Inguinal and anorectal Lymphogranuloma Venereum: a case series from a sexually transmitted disease center in Rome, Italy.

Science.gov (United States)

Latini, Alessandra; Zaccarelli, Mauro; Paglia, Maria Grazia; Donà, Maria Gabriella; Giglio, Amalia; Moretto, Domenico; Vulcano, Antonella; Giuliani, Massimo; Colafigli, Manuela; Ambrifi, Marina; Pimpinelli, Fulvia; Cristaudo, Antonio

2017-06-02

Lymphogranuloma venereum (LGV) is a sexually transmitted infection caused by L1, L2, L3 serovars of C. trachomatis (CT). Since 2003, LGV cases have been increasing in Europe. Aim of this report is to describe the LGV cases diagnosed in the largest STI center in Rome, Italy, from 2000 to 2016. This report shows that two clinically and epidemiologically different series of cases exist, and that, at present, the ano-rectal LGV represents the clinical variant occurring more frequently among men having sex with men (MSM), particularly those HIV-infected. Ten cases of LGV were observed. Three were diagnosed in 2009 in HIV-negative heterosexuals patients that presented the classical genito-ulcerative form with lymphadenopathy. Seven cases were observed in 2015-2016 in HIV-infected MSM, that presented the rectal variant and L2b serovar infection; 4 of these had been misclassified as a chronic bowel disease. Chlamydia infection was confirmed by CT-specific PCR (ompA gene nested PCR), followed by sequence analysis to identify the serovar. All the patients were treated with doxycycline for 3 weeks, obtaining a complete response with healing of both clinical symptoms and dermatological lesions. Our findings suggest that, in case of persistent rectal symptoms in HIV-infected MSM, LGV should be taken into account and investigated through molecular analyses, in order to achieve a correct diagnosis and management of the patients.

Critical hand ischemia treatment via orbital atherectomy-A single center observational retrospective analysis.

Science.gov (United States)

Bahro, Abdul; Igyarto, Zsuzsanna; Martinsen, Brad

2017-03-01

Critical hand ischemia (CHI) can be devastating and may result in amputation. Distal vessel calcification has been shown to be a major factor in causing CHI. Atherectomy in the upper extremities is not typically considered due to the small anatomy; however, the Diamondback 360° Peripheral Orbital Atherectomy System (OAS) (Cardiovascular Systems, Inc.) can access treatment areas with a reference vessel diameter of 1.5mm. A retrospective, observational, single center (Merit Health Center, Jackson, MS) analysis of 11 CHI patients with calcific disease of the radial artery treated with orbital atherectomy (OAS) was completed. Demographics and procedural to 30-day outcomes were assessed. All patients had good blood flow to the hand after intervention and none experienced complications during or immediately post-procedure. At 30-days the freedom from revascularization and amputation was 100%, and all the wounds were healed. The following important principles were followed during the use of OAS for CHI: (1) ACT was therapeutic (~250s); (2) Gentle wire manipulation; (3) Utilization of a small OAS crown (1.25mm); (4) Aggressive vasodilator use-given through the exchange catheter; (5) Angioplasty balloon was matched to the size of the vessel and long and low pressure inflations were completed. Critical hand ischemia can be treated with endovascular techniques. Obtaining good outflow to the fingers is critical for wound healing and preventing amputation. Orbital atherectomy is a useful tool in preparing vessels for balloon angioplasty; particularly in cases where calcification is present. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Observation of Diamond Nitrogen-Vacancy Center Photoluminescence under High Vacuum in a Magneto-Gravitational Trap

Science.gov (United States)

Ji, Peng; Hsu, Jen-Feng; Lewandowski, Charles W.; Dutt, M. V. Gurudev; D'Urso, Brian

2016-05-01

We report the observation of photoluminescence from nitrogen-vacancy (NV) centers in diamond nanocrystals levitated in a magneto-gravitational trap. The trap utilizes a combination of strong magnetic field gradients and gravity to confine diamagnetic particles in three dimensions. The well-characterized NV centers in trapped diamond nanocrystals provide an ideal built-in sensor to measure the trap magnetic field and the temperature of the trapped diamond nanocrystal. In the future, the NV center spin state could be coupled to the mechanical motion through magnetic field gradients, enabling in an ideal quantum interface between NV center spin and the mechanical motion. National Science Foundation, Grant No. 1540879.

Technostress in Libraries and Media Centers: Case Studies and Coping Strategies.

Science.gov (United States)

Hickey, Kate D., Ed.

1992-01-01

Discusses technostress--i.e., stress brought on by changes in technology--in libraries and media centers. Case studies are presented that show stress in community college libraries caused by the rapid implementation of new technologies; coping strategies for librarians and media specialists are discussed; and strategies for managers are suggested.…

Image changes of the cases with neuroblastoma observed without therapy

International Nuclear Information System (INIS)

Takeuchi, Maho; Aida, Noriko

1999-01-01

Fifteen cases (10 males and 5 females) of neuroblastoma diagnosed by mass screening from November 1993 to October 1997, were observed without therapy. The mean age was 7.9 months. There were tumors in para-aortic area in 4 cases, in adrenal parts in 7 cases, in mediastinum in 3 cases. The other case had tumors in mediastinum and adrenal parts, bilaterally. The observation was executed by the ultrasonography in cases with the abdominal tumor and by MRI in cases with the mediastinal tumor. CT, MRI and US were performed in the first examination by radiologist. MIBG scintigraphy was used mainly for the detection of distant metastases. Imaging was performed at every one or two months in the beginning of observation, and at every three or four months afterwards. Tumors reduced in 9 cases, unchanged in 1 case and increased in 5 cases (8 tumors). The change of tumor size could be evaluated accurately, but the prediction of benignity or malignancy was difficult. Pathological findings were obtained from 5 cases who underwent surgical resection. Four cases had increased tumor. Two of them had benign neuroblastoma or ganglioma, and 2 cases had malignant neuroblastoma of low differentiation. One case with decreased tumor had neuroblastoma and became benign. (K.H.)

Medical Waste Management in Community Health Centers.

Science.gov (United States)

Tabrizi, Jafar Sadegh; Rezapour, Ramin; Saadati, Mohammad; Seifi, Samira; Amini, Behnam; Varmazyar, Farahnaz

2018-02-01

Non-standard management of medical waste leads to irreparable side effects. This issue is of double importance in health care centers in a city which are the most extensive system for providing Primary Health Care (PHC) across Iran cities. This study investigated the medical waste management standards observation in Tabriz community health care centers, northwestern Iran. In this triangulated cross-sectional study (qualitative-quantitative), data collecting tool was a valid checklist of waste management process developed based on Iranian medical waste management standards. The data were collected in 2015 through process observation and interviews with the health center's staff. The average rate of waste management standards observance in Tabriz community health centers, Tabriz, Iran was 29.8%. This case was 22.8% in dimension of management and training, 27.3% in separating and collecting, 31.2% in transport and temporary storage, and 42.9% in sterilization and disposal. Lack of principal separation of wastes, inappropriate collecting and disposal cycle of waste and disregarding safety tips (fertilizer device performance monitoring, microbial cultures and so on) were among the observed defects in health care centers supported by quantitative data. Medical waste management was not in a desirable situation in Tabriz community health centers. The expansion of community health centers in different regions and non-observance of standards could predispose to incidence the risks resulted from medical wastes. So it is necessary to adopt appropriate policies to promote waste management situation.

A cross-case analysis of three Native Science Field Centers

Science.gov (United States)

Augare, Helen J.; Davíd-Chavez, Dominique M.; Groenke, Frederick I.; Little Plume-Weatherwax, Melissa; Lone Fight, Lisa; Meier, Gene; Quiver-Gaddie, Helene; Returns From Scout, Elvin; Sachatello-Sawyer, Bonnie; St. Pierre, Nate; Valdez, Shelly; Wippert, Rachel

2017-06-01

Native Science Field Centers (NSFCs) were created to engage youth and adults in environmental science activities through the integration of traditional Native ways of knowing (understanding about the natural world based on centuries of observation including philosophy, worldview, cosmology, and belief systems of Indigenous peoples), Native languages, and Western science concepts. This paper focuses on the Blackfeet Native Science Field Center, the Lakota Native Science Field Center, and the Wind River Native Science Field Center. One of the long-term, overarching goals of these NSFCs was to stimulate the interest of Native American students in ways that encouraged them to pursue academic and career paths in science, technology, engineering, and mathematics (STEM) fields. A great deal can be learned from the experiences of the NSFCs in terms of effective educational strategies, as well as advantages and challenges in blending Native ways of knowing and Western scientific knowledge in an informal science education setting. Hopa Mountain—a Bozeman, Montana-based nonprofit—partnered with the Blackfeet Community College on the Blackfeet Reservation, Fremont County School District #21 on the Wind River Reservation, and Oglala Lakota College on the Pine Ridge Reservation to cooperatively establish the Native Science Field Centers. This paper presents a profile of each NSFC and highlights their program components and accomplishments.

Student-Centered Teaching Meets New Media: Concept and Case Study

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Andreas Holzinger

2002-10-01

Full Text Available There exists empirical evidence proving that students who are given the freedom to explore areas based on their personal interests, and who are accompanied in their learning by a supportive, understanding facilitator, not only achieve superior academic results but also develop socially and grow personally. However, pure Student-Centered Teaching is more demanding in terms of communication, organization, as well as the provision of learning material. Thus, the basic idea underlying our paradigm is to combine Student-Centered Teaching with eLearning in order to exploit the advantages of the two approaches. We refer to this combined style as Student-Centered eLearning (SCeL. Strongly simplified, the computer takes over the task of providing information, while presence phases can be used for giving the content more meaning by means of transparent, open, respectful and empathic interactions within the group. Our case study indicates that Student-Centered eLearning has the potential of reducing the increased demands of Student-Centered Teaching in the long run, while fully retaining all its benefits, such as deeper learning processes, personal growth, social skills, and a higher degree of flexibility. Furthermore, the maturity for life-long learning is cultivated. In this paper we introduce our concept and derive first hypotheses on the conditions under which our paradigm appears most effective. While potential continuations of our studies are manifold, we intend to employ SCeL in the course of the new curriculum of the medical faculty of GrazUniversity where a Virtual Medical Campus (http://vmc.uni-graz.at is currently being developed.

Relation of people-centered public health and person-centered healthcare management: a case study to reduce burn-out.

Science.gov (United States)

Stoyanov, Drozdstoj S; Cloninger, C Robert

2012-01-01

Healthcare management is one practical tool for mediation and implementation of public health into clinical healthcare outcomes and is taken in our case study as an exemplar arena to demonstrate the vital importance of the person-centered approach. Healthcare personnel are frequently at risk for the 'burn-out' syndrome. However, modern measures of burn-out recognize burn-out only at a late stage when it is fully developed. There are no available methods to assess the risk for vulnerability to burnout in healthcare systems. Our aim was therefore to design a complex person-centered model for detection of high risk for burn-out at an early stage, that has been termed 'flame-out'. We accept the observation that decreased personal performance is one crucial expression of burn-out. Low personal performance and negative emotions are strongly related to low self-directedness as measured by the Temperament and Character Inventory (TCI). At the same time, burn-out is characterized by decreased interest and positive emotions from work. Decreased positive emotion is directly related to low self-transcendence as measured by the TCI. Burn-out is also frequently associated with feelings of social alienation or inadequacy of support, which is in turn related to low TCI Cooperativeness. However, high Persistence and Harm Avoidance are predisposing traits for burn-out in healthcare professionals who are often overly perfectionistic and compulsive, predisposing them to anxiety, depression, suicide and burn-out. Hence, people at risk for future burn-out are often highly conscientious over-achievers with intense mixtures of positive and negative emotions. The high demand for perfection comes from both intrinsic characteristics and from features of the social milieu in their psychological climate. Letting go of the unfulfillable desire to be perfect by increasing self-transcendence allows acceptance of the imperfection of the human condition, thereby preventing burn-out and other

HERSCHEL OBSERVATIONS REVEAL ANOMALOUS MOLECULAR ABUNDANCES TOWARD THE GALACTIC CENTER

Energy Technology Data Exchange (ETDEWEB)

Sonnentrucker, P. [Space Telescope Science Institute, Baltimore, MD 21218 (United States); Neufeld, D. A.; Indriolo, N. [Physics and Astronomy Department, Johns Hopkins University, Baltimore, MD 21218 (United States); Gerin, M.; De Luca, M. [LERMA-LRA, UMR 8112 du CNRS, Observatoire de Paris, Ecole Normale Superieure, UPMC and UCP, 24 rue Lhomond, F-75231, Paris Cedex 05 (France); Lis, D. C. [Astronomy Department, California Institute of Technology, Pasadena, CA 91125 (United States); Goicoechea, J. R., E-mail: sonnentr@stsci.edu [Centro de Astrobiologia, CSIC/INTA, E-28850, Madrid (Spain)

2013-01-20

We report the Herschel detections of hydrogen fluoride (HF) and para-water (p-H{sub 2}O) in gas intercepting the sight lines to two well-studied molecular clouds in the vicinity of the Sgr A complex: G-0.02-0.07 (the {sup +}50 km s{sup -1} cloud{sup )} and G-0.13-0.08 (the {sup +}20 km s{sup -1} cloud{sup )}. Toward both sight lines, HF and water absorption components are detected over a wide range of velocities covering {approx}250 km s{sup -1}. For all velocity components with V{sub LSR} > -85 km s{sup -1}, we find that the HF and water abundances are consistent with those measured toward other sight lines probing the Galactic disk gas. The velocity components with V{sub LSR} {<=} -85 km s{sup -1}, which are known to trace gas residing within {approx}200 pc of the Galactic center, however, exhibit water vapor abundances with respect to HF at least a factor three higher than those found in the Galactic disk gas. Comparison with CH data indicates that our observations are consistent with a picture where HF and a fraction of the H{sub 2}O absorption arise in diffuse molecular clouds showing Galactic disk-like abundances while the bulk of the water absorption arises in warmer (T {>=} 400 K) diffuse molecular gas for V{sub LSR} {<=} -85 km s{sup -1}. This diffuse Interstellar Medium (ISM) phase has also been recently revealed through observations of CO, HF, H{sup +}{sub 3}, and H{sub 3}O{sup +} absorption toward other sight lines probing the Galactic center inner region.

Model of Emergency and Observation Nursing Services at the Community Health Center in East Java

Directory of Open Access Journals (Sweden)

Dwi Ananto Wibrata

2017-07-01

Full Text Available Public health centers as the spearhead of health services, also provide 'emergency and observation' nursing services, due to the high number of accidents in East Java. The purpose of this study was to develop the nurse's performance model in providing 'emergency and obeservation' nursing services at Puskesgadarsi ('Emergency and Observation' Community Health Center in East Java, using cross sectional design. The subjects of 120 nurses were selected by multi stage sampling technique. Data were collected through questionnaires and FGDs, and then analyzed using structural equation modeling to produce an model of ‘emergency and observation’ nursing service for nurses at Puskesgadarsi. Components of the model were reinforcing factors, personal factors, cognition factors, affection factors, commitment, interpersonal, reinforcement and nurse performance. Nurses can use this model in providing nursing services with due regard to their knowledge and skills, facilities and infrastructure, as well as interaction and self-reinforcement, so as to be able to perform nursing services 'emergency and observation' well.

Patient-Centered Medical Home Undergraduate Internship, Benefits to a Practice Manager: Case Study.

Science.gov (United States)

Sasnett, Bonita; Harris, Susie T; White, Shelly

Health services management interns become practice facilitators for primary care clinics interested in pursuing patient-centered recognition for their practice. This experience establishes a collaborative relationship between the university and clinic practices where students apply their academic training to a system of documentation to improve the quality of patient care delivery. The case study presents the process undertaken, benefits, challenges, lessons learned, and recommendations for intern, practice mangers, and educators. The practice manager benefits as interns become Patient-Centered Medical Home facilitators and assist practice managers in the recognition process.

Depression management within GP-centered health care - A case-control study based on claims data.

Science.gov (United States)

Freytag, Antje; Krause, Markus; Lehmann, Thomas; Schulz, Sven; Wolf, Florian; Biermann, Janine; Wasem, Jürgen; Gensichen, Jochen

For most patients with depression, GPs are the first and long-term medical providers. GP-centered health care (GPc-HC) programs target patients with chronic diseases. What are the effects of GPc-HC on primary care depression management? An observational retrospective case-control study was conducted using health insurance claims data of patients with depressive disorder from July 2011 to December 2012. From 40,298 patients insured with the largest health plan in Central Germany participating in the GPc-HC program (intervention group, IG), we observed 4645 patients with depression over 18months: 72.2% women; 66.6years (mean); multiple conditions (morbidity-weight 2.50 (mean), 86%>1.0). We compared them with 4013 patients who did not participate (control group). In participants we found lower number of incomplete/non-specified depression diagnoses (4.46vs.4.82;MD-0.36; pcare" (38.2%vs.30.2%;PP+8.0;pDepressive patients participating in a GPc-HC program may be more often diagnosed by a GP, receive symptom-monitoring and appropriate depression treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

M-center growth in alkali halides: computer simulation

International Nuclear Information System (INIS)

Aguilar, M.; Jaque, F.; Agullo-Lopez, F.

1983-01-01

The heterogeneous interstitial nucleation model previously proposed to explain F-center growth curves in irradiated alkali halides has been extended to account for M-center kinetics. The interstitials produced during the primary irradiation event are assumed to be trapped at impurities and interstitial clusters or recombine with F and M centers. For M-center formation two cases have been considered: (a) diffusion and aggregation of F centers, and (b) statistical generation and pairing of F centers. Process (b) is the only one consistent with the quadratic relationship between M and F center concentrations. However, to account for the F/M ratios experimentally observed as well as for the role of dose-rate, a modified statistical model involving random creation and association of F + -F pairs has been shown to be adequate. (author)

Reliability centered maintenance : a case study of railway transit maintenance to achieve optimal performance.

Science.gov (United States)

2010-12-01

The purpose of this qualitative case study was to identify the types of obstacles and patterns experienced by a single heavy rail transit agency located in North America that embedded a Reliability Centered Maintenance (RCM) Process. The outcome of t...

A Case Study Documenting the Process by Which Biology Instructors Transition from Teacher-Centered to Learner-Centered Teaching

Science.gov (United States)

Marbach-Ad, Gili; Hunt Rietschel, Carly

2016-01-01

In this study, we used a case study approach to obtain an in-depth understanding of the change process of two university instructors who were involved with redesigning a biology course. Given the hesitancy of many biology instructors to adopt evidence-based, learner-centered teaching methods, there is a critical need to understand how biology instructors transition from teacher-centered (i.e., lecture-based) instruction to teaching that focuses on the students. Using the innovation-decision model for change, we explored the motivation, decision-making, and reflective processes of the two instructors through two consecutive, large-enrollment biology course offerings. Our data reveal that the change process is somewhat unpredictable, requiring patience and persistence during inevitable challenges that arise for instructors and students. For example, the change process requires instructors to adopt a teacher-facilitator role as opposed to an expert role, to cover fewer course topics in greater depth, and to give students a degree of control over their own learning. Students must adjust to taking responsibility for their own learning, working collaboratively, and relinquishing the anonymity afforded by lecture-based teaching. We suggest implications for instructors wishing to change their teaching and administrators wishing to encourage adoption of learner-centered teaching at their institutions. PMID:27856550

Adalimumab for maintenance therapy for one year in Crohn's disease: results of a Latin American single-center observational study.

Science.gov (United States)

Kotze, Paulo Gustavo; Abou-Rejaile, Vinícius Rezende; Uiema, Luciana Aparecida; Olandoski, Marcia; Sartor, Maria Cristina; Miranda, Eron Fábio; Kotze, Lorete Maria da Silva; Saad-Hossne, Rogério

2014-01-01

Adalimumab is a fully-human antibody that inhibits TNF alpha, with a significant efficacy for long-term maintenance of remission. Studies with this agent in Latin American Crohn's disease patients are scarce. The objective of this study was to outline clinical remission rates after 12 months of adalimumab therapy for Crohn's disease patients. Retrospective, single-center, observational study of a Brazilian case series of Crohn's disease patients under adalimumab therapy. Variables analyzed: demographic data, Montreal classification, concomitant medication, remission rates after 1, 4, 6 and 12 months. Remission was defined as Harvey-Bradshaw Index ≤ 4, and non-responder-imputation and last-observation-carried-forward analysis were used. The influence of infliximab on remission rates was analyzed by Fischer and Chi-square tests (Panalysis. After 12 months, remission on patients with previous infliximab occurred in 69.23% as compared to 94.59% in infliximab-naïve patients (P = 0.033). Adalimumab was effective in maintaining clinical remission after 12 months of therapy, with an adequate safety profile, and was also more effective in infliximab naïve patients.

A Case Study Using Child-Centered Play Therapy Approach to Treat Enuresis and Encopresis.

Science.gov (United States)

Cuddy-Casey, Maria

1997-01-01

Demonstrates an alternative method (nondirective child-centered therapy) in treating enuresis and encopresis resulting from emotional disturbances. Examines various etiologies and approaches to treating these conditions. Provides a case study example. Claims that professionals must differentiate between primary and secondary occurrences of these…

Building America Case Study: New Town Builders' Power of Zero Energy Center, Denver, Colorado (Brochure)

Energy Technology Data Exchange (ETDEWEB)

2014-10-01

New Town Builders, a builder of energy efficient homes in Denver, Colorado, offers a zero energy option for all the homes it builds. To attract a wide range of potential homebuyers to its energy efficient homes, New Town Builders created a 'Power of Zero Energy Center' linked to its model home in the Stapleton community of Denver. This case study presents New Town Builders' marketing approach, which is targeted to appeal to homebuyers' emotions rather than overwhelming homebuyers with scientific details about the technology. The exhibits in the Power of Zero Energy Center focus on reduced energy expenses for the homeowner, improved occupant comfort, the reputation of the builder, and the lack of sacrificing the homebuyers' desired design features to achieve zero net energy in the home. The case study also contains customer and realtor testimonials related to the effectiveness of the Center in influencing homebuyers to purchase a zero energy home.

Leaders' Experiences with High School-College Writing Center Collaborations: A Qualitative Multiple-Case Study

Science.gov (United States)

Story, Julie A.

2014-01-01

The purpose of this qualitative multiple-case study was to explore academic leaders' experiences with the organizational elements of their own high school-college writing center collaborations. Conjoining theories framed this study: collaborative leadership theory, Kenneth Bruffee's notion of social constructionism and collaborative learning…

‘Patient-Centered Care’ for Complex Patients with Type 2 Diabetes Mellitus—Analysis of Two Cases

OpenAIRE

Jennifer M. Hackel

2013-01-01

Purpose This paper serves to apply and compare aspects of person centered care and recent consensus guidelines to two cases of older adults with poorly controlled diabetes in the context of relatively similar multimorbidity. Methods After review of the literature regarding the shift from guidelines promoting tight control in diabetes management to individualized person centered care, as well as newer treatment approaches emerging in diabetes care, the newer guidelines and potential treatment ...

Lionfish string experiences of an inland poison center: a retrospective study of 23 cases.

Science.gov (United States)

Trestrail, J H; al-Mahasneh, Q M

1989-04-01

From January 1979 through March 1988, our regional poison center, located many hundreds of miles from the nearest coastal salt water, documented 23 cases of envenomation by "Lionfish" (members of genus Pterois). All cases involved specimens which were maintained in the homes of amateur aquarists. A study of patient epidemiology showed the following: patient's sex 91.3% male, 8.7% female; patients ages ranged from 17 to 50 years with an average age for males of 29.8 years and 35 years for females; the site of the envenomation accident was always in the home; the only part of the body envenomated was the hand or finger; and all of the patients were symptomatic. Symptoms noted included sharp pain, swelling, redness, bleeding, nausea, numbness, joint pain, anxiety, headache, disorientation, and dizziness. One patient had a complication of cellulitis. Treatment provided included immersion of the effected area in hot water at 40 C for 60 to 90 min, analgesics, tetanus toxoid, and antibiotics. There were no deaths noted and treatment proved effective in all cases. This paper also discusses the natural history, clinical effects, and current treatment for envenomations from these beautiful but dangerous venomous fish, which can cause poisoning exposures that are likely to be encountered by poison centers anywhere in the world.

New Whole-House Solutions Case Study: New Town Builders' Power of Zero Energy Center - Denver, Colorado

Energy Technology Data Exchange (ETDEWEB)

None

2014-10-01

New Town Builders, a builder of energy efficient homes in Denver, Colorado, offers a zero energy option for all the homes it builds. To attract a wide range of potential homebuyers to its energy efficient homes, New Town Builders created a "Power of Zero Energy Center" linked to its model home in the Stapleton community. This case study presents New Town Builders' marketing approach, which is targeted to appeal to homebuyers' emotions rather than overwhelming homebuyers with scientific details about the technology. The exhibits in the Power of Zero Energy Center focus on reduced energy expenses for the homeowner, improved occupant comfort, the reputation of the builder, and the lack of sacrificing the homebuyers' desired design features to achieve zero net energy in the home. This case study also contains customer and realtor testimonials related to the effectiveness of the Center in influencing homebuyers to purchase a zero energy home.

High Spectral Resolution Observation of the Soft Diffuse X-ray Background in the Direction of the Galactic Anti-Center

Science.gov (United States)

Wulf, Dallas; Eckart, Mega E.; Galeazzi, Massimiliano; Jaeckel, Felix; Kelley, Richard L.; Kilbourne, Caroline A.; McCammon, Dan; Morgan, Kelsey M.; Porter, Frederick S.; Szymkowiak, Andrew E.

2018-01-01

High spectral resolution observations in the soft x-rays are necessary for understanding and modelling the hot component of the interstellar medium and its contribution to the Soft X-ray Background (SXRB). This extended source emission cannot be resolved with most wavelength dispersive spectrometers, making energy dispersive microcalorimeters the ideal choice for these observations. We present here the analysis of the most recent sounding rocket flight of the University of Wisconsin-Madison/Goddard Space Flight Center X-ray Quantum Calorimeter (XQC), a large area silicon thermistor microcalorimeter. This 111 second observation integrates a nearly 1 steradian field of view in the direction of the galactic anti-center (l, b = 165°, -5°) and features ~5 eV spectral resolution below 1 keV. Direct comparison will also be made to the previous, high-latitude observations.

Advancing Patient-Centered Care in Tuberculosis Management: A Mixed-Methods Appraisal of Video Directly Observed Therapy.

Science.gov (United States)

Holzman, Samuel B; Zenilman, Avi; Shah, Maunank

2018-04-01

Directly observed therapy (DOT) remains an integral component of treatment support and adherence monitoring in tuberculosis care. In-person DOT is resource intensive and often burdensome for patients. Video DOT (vDOT) has been proposed as an alternative to increase treatment flexibility and better meet patient-specific needs. We conducted a pragmatic, prospective pilot implementation of vDOT at 3 TB clinics in Maryland. A mixed-methods approach was implemented to assess (1) effectiveness, (2) acceptability, and (3) cost. Medication adherence on vDOT was compared with that of in-person DOT. Interviews and surveys were conducted with patients and providers before and after implementation, with framework analysis utilized to extract salient themes. Last, a cost analysis assessed the economic impacts of vDOT implementation across heterogeneous clinic structures. Medication adherence on vDOT was comparable to that of in-person DOT (94% vs 98%, P = .17), with a higher percentage of total treatment doses (inclusive of weekend/holiday self-administration) ultimately observed during the vDOT period (72% vs 66%, P = .03). Video DOT was well received by staff and patients alike, who cited increased treatment flexibility, convenience, and patient privacy. Our cost analysis estimated a savings with vDOT of $1391 per patient for a standard 6-month treatment course. Video DOT is an acceptable and important option for measurement of TB treatment adherence and may allow a higher proportion of prescribed treatment doses to be observed, compared with in-person DOT. Video DOT may be cost-saving and should be considered as a component of individualized, patient-centered case management plans.

General Case in Determining Center-To-Center Spacing Between the Screw and the Roller in a Roller Drive, and Initial Contact Point of Their Mating Thread Turns. Development of Calculation Method and Software

Directory of Open Access Journals (Sweden)

D. S. Blinov

2017-01-01

Full Text Available One of the most important trends in development of machine engineering is to improve load capacity of mechanisms, assemblies and parts without increasing their overall dimensions and weight. This is also relevant to the most promising items so far, i.e. orbital roller drives (ORD, which are the rotational-to-progressive motion converters widely used in vehicles. The previously published article suggested increasing a load capacity (by about 15% through reducing a thread turn section angle of the threaded ORD components and change of the radius of roller thread turn section outline. Due to such ORD modification, a number of the most critical ORD parameters are to be changed thereby demanding further research. Further, the article published suggests a method considering the abovementioned changes to calculate the dimensions of ORD main components and their tolerance ranges.Though this method being not complete as the increment of ORD center-to-center spacing in relation to its rated value, required for assembly, is unknown; and to determine the ORD center-to-center spacing increment, outer diameters of the roller and screw threads are to be known. Hence, these two methods are interconnected.This article presents the numerical calculation method, mathematical support and method to determine the increment of ORD center-to-center spacing and initial contact point of the mating roller and screw thread turns. Due to considerable scope of calculations, the method was turned into the software.Similar calculation methods and techniques were developed to a particular case, where the thread turn section angle of the threaded components was of 90°, and the roller thread turn section outline was a circular arc centered to the roller axis. Hence the developed numerical calculation method, mathematical support and technique refer to the general case which is to determine the ORD center-to-center spacing increment and initial contact point of the mating roller

Angiographic characteristics of hysteromyoma and multi-center observation of short-term curative effects of uterine artery embolization

International Nuclear Information System (INIS)

Li Guangqi; Wang Zhimin; Zhang Hongxin; Yang Qingfeng; Li Chao; Zhao Siyuan; Yang Kangjian; Zhao Binyu; He Chao; Li Bo; Zhang Xufeng; Peng Jianming; Zhang Longquan; Feng Rongcai

2010-01-01

contralateral oblique projection (n=824, 71.6%). The results indicated that contralateral oblique projection was the best exposure position for displaying the opening orifice and traveling route of uterine artery. The hysteromyoma got its blood supply from unilateral uterine artery (n=107) or from bilateral uterine artery (n=1 044). Hysteromyoma was supplied by bilateral dominance in 751 cases (65.3%), presented with bilateral dominance of blood supply, bilateral blood supply but lateral dominance in 284 cases (24.7%) and unilateral blood supply in 116 cases (10.1%). The tumor contrast staining was characterized by markedly thickened and tortuous unilateral or bilateral uterine arteries. In the arterial phase,the tumor vessels were increased, thickened and circuitous,and were formed into a globular vascular net in some cases. In addition, intranidal vessels were increased and disordered, and were aggregated into wool coil-shaped structure, producing so called wool-coil sign. In the parenchymal phase, solitary hysteromyoma body was densely and evenly stained with a sharp contour; multiple hysteromyoma body was stained with clear shape and border. However, hysteromyoma body was not stained clearly in 35 cases (3%). In the venous phase, venous angiography did not show the presence of arterio-venous fistula. B-ultrasonography results demonstrated that at 3, 6 and 12 months after treatment the tumor was shrunk to half size in 351 cases (31%), 691 cases (61%) and 897 cases (78%), respectively. Disappearance of hysteromyoma blood supply with no change in tumor size was seen in 79 cases (6.9%). No improvement was seen in 16 cases (1.4%). Conclusion: Large-size multi-center observation indicates that hysteromyoma is a hypervascular benign tumor. Uterine artery embolization shows good short-term curative effects. The understanding of the vascular anatomical characteristics of uterine artery and the use of proper projection body position can greatly improve the successful rate of super

Metropolitan transportation management center : a case study : Michigan intelligent transportation system : improving safety and air quality while reducing stress for motorists

Science.gov (United States)

1999-10-01

The following case study provides a snapshot of Michigan's Intelligent Transportation Systems transportation management center (MITSC). It follows the outline provided in the companion document, Metropolitan Transportation Management Center Concepts ...

Reconsidering the popularity of primary health centers in India: a case study from rural Maharashtra.

Science.gov (United States)

Kamat, V R

1995-07-01

Most evaluations of India's primary health care (PHC) program have been critical of the ways government primary health centers have been functioning. It has been commonly noted that utilization of health services is poor and community participation in the PHC outreach program low. Additionally, medical officers and health center staff are often accused of being negligent in their duties. In this paper I argue that it is worthwhile examining how a popular primary health center functions in a context marked by a growing demand for Western medicines. Attention is drawn to the ingenious ways in which health personnel respond to client demands and government medicine shortages. The case of a popular primary health center in rural Maharashtra is presented. This health center is both the site of public and private health care. Discussed is the manner in which rural populations in India maximize available health care options given time, cash and transportation constraints. Current thinking about community health financing is considered in light of existing health care utilization patterns, community evaluation of free services, perceptions of entitlement and the likely response of practitioners to such schemes.

Gastrointestinal stromal tumor: analysis of 146 cases of the center of reference of the National Cancer Institute--INCA.

Science.gov (United States)

Linhares, Eduardo; Gonçalves, Rinaldo; Valadão, Marcus; Vilhena, Bruno; Herchenhorn, Daniel; Romano, Sergio; Ferreira, Maria Aparecida; Ferreira, Carlos Gil; Ramos, Cintia de Araujo; de Jesus, José Paulo

2011-01-01

To evaluate the treatment of GIST in INCA. We conducted a retrospective analysis of all cases of GIST treated at INCA in the period from 1997 to 2009. We analyzed 146 patients with a mean age of 44.5 years and female predominance. The main symptom was abdominal pain. We observed the occurrence of a second primary tumor in 22% of cases and 92% of the immunohistochemistry exams were positive for CD117. The most frequent location was in the stomach and the high-risk group was predominant. Surgery was considered R0 (extensive) in 70% of the cases and the main sites of metastases were liver and peritoneum. Overall survival in two and five years was, respectively, 86% and 59%. There was a significant difference between overall survival (p = 0.29) of the high-risk group versus the other. Our patients presented mainly in the form of high-risk disease, with obvious impact on survival. The use of imatinib improved survival of patients with recurrent and metastatic disease. We should study its use in the setting of adjuvant and neoadjuvant therapy to improve results of the high risk group. The creation of reference centers is a need for the study of rare diseases.

Triploidy--Observations in 154 Diandric Cases.

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Nanna Brink Scholz

Full Text Available Hydatidiform moles (HMs are abnormal human pregnancies with vesicular chorionic villi, imposing two clinical challenges; miscarriage and a risk of gestational trophoblastic neoplasia (GTN. The parental type of most HMs are either diandric diploid (PP or diandric triploid (PPM. We consecutively collected 154 triploid or near-triploid samples from conceptuses with vesicular chorionic villi. We used analysis of DNA markers and/or methylation sensitive-MLPA and collected data from registries and patients records. We performed whole genome SNP analysis of one case of twinning (PP+PM.In all 154 triploids or near-triploids we found two different paternal contributions to the genome (P1P2M. The ratios between the sex chromosomal constitutions XXX, XXY, and XYY were 5.7: 6.9: 1.0. No cases of GTN were observed. Our results corroborate that all triploid human conceptuses with vesicular chorionic villi have the parental type P1P2M. The sex chromosomal ratios suggest approximately equal frequencies of meiosis I and meiosis II errors with selection against the XYY conceptuses or a combination of dispermy, non-disjunction in meiosis I and meiosis II and selection against XYY conceptuses. Although single cases of GTN after a triploid HM have been reported, the results of this study combined with data from previous prospective studies estimate the risk of GTN after a triploid mole to 0% (95% CI: 0-1,4%.

Transformational leadership, transnational culture and political competence in globalizing health care services: a case study of Jordan's King Hussein Cancer Center

Directory of Open Access Journals (Sweden)

Pappas Gregory

2007-11-01

Full Text Available Abstract Background Following the demise of Jordan's King Hussein bin Talal to cancer in 1999, the country's Al-Amal Center was transformed from a poorly perceived and ineffectual cancer care institution into a Western-style comprehensive cancer center. Renamed King Hussein Cancer Center (KHCC, it achieved improved levels of quality, expanded cancer care services and achieved Joint Commission International accreditation under new leadership over a three-year period (2002–2005. Methods An exploratory case research method was used to explain the rapid change to international standards. Sources including personal interviews, document review and on-site observations were combined to conduct a robust examination of KHCC's rapid changes. Results The changes which occurred at the KHCC during its formation and leading up to its Joint Commission International (JCI accreditation can be understood within the conceptual frame of the transformational leadership model. Interviewees and other sources for the case study suggest the use of inspirational motivation, idealized influence, individualized consideration and intellectual stimulation, four factors in the transformational leadership model, had significant impact upon the attitudes and motivation of staff within KHCC. Changes in the institution were achieved through increased motivation and positive attitudes toward the use of JCI continuous improvement processes as well as increased professional training. The case study suggests the role of culture and political sensitivity needs re-definition and expansion within the transformational leadership model to adequately explain leadership in the context of globalizing health care services, specifically when governments are involved in the change initiative. Conclusion The KHCC case underscores the utility of the transformational leadership model in an international health care context. To understand leadership in globalizing health care services, KHCC

Observing the effect of a policy: a maintenance case

NARCIS (Netherlands)

Rijsdijk, Chris; Tinga, Tiedo

2016-01-01

Purpose – The purpose of this paper is to show that maintenance performance is potentially better predictable from recording routines. Design/methodology/approach – An attempt is made to observe an effect of a policy. Maintenance cases seem exceptional because of the efficiently obtainable evidence

ADALIMUMAB FOR MAINTENANCE THERAPY FOR ONE YEAR IN CROHN?S DISEASE: results of a Latin American single-center observational study

Directory of Open Access Journals (Sweden)

Paulo Gustavo KOTZE

2014-03-01

Full Text Available Context Adalimumab is a fully-human antibody that inhibits TNF alpha, with a significant efficacy for long-term maintenance of remission. Studies with this agent in Latin American Crohn’s disease patients are scarce. Objectives The objective of this study was to outline clinical remission rates after 12 months of adalimumab therapy for Crohn’s disease patients. Methods Retrospective, single-center, observational study of a Brazilian case series of Crohn’s disease patients under adalimumab therapy. Variables analyzed: demographic data, Montreal classification, concomitant medication, remission rates after 1, 4, 6 and 12 months. Remission was defined as Harvey-Bradshaw Index ≤4, and non-responder-imputation and last-observation-carried-forward analysis were used. The influence of infliximab on remission rates was analyzed by Fischer and Chi-square tests (P<0.05. Results Fifty patients, with median age of 35 years at therapy initiation, were included. Remission rates after 12 months of therapy were 54% under non-responder-imputation and 88% under last-observation-carried-forward analysis. After 12 months, remission on patients with previous infliximab occurred in 69.23% as compared to 94.59% in infliximab-naïve patients (P = 0.033. Conclusions Adalimumab was effective in maintaining clinical remission after 12 months of therapy, with an adequate safety profile, and was also more effective in infliximab naïve patients.

Is case triaging a useful tool for emergency surgeries? A review of 106 trauma surgery cases at a level 1 trauma center in South Africa.

Science.gov (United States)

Chowdhury, Sharfuddin; Nicol, Andrew John; Moydien, Mahammed Riyaad; Navsaria, Pradeep Harkison; Montoya-Pelaez, Luis Felipe

2018-01-01

The optimal timing for emergency surgical interventions and implementation of protocols for trauma surgery is insufficient in the literature. The Groote Schuur emergency surgery triage (GSEST) system, based on Cape Triaging Score (CTS), is followed at Groote Schuur Hospital (GSH) for triaging emergency surgical cases including trauma cases. The study aimed to look at the effect of delay in surgery after scheduling based on the GSEST system has an impact on outcome in terms of postoperative complications and death. Prospective audit of patients presenting to GSH trauma center following penetrating or blunt chest, abdominal, neck and peripheral vascular trauma who underwent surgery over a 4-month period was performed. Post-operative complications were graded according to Clavien-Dindo classification of surgical complications. One-hundred six patients underwent surgery during the study period. One-hundred two (96.2%) cases were related to penetrating trauma. Stab wounds comprised 71 (67%) and gunshot wounds (GSW) 31 (29.2%) cases. Of the 106 cases, 6, 47, 40, and 13 patients were booked as red, orange, yellow, and green, respectively. The median delay for green, yellow, and orange cases was within the expected time. The red patients took unexpectedly longer (median delay 48 min, IQR 35-60 min). Thirty-one (29.3%) patients developed postoperative complications. Among the booked red, orange, yellow, and green cases, postoperative complications developed in 3, 18, 9, and 1 cases, respectively. Only two (1.9%) postoperative deaths were documented during the study period. There was no statistically significant association between operative triage and post-operative complications ( p  = 0.074). Surgical case categorization has been shown to be useful in prioritizing emergency trauma surgical cases in a resource constraint high-volume trauma center.

A Case Study Documenting the Process by Which Biology Instructors Transition from Teacher-Centered to Learner-Centered Teaching.

Science.gov (United States)

Marbach-Ad, Gili; Hunt Rietschel, Carly

2016-01-01

In this study, we used a case study approach to obtain an in-depth understanding of the change process of two university instructors who were involved with redesigning a biology course. Given the hesitancy of many biology instructors to adopt evidence-based, learner-centered teaching methods, there is a critical need to understand how biology instructors transition from teacher-centered (i.e., lecture-based) instruction to teaching that focuses on the students. Using the innovation-decision model for change, we explored the motivation, decision-making, and reflective processes of the two instructors through two consecutive, large-enrollment biology course offerings. Our data reveal that the change process is somewhat unpredictable, requiring patience and persistence during inevitable challenges that arise for instructors and students. For example, the change process requires instructors to adopt a teacher-facilitator role as opposed to an expert role, to cover fewer course topics in greater depth, and to give students a degree of control over their own learning. Students must adjust to taking responsibility for their own learning, working collaboratively, and relinquishing the anonymity afforded by lecture-based teaching. We suggest implications for instructors wishing to change their teaching and administrators wishing to encourage adoption of learner-centered teaching at their institutions. © 2016 G. Marbach-Ad and C. H. Rietschel. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

From Isolation to Insulation: The Impact of Campus Culture on the Existence of Two Cultural Centers

Science.gov (United States)

Pinchback-Hines, Cynthia Juanesta

2013-01-01

This case study examined how the campus culture influences the existence of a Black cultural center and a multicultural center at a predominantly White university. A qualitative ethnography was conducted using focus group interviews, personal interviews, archival research, and anecdotal observation. The results of the study identified five themes:…

Center vortex properties in the Laplace center gauge of SU(2) Yang-Mills theory

OpenAIRE

Langfeld, K.; Reinhardt, H.; Schafke, A.

2001-01-01

Resorting to the the Laplace center gauge (LCG) and to the Maximal-center gauge (MCG), respectively, confining vortices are defined by center projection in either case. Vortex properties are investigated in the continuum limit of SU(2) lattice gauge theory. The vortex (area) density and the density of vortex crossing points are investigated. In the case of MCG, both densities are physical quantities in the continuum limit. By contrast, in the LCG the piercing as well as the crossing points li...

Trauma Center Based Youth Violence Prevention Programs: An Integrative Review.

Science.gov (United States)

Mikhail, Judy Nanette; Nemeth, Lynne Sheri

2016-12-01

Youth violence recidivism remains a significant public health crisis in the United States. Violence prevention is a requirement of all trauma centers, yet little is known about the effectiveness of these programs. Therefore, this systematic review summarizes the effectiveness of trauma center-based youth violence prevention programs. A systematic review of articles from MEDLINE, CINAHL, and PsychINFO databases was performed to identify eligible control trials or observational studies. Included studies were from 1970 to 2013, describing and evaluating an intervention, were trauma center based, and targeted youth injured by violence (tertiary prevention). The social ecological model provided the guiding framework, and findings are summarized qualitatively. Ten studies met eligibility requirements. Case management and brief intervention were the primary strategies, and 90% of the studies showed some improvement in one or more outcome measures. These results held across both social ecological level and setting: both emergency department and inpatient unit settings. Brief intervention and case management are frequent and potentially effective trauma center-based violence prevention interventions. Case management initiated as an inpatient and continued beyond discharge was the most frequently used intervention and was associated with reduced rearrest or reinjury rates. Further research is needed, specifically longitudinal studies using experimental designs with high program fidelity incorporating uniform direct outcome measures. However, this review provides initial evidence that trauma centers can intervene with the highest of risk patients and break the youth violence recidivism cycle. © The Author(s) 2015.

GLOBE Observer and the Association of Science & Technology Centers: Leveraging Citizen Science and Partnerships for an International Science Experiment to Build Climate Literacy

Science.gov (United States)

Riebeek Kohl, H.; Chambers, L. H.; Murphy, T.

2016-12-01

For more that 20 years, the Global Learning and Observations to Benefit the Environment (GLOBE) Program has sought to increase environment literacy in students by involving them in the process of data collection and scientific research. In 2016, the program expanded to accept observations from citizen scientists of all ages through a relatively simple app. Called GLOBE Observer, the new program aims to help participants feel connected to a global community focused on advancing the scientific understanding of Earth system science while building climate literacy among participants and increasing valuable environmental data points to expand both student and scientific research. In October 2016, GLOBE Observer partnered with the Association of Science & Technology Centers (ASTC) in an international science experiment in which museums and patrons around the world collected cloud observations through GLOBE Observer to create a global cloud map in support of NASA satellite science. The experiment was an element of the International Science Center and Science Museum Day, an event planned in partnership with UNESCO and ASTC. Museums and science centers provided the climate context for the observations, while GLOBE Observer offered a uniform experience and a digital platform to build a connected global community. This talk will introduce GLOBE Observer and will present the results of the experiment, including evaluation feedback on gains in climate literacy through the event.

[Medical fault or professional negligence? Case studies in two recovery nutrition centers in Niger].

Science.gov (United States)

Halidou Doudou, M; Manzo, M L; Guero, D

2014-12-01

In developing countries such as Niger, the risk of medical malpractice is ubiquitous in health, jeopardizing patient safety. The aim of this work was to contribute to patients' safety and respect of code of ethics and conduct in the exercise of the medical profession. The reported cases involved two children under 5 years who were admitted to nutrition rehabilitation centers, died as a result of medical malpractice. In Niger, there are no statistics on this phenomenon and a few cases found have always been considered "accident" or "fate." The establishment of an observatory collections of such information should improve their frequency, consequences and propose a prevention plan. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

U.S. Geological Survey (USGS) Earth Resources Observation and Science (EROS) Center-fiscal year 2010 annual report

Science.gov (United States)

Nelson, Janice S.

