sub-component geometry and material composition for structures that are not directly accessible for physical inspection. A simple example is a pipe that extends into or through a wall or foundation. Both advanced electromagnetic and acoustic modalities will be discussed. These include advanced radar imaging, transient thermographic imaging, and guided acoustic wave imaging. Examples of current applications are provided. The basic principles and mechanisms of these inspection techniques are presented along with the salient practical features, advantages, and disadvantages of each technique. Other important considerations, such as component geometries, materials, and degree of access are also treated. The importance of, and strategies for, developing valid inspection models are also discussed. Beyond these basic technology adaptation and evaluation issues, important user interface considerations are outlined, along with approaches to quantify the overall performance reliability of the various inspection methods.

Advances in welding science and technology

International Nuclear Information System (INIS)

David, S.A.; Babu, S.S.; Vitek, J.M.

1995-01-01

Over the years, welding has been more of an art than a science, but in the last few decades major advances have taken place in welding science and technology. With the development of new methodologies at the crossroads of basic and applied sciences, enormous opportunities and potential exist to develop a science-based design of composition, structure, and properties of welds with intelligent control and automation of the welding processes. In the last several decades, welding has evolved as an interdisciplinary activity requiring synthesis of knowledge from various disciplines and incorporating the most advanced tools of various basic applied sciences. A series of international conferences and other publications have covered the issues, current trends and directions in welding science and technology. In the last few decades, major progress has been made in (i) understanding physical processes in welding, (ii) characterization of microstructure and properties, and (iii) intelligent control and automation of welding. This paper describes some of these developments

Advanced energy utilization MHD power generation

International Nuclear Information System (INIS)

2008-01-01

The 'Technical Committee on Advanced Energy Utilization MHD Power Generation' was started to establish advanced energy utilization technologies in Japan, and has been working for three years from June 2004 to May 2007. This committee investigated closed cycle MHD, open cycle MHD, and liquid metal MHD power generation as high-efficiency power generation systems on the earth. Then, aero-space application and deep space exploration technologies were investigated as applications of MHD technology. The spin-off from research and development on MHD power generation such as acceleration and deceleration of supersonic flows was expected to solve unstart phenomena in scramjet engine and also to solve abnormal heating of aircrafts by shock wave. In addition, this committee investigated researches on fuel cells, on secondary batteries, on connection of wind power system to power grid, and on direct energy conversion system from nuclear fusion reactor for future. The present technical report described results of investigations by the committee. (author)

Direct Metal Laser Sintering: A Digitised Metal Casting Technology

OpenAIRE

Venkatesh, K. Vijay; Nandini, V. Vidyashree

2013-01-01

Dental technology is undergoing advancements at a fast pace and technology is being imported from various other fields. One such imported technology is direct metal laser sintering technology for casting metal crowns. This article will discuss the process of laser sintering for making metal crowns and fixed partial dentures with a understanding of their pros and cons.

Direct metal laser sintering: a digitised metal casting technology.

Science.gov (United States)

Venkatesh, K Vijay; Nandini, V Vidyashree

2013-12-01

Dental technology is undergoing advancements at a fast pace and technology is being imported from various other fields. One such imported technology is direct metal laser sintering technology for casting metal crowns. This article will discuss the process of laser sintering for making metal crowns and fixed partial dentures with a understanding of their pros and cons.

Laboratory directed research and development

Energy Technology Data Exchange (ETDEWEB)

1991-11-15

The purposes of Argonne's Laboratory Directed Research and Development (LDRD) Program are to encourage the development of novel concepts, enhance the Laboratory's R D capabilities, and further the development of its strategic initiatives. Among the aims of the projects supported by the Program are establishment of engineering proof-of-principle''; development of an instrumental prototype, method, or system; or discovery in fundamental science. Several of these project are closely associated with major strategic thrusts of the Laboratory as described in Argonne's Five Year Institutional Plan, although the scientific implications of the achieved results extend well beyond Laboratory plans and objectives. The projects supported by the Program are distributed across the major programmatic areas at Argonne. Areas of emphasis are (1) advanced accelerator and detector technology, (2) x-ray techniques in biological and physical sciences, (3) advanced reactor technology, (4) materials science, computational science, biological sciences and environmental sciences. Individual reports summarizing the purpose, approach, and results of projects are presented.

Wind measurement via direct detection lidar

Science.gov (United States)

Afek, I.; Sela, N.; Narkiss, N.; Shamai, G.; Tsadka, S.

2013-10-01

Wind sensing Lidar is considered a promising technology for high quality wind measurements required for various applications such as hub height wind resource assessment, power curve measurements and advanced, real time, forward looking turbine control. Until recently, the only available Lidar technology was based on coherent Doppler shift detection, whose market acceptance has been slow primarily due to its exuberant price. Direct detection Lidar technology provides an alternative to remote sensing of wind by incorporating high precision measurement, a robust design and an affordable price tag.

Advanced Demonstration and Test Reactor Options Study

Energy Technology Data Exchange (ETDEWEB)

Petti, David Andrew [Idaho National Lab. (INL), Idaho Falls, ID (United States); Hill, R. [Argonne National Lab. (ANL), Argonne, IL (United States); Gehin, J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Gougar, Hans David [Idaho National Lab. (INL), Idaho Falls, ID (United States); Strydom, Gerhard [Idaho National Lab. (INL), Idaho Falls, ID (United States); Heidet, F. [Argonne National Lab. (ANL), Argonne, IL (United States); Kinsey, J. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Grandy, Christopher [Argonne National Lab. (ANL), Argonne, IL (United States); Qualls, A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Brown, Nicholas [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Powers, J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Hoffman, E. [Argonne National Lab. (ANL), Argonne, IL (United States); Croson, D. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2017-01-01

Global efforts to address climate change will require large-scale decarbonization of energy production in the United States and elsewhere. Nuclear power already provides 20% of electricity production in the United States (U.S.) and is increasing in countries undergoing rapid growth around the world. Because reliable, grid-stabilizing, low emission electricity generation, energy security, and energy resource diversity will be increasingly valued, nuclear power’s share of electricity production has a potential to grow. In addition, there are non electricity applications (e.g., process heat, desalination, hydrogen production) that could be better served by advanced nuclear systems. Thus, the timely development, demonstration, and commercialization of advanced nuclear reactors could diversify the nuclear technologies available and offer attractive technology options to expand the impact of nuclear energy for electricity generation and non-electricity missions. The purpose of this planning study is to provide transparent and defensible technology options for a test and/or demonstration reactor(s) to be built to support public policy, innovation and long term commercialization within the context of the Department of Energy’s (DOE’s) broader commitment to pursuing an “all of the above” clean energy strategy and associated time lines. This planning study includes identification of the key features and timing needed for advanced test or demonstration reactors to support research, development, and technology demonstration leading to the commercialization of power plants built upon these advanced reactor platforms. This planning study is consistent with the Congressional language contained within the fiscal year 2015 appropriation that directed the DOE to conduct a planning study to evaluate “advanced reactor technology options, capabilities, and requirements within the context of national needs and public policy to support innovation in nuclear energy�

Advanced Demonstration and Test Reactor Options Study

International Nuclear Information System (INIS)

Petti, David Andrew; Hill, R.; Gehin, J.; Gougar, Hans David; Strydom, Gerhard; Heidet, F.; Kinsey, J.; Grandy, Christopher; Qualls, A.; Brown, Nicholas; Powers, J.; Hoffman, E.; Croson, D.

2017-01-01

Global efforts to address climate change will require large-scale decarbonization of energy production in the United States and elsewhere. Nuclear power already provides 20% of electricity production in the United States (U.S.) and is increasing in countries undergoing rapid growth around the world. Because reliable, grid-stabilizing, low emission electricity generation, energy security, and energy resource diversity will be increasingly valued, nuclear power's share of electricity production has a potential to grow. In addition, there are non electricity applications (e.g., process heat, desalination, hydrogen production) that could be better served by advanced nuclear systems. Thus, the timely development, demonstration, and commercialization of advanced nuclear reactors could diversify the nuclear technologies available and offer attractive technology options to expand the impact of nuclear energy for electricity generation and non-electricity missions. The purpose of this planning study is to provide transparent and defensible technology options for a test and/or demonstration reactor(s) to be built to support public policy, innovation and long term commercialization within the context of the Department of Energy's (DOE's) broader commitment to pursuing an 'all of the above' clean energy strategy and associated time lines. This planning study includes identification of the key features and timing needed for advanced test or demonstration reactors to support research, development, and technology demonstration leading to the commercialization of power plants built upon these advanced reactor platforms. This planning study is consistent with the Congressional language contained within the fiscal year 2015 appropriation that directed the DOE to conduct a planning study to evaluate 'advanced reactor technology options, capabilities, and requirements within the context of national needs and public policy to support innovation in nuclear energy'. Advanced reactors are

Advances and perspectives in in vitro human gut fermentation modeling.

Science.gov (United States)

Payne, Amanda N; Zihler, Annina; Chassard, Christophe; Lacroix, Christophe

2012-01-01

The gut microbiota is a highly specialized organ containing host-specific assemblages of microbes whereby metabolic activity directly impacts human health and disease. In vitro gut fermentation models present an unmatched opportunity of performing studies frequently challenged in humans and animals owing to ethical concerns. Multidisciplinary systems biology analyses supported by '-omics' platforms remain widely neglected in the field of in vitro gut fermentation modeling but are key to advancing the significance of these models. Model-driven experimentation using a combination of in vitro gut fermentation and in vitro human cell models represent an advanced approach in identifying complex host-microbe interactions and niches central to gut fermentation processes. The aim of this review is to highlight the advances and challenges exhibited by in vitro human gut fermentation modeling. Copyright © 2011 Elsevier Ltd. All rights reserved.

Technological Advances in Deep Brain Stimulation.

Science.gov (United States)

Ughratdar, Ismail; Samuel, Michael; Ashkan, Keyoumars

2015-01-01

Functional and stereotactic neurosurgery has always been regarded as a subspecialty based on and driven by technological advances. However until recently, the fundamentals of deep brain stimulation (DBS) hardware and software design had largely remained stagnant since its inception almost three decades ago. Recent improved understanding of disease processes in movement disorders as well clinician and patient demands has resulted in new avenues of development for DBS technology. This review describes new advances both related to hardware and software for neuromodulation. New electrode designs with segmented contacts now enable sophisticated shaping and sculpting of the field of stimulation, potentially allowing multi-target stimulation and avoidance of side effects. To avoid lengthy programming sessions utilising multiple lead contacts, new user-friendly software allows for computational modelling and individualised directed programming. Therapy delivery is being improved with the next generation of smaller profile, longer-lasting, re-chargeable implantable pulse generators (IPGs). These include IPGs capable of delivering constant current stimulation or personalised closed-loop adaptive stimulation. Post-implantation Magnetic Resonance Imaging (MRI) has long been an issue which has been partially overcome with 'MRI conditional devices' and has enabled verification of DBS lead location. Surgical technique is considering a shift from frame-based to frameless stereotaxy or greater role for robot assisted implantation. The challenge for these contemporary techniques however, will be in demonstrating equivalent safety and accuracy to conventional methods. We also discuss potential future direction utilising wireless technology allowing for miniaturisation of hardware.

Can Individualized Learning Plans in an advanced clinical experience course for fourth year medical students foster Self-Directed Learning?

Science.gov (United States)

Chitkara, Maribeth B; Satnick, Daniel; Lu, Wei-Hsin; Fleit, Howard; Go, Roderick A; Chandran, Latha

2016-09-01

Residency programs have utilized Individualized Learning Plans (ILPs) to customize resident education while undergraduate medical education has not done so in a meaningful way. We discuss the use of ILPs within a fourth year medical school course to facilitate self-directed learning (SDL). At Stony Brook University School of Medicine, an ILP component was added to the Advanced Clinical Experience (ACE) course for fourth year students. Each completed an ILP outlining personal learning goals and strategies to achieve them. An adaptation of the Motivated Strategies for Learning Questionnaire (MSLQ) (Duncan T and McKeachie W, Educ Psych 40(2):117-128, 2005 and Cook DA et al., Med Ed 45:1230-1240, 2011) was used to measure success of ILPs in improving SDL. Qualitative data analysis was conducted on the ILPs and self-reflections. Forty-eight students participated. Two of the four SDL sub-domains identified on the MSLQ showed improvement; self-efficacy (p = .001) and self-regulation (p = .002). 'Medical Knowledge' was the competency most frequently identified as an area of concentration (90 %) and professionalism was selected least frequently (4 %). A higher percentage (83 %) of students who reported complete achievement of their ILP goals also reported feeling better prepared for entering residency. ILPs improve SDL strategies among medical students and may serve as useful tools to help shape future learning goals as they transition to residency training.

Advanced High-Level Waste Glass Research and Development Plan

Energy Technology Data Exchange (ETDEWEB)

Peeler, David K. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Vienna, John D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Schweiger, Michael J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Fox, Kevin M. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

2015-07-01

The U.S. Department of Energy Office of River Protection (ORP) has implemented an integrated program to increase the loading of Hanford tank wastes in glass while meeting melter lifetime expectancies and process, regulatory, and product quality requirements. The integrated ORP program is focused on providing a technical, science-based foundation from which key decisions can be made regarding the successful operation of the Hanford Tank Waste Treatment and Immobilization Plant (WTP) facilities. The fundamental data stemming from this program will support development of advanced glass formulations, key process control models, and tactical processing strategies to ensure safe and successful operations for both the low-activity waste (LAW) and high-level waste (HLW) vitrification facilities with an appreciation toward reducing overall mission life. The purpose of this advanced HLW glass research and development plan is to identify the near-, mid-, and longer-term research and development activities required to develop and validate advanced HLW glasses and their associated models to support facility operations at WTP, including both direct feed and full pretreatment flowsheets. This plan also integrates technical support of facility operations and waste qualification activities to show the interdependence of these activities with the advanced waste glass (AWG) program to support the full WTP mission. Figure ES-1 shows these key ORP programmatic activities and their interfaces with both WTP facility operations and qualification needs. The plan is a living document that will be updated to reflect key advancements and mission strategy changes. The research outlined here is motivated by the potential for substantial economic benefits (e.g., significant increases in waste throughput and reductions in glass volumes) that will be realized when advancements in glass formulation continue and models supporting facility operations are implemented. Developing and applying advanced

Advancing the Field Elder Abuse: Future Directions and Policy Implications

Science.gov (United States)

Dong, XinQi

2012-01-01

Elder abuse, sometime called elder mistreatment or elder maltreatment, includes psychological, physical, and sexual abuse, neglect (caregiver neglect and self-neglect), and financial exploitation. Evidence suggests that 1 out of 10 older adult experiences some form of elder abuse, and only 1 of out 25 cases are actually reported to social services agencies. At the same time, elder abuse is associated with significant morbidity and premature mortality. Despite these findings, there is a great paucity in research, practice, and policy dealing with the pervasive issues of elder abuse. Through my experiences as a American Political Sciences Association Congressional Policy Fellow/Health and Aging Policy Fellow working with Administration on Community Living (ACL) (Previously known at Administration on Aging (AoA)) for the last two years, I will describe the major functions of the ACL; and highlight on two major pieces of federal legislation: The Older Americans Act (OAA) and the Elder Justice Act (EJA). Moreover, I will highlight major research gaps and future policy relevant research directions for the field of elder abuse. PMID:23110488

Recent designs for advanced fusion reactor blankets

International Nuclear Information System (INIS)

Sze, D.K.