2011-01-01

The Earth Resources Observation and Science (EROS) Center is a U.S. Geological Survey (USGS) facility focused on providing science and imagery to better understand our Earth. The work of the Center is shaped by the earth sciences, the missions of our stakeholders, and implemented through strong program and project management, and application of state-of-the-art information technologies. Fundamentally, EROS contributes to the understanding of a changing Earth through 'research to operations' activities that include developing, implementing, and operating remote-sensing-based terrestrial monitoring capabilities needed to address interdisciplinary science and applications objectives at all levels-both nationally and internationally. The Center's programs and projects continually strive to meet, and where possible exceed, the changing needs of the USGS, the Department of the Interior, our Nation, and international constituents. The Center's multidisciplinary staff uses their unique expertise in remote sensing science and technologies to conduct basic and applied research, data acquisition, systems engineering, information access and management, and archive preservation to address the Nation's most critical needs. Of particular note is the role of EROS as the primary provider of Landsat data, the longest comprehensive global land Earth observation record ever collected. This report is intended to provide an overview of the scientific and engineering achievements and illustrate the range and scope of the activities and accomplishments at EROS throughout fiscal year (FY) 2010. Additional information concerning the scientific, engineering, and operational achievements can be obtained from the scientific papers and other documents published by EROS staff or by visiting our web site at http://eros.usgs.gov. We welcome comments and follow-up questions on any aspect of this Annual Report and invite any of our customers or partners to contact us at their convenience. To

Radiotherapy of primary cutaneous follicle center lymphoma: case report and review of literature

International Nuclear Information System (INIS)

Ceovic, Romana; Jovanovic, Ivana; Kostovic, Kresimir; Rados, Jaka; Dotlic, Snjezana; Radman, Ivo; Kulisic, Sandra Marinovic; Loncaric, Davorin

2013-01-01

Primary cutaneous follicle center lymphoma is an indolent primary cutaneous B-cell lymphoma originating from the follicle center cells, composed of a combination of centrocytes (small and large cleaved cells) and centroblasts (large noncleaved cells) with a follicular, follicular/diffuse, or diffuse growth pattern. Lesions are mostly located on the head, neck and trunk. A case is presented of a 56-year-old male patient with primary cutaneous follicle center lymphoma, with lesions involving the skin of the back, shoulders, presternal area and right forearm. As the patient presented a disseminated cutaneous form of the disease that involved several anatomical regions, complete work-up was followed by superficial fractionated radiotherapy of eight fields in VI expositions, with total irradiation dose of 1400 cGy upon the following fields: right and left pectoral region, left and right shoulders, right suprascapular region, and proximal third of the right forearm. Total irradiation dose applied upon each field for the lesions located on the left and right side of the back was 1500 cGy. This therapy resulted in significant reduction of visible tumor. The patient was regularly followed up on outpatient basis for 12 months of radiotherapy, being free from local recurrence and systemic spread of the disease

Embodying Authentic Leadership through Popular Education at Highlander Research and Education Center: A Qualitative Case Study

Science.gov (United States)

Glowacki-Dudka, Michelle; Griswold, Wendy

2016-01-01

In 2013 and 2014, workshops were held at Highlander Research and Education Center that explored the topics of authentic leadership and popular education. The participants shared their experiences through reflective writing upon completion of the workshops and approximately a year following. These reflections were developed into a case study. This…

[Monkeypox: second human case observed in Ivory Coast (rural health sector of Daloa].

Science.gov (United States)

Merouze, F; Lesoin, J J

1983-01-01

A second case of human monkeypox (world fifty-forth case) has been observed in Ivory Coast (rural health sector of Daloa). A three years old girl presented a major pox-like eruption which evolved to recovery. The authors describe the eruption, the evolution of the sickness, and the scars observed at the fourth month after recovery. It has not been possible to prove neither animal-human nor interhuman contagion.

New methods for solving a vertex p-center problem with uncertain demand-weighted distance: A real case study

Directory of Open Access Journals (Sweden)

Javad Nematian

2015-04-01

Full Text Available Vertex and p-center problems are two well-known types of the center problem. In this paper, a p-center problem with uncertain demand-weighted distance will be introduced in which the demands are considered as fuzzy random variables (FRVs and the objective of the problem is to minimize the maximum distance between a node and its nearest facility. Then, by introducing new methods, the proposed problem is converted to deterministic integer programming (IP problems where these methods will be obtained through the implementation of the possibility theory and fuzzy random chance-constrained programming (FRCCP. Finally, the proposed methods are applied for locating bicycle stations in the city of Tabriz in Iran as a real case study. The computational results of our study show that these methods can be implemented for the center problem with uncertain frameworks.

Empowering patients of a mental rehabilitation center in a low-resource context: a Moroccan experience as a case study.

Science.gov (United States)

Khabbache, Hicham; Jebbar, Abdelhak; Rania, Nadia; Doucet, Marie-Chantal; Watfa, Ali Assad; Candau, Joël; Martini, Mariano; Siri, Anna; Brigo, Francesco; Bragazzi, Nicola Luigi

2017-01-01

Mental, neurological and substance use (MNS) disorders represent a major source of disability and premature mortality worldwide. However, in developing countries patients with MNS disorders are often poorly managed and treated, particularly in marginalized, impoverished areas where the mental health gap and the treatment gap can reach 90%. Efforts should be made in promoting help by making mental health care more accessible. In this article, we address the challenges that psychological and psychiatric services have to face in a low-resource context, taking our experience at a Moroccan rehabilitation center as a case study. A sample of 60 patients were interviewed using a semi-structured questionnaire during the period of 2014-2015. The questionnaire investigated the reactions and feelings of the patients to the rehabilitation program, and their perceived psychological status and mental improvement, if any. Interviews were then transcribed and processed using ATLAS.ti V.7.0 qualitative analysis software. Frequencies and co-occurrence analyses were carried out. Despite approximately 30 million inhabitants within the working age group, Morocco suffers from a shortage of specialized health workers. Our ethnographic observations show that psychiatric treatment can be ensured, notwithstanding these hurdles, if a public health perspective is assumed. In resource-limited settings, working in the field of mental health means putting oneself on the line, exposing oneself to new experiences, and reorganizing one's own skills and expertise. In the present article, we have used our clinical experience at a rehabilitation center in Fes as a case study and we have shown how to use peer therapy to overcome the drawbacks that we are encountered daily in a setting of limited resources.

INTEGRAL/IBIS observations of the Galactic center region at the epoch of the short Fermi/LAT flare

DEFF Research Database (Denmark)

Fiocchi, M.; Sanchez-Fernandez, C.; Natalucci, L.

2011-01-01

, the second one was selected because the source position was most optimal, i.e., about 6-8 degrees off-axis, the closest to the Galactic center region. The second slot is only a few hours apart from the Swift/XRT observation of SAX J1747.0-2853 (ATEL #3163), during which very bright emission from this source...

High Temporal Resolution Tropospheric Wind Profile Observations at NASA Kennedy Space Center During Hurricane Irma

Science.gov (United States)

Decker, Ryan K.; Barbre, Robert E., Jr.; Huddleston, Lisa; Brauer, Thomas; Wilfong, Timothy

2018-01-01

The NASA Kennedy Space Center (KSC) operates a 48-MHz Tropospheric/Stratospheric Doppler Radar Wind Profiler (TDRWP) on a continual basis generating wind profiles between 2-19 km in the support of space launch vehicle operations. A benefit of the continual operability of the system is the ability to provide unique observations of severe weather events such as hurricanes. Over the past two Atlantic Hurricane seasons the TDRWP has made high temporal resolution wind profile observations of Hurricane Irma in 2017 and Hurricane Matthew in 2016. Hurricane Irma was responsible for power outages to approximately 2/3 of Florida's population during its movement over the state(Stein,2017). An overview of the TDRWP system configuration, brief summary of Hurricanes Irma and Matthew storm track in proximity to KSC, characteristics of the tropospheric wind observations from the TDRWP during both events, and discussion of the dissemination of TDRWP data during the event will be presented.

Profile of European proton and carbon ion therapy centers assessed by the EORTC facility questionnaire.

Science.gov (United States)

Weber, Damien C; Abrunhosa-Branquinho, André; Bolsi, Alessandra; Kacperek, Andrzej; Dendale, Rémi; Geismar, Dirk; Bachtiary, Barbara; Hall, Annika; Heufelder, Jens; Herfarth, Klaus; Debus, Jürgen; Amichetti, Maurizio; Krause, Mechthild; Orecchia, Roberto; Vondracek, Vladimir; Thariat, Juliette; Kajdrowicz, Tomasz; Nilsson, Kristina; Grau, Cai

2017-08-01

We performed a survey using the modified EORTC Facility questionnaire (pFQ) to evaluate the human, technical and organizational resources of particle centers in Europe. The modified pFQ consisted of 235 questions distributed in 11 sections accessible on line on an EORTC server. Fifteen centers from 8 countries completed the pFQ between May 2015 and December 2015. The average number of patients treated per year and per particle center was 221 (range, 40-557). The majority (66.7%) of centers had pencil beam or raster scanning capability. Four (27%) centers were dedicated to eye treatment only. An increase in the patients-health professional FTE ratio was observed for eye tumor only centers when compared to other centers. All centers treated routinely chordomas/chondrosarcomas, brain tumors and sarcomas but rarely breast cancer. The majority of centers treated pediatric cases with particles. Only a minority of the queried institutions treated non-static targets. As the number of particle centers coming online will increase, the experience with this treatment modality will rise in Europe. Children can currently be treated in these facilities in a majority of cases. The majority of these centers provide state of the art particle beam therapy. Copyright © 2017 Elsevier B.V. All rights reserved.

Excitation of surface plasmon polariton modes with multiple nitrogen vacancy centers in single nanodiamonds

International Nuclear Information System (INIS)

Kumar, Shailesh; Lausen, Jens L; Andersen, Sebastian K H; Roberts, Alexander S; Radko, Ilya P; Bozhevolnyi, Sergey I; Garcia-Ortiz, Cesar E; Smith, Cameron L C; Kristensen, Anders

2016-01-01

Nitrogen-vacancy (NV) centers in diamonds are interesting due to their remarkable characteristics that are well suited to applications in quantum-information processing and magnetic field sensing, as well as representing stable fluorescent sources. Multiple NV centers in nanodiamonds (NDs) are especially useful as biological fluorophores due to their chemical neutrality, brightness and room-temperature photostability. Furthermore, NDs containing multiple NV centers also have potential in high-precision magnetic field and temperature sensing. Coupling NV centers to propagating surface plasmon polariton (SPP) modes gives a base for lab-on-a-chip sensing devices, allows enhanced fluorescence emission and collection which can further enhance the precision of NV-based sensors. Here, we investigate coupling of multiple NV centers in individual NDs to the SPP modes supported by silver surfaces protected by thin dielectric layers and by gold V-grooves (VGs) produced via the self-terminated silicon etching. In the first case, we concentrate on monitoring differences in fluorescence spectra obtained from a source ND, which is illuminated by a pump laser, and from a scattering ND illuminated only by the fluorescence-excited SPP radiation. In the second case, we observe changes in the average NV lifetime when the same ND is characterized outside and inside a VG. Fluorescence emission from the VG terminations is also observed, which confirms the NV coupling to the VG-supported SPP modes. (paper)

Excitation of surface plasmon polariton modes with multiple nitrogen vacancy centers in single nanodiamonds

Science.gov (United States)

Kumar, Shailesh; Lausen, Jens L.; Garcia-Ortiz, Cesar E.; Andersen, Sebastian K. H.; Roberts, Alexander S.; Radko, Ilya P.; Smith, Cameron L. C.; Kristensen, Anders; Bozhevolnyi, Sergey I.

2016-02-01

Nitrogen-vacancy (NV) centers in diamonds are interesting due to their remarkable characteristics that are well suited to applications in quantum-information processing and magnetic field sensing, as well as representing stable fluorescent sources. Multiple NV centers in nanodiamonds (NDs) are especially useful as biological fluorophores due to their chemical neutrality, brightness and room-temperature photostability. Furthermore, NDs containing multiple NV centers also have potential in high-precision magnetic field and temperature sensing. Coupling NV centers to propagating surface plasmon polariton (SPP) modes gives a base for lab-on-a-chip sensing devices, allows enhanced fluorescence emission and collection which can further enhance the precision of NV-based sensors. Here, we investigate coupling of multiple NV centers in individual NDs to the SPP modes supported by silver surfaces protected by thin dielectric layers and by gold V-grooves (VGs) produced via the self-terminated silicon etching. In the first case, we concentrate on monitoring differences in fluorescence spectra obtained from a source ND, which is illuminated by a pump laser, and from a scattering ND illuminated only by the fluorescence-excited SPP radiation. In the second case, we observe changes in the average NV lifetime when the same ND is characterized outside and inside a VG. Fluorescence emission from the VG terminations is also observed, which confirms the NV coupling to the VG-supported SPP modes.

Evaluation of a National Call Center and a Local Alerts System for Detection of New Cases of Ebola Virus Disease - Guinea, 2014-2015.

Science.gov (United States)

Lee, Christopher T; Bulterys, Marc; Martel, Lise D; Dahl, Benjamin A

2016-03-11

The epidemic of Ebola virus disease (Ebola) in West Africa began in Guinea in late 2013 (1), and on August 8, 2014, the World Health Organization (WHO) declared the epidemic a Public Health Emergency of International Concern (2). Guinea was declared Ebola-free on December 29, 2015, and is under a 90 day period of enhanced surveillance, following 3,351 confirmed and 453 probable cases of Ebola and 2,536 deaths (3). Passive surveillance for Ebola in Guinea has been conducted principally through the use of a telephone alert system. Community members and health facilities report deaths and suspected Ebola cases to local alert numbers operated by prefecture health departments or to a national toll-free call center. The national call center additionally functions as a source of public health information by responding to questions from the public about Ebola. To evaluate the sensitivity of the two systems and compare the sensitivity of the national call center with the local alerts system, the CDC country team performed probabilistic record linkage of the combined prefecture alerts database, as well as the national call center database, with the national viral hemorrhagic fever (VHF) database; the VHF database contains records of all known confirmed Ebola cases. Among 17,309 alert calls analyzed from the national call center, 71 were linked to 1,838 confirmed Ebola cases in the VHF database, yielding a sensitivity of 3.9%. The sensitivity of the national call center was highest in the capital city of Conakry (11.4%) and lower in other prefectures. In comparison, the local alerts system had a sensitivity of 51.1%. Local public health infrastructure plays an important role in surveillance in an epidemic setting.

Statistical Analysis of Sport Movement Observations: the Case of Orienteering

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Amouzandeh, K.; Karimipour, F.

2017-09-01

Study of movement observations is becoming more popular in several applications. Particularly, analyzing sport movement time series has been considered as a demanding area. However, most of the attempts made on analyzing movement sport data have focused on spatial aspects of movement to extract some movement characteristics, such as spatial patterns and similarities. This paper proposes statistical analysis of sport movement observations, which refers to analyzing changes in the spatial movement attributes (e.g. distance, altitude and slope) and non-spatial movement attributes (e.g. speed and heart rate) of athletes. As the case study, an example dataset of movement observations acquired during the "orienteering" sport is presented and statistically analyzed.

U.S. Geological Survey (USGS) Earth Resources Observation and Science (EROS) Center-Fiscal Year 2009 Annual Report

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Nelson, Janice S.

2010-01-01

The Earth Resources Observation and Science (EROS) Center is a U.S. Geological Survey (USGS) facility focused on providing science and imagery to better understand our Earth. As part of the USGS Geography Discipline, EROS contributes to the Land Remote Sensing (LRS) Program, the Geographic Analysis and Monitoring (GAM) Program, and the National Geospatial Program (NGP), as well as our Federal partners and cooperators. The work of the Center is shaped by the Earth sciences, the missions of our stakeholders, and implemented through strong program and project management and application of state-of-the-art information technologies. Fundamentally, EROS contributes to the understanding of a changing Earth through 'research to operations' activities that include developing, implementing, and operating remote sensing based terrestrial monitoring capabilities needed to address interdisciplinary science and applications objectives at all levels-both nationally and internationally. The Center's programs and projects continually strive to meet and/or exceed the changing needs of the USGS, the Department of the Interior, our Nation, and international constituents. The Center's multidisciplinary staff uses their unique expertise in remote sensing science and technologies to conduct basic and applied research, data acquisition, systems engineering, information access and management, and archive preservation to address the Nation's most critical needs. Of particular note is the role of EROS as the primary provider of Landsat data, the longest comprehensive global land Earth observation record ever collected. This report is intended to provide an overview of the scientific and engineering achievements and illustrate the range and scope of the activities and accomplishments at EROS throughout fiscal year (FY) 2009. Additional information concerning the scientific, engineering, and operational achievements can be obtained from the scientific papers and other documents published by

Early failure analysis of machining centers: a case study

International Nuclear Information System (INIS)

Wang Yiqiang; Jia Yazhou; Jiang Weiwei

2001-01-01

To eliminate the early failures and improve the reliability, nine ex-factory machining centers are traced under field conditions in workshops. Their early failure information throughout the ex-factory run-in test is collected. The field early failure database is constructed based on the collection of field early failure data and the codification of data. Early failure mode and effects analysis is performed to indicate the weak subsystem of a machining center or the troublemaker. The distribution of the time between early failures is analyzed and the optimal ex-factory run-in test time for machining center that may expose sufficiently the early failures and cost minimum is discussed. Suggestions how to arrange ex-factory run-in test and how to take actions to reduce early failures for machining center is proposed

Impact of Case Mix Severity on Quality Improvement in a Patient-centered Medical Home (PCMH) in the Maryland Multi-Payor Program.

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Khanna, Niharika; Shaya, Fadia T; Chirikov, Viktor V; Sharp, David; Steffen, Ben

2016-01-01

We present data on quality of care (QC) improvement in 35 of 45 National Quality Forum metrics reported annually by 52 primary care practices recognized as patient-centered medical homes (PCMHs) that participated in the Maryland Multi-Payor Program from 2011 to 2013. We assigned QC metrics to (1) chronic, (2) preventive, and (3) mental health care domains. The study used a panel data design with no control group. Using longitudinal fixed-effects regressions, we modeled QC and case mix severity in a PCMH. Overall, 35 of 45 quality metrics reported by 52 PCMHs demonstrated improvement over 3 years, and case mix severity did not affect the achievement of quality improvement. From 2011 to 2012, QC increased by 0.14 (P case mix severity did not correlate with QC. In multivariate analyses, higher QC correlated with larger practices, greater proportion of older patients, and readmission visits. Rural practices had higher proportions of Medicaid patients, lower QC, and higher QC improvement in interaction analyses with time. The gains in QC in the chronic disease domain, the preventive care domain, and, most significantly, the mental health care domain were observed over time regardless of patient case mix severity. QC improvement was generally not modified by practice characteristics, except for rurality. © Copyright 2016 by the American Board of Family Medicine.

The Application of Barnes Filter to Positioning the Center of Landed Tropical Cyclone in Numerical Models

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Haibo Zou

2018-01-01

Full Text Available After a tropical cyclone (TC making landfall, the numerical model output sea level pressure (SLP presents many small-scale perturbations which significantly influence the positioning of the TC center. To fix the problem, Barnes filter with weighting parameters C=2500 and G=0.35 is used to remove these perturbations. A case study of TC Fung-Wong which landed China in 2008 shows that Barnes filter not only cleanly removes these perturbations, but also well preserves the TC signals. Meanwhile, the centers (track obtained from SLP processed with Barnes filter are much closer to the observations than that from SLP without Barnes filter. Based on the distance difference (DD between the TC center determined by SLP with/without Barnes filter and observation, statistics analysis of 12 TCs which landed China during 2005–2015 shows that in most cases (about 85% the DDs are small (between −30 km and 30 km, while in a few cases (about 15% the DDs are large (greater than 30 km even 70 km. This further verifies that the TC centers identified from SLP with Barnes filter are more accurate compared to that directly obtained from model output SLP. Moreover, the TC track identified with Barnes filter is much smoother than that without Barnes filter.

White centered retinal hemorrhages in vitamin b(12) deficiency anemia.

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Zehetner, Claus; Bechrakis, Nikolaos E

2011-05-01

To report a case of severe vitamin B(12) deficiency anemia presenting with white centered retinal hemorrhages. Interventional case report. A 40-year-old man, general practitioner himself, presented with a 1-day history of diminished left visual acuity and a drop-shaped central scotoma. The corrected visual acuities were 20/20, OD and 20/100, OS. Ophthalmic examination revealed bilaterally pale tarsal conjunctiva, discretely icteric bulbar conjunctiva and disseminated white centered intraretinal hemorrhages with foveal involvement. OCT imaging through these lesions revealed a retinal thickening caused by a sub-ILM accumulation of hyperreflective and inhomogeneous deposits within the nerve fiber layer. Immediate laboratory work-up showed severe megaloblastic anemia caused by vitamin B(12) deficiency requiring erythrocyte transfusions. Most reports of white centered retinal hemorrhages have been described in patients with leukemic retinopathy and bacterial endocarditis. It is interesting that this case of vitamin B(12) deficiency anemia retinopathy has a clinically indistinguishable fundus appearance. This is probably due to the common pathology of capillary disruption and subsequent hemostatic fibrin plug formation. In megaloblastic anemia, direct anoxia results in endothelial dysfunction. The loss of impermeability allows extrusion of whole blood and subsequent diffusion from the disrupted site throughout and above the nerve fiber layer. Therefore the biomicroscopic pattern of white centered hemorrhages observed in anemic retinopathy is most likely due to the clot formation as the reparative sequence after capillary rupture.

White Centered Retinal Hemorrhages in Vitamin B12 Deficiency Anemia

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Claus Zehetner

2011-05-01

Full Text Available Background: To report a case of severe vitamin B12 deficiency anemia presenting with white centered retinal hemorrhages. Methods: Interventional case report. Results: A 40-year-old man, general practitioner himself, presented with a 1-day history of diminished left visual acuity and a drop-shaped central scotoma. The corrected visual acuities were 20/20, OD and 20/100, OS. Ophthalmic examination revealed bilaterally pale tarsal conjunctiva, discretely icteric bulbar conjunctiva and disseminated white centered intraretinal hemorrhages with foveal involvement. OCT imaging through these lesions revealed a retinal thickening caused by a sub-ILM accumulation of hyperreflective and inhomogeneous deposits within the nerve fiber layer. Immediate laboratory work-up showed severe megaloblastic anemia caused by vitamin B12 deficiency requiring erythrocyte transfusions. Discussion: Most reports of white centered retinal hemorrhages have been described in patients with leukemic retinopathy and bacterial endocarditis. It is interesting that this case of vitamin B12 deficiency anemia retinopathy has a clinically indistinguishable fundus appearance. This is probably due to the common pathology of capillary disruption and subsequent hemostatic fibrin plug formation. In megaloblastic anemia, direct anoxia results in endothelial dysfunction. The loss of impermeability allows extrusion of whole blood and subsequent diffusion from the disrupted site throughout and above the nerve fiber layer. Therefore the biomicroscopic pattern of white centered hemorrhages observed in anemic retinopathy is most likely due to the clot formation as the reparative sequence after capillary rupture.

Person-centered methods configural frequency analysis (CFA) and other methods for the analysis of contingency tables

CERN Document Server

Stemmler, Mark

2014-01-01

This book takes an easy-to-understand look at the statistical approach called the person-centered method. Instead of analyzing means, variances and covariances of scale scores as in the common variable-centered approach, the person-centered approach analyzes persons or objects grouped according to their characteristic patterns or configurations in contingency tables. The main focus of the book will be on Configural Frequency Analysis (CFA; Lienert and Krauth, 1975) which is a statistical method that looks for over and under-frequented cells or patterns. Over frequented means that the observations in this cell or configuration are observed more often than expected, under-frequented means that this cell or configuration is observed less often than expected. In CFA a pattern or configuration that contains more observed cases than expected is called a type; similarly, a pattern or configuration that is less observed than expected are called an antitype. CFA is similar to log-linear modeling. In log-linear modelin...

Color centers inside crystallic active media

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Mierczyk, Zygmunt; Kaczmarek, Slawomir M.; Kopczynski, Krzysztof

1995-03-01

This paper presents research results on color centers induced by radiation of a xenon lamp in non doped crystals of yttrium aluminum garnet Y3Al5O12 (YAG), strontium- lanthanum aluminate SrLaAlO4 (SLAO), strontium-lanthanum gallate SrLaGa3O7 (SLGO), and in doped crystals: Nd:YAG, Cr, Tm, Ho:YAG (CTH:YAG), Nd:SLAO and Nd:SLGO. In all these investigated crystals under the influence of intensive exposure by xenon lamp radiation additional bands connected with centers O-2, O2 and centers F came up near the short-wave absorption edge. In the case of doped crystals the observed processes are much more complicated. In crystals CTH:YAG the greatest perturbations in relation to basic state are present at the short-wave absorption edge, as well as on areas of absorption bands of ions Cr+3 and Tm+3 conditioning the sensibilization process of ions Ho+3. These spectral structure disturbances essentially influence the efficiency of this process, as proven during generating investigations. In the case of SrLaGa3O7:Nd+3 under the influence of exposure substantial changes of absorption spectrum occurred on spectral areas 346 divided by 368 nm, 429 divided by 441 nm and 450 divided by 490 nm. Those changes have an irreversible character. They disappear not before the plate is being held at oxidizing atmosphere. Investigations of laser rods Nd:SLGO, CTH:YAG, and Nd:YAG in a free generation demonstrated that the color centers of these crystals are induced by pomp radiation from the spectral area up to 450 nm.

Symphony: A case study for exploring and describing design methods and guidelines for learner-centered design

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Quintana, Christopher

Learner-centered design is an evolving software design perspective addressing the needs of learners---a specific audience trying to work in and understand new work practices in which they have a novice or naive understanding. Learner-centered design involves designing software that incorporates work support features (or scaffolding features) informed by social constructivist learning theories. By adopting a constructivist "learning by doing" perspective, scaffolds should support learners so they can mindfully engage in previously inaccessible work activity, which in turn allows those learners to progressively gain a better understanding of the new work. While there is an intuitive notion of "learner-centered design", there is less specific design information for developing learner-centered software. As a result, learner-centered software results from "educated guesses" and ad-hoc design approaches rather than from systematic design methods. Thus there is a need for specific design guidance to facilitate the development of learner-centered tools that help learners see the tasks, terminology, tools, etc. in the new work context and engage in that work. The research in this dissertation provides a more specific base of learner-centered design descriptions, methods, and guidelines to analyze work practices and design and evaluate scaffolds. The research approach involves using the development of Symphony---a scaffolded integrated tool environment for high-school students learning the work of computational science inquiry---as a case study to develop the learner-centered design approach. Symphony incorporates a variety of science tools with process scaffolding to support students in performing complex air pollution investigations. Six ninth-grade students used Symphony to investigate air quality questions for several weeks in an environmental science class. The student testing helped assess the effectiveness of the software scaffolding and in turn, the learner-centered

STATISTICAL ANALYSIS OF SPORT MOVEMENT OBSERVATIONS: THE CASE OF ORIENTEERING

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K. Amouzandeh

2017-09-01

Full Text Available Study of movement observations is becoming more popular in several applications. Particularly, analyzing sport movement time series has been considered as a demanding area. However, most of the attempts made on analyzing movement sport data have focused on spatial aspects of movement to extract some movement characteristics, such as spatial patterns and similarities. This paper proposes statistical analysis of sport movement observations, which refers to analyzing changes in the spatial movement attributes (e.g. distance, altitude and slope and non-spatial movement attributes (e.g. speed and heart rate of athletes. As the case study, an example dataset of movement observations acquired during the “orienteering” sport is presented and statistically analyzed.

KECK OBSERVATIONS OF THE GALACTIC CENTER SOURCE G2: GAS CLOUD OR STAR?

Energy Technology Data Exchange (ETDEWEB)

Phifer, K.; Meyer, L.; Ghez, A. M.; Witzel, G.; Yelda, S.; Boehle, A.; Morris, M. R.; Becklin, E. E. [Department of Physics and Astronomy, University of California, Los Angeles, CA 90095 (United States); Do, T. [Dunlap Institute for Astronomy and Astrophysics, University of Toronto, Toronto, Ontario, M5S 3H4 (Canada); Lu, J. R. [Institute for Astronomy, University of Hawaii, Hilo, HI 96720 (United States); Matthews, K., E-mail: ghez@astro.ucla.edu [Division of Physics, Mathematics, and Astronomy, California Institute of Technology, Pasadena, CA 91125 (United States)

2013-08-10

We present new observations and analysis of G2-the intriguing red emission-line object which is quickly approaching the Galaxy's central black hole. The observations were obtained with the laser guide star adaptive optics systems on the W. M. Keck I and II telescopes (2006-2012) and include spectroscopy (R {approx} 3600) centered on the hydrogen Br{gamma} line as well as K' (2.1 {mu}m) and L' (3.8 {mu}m) imaging. Analysis of these observations shows the Br{gamma} line emission has a positional offset from the L' continuum. This offset is likely due to background source confusion at L'. We therefore present the first orbital solution derived from Br{gamma} line astrometry, which, when coupled with radial velocity measurements, results in a later time of closest approach (2014.21 {+-} 0.14), closer periastron (130 AU, 1600 R{sub s}), and higher eccentricity (0.9814 {+-} 0.0060) compared to a solution using L' astrometry. It is shown that G2 has no K' counterpart down to K' {approx} 20 mag. G2's L' continuum and the Br{gamma} line emission appears unresolved in almost all epochs, which implies that the bulk of the emission resides in a compact region. The observations altogether suggest that while G2 has a gaseous component that is tidally interacting with the central black hole, there is likely a central star providing the self-gravity necessary to sustain the compact nature of this object.

ALMA Observations of Molecular Clouds in Three Group-centered Elliptical Galaxies: NGC 5846, NGC 4636, and NGC 5044

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Temi, Pasquale; Amblard, Alexandre; Gitti, Myriam; Brighenti, Fabrizio; Gaspari, Massimo; Mathews, William G.; David, Laurence

2018-05-01

We present new ALMA CO(2–1) observations of two well-studied group-centered elliptical galaxies: NGC 4636 and NGC 5846. In addition, we include a revised analysis of Cycle 0 ALMA observations of the central galaxy in the NGC 5044 group. We find evidence that molecular gas is a common presence in bright group-centered galaxies (BGG). CO line widths are broader than Galactic molecular clouds, and using the reference Milky Way X CO, the total molecular mass ranges from 2.6 × 105 M ⊙ in NGC 4636 to 6.1 × 107 M ⊙ in NGC 5044. Complementary observations using the ALMA Compact Array do not exhibit any detection of a CO diffuse component at the sensitivity level achieved by current exposures. The origin of the detected molecular features is still uncertain, but these ALMA observations suggest that they are the end product of the hot gas cooling process and not the result of merger events. Some of the molecular clouds are associated with dust features as revealed by HST dust extinction maps, suggesting that these clouds formed from dust-enhanced cooling. The global nonlinear condensation may be triggered via the chaotic turbulent field or buoyant uplift. The large virial parameter of the molecular structures and correlation with the warm ({10}3{--}{10}5 {{K}})/hot (≥106) phase velocity dispersion provide evidence that they are unbound giant molecular associations drifting in the turbulent field, consistent with numerical predictions of the chaotic cold accretion process. Alternatively, the observed large CO line widths may be generated by molecular gas flowing out from cloud surfaces due to heating by the local hot gas atmosphere.

Case Descriptions and Observations About Cutis Marmorata From Hypobaric Decompressions

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Conkin, Johnny; Pilmanis, Andrew A.; Webb, James T.

2002-01-01

There is disagreement about the pathophysiology, classification, and treatment of cutis marmorata (CM), so there is disagreement about the disposition and medical status of a person that had CM. CM is rare, associated with stressful decompressions, and may be associated with serious signs and symptoms of decompression sickness (DCS). CM presents as purple or bluish-red skin mottling, often in the pectoral region, shoulders, chest, or upper abdomen. It is unethical to induce CM in humans so all information comes from retrospective analysis of case reports, or from animal models. A literature search, seven recent case reports from the Johnson Space Center and Brooks Air Force Base Hypobaric DCS Databases, interviews with DCS treatment experts, and responses to surveys provided the factual information used to arrive at our conclusions and recommendations. The "weight of evidence" indicates that CM is a local, not centrally mediated or systemic response to bubbles. It is unclear whether obstruction of arterial or venous blood flow is the primary insult since the lesion is reported under either condition. Any neurological or cardiovascular involvements are coincidental, developing along the same time course. The skin could be the source of the bubbles due to its mass, the associated layer of fat, and the variable nature of skin blood flow. CM should not be categorized as Type II DCS, should be included with other skin manifestations in a category called cutaneous DCS, and hyperbaric treatment is only needed if ground level oxygen is ineffective in the case of altitude-induced CM.

Using secure web services to visualize poison center data for nationwide biosurveillance: a case study.

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Savel, Thomas G; Bronstein, Alvin; Duck, William; Rhodes, M Barry; Lee, Brian; Stinn, John; Worthen, Katherine

2010-01-01

Real-time surveillance systems are valuable for timely response to public health emergencies. It has been challenging to leverage existing surveillance systems in state and local communities, and, using a centralized architecture, add new data sources and analytical capacity. Because this centralized model has proven to be difficult to maintain and enhance, the US Centers for Disease Control and Prevention (CDC) has been examining the ability to use a federated model based on secure web services architecture, with data stewardship remaining with the data provider. As a case study for this approach, the American Association of Poison Control Centers and the CDC extended an existing data warehouse via a secure web service, and shared aggregate clinical effects and case counts data by geographic region and time period. To visualize these data, CDC developed a web browser-based interface, Quicksilver, which leveraged the Google Maps API and Flot, a javascript plotting library. Two iterations of the NPDS web service were completed in 12 weeks. The visualization client, Quicksilver, was developed in four months. This implementation of web services combined with a visualization client represents incremental positive progress in transitioning national data sources like BioSense and NPDS to a federated data exchange model. Quicksilver effectively demonstrates how the use of secure web services in conjunction with a lightweight, rapidly deployed visualization client can easily integrate isolated data sources for biosurveillance.

Implementation of case studies in undergraduate didactic nursing courses: a qualitative study.

Science.gov (United States)

Dutra, Danette K

2013-07-04

The implementation of unfolding scenario-based case studies in the didactic classroom is associated with learner-centered education. The utilization of learner-centered pedagogies, such as case studies, removes the focus from the instructor and instead places it on the student. Learner-centered pedagogies are believed to improve students' levels of cognition. The purpose of this study was to examine how nurse educators are implementing the pedagogies of case studies in their undergraduate didactic courses. The goal was to examine, document, report, and, ultimately, implement the strategies. Purposeful sampling was utilized in this qualitative, multisite-designed study. For each of the four participants, three separate site visits were completed. Observations and post-observational interviews took place at each site visit. Transcribed data from interviews, observations, and course documents were imported into the computer program Nvivo8. Repetitive comparative analysis was utilized to complete the data coding process. The guiding research question of this study sought to investigate the implementation strategies of case studies in didactic nursing courses. The implementation of case studies by the participants reflected two primary patterns: Formal Implementation (FI) and Informal Implementation (II) of case studies. The FI of case studies was further divided into two subcategories: Formal Implementation of case studies used Inside the Classroom setting (FIIC) and Formal Implementation of cases studies used Outside of the Classroom (FIOC). Results of this investigation have led to an increased understanding of implementation strategies of unfolding scenario-based case studies in undergraduate nursing didactic courses. Data collected were rich in the description of specific methodologies for utilization of case studies and may serve as a resource for faculty in development of creative strategies to enhance the didactic classroom experience.

Hematological observations on two cases of acute radiation syndrome

International Nuclear Information System (INIS)

Jiang Benrong; Wang Guilin; Huang Shimin

1990-01-01

The hematological changes of two cases of acute radiation syndrome were observed. The physical doses of patients Liang and Yan were 3.5 Gy and 2.6 Gy respectively. According to the changes in WBC and platelet counts and the absolute count of lymphocytes and in comparison with the hematological data of the victims of Y-12 accident in USA in 1958 and those of previous accidents in China, Liang suffered from a moderate or moderate to severe degree, and Yan suffered from a moderate or moderate mild degree of hemopoietic form of acute radiation syndrome. This estimation was consistent with their clinical course and physical doses. Some blood cells appeared in the cytoplasm of megakaryocytes in bone marrow smears of those two cases. The mechanism of this phenomenon is discussed and its clinical significance remains to be studied

AN OBSERVATIONAL STUDY OF MATERNAL NEAR MISS CASES IN A TERTIARY CARE CENTRE

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Elizabeth Joseph

2016-12-01

Full Text Available BACKGROUND DM WIMS is the only tertiary care referral hospital in the hilly tribal district of Wayanad. This is an observational study of 20 maternal near miss cases that presented in our hospital over a period of 4 months. MATERIALS AND METHODS This study was conducted by collecting data over a period of 4 months. Total number of live births in this period was 373. There were 20 cases of maternal near miss cases. Maternal near miss cases were chosen based on the inclusion criteria provided by WHO near miss approach for maternal health. RESULTS There were 373 live births in the 4-month observational period. In these 4 months, there were 20 cases of maternal near miss cases in our hospital. That is, maternal near miss ratio was 53.6/1000 live births. The majority were referred cases with MNM ratio of intrahospital cases being 13.4/1000 live births. The potentially life-threatening complications were obstetric haemorrhage and hypertensive disorders, which coexisted in majority of the women. The obstetric haemorrhage was mainly due to abruptio placenta, which can be attributed to the hypertensive complications. Preexisting anaemia was present in 35% of the MNM cases increasing their morbidity. CONCLUSION The maternal near miss ratio was 53.6/1000 live births, which is high. This can be attributed to the fact that our hospital is the only tertiary referral hospital in the hilly tribal district of Wayanad. Despite the MNM ratio being high, there were no cases of maternal death in this period. Low maternal mortality indicates the good first line of management given at the periphery hospital.

Viral Hepatitis A in 108 Adult Patients During an Eight-Year Observation at a Single Center in Poland.

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Bura, Maciej; Michalak, Michał; Chojnicki, Michał K; Kowala-Piaskowska, Arleta; Mozer-Lisewska, Iwona

2015-01-01

Hepatitis A is related to significant morbidity and occasional mortality. Based on data from the Polish National Institute of Hygiene, from 2000 to 2013 a mean of 213 hepatitis A cases were reported yearly. The aim of the study was to assess selected data in adults hospitalized for symptomatic hepatitis A during an eight-year period in a single center in the Wielkopolska Region of Poland. All the hepatitis A patients hospitalized in the center from 2005 to 2013 were analyzed retrospectively. Data were extracted from the medical records of these individuals. The disease was confirmed by anti-HAV IgM testing. In total, 108 patients (71 men and 37 women), aged 18-65 years, were identified. All but 1 patient recovered (99.1%) and in 6 cases (5.6%) a relapse occurred. Risk factors for hepatitis A were identified in 56 patients (52%), with travel abroad being the most common one (32 patients); 19 cases were secondary and 5 patients were men who have sex with men. One hepatitis A outbreak was noted in the region during the study period. Acalculous cholecystitis was found in 33.3% of the patients who underwent abdominal ultrasound. This tended to be more common among older individuals (47.8% in patients over 40 vs. 22.6% in patients aged 18-40, p=0.0521). Patients with this finding had significantly higher mean peak ALT in comparison to those with no gallbladder abnormalities. Although hepatitis A in adults is typically a benign, self-limited disease, it can occasionally have a fatal course. In a significant proportion of patients with an evident risk factor for hepatitis A, the possibility of active prophylaxis was not used. Hepatitis A should be regarded as a sexually transmitted infection. Acalculous cholecystitis is a frequent finding among adults with symptomatic hepatitis A.

Employee health benefit redesign at the academic health center: a case study.

Science.gov (United States)

Marshall, Julie; Weaver, Deirdre C; Splaine, Kevin; Hefner, David S; Kirch, Darrell G; Paz, Harold L

2013-03-01

The rapidly escalating cost of health care, including the cost of providing health care benefits, is a significant concern for many employers. In this article, the authors examine a case study of an academic health center that undertook a complete redesign of its health benefit structure to control rising costs, encourage use of its own provider network, and support employee wellness. With the implementation in 2006 of a high-deductible health plan combined with health reimbursement arrangements and wellness incentives, the Penn State Hershey Medical Center (PSHMC) was able to realize significant cost savings and increase use of its own network while maintaining a high level of employee satisfaction. By contracting with a single third-party administrator for its self-insured plan, PSHMC reduced its administrative costs and simplified benefit choices for employees. In addition, indexing employee costs to salary ensured that this change was equitable for all employees, and the shift to a consumer-driven health plan led to greater employee awareness of health care costs. The new health benefit plan's strong focus on employee wellness and preventive health has led to significant increases in the use of preventive health services, including health risk assessments, cancer screenings, and flu shots. PSHMC's experience demonstrates the importance of clear and ongoing communication with employees throughout--before, during, and even after--the process of health benefit redesign.

Epidemiology of volatile substance abuse (VSA) cases reported to US poison centers.

Science.gov (United States)

Spiller, Henry A

2004-01-01

Volatile substance abuse (VSA) is believed to be widespread. The Toxic Exposure Surveillance System (TESS) of the American Association of Poison Control Systems offers an opportunity to evaluate the epidemiology of volatile substance abuse using a data set that captures data from a large geographic area covering a wide-ranging group of socioeconomic strata, ethnic groups, and demographics. To utilize this potential we analyzed a data set of TESS for the 6-year period of 1996 through 2001 involving all cases of intentional inhalational abuse of nonpharmaceutical substances. Over the study period there was a mean annual decline of 9% of reported VSA with an overall decline of 37% from 1996 to 2001. Volatile substance abuse was reported primarily in children, with 6358 cases (54%) in children 13-19 yr and 1803 (15%) cases in children 6-12 yr. Fifty-two cases were reported in children air fresheners (6%), and formalin (5%). Three categories were responsible for the majority of deaths: gasoline (45%), air fresheners (26%), and propane/butane (11%). While there was a decline in reported cases, there was no decline in major outcomes or fatalities. Volatile substance abuse was reported in all 50 states, with case distribution similar to population distribution. However, seven states had > 2 times the expected rate based on their population; three western states, two midwestern states, and two Appalachian states. The role of urban vs. rural population may possibly explain the difference in numbers, with a greater incidence of VSA cases reported in states with large rural populations. The mean monthly occurrence rate was 162 VSA cases/month (S.D. +/- 10.85). There were 4 months that were > 2 standard deviations from the mean, with two peak months (May, 192/month and March, 187/month) and two trough months (December, 126/month and January, 137/month). This report presents a broad picture of VSA in the United States. Volatile substance abuse, as reported to U.S. poison centers

Computed tomography-guided core-needle biopsy of lung lesions: an oncology center experience

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Guimaraes, Marcos Duarte; Fonte, Alexandre Calabria da; Chojniak, Rubens, E-mail: marcosduarte@yahoo.com.b [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. of Radiology and Imaging Diagnosis; Andrade, Marcony Queiroz de [Hospital Alianca, Salvador, BA (Brazil); Gross, Jefferson Luiz [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. of Chest Surgery

2011-03-15

Objective: The present study is aimed at describing the experience of an oncology center with computed tomography guided core-needle biopsy of pulmonary lesions. Materials and Methods: Retrospective analysis of 97 computed tomography-guided core-needle biopsy of pulmonary lesions performed in the period between 1996 and 2004 in a Brazilian reference oncology center (Hospital do Cancer - A.C. Camargo). Information regarding material appropriateness and the specific diagnoses were collected and analyzed. Results: Among 97 lung biopsies, 94 (96.9%) supplied appropriate specimens for histological analyses, with 71 (73.2%) cases being diagnosed as malignant lesions and 23 (23.7%) diagnosed as benign lesions. Specimens were inappropriate for analysis in three cases. The frequency of specific diagnosis was 83 (85.6%) cases, with high rates for both malignant lesions with 63 (88.7%) cases and benign lesions with 20 (86.7%). As regards complications, a total of 12 cases were observed as follows: 7 (7.2%) cases of hematoma, 3 (3.1%) cases of pneumothorax and 2 (2.1%) cases of hemoptysis. Conclusion: Computed tomography-guided core needle biopsy of lung lesions demonstrated high rates of material appropriateness and diagnostic specificity, and low rates of complications in the present study. (author)

Analysis of the Service Quality of Medical Centers Using Servqual Model (Case:Shaheed Rahnemoon Hospital

Directory of Open Access Journals (Sweden)

H Zare Ahmadabadi

2007-07-01

Full Text Available Introduction: Many organizations, especially service oriented ones, relative to their goals and mission, have a special view towards quality phenomena and its management. Methods: This paper analyzes medical service quality in one case; The internal section of Shaheed Rahnemoon Hospital Based on the basis of gap analysis model and Servqual technique. A questionnaire was designed and applied to measure expectations and perceptions of patients and personnel of the hospital. Results: On application of non-parametric statistical tests, we propose certain recommendations. These tests drive on five conceptual dimensions of service quality including intangibility, responsiveness, reliability, assurance and empathy. Results show that patients in this section were satisfied from the service provider’s responsiveness, but there are significant differences between expectations and perceptions in other dimensions. Conclusion: The service quality analysis models are useful for managers of medical centers to distinguish gaps between the two sides of service representation; patients and medical centers personnel. Ultimately, they can reinforce strengths and control weaknesses.

[Pheochromocytoma in 8-year observation at a single endocrinological center in Wroclaw].

Science.gov (United States)

Bednarek-Tupikowska, Grazyna; Bucyk, Barbara; Daroszewski, Jacek; Bidzińska-Speichert, Bozena; Bohdanowicz-Pawlak, Anna; Szymczak, Jadwiga; Bednorz, Włodzimierz; Podgórski, Franciszek; Zareba-Bogdał, Elzbieta; Kuliczkowska-Płaksej, Justyna; Lenarcik, Agnieszka; Filus, Alicja; Kałuzny, Marcin; Kubicka, Eliza; Syrycka, Joanna; Tupikowska, Małgorzata; Lizurej, Oskar; Bolanowski, Marek; Milewicz, Andrzej

2009-01-01

Pheochromocytoma is rare tumor with a highly variable clinical presentation. This report provides clinical picture, efficiency of diagnostics and treatment of pheochromocytoma in 8-years in the endocrinological center in Wroclaw. The records of 37 patients with pheochromocytoma were identified, who were treated in 2000-2007 in the Department of Endocrinology, Diabetology and Isotope Treatment in Wroclaw. There were 23 women (age 23-75 year) and 14 men (age 17-74). We studied frequency of clinical signs, usefulness of diagnostic methods and efficacy of treatment. The duration of the clinical history ranged from 2 months to 16 years. The most frequent symptoms were: hypertension paroxysmal and constant, palpitations, headache, sweating and anxiety. The most sensitive diagnostic method was increased concentration of urinary metanephrine in 24-hour urine. Computed tomography was the most widely used method for tumor localization. Adrenal pheochromocytoma was detecting by CT in all patients, predominated in right adrenal, in 1 case in urinary bladder. Surgery caused remission of hypertension in 59%, improvement in 26.8%, and no changes in 13.9% of patients. Malignancy was reported in 2 cases, 1 woman died after surgery. MEN 2A occur in 21.6%. The diagnosis of pheochromocytma is usually made after long duration of the disease. The study confirms that clinical presentation of pheochromocytoma is variable and nonspecific, this finding makes the diagnosis very difficult. The most typical symptom is paroxysmal hypertension, which is present only in 40%, other symptoms are nonspecific. The measurement of 24-hour urinary metanephrines was the best indicator. CT was almost always successful in localizing the tumor. Patients with pheochromocytoma should be consider for other endocrine diseases especially medullary carcinoma, primary hyperparathyroidism and other component of MEN 2A.

Vaginismus in Assisted Reproductive Technology Centers: an invisible population in need of care.

Science.gov (United States)

Souza, Maria do Carmo B de; Gusmão, Marcia C G; Antunes, Roberto A; Souza, Marcelo M de; Rito, Ana L S; Lira, Paloma; Mancebo, Ana C A; Tamm, Maria A; Panaino, Tatiana R; Bahia, Maria J

2018-03-01

Genital and sexual pain is still neglected. Consequences may be dramatic, since infertility and sexual dysfunction may be reciprocally linked. This is the first study to focus on the identification of cases of vaginismus in the ART scenario and on the introduction of intra-cycle interventions as part of a comprehensive, integrated and patient-centered perspective. This observational prospective study looked into 425 IVF/ICSI cycles and 226 frozen embryo transfers carried out from January 1, 2015 to December 31, 2016, and found seven cases of vaginismus. Within a six-month period, a questionnaire placed on SurveyMonkey was sent twice to 228 ART centers in Latin America. The purpose was to learn how often cases of vaginismus were found in ART centers and the perceptions around the presence of this condition. The few centers that took the time to answer the questionnaire (24/10.5%) stated that the number of cases in which they had trouble performing control ultrasound examination or needed to perform transfers with patients under sedation was not significant. Although 81% agreed that the incidence of these conditions is low, no references were made to cases of vaginismus, dyspareunia or sexual dysfunction. Our multidisciplinary team found seven cases of vaginismus, involving women with higher education degrees with a mean age of 37.8 years and married for a mean of four years. Although two reported they were able to tolerate intercourse, all reported undergoing treatments such as using vaginal dilators (3), psychotherapy (4) and psychiatric care (1). The care provided by the staff was designed to mitigate patient suffering. Gentle care and sensitive listening should be integral components in the work of multidisciplinary teams to identify women with vaginismus and offer couples better quality treatment.

Computer aided detection of masses in mammography using subregion Hotelling observers

International Nuclear Information System (INIS)

Baydush, Alan H.; Catarious, David M.; Abbey, Craig K.; Floyd, Carey E.

2003-01-01

We propose to investigate the use of the subregion Hotelling observer for the basis of a computer aided detection scheme for masses in mammography. A database of 1320 regions of interest (ROIs) was selected from the DDSM database collected by the University of South Florida using the Lumisys scanner cases. The breakdown of the cases was as follows: 656 normal ROIs, 307 benign ROIs, and 357 cancer ROIs. Each ROI was extracted at a size of 1024x1024 pixels and subsampled to 128x128 pixels. For the detection task, cancer and benign cases were considered positive and normal was considered negative. All positive cases had the lesion centered in the ROI. We chose to investigate the subregion Hotelling observer as a classifier to detect masses. The Hotelling observer incorporates information about the signal, the background, and the noise correlation for prediction of positive and negative and is the optimal detector when these are known. For our study, 225 subregion Hotelling observers were set up in a 15x15 grid across the center of the ROIs. Each separate observer was designed to 'observe', or discriminate, an 8x8 pixel area of the image. A leave one out training and testing methodology was used to generate 225 'features', where each feature is the output of the individual observers. The 225 features derived from separate Hotelling observers were then narrowed down by using forward searching linear discriminants (LDs). The reduced set of features was then analyzed using an additional LD with receiver operating characteristic (ROC) analysis. The 225 Hotelling observer features were searched by the forward searching LD, which selected a subset of 37 features. This subset of 37 features was then analyzed using an additional LD, which gave a ROC area under the curve of 0.9412+/-0.006 and a partial area of 0.6728. Additionally, at 98% sensitivity the overall classifier had a specificity of 55.9% and a positive predictive value of 69.3%. Preliminary results suggest that

Evaluation of a National Call Center and a Local Alerts System for Detection of New Cases of Ebola Virus Disease - Guinea, 2014-2015

Science.gov (United States)

2016-03-11

call centers were established in response to the Ebola epidemic in Guinea, Liberia , and Sierra Leone, the sensitivity of those call centers for...Control and Prevention Evaluation of a National Call Center and a Local Alerts System for Detection of New Cases of Ebola Virus Disease — Guinea, 2014...2015 Christopher T. Lee, MD1,2,3; Marc Bulterys, MD, PhD2,4,5; Lise D. Martel, PhD2,6; Benjamin A. Dahl PhD2,5 The epidemic of Ebola virus disease ( Ebola

The IRIS Data Management Center: Enabling Access to Observational Time Series Spanning Decades

Science.gov (United States)

Ahern, T.; Benson, R.; Trabant, C.

2009-04-01

The Incorporated Research Institutions for Seismology (IRIS) is funded by the National Science Foundation (NSF) to operate the facilities to generate, archive, and distribute seismological data to research communities in the United States and internationally. The IRIS Data Management System (DMS) is responsible for the ingestion, archiving, curation and distribution of these data. The IRIS Data Management Center (DMC) manages data from more than 100 permanent seismic networks, hundreds of temporary seismic deployments as well as data from other geophysical observing networks such as magnetotelluric sensors, ocean bottom sensors, superconducting gravimeters, strainmeters, surface meteorological measurements, and in-situ atmospheric pressure measurements. The IRIS DMC has data from more than 20 different types of sensors. The IRIS DMC manages approximately 100 terabytes of primary observational data. These data are archived in multiple distributed storage systems that insure data availability independent of any single catastrophic failure. Storage systems include both RAID systems of greater than 100 terabytes as well as robotic tape robots of petabyte capacity. IRIS performs routine transcription of the data to new media and storage systems to insure the long-term viability of the scientific data. IRIS adheres to the OAIS Data Preservation Model in most cases. The IRIS data model requires the availability of metadata describing the characteristics and geographic location of sensors before data can be fully archived. IRIS works with the International Federation of Digital Seismographic Networks (FDSN) in the definition and evolution of the metadata. The metadata insures that the data remain useful to both current and future generations of earth scientists. Curation of the metadata and time series is one of the most important activities at the IRIS DMC. Data analysts and an automated quality assurance system monitor the quality of the incoming data. This insures data

Marketing Management and Cultural Learning Center: The Case Study of Arts and Cultural Office, Suansunandha Rajabhat University

OpenAIRE

Pirada Techaratpong

2014-01-01

This qualitative research has 2 objectives: to study marketing management of the cultural learning center in Suansunandha Rajabhat University and to suggest guidelines to improve its marketing management. This research is based on a case study of the Arts and Culture Office in Suansunandha Rajabhat University, Bangkok. This research found the Art and Culture Office has no formal marketing management. However, the marketing management is partly covered in the overall bu...

Observation of e(+)e(-) -> eta ' J/psi center-of-mass energies between 4.189 and 4.600 GeV

NARCIS (Netherlands)

Ablikim, M.; Achasov, M. N.; Ahmed, S.; Ai, X. C.; Albayrak, O.; Albrecht, M.; Ambrose, D. J.; Amoroso, A.; An, F. F.; An, Q.; Bai, J. Z.; Ferroli, R. Baldini; Ban, Y.; Bennett, D. W.; Bennett, J. V.; Berger, N.; Bertani, M.; Bettoni, D.; Bian, J. M.; Bianchi, F.; Boger, E.; Boyko, I.; Briere, R. A.; Cai, H.; Cai, X.; Cakir, O.; Calcaterra, A.; Cao, G. F.; Cetin, S. A.; Chang, J. F.; Chelkov, G.; Chen, G.; Chen, H. S.; Chen, H. Y.; Chen, J. C.; Chen, M. L.; Chen, S.; Chen, S. J.; Chen, X.; Chen, X. R.; Chen, Y. B.; Cheng, H. P.; Chu, X. K.; Cibinetto, G.; Dai, H. L.; Dai, J. P.; Dbeyssi, A.; Dedovich, D.; Deng, Z. Y.; Denig, A.; Denysenko, I.; Destefanis, M.; De Mori, F.; Ding, Y.; Dong, C.; Dong, J.; Dong, L. Y.; Dong, M. Y.; Dou, Z. L.; Du, S. X.; Duan, P. F.; Fan, J. Z.; Fang, J.; Fang, S. S.; Fang, X.; Fang, Y.; Farinelli, R.; Fava, L.; Fedorov, O.; Feldbauer, F.; Felici, G.; Feng, C. Q.; Fioravanti, E.; Fritsch, M.; Fu, C. D.; Gao, Q.; Gao, X. L.; Gao, X. Y.; Gao, Y.; Gao, Z.; Garzia, I.; Goetzen, K.; Gong, L.; Gong, W. X.; Gradl, W.; Greco, M.; Gu, M. H.; Gu, Y. T.; Guan, Y. H.; Guo, A. Q.; Guo, L. B.; Guo, R. P.; Guo, Y.; Guo, Y. P.; Haddadi, Z.; Hafner, A.; Han, S.; Hao, X. Q.; Harris, F. A.; He, K. L.; Heinsius, F. H.; Held, T.; Heng, Y. K.; Holtmann, T.; Hou, Z. L.; Hu, C.; Hu, H. M.; Hu, J. F.; Hu, T.; Hu, Y.; Huang, G. S.; Huang, J. S.; Huang, X. T.; Huang, X. Z.; Huang, Y.; Huang, Z. L.; Hussain, T.; Ji, Q.; Ji, Q. P.; Ji, X. B.; Ji, X. L.; Jiang, L. W.; Jiang, X. S.; Jiang, X. Y.; Jiao, J. B.; Jiao, Z.; Jin, D. P.; Jin, S.; Johansson, T.; Julin, A.; Kalantar-Nayestanaki, N.; Kang, X. L.; Kang, X. S.; Kavatsyuk, M.; Ke, B. C.; Kiese, P.; Kliemt, R.; Kloss, B.; Kolcu, O. B.; Kopf, B.; Kornicer, M.; Kupsc, A.; Kuehn, W.; Lange, J. S.; Lara, M.; Larin, P.; Leithoff, H.; Leng, C.; Li, C.; Li, Cheng; Li, D. M.; Li, F.; Li, F. Y.; Li, G.; Li, H. B.; Li, H. J.; Li, J. C.; Li, Jin; Li, K.; Li, K.; Li, Lei; Li, P. R.; Li, Q. Y.; Li, T.; Li, W. D.; Li, W. G.; Li, X. L.; Li, X. N.; Li, X. Q.; Li, Y. B.; Li, Z. B.; Liang, H.; Liang, Y. F.; Liang, Y. T.; Liao, G. R.; Lin, D. X.; Liu, B.; Liu, B. J.; Liu, C. X.; Liu, D.; Liu, F. H.; Liu, Fang; Liu, Feng; Liu, H. B.; Liu, H. H.; Liu, H. H.; Liu, H. M.; Liu, J.; Liu, J. B.; Liu, J. P.; Liu, J. Y.; Liu, K.; Liu, K. Y.; Liu, L. D.; Liu, P. L.; Liu, Q.; Liu, S. B.; Liu, X.; Liu, Y. B.; Liu, Y. Y.; Liu, Z. A.; Liu, Zhiqing; Loehner, H.; Lou, X. C.; Lu, H. J.; Lu, J. G.; Lu, Y.; Lu, Y. P.; Luo, C. L.; Luo, M. X.; Luo, T.; Luo, X. L.; Lyu, X. R.; Ma, F. C.; Ma, H. L.; Ma, L. L.; Ma, M. M.; Ma, Q. M.; Ma, T.; Ma, X. N.; Ma, X. Y.; Ma, Y. M.; Maas, F. E.; Maggiora, M.; Mao, Y. J.; Mao, Z. P.; Marcello, S.; Messchendorp, J. G.; Mezzadri, G.; Min, J.; Mitchell, R. E.; Mo, X. H.; Mo, Y. J.; Morales, C. Morales; Muchnoi, N. Yu.; Muramatsu, H.; Musiol, P.; Nefedov, Y.; Nerling, F.; Nikolaev, I. B.; Ning, Z.; Nisar, S.; Niu, S. L.; Niu, X. Y.; Olsen, S. L.; Ouyang, Q.; Pacetti, S.; Pan, Y.; Patteri, P.; Pelizaeus, M.; Peng, H. P.; Peters, K.; Pettersson, J.; Ping, J. L.; Ping, R. G.; Poling, R.; Prasad, V.; Qi, H. R.; Qi, M.; Qian, S.; Qiao, C. F.; Qin, L. Q.; Qin, N.; Qin, X. S.; Qin, Z. H.; Qiu, J. F.; Rashid, K. H.; Redmer, C. F.; Ripka, M.; Rong, G.; Rosner, Ch.; Ruan, X. D.; Sarantsev, A.; Savrie, M.; Schnier, C.; Schoenning, K.; Schumann, S.; Shan, W.; Shao, M.; Shen, C. P.; Shen, P. X.; Shen, X. Y.; Sheng, H. Y.; Shi, M.; Song, W. M.; Song, X. Y.; Sosio, S.; Spataro, S.; Sun, G. X.; Sun, J. F.; Sun, S. S.; Sun, X. H.; Sun, Y. J.; Sun, Y. Z.; Sun, Z. J.; Sun, Z. T.; Tang, C. J.; Tang, X.; Tapan, I.; Thorndike, E. H.; Tiemens, M.; Uman, I.; Varner, G. S.; Wang, B.; Wang, B. L.; Wang, D.; Wang, D. Y.; Wang, K.; Wang, L. L.; Wang, L. S.; Wang, M.; Wang, P.; Wang, P. L.; Wang, S. G.; Wang, W.; Wang, W. P.; Wang, X. F.; Wang, Y.; Wang, Y. D.; Wang, Y. F.; Wang, Y. Q.; Wang, Z.; Wang, Z. G.; Wang, Z. H.; Wang, Z. Y.; Wang, Z. Y.; Weber, T.; Wei, D. H.; Wei, J. B.; Weidenkaff, P.; Wen, S. P.; Wiedner, U.; Wolke, M.; Wu, L. H.; Wu, L. J.; Wu, Z.; Xia, L.; Xia, L. G.; Xia, Y.; Xiao, D.; Xiao, H.; Xiao, Z. J.; Xie, Y. G.; Xiu, Q. L.; Xu, G. F.; Xu, J. J.; Xu, L.; Xu, Q. J.; Xu, Q. N.; Xu, X. P.; Yan, L.; Yan, W. B.; Yan, W. C.; Yan, Y. H.; Yang, H. J.; Yang, H. X.; Yang, L.; Yang, Y. X.; Ye, M.; Ye, M. H.; Yin, J. H.; Yu, B. X.; Yu, C. X.; Yu, J. S.; Yuan, C. Z.; Yuan, W. L.; Yuan, Y.; Yuncu, A.; Zafar, A. A.; Zallo, A.; Zeng, Y.; Zeng, Z.; Zhang, B. X.; Zhang, B. Y.; Zhang, C.; Zhang, C. C.; Zhang, D. H.; Zhang, H. H.; Zhang, H. Y.; Zhang, J.; Zhang, J. J.; Zhang, J. L.; Zhang, J. Q.; Zhang, J. W.; Zhang, J. Y.; Zhang, J. Z.; Zhang, K.; Zhang, L.; Zhang, S. Q.; Zhang, X. Y.; Zhang, Y.; Zhang, Y. H.; Zhang, Y. N.; Zhang, Y. T.; Zhang, Yu; Zhang, Z. H.; Zhang, Z. P.; Zhang, Z. Y.; Zhao, G.; Zhao, J. W.; Zhao, J. Y.; Zhao, J. Z.; Zhao, Lei; Zhao, Ling; Zhao, M. G.; Zhao, Q.; Zhao, Q. W.; Zhao, S. J.; Zhao, T. C.; Zhao, Y. B.; Zhao, Z. G.; Zhemchugov, A.; Zheng, B.; Zheng, J. P.; Zheng, W. J.; Zheng, Y. H.; Zhong, B.; Zhou, L.; Zhou, X.; Zhou, X. K.; Zhou, X. R.; Zhou, X. Y.; Zhu, K.; Zhu, K. J.; Zhu, S.; Zhu, S. H.; Zhu, X. L.; Zhu, Y. C.; Zhu, Y. S.; Zhu, Z. A.; Zhuang, J.; Zotti, L.; Zou, B. S.; Zou, J. H.

2016-01-01

The process e(+)e(-) -> eta' J/psi is observed for the first time with a statistical significance of 8.6 sigma at center-of-mass energy root s = 4.226 GeV and 7.3 sigma at root s = 4.258 GeV using data samples collected with the BESIII detector. The Born cross sections are measured to be (3.7 +/-

Risk factors associated with mortality in systemic lupus erythematosus. A case-control study in a tertiary care center in Mexico City.

Science.gov (United States)

Hernández-Cruz, B; Tapia, N; Villa-Romero, A R; Reyes, E; Cardiel, M H

2001-01-01

To identify the mortality risk factors in a group of Mexican patients with SLE. A case-control autopsy study in a tertiary care center in Mexico, City. Patients with SLE who died during 1958 to 1994 with an autopsy study were selected as cases, and alive patients matched by age (+/- 3 years), decade of SLE onset, and disease duration (+/- 5 years) were defined as controls. Clinical charts were reviewed looking at clinical variables. SLE disease activity was evaluated with the MexSledai index, and SLE disease severity with the Severity Index. Variables were classified as present at any moment during the follow-up and 3 months before death in cases or cut-off date in controls. matched univariate and multivariate analysis by multiple logistic regression were performed, and the results were presented as odds ratio and 95% confidence intervals (OR, 95%CI). 76 matched pairs of patients were studied. Age, gender, and years offormal education were similar in the cases and controls. Variables associated with mortality three months before death were: lung involvement OR= 15.6, 95%CI (4.8-50.3), p<0.001; severe thrombocytopenia 9.6 (2.9-31.7), p<0.001; heart involvement 5.8 (2.6-13.0), p<0.001; and the severity index (cases 8.8 mu, 2.4 sigma vs controls 3.5, 2.0, respectively) 2.2 (1.5-3.4), p<0.001. Variables associated with mortality detected at any moment before death were kidney involvement 2.16 (1.09-4.29), p<0.02; the steroid therapeutic index 2.3 (1.2-4.5), p<0.001; number of previous admissions 2.4 (1.4-4.3), p<0.001; the MEX-SLEDAI index (cases 21.6 mu 6.3 sigma vs controls 12.6, 5.8), 1.2 (1.1-1.3), p<0.001; and the number of severe infections 14.4 (4.4-46.2), p<0.001. Protective variables were skin involvement 0.1 (0.3-0.6), p<0.001; daily dose of chloroquine (cases 3.9 mu, 24.1 sigma vs controls 39.4, 60.0 mg), p <0.0001 and the time from thefirst SLE symptom to the patient's demise or the cut-off date 0.7(0.6-0.9), p<0.001. Multiple logistic regression showed

Explanation of observable secular variations of gravity and alternative methods of determination of drift of the center of mass of the Earth

Science.gov (United States)

Barkin, Yury

2010-05-01

The summary. On the basis of geodynamic model of the forced relative displacement of the centers of mass of the core and the mantle of the Earth the secular variations of a gravity and heights of some gravimetry stations on a surface of the Earth have ben studied. At the account of secular drift of the center of mass of the Earth which on our geodynamic model is caused by the unidirectional drift of the core of the Earth relatively to the mantle, the full explanation is given to observable secular variations of a gravity at stations Ny-Alesund (Norway), Churchill (Canada), Medicine (Italy), Sayowa (Antarctica), Strastburg (France), Membach (Belgium), Wuhan (China) and Metsahovi (Finland). Two new methods of determination of secular drift of the center of mass of the Earth, alternative to classical method of a space geodesy are offered: 1) on the basis of gravimetry data about secular trends of a gravity at the stations located on all basic regions of the Earth; 2) on the basis of the comparative analysis of altimetry and coastal data about secular changes of sea level also in basic regions of ocean. 1. Secular drift of the center of mass of the core and the center of mass of the Earth. A secular drift of the center of mass of the Earth to the North relatively to special center O on an axis of rotation of the Earth for which the coefficient of third zonal harmonic J3' = 0, has been predicted in the author work [1]. A drift in a direction to a geographical point (pole P) 70°0 N and 104°3 E has been established for the first time theoretically - as a result of the analysis of the global directed redistribution of masses of the Earth, explaining the observed secular drift of the pole of an axis of rotation of the Earth and not tidal acceleration of its axial rotation [2]. In [1] velocity of drift it has been estimated in 1-2 cm/yr. For specified center O the figure of a planet is as though deprived of pure-shaped form (J3' = 0). And in this sense the point O can be

SINGLE-PULSE RADIO OBSERVATIONS OF THE GALACTIC CENTER MAGNETAR PSR J1745–2900

Energy Technology Data Exchange (ETDEWEB)

Yan, Zhen; Shen, Zhi-Qiang; Wu, Ya-Jun; Zhao, Rong-Bing; Fan, Qing-Yuan; Hong, Xiao-Yu; Jiang, Dong-Rong; Li, Bin; Liang, Shi-Guang; Ling, Quan-Bao; Liu, Qing-Hui; Qian, Zhi-Han; Zhang, Xiu-Zhong; Zhong, Wei-Ye; Ye, Shu-Hua [Shanghai Astronomical Observatory, Chinese Academy of Sciences, Shanghai 200030 (China); Wu, Xin-Ji [Department of Astronomy, Peking University, Beijing 100871 (China); Manchester, R. N. [CSIRO Astronomy and Space Science, P.O. Box 76, Epping, NSW 1710 (Australia); Weltevrede, P. [Jodrell Bank Centre for Astrophysics, School of Physics and Astronomy, University of Manchester, Manchester M13 9PL (United Kingdom); Yuan, Jian-Ping [Key Laboratory of Radio Astronomy, Chinese Academy of Sciences (China); Lee, Ke-Jia, E-mail: yanzhen@shao.ac.cn [Kavli Institute for Astronomy and Astrophysics, Peking University, Beijing 100871 (China)

2015-11-20

In this paper, we report radio observations of the Galactic Center magnetar PSR J1745–2900 at six epochs between 2014 June and October. These observations were carried out using the new Shanghai Tian Ma Radio Telescope at a frequency of 8.6 GHz. Both the flux density and integrated profile of PSR J1745–2900 show dramatic changes from epoch to epoch, showing that the pulsar was in its “erratic” phase. On MJD 56836, the flux density of this magnetar was about 8.7 mJy, which was 10 times larger than that reported at the time of discovery, enabling a single-pulse analysis. The emission is dominated by narrow “spiky” pulses that follow a log-normal distribution in peak flux density. From 1913 pulses, we detected 53 pulses whose peak flux densities are 10 times greater than that of the integrated profile. They are concentrated in pulse phase at the peaks of the integrated profile. The pulse widths at the 50% level of these bright pulses were between 0.°2 and 0.°9, much narrower than that of the integrated profile (∼12°). The observed pulse widths may be limited by interstellar scattering. No clear correlation was found between the widths and peak flux density of these pulses and no evidence was found for subpulse drifting. Relatively strong spiky pulses are also detected in the other five epochs of observation, showing the same properties as those detected in MJD 56836. These strong spiky pulses cannot be classified as “giant” pulses but are more closely related to normal pulse emission.

Quantum limits to center-of-mass measurements

International Nuclear Information System (INIS)

Vaughan, Timothy; Drummond, Peter; Leuchs, Gerd

2007-01-01

We discuss the issue of measuring the mean position (center of mass) of a group of bosonic or fermionic quantum particles, including particle number fluctuations. We introduce a standard quantum limit for these measurements at ultralow temperatures, and discuss this limit in the context of both photons and ultracold atoms. In the case of non-interacting harmonically trapped fermions, we present evidence that the Pauli exclusion principle has a strongly beneficial effect, giving rise to a 1/N scaling in the position standard deviation--as opposed to a 1/√(N) scaling for bosons. The difference between the actual mean-position fluctuation and this limit is evidence for quantum wave-packet spreading in the center of mass. This macroscopic quantum effect cannot be readily observed for noninteracting particles, due to classical pulse broadening. For this reason, we also study the evolution of photonic and matter-wave solitons, where classical dispersion is suppressed. In the photonic case, we show that the intrinsic quantum diffusion of the mean position can contribute significantly to uncertainties in soliton pulse arrival times. We also discuss ways in which the relatively long lifetimes of attractive bosons in matter-wave solitons may be used to demonstrate quantum interference between massive objects composed of thousands of particles

Case-mix adjustment and the comparison of community health center performance on patient experience measures.

Science.gov (United States)

Johnson, M Laura; Rodriguez, Hector P; Solorio, M Rosa

2010-06-01

To assess the effect of case-mix adjustment on community health center (CHC) performance on patient experience measures. A Medicaid-managed care plan in Washington State collected patient survey data from 33 CHCs over three fiscal quarters during 2007-2008. The survey included three composite patient experience measures (6-month reports) and two overall ratings of care. The analytic sample includes 2,247 adult patients and 2,859 adults reporting for child patients. We compared the relative importance of patient case-mix adjusters by calculating each adjuster's predictive power and variability across CHCs. We then evaluated the impact of case-mix adjustment on the relative ranking of CHCs. Important case-mix adjusters included adult self-reported health status or parent-reported child health status, adult age, and educational attainment. The effects of case-mix adjustment on patient reports and ratings were different in the adult and child samples. Adjusting for race/ethnicity and language had a greater impact on parent reports than adult reports, but it impacted ratings similarly across the samples. The impact of adjustment on composites and ratings was modest, but it affected the relative ranking of CHCs. To ensure equitable comparison of CHC performance on patient experience measures, reports and ratings should be adjusted for adult self-reported health status or parent-reported child health status, adult age, education, race/ethnicity, and survey language. Because of the differential impact of case-mix adjusters for child and adult surveys, initiatives should consider measuring and reporting adult and child scores separately.

Poison exposures in young Israeli military personnel: a National Poison Center Data analysis.

Science.gov (United States)

Lavon, Ophir; Bentur, Yedidia

2017-06-01

To characterize poison exposures in young Israeli military personnel as reported to the national poison center. Retrospective poison center chart review over a 14-year period. Cases included were Israeli soldiers aged 18-21 years, the compulsory military service age required by the Israeli law. 1770 records of poison exposures in young military personnel were identified. Most exposed individuals involved males (n = 1268, 71.6%). Main routes of exposure were ingestion (n = 854, 48.3%), inhalation (n = 328, 18.6%) and ocular (n = 211, 11.9%). Accidents or misuse (n = 712, 40.2%) were the most frequently reported circumstances, followed by suicide attempts (370, 20.9%), and bites and stings (161, 9.1%). More than half of the cases involved chemicals (n = 939, 53.1%); hydrocarbons, gases and corrosives were the main causative agents. Pharmaceuticals (mainly analgesics) were involved in 519 (29.3%) cases, venomous animals (mainly scorpions, centipedes, and snakes) in 79 (4.5%). Clinical manifestations were reported in 666 (37.6%) cases, mostly gastrointestinal, neurologic, and respiratory. The vast majority of cases (1634, 92.3%) were asymptomatic or mildly affected; no fatalities were recorded. In 831 (46.9%) cases the clinical toxicologist recommended referral to an emergency department; ambulatory observation was recommended in 563 (31.8%) cases, and hospitalization in 86 (4.9%). Our data show that poison exposures among young soldiers involve mainly males, accidents, misuse and suicides, oral route and chemicals; most exposures were asymptomatic or with mild severity. Repeated evaluations of poison center data pertaining to military personnel is advised for identifying trends in poison exposure and characteristics in this particular population.

Observations of galactic center for annihilation line at 0.511 MeV

International Nuclear Information System (INIS)

Jayanthi, U.B.; Martin, I.M.; Braga, J.; Neri, J.A.C.F.; Jardim, M.V.A.; Rao, K.R.

1983-10-01

The presence of the 0.511 MeV gamma line emission from galactic center is well-established from various balloon experiments. Recent results in 1980-82 from balloon and satellite experiments show significant decrease in this line intensity. To confirm these results a fly on balloon is performed with a large area sodium iodide detector to measure 0.511 MeV line from galactic center. The preliminary results indicate flux -3 photons cm -2 s -1 . (Author) [pt

Assimilation of Aircraft Observations in High-Resolution Mesoscale Modeling

Directory of Open Access Journals (Sweden)

Brian P. Reen

2018-01-01

Full Text Available Aircraft-based observations are a promising source of above-surface observations for assimilation into mesoscale model simulations. The Tropospheric Airborne Meteorological Data Reporting (TAMDAR observations have potential advantages over some other aircraft observations including the presence of water vapor observations. The impact of assimilating TAMDAR observations via observation nudging in 1 km horizontal grid spacing Weather Research and Forecasting model simulations is evaluated using five cases centered over California. Overall, the impact of assimilating the observations is mixed, with the layer with the greatest benefit being above the surface in the lowest 1000 m above ground level and the variable showing the most consistent benefit being temperature. Varying the nudging configuration demonstrates the sensitivity of the results to details of the assimilation, but does not clearly demonstrate the superiority of a specific configuration.

Statistical Machines for Trauma Hospital Outcomes Research: Application to the PRospective, Observational, Multi-Center Major Trauma Transfusion (PROMMTT Study.

Directory of Open Access Journals (Sweden)

Sara E Moore

Full Text Available Improving the treatment of trauma, a leading cause of death worldwide, is of great clinical and public health interest. This analysis introduces flexible statistical methods for estimating center-level effects on individual outcomes in the context of highly variable patient populations, such as those of the PRospective, Observational, Multi-center Major Trauma Transfusion study. Ten US level I trauma centers enrolled a total of 1,245 trauma patients who survived at least 30 minutes after admission and received at least one unit of red blood cells. Outcomes included death, multiple organ failure, substantial bleeding, and transfusion of blood products. The centers involved were classified as either large or small-volume based on the number of massive transfusion patients enrolled during the study period. We focused on estimation of parameters inspired by causal inference, specifically estimated impacts on patient outcomes related to the volume of the trauma hospital that treated them. We defined this association as the change in mean outcomes of interest that would be observed if, contrary to fact, subjects from large-volume sites were treated at small-volume sites (the effect of treatment among the treated. We estimated this parameter using three different methods, some of which use data-adaptive machine learning tools to derive the outcome models, minimizing residual confounding by reducing model misspecification. Differences between unadjusted and adjusted estimators sometimes differed dramatically, demonstrating the need to account for differences in patient characteristics in clinic comparisons. In addition, the estimators based on robust adjustment methods showed potential impacts of hospital volume. For instance, we estimated a survival benefit for patients who were treated at large-volume sites, which was not apparent in simpler, unadjusted comparisons. By removing arbitrary modeling decisions from the estimation process and concentrating

Variability in prostate and seminal vesicle delineations defined on magnetic resonance images, a multi-observer, -center and -sequence study

DEFF Research Database (Denmark)

Nyholm, Tufve; Jonsson, Joakim; Söderström, Karin

2013-01-01

and approximately equal for the prostate and seminal vesicles. Large differences in variability were observed for individual patients, and also for individual imaging sequences used at the different centers. There was however no indication of decreased variability with higher field strength. CONCLUSION: The overall......BACKGROUND: The use of magnetic resonance (MR) imaging as a part of preparation for radiotherapy is increasing. For delineation of the prostate several publications have shown decreased delineation variability using MR compared to computed tomography (CT). The purpose of the present work....... Two physicians from each center delineated the prostate and the seminal vesicles on each of the 25 image sets. The variability between the delineations was analyzed with respect to overall, intra- and inter-physician variability, and dependence between variability and origin of the MR images, i...

Energy efficient data centers

Energy Technology Data Exchange (ETDEWEB)

Tschudi, William; Xu, Tengfang; Sartor, Dale; Koomey, Jon; Nordman, Bruce; Sezgen, Osman

2004-03-30

Data Center facilities, prevalent in many industries and institutions are essential to California's economy. Energy intensive data centers are crucial to California's industries, and many other institutions (such as universities) in the state, and they play an important role in the constantly evolving communications industry. To better understand the impact of the energy requirements and energy efficiency improvement potential in these facilities, the California Energy Commission's PIER Industrial Program initiated this project with two primary focus areas: First, to characterize current data center electricity use; and secondly, to develop a research ''roadmap'' defining and prioritizing possible future public interest research and deployment efforts that would improve energy efficiency. Although there are many opinions concerning the energy intensity of data centers and the aggregate effect on California's electrical power systems, there is very little publicly available information. Through this project, actual energy consumption at its end use was measured in a number of data centers. This benchmark data was documented in case study reports, along with site-specific energy efficiency recommendations. Additionally, other data center energy benchmarks were obtained through synergistic projects, prior PG&E studies, and industry contacts. In total, energy benchmarks for sixteen data centers were obtained. For this project, a broad definition of ''data center'' was adopted which included internet hosting, corporate, institutional, governmental, educational and other miscellaneous data centers. Typically these facilities require specialized infrastructure to provide high quality power and cooling for IT equipment. All of these data center types were considered in the development of an estimate of the total power consumption in California. Finally, a research ''roadmap'' was developed

The Barrow Innovation Center Case Series: A novel 3D-printed retractor for use with electromagnetic neuronavigation systems.

Science.gov (United States)

Bohl, Michael A; Xu, David S; Cavallo, Claudio; Paisan, Gabriella M; Smith, Kris A; Nakaji, Peter

2018-06-01

The Barrow Innovation Center consists of an educational program that promotes interdisciplinary collaboration among neurosurgery, legal, and engineering professionals to foster the development of new medical devices. This report describes a common issue faced during the placement of ventricular shunts for the treatment of hydrocephalus, and the solution to this problem that was developed through the Barrow Innovation Center. Neurosurgery residents involved in the Barrow Innovation Center presented the problem of ferromagnetic retractors interfering with pinless image-guidance systems at a monthly meeting. Potential solutions were openly discussed by an interdisciplinary committee of neurosurgeons, patent lawyers, and biomedical engineers. The committee decided to pursue development of a novel self-retaining retractor made of non-ferromagnetic material as a solution to the problem. Each retractor design was tested in the cadaver laboratory for size and functionality. A final design was chosen and used in a surgical case requiring ventriculoperitoneal shunt placement. The new retractor successfully retracted the scalp without interfering with the electromagnetic image-guidance system. Through the interdisciplinary Barrow Innovation Center program, a newly designed, 3-dimensional-printed skin and soft tissue retractor was created, along with an innovative universal shunt retainer. Through this integrated program dedicated to surgical innovation (i.e., the Barrow Innovation Center), the process of developing and implementing new technology at our institution has been streamlined, creating a culture of innovation within the neurosurgery training program. Copyright © 2018 Elsevier Inc. All rights reserved.

Prevalence of Nontuberculous Mycobacteria among Extrapulmonary Tuberculosis Cases in Tertiary Care Centers in Northern India

Directory of Open Access Journals (Sweden)

A. K. Maurya

2015-01-01

Full Text Available The reports of nontuberculous mycobacteria (NTM associated with extrapulmonary diseases are increasing in tertiary care hospitals. Despite a significant increase in knowledge about NTM infections, they still represent a diagnostic and therapeutic challenge. The aim of this study is to know the prevalence of NTN among extrapulmonary tuberculosis cases in tertiary care centers in Northern India. A total of 227 culture positive isolates from 756 cases were tested for niacin production and catalase assay. BIO-LINE SD Ag MPT64 TB test and final identification and differentiation between MTBC and different species of NTM were further confirmed by GenoType Mycobacterium CM/AS assay. 71 cases (9.3% were positive for AFB by ZN staining and 227 cases (30.1% were positive for mycobacteria by culture. Niacin production and catalase activity were negative in 62/227 (27.4% strains and after using a panel of different biochemicals and final confirmation by GenoType Mycobacterium CM assay. Out of 227 cultures tested, 165 (72.6% strains were confirmed as M. tuberculosis complex, and 62 (27.4% were confirmed as NTM. The most common NTM species identified were M. fortuitum 17 (27.5% and M. intracellulare 13 (20.9%. The rapid identification of NTM species may help in targeted therapy and management of the diseases.

Patient-centered boundary mechanisms to foster intercultural partnerships in health care: a case study in Guatemala.

Science.gov (United States)

Hitziger, Martin; Berger Gonzalez, Mónica; Gharzouzi, Eduardo; Ochaíta Santizo, Daniela; Solis Miranda, Regina; Aguilar Ferro, Andrea Isabel; Vides-Porras, Ana; Heinrich, Michael; Edwards, Peter; Krütli, Pius

2017-08-08

Up to one half of the population in Africa, Asia and Latin America has little access to high-quality biomedical services and relies on traditional health systems. Medical pluralism is thus in many developing countries the rule rather than the exception, which is why the World Health Organization is calling for intercultural partnerships to improve health care in these regions. They are, however, challenging due to disparate knowledge systems and lack of trust that hamper understanding and collaboration. We developed a collaborative, patient-centered boundary mechanism to overcome these challenges and to foster intercultural partnerships in health care. To assess its impact on the quality of intercultural patient care in a medically pluralistic developing country, we conducted and evaluated a case study. The case study took place in Guatemala, since previous efforts to initiate intercultural medical partnerships in this country were hampered by intense historical and societal conflicts. It was designed by a team from ETH Zurich's Transdisciplinarity Lab, the National Cancer Institute of Guatemala, two traditional Councils of Elders and 25 Mayan healers from the Kaqchikel and Q'eqchi' linguistic groups. It was implemented from January 2014 to July 2015. Scientists and traditional political authorities collaborated to facilitate workshops, comparative diagnoses and patient referrals, which were conducted jointly by biomedical and traditional practitioners. The traditional medical practices were thoroughly documented, as were the health-seeking pathways of patients, and the overall impact was evaluated. The boundary mechanism was successful in discerning barriers of access for indigenous patients in the biomedical health system, and in building trust between doctors and healers. Learning outcomes included a reduction of stereotypical attitudes towards traditional healers, improved biomedical procedures due to enhanced self-reflection of doctors, and improved

Massive Young Stellar Objects in the Galactic Center. 1; Spectroscopic Identification from Spitzer/IRS Observations

Science.gov (United States)

An, Deokkeun; Ramirez, Solange V.; Sellgren, Kris; Arendt, Richard G.; Boogert, A. C. Adwin; Robitaille, Thomas P.; Schultheis, Mathias; Cotera, Angela S.; Smith, Howard A.; Stolovy, Susan R.

2011-01-01

We present results from our spectroscopic study, using the Infrared Spectrograph (IRS) onboard the Spitzer Space Telescope, designed to identify massive young stellar objects (YSOs) in the Galactic Center (GC). Our sample of 107 YSO candidates was selected based on IRAC colors from the high spatial resolution, high sensitivity Spitzer/IRAC images in the Central Molecular Zone (CMZ), which spans the central approximately 300 pc region of the Milky Way Galaxy. We obtained IRS spectra over 5 micron to 35 micron using both high- and low-resolution IRS modules. We spectroscopically identify massive YSOs by the presence of a 15.4 micron shoulder on the absorption profile of 15 micron CO2 ice, suggestive of CO2 ice mixed with CH30H ice on grains. This 15.4 micron shoulder is clearly observed in 16 sources and possibly observed in an additional 19 sources. We show that 9 massive YSOs also reveal molecular gas-phase absorption from C02, C2H2, and/or HCN, which traces warm and dense gas in YSOs. Our results provide the first spectroscopic census of the massive YSO population in the GC. We fit YSO models to the observed spectral energy distributions and find YSO masses of 8 - 23 solar Mass, which generally agree with the masses derived from observed radio continuum emission. We find that about 50% of photometrically identified YSOs are confirmed with our spectroscopic study. This implies a preliminary star formation rate of approximately 0.07 solar mass/yr at the GC.

Stennis Space Center observes 2009 Safety and Health Day

Science.gov (United States)

2009-01-01

Sue Smith, a medical clinic employee at NASA's John C. Stennis Space Center, takes the temperature of colleague Karen Badon during 2009 Safety and Health Day activities Oct. 22. Safety Day activities included speakers, informational sessions and a number of displays on safety and health issues. Astronaut Dominic Gorie also visited the south Mississippi rocket engine testing facility during the day to address employees and present several Silver Snoopy awards for outstanding contributions to flight safety and mission success. The activities were part of an ongoing safety and health emphasis at Stennis.

Observations of the galactic center and search for exotic signals with H.E.S.S

International Nuclear Information System (INIS)

Vivier, M.

2009-06-01

Very high energy γ-ray astronomy is a new and young physics field which aims to study the origin of cosmic rays and their acceleration process inside various astrophysical objects such as pulsars, black holes or supernovae remnants. This is also a promising way to search for exotic high energy phenomena and unknown physics. This dissertation deals with three fundamental physics topics closely connected to very high energy γ-ray astronomy: particle acceleration in the vicinity of a supermassive black hole, primordial black holes evaporation, and indirect searches for (dark matter. Each of these topics is studied with data collected by the H.E.S.S (High Energy Stereoscopic System) instrument, an imaging Cherenkov array dedicated for the detection of very high energy γ-rays above 100 GeV. In the first part of the dissertation, we present a rapid overview of the field of very high energy γ-ray astronomy. A precise description of the H.E.S.S detector is then given as well as the data analysis techniques used to derive the results that are subsequently presented. The first subject is related to black hole astrophysics and concerns observations of the Galactic Center region with H.E.S.S. The source of the γ-ray emission discovered in 2004 toward this region is unidentified. A precise determination of the source energy spectrum and variability with new data is reported here. Results are then compared with models of particle acceleration in the vicinity of Sgr A * , the supermassive black hole located at the dynamical center of the Galaxy. In a second subject, the whole data collected with H.E.S.S is used to search for the signature o f primordial black holes evaporation through their emission of bursts of γ-rays. Primordial black holes are exotic objects that might have formed in the early stages of the Universe. As the bulk of the γ-ray emission is likely to originate from a standard astrophysical mechanism, the Galactic Center is not an ideal target for the

[The management of 126 cases of posterior cracked crown of tooth and its effective observation].

Science.gov (United States)

Chen, L L

2000-06-01

To detect the treatment and effect of posterior cracked tooth. 162 posterior cracked teeth of 158 cases, including enamel fissure and dentin fissure, all there cases undergone the synthetical treatment and follow up in different period, the longest observation period was 2.5 years. The healing and improved rate of 162 cracked teeth 90.74%. Among cases of failure, we have founded 6 cases of acute pulpitis (3.7%), 3 cases of alveodental abscess (1.85%), 2 cases of chronic apical periodontitis (1.24%), 4 cases of tooth fracture (2.4%). Cracked tooth was caused by multiple factors. Early diagnosis, synthetical treatment, and follow up in different period are 3 main factors in treatment.

Explaining the accreditation process from the institutional isomorphism perspective: a case study of Jordanian primary healthcare centers.

Science.gov (United States)

Alyahya, Mohammad; Hijazi, Heba; Harvey, Heather

2018-01-01

While the main focus of accreditation initiatives has been on hospitals, the implementation of these programs is a relatively new notion among other types of healthcare facilities. Correspondingly, this study aims to understand how accreditation is perceived among primary public healthcare centers using an isomorphic institutional theory. Semi-structured, in-depth interviews were conducted with 56 healthcare professionals and administrative staff from seven non-profit healthcare centers in Jordan using an explanatory case-study approach. The informants' narratives revealed that all three components of institutional theory: coercive, mimetic, and normative pressure, were drivers for institutional change in seeking accreditation. There was an overlapping and blending between the three various types of pressure. While participants perceived that healthcare centers faced formal and informal pressures to achieve accreditation, health centers were reluctant about the time, amount of effort, and their ability to achieve the accreditation. Ambiguity and fear of failure forced them to model successful ones. Moreover, the findings revealed that normative values of health professionals enhanced institutional isomorphism and influenced the accreditation process. Identifying these isomorphic changes may help key stakeholders to develop plans, policies, and procedures that could improve the quality of healthcare and enhance accreditation as an organizational strategic plan. Moreover, the study provided explanations of why and how organizations move to adopt new interventions and grow over time. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Day-Case Treatment of Peripheral Arterial Disease: Results from a Multi-Center European Study

Energy Technology Data Exchange (ETDEWEB)

Spiliopoulos, Stavros, E-mail: stavspiliop@med.uoa.gr, E-mail: stavspiliop@upatras.gr; Karnabatidis, Dimitrios, E-mail: karnaby@med.upatras.gr [Patras University Hospital, Department of Interventional Radiology (Greece); Katsanos, Konstantinos, E-mail: katsanos@med.upatras.gr; Diamantopoulos, Athanasios, E-mail: adiamantopoulos@gmail.com [Guy’s and St Thomas’ Hospitals, NHS Foundation Trust, King’s Health Partners, Department of Interventional Radiology (United Kingdom); Ali, Tariq, E-mail: tariq.ali@addenbrookes.nhs.uk [Addenbrooke’s University Hospital, NHS Foundation Trust, Department of Interventional Radiology (United Kingdom); Kitrou, Panagiotis, E-mail: panoskitrou@gmail.com [Patras University Hospital, Department of Interventional Radiology (Greece); Cannavale, Alessandro, E-mail: alessandro.cannavale@hotmail.com; Krokidis, Miltiadis, E-mail: miltiadis.krokidis@addenbrookes.nhs.uk [Addenbrooke’s University Hospital, NHS Foundation Trust, Department of Interventional Radiology (United Kingdom)

2016-12-15

PurposeThe purpose of the study was to investigate safety and feasibility of day-case endovascular procedures for the management of peripheral arterial disease.Materials and MethodsThis was a multi-center, retrospective study including all patients treated over a 30-month period with endovascular angioplasty or stenting for intermittent claudication (IC) or critical limb ischemia (CLI) on a day-case basis, in Interventional Radiology (IR) departments of three European tertiary hospitals. Exclusion criteria were not related to the type of lesion and included unavailability of an adult able to take care of patient overnight; high bleeding risk and ASA score ≥4. Primary efficacy outcome was the rate of procedures performed on an outpatient basis requiring no further hospitalization and primary safety outcome was freedom from 30-day major complications’ rate.ResultsThe study included 652 patients (male 75 %; mean age 68 ± 10 years; range: 27–93), 24.6 % treated for CLI. In 53.3 % of the cases a 6Fr sheath was used. Technical success was 97.1 %. Haemostasis was obtained by manual compression in 52.4 % of the accesses. The primary efficacy outcome occurred in 95.4 % (622/652 patients) and primary safety outcome in 98.6 % (643/652 patients). Major complications included five (0.7 %) retroperitoneal hematomas requiring transfusion; one (0.1 %) common femoral artery pseudoaneurysm successfully treated with US-guided thrombin injection, two cases of intra-procedural distal embolization treated with catheter-directed local thrombolysis and one on-table cardiac arrest necessitating >24 h recovery. No major complication was noted after same-day discharge.ConclusionsDay-case endovascular procedures for the treatment of IC or CLI can be safely and efficiently performed in experienced IR departments of large tertiary hospitals.

Residential Treatment Centers for Child Abuse

Directory of Open Access Journals (Sweden)

Serhat Nasiroglu

2014-02-01

Full Text Available Every year millions of reports are being held and cases regarding those reports in courts are carrying on about abusement and omission against children . Abusement against children has been seen throughout of the history. Significant and permanent impacts can occur upon child abusement and neglect on victim children. It is important to know the psychological dynamics which have been lived by the children by the mental health professionalsto protect the children after the abusement report has been written. Cognitive Behaviour Therapy and medications are being used commonly in the treatment of abusement cases. However in some cases it is necessary to send away the victims from environment, enable them to continue their education life, make sure that they are treated by the professional individuals in safe area. For this end there are many Residential Treatment Centers around the world. and ldquo;Oguz Kagan Koksal Social Care and Rehabilitation Center and rdquo; was established in Adana as the first Residential Treatment Center in Turkey. In this report the historical dimensions of the child abusement, the definition of it, its psychological dynamics, the psychological disorders caused by it, treatment approaches and residential treatment centers have been reviewed. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(1.000: 67-78

PTSD: National Center for PTSD

Medline Plus

Full Text Available ... Media Room Public Affairs News Releases Speeches Videos Publications National Observances Veterans Day Memorial Day Celebrating America's ... Providers and Clergy Co-Occurring Conditions Continuing Education Publications List of Center Publications Articles by Center Staff ...

A Power Load Distribution Algorithm to Optimize Data Center Electrical Flow

Directory of Open Access Journals (Sweden)

Paulo Maciel

2013-07-01

Full Text Available Energy consumption is a matter of common concern in the world today. Research demonstrates that as a consequence of the constantly evolving and expanding field of information technology, data centers are now major consumers of electrical energy. Such high electrical energy consumption emphasizes the issues of sustainability and cost. Against this background, the present paper proposes a power load distribution algorithm (PLDA to optimize energy distribution of data center power infrastructures. The PLDA, which is based on the Ford-Fulkerson algorithm, is supported by an environment called ASTRO, capable of performing the integrated evaluation of dependability, cost and sustainability. More specifically, the PLDA optimizes the flow distribution of the energy flow model (EFM. EFMs are responsible for estimating sustainability and cost issues of data center infrastructures without crossing the restrictions of the power capacity that each device can provide (power system or extract (cooling system. Additionally, a case study is presented that analyzed seven data center power architectures. Significant results were observed, achieving a reduction in power consumption of up to 15.5%.