1994-01-01

A series of reactor design studies based on the Tokamak configuration have been carried out under the direction of Professor Robert Conn of UCLA. They are called ARIES-I through IV. The key mission of these studies is to evaluate the attractiveness of fusion assuming different degrees of advancement in either physics or engineering development. This paper discusses the directions and conclusions of the blanket and related engineering systems for those design studies. ARIES-1 investigated the use of SiC composite as the structural material to increase the blanket temperature and reduce the blanket activation. Li 2 ZrO 3 was used as the breeding material due to its high temperature stability and good tritium recovery characteristics. The ARIES-IV is a modification of ARIES-1. The plasma was in the second stability regime. Li 2 O was used as the breeding material to remove Zr. A gaseous divertor was used to replace the conventional divertor so that high Z divertor target is not required. The physics of ARIES-II was the same as ARIES-IV. The engineering design of the ARIES-II was based on a self-cooled lithium blanket with a V-alloy as the structural material. Even though it was assumed that the plasma was in the second stability regime, the plasma beta was still rather low (3.4%). The ARIES-III is an advanced fuel (D- 3 He) tokamak reactor. The reactor design assumed major advancement on the physics, with a plasma beta of 23.9%. A conventional structural material is acceptable due to the low neutron wall loading. From the radiation damage point of view, the first wall can last the life of the reactor, which is expected to be a major advantage from the engineering design and waste disposal point of view

Novel advances in shotgun lipidomics for biology and medicine.

Science.gov (United States)

Wang, Miao; Wang, Chunyan; Han, Rowland H; Han, Xianlin

2016-01-01

The field of lipidomics, as coined in 2003, has made profound advances and been rapidly expanded. The mass spectrometry-based strategies of this analytical methodology-oriented research discipline for lipid analysis are largely fallen into three categories: direct infusion-based shotgun lipidomics, liquid chromatography-mass spectrometry-based platforms, and matrix-assisted laser desorption/ionization mass spectrometry-based approaches (particularly in imagining lipid distribution in tissues or cells). This review focuses on shotgun lipidomics. After briefly introducing its fundamentals, the major materials of this article cover its recent advances. These include the novel methods of lipid extraction, novel shotgun lipidomics strategies for identification and quantification of previously hardly accessible lipid classes and molecular species including isomers, and novel tools for processing and interpretation of lipidomics data. Representative applications of advanced shotgun lipidomics for biological and biomedical research are also presented in this review. We believe that with these novel advances in shotgun lipidomics, this approach for lipid analysis should become more comprehensive and high throughput, thereby greatly accelerating the lipidomics field to substantiate the aberrant lipid metabolism, signaling, trafficking, and homeostasis under pathological conditions and their underpinning biochemical mechanisms. Copyright © 2015 Elsevier B.V. All rights reserved.

Advances in point-of-care technologies for molecular diagnostics.

Science.gov (United States)

Zarei, Mohammad

2017-12-15

Advances in miniaturization, nanotechnology, and microfluidics, along with developments in cloud-connected point-of-care (POC) diagnostics technologies are pushing the frontiers of POC devices toward low-cost, user-friendly, and enhanced sensitivity molecular-level diagnostics. The combination of various bio-sensing platforms within smartphone-integrated electronic readers provides accurate on-site and on-time diagnostics based on various types of chemical and biological targets. Further, 3D printing technology shows a huge potential toward fabrication and improving the performance of POC devices. Integration of skin-like flexible sensors with wireless communication technology creates a unique opportunity for continuous, real-time monitoring of patients for both preventative healthcare and during disease outbreaks. Here, we review recent developments and advances in POC technologies and describe how these advances enhance the performance of POC platforms. Also, this review describes challenges, directions, and future trends on application of emerging technologies in POC diagnostics. Copyright © 2017 Elsevier B.V. All rights reserved.

75 FR 32313 - Specifications and Drawings for Construction Direct Buried Plant

Science.gov (United States)

2010-06-08

... construction units for Fiber-to-the-Home, remove redundant or outdated requirements, and simplify the.... Because of Fiber-to-the-Home construction and advancements made in construction installation methods and... Construction Direct Buried Plant AGENCY: Rural Utilities Service, USDA. ACTION: Proposed Rule. SUMMARY: The...

Advanced computations in plasma physics

International Nuclear Information System (INIS)

Tang, W.M.

2002-01-01

Scientific simulation in tandem with theory and experiment is an essential tool for understanding complex plasma behavior. In this paper we review recent progress and future directions for advanced simulations in magnetically confined plasmas with illustrative examples chosen from magnetic confinement research areas such as microturbulence, magnetohydrodynamics, magnetic reconnection, and others. Significant recent progress has been made in both particle and fluid simulations of fine-scale turbulence and large-scale dynamics, giving increasingly good agreement between experimental observations and computational modeling. This was made possible by innovative advances in analytic and computational methods for developing reduced descriptions of physics phenomena spanning widely disparate temporal and spatial scales together with access to powerful new computational resources. In particular, the fusion energy science community has made excellent progress in developing advanced codes for which computer run-time and problem size scale well with the number of processors on massively parallel machines (MPP's). A good example is the effective usage of the full power of multi-teraflop (multi-trillion floating point computations per second) MPP's to produce three-dimensional, general geometry, nonlinear particle simulations which have accelerated progress in understanding the nature of turbulence self-regulation by zonal flows. It should be emphasized that these calculations, which typically utilized billions of particles for thousands of time-steps, would not have been possible without access to powerful present generation MPP computers and the associated diagnostic and visualization capabilities. In general, results from advanced simulations provide great encouragement for being able to include increasingly realistic dynamics to enable deeper physics insights into plasmas in both natural and laboratory environments. The associated scientific excitement should serve to

Direct dating of human fossils.

Science.gov (United States)

Grün, Rainer

2006-01-01

The methods that can be used for the direct dating of human remains comprise of radiocarbon, U-series, electron spin resonance (ESR), and amino acid racemization (AAR). This review gives an introduction to these methods in the context of dating human bones and teeth. Recent advances in ultrafiltration techniques have expanded the dating range of radiocarbon. It now seems feasible to reliably date bones up to 55,000 years. New developments in laser ablation mass spectrometry permit the in situ analysis of U-series isotopes, thus providing a rapid and virtually non-destructive dating method back to about 300,000 years. This is of particular importance when used in conjunction with non-destructive ESR analysis. New approaches in AAR analysis may lead to a renaissance of this method. The potential and present limitations of these direct dating techniques are discussed for sites relevant to the reconstruction of modern human evolution, including Florisbad, Border Cave, Tabun, Skhul, Qafzeh, Vindija, Banyoles, and Lake Mungo. (c) 2006 Wiley-Liss, Inc.

Sarcopenia is associated with an increased risk of advanced colorectal neoplasia.

Science.gov (United States)

Park, Youn Su; Kim, Ji Won; Kim, Byeong Gwan; Lee, Kook Lae; Lee, Jae Kyung; Kim, Joo Sung; Koh, Seong-Joon

2017-04-01

Although sarcopenia is associated with an increased risk for mortality after the curative resection of colorectal cancer, its influence on the development of advanced colonic neoplasia remains unclear. This study included 1270 subjects aged 40 years or older evaluated with first-time screening colonoscopy at Seoul National University Boramae Health Care Center from January 2010 to February 2015. Skeletal muscle mass was measured with a body composition analyzer (direct segmental multifrequency bioelectrical impedance analysis method). Multiple logistic regression analysis was performed to determine whether sarcopenia is associated with advanced colorectal neoplasia. Of 1270 subjects, 139 (10.9%) were categorized into the sarcopenia group and 1131 (89.1%) into the non-sarcopenia group. In the non-sarcopenia group, 55 subjects (4.9%) had advanced colorectal neoplasia. However, in the sarcopenia group, 19 subjects (13.7%) had advanced colorectal neoplasia, including 1 subject with invasive colorectal cancer (0.7%). In addition, subjects with sarcopenia had a higher prevalence of advanced adenoma (P sarcopenia. According to the multiple logistic regression analysis adjusted for variable confounders, age (odds ratio 1.062, 95% confidence interval 1.032-1.093; P sarcopenia (odds ratio 2.347, 95% confidence interval 1.311-4.202; P = 0.004) were associated with an advanced colorectal neoplasia. Sarcopenia is associated with an increased risk of advanced colorectal neoplasia.

Interagency Advanced Power Group (IAPG) meeting compendium. October 1991--December 1992

Energy Technology Data Exchange (ETDEWEB)

1993-01-01

Under the direction of the Interagency Advanced Power Group (IAPG), the Power Information Center (PIC) provides support services for each IAPG information exchange session. IAPG members meet a minimum of once each year to share programmatic and technical information on federally funded research and development (R&D) projects in the area of advanced power. This R&D is directed by one of the five IAPG member agencies-the US Army, US Navy, US Air Force, US Department of Energy, and the National Aeronautics and Space Administration. Affiliated Federal groups and federally funded research and development centers can also participate. To enhance the exchange of information between Government researchers, this 1992 IAPG Meeting Compendium has been assembled. This publication is a re-printing of abstracts of each IAPG presentation offered during 1991-1992. The information is arranged chronologically by IAPG meeting. During the 1992 IAPG meeting year, there were presentations restricted to Government audiences only. These ``Restricted`` minutes have not been included in this compilation.

Advanced applications in microphotonics using proton beam writing

International Nuclear Information System (INIS)

Bettiol, A.A.; Chiam, S.Y.; Teo, E.J.; Udalagama, C.; Chan, S.F.; Hoi, S.K.; Kan, J.A. van; Breese, M.B.H.; Watt, F.

2009-01-01

Proton beam writing (PBW) is a powerful tool for prototyping microphotonic structures in a wide variety of materials including polymers, insulators, semiconductors and metals. Prototyping is achieved either through direct fabrication with the proton beam, or by the fabrication of a master that can be used for replication. In recent times we have explored the use of PBW for various advanced optical applications including fabrication of subwavelength metallic structures and metamaterials, direct write of silicon waveguides for mid IR applications and integrated waveguides for lab-on-a-chip devices. This paper will review the recent progress made in these areas with particular emphasis on the main advantages of using the PBW technique for these novel applications.

Advance care planning within survivorship care plans for older cancer survivors: A systematic review.

Science.gov (United States)

O'Caoimh, Rónán; Cornally, Nicola; O'Sullivan, Ronan; Hally, Ruth; Weathers, Elizabeth; Lavan, Amanda H; Kearns, Tara; Coffey, Alice; McGlade, Ciara; Molloy, D William

2017-11-01

Advances in the medical treatment of cancer have increased the number of survivors, particularly among older adults, who now represent the majority of these. Survivorship care plans (SCPs) are documents that cancer patients receive summarising their care, usually at the end of treatment but preferably from initial diagnosis. These may increase patient satisfaction and represent an opportunity to initiate preventative strategies and address future care needs. Advance care planning (ACP), incorporating advance healthcare decision-making, including formal written directives, increases satisfaction and end-of-life care. This paper systematically reviews evaluations of ACP within SCPs among older (≥65 years) cancer survivors. No studies meeting the inclusion criteria were identified by search strategies conducted in PubMed/MEDLINE and the Cochrane databases. One paper examined cancer survivors' mainly positive views of ACP. Another discussed the use of a SCP supported by a 'distress inventory' that included an advance care directive (living will) as an issue, though no formal evaluation was reported. Although ACP is important for older adults, no study was found that evaluated its role within survivorship care planning. Despite the risk of recurrence and the potential for morbidity and mortality, especially among older cancer survivors, ACP is not yet a feature of SCPs. Copyright © 2017 Elsevier B.V. All rights reserved.

Future Directions in Etiologic, Prevention, and Treatment Research for Eating Disorders

Science.gov (United States)

Stice, Eric; South, Kelsey; Shaw, Heather

2012-01-01

Significant advances have occurred regarding the understanding of etiologic processes that give rise to eating disorders and the design and evaluation of efficacious prevention programs and treatment interventions. Herein we offer suggestions regarding potentially fruitful directions for future research in these areas. We suggest it would be…

NATO Advanced Study Institute on Advances in Microlocal Analysis

CERN Document Server

1986-01-01

The 1985 Castel vecchio-Pas coli NATO Advanced Study Institute is aimed to complete the trilogy with the two former institutes I organized : "Boundary Value Problem for Evolution Partial Differential Operators", Liege, 1976 and "Singularities in Boundary Value Problems", Maratea, 1980. It was indeed necessary to record the considerable progress realized in the field of the propagation of singularities of Schwartz Distri­ butions which led recently to the birth of a new branch of Mathema­ tical Analysis called Microlocal Analysis. Most of this theory was mainly built to be applied to distribution solutions of linear partial differential problems. A large part of this institute still went in this direction. But, on the other hand, it was also time to explore the new trend to use microlocal analysis In non linear differential problems. I hope that the Castelvecchio NATO ASI reached its purposes with the help of the more famous authorities in the field. The meeting was held in Tuscany (Italy) at Castelvecchio-P...

Direct Differentiation of Human Pluripotent Stem Cells into Haploid Spermatogenic Cells

Directory of Open Access Journals (Sweden)

Charles A. Easley, IV

2012-09-01

Full Text Available Human embryonic stem cells (hESCs and induced pluripotent stem cells (hiPSCs have been shown to differentiate into primordial germ cells (PGCs but not into spermatogonia, haploid spermatocytes, or spermatids. Here, we show that hESCs and hiPSCs differentiate directly into advanced male germ cell lineages, including postmeiotic, spermatid-like cells, in vitro without genetic manipulation. Furthermore, our procedure mirrors spermatogenesis in vivo by differentiating PSCs into UTF1-, PLZF-, and CDH1-positive spermatogonia-like cells; HIWI- and HILI-positive spermatocyte-like cells; and haploid cells expressing acrosin, transition protein 1, and protamine 1 (proteins that are uniquely found in spermatids and/or sperm. These spermatids show uniparental genomic imprints similar to those of human sperm on two loci: H19 and IGF2. These results demonstrate that male PSCs have the ability to differentiate directly into advanced germ cell lineages and may represent a novel strategy for studying spermatogenesis in vitro.

New perspectives for advanced automobile diesel engines

Science.gov (United States)

Tozzi, L.; Sekar, R.; Kamo, R.; Wood, J. C.

1983-01-01

Computer simulation results are presented for advanced automobile diesel engine performance. Four critical factors for performance enhancement were identified: (1) part load preheating and exhaust gas energy recovery, (2) fast heat release combustion process, (3) reduction in friction, and (4) air handling system efficiency. Four different technology levels were considered in the analysis. Simulation results are compared in terms of brake specific fuel consumption and vehicle fuel economy in km/liter (miles per gallon). Major critical performance sensitivity areas are: (1) combustion process, (2) expander and compressor efficiency, and (3) part load preheating and compound system. When compared to the state of the art direct injection, cooled, automobile diesel engine, the advanced adiabatic compound engine concept showed the unique potential of doubling the fuel economy. Other important performance criteria such as acceleration, emissions, reliability, durability and multifuel capability are comparable to or better than current passenger car diesel engines.

Technological advances in perioperative monitoring: Current concepts and clinical perspectives.

Science.gov (United States)

Chilkoti, Geetanjali; Wadhwa, Rachna; Saxena, Ashok Kumar

2015-01-01

Minimal mandatory monitoring in the perioperative period recommended by Association of Anesthetists of Great Britain and Ireland and American Society of Anesthesiologists are universally acknowledged and has become an integral part of the anesthesia practice. The technologies in perioperative monitoring have advanced, and the availability and clinical applications have multiplied exponentially. Newer monitoring techniques include depth of anesthesia monitoring, goal-directed fluid therapy, transesophageal echocardiography, advanced neurological monitoring, improved alarm system and technological advancement in objective pain assessment. Various factors that need to be considered with the use of improved monitoring techniques are their validation data, patient outcome, safety profile, cost-effectiveness, awareness of the possible adverse events, knowledge of technical principle and ability of the convenient routine handling. In this review, we will discuss the new monitoring techniques in anesthesia, their advantages, deficiencies, limitations, their comparison to the conventional methods and their effect on patient outcome, if any.

Analysis of Petroleum Technology Advances Through Applied Research by Independent Oil Producers

Energy Technology Data Exchange (ETDEWEB)

Brashear, Jerry P.; North, Walter B.; Thomas Charles P.; Becker, Alan B.; Faulder, David D.