Robustness analysis of geodetic networks in the case of correlated observations

Directory of Open Access Journals (Sweden)

Mevlut Yetkin

Full Text Available GPS (or GNSS networks are invaluable tools for monitoring natural hazards such as earthquakes. However, blunders in GPS observations may be mistakenly interpreted as deformation. Therefore, robust networks are needed in deformation monitoring using GPS networks. Robustness analysis is a natural merger of reliability and strain and defined as the ability to resist deformations caused by the maximum undetecle errors as determined from internal reliability analysis. However, to obtain rigorously correct results; the correlations among the observations must be considered while computing maximum undetectable errors. Therefore, we propose to use the normalized reliability numbers instead of redundancy numbers (Baarda's approach in robustness analysis of a GPS network. A simple mathematical relation showing the ratio between uncorrelated and correlated cases for maximum undetectable error is derived. The same ratio is also valid for the displacements. Numerical results show that if correlations among observations are ignored, dramatically different displacements can be obtained depending on the size of multiple correlation coefficients. Furthermore, when normalized reliability numbers are small, displacements get large, i.e., observations with low reliability numbers cause bigger displacements compared to observations with high reliability numbers.

Zolpidem (Ambien): a pediatric case series.

Science.gov (United States)

Kurta, D L; Myers, L B; Krenzelok, E P

1997-01-01

In 1993, the nonbenzodiazepine sedative-hypnotic zolpidem tartrate (Ambien) was approved for use in the US. Zolpidem has an imidazopyridine structure and possesses a rapid onset of action and a short half-life. The toxic threshold and profile have not been well established in the pediatric population. All pediatric zolpidem exposures reported to a regional poison information center over 24 months were reviewed retrospectively from the American Association of Poison Control Centers Toxic Exposure Surveillance System data collection forms. Twelve pediatric zolpidem exposures were reported. Seven were unintentional (ages 20 mon-5 y) and five were intentional misuse/suicide (ages 12-16 y). The regional poison information center was contacted within 1 h in ten cases with onset of symptoms within 10 to 60 min (mean 31.6 min). One child had no effect with 2.5 mg. As little as 5 mg caused symptoms with minor outcome in six unintentional ingestions (5-30 mg). Minor to moderate symptoms were reported 1-4 h after intentional ingestions (12.5-150 mg). The duration of symptoms in the unintentional cases ranged from less than 60 min up to 4 h (mean 2.4 h) and 6-10 h (mean 7.5 h) in the intentional exposures. Treatment consisted of observation (4), syrup of ipecac (1), lavage and activated charcoal (1), activated charcoal alone (5), and unknown (1). Due to the very rapid onset of central nervous system symptoms in children, emesis is not a treatment option. Supportive care, activated charcoal in large ingestions, and observation until symptoms resolve may be sufficient in most pediatric cases.

Three-body scattering problem in the fixed center approximation: The case of attraction

Energy Technology Data Exchange (ETDEWEB)

Kudryavtsev, Alexander E. [National Research Center Kurchatov Institute, Institute for Theoretical and Experimental Physics, Moscow (Russian Federation); Gani, Vakhid A. [National Research Center Kurchatov Institute, Institute for Theoretical and Experimental Physics, Moscow (Russian Federation); National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow (Russian Federation); Romanov, Alexander I. [National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), Moscow (Russian Federation)

2016-12-15

We study the scattering of a light particle on a bound pair of heavy particles (e.g., the deuteron) within the fixed center approximation in the case of light-heavy attraction, solving the integral equation for the three-body Green's function both in the coordinate and in the momentum space. The results for the three-body scattering amplitude appear to be ambiguous -they depend on a single real parameter. This parameter may be fixed by a three-body input, e.g., the three-body scattering length. We also solve the integral equation for the three-body Green function in the momentum space, introducing a finite cut-off. We show that all three approaches are equivalent. We also discuss how our approach to the problem matches with the introduction of three-body contact interaction as done by other authors. (orig.)

Evaluation of the Association between Air Pollutants and Number of Cases with Severe Acute Respiratory Syndrome Recorded at Emergency Medical Centers in Tehran, Iran in 2013

Directory of Open Access Journals (Sweden)

sadegh khazaei

2016-09-01

Full Text Available Introduction and purpose: Air pollution is an important risk factor for the environment and public health, associated with increased severity of respiratory diseases. This study aimed to evaluate the association between various air pollutants and number of cases with severe acute respiratory syndrome referred to emergency medical centers in Tehran, Iran in 2013. Methods: In this ecological study, the relationship between air pollution and acute respiratory symptoms in patients referred to the emergency centers of Tehran in 2013 was assessed. In total, 36787 patients with acute respiratory symptoms has been registered in these centers. Data on the number of cases with acute respiratory symptoms and air pollutants of emergency centers and air quality monitoring stations were collected. Moreover, Poisson regression was used to assess the relationship between air pollutant concentrations (PM2.5, SO2, NO2, O3, CO and the number of cases with severe acute respiratory syndrome. Results: The results of the current study demonstrated that CO (weekly average IRR=1.1 and SO2 (three days average IRR=1.03 and weekly average IRR= 1.04 increased the risk of respiratory diseases 10%, 3%, and 4%, respectively. Consequently, longer duration of pollutants would increase the risk of respiratory syndromes. Conclusion: According to the results of this study, increased air pollutant concentrations could be associated with escalated number of patients with acute respiratory symptoms referred to the emergency medical centers in Tehran.

Brain fag: New perspectives from case observations.

Science.gov (United States)

Ebigbo, Peter O; Lekwas, Elekwachi Chimezie; Chukwunenyem, Nweze Felix

2015-06-01

Brain fag was originally described as a culture-bound syndrome among West African students. The term "brain fag" literally means "brain fatigue." Available literature indicates that brain fag symptoms usually present in formal academic settings when African students are required to transit to a reliance on written literature (as opposed to more traditional oral forms of information transmission) and to adapt to westernized, individualistic systems of education that, at times, oppose the values of relatively collectivistic African societies. Based on detailed observation of two typical and two nontypical cases of brain fag, the authors suggest that the syndrome may not be solely related to tensions in the academic sphere, but may function more generally as an expression of psychological distress that results from societal pressures that exceed the coping capacity of the individual. The brain fag symptoms, including lack of concentration, sensations of internal heat in the head and body, heaviness, and multiple somatic complaints, may constitute a defensive process which helps prevent a full-fledged decompensation. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Initial experience with the unrestricted introduction of sugammadex at a large academic medical center: a retrospective observational study examining postoperative mechanical ventilation and efficiency outcomes.

Science.gov (United States)

Reilly-Shah, Vikas N O'; Lynde, Grant C; Mitchell, Matthew L; Maffeo, Carla L; Jabaley, Craig S; Wolf, Francis A

2018-05-30

Sugammadex can rapidly reverse deep neuromuscular blockade, but due to cost questions remain as to its optimal utilization. After introduction for unrestricted use at an academic medical center, we hypothesized that reductions would be demonstrated in the primary outcome of post-anesthesia care unit (PACU) mechanical ventilation (MV) and secondary outcomes of PACU length of stay (LOS), and emergence time (surgery end to anesthesia end time in PACU). We conducted a retrospective observational study of patients undergoing general anesthesia over a 12-month period. Using multiple variable penalized logistic regression in a one group before-and-after design, we compared categorized rates of PACU MV to examine the effect of sugammadex introduction following a post-hoc chart review to ascertain the reason for postoperative MV. Additionally, multiple variable linear regression was used to assess for differences in PACU LOS and emergence time within a propensity matched set of patients receiving neostigmine or sugammadex. 7,217 cases met inclusion criteria: 3,798 before and 3,419 after the introduction of sugammadex. The incidence of PACU MV was 2.3% before and 1.8% after (p=0.118). PACU MV due to residual neuromuscular blockade (rNMB) decreased from 0.63% to 0.20% (p=0.005). Ventilation due to other causes was unchanged. PACU LOS and emergence time were unchanged in a propensity matched set of 1,444 cases. We identified rNMB as an important contributor to PACU MV utilization and observed a significant decrease after sugammadex was introduced. The selected efficiency measures may not have been sufficiently granular to identify improvements following introduction.

User-Centered Design for Interactive Maps: A Case Study in Crime Analysis

Directory of Open Access Journals (Sweden)

Robert E. Roth

2015-02-01

Full Text Available In this paper, we address the topic of user-centered design (UCD for cartography, GIScience, and visual analytics. Interactive maps are ubiquitous in modern society, yet they often fail to “work” as they could or should. UCD describes the process of ensuring interface success—map-based or otherwise—by gathering input and feedback from target users throughout the design and development of the interface. We contribute to the expanding literature on UCD for interactive maps in two ways. First, we synthesize core concepts on UCD from cartography and related fields, as well as offer new ideas, in order to organize existing frameworks and recommendations regarding the UCD of interactive maps. Second, we report on a case study UCD process for GeoVISTA CrimeViz, an interactive and web-based mapping application supporting visual analytics of criminal activity in space and time. The GeoVISTA CrimeViz concept and interface were improved iteratively by working through a series of user→utility→usability loops in which target users provided input and feedback on needs and designs (user, prompting revisions to the conceptualization and functional requirements of the interface (utility, and ultimately leading to new mockups and prototypes of the interface (usability for additional evaluation by target users (user… and so on. Together, the background review and case study offer guidance for applying UCD to interactive mapping projects, and demonstrate the benefit of including target users throughout design and development.

Adolescents with Cancer in Italy: Improving Access to National Cooperative Pediatric Oncology Group (AIEOP) Centers.

Science.gov (United States)

Ferrari, Andrea; Rondelli, Roberto; Pession, Andrea; Mascarin, Maurizio; Buzzoni, Carlotta; Mosso, Maria Luisa; Maule, Milena; Barisone, Elena; Bertolotti, Marina; Clerici, Carlo Alfredo; Jankovic, Momcilo; Fagioli, Franca; Biondi, Andrea

2016-06-01

This analysis compared the numbers of patients treated at Italian pediatric oncology group (Associazione Italiana Ematologia Oncologia Pediatrica [AIEOP]) centers with the numbers of cases predicted according to the population-based registry. It considered 32,431 patients registered in the AIEOP database (1989-2012). The ratio of observed (O) to expected (E) cases was 0.79 for children (0-14 years old) and 0.15 for adolescents (15-19 years old). The proportion of adolescents increased significantly over the years, however, from 0.05 in the earliest period to 0.10, 0.18, and then 0.28 in the latest period of observation, suggesting a greater efficacy of local/national programs dedicated to adolescents. © 2016 Wiley Periodicals, Inc.

Microvascular Outcomes of Pediatric-Onset Type 1 Diabetes Mellitus: A Single-Center Observational Case Reviews in Sana’a, Yemen

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Abdallah Ahmed Gunaid

2018-01-01

Full Text Available Microvascular complications of pediatric-onset type 1 diabetes are common in low-income countries. In this study, we aimed at reviewing microvascular outcomes in 6 cases with type 1 diabetes over 14 to 31 years of follow-up. Severe proliferative diabetic retinopathy (PDR and/or diabetic macular edema (maculopathy (DME and overt diabetic nephropathy (macroalbuminuria were seen among 4 of 6 patients, whereas severe diabetic peripheral neuropathy with Charcot neuroarthropathy was seen in 1 patient only, who had the longest duration of follow-up. The weighted mean (SD (95% confidence interval hemoglobin A 1c was 8.9 (1.6 (8.4-9.4% [74 (17 (68-80 mmol/mol] for PDR/DME and 8.6 (1.7 (8.0-9.0% [71 (19 (65-77 mmol/mol] for macroalbuminuria. Thyroid autoimmunity was positive in 3 patients with overt hypothyroidism in 2 of them. Worse microvascular outcomes among these cases might be attributed to poor glycemic control, lack of knowledge, and limited financial resources.

The Danish National badminton center: A successful talent development environment

DEFF Research Database (Denmark)

Larsen, Carsten Hvid; Storm, Louise Kamuk; Henriksen, Kristoffer

A specific shared feature of the successful environments is a strong and coherent organizational culture characterized by a close coherence between espoused and enacted values. Organizational culture of elite and talent development environments and sporting organizations exerts an important impact...... and qualitatively oriented case study. Methods of data collection included interviewing coaches, young players, professional players, management, and also observations of daily life in the center to obtain systematic and detailed knowledge of the environment as it occurs in the real world. The environment...

Adult-onset intradural spinal teratoma: report of 18 consecutive cases and outcomes in a single center.

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Wan, Wei; Yang, Cheng; Yan, Wangjun; Liu, Tielong; Yang, Xinghai; Song, Dianwen; Xiao, Jianru

2017-07-01

Eighteen consecutive patients with adult-onset intradural spinal teratoma underwent surgical treatment in our center from 1998 to 2013. Teratoma is defined as a neoplasm composed of elements derived from three germ cell layers (ectoderm, endoderm and mesoderm). Intraspinal teratoma is extremely rare and accounts for 0.2-0.5% of all spinal cord tumors. Moreover, teratoma occurs primarily in neonates and young children. Adult-onset intradural spinal teratoma is even rare. The aim of this study was to discuss the clinical characteristics, diagnosis and therapeutic strategies of adult-onset intradural spinal teratoma. This retrospective study included 18 consecutive adult patients with intradural teratoma who were surgically treated in our center between 1998 and 2013. The clinical features, pathogenesis, diagnostic strategies and surgical outcomes were discussed. Neurological function outcomes were evaluated by the JOA scoring system. Of the 18 included patients, 4 patients received subtotal resection and the other 14 patients received total resection. All the 18 cases were diagnosed with mature teratoma. The mean follow-up period was 79.7 (median 60.5; range 27-208) months. Local recurrence occurred in two of the four patients who underwent subtotal resection and in no patient who underwent total resection. The neurologic status improved in 16 cases and remained unchanged in the other two patients. Adult-onset intradural spinal teratoma is extremely rare. To the best of our knowledge, this is the largest series of patients with this disease. Despite the slow-growth and indolent nature, radical resection remains the recommended treatment to reduce tumor recurrence.

Bistable amphoteric centers in semiconductors

International Nuclear Information System (INIS)

Nikitina, A. G.; Zuev, V. V.

2008-01-01

It is shown that, at thermodynamic equilibrium, the release of charge carriers from the localized states of bistable amphoteric centers into quasi-free states depends on the degree of compensation. This brings about different functional dependences of the concentration of free charge carriers on temperature. It is found that, in uncompensated semiconductors, the concentration of free charge carriers follows the same dependence in the case of bistable amphoteric centers and bistable amphoteric U - centers, although the distributions of charge carriers over the charge states and configurations are different for these types of centers. The results can be used for interpreting various experimental data insufficiently explained in the context of the traditional approach

Task shifting of HIV/AIDS case management to Community Health Service Centers in urban China: a qualitative policy analysis.

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Ma, Fuchang; Lv, Fan; Xu, Peng; Zhang, Dapeng; Meng, Sining; Ju, Lahong; Jiang, Huihui; Ma, Liping; Sun, Jiangping; Wu, Zunyou

2015-07-02

The growing number of people living with HIV/AIDS (PLWHA) in China points to an increased need for case management services of HIV/AIDS. This study sought to explore the challenges and enablers in shifting the HIV/AIDS case management services from Centers for Disease Control and Prevention (CDCs) to Community Health Service Centers (CHSCs) in urban China. A qualitative method based on the Health Policy Triangle (HPT) framework was employed to gain in-depth insights into four elements of the task shifting strategy. This included a review on published literature and health policy documents, 15 focus group discussions (FGDs) and 30 in-depth interviews (IDIs) with four types of key actors from three cities in China. A total of 78 studies and 17 policy files at the national, municipal and local levels were obtained and reviewed comprehensively. Three semi-structured interview guides were used to explore key actors' views on shifting the HIV/AIDS case management services to CHSCs. It is necessary and feasible for CHSCs to engage in case management services for PLWHA in local communities. The increasing number of PLWHA and shortage of qualified health professionals in CDCs made shifting case management services downwards to CHSCs an urgent agenda. CHSCs' wide distribution, technical capacity, accessibility and current practice enabled them to carry out case management services for PLWHA. However our findings indicated several challenges in this task shifting process. Those challenges included lack of specific policy and stable financial support for CHSCs, inadequate manpower, relatively low capacity for health service delivery, lack of coordination among sectors, PLWHA's fear for discrimination and privacy disclosure in local communities, which may compromise the effectiveness and sustainability of those services. Shifting the HIV/AIDS case management services from CDCs to CHSCs is a new approach to cope with the rising number of PLWHA in China, but it should be

Information systems performance evaluation, introducing a two-level technique: Case study call centers

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Hesham A. Baraka

2015-03-01

The objective of this paper was to introduce a new technique that can support decision makers in the call centers industry to evaluate, and analyze the performance of call centers. The technique presented is derived from the research done on measuring the success or failure of information systems. Two models are mainly adopted namely: the Delone and Mclean model first introduced in 1992 and the Design Reality Gap model introduced by Heeks in 2002. Two indices are defined to calculate the performance of the call center; the success index and the Gap Index. An evaluation tool has been developed to allow call centers managers to evaluate the performance of their call centers in a systematic analytical approach; the tool was applied on 4 call centers from different areas, simple applications such as food ordering, marketing, and sales, technical support systems, to more real time services such as the example of emergency control systems. Results showed the importance of using information systems models to evaluate complex systems as call centers. The models used allow identifying the dimensions for the call centers that are facing challenges, together with an identification of the individual indicators in these dimensions that are causing the poor performance of the call center.

The center of the core-cusp globular cluster M15: CFHT and HST Observations, ALLFRAME reductions

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Stetson, Peter B.

1994-03-01

The central brightness cusps seen in some globular clusters are thought to be the relics of a gravothermal core collapse that occurred sometime in the clusters' past. Recent observations show that the centers of such clusters are bluer than their outskirts, indicating that the stellar populations there are somehow different than those farther out, presumably as a result of unusual physical processes that took place in these extremely dense regions. Here I analyze a large body of digital imagery from the Canada-France-Hawaii Telescope and the Hubble Space Telescope to obtain color-magnitude and color-color diagrams for stars in the central two arcminutes of the prototypical core-cusp globular cluster M15 = NGC 7078 = C 2127 + 119. These data were reduced with a new computer program, named ALLFRAME, that is described in detail here for the first time. ALLFRAME makes simultaneous use of the geometric and photometric information from all images of a given field to derive a self-consistent set of positions and magnitudes for all detected starlike objects in that area of sky, thereby extending the range of magnitude and crowding conditions for which useful photometry is obtainable. I tentatively conclude that the color gradient in M15 is due to three distinct effects: (1) there is a deficiency of the brightest red giants in the central regions of the cluster; (2) the giant branch of the dominant cluster population shifts systematically toward the blue as the center of the cluster is approached; and (3) the very center of the cluster (radius approximately equal or less than 12 seconds) contains a large population of blue and yellow stragglers that occupy the area of the color-magnitude diagram between the main-sequence turnoff and the horizontal branch and between the extended blue horizontal branch and the subgiant branch; many of these appear to have a significant ultraviolet excess.

Exploring interprofessional, interagency multimorbidity care: case study based observational research

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McKinlay, Eileen M.; Morgan, Sonya J.; Gray, Ben V.; Macdonald, Lindsay M.; Pullon, Susan R.H.

2017-01-01

Background The increase in multimorbidity or co-occurring chronic illnesses is a leading healthcare concern. Patients with multimorbidity require ongoing care from many different professionals and agencies, and often report a lack of integrated care. Objective To explore the daily help-seeking behaviours of patients with multimorbidity, including which health professionals they seek help from, how professionals work together, and perceptions and characteristics of effective interprofessional, interagency multimorbidity care. Design Using a case study observational research design, multiple data sources were assembled for four patients with multimorbidity, identified by two general practitioners in New Zealand. In this paper, two case studies are presented, including the recorded instances of contact and communication between patients and professionals, and between professionals. Professional interactions were categorized as consultation, coordination, or collaboration. Results The two case studies illustrated two female patients with likely similar educational levels, but with different profiles of multimorbidity, social circumstances, and personal capabilities, involving various professionals and agencies. Engagement between professionals showed varying levels of interaction and a lack of clarity about leadership or care coordination. The majority of interactions were one-to-one consultations and rarely involved coordination and collaboration. Patients were rarely included in communications between professionals. Conclusion Cases constructed from multiple data sources illustrate the complexity of day-to-day, interprofessional, interagency multimorbidity care. While consultation is the most frequent mode of professional interaction, targeted coordinated and collaborative interactions (including the patient) are highly effective activities. Greater attention should be given to developing and facilitating these interactions and determining who should lead them. PMID

Case-based Learning in Microbiology: Observations from a North West Indian Medical College.

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Singhal, Anita

2017-12-01

Microbiology is usually taught by conventional lectures, and its retention and application is observed to be poor among medical graduates/practitioners. Introduction of case-based learning (CBL) in microbiology for second-year professional MBBS students. Students were divided into two groups of fifty each. Four clinical cases were used for CBL. One group had two CBL sessions whereas the other had didactic lectures (DLs) and then the groups were crossed over. Case scenario handouts were given to students a week before the session, and smaller groups were formed for discussions and presentations in CBL sessions. Posttest, in multiple choice questions format, was conducted in two phases: First, immediately after the completion of the four CBL and DL sessions, and second, 6 weeks after the first posttest. Student and faculty feedback was taken about CBL sessions. Hundred MBBS students of the fourth semester voluntarily participated in the CBL study. The CBL scores were significantly higher than DL session scores ( P = 0.015). This difference was more marked in scoring done after 6 weeks of session completion ( P < 0.001). Student reported satisfaction in being taught by CBL method in 5-point Likert scale feedback form. Faculty feedback was positive for CBL. CBL helped in retention of knowledge and its application better than DL in our observation. More sessions on commonly encountered case scenarios will be useful for students in recalling basic science knowledge in their later years as practitioners.

A review of 151 cases of pediatric noncystic fibrosis bronchiectasis in a tertiary care center

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Banjar Hanaa

2007-01-01

Full Text Available Objective: This study was conducted to review the etiological factors and diseases associated with pediatric noncystic fibrosis bronchiectasis in a tertiary care center in Saudi Arabia. Materials and Methods: A retrospective review of all patients with confirmed noncystic fibrosis (Non-CF bronchiectasis by chest X-ray and/or CT chest in a pulmonary clinic during the period 1993-2005 at a tertiary care center in Riyadh. Results: A total of 151 cases were diagnosed as Non-CF bronchiectasis. Seventy-five (49.7% were male, 76 (50.3% were female; 148 (98% are alive and 3 (2% died. The southwestern regions constituted 72 (50% of the cases. There was a period of (5 ± 3.2 years between the start of symptoms and diagnosis of bronchiectasis. More than two-thirds of the patients had cough, tachypnea, wheezing, sputum production and failure to thrive. Ninety-one (60% had associated diseases: Pulmonary diseases in 48 (32%, immunodeficiency in 27 (18%, central nervous system anomalies in 10 (7%, cardiac in 10 (7% and asthma in 103 (68% of the patients. Left lower lobe was commonly involved in 114 (76% patients. Sixty-eight (67% were found to have sinusitis. More than two-thirds of patients had two or more associated diseases. Forty-nine (32% developed gastroesophageal reflux. Hemophilus influenza was cultured in 56 (37%, strept pneumoniae in 25 (17% and pseudomonas aeruginosa in 24 (16% of the patients. Eighty percent of the patients who had pulmonary function test had abnormal changes. Disease progression was related to development of symptoms before 5 years of age, persistent atelectasis and right lower lobe involvement ( P < 0.05. Conclusion: Non-CF bronchiectasis should be included in the differential diagnosis of recurrent chest infection in Saudi Arabia. Early diagnosis and identification of associated diseases is needed to prevent progression of the disease.

Human-centered modeling in human reliability analysis: some trends based on case studies

International Nuclear Information System (INIS)

Mosneron-Dupin, F.; Reer, B.; Heslinga, G.; Straeter, O.; Gerdes, V.; Saliou, G.; Ullwer, W.

1997-01-01

As an informal working group of researchers from France, Germany and The Netherlands created in 1993, the EARTH association is investigating significant subjects in the field of human reliability analysis (HRA). Our initial review of cases from nuclear operating experience showed that decision-based unrequired actions (DUA) contribute to risk significantly on the one hand. On the other hand, our evaluation of current HRA methods showed that these methods do not cover such actions adequately. Especially, practice-oriented guidelines for their predictive identification are lacking. We assumed that a basic cause for such difficulties was that these methods actually use a limited representation of the stimulus-organism-response (SOR) paradigm. We proposed a human-centered model, which better highlights the active role of the operators and the importance of their culture, attitudes and goals. This orientation was encouraged by our review of current HRA research activities. We therefore decided to envisage progress by identifying cognitive tendencies in the context of operating and simulator experience. For this purpose, advanced approaches for retrospective event analysis were discussed. Some orientations for improvements were proposed. By analyzing cases, various cognitive tendencies were identified, together with useful information about their context. Some of them match psychological findings already published in the literature, some of them are not covered adequately by the literature that we reviewed. Finally, this exploratory study shows that contextual and case-illustrated findings about cognitive tendencies provide useful help for the predictive identification of DUA in HRA. More research should be carried out to complement our findings and elaborate more detailed and systematic guidelines for using them in HRA studies

The Centers for Medicare and Medicaid Services' Nursing Home Case-Mix and Quality Demonstration: a descriptive overview.

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Reilly, Karen E; Mueller, Christine; Zimmerman, David R

2007-01-01

This paper presents the first comprehensive account of a major national demonstration designed to integrate skilled nursing facilities (SNF) prospective case-mix payment and quality of care. It describes the Centers for Medicare and Medicaid Services' Nursing Home Case-Mix and Quality (NHCMQ) Demonstration-the template for Medicare's SNF Prospective Payment System (PPS) implemented July 1998. The NHCMQ Demonstration provided the basis for one of the most significant changes in SNF reimbursement and quality monitoring policies to date. Prospective reimbursement policies created positive incentive for providers to admit Medicare residents under more equitable payment rates. However, controversy regarding unanticipated perverse provider incentives remains. The quality management system designed under the NHCMQDemonstration is currently used in over 17,000 nursing homes. Furthermore, under the NHCMQ Demonstration, one standardized assessment tool-the MDS-was used to assess a resident's clinical condition, to monitor quality, and to calculate provider reimbursement. Experiences from the NHCMQ Demonstration and continued evaluation of the current national PPS, along with state systems, provide a rich information source regarding prospective, case-mix reimbursement, and provider incentives.

Impact of a Reference Center on Leprosy Control under a Decentralized Public Health Care Policy in Brazil.

Science.gov (United States)

Barbieri, Raquel Rodrigues; Sales, Anna Maria; Hacker, Mariana Andrea; Nery, José Augusto da Costa; Duppre, Nádia Cristina; Machado, Alice de Miranda; Moraes, Milton Ozório; Sarno, Euzenir Nunes

2016-10-01

We evaluated the profile of patients referred to the Fiocruz Outpatient Clinic, a reference center for the diagnosis and treatment of leprosy in Rio de Janeiro, RJ, and analyzed the origins and outcomes of these referrals. This is an observational retrospective study based on information collected from the Leprosy Laboratory database at Fiocruz, Rio de Janeiro, RJ, Brazil. A total of 1,845 suspected leprosy cases examined at the reference center between 2010 and 2014 were included. The originating health service referrals and diagnostic outcomes were analyzed as well as the clinical and epidemiological data of patients diagnosed with leprosy. Our data show that the profile of the patients treated at the Clinic has changed in recent years. There was an increase in both the proportion of patients with other skin diseases and those who had visited only one health service prior to our Clinic. Among the total 1,845 cases analyzed, the outcomes of 1,380 were linked to other diseases and, in 74% of these cases, a biopsy was not necessary to reach a diagnostic conclusion. A decrease in new leprosy case detection among our patients was also observed. Yet, among the leprosy patients, 40% had some degree of disability at diagnosis. The results of the present study demonstrated the importance of referral centers in support of basic health services within the decentralization strategy. But, the success of the program depends on the advent of new developmental tools to augment diagnostic accuracy for leprosy. However, it should be emphasized that for new diagnostic methods to be developed, a greater commitment on the part of the health care system regarding research is urgently needed.

Specialization and utilization after hepatectomy in academic medical centers.

Science.gov (United States)

Shaw, Joshua J; Santry, Heena P; Shah, Shimul A

2013-11-01

Specialized procedures such as hepatectomy are performed by a variety of specialties in surgery. We aimed to determine whether variation exists among utilization of resources, cost, and patient outcomes by specialty, surgeon case volume, and center case volume for hepatectomy. We queried centers (n = 50) in the University Health Consortium database from 2007-2010 for patients who underwent elective hepatectomy in which specialty was designated general surgeon (n = 2685; 30%) or specialist surgeon (n = 6277; 70%), surgeon volume was designated high volume (>38 cases annually) and center volume was designated high volume (>100 cases annually). We then stratified our cohort by primary diagnosis, defined as primary tumor (n = 2241; 25%), secondary tumor (n = 5466; 61%), and benign (n = 1255; 14%). Specialist surgeons performed more cases for primary malignancy (primary 26% versus 15%) while general surgeons operated more for secondary malignancies (67% versus 61%) and benign disease (18% versus 13%). Specialists were associated with a shorter total length of stay (LOS) (5 d versus 6 d; P specialization, surgeon volume and center volume may be important metrics for quality and utilization in complex procedures like hepatectomy. Further studies are necessary to link direct factors related to hospital performance in the changing healthcare environment. Copyright © 2013 Elsevier Inc. All rights reserved.

Trend of tuberculosis cases under directly observed treatment, short-course strategy in Tabriz, Iran, from 2001 to 2011

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Zhila Khamnian

2016-02-01

Full Text Available Introduction: The universal target under the Millennium Development Goals (MDGs is to reduce the worldwide burden of tuberculosis (TB 2015, and we wanted to evaluate development in TB control by assessment of the time trend in incidence and death rate in Tabriz, Iran. Methods: This was a retrospective trend analysis of the data have been recorded in East Azerbaijan State TB center during 10 years. Data were related to patients have been registered for treatment under the directly observed treatment, short-course (DOTS strategy from 2001 to 2011. Results: In total, 3283 TB patients were treated under DOTS strategy during 2001-2011. Males constituted 55.0% of subjects. The risk was the highest among the productive age group (15-44 years. About 61.0% of cases had pulmonary, and 78.0% of pulmonary TB patients were found to be the sputum smear positive than 46.0% of them were new sputum smear positive, and 2.0% of them were relapse. On average, for sputum smear positive, TB cases from 2005 to 2011; the treatment success rate was 87.3%; the cure rate was 80.2%; the treatment failure rate was 0.5% and death rate was 10.3%. In general, the TB incidence rate for all TB cases was decreased from 11.9-8.1 a 100000 population and the smear-positive pulmonary TB incidence rate were decreased from 4.7 to 4.1 a 100000 population in eastern Azerbaijan province during 2001-2011. Conclusion: In general, we had a decrease in the incidence rate for all of TB cases. In addition, we had a fall in cure rate and had an increase in drug side effects rate in this year that can be because of elevated old people ratio and high death rate by other indirect causes and lack of regular visits and medications taking according to the treatment protocol.

Urea cycle disorders in Spain: an observational, cross-sectional and multicentric study of 104 cases

OpenAIRE

Martín-Hernández, Elena; Aldámiz-Echevarría, Luis; Castejón-Ponce, Esperanza; Pedrón-Giner, Consuelo; Couce, María Luz; Serrano-Nieto, Juliana; Pintos-Morell, Guillem; Bélanger-Quintana, Amaya; Martínez-Pardo, Mercedes; García-Silva, María Teresa; Quijada-Fraile, Pilar; Vitoria-Miñana, Isidro; Dalmau, Jaime; Lama-More, Rosa A; Bueno-Delgado, María Amor

2014-01-01

Background Advances in the diagnosis and treatment of urea cycle disorders (UCDs) have led to a higher survival rate. The purpose of this study is to describe the characteristics of patients with urea cycle disorders in Spain. Methods Observational, cross-sectional and multicenter study. Clinical, biochemical and genetic data were collected from patients with UCDs, treated in the metabolic diseases centers in Spain between February 2012 and February 2013, covering the entire Spanish populatio...

Driving under the influence of khat--alkaloid concentrations and observations in forensic cases.

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Toennes, Stefan W; Kauert, Gerold F

2004-02-10

The use of the herbal stimulant khat (Catha edulis FORSK) is maintained by immigrants from countries where it is part of their cultural life (Arabian Peninsula and eastern Africa). In western countries the drug and its effects are largely unknown and no experience in evaluating impairment symptoms due to the khat-alkaloids, e.g. cathinone, cathine and norephedrine exists. Blood and urine samples from khat users involved in 19 cases of suspected driving under the influence of drugs were analysed and correlated with the results of medical examination and police officer reports. In 3 cases impaired driving and in 10 cases marked impairment of psychophysical functions was observed such as effects on the nervous system (slow pupil reaction to light, dry mouth, increased heart-rate), trembling, restlessness/nervousness, daze/apathy/dullness, impairment of attention, walking and standing on one leg. However, the alkaloid concentrations assayed in blood did not correlate with the impairment symptoms. Apart from an acute phase of indirect sympathomimetic action the development of habituation and withdrawal symptoms must also be considered in explaining the diversity of effects observed. From these results it can be concluded that chewing khat may severely impair driving ability, but may also be without noticeable effects.

Noise storm coordinated observations

International Nuclear Information System (INIS)

Elgaroey, Oe.; Tlamicha, A.

1983-01-01

The usually accepted bipolar model of noise storm centers is irrelevant for the present observations. An alternative model has been proposed in which the different sources of a noise storm center are located in different flux tubes connecting active regions with their surroundings. Radio emission is observed from the wide, descending branch of the flux tubes, opposite to the flaring site. The relation between the sense of circular polarization of the radio emission and the magnetic polarity, has been more precisely defined. The radiation is in the ordinary mode with respect to the underlying large scale photospheric magnetic polarity. Thus the ''irregular'' polarity of noice storm center ''B'' is explained. As regards center ''C'', one should note that although the observed radio emission is polarized in the ordinary mode with respect to the leading spot of region HR 17653, center ''C'' is not situated in flux tubes originating from the leading part of this region according to the proposed model. Rather, the radio sources are located in the wide and descending part of flux tubes connecting a large, quiet area of south magnetic polarity with the following part of the region HR 17653 (of north magnetic polarity). Thus it is the polarity of the extended area which determines the polarization of the radio emission. The observed polarization should result rather from the emission process than from complicated conditions of propagation for the radio waves

Clinical Observation on Insomnia Treated by Wei-Defensive Qi-Regulating and Brain-Strengthening Needling Technique

Institute of Scientific and Technical Information of China (English)

GAO Xi-yan; LI Xing-rui; MA Qiao-lin; ZHAO Xin-ji; SHAO Su-ju; WEI Yu-long; SUN Wei-xia; HANG Guo-qi

2007-01-01

In order to make a report on 90 cases of insomnia treated by the Wei-defensive qi-regulating and brain-strengthening needling technique,as a clinical subject of the multiple center,for assessing the preliminary standardized indications and operating methods and making an initial summary for writing the draft of the technique operation.Methods:By ratio of 1:1,the patients in conformity with the criteria were randomly divided into the experimental group and control group.In the experimental group,45 cases were treated with the Wei-defensive qi-regulating and brain-strengthening needling technique on Baihui (GV 20),Dazhui(GV 14),Shenmai(BL 62),Zhaohai(KI 6),plus ear points.In the control group,45 cases were treated with routine acupuncture on Sishencong(Ex-HN 1),Shenmen (HT 7),Sanyinjiao(SP 6),etc.The therapeutic effects in the two groups were observed and assessed in comparison.Results:The results showed cure in 15 cases.remarkable effect in 27 cases,effect in 42 cases,failure in 6 cases,and the total eriective rate in 94.4% in 90 cases of insomnia.In the three centers,the statistic management was performed based upon PSQI integral and showed significant difference(P＜0.01),and no significant difference among various groups(P＞0.01).Conclusion:The therapeutic effect in the treatment of insomnia by Wei-defensive qi-regulating and brain-strengthening needling technique is better than the control group and the therapeutic effect and methods in various centers are stable.without any deviation.

[Histopathological diagnostic concordance in bone and soft tissue sarcomas between two comprehensive cancer centers from eastern and western Europe: a collaborative experience].

Science.gov (United States)

Somcutian, Oana; Buiga, Rares; Galatir, Mihaela; Tudor Eniu, Dan; Rachieru, Claudiu; Coza, Daniela; Terrier, Philippe

2015-01-01

This study aims to assess the degree of concordance of histological diagnosis of bone and soft tissue sarcomas between a Comprehensive Cancer Center (CCC) of Eastern Europe - not specialized in this area of pathology - and an important CCC of Western Europe, which is one of the coordinators of a clinical reference network in sarcoma pathology. The goal is to have an overview of the sarcomatous pathology in a region of Eastern Europe and to discover diagnostic discrepancies between the two centers, while determining their cause. The initial diagnosis was compared with the revised diagnosis on 110 specimens from 88 patients with bone or soft tissue sarcomas from East-European CCC, in a one-year period of time. Complete diagnostic agreement was observed in 55 cases (62.5%), a partial agreement in 23 cases (26.1%) and a major disagreement in 10 cases (11.4%). Major discrepancies of the histological type was observed in only 3 cases (3.4%): one case of discordance benign/malignant and 2 cases of discordance mesenchymal/non mesenchymal. Minor histological discrepancies - not affecting the management of the patient - were observed in 18 cases (20.4%). A major discordance in grading - potentially changing the management of the patient - was noted in 7 cases (7.9%), and a minor discrepancy in 5 cases (5.7%). Some histological types were clearly overdiagnosed, like "adult fibrosarcomas" and "malignant peripheral nerve sheet tumors" (MPNST), mostly converted after the audit into "undifferentiated spindle cell sarcomas" or other types of sarcomas. Some "unclassified" sarcomas and "undifferentiated pleomorphic sarcomas" could be re-classified with the aid of an extensive panel of antibodies. Overall, immunohistochemistry was responsible, but not in exclusivity, for half of the minor discrepancies, and for 2 out of 3 cases of major histological discrepancies. Otherwise, the main cause of discrepancies was the difficulties in the interpretation of the morphology. Molecular

Rituximab for the therapy of systemic sclerosis: a series of 10 cases in a single center.

Science.gov (United States)

Vilela, Verônica Silva; Maretti, Giselle Baptista; Gama, Lívia Marques da Silva; Costa, Claudia Henrique da; Rufino, Rogério Lopes; Levy, Roger A

Systemic sclerosis (SSc) is a chronic autoimmune disease with a high morbidity and mortality. Although cyclophosphamide is effective for severe and refractory cases, there is demand for new treatments. The biological treatment with B-cell depletion with rituximab (RTX) has demonstrated efficacy for this demand in open-label studies. This study was conducted with the aim to retrospectively evaluate all patients who used RTX for the treatment of SSc in our center. We retrospectively evaluated medical records of all patients with SSc who used RTX to treat this disease from January 2009 to January 2015. Systemic, cutaneous, and pulmonary involvement data and laboratory results before and six months after the first infusion of RTX were collected. Ten patients received treatment during the study period and were included in this series. All patients had a diffuse form of the disease. Five patients suffered from an early (duration of disease shorter or equal to four years), rapidly progressive disease, and another five received RTX at late stages of the disease. In both groups of patients, stabilization of the pulmonary picture was observed, with a fall in the skin score in those patients with early forms of the disease. Similar to findings in previous studies, RTX was effective in treating early and rapidly progressive forms of SSc. We also found that patients with long-term illness may benefit from the treatment. Copyright © 2016. Published by Elsevier Editora Ltda.

Achieving excellence in community health centers: implications for health reform.

Science.gov (United States)

Gurewich, Deborah; Capitman, John; Sirkin, Jenna; Traje, Diana

2012-02-01

Existing studies tell us little about care quality variation within the community health center (CHC) delivery system. They also tell us little about the organizational conditions associated with CHCs that deliver especially high quality care. The purpose of this study was to examine the operational practices associated with a sample of high performing CHCs. Qualitative case studies of eight CHCs identified as delivering high-quality care relative to other CHCs were used to examine operational practices, including systems to facilitate care access, manage patient care, and monitor performance. Four common themes emerged that may contribute to high performance. At the same time, important differences across health centers were observed, reflecting differences in local environments and CHC capacity. In the development of effective, community-based models of care, adapting care standards to meet the needs of local conditions may be important.

Observations on the radiochemical control of radiopharmaceuticals at tajoura nuclear research center (TNRC)

International Nuclear Information System (INIS)

Abuzwida, M.A.; Saad, M.A.; Elmagrahi, H.; Elghanodi, Y.

1998-01-01

Production of radioisotopes for the radiopharmaceutical purposes is the main task of Tajoura nuclear center. During the analysis of the 131 I- radioactive solution which was produced using the so-called dry method, the following has been observed : in order to reduce the cost and the time of analytical cycle or time used for the radiochemical purity (RCP), a spot test has been used to indicate the position of the radioactivity in the chromatogram rather than using autoradiographing or the x-ray films. This method was based on the reaction between I 2 and starch to give a blue color at different R f values I 2 is liberated by I - oxidation (H 2 O 2 ) or by IO - 3 reaction with SCN - in the presence of HCl. A simple and fast test for the estimation of the content in the radioactive sample has been elaborated.This method was based on the reduction of Te (IV) or (VI) to Te metal using SnCI 2 in a alkaline media. The detection limit of the elaborated method was found to be 131 I- buffer solution, and 16.0 m S for Na CI saline solution were obtained

Airway-centered interstitial fibrosis: etiology, clinical findings and prognosis.

Science.gov (United States)

Kuranishi, Lilian Tiemi; Leslie, Kevin O; Ferreira, Rimarcs Gomes; Coletta, Ester Aparecida Ney; Storrer, Karin Mueller; Soares, Maria Raquel; de Castro Pereira, Carlos Alberto

2015-05-09

Airway-centered Interstitial Fibrosis (ACIF) is a common pathologic pattern observed in our practice. The objectives of this study are to describe the causes associated with ACIF in a large sample of patients and its effect on survival. A retrospective study in three centers of interstitial lung disease in São Paulo, between January of 1995 and December of 2012. The surgical lung biopsy specimens were reviewed by three pathologists. The clinical, functional and tomographic findings were analyzed by a standardized protocol. There were 68 cases of ACIF, most of them women. The mean age was 57 ± 12 yr. Dyspnea, cough, restrictive pattern at spirometry and oxygen desaturation at exercise were common. A reticular pattern with peribronchovascular infiltrates was found in 79% of the cases. The etiologies of ACIF were hypersensitivity pneumonitis in 29 (42.6%), gastroesophageal reflux disease in 17 (25.0%), collagen vascular disease in 4 (5.9%), a combination of them in 15 cases and idiopathic in 3 (4.4%). The median survival was 116 months (95% CI = 58.5 - 173.5). Lower values of oxygen saturation at rest, presence of cough and some histological findings--organizing tissue in the airways, fibroblastic foci and microscopic honeycombing--were predictors of worse survival. ACIF is an interstitial lung disease with a better survival when compared with IPF. The main etiologies are HP and GERD. The oxygen saturation at rest, the presence of cough and some histological findings are predictors of survival.

Economic viability of geriatric hip fracture centers.

Science.gov (United States)

Clement, R Carter; Ahn, Jaimo; Mehta, Samir; Bernstein, Joseph

2013-12-01

Management of geriatric hip fractures in a protocol-driven center can improve outcomes and reduce costs. Nonetheless, this approach has not spread as broadly as the effectiveness data would imply. One possible explanation is that operating such a center is not perceived as financially worthwhile. To assess the economic viability of dedicated hip fracture centers, the authors built a financial model to estimate profit as a function of costs, reimbursement, and patient volume in 3 settings: an average US hip fracture program, a highly efficient center, and an academic hospital without a specific hip fracture program. Results were tested with sensitivity analysis. A local market analysis was conducted to assess the feasibility of supporting profitable hip fracture centers. The results demonstrate that hip fracture treatment only becomes profitable when the annual caseload exceeds approximately 72, assuming costs characteristic of a typical US hip fracture program. The threshold of profitability is 49 cases per year for high-efficiency hip fracture centers and 151 for the urban academic hospital under review. The largest determinant of profit is reimbursement, followed by costs and volume. In the authors’ home market, 168 hospitals offer hip fracture care, yet 85% fall below the 72-case threshold. Hip fracture centers can be highly profitable through low costs and, especially, high revenues. However, most hospitals likely lose money by offering hip fracture care due to inadequate volume. Thus, both large and small facilities would benefit financially from the consolidation of hip fracture care at dedicated hip fracture centers. Typical US cities have adequate volume to support several such centers.

Clinicopathological characteristics and therapeutic outcomes in thyrotropin-secreting pituitary adenomas: a single-center study of 90 cases.

Science.gov (United States)

Yamada, Shozo; Fukuhara, Noriaki; Horiguchi, Kentaro; Yamaguchi-Okada, Mitsuo; Nishioka, Hiroshi; Takeshita, Akira; Takeuchi, Yasuhiro; Ito, Junko; Inoshita, Naoko

2014-12-01

The aim of this study was to analyze clinicopathological characteristics and treatment outcomes in a large single-center clinical series of cases of thyrotropin (TSH)-secreting pituitary adenomas. The authors retrospectively reviewed clinical, pathological, and treatment characteristics of 90 consecutive cases of TSH-secreting pituitary adenomas treated with transsphenoidal surgery between December 1991 and May 2013. The patient group included 47 females and 43 males (median age 42 years, range 11-74 years). Sixteen tumors (18%) were microadenomas and 74 (82%) were macroadenomas. Microadenomas were significantly more frequent in the more recent half of our case series (12 of 45 cases) (p = 0.0274). Cavernous sinus invasion was confirmed in 21 patients (23%). In 67 cases (74%), the tumors were firm elastic or hard in consistency. Acromegaly and hyperprolactinemia were observed, respectively, in 14 (16%) and 11 (12%) of the 90 cases. Euthyroidism was achieved in 40 (83%) of 48 patients and tumor shrinkage was found in 24 (55%) of 44 patients following preoperative somatostatin analog treatment. Conventional transsphenoidal surgery, extended transsphenoidal surgery, and a simultaneous combined supra- and infrasellar approach were performed in 85, 2, and 3 patients, respectively. Total removal with endocrinological remission was achieved in 76 (84%) of 90 patients, including all 16 (100%) patients with microadenomas, 60 (81%) of the 74 with macroadenomas, and 8 (38%) of the 21 with cavernous sinus invasion. None of these 76 patients experienced tumor recurrence during a median follow-up period of 2.8 years. Stratifying by Knosp grade, total removal with endocrinological remission was achieved in 34 of 36 patients with Knosp Grade 0 tumors, all 24 of those with Grade 1 tumors, 12 of the 14 with Grade 2 tumors, 6 of the 8 with Grade 3 tumors, and none of the 8 with Grade 4 tumors. Cavernous sinus invasion and tumor size were significant independent predictors of surgical

Crop Production for Advanced Life Support Systems - Observations From the Kennedy Space Center Breadboard Project

Science.gov (United States)

Wheeler, R. M.; Sager, J. C.; Prince, R. P.; Knott, W. M.; Mackowiak, C. L.; Stutte, G. W.; Yorio, N. C.; Ruffe, L. M.; Peterson, B. V.; Goins, G. D.

2003-01-01

The use of plants for bioregenerative life support for space missions was first studied by the US Air Force in the 1950s and 1960s. Extensive testing was also conducted from the 1960s through the 1980s by Russian researchers located at the Institute of Biophysics in Krasnoyarsk, Siberia, and the Institute for Biomedical Problems in Moscow. NASA initiated bioregenerative research in the 1960s (e.g., Hydrogenomonas) but this research did not include testing with plants until about 1980, with the start of the Controlled Ecological Life Support System (CELSS) Program. The NASA CELSS research was carried out at universities, private corporations, and NASA field centers, including Kennedy Space Center (KSC). The project at KSC began in 1985 and was called the CELSS Breadboard Project to indicate the capability for plugging in and testing various life support technologies; this name has since been dropped but bioregenerative testing at KSC has continued to the present under the NASA s Advanced Life Support (ALS) Program. A primary objective of the KSC testing was to conduct pre-integration tests with plants (crops) in a large, atmospherically closed test chamber called the Biomass Production Chamber (BPC). Test protocols for the BPC were based on observations and growing procedures developed by university investigators, as well as procedures developed in plant growth chamber studies at KSC. Growth chamber studies to support BPC testing focused on plant responses to different carbon dioxide (CO2) concentrations, different spectral qualities from various electric lamps, and nutrient film hydroponic culture techniques.

Centering mount for a gamma camera

International Nuclear Information System (INIS)

Mirkhodzhaev, A.Kh.; Kuznetsov, N.K.; Ostryj, Yu.E.

1988-01-01

A device for centering a γ-camera detector in case of radionuclide diagnosis is described. It permits the use of available medical coaches instead of a table with a transparent top. The device can be used for centering a detector (when it is fixed at the low end of a γ-camera) on a required area of the patient's body

The Survey of Contamination of Platelet Product with Aerobic Bacteria in Isfahan Blood Transfusion Center

Directory of Open Access Journals (Sweden)

F Baghban

2016-09-01

Full Text Available Introduction: Although nowadays the risk of transmission of bacterial pathogens through blood transfusion has been decreased, but there is the possibility of transmission of these factors by injection of these kind of products. The purpose of this survey was determination of contamination of platelet products with aerobic bacteria in Isfahan Blood Transfusion Center. Methods: In the spring and summer of 2014, 2000 platelet product samples were examined randomly in 5 months for aerobic bacterial contamination. First, samples were cultured in fluid thioglycollate medium. The bacteria that were grown in this medium were identified by Gram staining and biochemical tests. Then, DNA was extracted from isolated bacteria and PCR was done for 16S rRNA gene. After that the PCR products were sequenced and the bacteria were recognized at the level of species. Results: At this research, 4 contaminated samples were identified. Isolated bacteria were including: Klebsiella pneumoniae 1 case, Staphylococcus aureus 1 case, Staphylococcus epidermidis 1 case and Staphylococcus haemolyticus 1 case.    After sequencing of 16S rRNA gene, the homology was observed 97%, 83%, 99%, and 90% at theses bacteria, respectively. Discussion: According to the results of this research, platelet products may be contaminated with aerobic bacteria. Therefore, providing appropriate conditions in transfusion centers and other therapeutic centers for doing screening tests on platelet products to identifying bacterial contaminations before using of these products seems to be necessary.

The Link between Internal Marketing and Customer Relationship Management : A Case Study of one Nordea Call Center in Sweden

OpenAIRE

Stenbeck, Joakim; Cabander, Robin

2008-01-01

Purpose: The purpose of this thesis is to increase the understanding of the link between internal marketing and customer relationship management by conducting a case study of one Nordea call center. Background: Keeping existing customers is less expensive than acquiring new ones. Nowadays, up to sixty percent of marketing budgets are being dedicated towards retaining customers. So forth customer relationship manage-ment is slowly beginning to penetrate the banking industry as sustaina-ble rel...

Observer Variation in Computed Tomography of the Sacroiliac Joints: A Retrospective Analysis of 1383 Cases

International Nuclear Information System (INIS)

Geijer, M.; Gadeholt Goethlin, G.; Goethlin, J.H.

2007-01-01

Background: Computed tomography (CT) for evaluation of sacroiliitis has a higher diagnostic accuracy than radiography. There is a high degree of interobserver variation in evaluating sacroiliitis on radiographs. Purpose: To evaluate interobserver variation in CT of the sacroiliac joints for evaluation of sacroiliitis in a large number of patients. Material and Methods: 1383 CT examinations of the sacroiliac joints were reviewed by two observers. The outcomes as originally reported and the findings from the reviews were classified as no sacroiliitis, equivocal, unilateral sacroiliitis, or bilateral sacroiliitis. The unweighted kappa statistic was used for assessment of observer agreement. Results: The interobserver agreement between the two reviewers was good (0.6724), with excellent agreement on cases of bilateral sacroiliitis and moderate agreement on cases of unilateral sacroiliitis. Excellent agreement was also reached in normal cases. Compared to the original reports, there were moderate interobserver agreements between both reviewers' findings and the original reports 0.4651 and 0.4481, respectively). Conclusion: The interobserver variation for the diagnosis of sacroiliitis on CT between two reviewers in a study setting showed good agreement, with moderate agreement between each of the observers and the original clinical reports. CT is a reliable method for evaluating the sacroiliac joints for changes of sacroiliitis

Observer Variation in Computed Tomography of the Sacroiliac Joints: A Retrospective Analysis of 1383 Cases

Energy Technology Data Exchange (ETDEWEB)

Geijer, M.; Gadeholt Goethlin, G.; Goethlin, J.H. [Dept. of Diagnostic Radiology, Sahlgrenska Univ. Hospital, Goeteborg (Sweden)

2007-08-15

Background: Computed tomography (CT) for evaluation of sacroiliitis has a higher diagnostic accuracy than radiography. There is a high degree of interobserver variation in evaluating sacroiliitis on radiographs. Purpose: To evaluate interobserver variation in CT of the sacroiliac joints for evaluation of sacroiliitis in a large number of patients. Material and Methods: 1383 CT examinations of the sacroiliac joints were reviewed by two observers. The outcomes as originally reported and the findings from the reviews were classified as no sacroiliitis, equivocal, unilateral sacroiliitis, or bilateral sacroiliitis. The unweighted kappa statistic was used for assessment of observer agreement. Results: The interobserver agreement between the two reviewers was good (0.6724), with excellent agreement on cases of bilateral sacroiliitis and moderate agreement on cases of unilateral sacroiliitis. Excellent agreement was also reached in normal cases. Compared to the original reports, there were moderate interobserver agreements between both reviewers' findings and the original reports 0.4651 and 0.4481, respectively). Conclusion: The interobserver variation for the diagnosis of sacroiliitis on CT between two reviewers in a study setting showed good agreement, with moderate agreement between each of the observers and the original clinical reports. CT is a reliable method for evaluating the sacroiliac joints for changes of sacroiliitis.

Cosmological evolution of supermassive black holes in galactic centers unveiled by hard X-ray observations.

Science.gov (United States)

Ueda, Yoshihiro

2015-01-01

We review the current understanding of the cosmological evolution of supermassive black holes in galactic centers elucidated by X-ray surveys of active galactic nuclei (AGNs). Hard X-ray observations at energies above 2 keV are the most efficient and complete tools to find "obscured" AGNs, which are dominant populations among all AGNs. Combinations of surveys with various flux limits and survey area have enabled us to determine the space number density and obscuration properties of AGNs as a function of luminosity and redshift. The results have essentially solved the origin of the X-ray background in the energy band below ∼10 keV. The downsizing (or anti-hierarchical) evolution that more luminous AGNs have the space-density peak at higher redshifts has been discovered, challenging theories of galaxy and black hole formation. Finally, we summarize unresolved issues on AGN evolution and prospects for future X-ray missions.

The Examination of The Outdoors of Family Health-Care Center: A Case Study In Çanakkale City Center

OpenAIRE

SAĞLIK, Alper; KELKİT, Abdullah

2017-01-01

The gardens of the health-care centers are areas of fear, anxiety and stress based. In the process of the treatment of patients, these areas have psychological, physical and social significance. For this reason, health-care center gardens should be designed to help treatment of patients. Well designed gardens are important for elimination of adverse effects of clinical environments on patients and helping patients to stay away from the stress by ensuring their socia...

Building a Student-Centered Culture in Times of Natural Disaster: A Case Study

Science.gov (United States)

Hlinka, Karen Ramey

2013-01-01

Increased rates of student success and persistence have been positively linked to community colleges with student-centered cultures. A student-centered culture is one in which policies and practices promote a consistent message of concern and respect while expecting high standards of academic accomplishment. Developing a student-centered culture…

Lightcurve Analysis of L5 Trojan Asteroids at the Center for Solar System Studies 2017 September to December

Science.gov (United States)

Stephens, Robert D.; Warner, Brian D.

2018-04-01

Lightcurves for four Jovian Trojan asteroids were obtained at the Center for Solar System Studies (CS3) from 2017 September to December. From observations in 2016 June, 2759 Idomeneus was found to be another candidate for the special case of very wide binaries. This would be the fifth confirmed Jovian Trojan binary asteroid.

Fish bone foreign body presenting with an acute fulminating retropharyngeal abscess in a resource-challenged center: a case report

Directory of Open Access Journals (Sweden)

Oyewole Ezekiel O

2011-04-01

Full Text Available Abstract Introduction A retropharyngeal abscess is a potentially life-threatening infection in the deep space of the neck, which can compromise the airway. Its management requires highly specialized care, including surgery and intensive care, to reduce mortality. This is the first case of a gas-forming abscess reported from this region, but not the first such report in the literature. Case presentation We present a case of a 16-month-old Yoruba baby girl with a gas-forming retropharyngeal abscess secondary to fish bone foreign body with laryngeal spasm that was managed in the recovery room. We highlight specific problems encountered in the management of this case in a resource-challenged center such as ours. Conclusion We describe an unusual presentation of a gas-forming organism causing a retropharyngeal abscess in a child. The patient's condition was treated despite the challenges of inadequate resources for its management. We recommend early recognition through adequate evaluation of any oropharyngeal injuries or infection and early referral to the specialist with prompt surgical intervention.

Correlations between Abelian monopoles and center vortices

Energy Technology Data Exchange (ETDEWEB)

Hosseini Nejad, Seyed Mohsen, E-mail: smhosseininejad@ut.ac.ir; Deldar, Sedigheh, E-mail: sdeldar@ut.ac.ir

2017-04-15

We study the correlations between center vortices and Abelian monopoles for SU(3) gauge group. Combining fractional fluxes of monopoles, center vortex fluxes are constructed in the thick center vortex model. Calculating the potentials induced by fractional fluxes constructing the center vortex flux in a thick center vortex-like model and comparing with the potential induced by center vortices, we observe an attraction between fractional fluxes of monopoles constructing the center vortex flux. We conclude that the center vortex flux is stable, as expected. In addition, we show that adding a contribution of the monopole-antimonopole pairs in the potentials induced by center vortices ruins the Casimir scaling at intermediate regime.

R&D Characteristics and Organizational Structure: Case Studies of University-Industry Research Centers

Science.gov (United States)

Hart, Maureen McArthur

2013-01-01

Within the past few decades, university-industry research centers have been developed in large numbers and emphasized as a valuable policy tool for innovation. Yet little is known about the heterogeneity of organizational structure within these centers, which has implications regarding policy for and management of these centers. This dissertation…

Climate Prediction Center (CPC) U.S. Daily Precipitation Observations

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Observational reports of daily precipitation (1200 UTC to 1200 UTC) are made by members of the NWS Automated Surface Observing Systems (ASOS) network; NWS...

Improving the quality of health services organization structure by reengineering: circular design and clinical case impact in an academic medical center.

Science.gov (United States)

Lartin-Drake, J M; Curran, C; Gillis-Donovan, J; Kruger, N R; Ziegenfuss, J T; Ostrem, J; Zanotti, M

1996-01-01

Innovation to improve the quality of structure and process in health care organization is reported in this case example of change in an academic medical center. Interactive planning and the circular organization design concept were the driving principles and methods. This report presents the needs for and initial obstructions to change, planning and project design work, a description of the change process, and illustrative accomplishments to date--two cases, one of conscious sedation policy and one of nuisance pages. Evaluative criteria for judging the progress and lessons of the project regarding key design characteristics also are included.

Euclidean supergravity and multi-centered solutions

Directory of Open Access Journals (Sweden)

W.A. Sabra

2017-04-01

Full Text Available In ungauged supergravity theories, the no-force condition for BPS states implies the existence of stable static multi-centered solutions. The first solutions to Einstein–Maxwell theory with a positive cosmological constant describing an arbitrary number of charged black holes were found by Kastor and Traschen. Generalisations to five and higher dimensional theories were obtained by London. Multi-centered solutions in gauged supergravity, even with time-dependence allowed, have yet to be constructed. In this letter we construct supersymmetry-preserving multi-centered solutions for the case of D=5, N=2 Euclidean gauged supergravity coupled to an arbitrary number of vector multiplets. Higher dimensional Einstein–Maxwell multi-centered solutions are also presented.

Recommendations to Improve Downloads of Large Earth Observation Data

Directory of Open Access Journals (Sweden)

Rahul Ramachandran

2018-01-01

Full Text Available With the volume of Earth observation data expanding rapidly, cloud computing is quickly changing the way these data are processed, analyzed, and visualized. Collocating freely available Earth observation data on a cloud computing infrastructure may create opportunities unforeseen by the original data provider for innovation and value-added data re-use, but existing systems at data centers are not designed for supporting requests for large data transfers. A lack of common methodology necessitates that each data center handle such requests from different cloud vendors differently. Guidelines are needed to support enabling all cloud vendors to utilize a common methodology for bulk-downloading data from data centers, thus preventing the providers from building custom capabilities to meet the needs of individual vendors. This paper presents recommendations distilled from use cases provided by three cloud vendors (Amazon, Google, and Microsoft and are based on the vendors’ interactions with data systems at different Federal agencies and organizations. These specific recommendations range from obvious steps for improving data usability (such as ensuring the use of standard data formats and commonly supported projections to non-obvious undertakings important for enabling bulk data downloads at scale. These recommendations can be used to evaluate and improve existing data systems for high-volume data transfers, and their adoption can lead to cloud vendors utilizing a common methodology.

Trends in types of calls managed by U.S. poison centers 2000-2015.

Science.gov (United States)

Anderson, Bruce D; Seung, Hyunuk; Klein-Schwartz, Wendy

2017-12-05

The number of cases reported to poison centers has decreased since 2008 but there is evidence that the complexity of calls is increasing. The objectives are to evaluate national poison center data for trends in reason and how these changes effect management site, medical outcomes, and poison center workload. Data regarding reason, age, management site, and medical outcome were extracted from annual reports of the National Poison Data System from 2000 to 2015. The proportion of cases by year were determined for unintentional and intentional exposures. Analysis of data from a single poison center from 2005 to 2015 compared the number of interactions between poison center staff and callers for unintentional versus intentional reasons. Trend analyses found that from 2000 to 2015 the percent of unintentional cases decreased (from 85.9 to 78.4%, p Poison centers are managing more intentional exposures and fewer unintentional exposures. Intentional exposures require more poison center staff expertise and time. Looking only at poison center total call volume may not be an adequate method to gauge productivity.

Atlanta NAVIGATOR case study. Final report, May 1996--Jun 1997

Energy Technology Data Exchange (ETDEWEB)

Amodei, R.; Bard, E.; Brong, B.; Cahoon, F.; Jasper, K.

1998-11-01

The Atlanta metropolitan region was the location of one of the most ambitious Intelligent Transportation Systems (ITS) deployments in the United States. This deployment included several individual projects--a Central Transportation Management Center (TMC), six Traffic Control Centers (TCC), one Transit Information Center (TIC), the Travel Information Showcase (TIS), and the extension of the Metropolitan Atlanta Rapid Transit Authority (MARTA) rail network and the new high-occupancy vehicle (HOV) lanes on I-85 and I-75. The Atlanta Centennial Olympic Games and Paralympic Games created a focus for these projects. All of these systems were to be brought on line in time for the Olympic Games. This report presents the findings of the NAVIGATOR Case Study and documents the lessons learned from the Atlanta ITS deployment experience in order to improve other ITS deployments in the future. The Case Study focuses on the institutional, programmatic, and technical issues and opportunities from planning and implementing the ITS deployment in Atlanta. The Case Study collected data and information from interviews, observations, focus groups, and documentation reviews. It presents a series of lessons learned and recommendations for enabling successful ITS deployments nationwide.

Observations of the 10-micron natural laser emission from the mesospheres of Mars and Venus

Science.gov (United States)

Espenak, F.; Deming, D.; Jennings, D.; Kostiuk, T.; Mumma, M.; Zipoy, D.

1983-01-01

Observations of the total flux and center to limb dependence of the nonthermal emission occurring in the cores of the 9.4 and 10.4 micrometers CO2 bands on Mars are compared to a theoretical model based on this mechanism. The model successfully reproduces the observed center to limb dependence of this emission, to within the limits imposed by the spatial resolution of the observations of Mars and Venus. The observed flux from Mars agrees closely with the prediction of the model; the flux observed from Venus is 74 percent of the flux predicted by the model. This emission is used to obtain the kinetic temperatures of the Martian and Venusian mesospheres. For Mars near 70 km altitude, a rotational temperature analysis using five lines gives T = 135 + or - 20 K. The frequency width of the emission is also analyzed to derive a temperature of 126 + or - 6 K. In the case of the Venusian mesosphere near 109 km, the frequency width of the emission gives T = 204 + or - 10 K.

Observations of the 10 micrometer natural laser emission from the mesospheres of Mars and Venus

Science.gov (United States)

Deming, D.; Espenak, F.; Jennings, D.; Kostiuk, T.; Mumma, M. J.

1983-01-01

Observations of the total flux and center to limb dependence of the nonthermal emission occurring in the cores of the 9.4 and 10.4 micrometers CO2 bands on Mars are compared to a theoretical model based on this mechanism. The model successfully reproduces the observed center to limb dependence of this emission, to within the limits imposed by the spatial resolution of the observations of Mars and Venus. The observed flux from Mars agrees closely with the prediction of the model; the flux observed from Venus is 74% of the flux predicted by the model. This emission is used to obtain the kinetic temperatures of the Martian and Venusian mesospheres. For Mars near 70 km altitude, a rotational temperature analysis using five lines gives T = 135 + or - 20 K. The frequency width of the emission is also analyzed to derive a temperature of 126 + or - 6 K. In the case of the Venusian mesosphere near 109 km, the frequency width of the emission gives T = 204 + or - 10 K.

Observations of the 10 micrometer natural laser emission from the mesospheres of Mars and Venus

International Nuclear Information System (INIS)

Deming, D.; Espenak, F.; Jennings, D.; Kostiuk, T.; Mumma, M.J.

1983-06-01

Observations of the total flux and center to limb dependence of the nonthermal emission occurring in the cores of the 9.4 and 10.4 micrometers CO2 bands on Mars are compared to a theoretical model based on this mechanism. The model successfully reproduces the observed center to limb dependence of this emission, to within the limits imposed by the spatial resolution of the observations of Mars and Venus. The observed flux from Mars agrees closely with the prediction of the model the flux observed from Venus is 74% of the flux predicted by the model. This emission is used to obtain the kinetic temperatures of the Martian and Venusian mesospheres. For Mars near 70 km altitude, a rotational temperature analysis using five lines gives T 135 + or - 20 K. The frequency width of the emission is also analyzed to derive a temperature of 126 + or - 6 K. In the case of the Venusian mesosphere near 109 km, the frequency width of the emission gives T 204 + or - 10 K

Learning curve for intracranial angioplasty and stenting in single center.

Science.gov (United States)

Cai, Qiankun; Li, Yongkun; Xu, Gelin; Sun, Wen; Xiong, Yunyun; Sun, Wenshan; Bao, Yuanfei; Huang, Xianjun; Zhang, Yao; Zhou, Lulu; Zhu, Wusheng; Liu, Xinfeng

2014-01-01

To identify the specific caseload to overcome learning curve effect based on data from consecutive patients treated with Intracranial Angioplasty and Stenting (IAS) in our center. The Stenting and Aggressive Medical Management for Preventing Recurrent Stroke and Intracranial Stenosis trial was prematurely terminated owing to the high rate of periprocedural complications in the endovascular arm. To date, there are no data available for determining the essential caseload sufficient to overcome the learning effect and perform IAS with an acceptable level of complications. Between March 2004 and May 2012, 188 consecutive patients with 194 lesions who underwent IAS were analyzed retrospectively. The outcome variables used to assess the learning curve were periprocedural complications (included transient ischemic attack, ischemic stroke, vessel rupture, cerebral hyperperfusion syndrome, and vessel perforation). Multivariable logistic regression analysis was employed to illustrate the existence of learning curve effect on IAS. A risk-adjusted cumulative sum chart was performed to identify the specific caseload to overcome learning curve effect. The overall rate of 30-days periprocedural complications was 12.4% (24/194). After adjusting for case-mix, multivariate logistic regression analysis showed that operator experience was an independent predictor for periprocedural complications. The learning curve of IAS to overcome complications in a risk-adjusted manner was 21 cases. Operator's level of experience significantly affected the outcome of IAS. Moreover, we observed that the amount of experience sufficient for performing IAS in our center was 21 cases. Copyright © 2013 Wiley Periodicals, Inc.

Child-Centered Play Therapy

Science.gov (United States)

VanFleet, Rise; Sywulak, Andrea E.; Sniscak, Cynthia Caparosa

2010-01-01

Highly practical, instructive, and authoritative, this book vividly describes how to conduct child-centered play therapy. The authors are master clinicians who explain core therapeutic principles and techniques, using rich case material to illustrate treatment of a wide range of difficulties. The focus is on nondirective interventions that allow…

Changes in patterns of uveitis at a tertiary referral center in Northern Italy: analysis of 990 consecutive cases.

Science.gov (United States)

Luca, Cimino; Raffaella, Aldigeri; Sylvia, Marchi; Valentina, Mastrofilippo; Fabiana, Viscogliosi; Marco, Coassin; Annamaria, Soldani; Luisa, Savoldi; Alessandro, De Fanti; Lucia, Belloni; Alessandro, Zerbini; Maria, Parmeggiani; Matthew, Chersich; Alessandra, Soriano; Carlo, Salvarani; Luigi, Fontana

2018-02-01

The role of uveitis, an uncommon ocular disease, is often neglected in research and treatment of autoimmune conditions. The study described the spectrum of uveitis at a referral center in North Italy, and compared that to a previously published series of patients. We reviewed all patients with uveitis diagnosed from 2013 to 2015 at the Immunology Eye Unit, Arcispedale S. M. Nuova-IRCCS, Reggio Emilia, Italy. We examined patient characteristics, disease spectrum, and etiologies. In total, 990 cases of uveitis were identified, who were mostly female (59%) with a median age at presentation of 44 years (interquartile range = 29-57). Anterior uveitis was most frequent (53.5%), followed by panuveitis (22.8%), posterior (16.2%), and intermediate uveitis (5.5%). Anterior herpetic uveitis (15.6%), Fuchs uveitis (9.7%), and HLA-B27 positive anterior uveitis (7.7%) were the most common specific diagnoses. Compared with the previous series, we observed an increased incidence of uveitis, and a different pattern of diagnoses. Rates of herpetic, HLA-B27 positive uveitis, and presumed ocular tuberculosis were higher, but Fuchs uveitis was less frequent. The pattern of uveitis appears to be changing, very likely due to population-level increases in infectious diseases, to the availability of new diagnostic tests and to the interdisciplinary approach used in patient diagnosis.

Competitive service centers location in the cities with aim to reduce traffic (Case study: Health centers location in the city if Isfahan

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Hamid Moradi

2011-03-01

Full Text Available Abstract   Distribution of goods and services in cities is of utmost importance. Selecting appropriate venues for different service centers in a city not only enables the citizens to access these services much more easily, but also reduces the traffic load caused by trips made to reach them. Unfortunately, the lack of a correct urban planning has led to inappropriate formation of many cities around the world in terms of the locations assumed for different service centers. Since the private sector has been given the responsibility to construct most of these centers, changing their current locations may be restricted due to legal obligations. Therefore, it seems necessary for the government to construct new service centers with high competitive facilities to attract customers and to compete with those built by the private sector. In this paper, the selection of appropriate locations to construct new service centers has been studied. Such locations have been selected in a way to fulfill goals such as rapid and easy accessibility for the customers and reduction of traffic drawbacks caused by the related trips. In this regard, a model for service centers with restricted capacity has been designed and a parallel simulated annealing algorithm has been proposed to solve it. Finally, the proposed algorithm has been utilized to locate the health centers around the city of Isfahan and its efficiency has been investigated. The findings highlight the accuracy and speed of the proposed algorithm in location of the health centers of Isfahan.

MARKETING POLICIES THROUGH THE INTERNET: THE CASE OF SKIING CENTERS IN GREECE

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Panagiotis LEFAKIS

2012-09-01

Full Text Available Lately, Internet constitutes a major tool for transactions in every aspect and supports innovative marketing policies. Broadband Internet has become “the key to success” for businesses, as it offers various advantages and benefits through Internet marketing (e-marketing policies. In Greece, mountainous areas are usually covered with snow during winter months; so, skiing centers have become an important asset for winter tourism. The Internet evolution and the development of network infrastructure enhance marketing policies for winter tourism activities. This paper studies the use of marketing policies in Greek skiing centers through the Internet, such as promotional activities, website interactivity, accommodation & entertainment information, online weather forecast, guest book, etc Therefore, the paper aims to optimize and evaluate skiing centers in Greece, qualitatively and quantitatively according to e-marketing policies used as criteria, based on the multicriteria method of PROMETHEE II and further to classify them in groups. Finally we identify and describe the optimum group of skiing centers to be used as a model with enhanced customer communication services.

Better Broader Impacts through National Science Foundation Centers

Science.gov (United States)

Campbell, K. M.

2010-12-01

National Science Foundation Science and Technology Centers (STCs) play a leading role in developing and evaluating “Better Broader Impacts”; best practices for recruiting a broad spectrum of American students into STEM fields and for educating these future professionals, as well as their families, teachers and the general public. With staff devoted full time to Broader Impacts activities, over the ten year life of a Center, STCs are able to address both a broad range of audiences and a broad range of topics. Along with other NSF funded centers, such as Centers for Ocean Sciences Education Excellence, Engineering Research Centers and Materials Research Science and Engineering Centers, STCs develop both models and materials that individual researchers can adopt, as well as, in some cases, direct opportunities for individual researchers to offer their disciplinary research expertise to existing center Broader Impacts Programs. The National Center for Earth-surface Dynamics is an STC headquartered at the University of Minnesota. NCED’s disciplinary research spans the physical, biological and engineering issues associated with developing an integrative, quantitative and predictive understanding of rivers and river basins. Funded in 2002, we have had the opportunity to partner with individuals and institutions ranging from formal to informal education and from science museums to Tribal and women’s colleges. We have developed simple table top physical models, complete museum exhibitions, 3D paper maps and interactive computer based visualizations, all of which have helped us communicate with this wide variety of learners. Many of these materials themselves or plans to construct them are available online; in many cases they have also been formally evaluated. We have also listened to the formal and informal educators with whom we partner, from whom we have learned a great deal about how to design Broader Impacts activities and programs. Using NCED as a case study

Photodissociation comprehensive study of OH- on alkali halides and their interaction with colour centers

International Nuclear Information System (INIS)

Gomes, L.

1985-01-01

This work shows that the OH - defect induces changes in the electronics processes of the alkali halides such as in radiation damage and optical cycles of colour centers. Two cases were considered: with the presence of an OH - ion in the (1) excited state and (2) in the ground state; 1) the comprehensive study of resonant OH - photodissociation in several hosts showed that deep traps (for electrons) can be produced from the OH - dissociation. These traps can be effective for the capture of electrons produced in the radiation damage of the lattice as well as for trapping electrons from ionized color centers. It was observed a second channel (new) for the de-excitation of the (OH - )* molecule in KI and RbI. This effect can be effective only when the lattice around the molecule holds a large enough interstitial space. This new mechanism is responsible for the strong production at LNT of F centers and OH 0 molecules at the expenses of OH - defects. Considering the complete investigation of the full cycle it was proposed a phenomenological model that would explain the observed behaviour when one covers a wide variation of lattice parameters (KCl -> RbI); 2) It was verified that the OH - ion present in the lattice induces strong changes in the de-excitation processes of electronic defects with a spread out wave function (like F centers). A change in the reorientation behaviour of excited F 2 and F + 2 centers was also verified. Two main effects should be mentioned: A) The induced de-excitation is very fast and non-radiative on F centers. B) Another type of system investigated (F 2 and F + 2 ) has shown an intense increase of the speed of reorientation of the F 2 and F + 2 excited centers. (autor) [pt

Rhabdomyolysis in Ebola Virus Disease. Results of an Observational Study in a Treatment Center in Guinea.

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Cournac, Jean Marie; Karkowski, Ludovic; Bordes, Julien; Aletti, Marc; Duron, Sandrine; Janvier, Frédéric; Foissaud, Vincent; Savini, Hélène; de Greslan, Thierry; Rousseau, Claire; Billhot, Magali; Gagnon, Nicolas; Mac Nab, Christine; Dubrous, Philippe; Moroge, Sophie; Broto, Helene; Cotte, Jean; Maugey, Nancy; Cordier, Pierre-Yves; Sagui, Emmanuel; Merens, Audrey; Rapp, Christophe; Quentin, Benoit; Granier, Hervé; Carmoi, Thierry; Cellarier, Gilles

2016-01-01

The pathogenesis of Ebola virus disease (EVD) remains unclear. The sporadic nature of Ebola outbreaks and their occurrence in resource-limited settings have precluded the acquisition of extensive clinical and laboratory data. Rhabdomyolysis during EVD has been suggested to occur in previous studies showing increased aspartate aminotransferase-alanine aminotransferase ratios, but, to date, has not been confirmed with creatine kinase (CK) assays. We performed an observational study of 38 patients admitted to an Ebola treatment center from January to April 2015. CK values from patients with confirmed EVD were compared with those in patients without confirmed EVD. A panel of other analyses were also performed. In patients with EVD, characteristics were compared between survivors and nonsurvivors. High levels of CK were more frequent in patients with EVD than in those without (P = .002), and rhabdomyolysis was more frequent (59% vs 19%, respectively; P = .03). CK levels >5000 U/L were observed in 36% of patients with EVD. Also in patients with EVD, fatal outcome was significantly associated with higher creatinine and bilirubin levels, international normalized ratio, and viral load. Rhabdomyolysis is a frequent disorder in EVD and seems to be more common than in other viral infections. It may contribute to the renal failure observed in nonsurviving patients. More studies are needed to determine the impact of rhabdomyolysis on EVD outcome. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Spitzer Infrared Spectrograph Observations of the Galactic Center: Quantifying the Extreme Ultraviolet/Soft X-ray Fluxes

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Simpson, Janet P.

2018-04-01

It has long been shown that the extreme ultraviolet spectrum of the ionizing stars of H II regions can be estimated by comparing the observed line emission to detailed models. In the Galactic Center (GC), however, previous observations have shown that the ionizing spectral energy distribution (SED) of the local photon field is strange, producing both very low excitation ionized gas (indicative of ionization by late O stars) and also widespread diffuse emission from atoms too highly ionized to be found in normal H II regions. This paper describes the analysis of all GC spectra taken by Spitzer's Infrared Spectrograph and downloaded from the Spitzer Heritage Archive. In it, H II region densities and abundances are described, and serendipitously discovered candidate planetary nebulae, compact shocks, and candidate young stellar objects are tabulated. Models were computed with Cloudy, using SEDs from Starburst99 plus additional X-rays, and compared to the observed mid-infrared forbidden and recombination lines. The ages inferred from the model fits do not agree with recent proposed star formation sequences (star formation in the GC occurring along streams of gas with density enhancements caused by close encounters with the black hole, Sgr A*), with Sgr B1, Sgr C, and the Arches Cluster being all about the same age, around 4.5 Myr old, with similar X-ray requirements. The fits for the Quintuplet Cluster appear to give a younger age, but that could be caused by higher-energy photons from shocks from stellar winds or from a supernova.

Synthesis centers as critical research infrastructure

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Baron, Jill S.; Specht, Alison; Garnier, Eric; Bishop, Pamela; Campbell, C. Andrew; Davis, Frank W.; Fady, Bruno; Field, Dawn; Gross, Louis J.; Guru, Siddeswara M.; Halpern, Benjamin S; Hampton, Stephanie E.; Leavitt, Peter R.; Meagher, Thomas R.; Ometto, Jean; Parker, John N.; Price, Richard; Rawson, Casey H.; Rodrigo, Allen; Sheble, Laura A.; Winter, Marten

2017-01-01

investment to maximize benefits to science and society is justified. In particular, we argue that synthesis centers represent community infrastructure more akin to research vessels than to term-funded centers of science and technology (e.g., NSF Science and Technology Centers). Through our experience running synthesis centers and, in some cases, developing postfederal funding models, we offer our perspective on the purpose and value of synthesis centers. We present case studies of different outcomes of transition plans and argue for a fundamental shift in the conception of synthesis science and the strategic funding of these centers by government funding agencies.

Predictors of Default from Treatment for Tuberculosis: a Single Center Case-Control Study in Korea.

Science.gov (United States)

Park, Cheol-Kyu; Shin, Hong-Joon; Kim, Yu-Il; Lim, Sung-Chul; Yoon, Jeong-Sun; Kim, Young-Su; Kim, Jung-Chul; Kwon, Yong-Soo

2016-02-01

Default from tuberculosis (TB) treatment could exacerbate the disease and result in the emergence of drug resistance. This study identified the risk factors for default from TB treatment in Korea. This single-center case-control study analyzed 46 default cases and 100 controls. Default was defined as interrupting treatment for 2 or more consecutive months. The reasons for default were mainly incorrect perception or information about TB (41.3%) and experience of adverse events due to TB drugs (41.3%). In univariate analysis, low income (defaulter (15.2% vs. 2.0%, P = 0.005), and combined extrapulmonary TB (54.3% vs. 34.0%, P = 0.020) were significant risk factors for default. In multivariate analysis, the absence of TB stigma (adjusted odd ratio [aOR]: 46.299, 95% confidence interval [CI]: 8.078-265.365, P defaulters (aOR: 33.226, 95% CI: 2.658-415.309, P = 0.007), and low income (aOR: 5.246, 95% CI: 1.249-22.029, P = 0.024) were independent predictors of default from TB treatment. In conclusion, patients with absence of disease stigma, treated by a non-pulmonologist, who were former defaulters, and with low income should be carefully monitored during TB treatment in Korea to avoid treatment default.

The Polarization Signature of Photospheric Magnetic Fields in 3D MHD Simulations and Observations at Disk Center

Energy Technology Data Exchange (ETDEWEB)

Beck, C. [National Solar Observatory, 3665 Discovery Drive, Boulder, CO 80303 (United States); Fabbian, D. [Max-Planck-Institut für Sonnensytemforschung, Justus-von-Liebig-Weg 3, D-37077 Göttingen (Germany); Rezaei, R. [Instituto de Astrofísica de Canarias, C/Vía Láctea S/N, E-38205 La Laguna, Tenerife (Spain); Puschmann, K. G., E-mail: cbeck@nso.edu [Alzenau (Germany)

2017-06-10

Before using three-dimensional (3D) magnetohydrodynamical (MHD) simulations of the solar photosphere in the determination of elemental abundances, one has to ensure that the correct amount of magnetic flux is present in the simulations. The presence of magnetic flux modifies the thermal structure of the solar photosphere, which affects abundance determinations and the solar spectral irradiance. The amount of magnetic flux in the solar photosphere also constrains any possible heating in the outer solar atmosphere through magnetic reconnection. We compare the polarization signals in disk-center observations of the solar photosphere in quiet-Sun regions with those in Stokes spectra computed on the basis of 3D MHD simulations having average magnetic flux densities of about 20, 56, 112, and 224 G. This approach allows us to find the simulation run that best matches the observations. The observations were taken with the Hinode SpectroPolarimeter (SP), the Tenerife Infrared Polarimeter (TIP), the Polarimetric Littrow Spectrograph (POLIS), and the GREGOR Fabry–Pèrot Interferometer (GFPI), respectively. We determine characteristic quantities of full Stokes profiles in a few photospheric spectral lines in the visible (630 nm) and near-infrared (1083 and 1565 nm). We find that the appearance of abnormal granulation in intensity maps of degraded simulations can be traced back to an initially regular granulation pattern with numerous bright points in the intergranular lanes before the spatial degradation. The linear polarization signals in the simulations are almost exclusively related to canopies of strong magnetic flux concentrations and not to transient events of magnetic flux emergence. We find that the average vertical magnetic flux density in the simulation should be less than 50 G to reproduce the observed polarization signals in the quiet-Sun internetwork. A value of about 35 G gives the best match across the SP, TIP, POLIS, and GFPI observations.

Study on the operational guides of the off-site emergency management center

International Nuclear Information System (INIS)

Park, Won Jong; Han, S. J.; Oh, K. H.

2005-01-01

The emergency response organizational groups and roles of Off-site Emergency Management Center was proposed to respond in case of radiological emergency. Development of implementing procedures of Off-site Emergency Management Center in case of radiological emergency to improve effective co-operation and rapid response in radiological emergency. Establishment of 'The Ordinance of Operation of residence radiological emergency office of the Minister of Science and Technology' and announced by the Minister of Science and Technology. The Implementing procedures of Off-site Emergency Management Center and 'The Ordinance of Operation of residence radiological emergency office of the Minister of Science and Technology' can be provide guidelines in case of emergency

Lyme Neuroborreliosis: Preliminary Results from an Urban Referral Center Employing Strict CDC Criteria for Case Selection

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David S. Younger

2010-01-01

Full Text Available Lyme neuroborreliosis or “neurological Lyme disease” was evidenced in 2 of 23 patients submitted to strict criteria for case selection of the Centers for Disease Control and Prevention employing a two-tier test to detect antibodies to Borrelia burgdorferi at a single institution. One patient had symptomatic polyradiculoneuritis, dysautonomia, and serological evidence of early infection; and another had symptomatic small fiber sensory neuropathy, distal polyneuropathy, dysautonomia, and serological evidence of late infection. In the remaining patients symptoms initially ascribed to Lyme disease were probably unrelated to B. burgdorferi infection. Our findings suggest early susceptibility and protracted involvement of the nervous system most likely due to the immunological effects of B. burgdorferi infection, although the exact mechanisms remain uncertain.

DENSITY OF WARM IONIZED GAS NEAR THE GALACTIC CENTER: LOW RADIO FREQUENCY OBSERVATIONS

International Nuclear Information System (INIS)

Roy, Subhashis

2013-01-01

We have observed the Galactic center (GC) region at 0.154 and 0.255 GHz with the Giant Metrewave Radio Telescope. A total of 62 compact likely extragalactic (EG) sources are detected. Their scattering sizes decrease linearly with increasing angular distance from the GC up to about 1°. The apparent scattering sizes of the sources are more than an order of magnitude less than predicted earlier by the NE2001 model of Galactic electron distribution within 359.°5 e is ∼10 cm –3 , which matches the NE2001 model. This model predicts the EG sources to be resolved out from 1.4 GHz interferometric surveys. However, out of 10 EG sources expected in the region, 8 likely EG are present in the 1.4 GHz catalog. Ionized interfaces of dense molecular clouds to the ambient medium are most likely responsible for strong scattering and low radio frequency absorption. However, dense GC clouds traced by CS J = 1-0 emission are found to have a narrow distribution of ∼0.°2 across the Galactic plane. Angular distribution of most EG sources seen through the so-called Hyperstrong Scattering Region are random in b, and typically ∼7 out of 10 sources will not be seen through the dense molecular clouds, which explains why most of them are not scatter broadened at 1.4 GHz

Effectiveness of nutrition centers in Ceará state, northeastern Brazil

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Monte Cristina Maria Gomes do

1998-01-01

Full Text Available Childhood malnutrition has been a major, long-standing health concern in northeastern Brazil. In response, during 1992_1994, the state government of Ceará, with financial support from the World Bank, established 34 new nutrition centers. During 1996 an evaluation of the centers was conducted to determine their effectiveness in treating children with malnutrition and to identify weaknesses in the system and possible solutions. Also evaluated were the adequacy of resources, admission and discharge criteria, staff training, and community satisfaction. Effectiveness was found to be low. Treatment procedures did not conform with World Health Organization recommendations. Rates of weight gain were inadequate, and the mean duration of rehabilitation-8.7 months-was too long. Case fatality in two centers was unacceptably high, 40% and more. Entry and exit criteria for rehabilitation were ill defined, resulting in some nonmalnourished children being enrolled. Few staff were adequately trained; knowledge was weak, especially about case management; and mothers were not effectively instructed. Recommendations include setting objectives for the centers, improving referral systems, standardizing entry criteria, improving case management, and establishing performance indicators.

Occurrence and spatial distribution of intestinal parasites in an agricultural center in Paraná State, Brazil - doi: 10.4025/actascihealthsci.v32i2.5283 Occurrence and spatial distribution of intestinal parasites in an agricultural center in Paraná State, Brazil - doi: 10.4025/actascihealthsci.v32i2.5283

Directory of Open Access Journals (Sweden)

Vanderly Janeiro

2010-09-01

Full Text Available We determined the occurrence of human cases of intestinal parasites and their spatial distribution in an agricultural center of the state of Paraná in southern Brazil. Results from 5,219 stool examinations carried out in 2003 and 2004 in public and private clinical-pathology laboratories were analyzed. The overall occurrence of intestinal parasites was 19.8%. Entamoeba coli (7.2% and Giardia duodenalis (5.2% were the most frequent species. E. coli was present in 36.4%, G. duodenalis in 26.2% and E. nana in 13.6% of positive cases. According to spatial distribution, the highest occurrence of intestinal parasites was observed in the Piquiri/Guarujá area (p G. duodenalis (22.2% and E. coli (7.4%. Significant differences in the occurrence of enteroparasites were observed for females (p We determined the occurrence of human cases of intestinal parasites and their spatial distribution in an agricultural center of the state of Paraná in southern Brazil. Results from 5,219 stool examinations carried out in 2003 and 2004 in public and private clinical-pathology laboratories were analyzed. The overall occurrence of intestinal parasites was 19.8%. Entamoeba coli (7.2% and Giardia duodenalis (5.2% were the most frequent species. E. coli was present in 36.4%, G. duodenalis in 26.2% and E. nana in 13.6% of positive cases. According to spatial distribution, the highest occurrence of intestinal parasites was observed in the Piquiri/Guarujá area (p G. duodenalis (22.2% and E. coli (7.4%. Significant differences in the occurrence of enteroparasites were observed for females (p < 0.05 and children 0 to 10 years of age (p < 0.05. The occurrence of intestinal parasites in the municipality was mostly related to children, females, and residence in rural areas and the peripheries of urban centers, where the risk of infection is greater. This information will allow the development of appropriate measures for disease prevention and optimization of resources.

Monitoring progression of clinical reasoning skills during health sciences education using the case method - a qualitative observational study.

Science.gov (United States)

Orban, Kristina; Ekelin, Maria; Edgren, Gudrun; Sandgren, Olof; Hovbrandt, Pia; Persson, Eva K

2017-09-11

Outcome- or competency-based education is well established in medical and health sciences education. Curricula are based on courses where students develop their competences and assessment is also usually course-based. Clinical reasoning is an important competence, and the aim of this study was to monitor and describe students' progression in professional clinical reasoning skills during health sciences education using observations of group discussions following the case method. In this qualitative study students from three different health education programmes were observed while discussing clinical cases in a modified Harvard case method session. A rubric with four dimensions - problem-solving process, disciplinary knowledge, character of discussion and communication - was used as an observational tool to identify clinical reasoning. A deductive content analysis was performed. The results revealed the students' transition over time from reasoning based strictly on theoretical knowledge to reasoning ability characterized by clinical considerations and experiences. Students who were approaching the end of their education immediately identified the most important problem and then focused on this in their discussion. Practice knowledge increased over time, which was seen as progression in the use of professional language, concepts, terms and the use of prior clinical experience. The character of the discussion evolved from theoretical considerations early in the education to clinical reasoning in later years. Communication within the groups was supportive and conducted with a professional tone. Our observations revealed progression in several aspects of students' clinical reasoning skills on a group level in their discussions of clinical cases. We suggest that the case method can be a useful tool in assessing quality in health sciences education.

Iguana bites reported to Texas poison centers.

Science.gov (United States)

Forrester, Mathias B

2010-09-01

Although thousands of iguanas are kept as pets in the United States, information on their bites is limited. The intent of this investigation was to describe the pattern of iguana bites reported to Texas poison centers. Iguana bites reported during 1998-2008 were identified. The distribution of cases by various factors was determined. Of 59 total bites, 71% were managed on-site, 17% of the patients were at or en route to a health care facility when the poison center was contacted, and 10% were referred to a health care facility. The medical outcome was no effect in 9% of the cases, minor effect in 24%, moderate effect in 2%, not followed but minimal effects possible in 64%, and unable to follow but potentially toxic in 2%. Most iguana bites reported to Texas poison centers did not result in serious effects and were managed on-site. Copyright © 2010 Elsevier Inc. All rights reserved.

Comparison of outcomes in severely injured patients between a South Korean trauma center and matched patients treated in the United States.

Science.gov (United States)

Jung, Kyoungwon; Matsumoto, Shokei; Smith, Alan; Hwang, Kyungjin; Lee, John Cook-Jong; Coimbra, Raul

2018-06-05

The South Korean government recently developed a master plan for establishing a national trauma system based on the implementation of regional trauma centers. We aimed to compare outcomes between severely injured patients treated at a recently established South Korean trauma center and matched patients treated in American level-1 trauma centers. Two cohorts were selected from an institutional trauma database at Ajou University Medical Center (AUMC) and the American National Trauma Data Bank. Adult patients with an Injury Severity Score of ≥9 were included. Patients were matched based on covariates that affect mortality, using 1:1 propensity score matching. We compared outcomes between the two datasets and performed survival analyses. We created 1,451 and 2,103 matched pairs for the pre-trauma center and post-trauma center periods, respectively. The in-hospital mortality rate was higher in the institutional trauma database pre-trauma center period compared with the American National Trauma Data Bank (11.6% versus 8.1%, P<.001). However, the mortality rate decreased in the institutional trauma database post-trauma center period and was similar to that in the American National Trauma Data Bank (6.9% versus 6.8%, P=.903). Being treated at Ajou University Medical Center Trauma Center was significantly associated with higher mortality during the pre-trauma center period (OR: 1.842, 95% CI: 1.336-2.540; P<.001), although no significant association was observed during the post-trauma center period (OR: 1.102, 95% CI: 0.827-1.468; P=.509). The mortality rate improved after a trauma center was established in a South Korean hospital and is similar to that from matched cases treated at American level-1 trauma centers. Thus, creating trauma centers and a regional trauma system may improve outcomes in major trauma cases. Copyright © 2018 Elsevier Inc. All rights reserved.

Cutaneous sporotrichosis: a six-year review of 19 cases in a tertiary referral center in Malaysia.

Science.gov (United States)

Tang, Min Moon; Tang, Jyh Jong; Gill, Priya; Chang, Choong Chor; Baba, Roshidah

2012-06-01

Sporotrichosis is a subcutaneous fungal infection caused by a thermally dimorphic aerobic fungus, Sporothrix schenckii. It results from traumatic inoculation or contact with animals. Most cases were reported mainly in the tropics and subtropics.   The objective of our study is to assess the clinical characteristic of cutaneous sporotrichosis among our patients. We performed a retrospective review of all cases diagnosed with cutaneous sporotrichosis from July 2004 to June 2010. Patients' medical records were retrieved and analyzed according to demography, preceding trauma, sites of lesions, clinical subtypes, treatment, and clinical response. Nineteen cases were diagnosed with cutaneous sporotrichosis with a male/female ratio of 9:10. Thirteen cases (68.4%) were able to recall preceding trauma, and seven of them reported cat scratches or cat bites. Lymphocutaneous sporotrichosis was observed in 13 cases (68.4%) followed by four cases of fixed cutaneous sporotrichosis and two cases of disseminated sporotrichosis. Histologically, 11 cases (57.8%) demonstrated a granulomatous reaction. Sporothrix schenckii was cultured in 12 cases (63.2%). Thirteen cases (68.4%) were successfully treated with oral itraconazole alone for a mean duration of 15.6 weeks. Two cases with disseminated cutaneous sporotrichosis were treated with intravenous amphotericin B.   Lymphocutaneous sporotrichosis was the most common subtype of cutaneous sporotrichosis in our series, with cat scratches or bites being the most common preceding trauma. Oral itraconazole was highly effective for the localized subtypes, whereas intravenous amphotericin B was required in disseminated cutaneous sporotrichosis. © 2012 The International Society of Dermatology.