2000-01-12

Petroleum Technology Advances Through Applied Research by Independent Oil Producers is a program of the National Oil Research Program, U.S. Department of Energy. Between 1995 and 1998, the program competitively selected and cost-shared twenty-two projects with small producers. The purpose was to involve small independent producers in testing technologies of interest to them that would advance (directly or indirectly) one or more of four national program objectives: (1) Extend the productive life of reservoirs; (2) Increase production and/or reserves; (3) Improve environmental performance; and (4) Broaden the exchange of technology information.

Advances in direct radiographic magnification technique: First studies with a 1μ focal spot tube

International Nuclear Information System (INIS)

Huettenbrink, K.B.; Schadel, A.

1986-01-01

A direct radiographic enlargement technique mainly depends on the size of the focal spot. Up to now, its reduction was limited for physical reasons; therefore only minor degrees of magnification were applicable. With the new 1 μ focal spot tube, structures of microscopic dimensions can be visualized for the first time in a direct radiographic magnification of up to 100 diameters. First studies in isolated middle ear ossicles and a phantom soft-tissue-skull are demonstrated. Clinical usefullness seems to be limited, whereas its application for experimental research looks promising. (orig.) [de

Advanced gadolinia core and Toshiba advanced reactor management system

International Nuclear Information System (INIS)

Miyamoto, Toshiki; Yoshioka, Ritsuo; Ebisuya, Mitsuo

1988-01-01

At the Hamaoka Nuclear Power Station, Unit No. 3, advanced core design and core management technology have been adopted, significantly improving plant availability, operability and reliability. The outstanding technologies are the advanced gadolinia core (AGC) which utilizes gadolinium for the axial power distribution control, and Toshiba advanced reactor management system (TARMS) which uses a three-dimensional core physics simulator to calculate the power distribution. Presented here are the effects of these advanced technologies as observed during field testing. (author)

Turbostar: an ICF reactor using both direct and thermal power conversion. Revision 1

International Nuclear Information System (INIS)

Pitts, J.H.

1986-01-01

Combining direct and thermal power conversion results in a 52% gross plant efficiency with DT fuel and 68% with advanced DD fuel. We maximize the fraction of fusion-yield energy converted to kinetic energy in a liquid-lithium blanket, and use this energy directly with turbine generators to produce electricity. We use the remainder of the energy to produce electricity in a standard Rankine thermal power conversion cycle

Teaching advance care planning to medical students with a computer-based decision aid.

Science.gov (United States)

Green, Michael J; Levi, Benjamin H

2011-03-01

Discussing end-of-life decisions with cancer patients is a crucial skill for physicians. This article reports findings from a pilot study evaluating the effectiveness of a computer-based decision aid for teaching medical students about advance care planning. Second-year medical students at a single medical school were randomized to use a standard advance directive or a computer-based decision aid to help patients with advance care planning. Students' knowledge, skills, and satisfaction were measured by self-report; their performance was rated by patients. 121/133 (91%) of students participated. The Decision-Aid Group (n = 60) outperformed the Standard Group (n = 61) in terms of students' knowledge (p satisfaction with their learning experience (p student performance. Use of a computer-based decision aid may be an effective way to teach medical students how to discuss advance care planning with cancer patients.

Renewable Energy Laboratory Development for Biofuels Advanced Combustion Studies

Energy Technology Data Exchange (ETDEWEB)

Soloiu, Valentin A. [Georgia Southern Univ., Statesboro, GA (United States)

2012-03-31

The research advanced fundamental science and applied engineering for increasing the efficiency of internal combustion engines and meeting emissions regulations with biofuels. The project developed a laboratory with new experiments and allowed investigation of new fuels and their combustion and emissions. This project supports a sustainable domestic biofuels and automotive industry creating economic opportunities across the nation, reducing the dependence on foreign oil, and enhancing U.S. energy security. The one year period of research developed fundamental knowledge and applied technology in advanced combustion, emissions and biofuels formulation to increase vehicle's efficiency. Biofuels combustion was investigated in a Compression Ignition Direct Injection (DI) to develop idling strategies with biofuels and an Indirect Diesel Injection (IDI) intended for auxiliary power unit.

Assessment of HAPs emissions from advanced power systems

International Nuclear Information System (INIS)

Erickson, T.A.; Brekke, D.W.

1996-01-01

The 1990 Clean Air Act Amendments (CAAA) identified 189 substances as air toxics or hazardous air pollutants (HAPs). Under the CAAA, the U. S. Environmental Protection Agency (EPA) must regulate emissions of these HAPs at their sources, including advanced power systems used for the production of electricity. Eleven trace elements are included in the CAAA list of HAPS, as shown in Table 1. The EPA will define those sources that require regulation and limit their emissions according to regulatory directives. This project focused on evaluating and manipulating the advanced power systems HAPs data currently available for presentation to the U.S. Department of Energy (DOE). Trace components included in the 189 HAPs of the 1990 CAAA are: antimony compounds; arsenic compounds; beryllium compounds; cadmium compounds; chromium compounds; cobalt compounds; lead compounds; manganese compounds; mercury compounds; nickel compounds; and selenium compounds. The review of trace element emissions from advanced power systems and hot-gas cleanup systems included data from Tidd Station, General Electric hot-gas cleanup, Louisiana Gasification Technology Incorporated, and the Cool Water plant. Very few other sources of information were located, and those that were contained significantly flawed information that was not of value to this project. To offset the shortage of information, thermochemical equilibrium predictions were used in evaluating advanced control systems. An outline of the systems reviewed is given in Table 2. In addition to the four demonstration and 1 full-scale systems reviewed, nine conventional systems were also reviewed for comparison with the advanced systems

Direct Bonded Pontic (Laporan Kasus

Directory of Open Access Journals (Sweden)

Suhandi Sidjaja

2015-10-01

Full Text Available Advanced science and technology in dentistry enable dental practitioners to modified she bonding techniques in tooth replacement. A pontic made of composite resin bonded to etched enamel of the adjacent teeth can be used in the replacement of one missing anterior tooth with a virgin or sowed adpicent tooth. The advantages of this technique include a one visit treatment, cow cost, good esthetics, less side effects and easy repair or rebounding. Clinical evaluation showed a high success rate therefore with a proper diagnosis and a perfect skill of the direct bonded technique this treatment can be used as an alternative restoration.

Laser-based direct-write techniques for cell printing

Energy Technology Data Exchange (ETDEWEB)

Schiele, Nathan R; Corr, David T [Biomedical Engineering Department, Rensselaer Polytechnic Institute, Troy, NY (United States); Huang Yong [Department of Mechanical Engineering, Clemson University, Clemson, SC (United States); Raof, Nurazhani Abdul; Xie Yubing [College of Nanoscale Science and Engineering, University at Albany, SUNY, Albany, NY (United States); Chrisey, Douglas B, E-mail: schien@rpi.ed, E-mail: chrisd@rpi.ed [Material Science and Engineering Department, Rensselaer Polytechnic Institute, Troy, NY (United States)

2010-09-15

Fabrication of cellular constructs with spatial control of cell location ({+-}5 {mu}m) is essential to the advancement of a wide range of applications including tissue engineering, stem cell and cancer research. Precise cell placement, especially of multiple cell types in co- or multi-cultures and in three dimensions, can enable research possibilities otherwise impossible, such as the cell-by-cell assembly of complex cellular constructs. Laser-based direct writing, a printing technique first utilized in electronics applications, has been adapted to transfer living cells and other biological materials (e.g., enzymes, proteins and bioceramics). Many different cell types have been printed using laser-based direct writing, and this technique offers significant improvements when compared to conventional cell patterning techniques. The predominance of work to date has not been in application of the technique, but rather focused on demonstrating the ability of direct writing to pattern living cells, in a spatially precise manner, while maintaining cellular viability. This paper reviews laser-based additive direct-write techniques for cell printing, and the various cell types successfully laser direct-written that have applications in tissue engineering, stem cell and cancer research are highlighted. A particular focus is paid to process dynamics modeling and process-induced cell injury during laser-based cell direct writing. (topical review)

Laser-based direct-write techniques for cell printing

International Nuclear Information System (INIS)

Schiele, Nathan R; Corr, David T; Huang Yong; Raof, Nurazhani Abdul; Xie Yubing; Chrisey, Douglas B

2010-01-01

Fabrication of cellular constructs with spatial control of cell location (±5 μm) is essential to the advancement of a wide range of applications including tissue engineering, stem cell and cancer research. Precise cell placement, especially of multiple cell types in co- or multi-cultures and in three dimensions, can enable research possibilities otherwise impossible, such as the cell-by-cell assembly of complex cellular constructs. Laser-based direct writing, a printing technique first utilized in electronics applications, has been adapted to transfer living cells and other biological materials (e.g., enzymes, proteins and bioceramics). Many different cell types have been printed using laser-based direct writing, and this technique offers significant improvements when compared to conventional cell patterning techniques. The predominance of work to date has not been in application of the technique, but rather focused on demonstrating the ability of direct writing to pattern living cells, in a spatially precise manner, while maintaining cellular viability. This paper reviews laser-based additive direct-write techniques for cell printing, and the various cell types successfully laser direct-written that have applications in tissue engineering, stem cell and cancer research are highlighted. A particular focus is paid to process dynamics modeling and process-induced cell injury during laser-based cell direct writing. (topical review)

Direct contrast-enhanced MR venography in the diagnosis of May-Thurner Syndrome

Energy Technology Data Exchange (ETDEWEB)

Gurel, Kamil, E-mail: kamilgurel@hotmail.com [Baskent University, School of Medicine, Adana Medical and Research Center, Department of Radiology (Turkey); Gurel, Safiye; Karavas, Erdal [Abant Izzet Baysal University, Izzet Baysal School of Medicine, Department of Radiology (Turkey); Buharalioglu, Yavuz; Daglar, Bahadir [Abant Izzet Baysal University, Izzet Baysal School of Medicine, Department of Cardiovascular Surgery (Turkey)

2011-11-15

Visualization of lower extremity veins with MR venography still needs improvement. The latest advancement is direct contrast-enhanced 3D MR venography which is based on display of venous system during direct injection of paramagnetic extracellular contrast agent into pedal veins. We used automated injection of contrast agent with a power injector makings this application simpler and faster, achieved to show the iliac vein compression syndrome and post-thrombotic changes of the left iliac and femoral veins.

COMETS2: An advanced MATLAB toolbox for the numerical analysis of electric fields generated by transcranial direct current stimulation.

Science.gov (United States)

Lee, Chany; Jung, Young-Jin; Lee, Sang Jun; Im, Chang-Hwan

2017-02-01

Since there is no way to measure electric current generated by transcranial direct current stimulation (tDCS) inside the human head through in vivo experiments, numerical analysis based on the finite element method has been widely used to estimate the electric field inside the head. In 2013, we released a MATLAB toolbox named COMETS, which has been used by a number of groups and has helped researchers to gain insight into the electric field distribution during stimulation. The aim of this study was to develop an advanced MATLAB toolbox, named COMETS2, for the numerical analysis of the electric field generated by tDCS. COMETS2 can generate any sizes of rectangular pad electrodes on any positions on the scalp surface. To reduce the large computational burden when repeatedly testing multiple electrode locations and sizes, a new technique to decompose the global stiffness matrix was proposed. As examples of potential applications, we observed the effects of sizes and displacements of electrodes on the results of electric field analysis. The proposed mesh decomposition method significantly enhanced the overall computational efficiency. We implemented an automatic electrode modeler for the first time, and proposed a new technique to enhance the computational efficiency. In this paper, an efficient toolbox for tDCS analysis is introduced (freely available at http://www.cometstool.com). It is expected that COMETS2 will be a useful toolbox for researchers who want to benefit from the numerical analysis of electric fields generated by tDCS. Copyright © 2016. Published by Elsevier B.V.

An overview of DARPA's advanced space technology program

Science.gov (United States)

Nicastri, E.; Dodd, J.

1993-02-01

The Defense Advanced Research Projects Agency (DARPA) is the central research and development organization of the DoD and, as such, has the primary responsibility for the maintenance of U.S. technological superiority over potential adversaries. DARPA's programs focus on technology development and proof-of-concept demonstrations of both evolutionary and revolutionary approaches for improved strategic, conventional, rapid deployment and sea power forces, and on the scientific investigation into advanced basic technologies of the future. DARPA can move quickly to exploit new ideas and concepts by working directly with industry and universities. For four years, DARPA's Advanced Space Technology Program (ASTP) has addressed various ways to improve the performance of small satellites and launch vehicles. The advanced technologies that are being and will be developed by DARPA for small satellites can be used just as easily on large satellites. The primary objective of the ASTP is to enhance support to operational commanders by developing and applying advanced technologies that will provide cost-effective, timely, flexible, and responsive space systems. Fundamental to the ASTP effort is finding new ways to do business with the goal of quickly inserting new technologies into DoD space systems while reducing cost. In our view, these methods are prime examples of what may be termed 'technology leveraging.' The ASTP has initiated over 50 technology projects, many of which were completed and transitioned to users. The objectives are to quickly qualify these higher risk technologies for use on future programs and reduce the risk of inserting these technologies into major systems, and to provide the miniaturized systems that would enable smaller satellites to have significant - rather than limited - capability. Only a few of the advanced technologies are described, the majority of which are applicable to both large and small satellites.

Advanced parking management systems : a cross-cutting study : taking the stress out of parking

Science.gov (United States)

2007-01-01

This study examines advanced parking management systems (APMSs) in three venues: airports, central business districts, and transit park-and-ride locations. Specifically, the systems examined in this study provide directional and space availability in...

The Competencies, Roles and Scope of Practice of Advanced Psychiatric Nursing in Indonesia

Directory of Open Access Journals (Sweden)

Yulia Wardani

2014-01-01

Full Text Available The graduate advanced psychiatric nursing (psychiatric nursing specialist from master degree in Indonesia are about 70 nurses, 67 nurses were graduated from University of Indonesia. They are working at mental health services and educational setting around Indonesia and yet seem not ready to perform some specific advanced competencies in clinical area. The mastery on mental health assessment, neurochemical perspectives, medical management and psychotherapy have not yet performed by the psychiatric nurse specialist in the clinical area or community.To have those competencies and its performances, therefore the curriculum in a psychiatric nursing graduate program must include advanced courses in physiopsychology, psychopathology, advanced psychopharmacology, neurobehavioral science, advanced mental health assessment, and advanced treatment interventions such as psychotherapy and prescription and management of psychotropic medications as their core and major courses in the curriculum. Those courses should be performed in their clinical practice courses or other related learning experiences. When those qualifications are met, then they are competent to be called advanced psychiatric nurse.As advanced practice registered nurses, the advanced psychiatric nurses should be able to demonstrate their direct expertise and roles in advanced mental health assessment, diagnostic evaluation, psychopharmacology management, psychotherapy with individuals, group and families, case management, millieu management, liason and counselling from prevention, promotion until psychiatric rehabilitation. Meanwhile the skill such as psycho-education, teaching, unit management, research and staff development can be added as their indirect roles.

Factors Affecting the Self-directed Learning of Students at Clinical Practice Course for Advanced Practice Nurse

Directory of Open Access Journals (Sweden)

Miyoung Kim, RN, PhD, MBA, GNP

2011-03-01

Conclusions: This study demonstrated the hierarchical relationship among belongingness, self-esteem, and self-directed learning based on the conceptual framework developed by Levett-Jones and Lathlean, thus proving the usefulness of this framework for application in the field. Therefore, this study found that there are needs of high self-esteem and belongingness in order to improve self-directed learning for APN students in clinical practice.

Advanced Dynamics Analytical and Numerical Calculations with MATLAB

CERN Document Server

Marghitu, Dan B

2012-01-01

Advanced Dynamics: Analytical and Numerical Calculations with MATLAB provides a thorough, rigorous presentation of kinematics and dynamics while using MATLAB as an integrated tool to solve problems. Topics presented are explained thoroughly and directly, allowing fundamental principles to emerge through applications from areas such as multibody systems, robotics, spacecraft and design of complex mechanical devices. This book differs from others in that it uses symbolic MATLAB for both theory and applications. Special attention is given to solutions that are solved analytically and numerically using MATLAB. The illustrations and figures generated with MATLAB reinforce visual learning while an abundance of examples offer additional support. This book also: Provides solutions analytically and numerically using MATLAB Illustrations and graphs generated with MATLAB reinforce visual learning for students as they study Covers modern technical advancements in areas like multibody systems, robotics, spacecraft and des...

Advances in poultry litter disposal technology--a review.

Science.gov (United States)

Kelleher, B P; Leahy, J J; Henihan, A M; O'Dwyer, T F; Sutton, D; Leahy, M J

2002-05-01

The land disposal of waste from the poultry industry and subsequent environmental implications has stimulated interest into cleaner and more useful disposal options. The review presented here details advances in the three main alternative disposal routes for poultry litter, specifically in the last decade. Results of experimental investigations into the optimisation of composting, anaerobic digestion and direct combustion are summarised. These technologies open up increased opportunities to market the energy and nutrients in poultry litter to agricultural and non-agricultural uses. Common problems experienced by the current technologies are the existence and fate of nitrogen as ammonia, pH and temperature levels, moisture content and the economics of alternative disposal methods. Further advancement of these technologies is currently receiving increased interest, both academically and commercially. However, significant financial incentives are required to attract the agricultural industry.

Future challenges in single event effects for advanced CMOS technologies

International Nuclear Information System (INIS)

Guo Hongxia; Wang Wei; Luo Yinhong; Zhao Wen; Guo Xiaoqiang; Zhang Keying

2010-01-01

SEE have became a substantial Achilles heel for the reliability of space-based advanced CMOS technologies with features size downscaling. Future space and defense systems require identification and understanding of single event effects to develop hardening approaches for advanced technologies, including changes in device geometry and materials affect energy deposition, charge collection,circuit upset, parametric degradation devices. Topics covered include the impact of technology scaling on radiation response, including single event transients in high speed digital circuits, evidence for single event effects caused by proton direct ionization, and the impact for SEU induced by particle energy effects and indirect ionization. The single event effects in CMOS replacement technologies are introduced briefly. (authors)

Management accounting for advanced technological environments.

Science.gov (United States)

Kaplan, R S

1989-08-25

Management accounting systems designed decades ago no longer provide timely, relevant information for companies in today's highly competitive environment. New operational control and performance measurement systems are recognizing the importance of direct measurement of quality, manufacturing lead times, flexibility, and customer responsiveness, as well as more accurate measures of the actual costs of consumed resources. Activity-based cost systems can assign the costs of indirect and support resources to the specific products and activities that benefit from these resources. Both operational control and activity-based systems represent new opportunities for improved managerial information in complex, technologically advanced environments.

NATO Advanced Research Institute on the Efficiency of Manufacturing Systems

CERN Document Server

Berg, C; French, D

1983-01-01

The Advanced Research Institute (A.R. 1.) on "the efficiency of Manufacturing Systems" was held under the auspices of the NATO Special Programm~ Panel on Systems Science as a part of the NATO Science Committee's continuous effort to promote the advancement of science through international co-operation. Advanced Research Institutes are organised for the purpose of bringing together experts in a particular field of interest to identify and make known the present state of knowledge in that area and, through informed debate, to make recommendations for directions for future research that would benefit the community at large. To this end two kinds of contribution were obtained by invitation. There were those papers which were about the current state of work in the area of manufacturing systems and its organisation; in addition three theme papers were presented to provide a stimulus to the discussion in terms of ways of thinking, both about the area and about the kind of research needed.

Computation of Asteroid Proper Elements: Recent Advances

Science.gov (United States)

Knežević, Z.

2017-12-01

The recent advances in computation of asteroid proper elements are briefly reviewed. Although not representing real breakthroughs in computation and stability assessment of proper elements, these advances can still be considered as important improvements offering solutions to some practical problems encountered in the past. The problem of getting unrealistic values of perihelion frequency for very low eccentricity orbits is solved by computing frequencies using the frequency-modified Fourier transform. The synthetic resonant proper elements adjusted to a given secular resonance helped to prove the existence of Astraea asteroid family. The preliminary assessment of stability with time of proper elements computed by means of the analytical theory provides a good indication of their poorer performance with respect to their synthetic counterparts, and advocates in favor of ceasing their regular maintenance; the final decision should, however, be taken on the basis of more comprehensive and reliable direct estimate of their individual and sample average deviations from constancy.

Recent advances in 3D printing of biomaterials.

Science.gov (United States)

Chia, Helena N; Wu, Benjamin M

2015-01-01

3D Printing promises to produce complex biomedical devices according to computer design using patient-specific anatomical data. Since its initial use as pre-surgical visualization models and tooling molds, 3D Printing has slowly evolved to create one-of-a-kind devices, implants, scaffolds for tissue engineering, diagnostic platforms, and drug delivery systems. Fueled by the recent explosion in public interest and access to affordable printers, there is renewed interest to combine stem cells with custom 3D scaffolds for personalized regenerative medicine. Before 3D Printing can be used routinely for the regeneration of complex tissues (e.g. bone, cartilage, muscles, vessels, nerves in the craniomaxillofacial complex), and complex organs with intricate 3D microarchitecture (e.g. liver, lymphoid organs), several technological limitations must be addressed. In this review, the major materials and technology advances within the last five years for each of the common 3D Printing technologies (Three Dimensional Printing, Fused Deposition Modeling, Selective Laser Sintering, Stereolithography, and 3D Plotting/Direct-Write/Bioprinting) are described. Examples are highlighted to illustrate progress of each technology in tissue engineering, and key limitations are identified to motivate future research and advance this fascinating field of advanced manufacturing.

Argumentative patterns in the European Union directives : An effective tool to foster compliance by the Member States

NARCIS (Netherlands)

Andone, C.; Coman-Kund, F.

This paper provides an account of the arguments advanced by the European Union (EU) legislator in the preamble of directives adopted for harmonization in the internal market, and assesses them as to their potential at convincing the Member States to implement the directive at issue. We show what

Improved safety in advanced control complexes, without side effects

International Nuclear Information System (INIS)

Harmon, D.L.

1997-01-01

If we only look for a moment at the world around us, it is obvious that advances in digital electronic equipment and Human-System Interface (HSI) technology are occurring at a phenomenal pace. This is evidenced from our home entertainment systems to the dashboard and computer-based operation of our new cars. Though the nuclear industry has less vigorously embraced these advances, their application is being implemented through individual upgrades to current generation nuclear plants and as plant-wide control complexes for advanced plants. In both venues modem technology possesses widely touted advantages for improving plant availability as well as safety. The well-documented safety benefits of digital Instrumentation and Controls (I ampersand C) include higher reliability resulting from redundancy and fault tolerance, inherent self-test and self-diagnostic capabilities which have replaced error-prone human tasks, resistance to setpoint drift increasing available operating margins, and the ability to run complex, real-time, computer-based algorithms directly supporting an operator's monitoring and control task requirements. 22 refs., 3 figs., 5 tabs

Study of advanced rotary combustion engines for commuter aircraft

Science.gov (United States)

Berkowitz, M.; Jones, C.; Myers, D.

1983-01-01

Performance, weight, size, and maintenance data for advanced rotary aircraft engines suitable for comparative commuter aircraft system evaluation studies of alternate engine candidates are provided. These are turbocharged, turbocompounded, direct injected, stratified charge rotary engines. Hypothetical engines were defined (an RC4-74 at 895 kW and an RC6-87 at 1490 kW) based on the technologies and design approaches used in the highly advanced engine of a study of advanced general aviation rotary engines. The data covers the size range of shaft power from 597 kW (800 hp) to 1865 kW (2500 hp) and is in the form of drawings, tables, curves and written text. These include data on internal geometry and configuration, installation information, turbocharging and turbocompounding arrangements, design features and technologies, engine cooling, fuels, scaling for weight size BSFC and heat rejection for varying horsepower, engine operating and performance data, and TBO and maintenance requirements. The basic combustion system was developed and demonstrated; however the projected power densities and performance efficiencies require increases in engine internal pressures, thermal loading, and rotative speed.

Membranes for direct ethanol fuel cells: An overview

International Nuclear Information System (INIS)

Zakaria, Z.; Kamarudin, S.K.; Timmiati, S.N.

2016-01-01

Highlights: • DEFCs have emerged as alternative energy source. • But many issue need to be addressed. • This paper describes current problem and advancement of membrane in DEFC. - Abstract: Direct ethanol fuel cells (DEFCs) are attractive as a power source options because ethanol is a nontoxic, leading to ease of handling and a high energy density fuel, leading to high system energy density. However, to provide practical DEFCs power source there are several issues that still must be addressed including low power density, effect of ethanol crossover on efficiency of fuel utilization, electrical, mechanical and thermal stability and water uptake of the DEFCs electrolyte membrane. This paper describes the proton exchange membrane and alkaline exchange membrane for DEFCs, focusing on current problems and advancements in DEFC membranes. It also presents the specifications and performances of the membranes used in DEFC.

Prosocial motivation, stress and burnout among direct support workers.

Science.gov (United States)

Hickey, Robert

2014-03-01

This study explores whether the desire to engage in work that is beneficial to others moderates the effects of stress on burnout. Based on a survey of 1570 direct support professionals in Ontario, this study conducted linear regression analyses and tested for the interaction effects of prosocial motivation on occupational stress and burnout. Prosocial motivation significantly moderated the association of emotional exhaustion (EE) and role boundary stress with depersonalization (DP). Prosocial motivation also moderated the effects of role ambiguity stress with a direct support worker's sense of personal accomplishment. In contrast, prosocial motivation magnified feelings of EE when interacted with a sense of personal accomplishment. Prosocial motivation plays an important role in explaining the relatively low levels of DP in the sector. The study advances our understanding of the key components of burnout among direct support workers. © 2013 John Wiley & Sons Ltd.

Advanced thermally stable jet fuels

Energy Technology Data Exchange (ETDEWEB)

Schobert, H.H.

1999-01-31

The Pennsylvania State University program in advanced thermally stable coal-based jet fuels has five broad objectives: (1) Development of mechanisms of degradation and solids formation; (2) Quantitative measurement of growth of sub-micrometer and micrometer-sized particles suspended in fuels during thermal stressing; (3) Characterization of carbonaceous deposits by various instrumental and microscopic methods; (4) Elucidation of the role of additives in retarding the formation of carbonaceous solids; (5) Assessment of the potential of production of high yields of cycloalkanes by direct liquefaction of coal. Future high-Mach aircraft will place severe thermal demands on jet fuels, requiring the development of novel, hybrid fuel mixtures capable of withstanding temperatures in the range of 400--500 C. In the new aircraft, jet fuel will serve as both an energy source and a heat sink for cooling the airframe, engine, and system components. The ultimate development of such advanced fuels requires a thorough understanding of the thermal decomposition behavior of jet fuels under supercritical conditions. Considering that jet fuels consist of hundreds of compounds, this task must begin with a study of the thermal degradation behavior of select model compounds under supercritical conditions. The research performed by The Pennsylvania State University was focused on five major tasks that reflect the objectives stated above: Task 1: Investigation of the Quantitative Degradation of Fuels; Task 2: Investigation of Incipient Deposition; Task 3: Characterization of Solid Gums, Sediments, and Carbonaceous Deposits; Task 4: Coal-Based Fuel Stabilization Studies; and Task 5: Exploratory Studies on the Direct Conversion of Coal to High Quality Jet Fuels. The major findings of each of these tasks are presented in this executive summary. A description of the sub-tasks performed under each of these tasks and the findings of those studies are provided in the remainder of this volume

Advanced Ceramics

International Nuclear Information System (INIS)

1989-01-01

The First Florida-Brazil Seminar on Materials and the Second State Meeting about new materials in Rio de Janeiro State show the specific technical contribution in advanced ceramic sector. The others main topics discussed for the development of the country are the advanced ceramic programs the market, the national technic-scientific capacitation, the advanced ceramic patents, etc. (C.G.C.) [pt

Core mechanics and configuration behavior of advanced LMFBR core restraint concepts

International Nuclear Information System (INIS)

Fox, J.N.; Wei, B.C.

1978-02-01

Core restraint systems in LMFBRs maintain control of core mechanics and configuration behavior. Core restraint design is complex due to the close spacing between adjacent components, flux and temperature gradients, and irradiation-induced material property effects. Since the core assemblies interact with each other and transmit loads directly to the core restraint structural members, the core assemblies themselves are an integral part of the core restraint system. This paper presents an assessment of several advanced core restraint system and core assembly concepts relative to the expected performance of currently accepted designs. A recommended order for the development of the advanced concepts is also presented

Direct to consumer genetic testing-law and policy concerns in Ireland.

Science.gov (United States)

de Paor, Aisling

2017-11-25

With rapid scientific and technological advances, the past few years has witnessed the emergence of a new genetic era and a growing understanding of the genetic make-up of human beings. These advances have propelled the introduction of companies offering direct to consumer (DTC) genetic testing, which facilitates the direct provision of such tests to consumers, (for example, via the internet). Although DTC genetic testing offers benefits by enhancing consumer accessibility to such technology, promoting proactive healthcare and increasing genetic awareness, it presents a myriad of challenges, from an ethical, legal and regulatory perspective. As DTC genetic testing usually eliminates the need for a medical professional in accessing genetic tests, this lack of professional guidance and counselling may result in misinterpretation and confusion regarding results. In addition, an evident concern relates to the scientific validity and quality of these tests. A further problem arising is the lack or inadequacy of regulation in this field. Despite the increasing accessibility of DTC genetic testing, this legislative vacuum is apparent in Ireland, where there is no concrete legislation. This article explores the main ethical, legal and regulatory issues arising with the advent of rapid advances in DTC genetic testing in Ireland. Further, with inevitable future advances in genetic science, as well as increasing internet accessibility, the challenges presented are likely to become more amplified. In consideration of the ethical and legal challenges, this paper highlights the regulation of DTC genetic testing as a growing concern in Ireland, recognising its importance to both the scientific community as well as in respect of enhancing consumer confidence in such technologies.

Application of effect-directed analysis to identify mutagenic nitrogenous disinfection by-products of advanced oxidation drinking water treatment

NARCIS (Netherlands)

Vughs, D.; Baken, K.A.; Kolkman, A.; Martijn, A.J.; de Voogt, P.

Advanced oxidation processes are important barriers for organic micropollutants in (drinking) water treatment. It is however known that medium pressure UV/H2O2 treatment may lead to mutagenicity in the Ames test, which is no longer present after granulated activated carbon (GAC) filtration. Many

Advanced extravehicular protective systems for shuttle, space station, lunar base and Mars missions.

Science.gov (United States)

Heimlich, P. F.; Sutton, J. G.; Tepper, E. H.

1972-01-01

Advances in extravehicular life support system technology will directly influence future space mission reliability and maintainability considerations. To identify required new technology areas, an appraisal of advanced portable life support system and subsystem concepts was conducted. Emphasis was placed on thermal control and combined CO2 control/O2 supply subsystems for both primary and emergency systems. A description of study methodology, concept evaluation techniques, specification requirements, and selected subsystems and systems are presented. New technology recommendations encompassing thermal control, CO2 control and O2 supply subsystems are also contained herein.

Advanced Process Control Application and Optimization in Industrial Facilities

Directory of Open Access Journals (Sweden)

Howes S.

2015-01-01

Full Text Available This paper describes application of the new method and tool for system identification and PID tuning/advanced process control (APC optimization using the new 3G (geometric, gradient, gravity optimization method. It helps to design and implement control schemes directly inside the distributed control system (DCS or programmable logic controller (PLC. Also, the algorithm helps to identify process dynamics in closed-loop mode, optimizes controller parameters, and helps to develop adaptive control and model-based control (MBC. Application of the new 3G algorithm for designing and implementing APC schemes is presented. Optimization of primary and advanced control schemes stabilizes the process and allows the plant to run closer to process, equipment and economic constraints. This increases production rates, minimizes operating costs and improves product quality.