The Begun Center for Violence Prevention Research and Education at Case Western Reserve University

Science.gov (United States)

Flannery, Daniel J.; Singer, Mark I.

2015-01-01

Established in the year 2000, the Begun Center for Violence Prevention Research and Education is a multidisciplinary center located at a school of social work that engages in collaborative, community-based research and evaluation that spans multiple systems and disciplines. The Center currently occupies 4,200 sq. ft. with multiple offices and…

Elliptic genera from multi-centers

Energy Technology Data Exchange (ETDEWEB)

Gaddam, Nava [Institute for Theoretical Physics and Center for Extreme Matter and Emergent Phenomena,Utrecht University, 3508 TD Utrecht (Netherlands)

2016-05-13

I show how elliptic genera for various Calabi-Yau threefolds may be understood from supergravity localization using the quantization of the phase space of certain multi-center configurations. I present a simple procedure that allows for the enumeration of all multi-center configurations contributing to the polar sector of the elliptic genera — explicitly verifying this in the cases of the quintic in ℙ{sup 4}, the sextic in Wℙ{sub (2,1,1,1,1)}, the octic in Wℙ{sub (4,1,1,1,1)} and the dectic in Wℙ{sub (5,2,1,1,1)}. With an input of the corresponding ‘single-center’ indices (Donaldson-Thomas invariants), the polar terms have been known to determine the elliptic genera completely. I argue that this multi-center approach to the low-lying spectrum of the elliptic genera is a stepping stone towards an understanding of the exact microscopic states that contribute to supersymmetric single center black hole entropy in N=2 supergravity.

Audit of a Scientific Data Center for Certification as a Trustworthy Digital Repository: A Case Study

Science.gov (United States)

Downs, R. R.; Chen, R. S.

2011-12-01

Services that preserve and enable future access to scientific data are necessary to ensure that the data that are being collected today will be available for use by future generations of scientists. Many data centers, archives, and other digital repositories are working to improve their ability to serve as long-term stewards of scientific data. Trust in sustainable data management and preservation capabilities of digital repositories can influence decisions to use these services to deposit or obtain scientific data. Building on the Open Archival Information System (OAIS) Reference Model developed by the Consultative Committee for Space Data Systems (CCSDS) and adopted by the International Organization for Standardization as ISO 14721:2003, new standards are being developed to improve long-term data management processes and documentation. The Draft Information Standard ISO/DIS 16363, "Space data and information transfer systems - Audit and certification of trustworthy digital repositories" offers the potential to evaluate digital repositories objectively in terms of their trustworthiness as long-term stewards of digital resources. In conjunction with this, the CCSDS and ISO are developing another draft standard for the auditing and certification process, ISO/DIS 16919, "Space data and information transfer systems - Requirements for bodies providing audit and certification of candidate trustworthy digital repositories". Six test audits were conducted of scientific data centers and archives in Europe and the United States to test the use of these draft standards and identify potential improvements for the standards and for the participating digital repositories. We present a case study of the test audit conducted on the NASA Socioeconomic Data and Applications Center (SEDAC) and describe the preparation, the audit process, recommendations received, and next steps to obtain certification as a trustworthy digital repository, after approval of the ISO/DIS standards.

Then we all fall down: fall mortality by trauma center level.

Science.gov (United States)

Roubik, Daniel; Cook, Alan D; Ward, Jeanette G; Chapple, Kristina M; Teperman, Sheldon; Stone, Melvin E; Gross, Brian; Moore, Forrest O

2017-09-01

Ground-level falls (GLFs) are the predominant mechanism of injury in US trauma centers and accompany a spectrum of comorbidities, injury severity, and physiologic derangement. Trauma center levels define tiers of capability to treat injured patients. We hypothesized that risk-adjusted observed-to-expected mortality (O:E) by trauma center level would evaluate the degree to which need for care was met by provision of care. This retrospective cohort study used National Trauma Data Bank files for 2007-2014. Trauma center level was defined as American College of Surgeons (ACS) level I/II, ACS III/IV, State I/II, and State III/IV for within-group homogeneity. Risk-adjusted expected mortality was estimated using hierarchical, multivariable regression techniques. Analysis of 812,053 patients' data revealed the proportion of GLF in the National Trauma Data Bank increased 8.7% (14.1%-22.8%) over the 8 y studied. Mortality was 4.21% overall with a three-fold increase for those aged 60 y and older versus younger than 60 y (4.93% versus 1.46%, P < 0.001). O:E was lowest for ACS III/IV, (0.973, 95% CI: 0.971-0.975) and highest for State III/IV (1.043, 95% CI: 1.041-1.044). Risk-adjusted outcomes can be measured and meaningfully compared among groups of trauma centers. Differential O:E for ACS III/IV and State III/IV centers suggests that factors beyond case mix alone influence outcomes for GLF patients. More work is needed to optimize trauma care for GLF patients across the spectrum of trauma center capability. Copyright © 2017 Elsevier Inc. All rights reserved.

ADVANCED COMPOSITES TECHNOLOGY CASE STUDY AT NASA LANGLEY RESEARCH CENTER

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This report summarizes work conducted at the National Aeronautics and Space Administration's Langley Research Center (NASA-LaRC) in Hampton, VA, under the U.S. Environmental Protection Agency’s (EPA) Waste Reduction Evaluations at Federal Sites (WREAFS) Program. Support for...

Observing principles of medical ethics during family planning services at Tehran urban healthcare centers in 2007

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Saeed Motevallizadeh

2011-01-01

Full Text Available Background: Family planning has been defined in the framework of mothers and children plan as one of Primary Healthcare (PHC details. Besides quantity, the quality of services, particularly in terms of ethics, such as observing individuals’ privacy, is of great importance in offering family planning services.Objective: A preliminary study to gather information about the degree of medical ethics offered during family planning services at Tehran urban healthcare centers.Materials and Methods: A questionnaire was designed for study. In the first question regarding informed consent, 47 clients who were advised about various contraception methods were asked whether advantages and disadvantages of the contraceptive methods have been discussed by the service provider. Then a certain rank was measured for either client or method in 2007. Finally, average value of advantage and disadvantage for each method was measured. In questions about autonomy, justice and beneficence, yes/no answers have been expected and measured accordingly.Results: Health care providers have stressed more on the advantages of pills and disadvantages of tubectomy and have paid less attention to advantages of injection ampoules and disadvantages of pills in first time clients. While they have stressed more on the advantages and disadvantages of tubectomy and less attention to advantages of condom and disadvantages of vasectomy in second time clients. Clients divulged their 100% satisfaction in terms of observing turns and free charges services.Observance degree of autonomy was 64.7% and 77.3% for first time and second- time clients respectively.Conclusion: Applying the consultant’s personal viewpoint for selecting a method will breach an informed consent for first and second time clients. System has good consideration to justice and no malfeasance

A management plan for hospitals and medical centers facing radiation incidents.

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Davari, Fereshteh; Zahed, Arash

2015-09-01

Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

Identifying the Local Impacts of National ATE Centers on Their Host Institutions: An Exploratory Study

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Henderson, Charles; Fynewever, Herb; Petcovic, Heather; Bierema, Andrea

2012-01-01

The purpose of this study is to identify the local impacts of national advanced technological education (ATE) centers on their host institutions. A sample of three mature, national ATE centers are chosen, with each center serving as a case for a mixed-methods, collective case study research design. Results, drawn from interviews and surveys,…

Video-Based Self-Observation as a Component of Developmental Teacher Evaluation

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Leonardo A. Mercado

2014-09-01

Full Text Available In this paper, we explore the benefits to teacher evaluation when video-based self-observation is done by teachers as a vehicle for individual, reflective practice. We explore how it was applied systematically at the Instituto Cultural Peruano Norteamericano (ICPNA bi-national center in Lima, Peru among hundreds of English as a foreign language (EFL teachers in two institution-wide initiatives that have relied on self-observation through video professional development. In these cases, we provide a descriptive framework for each initiative as well as information on what was ultimately achieved by teachers, supervisors and the institution as a whole. We conclude with recommendations for implementing video-based self-evaluation.

A novel patient-centered "intention-to-treat" metric of U.S. lung transplant center performance.

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Maldonado, Dawn A; RoyChoudhury, Arindam; Lederer, David J

2018-01-01

Despite the importance of pretransplantation outcomes, 1-year posttransplantation survival is typically considered the primary metric of lung transplant center performance in the United States. We designed a novel lung transplant center performance metric that incorporates both pre- and posttransplantation survival time. We performed an ecologic study of 12 187 lung transplant candidates listed at 56 U.S. lung transplant centers between 2006 and 2012. We calculated an "intention-to-treat" survival (ITTS) metric as the percentage of waiting list candidates surviving at least 1 year after transplantation. The median center-level 1-year posttransplantation survival rate was 84.1%, and the median center-level ITTS was 66.9% (mean absolute difference 19.6%, 95% limits of agreement 4.3 to 35.1%). All but 10 centers had ITTS values that were significantly lower than 1-year posttransplantation survival rates. Observed ITTS was significantly lower than expected ITTS for 7 centers. These data show that one third of lung transplant candidates do not survive 1 year after transplantation, and that 12% of centers have lower than expected ITTS. An "intention-to-treat" survival metric may provide a more realistic expectation of patient outcomes at transplant centers and may be of value to transplant centers and policymakers. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

CLINICAL OBSERVATION ON TREATMENT OF 61 CASES OF INSOMNIA WITH AURICULAR PLASTER THERAPY

Institute of Scientific and Technical Information of China (English)

张家彤; 王月

2003-01-01

Objective: To observe the therapeutic effect of auricular plaster (otopoint-pressure) therapy in thetreatment of insomnia. Methods: In this paper, 61 cases of insomnia patients including 16 males and 45 females weretreated with Ershenmen (MA-TF 1), Zhen (MA-AT), Yuanzhong (MA-AT), Nao Dian and E (MA-AT), combined withother otopoints according to symptoms. The otopoint was stuck with a piece of plaster adhered with vaccaria seeds andpressured by the patient him- or her-self. The treatment was given twice a week, with 7 times being a therapeuticcourse. Results: After 1 - 2 courses of treatment, 19 (31.15%) cases were cured, 34 (55.74 % ) had improvementand 8 (13.11%) had no changes, with the total effective rate being 86.9%. Conclusion: Auricular plaster therapyworks well in the treatment of insomnia patient.

Data center networks and network architecture

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Esaki, Hiroshi

2014-02-01

This paper discusses and proposes the architectural framework, which is for data center networks. The data center networks require new technical challenges, and it would be good opportunity to change the functions, which are not need in current and future networks. Based on the observation and consideration on data center networks, this paper proposes; (i) Broadcast-free layer 2 network (i.e., emulation of broadcast at the end-node), (ii) Full-mesh point-to-point pipes, and (iii) IRIDES (Invitation Routing aDvertisement for path Engineering System).

Using Technology to Enhance Teaching of Patient-Centered Interviewing for Early Medical Students.

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Kaltman, Stacey; Talisman, Nicholas; Pennestri, Susan; Syverson, Eleri; Arthur, Paige; Vovides, Yianna

2018-06-01

Effective strategies for teaching communication skills to health professions students are needed. This article describes the design and evaluation of immersive and interactive video simulations for medical students to practice basic communication skills. Three simulations were developed, focusing on patient-centered interviewing techniques such as using open-ended questions, reflections, and empathic responses while assessing a patient's history of present illness. First-year medical students were randomized to simulation or education-as-usual arms. Students in the simulation arm were given access to three interactive video simulations developed using Articulate Storyline, an e-learning authoring tool, to practice and receive feedback on patient-centered interviewing techniques to prepare for their Observed Structured Clinical Examination (OSCE). Trained raters evaluated videos of two OSCE cases for each participant to assess specific communication skills used during the history of present illness component of the interview. Eighty-seven percent of the students in the simulation arm interacted with at least one simulation during the history of present illness. For both OSCE cases, students in the simulation arm asked significantly more open-ended questions. Students in the simulation arm asked significantly fewer closed-ended questions and offered significantly more empathic responses in one OSCE case. No differences were found for reflections. Students reported that the simulations helped improve their communication skills. The use of interactive video simulations was found to be feasible to incorporate into the curriculum and was appealing to students. In addition, students in the simulation arm displayed more behaviors consistent with the patient-centered interviewing model practiced in the simulations. Continued development and research are warranted.

Urea cycle disorders in Spain: an observational, cross-sectional and multicentric study of 104 cases.

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Martín-Hernández, Elena; Aldámiz-Echevarría, Luis; Castejón-Ponce, Esperanza; Pedrón-Giner, Consuelo; Couce, María Luz; Serrano-Nieto, Juliana; Pintos-Morell, Guillem; Bélanger-Quintana, Amaya; Martínez-Pardo, Mercedes; García-Silva, María Teresa; Quijada-Fraile, Pilar; Vitoria-Miñana, Isidro; Dalmau, Jaime; Lama-More, Rosa A; Bueno-Delgado, María Amor; Del Toro-Riera, Mirella; García-Jiménez, Inmaculada; Sierra-Córcoles, Concepción; Ruiz-Pons, Mónica; Peña-Quintana, Luis J; Vives-Piñera, Inmaculada; Moráis, Ana; Balmaseda-Serrano, Elena; Meavilla, Silvia; Sanjurjo-Crespo, Pablo; Pérez-Cerdá, Celia

2014-11-30

Advances in the diagnosis and treatment of urea cycle disorders (UCDs) have led to a higher survival rate. The purpose of this study is to describe the characteristics of patients with urea cycle disorders in Spain. Observational, cross-sectional and multicenter study. Clinical, biochemical and genetic data were collected from patients with UCDs, treated in the metabolic diseases centers in Spain between February 2012 and February 2013, covering the entire Spanish population. Heterozygous mothers of patients with OTC deficiency were only included if they were on treatment due to being symptomatic or having biochemistry abnormalities. 104 patients from 98 families were included. Ornithine transcarbamylase deficiency was the most frequent condition (64.4%) (61.2% female) followed by type 1 citrullinemia (21.1%) and argininosuccinic aciduria (9.6%). Only 13 patients (12.5%) were diagnosed in a pre-symptomatic state. 63% of the cases presented with type intoxication encephalopathy. The median ammonia level at onset was 298 μmol/L (169-615). The genotype of 75 patients is known, with 18 new mutations having been described. During the data collection period four patients died, three of them in the early days of life. The median current age is 9.96 years (5.29-18), with 25 patients over 18 years of age. Anthropometric data, expressed as median and z-score for the Spanish population is shown. 52.5% of the cases present neurological sequelae, which have been linked to the type of disease, neonatal onset, hepatic failure at diagnosis and ammonia values at diagnosis. 93 patients are following a protein restrictive diet, 0.84 g/kg/day (0.67-1.10), 50 are receiving essential amino acid supplements, 0.25 g/kg/day (0.20-0.45), 58 arginine, 156 mg/kg/day (109-305) and 45 citrulline, 150 mg/kg/day (105-199). 65 patients are being treated with drugs: 4 with sodium benzoate, 50 with sodium phenylbutyrate, 10 with both drugs and 1 with carglumic acid. Studies like this make it

S2 like Star Orbits near the Galactic Center in Rn and Yukawa Gravity

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Borka, Dusko; Jovanović, Predrag; Jovanović Vesna Borka; Zakharov, Alexander F.

2015-01-01

In this chapter we investigate the possibility to provide theoretical explanation for the observed deviations of S2 star orbit around the Galactic Center using gravitational potentials derived from extended gravity models, but in absence of dark matter. Extended Theories of Gravity are alternative theories of gravitational interaction developed from the exact starting points investigated first by Einstein and Hilbert and aimed from one side to extend the positive results of General Relativity and, on the other hand, to cure its shortcomings. One of the aims of these theories is to explain galactic and extragalactic dynamics without introduction of dark matter. They are based on straightforward generalizations of the Einstein theory where the gravitational action (the Hilbert-Einstein action) is assumed to be linear in the Ricci curvature scalar R. The f(R) gravity is a type of modified gravity which generalizes Einstein's General Relativity, i.e. the simplest case is just the General Relativity. It is actually a family of models, each one defined by a different function of the Ricci scalar. Here, we consider Rn (power-law fourth-order theories of gravity) and Yukawa-like modified gravities in the weak field limit and discuss the constrains on these theories. For that purpose we simulate the orbit of S2 star around the Galactic Center in Rn and Yukawa-like gravity potentials and compare it with New Technology Telescope/Very Large Telescope (NTT/VLT) as well as by Keck telescope observations. Our simulations result in strong constraints on the range of gravity interaction and showed that both Rn and Yukawa gravity could satisfactorily explain the observed orbits of S2 star. However, we concluded that parameters of Rn and Yukawa gravity theories must be very close to those corresponding to the Newtonian limit of the theory. Besides, in contrast to Newtonian gravity, these two modified theories induce orbital precession, even in the case of point-like central mass. The

Climate Prediction Center (CPC) U.S. Daily Snow Depth Observations

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National Oceanic and Atmospheric Administration, Department of Commerce — Observational reports of current snow depth (at 1200 UTC) are made by members of the NWS Automated Surface Observing Systems (ASOS) network and NWS Cooperative...

Using a Birth Center Model of Care to Improve Reproductive Outcomes in Informal Settlements-a Case Study.

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Wallace, Jacqueline

2018-06-04

The world is becoming increasingly urban. For the first time in history, more than 50% of human beings live in cities (United Nations, Department of Economic and Social Affairs, Population Division, ed. (2015)). Rapid urbanization is often chaotic and unstructured, leading to the formation of informal settlements or slums. Informal settlements are frequently located in environmentally hazardous areas and typically lack adequate sanitation and clean water, leading to poor health outcomes for residents. In these difficult circumstances women and children fair the worst, and reproductive outcomes for women living in informal settlements are grim. Insufficient uptake of antenatal care, lack of skilled birth attendants and poor-quality care contribute to maternal mortality rates in informal settlements that far outpace wealthier urban neighborhoods (Chant and McIlwaine (2016)). In response, a birth center model of maternity care is proposed for informal settlements. Birth centers have been shown to provide high quality, respectful, culturally appropriate care in high resource settings (Stapleton et al. J Midwifery Women's Health 58(1):3-14, 2013; Hodnett et al. Cochrane Database Syst Rev CD000012, 2012; Brocklehurst et al. BMJ 343:d7400, 2011). In this paper, three case studies are described that support the use of this model in low resource, urban settings.

Climate Prediction Center (CPC) U.S. Daily Snow Fall Observations

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National Oceanic and Atmospheric Administration, Department of Commerce — Observational reports of daily snow fall (1200 UTC to 1200 UTC) are made by members of the NWS Automated Surface Observing Systems (ASOS) network and NWS Cooperative...

Germinal center architecture disturbance during Plasmodium berghei ANKA infection in CBA mice

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Pelajo-Machado Marcelo

2007-05-01

Full Text Available Abstract Background Immune responses to malaria blood stage infection are in general defective, with the need for long-term exposure to the parasite to achieve immunity, and with the development of immunopathology states such as cerebral malaria in many cases. One of the potential reasons for the difficulty in developing protective immunity is the poor development of memory responses. In this paper, the potential association of cellular reactivity in lymphoid organs (spleen, lymph nodes and Peyer's patches with immunity and pathology was evaluated during Plasmodium berghei ANKA infection in CBA mice. Methods CBA mice were infected with 1 × 106 P. berghei ANKA-parasitized erythrocytes and killed on days 3, 6–8 and 10 of infection. The spleen, lymph nodes and Peyer's patches were collected, fixed in Carson's formalin, cut in 5 μm sections, mounted in glass slides, stained with Lennert's Giemsa and haematoxylin-eosin and analysed with bright-field microscopy. Results Early (day 3 strong activation of T cells in secondary lymphoid organs was observed and, on days 6–8 of infection, there was overwhelming activation of B cells, with loss of conventional germinal center architecture, intense centroblast activation, proliferation and apoptosis but little differentiation to centrocytes. In the spleen, the marginal zone disappeared and the limits between the disorganized germinal center and the red pulp were blurred. Intense plasmacytogenesis was observed in the T cell zone. Conclusion The observed alterations, especially the germinal center architecture disturbance (GCAD with poor centrocyte differentiation, suggest that B cell responses during P. berghei ANKA infection in mice are defective, with potential impact on B cell memory responses.

Benefits of the implementation and use of a warehouse management system in a distribution center

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Alexsander Machado

2011-12-01

Full Text Available The aim of this article was to describe how the deployment and use of a Warehouse Management System (WMS can help increase productivity, reduce errors and speed up the flow of information in a distribution center. The research method was the case study. We had chosen a distributor of goods, located in Vale do Rio dos Sinos, RS, which sells and distributes for companies throughout Brazil products for business use. The main research technique was participant observation. In order to highlight the observed results, we collected two indicators, productivity and errors for the separation of items into applications. After four months of observation, both showed significant improvement, strengthening the hypothesis that selection and implementation of management system was beneficial for the company.

Interdisciplinarity in work process at a Psychosocial Attention Center

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Maria Salete Bessa Jorge

2010-09-01

Full Text Available Objective: To analyze the work process of mental health professionals from a Psychosocial Attention Center (CAPS, from the knowledge and the practices applied in the production of care and its interface with user’s demands and the service offering. Methods: A case study with qualitative approach. Twenty-eight subjects joined in and were divided into three groups: I (eleven mental health workers, II (eleven users e III (six family members. The semistructured interview was used besides systematic observation, in the search for data about the work process of the professionals of the Psychosocial Attention Center, the relationship between team and user, offering and demand, access, technologies of care, knowledge and practices and interdisciplinarity. The investigation was based upon critical content analysis and was oriented by the flowchart analyzer. Results: The service organization and its work process are directed to the immediate supply of the population’s demands, which depicts a care based on prescriptive practices. Thus, the flow of assistance and the service offering complement each other in the need of a procedure and in its exhaustive offering by the service, dissolving interdisciplinary conductions of intervention shared with the user.Conclusion: Mental health care is still surrounded by biomedical hegemony centered in procedures directed to pharmacological prescription. Despite this reality, the work centered on the user and the utilization of soft technologies – communication, link, welcoming – begin to take part of the daily CAPS service offering, although it is only present in specific activities of certain procedures.

Relationships among Shopping Quality and Corporate Social Responsibility of Shopping Centers and Consumer Satisfaction: Case from Novi Sad (Serbia

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Ivana Blešić

2014-02-01

Full Text Available Taking into consideration satisfied customer as necessary for business maintenance, companies are trying to discover determinants which have the biggest influence on their consumer satisfaction. Here are presented two factors that have influence on consumer satisfaction in shopping centers: quality of shopping and corporate social responsibility. In this research, each of these factors had six elements. The results of the regression analysis are that “Value for money in stores” (beta=0.387, p=0.000 has the greatest impact on satisfaction when shopping quality performance is concerned, and that “Retailer support for (national/local cultural and sport events“ (beta=0.333, p<0.001 has the greatest impact on satisfaction in the case of CSR performance. Further analysis showed the difference in consumer perception of corporate social responsibility, depending on their occupation and level of education. It is also important to mention that consumers with environment and empathic concern have higher scores perception of CSR. However, there is not statistically important difference in consumer perception of shopping quality in shopping centers

VLBA Detects Earth's Motion Around the Milky Way's Center

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1999-06-01

It takes our Solar System more than 200 million years to orbit the center of the Milky Way Galaxy, 26,000 light-years away. Despite that tremendously long time span, astronomers using the National Science Foundation's (NSF) powerful Very Long Baseline Array (VLBA) radio telescope have shown they can detect this orbital motion in ten days! In addition, they have made a new and more accurate determination of just how long it takes us to circle our Galaxy -- 226 million years. "Not only is this a tremendous technical achievement, but it also has allowed us to greatly strengthen the scientific case for a supermassive black hole at the Galaxy's center -- definitely ruling out a multiple-star system," said Mark Reid of the Harvard-Smithsonian Center for Astrophysics. Reid, along with Anthony Readhead and Rene Vermuelen of Caltech and Robert Treuhaft of the Jet Propulsion Laboratory, announced their discovery at the American Astronomical Society's meeting in Chicago. The scientists used the continent-wide VLBA, part of the NSF's National Radio Astronomy Observatory (NRAO), to observe a radio-wave-emitting object called Sagittarius A* (pronounced "A-star"), that has been thought to mark the exact center of the Milky Way since its discovery more than two decades ago. They were able to measure its position on the sky within nearly one ten-thousandth of a second of arc -- a precision 600,000 times greater than that of the human eye and more than 500 times greater than that of the Hubble Space Telescope. With this precision, the astronomers were able to detect the slight apparent shift in position of Sagittarius A* compared to the positions of much more-distant quasars behind it. That apparent shift was caused by the motion of the Solar System around the Galaxy's center. "From these measurements, we estimate that we are moving at about 135 miles per second in our orbit around the center of the Milky Way," Reid said. "Even though it takes more than 200 million years for us to

Earth Observation Data Quality Monitoring and Control: A Case Study of STAR Central Data Repository

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Han, W.; Jochum, M.

2017-12-01

Earth observation data quality is very important for researchers and decision makers involved in weather forecasting, severe weather warning, disaster and emergency response, environmental monitoring, etc. Monitoring and control earth observation data quality, especially accuracy, completeness, and timeliness, is very useful in data management and governance to optimize data flow, discover potential transmission issues, and better connect data providers and users. Taking a centralized near real-time satellite data repository, STAR (Center for Satellite Applications and Research of NOAA) Central Data Repository (SCDR), as an example, this paper describes how to develop new mechanism to verify data integrity, check data completeness, and monitor data latency in an operational data management system. Such quality monitoring and control of large volume satellite data help data providers and managers improve data transmission of near real-time satellite data, enhance its acquisition and management, and overcome performance and management issues to better serve research and development activities.

The current status of emergency operations at a high-volume cancer center.

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Komori, Koji; Kimura, Kenya; Kinoshita, Takashi; Ito, Seiji; Abe, Tetsuya; Senda, Yoshiki; Misawa, Kazunari; Ito, Yuichi; Uemura, Norihisa; Natsume, Seiji; Kawai, Ryosuke; Kawakami, Jiro; Asano, Tomonari; Iwata, Yoshinori; Kurahashi, Shintaro; Tsutsuyama, Masayuki; Shigeyoshi, Itaru; Shimizu, Yasuhiro

2014-01-01

This study aimed to assess the pathogenic causes, clinical conditions, surgical procedures, in-hospital mortality, and operative death associated with emergency operations at a high-volume cancer center. Although many reports have described the contents, operative procedures, and prognosis of elective surgeries in high-volume cancer centers, emergency operations have not been studied in sufficient detail. We retrospectively enrolled 28 consecutive patients who underwent emergency surgery. Cases involving operative complications were excluded. The following surgical procedures were performed during emergency operations: closure in 3 cases (10.7%), diversion in 22 cases (78.6%), ileus treatment in 2 cases (7.1%), and hemostasis in 1 case (3.6%). Closure alone was performed only once for peritonitis. Diversion was performed in 17 cases (77.3%) of peritonitis, 4 cases (18.2%) of stenosis of the gastrointestinal tract, and 1 case (4.5%) of bleeding. There was a significant overall difference (P = 0.001). The frequency of emergency operations was very low at a high-volume cancer center. However, the recent shift in treatment approaches toward nonoperative techniques may enhance the status of emergency surgical procedures. The results presented in this study will help prepare for emergency situations and resolve them as quickly and efficiently as possible.

Trauma center accessibility for road traffic injuries in Hanoi, Vietnam.

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Nagata, Takashi; Takamori, Ayako; Kimura, Yoshinari; Kimura, Akio; Hashizume, Makoto; Nakahara, Shinji

2011-09-30

Rapid economic growth in Vietnam over the last decade has led to an increased frequency of road traffic injury (RTI), which now represents one of the leading causes of death in the nation. Various efforts toward injury prevention have not produced a significant decline in the incidence of RTIs. Our study sought to describe the geographic distribution of RTIs in Hanoi, Vietnam and to evaluate the accessibility of trauma centers to those injured in the city. We performed a cross-sectional study using Hanoi city police reports from 2006 to describe the epidemiology of RTIs occurring in Hanoi city. Additionally, we identified geographic patterns and determined the direct distance from injury sites to trauma centers by applying geographical information system (GIS) software. Factors associated with the accessibility of trauma centers were evaluated by multivariate regression analysis. We mapped 1,271 RTIs in Hanoi city. About 40% of RTIs occurred among people 20-29 years of age. Additionally, 63% of RTIs were motorcycle-associated incidents. Two peak times of injury occurrence were observed: 12 am-4 pm and 8 pm-0 am. "Hot spots" of road traffic injuries/fatalities were identified in the city area and on main highways using Kernel density estimation. Interestingly, RTIs occurring along the two north-south main roads were not within easy access of trauma centers. Further, fatal cases, gender and injury mechanism were significantly associated with the distance between injury location and trauma centers. Geographical patterns of RTIs in Hanoi city differed by gender, time, and injury mechanism; such information may be useful for injury prevention. Specifically, RTIs occurring along the two north-south main roads have lower accessibility to trauma centers, thus an emergency medical service system should be established.

Building an outpatient imaging center: A case study at genesis healthcare system, part 2.

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Yanci, Jim

2006-01-01

In the second of 2 parts, this article will focus on process improvement projects utilizing a case study at Genesis HealthCare System located in Zanesville, OH. Operational efficiency is a key step in developing a freestanding diagnostic imaging center. The process improvement projects began with an Expert Improvement Session (EIS) on the scheduling process. An EIS session is a facilitated meeting that can last anywhere from 3 hours to 2 days. Its intention is to take a group of people involved with the problem or operational process and work to understand current failures or breakdowns in the process. Recommendations are jointly developed to overcome any current deficiencies, and a work plan is structured to create ownership over the changes. A total of 11 EIS sessions occurred over the course of this project, covering 5 sections: Scheduling/telephone call process, Pre-registration, Verification/pre-certification, MRI throughput, CT throughput. Following is a single example of a project focused on the process improvement efforts. All of the process improvement projects utilized a quasi methodology of "DMAIC" (Define, Measure, Analyze, Improve, and Control).

Case Study: Guidelines for Producing Videos to Accompany Flipped Cases

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Prud'homme-Généreux, Annie; Schiller, Nancy A.; Wild, John H.; Herreid, Clyde Freeman

2017-01-01

Three years ago, the "National Center for Case Study Teaching in Science" (NCCSTS) was inspired to merge the case study and flipped classroom approaches. The resulting project aimed to create the materials required to teach a flipped course in introductory biology by assigning videos as homework and case studies in the classroom. Three…

Extensions of guiding center motion to higher order

International Nuclear Information System (INIS)

Northrop, T.G.; Rome, J.A.

1978-01-01

In a static magnetic field, some well-known guiding center equations maintain their form when extended to next order in gyroradius. In these cases, it is only necessary to include the next order term in the magnetic moment series. The differential equation for guiding center motion which describes both the parallel and perpendicular velocities correctly through first order in gyroradius is given. The question of how to define the guiding center position through second order arises and is discussed, and second order drifts are derived for one usual definition. The toroidal canonical angular momentum, P/sub phi/, of the guiding center in an axisymmetric field is shown to be conserved using the guiding center velocity correct through first order. When second-order motion is included, P/sub phi/ is no longer a constant. The above extensions of guiding center theory help to resolve the different tokamak orbits obtained either by using the guiding center equations of motion or by using conservation of P/sub phi/

Extensions of guiding center motion to higher order

International Nuclear Information System (INIS)

Northrop, T.G.; Rome, J.A.

1977-07-01

In a static magnetic field, some well-known guiding center equations maintain their form when extended to next order in gyroradius. In these cases, it is only necessary to include the next order term in the magnetic moment series. The differential equation for guiding center motion which describes both the parallel and perpendicular velocities correctly through first order in gyroradius is given. The question of how to define the guiding center position through second order arises and is discussed, and second order drifts are derived for one usual definition. The toroidal canonical angular momentum, P/sub phi/, of the guiding center in an axisymmetric field is shown to be conserved using the guiding center velocity correct through first order. When second order motion is included, P/sub phi/ is no longer a constant. The above extensions of guiding center theory help to resolve the different tokamak orbits obtained either by using the guiding center equations of motion or by using conservation of P/sub phi/

Evaluating the Impact of AIRS Observations on Regional Forecasts at the SPoRT Center

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Zavodsky, Bradley

2011-01-01

NASA Short-term Prediction Research and Transition (SPoRT) Center collaborates with operational partners of different sizes and operational goals to improve forecasts using targeted projects and data sets. Modeling and DA activities focus on demonstrating utility of NASA data sets and capabilities within operational systems. SPoRT has successfully assimilated the Atmospheric Infrared Sounder (AIRS) radiance and profile data. A collaborative project is underway with the Joint Center for Satellite Data Assimilation (JCSDA) to use AIRS profiles to better understand the impact of AIRS radiances assimilated within Gridpoint Statistical Interpolation (GSI) in hopes of engaging the operational DA community in a reassessment of assimilation methodologies to more effectively assimilate hyperspectral radiances.

Application of Suresight handheld auto-refractometer in refraction screening for infants in Community Health Service Center

Directory of Open Access Journals (Sweden)

Li-Hua Guo

2014-08-01

Full Text Available AIM: To observe the application of Suresight handheld auto-refractometer in measuring diopter of infants in Community Health Service Center. METHODS:Totally 836 cases(1 672 eyesfrom June 2013 to December 2013 were examined diopter of infants by Suresight handheld auto-refractometer in Community Health Service Center. RESULTS: Within 1 672 eyes of 836 infants were examined, 202 eyes were diagnosed ametropia, 38 eyes were suspicious, 240 eyes were transferred to the department of ophthalmology, the referral rate was 14.35%; 172 eyes were diagnosed ametropia, and the diagnosis rate of the referral patients was 71.67%. Among 172 eyes, 46 eyes were provided with corrected glasses, accounting for 2.75% of the number of screening, and 126 eyes were given intensive monitoring, accounting for 7.54% of the number of screening.CONCLUSION: Application of Suresight handheld auto-refractometer in refraction screening for infants in Community Health Service Center is convenient and effective. With two-way referral between community health service center and department of ophthalmology can monitor and intervene vision development of infants much earlier.

Determination of the activation energy of A-center in the uniaxially deformed n-Ge single crystals

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S. V. Luniov

2017-08-01

Full Text Available Based on the decisions of electroneutrality equation and experimental results of measurements of the piezo-Hall-effect the dependences of activation energy of the deep level A-center depending on the uniaxial pressure along the crystallographic directions [100], [110] and [111] for n-Ge single crystals, irradiated by the electrons with energy 10 MeV are obtained. Using the method of least squares approximational polynomials for the calculation of these dependences are obtained. It is shown that the activation energy of A-center deep level decreases linearly for the entire range of uniaxial pressure along the crystallographic direction [100]. For the cases of uniaxial deformation along the crystallographic directions [110] and [111] decrease of the activation energy according to the linear law is observed only at high uniaxial pressures, when the A-center deep level interacts with the minima of the germanium conduction band, which proved the lower at the deformation. The various dependences of the activation energy of A-center depending on the orientation of the axis of deformation may be connected with features of its microstructure.

Observations and NLTE modeling of Ellerman bombs

Science.gov (United States)

Berlicki, A.; Heinzel, P.

2014-07-01

Context. Ellerman bombs (EBs) are short-lived, compact, and spatially well localized emission structures that are observed well in the wings of the hydrogen Hα line. EBs are also observed in the chromospheric CaII lines and in UV continua as bright points located within active regions. Hα line profiles of EBs show a deep absorption at the line center and enhanced emission in the line wings with maxima around ±1 Å from the line center. Similar shapes of the line profiles are observed for the CaII IR line at 8542 Å. In CaII H and K lines the emission peaks are much stronger, and EBs emission is also enhanced in the line center. Aims: It is generally accepted that EBs may be considered as compact microflares located in lower solar atmosphere that contribute to the heating of these low-lying regions, close to the temperature minimum of the atmosphere. However, it is still not clear where exactly the emission of EBs is formed in the solar atmosphere. High-resolution spectrophotometric observations of EBs were used for determining of their physical parameters and construction of semi-empirical models. Obtained models allow us to determine the position of EBs in the solar atmosphere, as well as the vertical structure of the activated EB atmosphere Methods: In our analysis we used observations of EBs obtained in the Hα and CaII H lines with the Dutch Open Telescope (DOT). These one-hour long simultaneous sequences obtained with high temporal and spatial resolution were used to determine the line emissions. To analyze them, we used NLTE numerical codes for the construction of grids of 243 semi-empirical models simulating EBs structures. In this way, the observed emission could be compared with the synthetic line spectra calculated for all such models. Results: For a specific model we found reasonable agreement between the observed and theoretical emission and thus we consider such model as a good approximation to EBs atmospheres. This model is characterized by an

Outcome differences in adolescent blunt severe polytrauma patients managed at pediatric versus adult trauma centers.

Science.gov (United States)

Rogers, Amelia T; Gross, Brian W; Cook, Alan D; Rinehart, Cole D; Lynch, Caitlin A; Bradburn, Eric H; Heinle, Colin C; Jammula, Shreya; Rogers, Frederick B

2017-12-01

Previous research suggests adolescent trauma patients can be managed equally effectively at pediatric and adult trauma centers. We sought to determine whether this association would be upheld for adolescent severe polytrauma patients. We hypothesized that no difference in adjusted outcomes would be observed between pediatric trauma centers (PTCs) and adult trauma centers (ATCs) for this population. All severely injured adolescent (aged 12-17 years) polytrauma patients were extracted from the Pennsylvania Trauma Outcomes Study database from 2003 to 2015. Polytrauma was defined as an Abbreviated Injury Scale (AIS) score ≥3 for two or more AIS-defined body regions. Dead on arrival, transfer, and penetrating trauma patients were excluded from analysis. ATC were defined as adult-only centers, whereas standalone pediatric hospitals and adult centers with pediatric affiliation were considered PTC. Multilevel mixed-effects logistic regression models assessed the adjusted impact of center type on mortality and total complications while controlling for age, shock index, Injury Severity Score, Glasgow Coma Scale motor score, trauma center level, case volume, and injury year. A generalized linear mixed model characterized functional status at discharge (FSD) while controlling for the same variables. A total of 1,606 patients met inclusion criteria (PTC: 868 [54.1%]; ATC: 738 [45.9%]), 139 (8.66%) of which died in-hospital. No significant difference in mortality (adjusted odds ratio [AOR]: 1.10, 95% CI 0.54-2.24; p = 0.794; area under the receiver operating characteristic: 0.89) was observed between designations in adjusted analysis; however, FSD (AOR: 0.38, 95% CI 0.15-0.97; p = 0.043) was found to be lower and total complication trends higher (AOR: 1.78, 95% CI 0.98-3.32; p = 0.058) at PTC for adolescent polytrauma patients. Contrary to existing literature on adolescent trauma patients, our results suggest patients aged 12-17 presenting with polytrauma may experience

Study of X-ray and gamma ray sources observed by the SIGNE (Prognoz 6 Satellite) experiment in the regions of the galactic center and anticenter

International Nuclear Information System (INIS)

Violes, F.

1981-12-01

Characteristics of the SIGNE II MP 6 experiment are reported and procedures to obtain the fluxes detected from all the sources are described. We next present deconvolution method used to isolate the galactic center sources. In the last chapter we present and discuss the photon spectra of the sources observed by the SIGNE II MP 6 experiment [fr

Soft x-ray spectrographs for solar observations

International Nuclear Information System (INIS)

Bruner, M.E.

1988-01-01

This paper surveys some of the recent advances in the state of the art of soft X-ray spectrometers, particularly as they might be applied to Solar Observations. The discussions center on the windowless region from roughly 1 to 100 A, and covers both grating and crystal instruments. The author begins with a short discussion of the solar soft X-ray spectrum and its interpretation, followed by a few general comments on problems peculiar to soft X-ray instruments. The paper reviews of recent developments in spectrometer optical design, which has been a lively field during the last dozen years. This is particularly true in the case of grating spectrometers. The paper concludes with a short section on telescope considerations, and some remarks on future flight opportunities

High-resolution far-infrared observations of the galactic center

International Nuclear Information System (INIS)

Harvey, P.M.; Campbell, M.F.; Hoffmann, W.F.

1976-01-01

A map at 53 μ with 17'' resolution and three-color observations at 53 μ, 100 μ, and 175 μ with approx.30'' beams of Sgr A are presented. Sagittarius A is resolved into two main sources, one associated with the cluster of strong 10 μ sources and another approx.45'' to the southwest coincident with a weak 10 μ source. The dust temperature peaks near the strong 10 μ sources, but the 100 μ and 175 μ fluxes and the far-infrared optical depth are greatest near the southwest source. The amount of dust required to explain the far-infrared emission is comparable to that observed in absorption in the near-infrared

Thyroid Fine-Needle Aspiration under Ultrasound Guidance: Experience from an Academic Tertiary Care Center in Lebanon

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Rita Hajj Boutros

2017-07-01

Full Text Available Thyroid nodules are common. Malignancy was reported in only 5-15% of cases. Fine needle aspiration under US guidance (USG-FNA proved to be accurate for the detection of thyroid cancer. This is a retrospective review of 400 radiology and cytology USG-FNA reports, randomly selected among those done at the Radiology Department at a tertiary care center in Beirut during the last five years. The specimen was inadequate in 60 (12% of cases but FNA was repeated in 10 cases only. The final diagnosis was benign in 76.7% of cases, mostly in women. 35% of the malignant and 19% of the benign nodules were hypoechoic, p=0.03. No significant correlation was observed between malignancy and other ultrasonic characteristics. Hypoechogenecity was also more common in nodules with inadequate specimen (40% versus 21.4%, p=0.01. Age, gender, location and size of the nodule did not differ between groups of adequate and inadequate specimen. In conclusion, 3 out of 4 thyroid nodules referred for USG-FNA are benign, mostly in women. Inadequate specimen was observed in 12% of cases. Hypoechogenecity but not other ultrasonic characteristics was associated with malignancy and with test failure.   Key words: Thyroid nodule, fine needle aspirate, ultrasound guidance, thyroid cancer, inadequate.

Guillain-Barré Syndrome, Influenza Vaccination, and Antecedent Respiratory and Gastrointestinal Infections: A Case-Centered Analysis in the Vaccine Safety Datalink, 2009-2011.

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Sharon K Greene

Full Text Available Guillain-Barré Syndrome (GBS can be triggered by gastrointestinal or respiratory infections, including influenza. During the 2009 influenza A (H1N1 pandemic in the United States, monovalent inactivated influenza vaccine (MIV availability coincided with high rates of wildtype influenza infections. Several prior studies suggested an elevated GBS risk following MIV, but adjustment for antecedent infection was limited.We identified patients enrolled in health plans participating in the Vaccine Safety Datalink and diagnosed with GBS from July 2009 through June 2011. Medical records of GBS cases with 2009-10 MIV, 2010-11 trivalent inactivated influenza vaccine (TIV, and/or a medically-attended respiratory or gastrointestinal infection in the 1 through 141 days prior to GBS diagnosis were reviewed and classified according to Brighton Collaboration criteria for diagnostic certainty. Using a case-centered design, logistic regression models adjusted for patient-level time-varying sources of confounding, including seasonal vaccinations and infections in GBS cases and population-level controls.Eighteen confirmed GBS cases received vaccination in the 6 weeks preceding onset, among 1.27 million 2009-10 MIV recipients and 2.80 million 2010-11 TIV recipients. Forty-four confirmed GBS cases had infection in the 6 weeks preceding onset, among 3.77 million patients diagnosed with medically-attended infection. The observed-versus-expected odds that 2009-10 MIV/2010-11 TIV was received in the 6 weeks preceding GBS onset was odds ratio = 1.54, 95% confidence interval (CI, 0.59-3.99; risk difference = 0.93 per million doses, 95% CI, -0.71-5.16. The association between GBS and medically-attended infection was: odds ratio = 7.73, 95% CI, 3.60-16.61; risk difference = 11.62 per million infected patients, 95% CI, 4.49-26.94. These findings were consistent in sensitivity analyses using alternative infection definitions and risk intervals for prior

Multifunctional centers in rural areas

DEFF Research Database (Denmark)

Svendsen, Gunnar Lind Haase

2009-01-01

abandoned. One outcome has been closings of schools in remote rural areas. This evidently contributes to exacerbate depopulation in these areas. To stop this tendency, we need new models for high-quality, cost effective public services in rural areas as those as we find in Denmark. This chapter introduces...... ideological roots in history pointing at 19th c. national civic movements and an early 20th c. transnational Garden City movement within urban planning as crucial. Drawing on contemporary case studies of multifunctional centers in Holland and Denmark, I then suggest that public and private donors should...... invest in multifunctional centers in which the local public school is the dynamo. This in order to increase local levels of social as well as human capital. Ideally, such centers should contain both public services such as school, library and health care, private enterprises as hairdressers and banks...

Dark matter and pulsar model constraints from Galactic center Fermi/LAT γ-ray observations

Science.gov (United States)

Gordon, Chris; Macias, Oscar

2014-05-01

Employing Fermi/LAT γ-ray observations, several independent groups have found excess extended γ-ray emission at the Galactic center (GC). Both, annihilating dark matter (DM) or a population of ~ 103 unresolved millisecond pulsars (MSPs) are regarded as well motivated possible explanations. However, there is significant uncertainties in the diffuse Galactic background at the GC. We have performed a revaluation of these two models for the extended γ-ray source at the GC by accounting for the systematic uncertainties of the Galactic diffuse emission model. We also marginalize over point source and diffuse background parameters in the region of interest. We show that the excess emission is significantly more extended than a point source. We find that the DM (or pulsar population) signal is larger than the systematic errors and therefore proceed to determine the sectors of parameter space that provide an acceptable fit to the data. We found that a population of several thousand MSPs with parameters consistent with the average spectral shape of Fermi/LAT measured MSPs was able to fit the GC excess emission. For DM, we found that a pure τ+τ- annihilation channel is not a good fit to the data. But a mixture of τ+τ- and bb with a of order the thermal relic value and a DM mass of around 20 to 60 GeV provides an adequate fit.

Using Total Lightning Observations to Enhance Lightning Safety

Science.gov (United States)

Stano, Geoffrey T.

2012-01-01

Lightning is often the underrated threat faced by the public when it comes to dangerous weather phenomena. Typically, larger scale events such as floods, hurricanes, and tornadoes receive the vast majority of attention by both the general population and the media. This comes from the fact that these phenomena are large, longer lasting, can impact a large swath of society at one time, and are dangerous events. The threat of lightning is far more isolated on a case by case basis, although millions of cloud-to-ground lightning strikes hit this United States each year. While attention is given to larger meteorological events, lightning is the second leading cause of weather related deaths in the United States. This information raises the question of what steps can be taken to improve lightning safety. Already, the meteorological community s understanding of lightning has increased over the last 20 years. Lightning safety is now better addressed with the National Weather Service s access to the National Lightning Detection Network data and enhanced wording in their severe weather warnings. Also, local groups and organizations are working to improve public awareness of lightning safety with easy phrases to remember, such as "When Thunder Roars, Go Indoors." The impacts can be seen in the greater array of contingency plans, from airports to sports stadiums, addressing the threat of lightning. Improvements can still be made and newer technologies may offer new tools as we look towards the future. One of these tools is a network of sensors called a lightning mapping array (LMA). Several of these networks exist across the United States. NASA s Short-term Prediction Research and Transition Center (SPoRT), part of the Marshall Spaceflight Center, has access to three of these networks from Huntsville, Alabama, the Kennedy Space Center, and Washington D.C. The SPoRT program s mission is to help transition unique products and observations into the operational forecast environment

[Work as a source of pleasure: evaluating a Psychosocial Care Center team].