Soft computing in design and manufacturing of advanced materials

Science.gov (United States)

Cios, Krzysztof J.; Baaklini, George Y; Vary, Alex

1993-01-01

The potential of fuzzy sets and neural networks, often referred to as soft computing, for aiding in all aspects of manufacturing of advanced materials like ceramics is addressed. In design and manufacturing of advanced materials, it is desirable to find which of the many processing variables contribute most to the desired properties of the material. There is also interest in real time quality control of parameters that govern material properties during processing stages. The concepts of fuzzy sets and neural networks are briefly introduced and it is shown how they can be used in the design and manufacturing processes. These two computational methods are alternatives to other methods such as the Taguchi method. The two methods are demonstrated by using data collected at NASA Lewis Research Center. Future research directions are also discussed.

Advanced fission and fossil plant economics-implications for fusion

International Nuclear Information System (INIS)

Delene, J.G.

1994-01-01

In order for fusion energy to be a viable option for electric power generation, it must either directly compete with future alternatives or serve as a reasonable backup if the alternatives become unacceptable. This paper discusses projected costs for the most likely competitors with fusion power for baseload electric capacity and what these costs imply for fusion economics. The competitors examined include advanced nuclear fission and advanced fossil-fired plants. The projected costs and their basis are discussed. The estimates for these technologies are compared with cost estimates for magnetic and inertial confinement fusion plants. The conclusion of the analysis is that fusion faces formidable economic competition. Although the cost level for fusion appears greater than that for fission or fossil, the costs are not so high as to preclude fusion's potential competitiveness

Recent advances in understanding and treating COPD related to α1-antitrypsin deficiency.

Science.gov (United States)

Henao, Maria Paula; Craig, Timothy J

2016-12-01

Alpha-1-antitrypsin deficiency (AATD) is an orphan disease that predisposes individuals to COPD and liver disease. The following is a comprehensive review of AATD from epidemiology to treatment for physicians who treat COPD or asthma. Areas covered: In this comprehensive review of alpha-1-antitrypsin deficiency, we describe the historical perspective, genetics, epidemiology, clinical presentation and symptoms, screening and diagnosis, and treatments of the condition. Expert commentary: The two most important directions for advancing the understanding of AATD involve improving detection of the condition, especially in asymptomatic patients, and advancing knowledge of treatments directed specifically at AATD-related conditions. With regard to treatment for AATD-related conditions, research must continue to explore the implications and importance of augmentation therapy as well as consider new implementations that may prove more successful taking into consideration not only factors of pulmonary function and liver health, but also product availability and financial viability.

Hydrogen-bromine fuel cell advance component development

Science.gov (United States)

Charleston, Joann; Reed, James

1988-01-01

Advanced cell component development is performed by NASA Lewis to achieve improved performance and longer life for the hydrogen-bromine fuel cells system. The state-of-the-art hydrogen-bromine system utilizes the solid polymer electrolyte (SPE) technology, similar to the SPE technology developed for the hydrogen-oxygen fuel cell system. These studies are directed at exploring the potential for this system by assessing and evaluating various types of materials for cell parts and electrode materials for Bromine-hydrogen bromine environment and fabricating experimental membrane/electrode-catalysts by chemical deposition.

Direct electron transfer: an approach for electrochemical biosensors with higher selectivity and sensitivity

Directory of Open Access Journals (Sweden)

Freire Renato S.

2003-01-01

Full Text Available The most promising approach for the development of electrochemical biosensors is to establish a direct electrical communication between the biomolecules and the electrode surface. This review focuses on advances, directions and strategies in the development of third generation electrochemical biosensors. Subjects covered include a brief description of the fundamentals of the electron transfer phenomenon and amperometric biosensor development (different types and new oriented enzyme immobilization techniques. Special attention is given to different redox enzymes and proteins capable of electrocatalyzing reactions via direct electron transfer. The analytical applications and future trends for third generation biosensors are also presented and discussed.

Clinical experience of intrapleural administration of fibrin glue for secondary pneumothorax with advanced lung cancer

International Nuclear Information System (INIS)

Nishino, Takeshi; Takizawa, Hiromitsu; Yoshida, Mitsuteru; Kawakami, Yukikiyo; Sakiyama, Shoji; Kondo, Kazuya

2014-01-01

Secondary pneumothorax with advanced lung cancer is an intractable and serious pathosis, which directly aggravates patients' Quality of Life (QOL) and prognosis. We first select the intrapleural administration of fibrin glue for secondary pneumothorax with advanced lung cancer. From April 2009 to May 2012, we encountered 5 patients who developed secondary pneumothorax during treatment for advanced lung cancer. Their average age was 60.8 years old, and 4 of them had squamous cell carcinoma, 1 had adenocarcinoma, and all had unresectable advanced lung cancer. In 4 of them, the point of air leakage could be detected by pleurography, and leakage could be stopped by the intrapleural administration of fibrin glue. All of them could receive chemotherapy or radiotherapy after treatment for secondary pneumothorax. The intrapleural administration of fibrin glue may be an effective and valid treatment for intractable secondary pneumothorax with advanced lung cancer. (author)

Commentary on Future directions: Building technologies and design tools''

Energy Technology Data Exchange (ETDEWEB)

Quadrel, R.W.

1992-08-10

This paper presents a number of interesting and thought-provoking scenarios about the future use of advanced technology in the design and operation of commercial buildings. I will express my reactions in the following series of short paragraphs. These thoughts will, I hope, raise some new questions and offer fruitful directions for further exploration.

Direct energy conversion of radiation energy in fusion reactor

International Nuclear Information System (INIS)

Yamaguchi, S.; Iiyoshi, A.; Motojima, O.; Okamoto, M.; Sudo, S.; Ohnishi, M.; Onozuka, M.; Uenosono, C.

1993-11-01

Direct energy conversion from plasma heat flux has been studied. Since major parts of fusion energy in the advanced fusion reactor are radiation and charged particle energies, the flexible design of the blanket is possible. We discuss the potentiality of the thermoelectric element that generates electricity by temperature gradient in conductors. A strong magnetic field is used to confine the fusion plasma, therefore, it is appropriate to consider the effect of the magnetic field. We propose a new element which is called Nernst element. The new element needs the magnetic field and the temperature gradient. We compare the efficiency of these two elements in a semiconductor model. Finally, a direct energy conversion are mentioned. (author)

Direct energy conversion of radiation energy in fusion reactor

Science.gov (United States)

Yamaguchi, S.; Iiyoshi, A.; Motojima, O.; Okamoto, M.; Sudo, S.; Ohnishi, M.; Onozuka, M.; Uenosono, C.

1993-11-01

Direct energy conversion from plasma heat flux has been studied. Since major parts of fusion energy in the advanced fusion reactor are radiation and charged particle energies, the flexible design of the blanket is possible. We discuss the potentiality of the thermoelectric element that generates electricity by temperature gradient in conductors. A strong magnetic field is used to confine the fusion plasma, therefore, it is appropriate to consider the effect of the magnetic field. We propose a new element which is called Nernst element. The new element needs the magnetic field and the temperature gradient. We compare the efficiency of these two elements in a semiconductor model. Finally, a direct energy conversion are mentioned.

Direct energy conversion of radiation energy in fusion reactor

Energy Technology Data Exchange (ETDEWEB)

Yamaguchi, S.; Iiyoshi, A.; Motojima, O.; Okamoto, M.; Sudo, S.; Ohnishi, M.; Onozuka, M.; Uenosono, C.

1993-11-01

Direct energy conversion from plasma heat flux has been studied. Since major parts of fusion energy in the advanced fusion reactor are radiation and charged particle energies, the flexible design of the blanket is possible. We discuss the potentiality of the thermoelectric element that generates electricity by temperature gradient in conductors. A strong magnetic field is used to confine the fusion plasma, therefore, it is appropriate to consider the effect of the magnetic field. We propose a new element which is called Nernst element. The new element needs the magnetic field and the temperature gradient. We compare the efficiency of these two elements in a semiconductor model. Finally, a direct energy conversion are mentioned. (author).

Direct energy conversion of radiation energy in fusion reactor

Energy Technology Data Exchange (ETDEWEB)

Yamaguchi, S.; Iiyoshi, A.; Motojima, O.; Okamoto, M.; Sudo, S. [National Inst. for Fusion Science, Nagoya (Japan); Ohnishi, M.; Onozuka, M.; Uenosono, C.

1994-12-31

Direct energy conversion from plasma heat flux has been studied. Since major parts of fusion energy in the advanced fusion reactor are radiation and charged particle energies, the flexible design of the blanket is possible. We discuss the potentiality of the thermoelectric element that generate electricity by temperature gradient in conductors. A Strong magnetic field is used to confine the fusion plasma, therefore, it is appropriate to consider the effect of the magnetic field. We propose a new element which is called Nernst element. The new element needs the magnetic field and the temperature gradient. We compare the efficiency of these two elements in a semiconductor model. Finally, a direct energy converter are mentioned. (author).

Direct energy conversion of radiation energy in fusion reactor

International Nuclear Information System (INIS)

Yamaguchi, S.; Iiyoshi, A.; Motojima, O.; Okamoto, M.; Sudo, S.; Ohnishi, M.; Onozuka, M.; Uenosono, C.

1994-01-01

Direct energy conversion from plasma heat flux has been studied. Since major parts of fusion energy in the advanced fusion reactor are radiation and charged particle energies, the flexible design of the blanket is possible. We discuss the potentiality of the thermoelectric element that generate electricity by temperature gradient in conductors. A Strong magnetic field is used to confine the fusion plasma, therefore, it is appropriate to consider the effect of the magnetic field. We propose a new element which is called Nernst element. The new element needs the magnetic field and the temperature gradient. We compare the efficiency of these two elements in a semiconductor model. Finally, a direct energy converter are mentioned. (author)

Recent Advances in Monoclonal Antibody Therapies for Multiple Sclerosis

Science.gov (United States)

Stavropoulos, Nikolaos; Wittenberg, Nathan J.; Dasari, Harika; Abdelrahim, Murtada A.; Henley, John R.; Oh, Sang-Hyun; Warrington, Arthur E.; Rodriguez, Moses

2016-01-01

Introduction Multiple sclerosis (MS) is the most common chronic inflammatory, demyelinating disease of the CNS and results in neurological disability. Existing immunomodulatory and immunosuppressive approaches lower the number of relapses but do not cure or reverse existing deficits nor improve long-term disability in MS patients. Areas Covered Monogenic antibodies were described as treatment options for MS, however the immunogenicity of mouse antibodies hampered the efficacy of potential therapeutics in humans. Availability of improved antibody production technologies resulted in a paradigm shift in MS treatment strategies. In this review, an overview of immunotherapies for MS that use conventional monoclonal antibodies reactive to immune system and their properties and mechanisms of action will be discussed, including recent advances in MS therapeutics and highlight natural autoantibodies (NAbs) that directly target CNS cells. Expert Opinion Recent challenges for MS therapy are the identification of relevant molecular and cellular targets, time frame of treatment, and antibody toxicity profiles to identify safe treatment options for MS patients. The application of monoclonal antibody therapies with better biological efficacy associated with minimum side effects possesses huge clinical potential. Advances in monoclonal antibody technologies that directly target cells of nervous system may promote the CNS regeneration field from bench to bedside. PMID:26914737

Analysis of emergency core cooling capability of direct vessel vertical injection using CFX

International Nuclear Information System (INIS)

Yoon, Sang H.; Yu, Yong H.; Suh, Kune Y.

2003-01-01

More reliable and efficient safety injection system is of utmost importance in the design of advanced reactors such as the APR1400 (Advanced Power Reactor 1400 MWe). In this work, a new idea is proposed to inject the Emergency Core Cooling (ECC) water utilizing a dedicated nozzle with a vertically downward elbow. The Direct Vessel Injection (DVI) system is located horizontally above the cold leg in the APR1400. However, the horizontal injection method may not always satisfy the ECC penetration requirement into the core on account of rather involved multidimensional thermal and hydraulic phenomena occurring in the annular reactor downcomer such as bypass, impingement, entrainment and sweepout, condensation oscillation, etc. Thus, a novel concept is called for from the reactor safety point of view. The Direct Vessel Vertical Injection (DVVI) system is one of these efforts to penetrate as much the ECC water through the downcomer into the core as is practically achievable. The DVVI system can increase the momentum of the downward flow, thus minimizing the effect of water impingement on the core barrel and the direct bypass though the break. To support the claim of increased downward momentum of flow in the DVVI system, computational fluid dynamics analyses were performed using CFX. The new concept of the DVVI system, which can certainly help increase the core thermal margin, is found to be more efficient than DVI. If the structural problem in the manufacturing process is properly solved, this concept can safely be applied in the advanced nuclear reactor design

Advancing Sexuality Studies: A Short Course on Sexuality Theory and Research Methodologies

Science.gov (United States)

Fletcher, Gillian; Dowsett, Gary W.; Duncan, Duane; Slavin, Sean; Corboz, Julienne

2013-01-01

Critical Sexuality Studies is an emerging field of academic enquiry linked to an international network of advocacy agencies, activists, and political issues. This paper reports on the development of an advanced short course in sexuality theory and research, drawing on Critical Sexuality Studies and aiming directly at academics in developing…

NASA's Advanced Information Systems Technology (AIST) Program: Advanced Concepts and Disruptive Technologies

Science.gov (United States)

Little, M. M.; Moe, K.; Komar, G.

2014-12-01

NASA's Earth Science Technology Office (ESTO) manages a wide range of information technology projects under the Advanced Information Systems Technology (AIST) Program. The AIST Program aims to support all phases of NASA's Earth Science program with the goal of enabling new observations and information products, increasing the accessibility and use of Earth observations, and reducing the risk and cost of satellite and ground based information systems. Recent initiatives feature computational technologies to improve information extracted from data streams or model outputs and researchers' tools for Big Data analytics. Data-centric technologies enable research communities to facilitate collaboration and increase the speed with which results are produced and published. In the future NASA anticipates more small satellites (e.g., CubeSats), mobile drones and ground-based in-situ sensors will advance the state-of-the-art regarding how scientific observations are performed, given the flexibility, cost and deployment advantages of new operations technologies. This paper reviews the success of the program and the lessons learned. Infusion of these technologies is challenging and the paper discusses the obstacles and strategies to adoption by the earth science research and application efforts. It also describes alternative perspectives for the future program direction and for realizing the value in the steps to transform observations from sensors to data, to information, and to knowledge, namely: sensor measurement concepts development; data acquisition and management; data product generation; and data exploitation for science and applications.

Localization of gravitational wave sources with networks of advanced detectors

International Nuclear Information System (INIS)

Klimenko, S.; Mitselmakher, G.; Pankow, C.; Vedovato, G.; Drago, M.; Prodi, G.; Mazzolo, G.; Salemi, F.; Re, V.; Yakushin, I.

2011-01-01

Coincident observations with gravitational wave (GW) detectors and other astronomical instruments are among the main objectives of the experiments with the network of LIGO, Virgo, and GEO detectors. They will become a necessary part of the future GW astronomy as the next generation of advanced detectors comes online. The success of such joint observations directly depends on the source localization capabilities of the GW detectors. In this paper we present studies of the sky localization of transient GW sources with the future advanced detector networks and describe their fundamental properties. By reconstructing sky coordinates of ad hoc signals injected into simulated detector noise, we study the accuracy of the source localization and its dependence on the strength of injected signals, waveforms, and network configurations.

Optimization of time distribution for studying the course modules on advanced training of health care administrators

Directory of Open Access Journals (Sweden)

Dorovskaya A.l.

2015-06-01

Full Text Available The research objective is rational (optimal time management in studying the course modules on Advanced Training of Health Care Administrators. Materials and methods. We conducted expert survey of 73 healthcare administrators from medical organizations of Saratov region. Branch-and-bound method was used for rescheduling the educational program. Results. Both direct and inverse problems have been solved. The direct one refers to time distribution for each module of the advanced Training of Healthcare Administrators course so that the total score is maximum and each module is marked not lower than "satisfactory". The inverse one resulted in achieving minimal time characteristics for varieties of average score. Conclusion. The offered approach allows to solve problems of managing time given for education.