Science.gov (United States)

Glanzner, Cecília Helena; Olschowsky, Agnes; Kantorski, Luciane Prado

2011-06-01

The objective of this study was to evaluate the pleasure at work felt by the members of a Psychosocial Care Center team. This qualitative case study used Forth Generation Evaluation. This study was performed in Foz do Iguaçu, Parana, Brazil, in November and December 2006. Participants were 10 tem members. Data collection was performed through observation and individual interviews. The analysis was initiated at the same time as the data collection, and the final analysis was performed as per the following steps: data ordering, classification and final analysis. The following analysis themes were developed: work characteristics at the psychological care center, suffering and coping with suffering at work. During the evaluation, the participants showed pleasure and fulfillment with their work by expressing pride, fulfillment and appreciation of what they deliver. Pleasure occurs during the development of psychosocial care, because they always have the freedom to rearrange their manner of working, making possible to develop activities and attitudes capable of giving them pleasure.

Ground-truth aerosol lidar observations: can the Klett solutions obtained from ground and space be equal for the same aerosol case?

International Nuclear Information System (INIS)

Ansmann, Albert

2006-01-01

Upcoming multiyear satellite lidar aerosol observations need strong support by a worldwide ground-truth lidar network. In this context the question arises as to whether the ground stations can deliver the same results as obtained from space when the Klett formalism is applied to elastic backscatter lidar data for the same aerosol case. This question is investigated based on simulations of observed cases of simple and complex aerosol layering. The results show that the differences between spaceborne and ground-based observations can be as large as20% for the backscatter and extinction coefficients and the optimum estimates of the column lidar ratios. In cases with complex aerosol layering, the application of the two-layer approach can lead to similar results (space, ground) and accurate products provided that horizontally homogeneous aerosol conditions are given

Analysis of differences in outcome of two European liver transplant centers

NARCIS (Netherlands)

Nemes, B; Polak, W; Ther, G; Hendriks, H; Kobori, L; Porte, RJ; Sarvary, E; de Jong, KP; Doros, A; Gerlei, Z; van den Berg, AP; Fehervari, [No Value; Gorog, D; Peeters, PM; Jaray, J; Slooff, MJH

Authors analyzed the differences in the outcome of two European liver transplant centers differing in case volume and experience. The first was the Transplantation and Surgical Clinic, Semmelweis University, Budapest, Hungary (SEB) and the second the University Medical Center Groningen, Groningen,

Case of pancreatolithiasis. CT observation of calculus formation

Energy Technology Data Exchange (ETDEWEB)

Sasaki, Fumio; Koga, Sukehiko; Takeuchi, Akira (Fujita-Gakuen Univ., School of Medicine, Aichi (Japan))

1982-11-01

During 3-year follow-up of a case of pancreatolithiasis localized in the pancreatic head, CT showed sudden new appearance of calculi over an extensive area of the body and tail of the pancreas after acute exacerbation of chronic pancreatitis. This case and the etiology and mechanism of pancreatolithiasis were discussed on the basis of literature.

Characteristics of Keratoconus Patients at a Tertiary Eye Center in India

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Vinay B Agrawal

2011-01-01

Full Text Available Purpose: To evaluate the presentation and characteristics of patients with keratoconus at a tertiary eye care center in Mumbai, India. Methods: This single center, non-comparative, retrospective cohort analysis was performed on patients with keratoconus who presented to the Clear Vision Eye Center clinic from April 2007 to March 2009. Data was collected to characterize correlations among visual acuity, corneal biomicroscopic findings, and refractive and topographic findings in keratoconus. Results: Records of 274 patients including 189 male and 85 female subjects with mean age of 20.1±3.5 (range, 13 to 29 years at the time of diagnosis were assessed. There was history of skin allergy in 73 (26.6%, symptomatic ocular allergy in 67 (24.45% and asthma in 31 (11.31% patients. The most frequent corneal sign was Fleischer′s ring which was observed in 81% of cases. Corneal topography revealed mean simK (simulated keratometry of 53.3±6.1 (range, 41.2 to 69.0 diopters. Corneal topography analysis with the Cone Location Magnitude Index disclosed the presence of inferior cones in 93% of patients. Conclusion: This group of patients had younger age at presentation and more severe keratoconus as compared to western populations; contact lenses were used only in a minority of patients.

A management plan for hospitals and medical centers facing radiation incidents

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Fereshteh Davari

2015-01-01

Full Text Available Background: Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. Materials and Methods: In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. Results: We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. Conclusion: With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

Cortical Activation during Landmark-Centered vs. Gaze-Centered Memory of Saccade Targets in the Human: An FMRI Study

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Ying Chen

2017-06-01

Full Text Available A remembered saccade target could be encoded in egocentric coordinates such as gaze-centered, or relative to some external allocentric landmark that is independent of the target or gaze (landmark-centered. In comparison to egocentric mechanisms, very little is known about such a landmark-centered representation. Here, we used an event-related fMRI design to identify brain areas supporting these two types of spatial coding (i.e., landmark-centered vs. gaze-centered for target memory during the Delay phase where only target location, not saccade direction, was specified. The paradigm included three tasks with identical display of visual stimuli but different auditory instructions: Landmark Saccade (remember target location relative to a visual landmark, independent of gaze, Control Saccade (remember original target location relative to gaze fixation, independent of the landmark, and a non-spatial control, Color Report (report target color. During the Delay phase, the Control and Landmark Saccade tasks activated overlapping areas in posterior parietal cortex (PPC and frontal cortex as compared to the color control, but with higher activation in PPC for target coding in the Control Saccade task and higher activation in temporal and occipital cortex for target coding in Landmark Saccade task. Gaze-centered directional selectivity was observed in superior occipital gyrus and inferior occipital gyrus, whereas landmark-centered directional selectivity was observed in precuneus and midposterior intraparietal sulcus. During the Response phase after saccade direction was specified, the parietofrontal network in the left hemisphere showed higher activation for rightward than leftward saccades. Our results suggest that cortical activation for coding saccade target direction relative to a visual landmark differs from gaze-centered directional selectivity for target memory, from the mechanisms for other types of allocentric tasks, and from the directionally

Data Center Consolidation: A Step towards Infrastructure Clouds

Science.gov (United States)

Winter, Markus

Application service providers face enormous challenges and rising costs in managing and operating a growing number of heterogeneous system and computing landscapes. Limitations of traditional computing environments force IT decision-makers to reorganize computing resources within the data center, as continuous growth leads to an inefficient utilization of the underlying hardware infrastructure. This paper discusses a way for infrastructure providers to improve data center operations based on the findings of a case study on resource utilization of very large business applications and presents an outlook beyond server consolidation endeavors, transforming corporate data centers into compute clouds.

Center vortices at strong couplings and all couplings

International Nuclear Information System (INIS)

Greensite, J.

2001-01-01

Motivations for the center vortex theory of confinement are discussed. In particular, it is noted that the abelian dual Meissner effect, which is the signature of dual superconductivity, cannot adequately describe the confining force at large distance scales. A long-range effective action is derived from strong-coupling lattice gauge theory in D=3 dimensions, and it is shown that center vortices emerge as the stable saddlepoints of this action. Thus, in the case of strong couplings, the vortex picture is arrived at analytically. I also respond briefly to a recent criticism regarding maximal center gauge. (author)

Risk factors for computer visual syndrome (CVS) among operators of two call centers in São Paulo, Brazil.

Science.gov (United States)

Sa, Eduardo Costa; Ferreira Junior, Mario; Rocha, Lys Esther

2012-01-01

The aims of this study were to investigate work conditions, to estimate the prevalence and to describe risk factors associated with Computer Vision Syndrome among two call centers' operators in São Paulo (n = 476). The methods include a quantitative cross-sectional observational study and an ergonomic work analysis, using work observation, interviews and questionnaires. The case definition was the presence of one or more specific ocular symptoms answered as always, often or sometimes. The multiple logistic regression model, were created using the stepwise forward likelihood method and remained the variables with levels below 5% (p vision (43.5%). The prevalence of Computer Vision Syndrome was 54.6%. Associations verified were: being female (OR 2.6, 95% CI 1.6 to 4.1), lack of recognition at work (OR 1.4, 95% CI 1.1 to 1.8), organization of work in call center (OR 1.4, 95% CI 1.1 to 1.7) and high demand at work (OR 1.1, 95% CI 1.0 to 1.3). The organization and psychosocial factors at work should be included in prevention programs of visual syndrome among call centers' operators.

Interview with Peter Samis and Mimi Michaelson, Authors of "Creating the Visitor-Centered Museum"

Science.gov (United States)

Spero, Susan

2017-01-01

"Creating the Visitor-Centered Museum" offers insight into why and how 10 case study museums have transformed to serve the needs of their public. Susan Spero interviews authors Peter Samis and Mimi Michaelson about the purpose of the book, their case study choices, the key characteristics of visitor-centered institutions and their…

Radio pulsars and transients in the Galactic center

International Nuclear Information System (INIS)

Lazio, Joseph; Deneva, J S; Bower, Geoffrey C; Cordes, J M; Hyman, Scott D; Backer, D C; Bhat, R; Chatterjee, S; Demorest, P; Ransom, S M; Vlemmings, W

2006-01-01

Radio pulsars and transients provide powerful probes of the star formation history, interstellar medium, and gravitational potential of the Galactic center. Historical radio observations of the Galactic center have not emphasized the time domain aspect of observing this region. We summarize a series of recent searches for and observations of radio transients and pulsars that make use of two advances in technology. The first is the formation of large fields of view (∼> 1 0 ) at relatively longer wavelengths (λ > 1 m), and the second is the construction of receivers and instruments capable of collecting data on microsecond time scales at relatively short wavelengths (∼ 3 cm)

Climate Prediction Center (CPC) U.S. Pan Evaporation Observations

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Observational reports of daily pan evaporation (1200 UTC to 1200 UTC) are made by members of the NWS Cooperative Network (COOP) or supplemental networks of NOAA's...

Hole centers in γ-irradiated, oxidized Al2O3

International Nuclear Information System (INIS)

Lee, K.H.; Holmberg, G.E.; Crawford, J.H. Jr.

1976-01-01

ESR observations of centers with S = 1/2, g approximately equal to 2, S = 1, g approximately equal to 2 have been made at 77 K on oxidized Al 2 O 3 after γ-irradiation at 30 0 C. From the radiation growth data, it is shown that the S = 1/2 centers are precursors of the S = 1 centers. In addition, when the S = 1 centers anneal out at about 110 0 C, the S = 1/2 centers reappear and eventually anneal out at about 260 0 C. Previously Gamble (Gamble, F.T.; Ph.D. Thesis, U. of Connecticut (1963)) and Cox (Cox, R.T.; Ph.D. Thesis, U. of Grenoble (1972) unpublished), respectively, observed S = 1/2 and S = 1 paramagnetic centers in electron-irradiated nominally pure Al 2 O 3 and γ-irradiated, oxidized, titanium-doped Al 2 O 3 . The models proposed for these centers were one hole and two holes trapped on oxygen ions adjacent to Al 3+ vacancies. Our results further substantiate these models. (author)

Strategic Project Management at the NASA Kennedy Space Center

Science.gov (United States)

Lavelle, Jerome P.

2000-01-01

This paper describes Project Management at NASA's Kennedy Space Center (KSC) from a strategic perspective. It develops the historical context of the agency and center's strategic planning process and illustrates how now is the time for KSC to become a center which has excellence in project management. The author describes project management activities at the center and details observations on those efforts. Finally the author describes the Strategic Project Management Process Model as a conceptual model which could assist KSC in defining an appropriate project management process system at the center.

Managing the Shopping Center Ambience Attributes by Using Importance-Performance Analysis: The Case from Serbia

Directory of Open Access Journals (Sweden)

Jelica Marković

2014-06-01

Full Text Available This paper examined customers’ perceived importance and performance of shopping center ambience on the examples of the Mercator shopping center and Sad Novi Bazaar shopping center in Novi Sad, Serbia. The shopping center ambience was examined through exterior and interior attributes. It was found that a number of them are very important to customers and their shopping behavior. According to the present research, the most important exterior attributes are: address and location, parking availability, congestion and traffic, exterior display windows and entrances. The most important interior attributes are: cleanliness, temperature, merchandise, lighting, music, scents, absence of tobacco smoke, width of aisles and P.A. usage. The paper also provided information for two studied shopping centers with ambience attributes that performed well or not and everything was presented on the importance-performance grids, which can serve managers as guidelines for further development.

Challenges in the Management and Stewardship of Airborne Observational Data at the National Center for Atmospheric Research (NCAR) Earth Observing Laboratory (EOL)

Science.gov (United States)

Aquino, J.; Daniels, M. D.

2015-12-01

The National Science Foundation (NSF) provides the National Center for Atmospheric Research (NCAR) Earth Observing Laboratory (EOL) funding for the operation, maintenance and upgrade of two research aircraft: the NSF/NCAR High-performance Instrumented Airborne Platform for Environmental Research (HIAPER) Gulfstream V and the NSF/NCAR Hercules C-130. A suite of in-situ and remote sensing airborne instruments housed at the EOL Research Aviation Facility (RAF) provide a basic set of measurements that are typically deployed on most airborne field campaigns. In addition, instruments to address more specific research requirements are provided by collaborating participants from universities, industry, NASA, NOAA or other agencies (referred to as Principal Investigator, or PI, instruments). At the 2014 AGU Fall Meeting, a poster (IN13B-3639) was presented outlining the components of Airborne Data Management included field phase data collection, formats, data archival and documentation, version control, storage practices, stewardship and obsolete data formats, and public data access. This talk will cover lessons learned, challenges associated with the above components, and current developments to address these challenges, including: tracking data workflows for aircraft instrumentation to facilitate identification, and correction, of gaps in these workflows; implementation of dataset versioning guidelines; and assignment of Digital Object Identifiers (DOIs) to data and instrumentation to facilitate tracking data and facility use in publications.

Molecular analysis of immunoglobulin variable genes supports a germinal center experienced normal counterpart in primary cutaneous diffuse large B-cell lymphoma, leg-type.

Science.gov (United States)

Pham-Ledard, Anne; Prochazkova-Carlotti, Martina; Deveza, Mélanie; Laforet, Marie-Pierre; Beylot-Barry, Marie; Vergier, Béatrice; Parrens, Marie; Feuillard, Jean; Merlio, Jean-Philippe; Gachard, Nathalie

2017-11-01

Immunophenotype of primary cutaneous diffuse large B-cell lymphoma, leg-type (PCLBCL-LT) suggests a germinal center-experienced B lymphocyte (BCL2+ MUM1+ BCL6+/-). As maturation history of B-cell is "imprinted" during B-cell development on the immunoglobulin gene sequence, we studied the structure and sequence of the variable part of the genes (IGHV, IGLV, IGKV), immunoglobulin surface expression and features of class switching in order to determine the PCLBCL-LT cell of origin. Clonality analysis with BIOMED2 protocol and VH leader primers was done on DNA extracted from frozen skin biopsies on retrospective samples from 14 patients. The clonal DNA IGHV sequence of the tumor was aligned and compared with the closest germline sequence and homology percentage was calculated. Superantigen binding sites were studied. Features of selection pressure were evaluated with the multinomial Lossos model. A functional monoclonal sequence was observed in 14 cases as determined for IGHV (10), IGLV (2) or IGKV (3). IGV mutation rates were high (>5%) in all cases but one (median:15.5%), with superantigen binding sites conservation. Features of selection pressure were identified in 11/12 interpretable cases, more frequently negative (75%) than positive (25%). Intraclonal variation was detected in 3 of 8 tumor specimens with a low rate of mutations. Surface immunoglobulin was an IgM in 12/12 cases. FISH analysis of IGHM locus, deleted during class switching, showed heterozygous IGHM gene deletion in half of cases. The genomic PCR analysis confirmed the deletions within the switch μ region. IGV sequences were highly mutated but functional, with negative features of selection pressure suggesting one or more germinal center passage(s) with somatic hypermutation, but superantigen (SpA) binding sites conservation. Genetic features of class switch were observed, but on the non functional allele and co-existing with primary isotype IgM expression. These data suggest that cell-of origin is

Characteristics of Patient-Centered Medical Home Initiatives that Generated Savings for Medicare: a Qualitative Multi-Case Analysis.

Science.gov (United States)

Burton, Rachel A; Lallemand, Nicole M; Peters, Rebecca A; Zuckerman, Stephen

2018-02-05

Through the Multi-Payer Advanced Primary Care Practice (MAPCP) Demonstration, Medicare, Medicaid, and private payers offered supplemental payments to 849 primary care practices that became patient-centered medical homes (PCMHs) in eight states; practices also received technical assistance and data reports. Average Medicare payments were capped at $10 per beneficiary per month in each state. Since there was variation in the eight participating states' demonstration designs, experiences, and outcomes, we conducted a qualitative multi-case analysis to identify the key factors that differentiated states that were estimated to have generated net savings for Medicare from states that did not. States' MAPCP Demonstration initiatives were comprehensively profiled in case studies based on secondary document review, three rounds of annual interviews with state staff, payers, practices, and other stakeholders, and other data sources. Case study findings were summarized in a case-ordered predictor-outcome matrix, which identified the presence or absence of key demonstration design features and experiences and arrayed states based on the amount of net savings or losses they generated for Medicare. We then used this matrix to identify initiative features that were present in at least three of the four states that generated net savings and absent from at least three of the four states that did not generate savings. A majority of the states that generated net savings: required practices to be recognized PCMHs to enter the demonstration, did not allow late entrants into the demonstration, used a consistent demonstration payment model across participating payers, and offered practices opportunities to earn performance bonuses. Practices in states that generated net savings also tended to report receiving the demonstration payments and bonuses they expected to receive, without any issues. Designers of future PCMH initiatives may increase their likelihood of generating net savings by

EFFECT OF NEBULIZED COLISTIN ON THE VENTILATOR CIRCUIT: A PROSPECTIVE PILOT CASE-CONTROL STUDY FROM A SINGLE CANCER CENTER

Directory of Open Access Journals (Sweden)

Iyad M Ghonimat

2015-04-01

Full Text Available Nebulized colistin (NC is used for the treatment of pneumonia due to multidrug-resistant Gram-negative bacteria. In this one-year case-control study, our objective was to evaluate the effect of NC on the ventilator circuit (VC components. The case group consisted of 25 mechanically-ventilated patients who received NC, while the control group was 25 mechanically-ventilated patients who did not receive NC. Respiratory therapists inspected the VC every 4 hrs and whenever a ventilator alarm was reported. The VC component was changed if the alarm did not subside after necessary measures were performed. Patients from both groups were treated at the adult ICU in King Hussein Cancer Center (KHCC. In the case group, 22(88% patients required changing at least one of the circuit components (flow sensor, exhalation membrane, or nebulizer kit. The median number of changes (range per patient of the flow sensor, exhalation membrane, and nebulizer kit were: 2(1-3, 2(1-6, and 1(1-2, respectively. Large amounts of white crystals, which resembled the colistin powder, were reported on the replaced VC components. The flow sensor was changed in 2 control patients, but white crystals were absent. Crystals obtained from one case subject were confirmed to be colistin by chromatographic mass spectroscopy. Further studies are needed to evaluate the effect of crystal formation on the efficacy of NC and clinical outcomes.

Calculation of controllability and observability matrices for special case of continuous-time multi-order fractional systems.

Science.gov (United States)

Hassanzadeh, Iman; Tabatabaei, Mohammad

2017-03-28

In this paper, controllability and observability matrices for pseudo upper or lower triangular multi-order fractional systems are derived. It is demonstrated that these systems are controllable and observable if and only if their controllability and observability matrices are full rank. In other words, the rank of these matrices should be equal to the inner dimension of their corresponding state space realizations. To reduce the computational complexities, these matrices are converted to simplified matrices with smaller dimensions. Numerical examples are provided to show the usefulness of the mentioned matrices for controllability and observability analysis of this case of multi-order fractional systems. These examples clarify that the duality concept is not necessarily true for these special systems. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

Interference effect on annealing temperature of A and E centers in silicon.

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Fang, P. H.; Tanaka, T.

1971-01-01

The significance of recent experimental observations on the annealing defects in n-type silicon has been examined. The observed anomalous annealing temperatures of A and E centers and their impurity concentration dependence are explained by an interference between the two centers.

Management Matters. Display and Promotion Ideas for Library Media Centers

Science.gov (United States)

Pappas, Marjorie L.

2005-01-01

School library media centers should be warm and inviting places where the environment entices children to read and explore. Creative bulletin board and case displays along with other exhibits help to make the library media center an exciting place. Bulletin board displays that promote authors, books, and exciting ideas motivate children to find…

Case studies of individualized professional development at an outdoor education center

Science.gov (United States)

Pearsall, Marjorie

various activities and lessons while at the center, and the assessment of the student's learning following the experience. The staff works with each teacher to prepare them to use transdisciplinary science lessons which were planned to satisfy and enrich state, district, and school expectations (Outdoor Education Guidebook, 1997). The staff members believe that if the teachers are prepared to do these things, not only will the current students learn more, but that the teacher will experience growth professionally and this will impact more children over time. The teachers gain science content knowledge and learn constructivist teaching strategies while learning how to use the facilities and equipment safely and confidently. Ideas for preparatory and follow-up activities are made available. This study looked closely at the individualization of the professional development provided by this informal science institution. Data from observations of professional development sessions as well as the on-site experiences with the children were used in the study. Teachers were asked to reflect on the degree to which the Arlington Echo approach to professional development was beneficial in building their confidence about providing science-based, interdisciplinary experiences for their students, with comparisons made between the responses of veteran teachers and those of teachers with fewer years of experience. Through the reflections of the participant teachers, it was possible to gather data about whether their beliefs about science and about how science is best taught were modified by this experience.

Curative Intent Treatment of Hepatocellular Carcinoma - 844 Cases Treated in a General Surgery and Liver Transplantation Center.

Science.gov (United States)

Grigorie, Răzvan; Alexandrescu, Sorin; Smira, Gabriela; Ionescu, Mihnea; Hrehoreţ, Doina; Braşoveanu, Vladislav; Dima, Simona; Ciurea, Silviu; Boeţi, Patricia; Dudus, Ionut; Picu, Nausica; Zamfir, Radu; David, Leonard; Botea, Florin; Gheorghe, Liana; Tomescu, Dana; Lupescu, Ioana; Boroş, Mirela; Grasu, Mugur; Dumitru, Radu; Toma, Mihai; Croitoru, Adina; Herlea, Vlad; Pechianu, Cătălin; Năstase, Anca; Popescu, Irinel

2017-01-01

Background: The objective of this study is to assess the outcome of the patients treated for hepatocellular carcinoma (HCC) in a General Surgery and Liver Transplantation Center. Methods: This retrospective study includes 844 patients diagnosed with HCC and surgically treated with curative intent methods. Curative intent treatment is mainly based on surgery, consisting of liver resection (LR), liver transplantation (LT). Tumor ablation could become the choice of treatment in HCC cases not manageable for surgery (LT or LR). 518 patients underwent LR, 162 patients benefited from LT and in 164 patients radiofrequency ablation (RFA) was performed. 615 patients (73%) presented liver cirrhosis. Results: Mordidity rates of patient treated for HCC was 30% and mortality was 4,3% for the entire study population. Five year overall survival rate was 39 % with statistically significant differences between transplanted, resected, or ablated patients (p 0.05) with better results in case of LT followed by LR and RFA. Conclusions: In HCC patients without liver cirrhosis, liver resection is the treatment of choice. For early HCC occurred on cirrhosis, LT offers the best outcome in terms of overall and disease free survival. RFA colud be a curative method for HCC patients not amenable for LT of LR. Celsius.

Dark matter and pulsar model constraints from Galactic Center Fermi-LAT gamma-ray observations

Science.gov (United States)

Gordon, Chris; Macías, Oscar

2013-10-01

Employing Fermi-LAT gamma-ray observations, several independent groups have found excess extended gamma-ray emission at the Galactic Center (GC). Both annihilating dark matter (DM) or a population of ˜103 unresolved millisecond pulsars (MSPs) are regarded as well-motivated possible explanations. However, there are significant uncertainties in the diffuse galactic background at the GC. We have performed a revaluation of these two models for the extended gamma-ray source at the GC by accounting for the systematic uncertainties of the Galactic diffuse emission model. We also marginalize over point-source and diffuse background parameters in the region of interest. We show that the excess emission is significantly more extended than a point source. We find that the DM (or pulsar-population) signal is larger than the systematic errors and therefore proceed to determine the sectors of parameter space that provide an acceptable fit to the data. We find that a population of 1000-2000 MSPs with parameters consistent with the average spectral shape of Fermi-LAT measured MSPs is able to fit the GC excess emission. For DM, we find that a pure τ+τ- annihilation channel is not a good fit to the data. But a mixture of τ+τ- and bb¯ with a ⟨σv⟩ of order the thermal relic value and a DM mass of around 20 to 60 GeV provides an adequate fit.

ISTSOS, SENSOR OBSERVATION MANAGEMENT SYSTEM: A REAL CASE APPLICATION OF HYDRO-METEOROLOGICAL DATA FOR FLOOD PROTECTION

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M. Cannata

2014-01-01

Full Text Available istSOS (Istituto scienze della Terra Sensor Observation Service is an implementation of the Sensor Observation Service standard from Open Geospatial Consortium (OGC. The development of istSOS started in 2009 in order to provide a simple implementation of the Sensor Observation Service (SOS standard for the management, provision and integration of hydro-meteorological data collected in Canton Ticino (Southern Switzerland. istSOS is entirely written in Python and is based on reliable open source software like PostgreSQL/PostGIS and Apache/mod_wsgi. The authors during this presentation want to illustrate the latest software enhancements together with a real case in a production environment. Latest software enhancement includes the development of a RESTful service and of a Web-based graphical user interface that allows hydrologists a better interaction with measurements. This includes the ability of new services creation, addition of new sensors and relative metadata, visualization and manipulation of stored observations, registration of new measures and setting of system properties like observable properties and data quality codes. The study will show a real case application of the system for the provision of data to interregional partners and to a hydrological model for lake level forecasting and flooding hazard assessment. The hydrological model uses a combination of WPS (Web Processing Service and SOS for the generation of model input data. This system is linked with a dedicated geo-portal used by the civil protection for the management, alert and protection of population and assets of the Locarno area (Verbano Lake flooding. Practical considerations and technical issues will be presented and discussed.

Teachers' Beliefs, Perceived Practice and Actual Classroom Practice in Relation to Traditional (Teacher-Centered) and Constructivist (Learner-Centered) Teaching (Note 1)

Science.gov (United States)

Kaymakamoglu, Sibel Ersel

2018-01-01

This study explored the EFL teachers' beliefs, perceived practice and actual classroom practice in relation to Traditional (teacher-centered) and Constructivist (learner-centered) teaching in Cyprus Turkish State Secondary Schools context. For this purpose, semi-structured interviews and structured observations were employed with purposively…

Center for Disease Control's Diethylstilbestrol Update: a case for effective operationalization of messaging in social marketing practice.

Science.gov (United States)

Mattson, Marifran; Basu, Ambar

2010-07-01

The Center for Disease Control's (CDC) Diethylstilbestrol (DES) Update, a campaign to educate people who may have been exposed to the drug DES, is framed on the premises of the social marketing model, namely formative research, audience segmentation, product, price, placement, promotion, and campaign evaluation. More than that, the campaign takes a critical step in extending the social marketing paradigm by highlighting the need to situate the messaging process at the heart of any health communication campaign. This article uses CDC's DES Update as a case study to illustrate an application of a message development tool within social marketing. This tool promotes the operationalization of messaging within health campaigns. Ultimately, the goal of this project is to extend the social marketing model and provide useful theoretical guidance to health campaign practitioners on how to accomplish stellar communication within a social marketing campaign.

Intestinal Parasites Prevalence in Children from Day Care Centers in Sinop City-MT

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B. Muchiutti

2013-03-01

Full Text Available Abstract: The aim of this study was to investigate the intestinal parasitosis prevalence of children from municipal day care centers in Sinop MT. Respecting ethical principles established by Resolution 196/96 of Health National Council/Ministry of Health of quantitative research, the anonymity of participants, as well accept and signature of parents of the Term of Free and Enlightened Consent were performed. Between Junes to October 2012 were applied coproparasitological methods for investigation. Fecal samples were analyzed by Hoffmans methods. From 103 students examined observed the prevalence rate of 19.42% of intestinal parasites. The intestinal parasites with highest prevalence rate were: Giardia lamblia (9.70% and Endolimax nana (5.82%. The results of this study demonstrate the need for sensitization of the population front of diagnosis importance, treatment and monitoring of positive cases and the necessity of more health professionals attention, especially with children.Key-words: Intestinal parasites, day care centers, children.

Climate Prediction Center (CPC) U.S. Daily Minimum Air Temperature Observations

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National Oceanic and Atmospheric Administration, Department of Commerce — Observational reports of daily air temperature (1200 UTC to 1200 UTC) are made by members of the NWS Automated Surface Observing Systems (ASOS) network; NWS...

Climate Prediction Center (CPC) U.S. Daily Maximum Air Temperature Observations

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Observational reports of daily air temperature (1200 UTC to 1200 UTC) are made by members of the NWS Automated Surface Observing Systems (ASOS) network; NWS...

Factor VII deficiency: a single-center experience.

Science.gov (United States)

Salcioglu, Zafer; Akcay, Arzu; Sen, Hulya Sayilan; Aydogan, Gonul; Akici, Ferhan; Tugcu, Deniz; Ayaz, Nuray Aktay; Baslar, Zafer

2012-11-01

Congenital factor VII deficiency is the most common form of rare coagulation factor deficiencies. This article presents a retrospective evaluation of 73 factor VII deficiency cases that had been followed at our center. The study consisted of 48 males and 25 females (2 months-19 years). Thirty-one (42.5%) of them were asymptomatic. Out of symptomatic patients, 17 had severe clinical symptoms, whereas 8 presented with moderate and 17 with mild symptoms. The symptoms listed in order of frequency were as follows: epistaxis, petechia or ecchymose, easy bruising, and oral cavity bleeding. The genotype was determined in 8 patients. Recombinant activated factor VII (rFVIIa) was used to treat 49 bleeding episodes in 8 patients after 2002. In 2 patients with repeated central nervous system bleeding prophylaxis with rFVIIa was administered. No allergic and thrombotic events were observed during both treatment and prophylaxis courses. Antibody occurrence was not detected in the patients during treatment.

Characteristics of Epstein-Barr virus-associated gastric cancer: A study of 235 cases at a comprehensive cancer center in U.S.A

Directory of Open Access Journals (Sweden)

Yu Yingyan

2009-02-01

Full Text Available Abstract Background Epstein-Barr virus (EBV has been shown to be associated with gastric cancer. However, inconsistent findings have been reported regarding the distribution of EBV infected cells (in normal gastric epithelium vs. intestinal metaplastic cells vs. in neoplastic cells and the characteristics of EBV-associated gastric cancer. Lymph node positive EBV-associated gastric cancer has not been systematically studied. The aims of this study were to evaluate EBV-associated gastric cancer, to assess the distribution of EBV infected cells including all positive lymph nodes, and to define the characteristics of EBV-associated gastric cancer. Design The study included primary gastric cancer patients who underwent surgical resection with no preoperative treatment at M.D. Anderson Cancer Center between 1987 and 2006. Formalin-fixed paraffin-embedded tissue from these resection specimens were assessed for EBV by in situ hybridization, the gold standard for EBV detection in tissue. EBV status was analyzed along with clinicopathologic parameters including age, gender, tumor type, lymph node status, and pathologic stage of the tumor. Results Among 235 patients, 12 had intranuclear expression of EBV. EBV staining was seen only in tumor cells and no detectable EBV was observed in normal gastric mucosa, intestinal metaplasia or stromal cells. Eight of 12 patients with EBV-associated gastric cancer had regional lymph node metastasis. Of note, metastatic tumor cells in all of the involved lymph nodes of these 8 cases contained EBV. The epidemiologic data showed 11 of the 12 patients with EBV-associated gastric cancer were men, ranging in age from 54 to 78 years (mean age, 60 years; median age, 62.1 years. The age distribution for non-EBV associated gastric cancer patients ranged from 21 to 93 years (mean age, 67 years; median age, 66.4 years. Conclusion Our study demonstrated that EBV is present exclusively in gastric cancer cells. The detection of EBV in

Integrating Student-Centered Learning in Finance Courses: The Case of a Malaysian Research University

Science.gov (United States)

Janor, Hawati; Rahim, Ruzita Abdul; Rahman, Aisyah Abdul; Auzairy, Noor Azryani; Hashim, Noor Azuan; Yusof, Muhamad Zain

2013-01-01

The student-centered learning (SCL) approach is an approach to education that focuses on learners and their needs, rather than relying upon the input of the teacher's. The present paper examines how the SCL approach is integrated as a learner-centered paradigm into finance courses offered at a business school in a research university in Malaysia.…

Solar radiation observation stations with complete listing of data archived by the National Climatic Center, Asheville, North Carolina and initial listing of data not currently archived

Science.gov (United States)

Carter, E. A.; Wells, R. E.; Williams, B. B.; Christensen, D. L.

1976-01-01

A listing is provided of organizations taking solar radiation data, the 166 stations where observations are made, the type of equipment used, the form of the recorded data, and the period of operation of each station. Included is a listing of the data from 150 solar radiation stations collected over the past 25 years and stored by the National Climatic Center.

Protecting victims of elder financial exploitation: the role of an Elder Abuse Forensic Center in referring victims for conservatorship.

Science.gov (United States)

Gassoumis, Zachary D; Navarro, Adria E; Wilber, Kathleen H

2015-01-01

The aim of this study was to examine the extent to which an Elder Abuse Forensic Center protects financial exploitation (FE) victims through referral to the Office of the Public Guardian (PG) for investigation and possible conservatorship (called 'guardianship' in many states). Los Angeles County Elder Abuse Forensic Center cases involving adults aged 65 and older (April 2007-December 2009) were matched using one-to-one propensity-score matching to 33,650 usual care Adult Protective Services (APS) cases. The final analysis sample consisted of 472 FE cases. Compared to usual care, Forensic Center cases were more likely to be referred to the PG for investigation (30.6%, n = 72 vs. 5.9%, n = 14, p Elder Abuse Forensic Center conceptual model and contribute to an emerging body of evidence on the role of the Forensic Center in addressing elder abuse.

The increasing incidence of paranasal organizing hematoma: a 20-year experience of 23 cases at a single center.

Science.gov (United States)

Kim, Jong Seung; Oh, Jong Seok; Kwon, Sam Hyun

2016-06-01

Sinonasal organized hematoma is a rare, benign disease that can be locally aggressive and may be mistaken for malignancy. Because of its rarity, the clinical characteristics are not well known. The aim of this study is to investigate the distinguishing features of organized hematoma with an emphasis on incidence change. In this retrospective study, we reviewed the records of 23 patients with organized hematoma confirmed histopathologically among 5,378 patients who underwent endoscopic sinus surgery performed by a single surgeon from January 1995 to December 2014 at a tertiary care center. Clinical symptoms, endoscopic photography, computed tomography, and operative findings were reviewed. We also reviewed the relevant literature. Age, sex, site, origin subsite and histopathology were investigated. A statistical review was performed using R 3.1.2 to examine incidence change. The most common complaint was frequent epistaxis and nasal obstruction (52.1%). Of the 23 patients, eight were women and 15 were men with an age range of 18 to 75 years. (mean 38.9 years). Nine of these hematomas occurred on the right side and 14 on the left side. The predominant occurrence site was the antrum (65%), followed by the septum (17.3%), inferior turbinate (8%), and ethmoid sinus (8%). The incidence steadily increased over 20 years. Investigation of the clinical characteristics and incidence change of organized hematoma can provide useful information. Through analysis of the 23 cases in our study, the age distribution was found to be bimodal and the incidence of organizing hematoma was observed to steadily increase. Clinicians should be aware of these characteristics to avoid misdiagnoses of malignant tumors.

[Body-centered psychotherapy IKP (Institute of Body-Centered Psychotherapy): holistic psychotherapy].

Science.gov (United States)

Maurer-Groeli, Y

1996-03-01

Body centered Psychotherapy IKP is treated in this article under the aspect of a holistic approach. First the theory and the system of science are summarised and shown as to which amount they are changing concerning knowledge of details and wholeness. It is pointed out that the actual paradigma "to the depth" has to be completed by that of "wideness". The way of holistic-multirelational thinking, stating a diagnosis and doing therapy is demonstrated along a case study going on at the background of a therapeutic encounter-relationship which is emotionally warm (Gestalt-approach).

A reexamination of the spreading center hypothesis for Ovda and Thetis Regiones, Venus

International Nuclear Information System (INIS)

Kiefer, W.S.

1990-01-01

Ceumpler, Head, and colleagues proposed that Ovda and Thetis Regiones are spreading centers. The strong positive correlation between geoid and topography observed in Ovda and Thetis is unlike that observed for terrestrial spreading centers. The maximum elevation expected for spreading centers on Venus is 1.5 km, and a cooling plate thermal model predicts a maximum geoid anomaly of 8 meters, both much less than observed. Even if a spreading center is operative in Ovda and Thetis, most of the geoid and topography must be due to other mechanisms. Crumpler et al. also proposed the existence of cross-strike discontinuities, interpreted as transform fault zones, but the evidence for these structures is not conclusive

Male Hypogonadism. A Case Report

Directory of Open Access Journals (Sweden)

Lisandro Hernández Madrazo

2012-07-01

Full Text Available The case of a 26 years old male patient who attended the Internal Medicine consultation at the La Fortaleza Integral Diagnostic Center in Maracaibo, Zulia State, Venezuela because of decreased external genitalia size, with poor development from childhood and swelling of the breasts is presented. Physical examination showed a trunk of feminoid configuration caused by adipose tissue accumulated in the lower abdomen, breast and pubic; wide pelvis; lower limb dominance over higher limbs; enucoid proportions; volume diffusely  increased in both breasts (gynecomastia; deposit of fatty tissue at the pelvic girdle, and absent or sparse facial, axillary and pubic hair. We observed decreased size, poor pigmentation, and soft consistency in penis and testicles. Exam was performed on plasma testosterone, luteinizing hormone and follicle stimulating hormone, thus concluding, by the Endocrinology Service at the Maracaibo University Hospital, to be the case of hypogonadotropic hypogonadism of improvable cause. The clinical diagnosis of hypogonadism in adults is unusual in medical practice, a fact that provides with relevance the case we present.

Stern-Center Potsdam; Stern-Center Potsdam

Energy Technology Data Exchange (ETDEWEB)

Anon.

1999-07-01

The ''Stern-Center Potsdam'' is a star-shaped shopping mall in the city center. [German] Das Stern-Center in Potsdam bietet als Einkaufszentrum vor den Toren Berlins Platz fuer eine Vielzahl von Geschaeften. Die sternfoermige Gebaeudestruktur des Centers bildet den Mittelpunkt des Stadtviertels 'Am Stern'. (orig.)

Guiding Center Equations in Toroidal Equilibria

International Nuclear Information System (INIS)

White, Roscoe; Zakharov, Leonid

2002-01-01

Guiding center equations for particle motion in a general toroidal magnetic equilibrium configuration are derived using magnetic coordinates. Previous derivations made use of Boozer coordinates, in which the poloidal and toroidal angle variables are chosen so that the Jacobian is inversely proportional to the square of the magnetic field. It is shown that the equations for guiding center motion in any equilibrium possessing nested flux surfaces have exactly the same simple form as those derived in this special case. This allows the use of more spatially uniform coordinates instead of the Boozer coordinates, greatly increasing the accuracy of calculations in large beta and strongly shaped equilibria

Dark matter annihilation into right-handed neutrinos and the galactic center gamma-ray excess

Energy Technology Data Exchange (ETDEWEB)

Tang, Yi-Lei [Center for High Energy Physics, Peking University,Beijing 100871 (China); Zhu, Shou-hua [Center for High Energy Physics, Peking University,Beijing 100871 (China); Institute of Theoretical Physics State Key Laboratory of Nuclear Physics and Technology,Peking University, Beijing 100871 (China); Collaborative Innovation Center of Quantum Matter,Beijing 100871 (China)

2016-03-08

In this paper, we will discuss a specific case that the dark matter particles annihilate into right-handed neutrinos. We calculate the predicted gamma-ray excess from the galactic center and compare our results with the data from the Fermi-LAT. An approximately 10–60 GeV right-handed neutrino with heavier dark matter particle can perfectly explain the observed spectrum. The annihilation cross section 〈σv〉 falls within the range 0.5–4×10{sup −26} cm{sup 3}/s, which is roughly compatible with the WIMP annihilation cross section.

Inference in media space. The case of IBM Software Executive Briefing Center - Rome

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Toni Marino

2014-11-01

Full Text Available In our paper we apply Peirce's model of Arguments (Statistical Deduction, Probabilistic Deduction, Induction and Abduction to a communication process where negotiating sense and meanings is emphasized. We selected a communication space where everything is planned as a medium of sense (video terminals, screens, lights, etc. namely the IBM Software Executive Briefing Center in Italy, a workplace used to exchange views, negotiate or transact. It is based in Rome in the same building as the International Development Laboratory of the IBM Software Group. The Software Center is the place where IBM welcomes its potential customers and has the opportunity to show them its technology and offer solutions. This paper focuses on "media space" in the Center which is structured by the seller according to his/her idea of the buyer's interpretive process. This paper analyzes the roles of visual codes in the allocation of functions. It also looks into the relation between the symbolism of the company with its marketing, past history and media space in order to define the buyer's typology of inference (deduction, induction or abduction in relation to the communication strategy of the media space design. The research is conducted directly in the field by interviewing the Manager of the IBM Center as well as asking people who use it to fill in an anonymous questionnaire, which analyses both the media space and the plan of the building.

Commercial speech in crisis: Crisis Pregnancy Center regulations and definitions of commercial speech.

Science.gov (United States)

Gilbert, Kathryn E

2013-02-01

Recent attempts to regulate Crisis Pregnancy Centers, pseudoclinics that surreptitiously aim to dissuade pregnant women from choosing abortion, have confronted the thorny problem of how to define commercial speech. The Supreme Court has offered three potential answers to this definitional quandary. This Note uses the Crisis Pregnancy Center cases to demonstrate that courts should use one of these solutions, the factor-based approach of Bolger v. Youngs Drugs Products Corp., to define commercial speech in the Crisis Pregnancy Center cases and elsewhere. In principle and in application, the Bolger factor-based approach succeeds in structuring commercial speech analysis at the margins of the doctrine.

[Study of the work and of working in Family Health Care Support Center].

Science.gov (United States)

Lancman, Selma; Gonçalves, Rita Maria de Abreu; Cordone, Nicole Guimarães; Barros, Juliana de Oliveira

2013-10-01

To understand the organization of and the working conditions in family health care support centers, as well as subjective experiences related to work in two of these centers. This was a case study carried out during 2011 and 2012 in two family health care support centers in Sao Paulo, Southeastern Brazil. Data were collected and analyzed using two theoretical-methodological references from ergonomics and work psychodynamics influenced, respectively, by ergonomic work analysis, developed based on open observations of a variety of tasks and on interviews and in practice in work psychodynamics, carried out using think tanks about the work. The work of the Family Health Care Support Centers in question is constituted on the bases of complex, diversified actions to be shared among the various professionals and teams involved. Innovative technological tools, which are not often adopted by primary health care professionals, are used and the parameters and productivity measures do not encompass the specificity and the complexity of the work performed. These situations require constant organizational rearrangement, especially between the Family Health Care Support Centers and the Family Health Care Teams, causing difficulties in carrying out the work as well as in constituting the identity of the professionals studied. The study attempts to lend greater visibility to the work processes at the Family Health Care Support Centers in order to contribute to advances in public policy on primary healthcare. It is important to stress that introducing changes at work, which affect both its organization and work conditions, is above all a commitment, which to be effective, must be permanent and must involve the different levels of hierarchy.

Determinants of U.S. poison center utilization.

Science.gov (United States)

Litovitz, Toby; Benson, Blaine E; Youniss, Jessica; Metz, Edward

2010-06-01

High poison center utilization has been associated with decreased emergency department usage and hospitalization rates. However, utilization requires awareness of the poison center. Penetrance, defined as the number of human poison exposures reported to a poison center per 1,000 population, has been used as a marker of poison center awareness. To identify factors that influence poison center penetrance to optimize the life- and cost-saving benefits of poison control centers. Human poison exposures that were reported to the National Poison Data System in 2001 were analyzed to identify and rank factors affecting poison center penetrance. Overall penetrance correlated with pediatric penetrance (R(2) = 0.75, p poison center that were already in or en route to a healthcare facility at the time of the call to the poison center (R(2) = 0.41, p poison center service populations were associated with lower penetrance (R(2) = 0.23, p poison center (multiple regression). Positive predictors included the percentage of the population younger than 5 years, the percentage of the adult population with a bachelor's degree, poison center certification, poison center educator FTEs (full time equivalents), Asian population percentage, and population density. The inverse correlation between pediatric penetrance and healthcare facility utilization supports prior observations of excessive healthcare utilization when a poison center is not called. Since race, language and distance are barriers to poison center utilization, and since healthcare utilization increases when poison center penetrance declines, low penetrance suggests a lack of awareness of the poison center rather than a low incidence of poisonings. Strategies to raise penetrance should be informed by an understanding of the barriers to utilization - language, Black/African American race, distance from the poison center, poverty, and lower education levels.

Statistical observation on autopsy cases of malignancy at the Japanese Red Cross, Nagasaki Atomic Bomb Hospital

Energy Technology Data Exchange (ETDEWEB)

Takahara, O; Toyoda, S; Tsuno, S; Mukai, H; Uemura, S [Nagasaki Atomic Bomb Hospital (Japan)

1976-09-01

Statistical observation was made as to autopsy cases of atomic-bomb survivors in Nagasaki. The total of autopsy cases at the Japanese Red Cross, Nagasaki Atomic Bomb Hospital from the opening of the hospital, 1968, to December in 1975 was 1,486 cases (autopsy rate, 65.1%) in which 880 cases of atomic bomb survivors (autopsy rate, 68.0%) were contained. Cases of malignancy totaled 829 and 528 cases of those were atomic bomb survivors. Cases of malignancy were divided into three groups, that is, group exposured to atomic bomb at place within 2 km from the explosion place, group exposured at place from more than 2 km or entering after explosion into the city, and not-exposured group. Relationship between main malignancies and exposure was discussed, and the following results were obtained. 1) Obvious relationship was found to exist between exposure and acute and chronic medullary leukemia. 2) Malignant lymphoma was scarcely correlated with exposure, but its occurrence rate was higher than the mean rate in Japan in reflection the region where this disease occurs much geographically. 3) Relationship between exposure and stomach cancer, lung cancer, cancer of the large intestine, and double cancer was not found obviously, but occurrence rate of hepatic cancer was higher than the mean rate in Japan in three groups. The reason was supposed to be geographical factor. 4) Cases of thyroid gland cancer were a small number in female of the group exposured within 2 km, and cases of prostate cancer were a small number in the group within 2 km, but their occurrence rate was high specifically.

Statistical observation on autopsy cases of malignancy at the Japanese Red Cross, Nagasaki Atomic Bomb Hospital

International Nuclear Information System (INIS)

Takahara, Osamu; Toyoda, Shigeki; Tsuno, Sumio; Mukai, Hideaki; Uemura, Seiji

1976-01-01

Statistical observation was made as to autopsy cases of atomic-bomb survivors in Nagasaki. The total of autopsy cases at the Japanese Red Cross, Nagasaki Atomic Bomb Hospital from the opening of the hospital, 1968, to December in 1975 was 1,486 cases (autopsy rate, 65.1%) in which 880 cases of atomic bomb survivors (autopsy rate, 68.0%) were contained. Cases of malignancy totaled 829 and 528 cases of those were atomic bomb survivors. Cases of malignancy were divided into three groups, that is, group exposured to atomic bomb at place within 2 km from the explosion place, group exposured at place from more than 2 km or entering after explosion into the city, and not-exposured group. Relationship between main malignancies and exposure was discussed, and the following results were obtained. 1) Obvious relationship was found to exist between exposure and acute and chronic medullary leukemia. 2) Malignant lymphoma was scarecely correlated with exposure, but its occurrence rate was higher than the mean rate in Japan in reflection the region where this disease occurs much geographically. 3) Relationship between exposure and stomach cancer, lung cancer, cancer of the large intestine, and double cancer was not found obviously, but occurrence rate of hepatic cancer was higher than the mean rate in Japan in three groups. The reason was supposed to be geographical factor. 4) Cases of thyroid gland cancer were a small number in female of the group exposured within 2 km, and cases of prostate cancer were a small number in the group within 2 km, but their occurrence rate was high specifically. (Tsunoda, M.)