Summary of recent works conducted in Azerbaijan Republic in the direction of peaceful use of nuclear energy

International Nuclear Information System (INIS)

Garibov, A.A.

2012-01-01

Full text :The following terms are shown for the projects carried out on peaceful use of nuclear energy: Scientific-technical innovations; Economical productivity; Maintenance of nuclear security and radiation safety; Competitiveness and inability of execution with order methods. In the Republic of Azerbaijan at state level has been determined the strategically trends in the direction of peaceful use of nuclear energy and expedient works are carried out. The achieved condition allows developing of the most advanced world technologies, scientific and technical directions in Azerbaijan Republic. For this purpose, the most advanced and modern projects are being conducted in the direction of peaceful use of nuclear and radiation technologies : 1) The most modern monitoring equipment's have been installed in all border crossing points and permanent and operative working regime has been provided. Import-export monitoring system is being conducted according to the international requirements; 2) The body provided with the most advanced technology and equipment's has been developed on the execution of storage and utilization of nuclear and radioactive wastes and existing problems in the field are being successfully solved; 3) The most advanced equipment's, methods and technologies are being applied on the basis of nuclear and radioactive materials in the diagnosis and treatment fields of medicine. 4. The most modern radiation calibrating and standardization center are being developed in the Republic. 5. Project is being carried out on the establishment of complex of the most modern sterilization purpose with high-active isotope source in Azerbaijan Republic; 6) Scientific-research works in Azerbaijan republic on peaceful use of nuclear energy has been carried out in the most actual directions since 1969; 7) Azerbaijan Republic actively participates in national and regional projects together with IAEA and other international organizations.

3D metal droplet printing development and advanced materials additive manufacturing

Directory of Open Access Journals (Sweden)

Lawrence E. Murr

2017-01-01

Full Text Available While commercial additive manufacturing processes involving direct metal wire or powder deposition along with powder bed fusion technologies using laser and electron beam melting have proliferated over the past decade, inkjet printing using molten metal droplets for direct, 3D printing has been elusive. In this paper we review the more than three decades of development of metal droplet generation for precision additive manufacturing applications utilizing advanced, high-temperature metals and alloys. Issues concerning process optimization, including product structure and properties affected by oxidation are discussed and some comparisons of related additive manufactured microstructures are presented.

Ligand-accelerated non-directed C-H functionalization of arenes

Science.gov (United States)

Wang, Peng; Verma, Pritha; Xia, Guoqin; Shi, Jun; Qiao, Jennifer X.; Tao, Shiwei; Cheng, Peter T. W.; Poss, Michael A.; Farmer, Marcus E.; Yeung, Kap-Sun; Yu, Jin-Quan

2017-11-01

The directed activation of carbon-hydrogen bonds (C-H) is important in the development of synthetically useful reactions, owing to the proximity-induced reactivity and selectivity that is enabled by coordinating functional groups. Palladium-catalysed non-directed C-H activation could potentially enable further useful reactions, because it can reach more distant sites and be applied to substrates that do not contain appropriate directing groups; however, its development has faced substantial challenges associated with the lack of sufficiently active palladium catalysts. Currently used palladium catalysts are reactive only with electron-rich arenes, unless an excess of arene is used, which limits synthetic applications. Here we report a 2-pyridone ligand that binds to palladium and accelerates non-directed C-H functionalization with arene as the limiting reagent. This protocol is compatible with a broad range of aromatic substrates and we demonstrate direct functionalization of advanced synthetic intermediates, drug molecules and natural products that cannot be used in excessive quantities. We also developed C-H olefination and carboxylation protocols, demonstrating the applicability of our methodology to other transformations. The site selectivity in these transformations is governed by a combination of steric and electronic effects, with the pyridone ligand enhancing the influence of sterics on the selectivity, thus providing complementary selectivity to directed C-H functionalization.

IEA Annex 26: Advanced Supermarket Refrigeration/Heat Recovery Systems

Energy Technology Data Exchange (ETDEWEB)

Baxter, VAN

2003-05-19

With increased concern about the impact of refrigerant leakage on global warming, a number of new supermarket refrigeration system configurations requiring significantly less refrigerant charge are being considered. In order to help promote the development of advanced systems and expand the knowledge base for energy-efficient supermarket technology, the International Energy Agency (IEA) established IEA Annex 26 (Advanced Supermarket Refrigeration/Heat Recovery Systems) under the ''IEA Implementing Agreement on Heat Pumping Technologies''. Annex 26 focuses on demonstrating and documenting the energy saving and environmental benefits of advanced systems design for food refrigeration and space heating and cooling for supermarkets. Advanced in this context means systems that use less energy, require less refrigerant and produce lower refrigerant emissions. Stated another way, the goal is to identify supermarket refrigeration and HVAC technology options that reduce the total equivalent warming impact (TEWI) of supermarkets by reducing both system energy use (increasing efficiency) and reducing total refrigerant charge. The Annex has five participating countries: Canada, Denmark, Sweden, the United Kingdom, and the United States. The working program of the Annex has involved analytical and experimental investigation of several candidate system design approaches to determine their potential to reduce refrigerant usage and energy consumption. Advanced refrigeration system types investigated include the following: distributed compressor systems--small parallel compressor racks are located in close proximity to the food display cases they serve thus significantly shortening the connecting refrigerant line lengths; secondary loop systems--one or more central chillers are used to refrigerate a secondary coolant (e.g. brine, ice slurry, or CO2) that is pumped to the food display cases on the sales floor; self-contained display cases--each food display case

Japan's advanced medicine.

Science.gov (United States)

Sho, Ri; Narimatsu, Hiroto; Murakami, Masayasu

2013-10-01

Like health care systems in other developed countries, Japan's health care system faces significant challenges due to aging of the population and economic stagnation. Advanced medicine (Senshin Iryou) is a unique system of medical care in Japan offering highly technology-driven medical care that is not covered by public health insurance. Advanced medicine has recently developed and expanded as part of health care reform. Will it work? To answer this question, we briefly trace the historical development of advanced medicine and describe the characteristics and current state of advanced medical care in Japan. We then offer our opinions on the future of advanced medicine with careful consideration of its pros and cons. We believe that developing advanced medicine is an attempt to bring health care reform in line rather than the goal of health care reform.

Advancing the field of elder abuse: future directions and policy implications.

Science.gov (United States)

Dong, XinQi

2012-11-01

Elder abuse, sometimes called elder mistreatment or elder maltreatment, includes psychological, physical, and sexual abuse; neglect (caregiver neglect and self-neglect); and financial exploitation. Evidence suggests that one in 10 older adults experiences some form of elder abuse, but only one in 25 cases is reported to social services agencies. At the same time, elder abuse is associated with significant morbidity and premature mortality. Despite these findings, there is a great paucity in research, practice, and policy addressing the pervasive issues of elder abuse. Through my experiences as a American Political Sciences Association Congressional Policy Fellow and Health and Aging Policy Fellow working with the Administration on Community Living (ACL) (previously known as the Administration on Aging) for the last 2 years, I will describe the major functions of the ACL and highlight two major pieces of federal legislation: The Older Americans Act and the Elder Justice Act. I will also highlight major research gaps and future policy relevant research directions for the field of elder abuse. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

Advanced CANDU reactors

International Nuclear Information System (INIS)

Dunn, J.T.; Finlay, R.B.; Olmstead, R.A.

1988-12-01

AECL has undertaken the design and development of a series of advanced CANDU reactors in the 700-1150 MW(e) size range. These advanced reactor designs are the product of ongoing generic research and development programs on CANDU technology and design studies for advanced CANDU reactors. The prime objective is to create a series of advanced CANDU reactors which are cost competitive with coal-fired plants in the market for large electricity generating stations. Specific plant designs in the advanced CANDU series will be ready for project commitment in the early 1990s and will be capable of further development to remain competitive well into the next century

ScienceDirect through SciVerse: a new way to approach Elsevier.

Science.gov (United States)

Bengtson, Jason

2011-01-01

SciVerse is the new combined portal from Elsevier that services their ScienceDirect collection, SciTopics, and their Scopus database. Using SciVerse to access ScienceDirect is the specific focus of this review. Along with advanced keyword searching and citation searching options, SciVerse also incorporates a very useful image search feature. The aim seems to be not only to create an interface that provides broad functionality on par with other database search tools that many searchers use regularly but also to create an open platform that could be changed to respond effectively to the needs of customers.

Comparison of two matrix data structures for advanced CSM testbed applications

Science.gov (United States)

Regelbrugge, M. E.; Brogan, F. A.; Nour-Omid, B.; Rankin, C. C.; Wright, M. A.

1989-01-01

The first section describes data storage schemes presently used by the Computational Structural Mechanics (CSM) testbed sparse matrix facilities and similar skyline (profile) matrix facilities. The second section contains a discussion of certain features required for the implementation of particular advanced CSM algorithms, and how these features might be incorporated into the data storage schemes described previously. The third section presents recommendations, based on the discussions of the prior sections, for directing future CSM testbed development to provide necessary matrix facilities for advanced algorithm implementation and use. The objective is to lend insight into the matrix structures discussed and to help explain the process of evaluating alternative matrix data structures and utilities for subsequent use in the CSM testbed.

More counselling for end-of-life decisions by GPs with own advance directives: A postal survey among German general practitioners.

Science.gov (United States)

Schnakenberg, Rieke; Radbruch, Lukas; Kersting, Christine; Frank, Friederike; Wilm, Stefan; Becka, Denise; Weckbecker, Klaus; Bleckwenn, Markus; Just, Johannes M; Pentzek, Michael; Weltermann, Birgitta

2018-12-01

Although general practitioners (GPs) are among the preferred contact persons for discussing end-of-life issues including advance directives (ADs), there is little data on how GPs manage such consultations. This postal survey asked German GPs about their counselling for end-of-life decisions. In 2015, a two-sided questionnaire was mailed to 959 GPs. GPs were asked for details of their consultations on ADs: frequency, duration, template use, and whether they have own ADs. Statistical analysis evaluated physician characteristics associated with an above-average number of consultations on AD. The participation rate was 50.3% (n = 482), 70.5% of the GPs were male; the average age was 54 years. GPs had an average of 18 years of professional experience, and 61.4% serve more than 900 patients per three months. Most (96.9%) GPs perform consultations on living wills (LW) and/or powers of attorney (PA), mainly in selected patients (72.3%). More than 20 consultations each on LWs and PAs are performed by 60% and 50% of GPs, respectively. The estimated mean duration of consultations was 21 min for LWs and 16 min for PAs. Predefined templates were used in 72% of the GPs, 50% of GPs had their ADs. A statistical model showed that GPs with ADs and/or a qualification in palliative medicine were more likely to counsel ≥20 patients per year for each document. The study confirmed that nearly all German GPs surveyed provide counselling on ADs. Physicians with ADs counsel more frequently than those without such documents.

The Role of the Advanced Practice Nurse in Geriatric Oncology Care.

Science.gov (United States)

Morgan, Brianna; Tarbi, Elise

2016-02-01

To describe how the Advanced Practice Nurse (APN) is uniquely suited to meet the needs of older adults throughout the continuum of cancer, to explore the progress that APNs have made in gero-oncology care, and make suggestions for future directions. Google Scholar, PubMed, and CINAHL. Search terms included: "gero-oncology," "geriatric oncology," "Advanced Practice Nurse," "Nurse Practitioner," "older adult," "elderly," and "cancer." Over the last decade, APNs have made advances in caring for older adults with cancer by playing a role in prevention, screening, and diagnosis; through evidence-based gero-oncology care during cancer treatment; and in designing tailored survivorship care models. APNs must combat ageism in treatment choice for older adults, standardize comprehensive geriatric assessments, and focus on providing person-centered care, specifically during care transitions. APNs are well-positioned to help understand the complex relationship between risk factors, geriatric syndromes, and frailty and translate research into practice. Palliative care must expand beyond specialty providers and shift toward APNs with a focus on early advanced care planning. Finally, APNs should continue to establish multidisciplinary survivorship models across care settings, with a focus on primary care. Copyright © 2015 Elsevier Inc. All rights reserved.

Structural integrity analyses: can we manage the advances?

International Nuclear Information System (INIS)

Sauve, R.

2006-01-01

Engineering has been one of a number of disciplines in which significant advances in analysis procedures has taken place in the last two decades. In particular, advances in computer technology and engineering software have revolutionized the assessment of component structural integrity for a wide range of applications. A significant development in computational mechanics directly related to computer technology that has had a profound impact on the field of structural integrity is the finite element method. The finite element method has re-defined and expanded the role of structural integrity assessments by providing comprehensive modelling capabilities to engineers involved in design and failure analyses. As computer processing speeds and capacity have increased, so has the role of computer modelling in assessments of component structural integrity. With new product development cycles shrinking, the role of initial testing is being reduced in favour of computer modelling and simulation to assess component life and durability. For ageing structures, the evaluation of remaining life and the impact of degraded structural integrity becomes tractable with the modern advances in computational methods. The areas of structural integrity that have derived great benefit from the advances in numerical techniques include stress analysis, fracture mechanics, dynamics, heat transfer, structural reliability, probabilistic methods and continuum mechanics in general. One of the salient features of the current methods is the ability to handle large complex steady state or transient dynamic problems that exhibit highly non-linear behaviour. With the ever-increasing usage of these advanced methods, the question is posed: Can we manage the advances? Better still are we managing the advances? As with all technological advances that enter mainstream use, comes the need for education, training and certification in the application of these methods, improved quality assurance procedures and

Advances in the GRADE approach to rate the certainty in estimates from a network meta-analysis.

Science.gov (United States)

Brignardello-Petersen, Romina; Bonner, Ashley; Alexander, Paul E; Siemieniuk, Reed A; Furukawa, Toshi A; Rochwerg, Bram; Hazlewood, Glen S; Alhazzani, Waleed; Mustafa, Reem A; Murad, M Hassan; Puhan, Milo A; Schünemann, Holger J; Guyatt, Gordon H

2018-01-01

This article describes conceptual advances of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) working group guidance to evaluate the certainty of evidence (confidence in evidence, quality of evidence) from network meta-analysis (NMA). Application of the original GRADE guidance, published in 2014, in a number of NMAs has resulted in advances that strengthen its conceptual basis and make the process more efficient. This guidance will be useful for systematic review authors who aim to assess the certainty of all pairwise comparisons from an NMA and who are familiar with the basic concepts of NMA and the traditional GRADE approach for pairwise meta-analysis. Two principles of the original GRADE NMA guidance are that we need to rate the certainty of the evidence for each pairwise comparison within a network separately and that in doing so we need to consider both the direct and indirect evidence. We present, discuss, and illustrate four conceptual advances: (1) consideration of imprecision is not necessary when rating the direct and indirect estimates to inform the rating of NMA estimates, (2) there is no need to rate the indirect evidence when the certainty of the direct evidence is high and the contribution of the direct evidence to the network estimate is at least as great as that of the indirect evidence, (3) we should not trust a statistical test of global incoherence of the network to assess incoherence at the pairwise comparison level, and (4) in the presence of incoherence between direct and indirect evidence, the certainty of the evidence of each estimate can help decide which estimate to believe. Copyright © 2017 Elsevier Inc. All rights reserved.

International Joint Conference on Mechanics, Design Engineering & Advanced Manufacturing

CERN Document Server

Nigrelli, Vincenzo; Oliveri, Salvatore; Peris-Fajarnes, Guillermo; Rizzuti, Sergio

2017-01-01

This book gathers papers presented at the International Joint Conference on Mechanics, Design Engineering and Advanced Manufacturing (JCM 2016), held on 14-16 September, 2016, in Catania, Italy. It reports on cutting-edge topics in product design and manufacturing, such as industrial methods for integrated product and process design; innovative design; and computer-aided design. Further topics covered include virtual simulation and reverse engineering; additive manufacturing; product manufacturing; engineering methods in medicine and education; representation techniques; and nautical, aeronautics and aerospace design and modeling. The book is divided into eight main sections, reflecting the focus and primary themes of the conference. The contributions presented here will not only provide researchers, engineers and experts in a range of industrial engineering subfields with extensive information to support their daily work; they are also intended to stimulate new research directions, advanced applications of t...

Advancement of remote technology: past perspectives and future plans

International Nuclear Information System (INIS)

Feldman, M.J.; Hamel, W.R.

1984-01-01

In the Consolidated Fuel Reprocessing Program at the Oak Ridge National Laboratory, a comprehensive remote systems development program has existed for the past five years. The new remote technology under development is expected to significantly improve remote operations by extending the range of admissible remote tasks and increasing remote work efficiency. The motivation and justification for the program are discussed by surveying the 40 years of remote operating experience which exists and considering the essential features of various old and new philosophies which have been, or are being, used in remote engineering. A future direction based upon the Remotex concept is explained, and recent progress in the development of an advanced servomanipulator-based maintenance concept is summarized to show that a new generation of remote systems capability is feasible through advanced technology. 20 references, 10 figures, 1 table

Advancement of remote technology: past perspectives and future plans

International Nuclear Information System (INIS)

Feldman, M.J.; Hamel, W.R.

1984-01-01

In the Consolidated Fuel Reprocessing Program at the Oak Ridge National Laboratory, a comprehensive remote systems development program has existed for the past five years. The new remote technology under development is expected to significantly improve remote operations by extending the range of admissible remote tasks and increasing remote work efficiency. The motivation and justification for the program are discussed by surveying the 40 years of remote operating experience which exists and considering the essential features of various old and new philosophies which have been, or are being, used in remote engineering. A future direction based upon the Remotex concept is explained, and recent progress in the development of an advanced servomanipulator-based maintenance concept is summarized to show that a new generation of remote systems capability is feasible through advanced technology. 20 references, 9 figures, 1 table

Interoperable mesh and geometry tools for advanced petascale simulations

International Nuclear Information System (INIS)

Diachin, L; Bauer, A; Fix, B; Kraftcheck, J; Jansen, K; Luo, X; Miller, M; Ollivier-Gooch, C; Shephard, M S; Tautges, T; Trease, H

2007-01-01

SciDAC applications have a demonstrated need for advanced software tools to manage the complexities associated with sophisticated geometry, mesh, and field manipulation tasks, particularly as computer architectures move toward the petascale. The Center for Interoperable Technologies for Advanced Petascale Simulations (ITAPS) will deliver interoperable and interchangeable mesh, geometry, and field manipulation services that are of direct use to SciDAC applications. The premise of our technology development goal is to provide such services as libraries that can be used with minimal intrusion into application codes. To develop these technologies, we focus on defining a common data model and data-structure neutral interfaces that unify a number of different services such as mesh generation and improvement, front tracking, adaptive mesh refinement, shape optimization, and solution transfer operations. We highlight the use of several ITAPS services in SciDAC applications

Higher-order relativistic periastron advances and binary pulsars

International Nuclear Information System (INIS)

Damour, T.; Schafer, G.

1988-01-01

The contributions to the periastron advance of a system of two condensed bodies coming from relativistic dynamical effects of order higher than the usual first post-Newtonian (1PN) equations of motion are investigated. The structure of the solution of the orbital second post-Newtonian (2PN) equations of motion is given in a simple parametrized form. The contributions to the secular pariastron advance, and the period, of orbital 2PN effects are then explicitly worked out by using the Hamilton-Jacobi method. The spin-orbit contribution to the secular precession of the orbit in space is rederived in a streamlined way by making full use of Hamiltonian methods. These results are then applied to the theoretical interpretation of the observational data of pulsars in close eccentric binary systems. It is shown that the higher-order relativistic contributions are already of theoretical and astophysical significance for interpreting the high-precision measurement of the secular periastron advance of PSR 1913+16 achived by Taylor and coworkers. The case of extremely fast spinning (millisecond) binary pulsars is also discussed, and shown to offer an easier ground for getting new tests of general relativity, and/or, a direct measurement of the moment of inertia of a neutron star

Two pedigrees of familial advanced sleep phase syndrome in Japan.

Science.gov (United States)

Satoh, Kohtoku; Mishima, Kazuo; Inoue, Yuichi; Ebisawa, Takashi; Shimizu, Tetsuo

2003-06-15

To determine whether a known missense mutation (bp2106 A/G) in hPer2 (a human homolog of the Drosophila period gene) for familial advanced sleep phase syndrome in a Caucasian family is involved in Japanese familial advanced sleep phase syndrome pedigrees. We identified 2 new Japanese families with advanced sleep phase syndrome, and a systematic survey was carried out in 28 relatives of theses 2 families. A total of 9 affected subjects were identified. The affected members showed significantly strong morningness tendencies compared with the unaffected members in various circadian parameters including the Horne-Ostberg Morningness-Eveningness Questionnaire score (77.3 +/- 4.8 vs 57.5 +/- 7.6, p sleep-onset time (20:45 +/- 75 min vs 23:16 +/- 64 min, p DNA samples were obtained from 7 affected and 7 unaffected subjects. None of the tested subjects possessed the missense mutation (bp2106 A/G) in hPer2. Furthermore, there is no significant linkage between affected subjects with hPer2 region by 2-point mapping and by direct sequencing of 23 exons of hPer2. These findings support the notion of genetic heterogeneity of familial advanced sleep phase syndrome cases in humans. The search for more familial advanced sleep phase syndrome cases and for loci other than hPer2 are necessary to further examine the roles of circadian-related genes in genetically determined human circadian rhythm disorders.

Advances in silicon nanophotonics

DEFF Research Database (Denmark)

Hvam, Jørn Märcher; Pu, Minhao

Silicon has long been established as an ideal material for passive integrated optical circuitry due to its high refractive index, with corresponding strong optical confinement ability, and its low-cost CMOS-compatible manufacturability. However, the inversion symmetry of the silicon crystal lattice.......g. in high-bit-rate optical communication circuits and networks, it is vital that the nonlinear optical effects of silicon are being strongly enhanced. This can among others be achieved in photonic-crystal slow-light waveguides and in nano-engineered photonic-wires (Fig. 1). In this talk I shall present some...... recent advances in this direction. The efficient coupling of light between optical fibers and the planar silicon devices and circuits is of crucial importance. Both end-coupling (Fig. 1) and grating-coupling solutions will be discussed along with polarization issues. A new scheme for a hybrid III...

MOTHER MK II: An advanced direct cycle high temperature gas reactor

International Nuclear Information System (INIS)

Hart, R.S.; Kendall, J.M.; Marsden, B.J.

2003-01-01

The MOTHER (MOdular Thermal HElium Reactor) power plant concepts employ high temperature gas reactors utilizing TRISO fuel, graphite moderator, and helium coolant, in combination with a direct Brayton cycle for electricity generation. The helium coolant from the reactor vessel passes through a Power Conversion Unit (PCU), which includes a turbine-generator, recuperator, precooler, intercooler and turbine-compressors, before being returned to the reactor vessel. The PCU substitutes for the reactor coolant system pumps and steam generators and most of the Balance Of Plant (BOP), including the steam turbines and condensers, employed by conventional nuclear power plants utilizing water cooled reactors. This provides a compact, efficient, and relatively simple plant configuration. The MOTHER MK I conceptual design, completed in the 1987 - 1989 time frame, was developed to economically meet the energy demands for extracting and processing heavy oil from the tar sands of western Canada. However, considerable effort was made to maximize the market potential beyond this application. Consistent with the remote and very high labour rate environment in the tar sands region, simplification of maintenance procedures and facilitation of 'change-out' in lieu of in situ repair was a design focus. MOTHER MK I had a thermal output of 288 MW and produced 120 MW electrical when operated in the electricity only production mode. An annular Prismatic reactor core was utilized, largely to minimize day-to-day operations activities. Key features of the power conversion system included two Power Conversion Units (144 MW th each), the horizontal orientation of all rotating machinery and major heat exchangers axes, high speed rotating machinery (17,030 rpm for the turbine-compressors and 10,200 rpm for the power turbine-generator), gas (helium) bearings for all rotating machinery, and solid state frequency conversion from 170 cps (at full power) to the grid frequency. Recognizing that the on

Materials and structural aspects of advanced gas-turbine helicopter engines

Science.gov (United States)

Freche, J. C.; Acurio, J.

1979-01-01

Advances in materials, coatings, turbine cooling technology, structural and design concepts, and component-life prediction of helicopter gas-turbine-engine components are presented. Stationary parts including the inlet particle separator, the front frame, rotor tip seals, vanes and combustors and rotating components - compressor blades, disks, and turbine blades - are discussed. Advanced composite materials are considered for the front frame and compressor blades, prealloyed powder superalloys will increase strength and reduce costs of disks, the oxide dispersion strengthened alloys will have 100C higher use temperature in combustors and vanes than conventional superalloys, ceramics will provide the highest use temperature of 1400C for stator vanes and 1370C for turbine blades, and directionally solidified eutectics will afford up to 50C temperature advantage at turbine blade operating conditions. Coatings for surface protection at higher surface temperatures and design trends in turbine cooling technology are discussed. New analytical methods of life prediction such as strain gage partitioning for high temperature prediction, fatigue life, computerized prediction of oxidation resistance, and advanced techniques for estimating coating life are described.

Vacuum source-field correlations and advanced waves in quantum optics

Directory of Open Access Journals (Sweden)

Adam Stokes

2018-01-01

Full Text Available The solution to the wave equation as a Cauchy problem with prescribed fields at an initial time $t=0$ is purely retarded. Similarly, in the quantum theory of radiation the specification of Heisenberg picture photon annihilation and creation operators at time $t \\gt 0$ in terms of operators at $t=0$ automatically yields purely retarded source-fields. However, we show that two-time quantum correlations between the retarded source-fields of a stationary dipole and the quantum vacuum-field possess advanced wave-like contributions. Despite their advanced nature, these correlations are perfectly consistent with Einstein causality. It is shown that while they do not significantly contribute to photo-detection amplitudes in the vacuum state, they do effect the statistics of measurements involving the radiative force experienced by a point charge in the field of the dipole. Specifically, the dispersion in the charge's momentum is found to increase with time. This entails the possibility of obtaining direct experimental evidence for the existence of advanced waves in physical reality, and provides yet another signature of the quantum nature of the vacuum.

New developments in the management of advanced melanoma - role of pembrolizumab

DEFF Research Database (Denmark)

Improta, Giuseppina; Leone, Isabella; Donia, Marco

2015-01-01

Cancer immunotherapy is now recognized to be fundamental in modern oncology, because immune system recruitment may represent a powerful and innovative strategy in cancer therapy. Pembrolizumab, a highly selective humanized monoclonal antibody directly blocking the interaction between programmed...... inhibitor. This review will focus on the clinical development and use of pembrolizumab in the clinical practice and in the management of advanced melanoma....

Recent case studies and advancements in probabilistic risk assessment

International Nuclear Information System (INIS)

Garrick, B.J.

1985-01-01

During the period from 1977 to 1984, Pickard, Lowe and Garrick, Inc., had the lead in preparing several full scope probabilistic risk assessments for electric utilities. Five of those studies are discussed from the point of view of advancements and lessons learned. The objective and trend of these studies is toward utilization of the risk models by the plant owners as risk management tools. Advancements that have been made are in presentation ad documentation of the PRAs, generation of more understandable plant level information, and improvements in methodology to facilitate technology transfer. Specific areas of advancement are in the treatment of such issues as dependent failures, human interaction, and the uncertainty in the source term. Lessons learned cover a wide spectrum and include the importance of plant specific models for meaningful risk management, the role of external events in risk, the sensitivity of contributors to choice of risk index, and the very important finding that the public risk is extremely small. The future direction of PRA is to establish less dependence on experts for in-plant application. Computerizing the PRAs such that they can be accessed on line and interactively is the key

Nurses’ perceptions of advance directives

Directory of Open Access Journals (Sweden)

Ernestina Silva

2014-11-01

Conclusion: Nurses have little experience with AD. They are available to respect the patient's will but did not feel able to address the issue on their own initiative. Most agree that the AD can “fail” if the patient does not reevaluate it periodically. Reflection and debate on the ethical issues surrounding AD should be promoted: promoting patient autonomy, care in vulnerable situations, team decisions and conscientious objection.

Los Alamos NEP research in advanced plasma thrusters

Science.gov (United States)

Schoenberg, Kurt; Gerwin, Richard

1991-01-01

Research was initiated in advanced plasma thrusters that capitalizes on lab capabilities in plasma science and technology. The goal of the program was to examine the scaling issues of magnetoplasmadynamic (MPD) thruster performance in support of NASA's MPD thruster development program. The objective was to address multi-megawatt, large scale, quasi-steady state MPD thruster performance. Results to date include a new quasi-steady state operating regime which was obtained at space exploration initiative relevant power levels, that enables direct coaxial gun-MPD comparisons of thruster physics and performance. The radiative losses are neglible. Operation with an applied axial magnetic field shows the same operational stability and exhaust plume uniformity benefits seen in MPD thrusters. Observed gun impedance is in close agreement with the magnetic Bernoulli model predictions. Spatial and temporal measurements of magnetic field, electric field, plasma density, electron temperature, and ion/neutral energy distribution are underway. Model applications to advanced mission logistics are also underway.

2017 Publications Demonstrate Advancements in Wind Energy Research

Energy Technology Data Exchange (ETDEWEB)

2018-01-17

In 2017, wind energy experts at the National Renewable Energy Laboratory (NREL) made significant strides to advance wind energy. Many of these achievements were presented in articles published in scientific and engineering journals and technical reports that detailed research accomplishments in new and progressing wind energy technologies. During fiscal year 2017, NREL wind energy thought leaders shared knowledge and insights through 45 journal articles and 25 technical reports, benefiting academic and national-lab research communities; industry stakeholders; and local, state, and federal decision makers. Such publications serve as important outreach, informing the public of how NREL wind research, analysis, and deployment activities complement advanced energy growth in the United States and around the world. The publications also illustrate some of the noteworthy outcomes of U.S. Department of Energy (DOE) Office of Energy Efficiency and Renewable Energy (EERE) and Laboratory Directed Research and Development funding, as well as funding and facilities leveraged through strategic partnerships and other collaborations.

Advanced direct liquefaction concepts for PETC generic units. Quarterly technical progress report, January--March 1992

Energy Technology Data Exchange (ETDEWEB)

1992-04-01

In the Advance Coal Liquefaction Concept Proposal (ACLCP) carbon monoxide (CO) and water have been proposed as the primary reagents in the pretreatment process. The main objective of this project is to develop a methodology for pretreating coal under mild conditions based on a combination of existing processes which have shown great promise in liquefaction, extraction and pyrolysis studies. The aim of this pretreatment process is to partially depolymerise the coal, eliminate oxygen and diminish the propensity for retograde reactions during subsequent liquefaction. The desirable outcome of the CO pretreatment step should be: (1) enhanced liquefaction activity and/or selectivity toward products of higher quality due to chemical modification of the coal structure; (2) cleaner downstream products; (3) overall improvement in operability and process economics.

Advanced Automotive Diesel Assessment Program, executive summary

Science.gov (United States)

1983-01-01

The objectives of this analytical study were: to select one advanced automotive diesel engine (AAD) concept which would increase the tank mileage of a 3,000 pound passenger car from the present 35 mpg to at least 52 mpg; to identify long term component research and development work required to bring the selected concept to fruition; and to prepare a development strategy that will bring the selected concept to a prototype testing phase. Cummins Engine Company has completed this study. The selected concept is a 4 stroke cycle, direct injection, spark assisted, advanced adiabatic diesel engine with positive displacement compounding plus expander and part load air preheating. The engine does not use a liquid coolant nor liquid lubricants. It is a 4 cylinder, in-line, 77 mm bore x 77 mm stroke, 1.434 liters displacement engine weighing 300 lb, and rated at 70 BHP at 3000 rpm. Installation dimensions are 621 mm length x 589 mm width x 479 mm height (24.4 inch x 22 inch x 18.9 inch).

Component-resolved diagnostics to direct in venom immunotherapy

DEFF Research Database (Denmark)

Blank, Simon; Bilò, Maria Beatrice; Ollert, Markus

2018-01-01

, the increasing knowledge about the molecular structure and relevance of important venom allergens and their availability as recombinant allergens, devoid of cross-reactive carbohydrate determinants, resulted in the development of an advanced component-resolved diagnostics (CRD) approach in venom allergy. Already...... immunotherapeutic intervention. Moreover, the detailed knowledge about sensitization profiles on a molecular level might open new options to identify patients who are at increased risk for side effects or not to respond to immunotherapy. Therefore, increasing potential of CRD becomes evident, to direct therapeutic...

Series lecture on advanced fusion reactors

International Nuclear Information System (INIS)

Dawson, J.M.

1983-01-01

The problems concerning fusion reactors are presented and discussed in this series lecture. At first, the D-T tokamak is explained. The breeding of tritium and the radioactive property of tritium are discussed. The hybrid reactor is explained as an example of the direct use of neutrons. Some advanced fuel reactions are proposed. It is necessary to make physics consideration for burning advanced fuel in reactors. The rate of energy production and the energy loss are important things. The bremsstrahlung radiation and impurity radiation are explained. The simple estimation of the synchrotron radiation was performed. The numerical results were compared with a more detailed calculation of Taimor, and the agreement was quite good. The calculation of ion and electron temperature was made. The idea to use the energy more efficiently is that one can take X-ray or neutrons, and pass them through a first wall of a reactor into a second region where they heat the material. A method to convert high temperature into useful energy is the third problem of this lecture. The device was invented by A. Hertzberg. The lifetime of the reactor depends on the efficiency of energy recovery. The idea of using spin polarized nuclei has come up. The spin polarization gives a chance to achieve a large multiplication factor. The advanced fuel which looks easiest to make go is D plus He-3. The idea of multipole is presented to reduce the magnetic field inside plasma, and discussed. Two other topics are explained. (Kato, T.)

Development of the high-order decoupled direct method in three dimensions for particulate matter: enabling advanced sensitivity analysis in air quality models

Directory of Open Access Journals (Sweden)

W. Zhang

2012-03-01

Full Text Available The high-order decoupled direct method in three dimensions for particulate matter (HDDM-3D/PM has been implemented in the Community Multiscale Air Quality (CMAQ model to enable advanced sensitivity analysis. The major effort of this work is to develop high-order DDM sensitivity analysis of ISORROPIA, the inorganic aerosol module of CMAQ. A case-specific approach has been applied, and the sensitivities of activity coefficients and water content are explicitly computed. Stand-alone tests are performed for ISORROPIA by comparing the sensitivities (first- and second-order computed by HDDM and the brute force (BF approximations. Similar comparison has also been carried out for CMAQ sensitivities simulated using a week-long winter episode for a continental US domain. Second-order sensitivities of aerosol species (e.g., sulfate, nitrate, and ammonium with respect to domain-wide SO₂, NO_x, and NH₃ emissions show agreement with BF results, yet exhibit less noise in locations where BF results are demonstrably inaccurate. Second-order sensitivity analysis elucidates poorly understood nonlinear responses of secondary inorganic aerosols to their precursors and competing species. Adding second-order sensitivity terms to the Taylor series projection of the nitrate concentrations with a 50% reduction in domain-wide NO_x or SO₂ emissions rates improves the prediction with statistical significance.

Danish risk management plans of the EU Floods Directive

Directory of Open Access Journals (Sweden)

Jebens Martin

2016-01-01

Full Text Available We evaluate the impact and effect of the EU Flood’s Directive (2007/60/EC in Denmark and the flood risk management plans that are the result of the national implementation. In a qualitative research approach, the flood risk management plans published by 22 Danish municipalities are reviewed and analyzed regarding main objectives and structural and non-structural mitigation measures. From the analyses conclusions are drawn on the non-structural risk management measures still to be improved to obtain the full benefits from the Directive. Conclusions point to the need of introducing better decision support systems, a need to define acceptable risks, and a need to enhance coordi-nation between municipal and cross-sectorial actors as well as an increased effort to involve civil society is necessary. In general, the implementation of the Directive has significantly advanced the national scientific and cross-sectorial working platform for dealing with risks from floods.

Recent advances in transition-metal-catalyzed intermolecular carbomagnesiation and carbozincation

Directory of Open Access Journals (Sweden)

Kei Murakami

2013-02-01

Full Text Available Carbomagnesiation and carbozincation reactions are efficient and direct routes to prepare complex and stereodefined organomagnesium and organozinc reagents. However, carbon–carbon unsaturated bonds are generally unreactive toward organomagnesium and organozinc reagents. Thus, transition metals were employed to accomplish the carbometalation involving wide varieties of substrates and reagents. Recent advances of transition-metal-catalyzed carbomagnesiation and carbozincation reactions are reviewed in this article. The contents are separated into five sections: carbomagnesiation and carbozincation of (1 alkynes bearing an electron-withdrawing group; (2 alkynes bearing a directing group; (3 strained cyclopropenes; (4 unactivated alkynes or alkenes; and (5 substrates that have two carbon–carbon unsaturated bonds (allenes, dienes, enynes, or diynes.

Energy and Economic Trade Offs for Advanced Technology Subsonic Aircraft

Science.gov (United States)

Maddalon, D. V.; Wagner, R. D.

1976-01-01

Changes in future aircraft technology which conserve energy are studied, along with the effect of these changes on economic performance. Among the new technologies considered are laminar-flow control, composite materials with and without laminar-flow control, and advanced airfoils. Aircraft design features studied include high-aspect-ratio wings, thickness ratio, and range. Engine technology is held constant at the JT9D level. It is concluded that wing aspect ratios of future aircraft are likely to significantly increase as a result of new technology and the push of higher fuel prices. Composite materials may raise aspect radio to about 11 to 12 and practical laminar flow-control systems may further increase aspect ratio to 14 or more. Advanced technology provides significant reductions in aircraft take-off gross weight, energy consumption, and direct operating cost.

Advance directives for future dementia can be modified by a brief video presentation on dementia care: An experimental study.

Directory of Open Access Journals (Sweden)

Theresia Volhard

practice of formulating, revising, and supporting advance directives.

Advanced byproduct recovery: Direct catalytic reduction of sulfur dioxide to elemental sulfur. Quarterly report, April 1--June 30, 1997

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-12-31

The team of Arthur D. Little, Tufts University and Engelhard Corporation are conducting Phase 1 of a four and a half year, two-phase effort to develop and scale-up an advanced byproduct recovery technology that is a direct, single-stage, catalytic process for converting sulfur dioxide to elemental sulfur. This catalytic process reduces SO{sub 2} over a fluorite-type oxide (such as ceria and zirconia). The catalytic activity can be significantly promoted by active transition metals, such as copper. More than 95% elemental sulfur yield, corresponding to almost complete sulfur dioxide conversion, was obtained over a Cu-Ce-O oxide catalyst as part of an on-going DOE-sponsored, University Coal Research Program. This type of mixed metal oxide catalyst has stable activity, high selectivity for sulfur production, and is resistant to water and carbon dioxide poisoning. Tests with CO and CH{sub 4} reducing gases indicate that the catalyst has the potential for flexibility with regard to the composition of the reducing gas, making it attractive for utility use. The performance of the catalyst is consistently good over a range of SO{sub 2} inlet concentration (0.1 to 10%) indicating its flexibility in treating SO{sub 2} tail gases as well as high concentration streams. The principal objective of the Phase 1 program is to identify and evaluate the performance of a catalyst which is robust and flexible with regard to choice of reducing gas. In order to achieve this goal, the authors have planned a structured program including: Market/process/cost/evaluation; Lab-scale catalyst preparation/optimization studies; Lab-scale, bulk/supported catalyst kinetic studies; Bench-scale catalyst/process studies; and Utility review. Progress is reported from all three organizations.

Locally advanced colon cancer with cutaneous invasion: case report.

Science.gov (United States)

Tenreiro, Nádia; Ferreira, Cátia; Silva, Silvia; Marques, Rita; Ribeiro, Artur; Sousa, Paulo Jorge; Luís, Fernando Próspero

2017-03-01

Locally advanced colon cancer with direct abdominal wall and skin invasion is an extremely rare finding with most data being derived from case reports, historical autopsy-based or single-center retrospective studies. We present a unique case of a colon cancer with direct cutaneous invasion and colocutaneous fistulization. Eighty-six year old Caucasian female with multiple comorbidities, referred to Surgical Consultation due to ulcerated skin lesion in the abdomen. She had a long-standing large umbilical hernia but with no previous episodes of incarceration or occlusive symptoms. She denied any digestive or constitutional symptoms. Physical examination showed a large non-reducible umbilical hernia, with an associated painless firm mass within the hernia sac and cutaneous ulcerated growth. Colonoscopy revealed transverse colon cancer (endoscopic biopsy of the tumor and skin punch biopsy confirmed adenocarcinoma of the colon). Computed tomography showed a tumoral mass within the umbilical hernia, with cutaneous infiltration and enlarged regional lymph nodes. Rapid local progression led to colocutaneous fistula with total fecal diversion. We performed an extended right hemicolectomy with en bloc excision of the hernia sac and infiltrating cutaneous mass. In the current era of widespread use of screening colonoscopies, initial diagnosis of locally advanced colon cancer is decreasing. However, this unique case presented an opportunity to recall the advantages of multivisceral resections.

Advancing Water Science through Data Visualization

Science.gov (United States)

Li, X.; Troy, T.

2014-12-01

As water scientists, we are increasingly handling larger and larger datasets with many variables, making it easy to lose ourselves in the details. Advanced data visualization will play an increasingly significant role in propelling the development of water science in research, economy, policy and education. It can enable analysis within research and further data scientists' understanding of behavior and processes and can potentially affect how the public, whom we often want to inform, understands our work. Unfortunately for water scientists, data visualization is approached in an ad hoc manner when a more formal methodology or understanding could potentially significantly improve both research within the academy and outreach to the public. Firstly to broaden and deepen scientific understanding, data visualization can allow for more analyzed targets to be processed simultaneously and can represent the variables effectively, finding patterns, trends and relationships; thus it can even explores the new research direction or branch of water science. Depending on visualization, we can detect and separate the pivotal and trivial influential factors more clearly to assume and abstract the original complex target system. Providing direct visual perception of the differences between observation data and prediction results of models, data visualization allows researchers to quickly examine the quality of models in water science. Secondly data visualization can also improve public awareness and perhaps influence behavior. Offering decision makers clearer perspectives of potential profits of water, data visualization can amplify the economic value of water science and also increase relevant employment rates. Providing policymakers compelling visuals of the role of water for social and natural systems, data visualization can advance the water management and legislation of water conservation. By building the publics' own data visualization through apps and games about water

Advanced smart-photosensitizers for more effective cancer treatment.

Science.gov (United States)

Park, Wooram; Cho, Soojeong; Han, Jieun; Shin, Heejun; Na, Kun; Lee, Byeongdu; Kim, Dong-Hyun

2017-12-19

Photodynamic therapy (PDT) based upon the use of light and photosensitizers (PSs) has been used as a novel treatment approach for a variety of tumors. It, however, has several major limitations in the clinic: poor water solubility, long-term phototoxicity, low tumor targeting efficacy, and limited light penetration. With advances in nanotechnology, materials science, and clinical interventional imaging procedures, various smart-PSs have been developed for improving their cancer-therapeutic efficacy while reducing the adverse effects. Here, we briefly review state-of-the-art smart-PSs and discuss the future directions of PDT technology.

Life cycle assessment of advanced waste water treatment

DEFF Research Database (Denmark)

Larsen, Henrik Fred; Hansen, Peter Augusto

The EU FP6 NEPTUNE project is related to the EU Water Framework Directive and the main goal is to develop new and optimize existing waste water treatment technologies (WWTT) and sludge handling methods for municipal waste water. Besides nutrients, a special focus area is micropollutants (e....... In total more that 20 different waste water and sludge treatment technologies are to be assessed. This paper will present the preliminary LCA results from running the induced versus avoided impact approach (mainly based on existing LCIA methodology) on one of the advanced treatment technologies, i...

Radiation Damage in Nuclear Fuel for Advanced Burner Reactors: Modeling and Experimental Validation

Energy Technology Data Exchange (ETDEWEB)

Jensen, Niels Gronbech; Asta, Mark; Ozolins, Nigel Browning' Vidvuds; de Walle, Axel van; Wolverton, Christopher

2011-12-29

The consortium has completed its existence and we are here highlighting work and accomplishments. As outlined in the proposal, the objective of the work was to advance the theoretical understanding of advanced nuclear fuel materials (oxides) toward a comprehensive modeling strategy that incorporates the different relevant scales involved in radiation damage in oxide fuels. Approaching this we set out to investigate and develop a set of directions: 1) Fission fragment and ion trajectory studies through advanced molecular dynamics methods that allow for statistical multi-scale simulations. This work also includes an investigation of appropriate interatomic force fields useful for the energetic multi-scale phenomena of high energy collisions; 2) Studies of defect and gas bubble formation through electronic structure and Monte Carlo simulations; and 3) an experimental component for the characterization of materials such that comparisons can be obtained between theory and experiment.

Ex-Ante Impact Assessment of Sustainability Information–The Directive 2014/95

Directory of Open Access Journals (Sweden)

Cristian Carini

2018-02-01

Full Text Available Directive 2014/95, in force since 2017, is the first European step that requires undertakings to provide mandatory non-financial information. The regulation concerns sustainability information, such as environmental, social, and employee information, human rights, and anti-corruption and bribery matters, and the disclosure of diversity policies for board members. According to the theoretical framework of Integrated Assessment (IA, the study aims to examine the expected impact of the Directive within the analysis of empirical evidence before the mandatory approach. This allows, on the regulatory side, evaluation of the quality of the regulation, therefore, whether the law achieves its policy objectives (i.e., if it fills the gap in the sustainability disclosure and, on the firms’ side, to identify where companies have to invest to meet the legal requirements. The oil and gas sector is chosen as a sample for the study, because it is one of the most advanced sectors in sustainability disclosure, and if the regulation could impact on this sector, it would be the same for less-informed ones. The findings reveal a fair level of completeness of non-financial information, however, there are some areas that have to be improved to achieve the requirements of the Directive. The results also show the presence of overlap between financial and sustainability reports. In conclusion, the quality of regulation is good because it will also increase sustainability disclosure in an advanced sector, such as oil and gas, even if there is an open point on the location of information; companies in this sector will have to invest more in environmental and employee information in future years to comply with the Directive.

Radiation protection in dental radiology - Recent advances and future directions.

Science.gov (United States)

Tsapaki, V

2017-12-01

Dental radiology uses X-ray technology to diagnose and design treatment of various clinical problems related to the oral cavity and surrounding tissues. As technology quickly evolves, there are numerous X-ray modalities using different tools in the attempt to best image and treat efficiently these diseases, disorders or other related clinical conditions. The reported numbers of dental X-rays, the fact that these may be under-reported in many countries and because dental X-rays are performed more on younger individuals, whose teeth and dentition are still developing, calls for increased need on radiation protection. The objectives of this paper are to report on the latest technology updates and related radiation protection issues, to present future directions and define gaps. Most of existing radiation protection national and international guidelines are more than a decade old. Update is needed to account for newer technologies such as cone beam computed tomography (CBCT) and digital imaging. Diagnostic Reference Levels (DRLs), a well established method for dose optimization, are not yet defined for CBCT and have to be set for various clinical indications. As far as shielding is concerned, recent data confirm that use of lead apron, even in pregnant patients, or gonadal shielding are not recommended, due to negligible radiation dose reduction. Thyroid lead shielding should be used in case the organ is in or close to the primary beam. Specifically for CBCT, leaded glasses, thyroid collars and collimation (smaller field of view (FOV) especially for paediatric patients) minimize the dose to organs outside the FOV. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.