Is total pancreatectomy as feasible, safe, efficacious, and cost-effective as pancreaticoduodenectomy? A single center, prospective, observational study.

Science.gov (United States)

Casadei, Riccardo; Ricci, Claudio; Taffurelli, Giovanni; Guariniello, Anna; Di Gioia, Anthony; Di Marco, Mariacristina; Pagano, Nico; Serra, Carla; Calculli, Lucia; Santini, Donatella; Minni, Francesco

2016-09-01

Total pancreatectomy is actually considered a viable option in selected patients even if large comparative studies between partial versus total pancreatectomy are not currently available. Our aim was to evaluate whether total pancreatectomy can be considered as feasible, safe, efficacious, and cost-effective as pancreaticoduodenectomy. A single center, prospective, observational trial, regarding postoperative outcomes, long-term results, and cost-effectiveness, in a tertiary referral center was conducted, comparing consecutive patients who underwent elective total pancreatectomy and/or pancreaticoduodenectomy. Seventy-three consecutive elective total pancreatectomies and 184 pancreaticoduodenectomies were compared. There were no significant differences regarding postoperative outcomes and overall survival. The quality of life, evaluated in 119 patients according to the EQ-5D-5L questionnaire, showed that there were no significant differences regarding the five items considered. The mean EQ-5D-5L score was similar in the two procedures (total pancreatectomy = 0.872, range 0.345-1.000; pancreaticoduodenectomy = 0.832, range 0.393-1.000; P = 0.320). The impact of diabetes according to the Problem Areas in Diabetes (PAID) questionnaire did not show any significant differences except for question 13 (total pancreatectomy = 0.60; pancreaticoduodenectomy = 0.19; P = 0.022). The cost-effectiveness analysis suggested that the quality-adjusted life year was not significantly different between the two procedures (total pancreatectomy = 0.910, range 0.345-1.000; pancreaticoduodenectomy = 0.910, range -0.393-1.000; P = 0.320). From this study, it seems reasonable to suggest that total pancreatectomy can be considered as safe, feasible, and efficacious as PD and acceptable in terms of cost-effectiveness.

The acoustic center of laboratory standard microphones

DEFF Research Database (Denmark)

Barrera Figueroa, Salvador; Rasmussen, Knud; Jacobsen, Finn

2006-01-01

An experimental procedure is described for obtaining the effective acoustic distance between pairs of microphones coupled by a free field, leading to the determination of the position of the acoustic center of the microphones. The procedure, which is based on measuring the modulus of the electrical...... transfer impedance, has been applied to a large number of microphones. In all cases effects due to reflections from the walls of the anechoic chamber and the interference between the microphones have been removed using a time-selective technique. The procedure of determining the position of the acoustic...... center from the inverse distance law is analyzed. Experimental values of the acoustic center of laboratory standard microphones are presented, and numerical results obtained using the boundary element method supplement the experimental data. Estimated uncertainties are also presented. The results...

The Moessbauer effect data center: A report

International Nuclear Information System (INIS)

Stevens, J.G.

1990-01-01

The Moessbauer Effect Data Center is unique in its operation and the kind of information services that it provides. It is probably the only user-supported information center in the basic sciences. This has been primarily possible due to the broad support and encouragement the center receives from the international Moessbauer community. This report also discusses the demographics of the Moessbauer community: identifying such items as the most active areas of research in Moessbauer Spectroscopy, where is this research being done and who is doing it. Also, examined is where Moessbauer research investigations are being published. BITNET and other forms of electronic mail are being widely used in the scientific community. This is also the case in the Moessbauer community. Directories and list-servers are being established. (orig.)

"Tuberculosis Case Management" Training.

Science.gov (United States)

Knebel, Elisa; Kolodner, Jennifer

2001-01-01

The need to isolated health providers with critical knowledge in tuberculosis (TB) case management prompted the development of "Tuberculosis Case Management" CD-ROM. Features include "Learning Center,""Examination Room," and "Library." The combination of audio, video, and graphics allows participants to…

Xylazine Exposures Reported to Texas Poison Centers.

Science.gov (United States)

Forrester, Mathias B

2016-10-01

Xylazine is a sedative, analgesic, anesthetic, and central muscle relaxant approved for animals but not humans. Although xylazine is an emerging drug of abuse, there are limited data on potentially adverse exposures to the drug. The intent of this study was to describe potentially adverse xylazine exposures reported to a large poison center system. All xylazine exposures reported to Texas poison centers between 2000 and 2014 were included. The distribution of cases by select variables was determined. Of 76 total cases, 93% of the patients were ≥20 years of age, and 54% were male. Fifty-one percent of the exposures occurred by injection, 28% by ingestion, 16% were dermal, 14% were ocular, and 3% by inhalation. Sixty-four percent of the exposures were unintentional, 32% were intentional, and 1% each was related to malicious use and adverse reaction. Sixty-seven percent of the patients were already at or en route to a health care facility when the poison center was contacted, 21% were managed on-site, and 9% were referred to a health care facility. The most common clinical effects were drowsiness or lethargy (47%), bradycardia (20%), hypotension (11%), hypertension (9%), puncture or wound (8%), and slurred speech (8%). Xylazine exposures tended to involve patients who were adult males, exposures were typically unintentional; and most often occurred by injection. Most of the patients were already at or en route to a health care facility when a poison center was contacted. The most frequently reported adverse effects were cardiovascular or neurologic in nature. Copyright © 2016 Elsevier Inc. All rights reserved.

Energy conserving site design case study, Burke Center, Virginia. Final report

Energy Technology Data Exchange (ETDEWEB)

1979-12-01

The pattern of energy consumption within a modern suburban community, Burke Center, is examined. A variety of actions that could be incorporated to reduce its future energy demands is proposed. Recommendations have been limited to those that are technically feasible today, are reasonably cost-effective, and that should generate little or no market resistance. Findings are that: of the total energy consumed by the Burke Center Community, 57% will go to off-site transportation needs; energy conserving site planning generally coincides with cost-effective site planning; water-to-air heat pumps proved to be the most efficient and cost-effective method available today in the study area for reducing heating and cooling costs in buildings; certain public services such as the collection of solid waste, mail pick-up and delivery, and other routine activities can be made more energy efficient; and the use of available water saving devices in residential and commercial buildings can reduce a community's total utility energy consumption by as much as 20%. (MCW)

Effects of different cutting centers on LASIK surgery in myopic patients

Directory of Open Access Journals (Sweden)

Yan-Wei Liu

2017-07-01

Full Text Available AIM:To investigate the effect of different cutting centers on the visual acuity, refractive diopter and visual quality of patients undergoing laser assisted in situ keratomileusis(LASIK. METHODS: A total of 80 patients(160 eyeswith myopia treated by elective LASIK were divided into two groups. Thirty-six cases(72 eyeswith visual axis corneal reflection point(VACRPas the cutting center were included into the VACRP group while 44 cases(88 eyeswith pupil center(PCas the cutting center were included into the PC group. The uncorrected visual acuity(UCVA, the best corrected visual acuity(BCVA, refractive diopter, corneal aberration \\〖total corneal and anterior corneal surface higher-order aberrations(HOA, spherical aberration(Z40, vertical coma(Z3-1, horizontal coma(totZ31and offset of cutting centers were determined before surgery and 1mo after surgery. RESULTS: There was no difference in the probability of UCVA ≥ 0.1, BCVA and refractive diopter between the two groups at 1mo after surgery(P>0.05. The astigmatism and cutting center deviation of VACRP group were lower than those of PC group(P40, totZ3-1, totZ31, froHOA, froZ3-1、froZ31 and froZ40 were lower in VACRP group than PC group at 1mo after surgery(PCONCLUSION: The UCVA of patients treated with both cutting centers for LASIK is good but VACRP has more advantages in reducing the offset of cutting center and improving postoperative visual quality.

A rare case of haboob in Tehran: Observational and numerical study

Science.gov (United States)

Karami, S.; Ranjbar, A.; Mohebalhojeh, A. R.; Moradi, M.

2017-03-01

A great dust storm occurred in Tehran on 2 June 2014 and caused severe damage to properties and involved loss of human life. From the visual evidence available, it can be regarded as a case of haboob. As a lower latitude phenomenon, its occurrence in Tehran was unprecedented in the last 50 years. This paper aims to present a detailed analysis of the weather conditions, the pathways by which dust particles were ingested by the haboob, as well as the impact of the urban boundary layer on the intensity and propagation of the dust storm. Using numerical simulation carried out by the WRF-Chem model and various observational techniques, the coupling of a low-level small-scale deformation field with a lower-tropospheric cold pool produced by precipitating mid-tropospheric clouds is identified as the main process involved in shaping this rare dust storm.

Continuing stability of center differences in pediatric diabetes care

DEFF Research Database (Denmark)

De Beaufort, Carine E.; Swift, Peter G.F.; Skinner, Chas T.

2007-01-01

OBJECTIVE- To reevaluate the persistence and stability of previously observed differences between pediatric diabetes centers and to investigate the influence of demography, language communication problems, and changes in insulin regimens on metabolic outcome, hypoglycemia, and ketoacidosis....... CONCLUSIONS - Despite many changes in diabetes management, major differences in metabolic outcome between 21 international pediatric diabetes centers persist. Different application between centers in the implementation of insulin treatment appears to be of more importance and needs further exploration....

Kinetics of the electronic center annealing in Al2O3 crystals

Science.gov (United States)

Kuzovkov, V. N.; Kotomin, E. A.; Popov, A. I.

2018-04-01

The experimental annealing kinetics of the primary electronic F, F+ centers and dimer F2 centers observed in Al2O3 produced under neutron irradiation were carefully analyzed. The developed theory takes into account the interstitial ion diffusion and recombination with immobile F-type and F2-centers, as well as mutual sequential transformation with temperature of three types of experimentally observed dimer centers which differ by net charges (0, +1, +2) with respect to the host crystalline sites. The relative initial concentrations of three types of F2 electronic defects before annealing are obtained, along with energy barriers between their ground states as well as the relaxation energies.

Characterizing complexity in socio-technical systems: a case study of a SAMU Medical Regulation Center.

Science.gov (United States)

Righi, Angela Weber; Wachs, Priscila; Saurin, Tarcísio Abreu

2012-01-01

Complexity theory has been adopted by a number of studies as a benchmark to investigate the performance of socio-technical systems, especially those that are characterized by relevant cognitive work. However, there is little guidance on how to assess, systematically, the extent to which a system is complex. The main objective of this study is to carry out a systematic analysis of a SAMU (Mobile Emergency Medical Service) Medical Regulation Center in Brazil, based on the core characteristics of complex systems presented by previous studies. The assessment was based on direct observations and nine interviews: three of them with regulator of emergencies medical doctor, three with radio operators and three with telephone attendants. The results indicated that, to a great extent, the core characteristics of complexity are magnified) due to basic shortcomings in the design of the work system. Thus, some recommendations are put forward with a view to reducing unnecessary complexity that hinders the performance of the socio-technical system.

Empowering patients of a mental rehabilitation center in a low-resource context: a Moroccan experience as a case study

Directory of Open Access Journals (Sweden)

Khabbache H

2017-04-01

2014–2015. The questionnaire investigated the reactions and feelings of the patients to the rehabilitation program, and their perceived psychological status and mental improvement, if any. Interviews were then transcribed and processed using ATLAS.ti V.7.0 qualitative analysis software. Frequencies and co-occurrence analyses were carried out. Despite approximately 30 million inhabitants within the working age group, Morocco suffers from a shortage of specialized health workers. Our ethnographic observations show that psychiatric treatment can be ensured, notwithstanding these hurdles, if a public health perspective is assumed. In resource-limited settings, working in the field of mental health means putting oneself on the line, exposing oneself to new experiences, and reorganizing one’s own skills and expertise. In the present article, we have used our clinical experience at a rehabilitation center in Fes as a case study and we have shown how to use peer therapy to overcome the drawbacks that we are encountered daily in a setting of limited resources. Keywords: peer therapy, low-resource setting, patient empowerment, qualitative analysis

Marked seasonality of Cyclospora cayetanensis infections: ten-year observation of hospital cases, Honduras.

Science.gov (United States)

Kaminsky, Rina Girard; Lagos, Javier; Raudales Santos, Gabriela; Urrutia, Samuel

2016-02-04

Document seasonality occurrence and epidemiologic characteristics of Cyclospora cayetanensis infections during a 10-year period from patients consulting at the University Hospital, Honduras. Retrospective non interventional hospital-based study analyzed laboratory results from the period 2002 to 2011 of fresh and Ziehl-Nielsen carbolfuchsin stained routine stool samples received for parasitologic examination. Sporadically a sample with numerous oocysts was allowed to sporulate in 2.5 % potassium dichromate confirming the presence of bi-cystic bi-zoic oocysts. A total of 35,157 fecal samples were examined during a ten-year span, of which a third (28.4 %) was stained by the Ziehl-Neelsen carbolfuchsin method diagnosing a total of 125 (1.3 %) C.cayetanensis infections. A statistically significant apparent seasonality was observed most years during May to August (range p < 0.036-0.001), with 83.3 % of 125 cases occurring in those rainy months. All C. cayetanensis cases came from urban poor neighborhoods; male/female relation was 1:1 except in 2006, when all patients were females (p = 0.05; r(2) = 22,448). Forty four point eight percent of the stool samples were diarrheic or liquid and 65.6 % infections were identified in children 10 years old or less. Enteric helminths and protozoa co-infected Cyclospora positive patients in 52 instances.: 8 % Ascaris lumbricoides, 8 % Giardia duodenalis, 23.2 % Blastocystis spp. and less frequently Entamoeba histolytica/E. dispar, Strongyloides stercoralis, and Trichuris trichiura. Results suggest a seasonal pattern for Cyclospora infections diagnosed in a clinical setting during the rainy months in Tegucigalpa and surrounding areas. Community studies should be conducted to support or dispute these observations.

Muonium centers in the alkali halides

International Nuclear Information System (INIS)

Baumeler, H.; Kiefl, R.F.; Keller, H.; Kuendig, W.; Odermatt, W.; Patterson, B.D.; Schneider, J.W.; Savic, I.M.

1986-01-01

Muonium centers (Mu) in single crystals and powdered alkali halides have been studied using the high-timing-resolution transverse field μSR technique. Mu has been observed and its hyperfine parameter (HF) determined in every alkali halide. For the rocksalt alkali halides, the HF parameter A μ shows a systematic dependence on the host lattice constant. A comparison of the Mu HF parameter with hydrogen ESR data suggests that the Mu center is the muonic analogue of the interstitial hydrogen H i 0 -center. The rate of Mu diffusion can be deduced from the motional narrowing of the nuclear hyperfine interaction. KBr shows two different Mu states, a low-temperature Mu I -state and a high-temperature Mu II -state. (orig.)

Developing the role of the social worker as coordinator of services at the surrogate parenting center.

Science.gov (United States)

Gagin, Roni; Cohen, Miri; Greenblatt, Lee; Solomon, Hanah; Itskovitz-Eldor, Joseph

2004-01-01

A law permitting couples to conceive biological children through surrogacy was legislated in Israel in March 1996. The Rambam Medical Center has established the only nonprofit Surrogate Parenting Center at a public hospital in Israel. The multidisciplinary teamwork at the Center is case managed by a social worker. An important role of the social work intervention is consultation and support for the couple and the surrogate at all stages of the process. The case study presented in the article illustrates the need for sensitive and professional intervention due to the complexity of the surrogacy process and the crisis it involves for both the surrogate and the couple. In light of the growing parenting surrogacy cases in the United States, Europe, and Israel, a structured social work intervention model is described, which may be implemented at public or private surrogate parenting centers.

Information sharing guidebook for transportation management centers, emergency operations centers, and fusion centers

Science.gov (United States)

2010-06-01

This guidebook provides an overview of the mission and functions of transportation management centers, emergency operations centers, and fusion centers. The guidebook focuses on the types of information these centers produce and manage and how the sh...

Information sharing guidebook for transportation management centers, emergency operations centers, and fusion centers.

Science.gov (United States)

2010-06-01

This guidebook provides an overview of the mission and functions of transportation management centers, emergency operations centers, and fusion centers. The guidebook focuses on the types of information these centers produce and manage and how the sh...

Access to Educational Opportunity in Rural Communities: Alternative Patterns of Delivering Vocational Education in Sparsely Populated Areas. Volume 2: The Heartland Vocational Center: A Decentralized Center.

Science.gov (United States)

Thomas, Ruth G.; And Others

One of the four case studies addressing access of rural students to vocational education through inter-school district cooperation, the Heartland case study represents the decentralized variation of the center cooperative school pattern, identifies essential features of this form of cooperation, details factors facilitating/impeding the…

[Client centered psychotherapy].

Science.gov (United States)

Werthmann, H V

1979-01-01

In the discussion concerning which psychotherapeutic methods should come under the auspices of the medical health system in West Germany, the question is raised regarding the client-centered therapy of Carl Rogers. Can it be considered a distinct psychotherapeutic method? A review of the scientific literature dealing with this method shows that it provides neither a theory of mental illness nor a theory of clinical application based on individual cases or specific neurotic disturbances, Therefore it should be categorized as a useful method of communication in the field of psychology and not as a therapeutic method for treating mental illness.

Transforming trauma healthcare delivery in rural areas by use of an integrated call center.

Science.gov (United States)

Agrawal, Deepak

2012-01-01

There is poor penetration of trauma healthcare delivery in rural areas. On the other hand, mobile penetration in India is now averaging 80% with most families having access to mobile phone. The aim of this study was to assess the implementation and socioeconomic impact of a call center in providing healthcare delivery for patients with head and spinal injuries. This was a prospective observational study carried out over a 6-month period at a level I trauma Center in New Delhi, India. A nine-seater call center was outsourced to a private company and the hospital's electronic medical records were integrated with the call-center operations. The call center was given responsibility of maintaining appointments and scheduling clinics for the whole hospital as well as ensuring follow-up visits. Trained call-center staff handled simple patient queries and referred the rest via email to concerned doctors. A telephonic survey was done prior to the start of call-center operations and after 3 months to assess for user satisfaction. The initial cost of outsourcing the call center was Rs 1.6 lakhs (US$ 4000), with a recurring cost of Rs 80,000 (US$ 2000) per month. A total of 484 patients were admitted in the department of Neurosurgery during the study period. Of these, 63% (n=305) were from rural areas. Patients' overall experience for clinic visits improved markedly following implementation of call center. Patient satisfaction for follow-up visits increased from a mean of 32-96%. Ninety-five percent patients reported a significant decrease in waiting time in clinics 80.4% reporting improved doctor-patient interaction. A total of 52 visits could be postponed/cancelled for patients living in far flung areas resulting in major socioeconomic benefits to these families. As shown by our case study, call centers have the potential to revolutionize delivery of trauma healthcare to rural areas in an extremely cost-effective manner.

Transforming trauma healthcare delivery in rural areas by use of an integrated call center

Directory of Open Access Journals (Sweden)

Deepak Agrawal

2012-01-01

Full Text Available Introduction: There is poor penetration of trauma healthcare delivery in rural areas. On the other hand, mobile penetration in India is now averaging 80% with most families having access to mobile phone. Aims and Objectives: The aim of this study was to assess the implementation and socioeconomic impact of a call center in providing healthcare delivery for patients with head and spinal injuries. Materials and Methods: This was a prospective observational study carried out over a 6-month period at a level I trauma Center in New Delhi, India. A nine-seater call center was outsourced to a private company and the hospital′s electronic medical records were integrated with the call-center operations. The call center was given responsibility of maintaining appointments and scheduling clinics for the whole hospital as well as ensuring follow-up visits. Trained call-center staff handled simple patient queries and referred the rest via email to concerned doctors. A telephonic survey was done prior to the start of call-center operations and after 3 months to assess for user satisfaction. Results: The initial cost of outsourcing the call center was Rs 1.6 lakhs (US$ 4000, with a recurring cost of Rs 80,000 (US$ 2000 per month. A total of 484 patients were admitted in the department of Neurosurgery during the study period. Of these, 63% (n=305 were from rural areas. Patients′ overall experience for clinic visits improved markedly following implementation of call center. Patient satisfaction for follow-up visits increased from a mean of 32-96%. Ninety-five percent patients reported a significant decrease in waiting time in clinics 80.4% reporting improved doctor-patient interaction. A total of 52 visits could be postponed/cancelled for patients living in far flung areas resulting in major socioeconomic benefits to these families. Conclusions: As shown by our case study, call centers have the potential to revolutionize delivery of trauma healthcare to

Transforming trauma healthcare delivery in rural areas by use of an integrated call center

Science.gov (United States)

Agrawal, Deepak

2012-01-01

Introduction: There is poor penetration of trauma healthcare delivery in rural areas. On the other hand, mobile penetration in India is now averaging 80% with most families having access to mobile phone. Aims and Objectives: The aim of this study was to assess the implementation and socioeconomic impact of a call center in providing healthcare delivery for patients with head and spinal injuries. Materials and Methods: This was a prospective observational study carried out over a 6-month period at a level I trauma Center in New Delhi, India. A nine-seater call center was outsourced to a private company and the hospital's electronic medical records were integrated with the call-center operations. The call center was given responsibility of maintaining appointments and scheduling clinics for the whole hospital as well as ensuring follow-up visits. Trained call-center staff handled simple patient queries and referred the rest via email to concerned doctors. A telephonic survey was done prior to the start of call-center operations and after 3 months to assess for user satisfaction. Results: The initial cost of outsourcing the call center was Rs 1.6 lakhs (US$ 4000), with a recurring cost of Rs 80,000 (US$ 2000) per month. A total of 484 patients were admitted in the department of Neurosurgery during the study period. Of these, 63% (n=305) were from rural areas. Patients’ overall experience for clinic visits improved markedly following implementation of call center. Patient satisfaction for follow-up visits increased from a mean of 32-96%. Ninety-five percent patients reported a significant decrease in waiting time in clinics 80.4% reporting improved doctor-patient interaction. A total of 52 visits could be postponed/cancelled for patients living in far flung areas resulting in major socioeconomic benefits to these families. Conclusions: As shown by our case study, call centers have the potential to revolutionize delivery of trauma healthcare to rural areas in an

Role of observation of live cases done by Japanese experts in the acquisition of ESD skills by a western endoscopist.

Science.gov (United States)

Draganov, Peter V; Chang, Myron; Coman, Roxana M; Wagh, Mihir S; An, Qi; Gotoda, Takuji

2014-04-28

To evaluate the role of observation of experts performing endoscopic submucosal dissection (ESD) in the acquisition of ESD skills. This prospective study is documenting the learning curve of one Western endoscopist. The study consisted of three periods. In the first period (pre-observation), the trainee performed ESDs in animal models in his home institution in the United States. The second period (observation) consisted of visit to Japan and observation of live ESD cases done by experts. The observation of cases occurred over a 5-wk period. During the third period (post-observation), the trainee performed ESD in animal models in a similar fashion as in the first period. Three animal models were used: live 40-50 kg Yorkshire pig, explanted pig stomach model, and explanted pig rectum model. The outcomes from the ESDs done in the animal models before and after observation of live human cases (main study intervention) were compared. Statistical analysis of the data included: Fisher's exact test to compare distributions of a categorical variable, Wilcoxon rank sum test to compare distributions of a continuous variable between the two groups (pre-observation and post-observation), and Kruskal-Wallis test to evaluate the impact of lesion location and type of model (ex-vivo vs live pig) on lesion removal time. The trainee performed 38 ESDs in animal model (29 pre-observation/9 post-observation). The removal times post-observation were significantly shorter than those pre-observation (32.7 ± 15.0 min vs 63.5 ± 9.8 min, P < 0.001). To minimize the impact of improving physician skill, the 9 lesions post-observation were compared to the last 9 lesions pre-observation and the removal times remained significantly shorter (32.7 ± 15.0 min vs 61.0 ± 7.4 min, P = 0.0011). Regression analysis showed that ESD observation significantly reduced removal time when controlling for the sequence of lesion removal (P = 0.025). Furthermore, it was also noted a trend towards decrease in

Effects of donepezil on behavioural manifestations of thalamic infarction: a single case observation

Directory of Open Access Journals (Sweden)

Rodrigo eRiveros

2011-03-01

Full Text Available Objective: To examine the effect of donepezil for the treatment of cognitive and behavioural disorders associated with thalamic lesions in a 45 years old male who suffered an infarct in the left thalamus. Background: Recent studies suggest that donepezil may improve executive functions impairments due to subcortical ischemic lesionsMethod: The crossover effects of donepezil were analyzed in a single case of thalamic infarction with cognitive and behavioural alterations. Results: Significant behavioural modifications related to improved performances in executive functions were observed with the treatment. Conclusions: The results suggest that donepezil may have significant effect on executive functions that can alter behavioural outcomes after thalamic infarctions

Compressional heating in magnetized disks neighborhood: from the galactic center to micro-quasars

International Nuclear Information System (INIS)

Belmont, Renaud

2005-01-01

Faint, magnetized and energetic plasmas are very common media in Astrophysics. This thesis is dedicated to two specific cases characterized by a thin disk geometry: the Galactic center and the corona of micro-quasars. In both cases, observations show evidence for a faint and very hot plasma (at 100 million and 1 billion degrees) whose origin is unknown; some clues seem also to indicate a strong, large scale bipolar magnetic field. At the Galactic Center, the gas temperature is such that, if it were collisional and mostly composed by hydrogen, it would escape quickly, so that the power required to sustain the related energy losses would be huge. We however show that the specific conditions of this region can lead to form a helium plasma that is confined by the Galactic potential. In this favorable situation, we study a possible heating mechanism based on the high viscosity of the hot plasma and friction with cold molecular clouds flowing in this region. The corona of micro-quasars is a very similar issue but it is probably weakly collisional. In this regime we study a heating by magnetic pumping, by which the resonance between the periodic motion of some coronal ions and the periodic excitation by an instability in the disc itself can energize the corona. We show that this mechanism is inefficient to explain the hot temperature. (author) [fr

The Kinematics of Molecular Cloud Cores in the Presence of Driven and Decaying Turbulence: Comparisons with Observations

Energy Technology Data Exchange (ETDEWEB)

Offner, S R; Krumholz, M R; Klein, R I; McKee, C F

2007-12-17

In this study we investigate the formation and properties of prestellar and protostellar cores using hydrodynamic, self-gravitating Adaptive Mesh Refinement simulations, comparing the cases where turbulence is continually driven and where it is allowed to decay. We model observations of these cores in the C{sup 18}O(2 {yields} 1), NH{sub 3}(1, 1), and N{sub 2}H{sup +}(1 {yields} 0) lines, and from the simulated observations we measure the linewidths of individual cores, the linewidths of the surrounding gas, and the motions of the cores relative to one another. Some of these distributions are significantly different in the driven and decaying runs, making them potential diagnostics for determining whether the turbulence in observed star-forming clouds is driven or decaying. Comparing our simulations with observed cores in the Perseus and {rho} Ophiuchus clouds shows reasonably good agreement between the observed and simulated core-to-core velocity dispersions for both the driven and decaying cases. However, we find that the linewidths through protostellar cores in both simulations are too large compared to the observations. The disagreement is noticeably worse for the decaying simulation, in which cores show highly supersonic in fall signatures in their centers that decrease toward their edges, a pattern not seen in the observed the regions.

Teleradiology for a family practice center

International Nuclear Information System (INIS)

Franken, E.A.; Driscoll, C.E.; Berbaum, K.S.; Smith, W.L.; Sato, Y.; Kao, S.C.; Steinkraus, L.

1988-01-01

This study evaluated the role of teleradiology (TR) in providing radiology consultation to a family practice center. All radiographs obtained in the center over a 5-month period were read twice independently: once by TR and once with the original radiograph. Accuracy was comparable for TR and plain films, with an average error rate of 7%. Effect of the radiologist's consultation on the family practitioner was substantial, causing changes in the confidence of diagnosis in over half of cases, and in treatment or prognosis in others. The immediate TR report tended to have a greater impact than the late consultation. The authors conclude that TR offers an acceptable mechanism for radiologic consultation

Dietary supplement adverse events: report of a one-year poison center surveillance project.

Science.gov (United States)

Haller, Christine; Kearney, Tom; Bent, Stephen; Ko, Richard; Benowitz, Neal; Olson, Kent

2008-06-01

The safety and efficacy of dietary supplements is of growing concern to regulators, health-care providers and consumers. Few scientific data exist on clinical effects and potential toxicities of marketed products. Harmful supplements may not be identified for months or years with existing adverse event monitoring mechanisms. Retrospective review of poison center statistics to capture supplement-associated toxicity also has limitations. We collaborated with the FDA Center for Food Safety and Nutrition (CFSAN) to conduct a 1-year prospective surveillance study of dietary supplement-related poison control center calls in 2006. Prompt follow-up of symptomatic cases, laboratory analysis of implicated dietary supplements, and causality assessment by a case review expert panel were performed. Of 275 dietary supplements calls, 41% involved symptomatic exposures; and two-thirds were rated as probably or possibly related to supplement use. Eight adverse events required hospital admission. Sympathomimetic toxicity was most common, with caffeine products accounting for 47%, and yohimbe products accounting for 18% of supplement-related symptomatic cases. Suspected drug-herb interactions occurred in 6 cases, including yohimbe co-ingested with buproprion (1) and methamphetamine (3), and additive anticoagulant/antiplatelet effects of NSAIDs taken with fish oils (1) and ginkgo (1). Laboratory analysis identified a pharmacologically active substance in 4 cases; supplement toxicity was ruled unlikely when analytical testing was negative in 5 cases. Most supplement-related adverse events were minor. Clinically significant toxic effects were most frequently reported with caffeine and yohimbe-containing products. Active surveillance of poison control center reports of dietary supplement adverse events enables rapid detection of potentially harmful products, which may facilitate regulatory oversight.

Results from the 2014 CASE Survey of Community College Foundations. CASE White Paper

Science.gov (United States)

Paradise, Andrew

2015-01-01

In 2011, the Council for Advancement and Support of Education (CASE) founded the Center for Community College Advancement to provide training and resources to help community colleges build and sustain effective fundraising, alumni relations, and communications and marketing programs. A goal for the center is to collect data on best practices at…

Thermal reorientation of hydrogenic Pr3+ centers

International Nuclear Information System (INIS)

Jones, G. D.

1996-01-01

Sets of five multi-hydrogenic centers of both CaF 2 :Pr 3+ and SrF 2 :Pr 3 + show bleaching under selective polarized-light irradiation. Two forms of bleaching behaviour are observed. In reversible polarized bleaching, irradiation creates re-oriented equivalent centers, which can be restored to the original orientation by switching the laser polarization by 90 deg. Indefinite sequences of bleaching and recovery can be established. In photoproduct bleaching, inequivalent centers are produced, which can be reverted by subsequently selectively exciting their absorption lines. Thermal recovery of the bleached centers on warming the crystals occurs abruptly over a 5 K range around 100 K and is noteworthy in occurring at essentially identical temperatures for H - , D - and T - centers. The simplest model for this thermal recovery is thermal activation of the mobile hydrogenic ions over a double well potential barrier. An alternative model proposed by Universitaet Regensburg requires the involvement of high frequency excitations in scattering processes for surmounting the barrier

Presentation of the Western Danish Sexual Assault Center

DEFF Research Database (Denmark)

Hansen, Ole Ingemann

November 1999 the first Center for (adult) Victims of Sexual Assault in Denmark opened in the town of Aarhus in cooperation with the Aarhus County’s Health Service, Aarhus University Hospital, the police and the Institute of Forensic Medicine, University of Aarhus. The Center is located at the em......November 1999 the first Center for (adult) Victims of Sexual Assault in Denmark opened in the town of Aarhus in cooperation with the Aarhus County’s Health Service, Aarhus University Hospital, the police and the Institute of Forensic Medicine, University of Aarhus. The Center is located...... - the others were taken care of by the nurses and/or the psychologist. 256 victims examined by the physicians were reported to the police (78%). The Aarhus Center is now well established, and there is an excellent cooperation in the region between the Center and the affiliated partners: the police......, the forensic scientists, the department of gynaecology, the county’s general practitioners and the university institutes of psychology and forensic medicine. The prevention of sexual assault is a difficult issue, but the fact that half the cases happens in privacy or at work, and that only 25...

Dynamic centering of liquid shells

International Nuclear Information System (INIS)

Tsamopoulos, J.A.; Brown, R.A.

1987-01-01

The moderate-amplitude axisymmetric oscillations of an inviscid liquid shell surrounding an incompressible gas bubble are calculated by a multiple-time-scale expansion for initial deformations composed of two-lobed perturbations of the shell and a displacement of the bubble from the center of mass of the liquid. Two types of small-amplitude motion are identified and lead to very different nonlinear dynamic interactions, as described by the results valid up to second order in the amplitude of the initial deformation. In the ''bubble mode,'' the oscillations of the captive bubble and the liquid shell are exactly in phase and the bubble vibrates about its initial eccentric location. The bubble moves toward the center of the drop when the shell is perturbed into a ''sloshing mode'' of oscillation where both interfaces move out of phase. These results explain the centering of liquid shells observed in several experiments

Physical Activity Opportunities Within the Schedule of Early Care and Education Centers.

Science.gov (United States)

Mazzucca, Stephanie; Hales, Derek; Evenson, Kelly R; Ammerman, Alice; Tate, Deborah F; Berry, Diane C; Ward, Dianne S

2018-02-01

Physical activity has many benefits for young children's health and overall development, but few studies have investigated how early care and education centers allot time for physical activity, along with measured individual physical activity levels for indoor/outdoor activities during a typical day. Fifty early care and education centers in central North Carolina participated in 4 full-day observations, and 559 children aged 3-5 years within centers wore accelerometers assessing physical activity during observation days. Observation and physical activity data were linked and analyzed for associations between child activity and type of classroom activity. Children averaged 51 (13) minutes per day of moderate to vigorous physical activity and 99 (18) minutes per day of light physical activity while in child care. Children averaged 6 (10) and 10 (13) minutes per day of observed outdoor and indoor daily teacher-led physical activity, respectively. Outdoor time averaged 67 (49) minutes per day, and physical activity levels were higher during outdoor time than during common indoor activities (center time, circle time, and TV time). Physical activity levels varied between indoor and outdoor class activities. Policy and program-related efforts to increase physical activity in preschoolers should consider these patterns to leverage opportunities to optimize physical activity within early care and education centers.

Observation and studies of jet quenching in PbPb collisions at nucleon-nucleon center-of-mass energy = 2.76 TeV

Energy Technology Data Exchange (ETDEWEB)

Chatrchyan, Serguei [Yerevan Physics Inst. (Armenia); et al.

2011-08-01

Jet production in PbPb collisions at a nucleon-nucleon center-of-mass energy of 2.76 TeV was studied with the CMS detector at the LHC, using a data sample corresponding to an integrated luminosity of 6.7 inverse microbarns. Jets are reconstructed using the energy deposited in the CMS calorimeters and studied as a function of collision centrality. With increasing collision centrality, a striking imbalance in dijet transverse momentum is observed, consistent with jet quenching. The observed effect extends from the lower cut-off used in this study (jet transverse momentum = 120 GeV/c) up to the statistical limit of the available data sample (jet transverse momentum approximately 210 GeV/c). Correlations of charged particle tracks with jets indicate that the momentum imbalance is accompanied by a softening of the fragmentation pattern of the second most energetic, away-side jet. The dijet momentum balance is recovered when integrating low transverse momentum particles distributed over a wide angular range relative to the direction of the away-side jet.

Supporting learner-centered technology integration through situated mentoring

Science.gov (United States)

Rosenberg, Marian Goode

Situated mentoring was used as a professional development method to help 11 high school science teachers integrate learner-centered technology. The teachers' learner-centered technology beliefs and practices as well as their perception of barriers to learner-centered technology integration were explored before and after participating in the mentoring program. In addition, the participants' thoughts about the effectiveness of various components of the mentoring program were analyzed along with the mentor's observations of their practices. Situated mentoring can be effective for supporting learner-centered technology integration, in particular decreasing the barriers teachers experience. Goal setting, collaborative planning, reflection, and onsite just-in-time support were thought to be the most valuable components of the mentoring program.

On Symmetries of Extremal Black Holes with One and Two Centers

CERN Document Server

Ferrara, Sergio

2013-01-01

After a brief introduction to the Attractor Mechanism, we review the appearance of groups of type E7 as generalized electric-magnetic duality symmetries in locally supersymmetric theories of gravity, with particular emphasis on the symplectic structure of fluxes in the background of extremal black hole solutions, with one or two centers. In the latter case, the role of an "horizontal" symmetry SL(2,R) is elucidated by presenting a set of two-centered relations governing the structure of two-centered invariant polynomials.

Decay of paramagnetic centers in polyacetylene

International Nuclear Information System (INIS)

Hola, O.

1994-01-01

The time dependences of the relative concentration of spins in irradiated and unirradiated samples of polyacetylene have been studied. Similar courses of the decay of paramagnetic centers were observed in both types of samples. (author) 6 refs.; 1 fig

The Current State of Poison Control Centers in Pakistan and the Need for Capacity Building

Directory of Open Access Journals (Sweden)

Nadeem Khan

2014-03-01

Full Text Available Background: Chemical exposure is a major health problem globally. Poison control centers (PCCs play a leading role both in developed and developing countries in the prevention and control of poisonous chemical exposures. In this study, we aimed to assess the current state of PCCs in Pakistan and highlight capacity building needs in these centers. Methods: A cross-sectional survey of the two registered PCCs was done during August – December 2011. Necessary services of the PCCs were evaluated and the data were recorded on a predesigned checklist. Results: Both PCCs are affiliated to a tertiary care hospital. Clinical services to poisoned patients were available 24 hours a day / 7 days a week. Information on common local products was available to poison center staff. Both centers were involved in undergraduate and post graduate teaching. Telephone poison information service was not available in either of centers. There was a limited capacity for qualitative and analytical toxicology. Common antidotes were available. There were limited surveillance activities to capture toxic risks existing in the community and also a deficiency was observed in chemical disaster planning. Conclusion: PCCs in Pakistan need capacity building for specialized training in toxicology, toxicovigilance, chemical disaster planning, analytical laboratory tests and telephone service for consultation in poisoning cases.   How to cite this article: Khan NU, Mir MU, Khan UR, Khan AR, Ara J, Raja K, et al. The Current State of Poison Control Centers in Pakistan and the Need for Capacity Building. Asia Pac J Med Toxicol 2014;3:31-5.

University Counseling Center Use of Prolonged Exposure Therapy: In-Clinic Treatment for Students with PTSD

Science.gov (United States)

Bonar, Ted C.

2015-01-01

Students utilize university counseling center services to address distress related to post-traumatic stress disorder (PTSD). Since counseling centers services such as group work or general psychotherapy may not address specific PTSD-symptom reduction, centers often give community referrals in such cases. Evidence-based therapies (EBTs), including…

High-resolution spectrum of the Galactic center

Science.gov (United States)

Mahoney, W. A.; Ling, J. C.; Wheaton, W. A.

1993-01-01

Recent observations of the Galactic center region indicate the presence of a narrow gamma-ray line feature at 170 keV, and theoretical speculations suggest it may result from Compton backscattering of the 511 keV annihilation radiation. The high-resolution gamma-ray spectrometer on HEAO 3 observed the Galactic center in the fall of 1979 and in the spring of 1980. In view of the recent developments, the HEAO data were re-examined to search for this new feature and to look for possible correlations with the 511 keV line emisison. No evidence for such Compton backscattered radiation was found and the derived upper limits for emission in a line feature near 170 keV were well below previously reported fluxes, indicating possible time variability.

Comparison Of Seismic Performance Of Erciş Cultural Center Building With Observed And Calculated By Turkish Earthquake Code-2007

Directory of Open Access Journals (Sweden)

Recep Ali Dedecan

2013-08-01

Full Text Available The goal of this paper is to review the validity of seismic assessment procedure given in the Turkish Earthquake Code by comparing the assessment results with real structures from Eastern Turkey, where the 2011 Van earthquake occurred. To test the analysis methods for a typically suitable structure, the cultural center building at Erciş with 3 stories, is selected. In order to compare the results of the three different analysis techniques, for an identical earthquake, the ground motion used in analysis was characterized by equivalent elastic earthquake spectra, which were developed from available time history at the nearest construction site. It was found that the damage predictions by using the by Turkish Earthquake Code procedures point out the different level of damages. But, it is concluded that nonlinear time history analysis calculated the best estimation of the damage observed in the site.

Contraceptive Use and the Risk of Ectopic Pregnancy: A Multi-Center Case-Control Study.

Science.gov (United States)

Li, Cheng; Zhao, Wei-Hong; Meng, Chun-Xia; Ping, Hua; Qin, Guo-Juan; Cao, Shu-Jun; Xi, Xiaowei; Zhu, Qian; Li, Xiao-Cui; Zhang, Jian

2014-01-01

To evaluate the association between the risk of ectopic pregnancy (EP) and the use of common contraceptives during the previous and current conception/menstrual cycle. A multi-center case-control study was conducted in Shanghai. Women diagnosed with EP were recruited as the case group (n = 2,411). Women with intrauterine pregnancy (IUP) (n = 2,416) and non-pregnant women (n = 2,419) were matched as controls at a ratio of 1∶1. Information regarding the previous and current use of contraceptives was collected. Multivariate logistic regression analyses were performed to calculate odds ratios (ORs) and the corresponding 95% confidential intervals (CIs). Previous use of intrauterine devices (IUDs) was associated with a slight risk of ectopic pregnancy (AOR1 = 1.87 [95% CI: 1.48-2.37]; AOR2 = 1.84 [1.49-2.27]), and the risk increased with the duration of previous use (P1 for trend contraceptives reduced the risk of both unwanted IUP (condom: AOR = 0.04 [0.03-0.05]; withdrawal method: AOR = 0.10 [0.07-0.13]; calendar rhythm method: AOR = 0.54 [0.40-0.73]; oral contraceptive pills [OCPs]: AOR = 0.03 [0.02-0.08]; levonorgestrel emergency contraception [LNG-EC]: AOR = 0.22 [0.16-0.30]; IUDs: AOR = 0.01 [0.005-0.012]; tubal sterilization: AOR = 0.01 [0.001-0.022]) and unwanted EP (condom: AOR1 = 0.05 [0.04-0.06]; withdrawal method: AOR1 = 0.13 [0.09-0.19]; calendar rhythm method: AOR1 = 0.66 [0.48-0.91]; OCPs: AOR1 = 0.14 [0.07-0.26]; IUDs: AOR1 = 0.17 [0.13-0.22]; tubal sterilization: AOR1 = 0.04 [0.02-0.08]). However, when contraception failed and pregnancy occurred, current use of OCPs (AOR2 = 4.06 [1.64-10.07]), LNG-EC (AOR2 = 4.87 [3.88-6.10]), IUDs (AOR2 = 21.08 [13.44-33.07]), and tubal sterilization (AOR2 = 7.68 [1.69-34.80]) increased the risk of EP compared with the non-use of contraceptives. Current use of most contraceptives reduce the risk of both IUP and EP. However, if the

Contraceptive Use and the Risk of Ectopic Pregnancy: A Multi-Center Case-Control Study.

Directory of Open Access Journals (Sweden)

Cheng Li

Full Text Available To evaluate the association between the risk of ectopic pregnancy (EP and the use of common contraceptives during the previous and current conception/menstrual cycle.A multi-center case-control study was conducted in Shanghai. Women diagnosed with EP were recruited as the case group (n = 2,411. Women with intrauterine pregnancy (IUP (n = 2,416 and non-pregnant women (n = 2,419 were matched as controls at a ratio of 1∶1. Information regarding the previous and current use of contraceptives was collected. Multivariate logistic regression analyses were performed to calculate odds ratios (ORs and the corresponding 95% confidential intervals (CIs.Previous use of intrauterine devices (IUDs was associated with a slight risk of ectopic pregnancy (AOR1 = 1.87 [95% CI: 1.48-2.37]; AOR2 = 1.84 [1.49-2.27], and the risk increased with the duration of previous use (P1 for trend <10-4, P2 for trend <10-4. The current use of most contraceptives reduced the risk of both unwanted IUP (condom: AOR = 0.04 [0.03-0.05]; withdrawal method: AOR = 0.10 [0.07-0.13]; calendar rhythm method: AOR = 0.54 [0.40-0.73]; oral contraceptive pills [OCPs]: AOR = 0.03 [0.02-0.08]; levonorgestrel emergency contraception [LNG-EC]: AOR = 0.22 [0.16-0.30]; IUDs: AOR = 0.01 [0.005-0.012]; tubal sterilization: AOR = 0.01 [0.001-0.022] and unwanted EP (condom: AOR1 = 0.05 [0.04-0.06]; withdrawal method: AOR1 = 0.13 [0.09-0.19]; calendar rhythm method: AOR1 = 0.66 [0.48-0.91]; OCPs: AOR1 = 0.14 [0.07-0.26]; IUDs: AOR1 = 0.17 [0.13-0.22]; tubal sterilization: AOR1 = 0.04 [0.02-0.08]. However, when contraception failed and pregnancy occurred, current use of OCPs (AOR2 = 4.06 [1.64-10.07], LNG-EC (AOR2 = 4.87 [3.88-6.10], IUDs (AOR2 = 21.08 [13.44-33.07], and tubal sterilization (AOR2 = 7.68 [1.69-34.80] increased the risk of EP compared with the non-use of contraceptives.Current use of most

Radioimmunoassay of alpha-foeto-protein in hepatology. Observation of 151 cases

International Nuclear Information System (INIS)

Dao, Mouhamadou.

1976-03-01

Alpha-foeto-protein, although discovered several years ago, was considered as only able to exist in primary adult liver cancer. With progress in science and in research it was observed that AFP can be found in normal subjects, without any pathological significance. APF has been found moreover in illnesses other than primary liver cancer. This range of diseases, restricted at first, has continued to widen, a development due to the discovery of new AFP detection methods and radioimmunoassay. Our work, covering 151 cases discussed in detail in the 'Material and Methods' chapter, is interesting from two viewpoints: in hepatology it is useful to know whether the very sensitive radio-immunological method reveals abnormal AFP content variations in different liver diseases; given the large number of hepatomas in our series it is also interesting to have the value of this determination confirmed in primary liver cancer diagnosis. Radioimmunoassay now replaces other quantitative methods (MANCINI's radial immunodiffusion and LAURELL's elec. diffusion) and is the most accurate [fr

Hospital-Acquired Pressure Ulcers at Academic Medical Centers in the United States, 2008-2012: Tracking Changes Since the CMS Nonpayment Policy.

Science.gov (United States)

Padula, William V; Makic, Mary Beth F; Wald, Heidi L; Campbell, Jonathan D; Nair, Kavita V; Mishra, Manish K; Valuck, Robert J

2015-06-01

In 2007, the Centers for Medicare & Medicaid Services (CMS) announced its intention to no longer reimburse hospitals for costs associated with hospital-acquired pressure ulcers (HAPUs) and a list of other hospital-acquired conditions (HACs), which was followed by enactment of the nonpayment policy in October 2008. This study was conducted to define changes in HAPU incidence and variance since 2008. In a retrospective observational study, HAPU cases were identified at 210 University HealthSystem Consortium (UHC) academic medical centers in the United States. HAPU incidence rates were calculated as a ratio of HAPU cases to the total number of UHC inpatients between the first quarter of 2008 and the second quarter of 2012. HAPU cases were defined by multiple criteria: not present on admission (POA); coded for stage III or IV pressure ulcers; and a length of stay greater than four days. Among the UHC hospitals between 2008 and June 2012, 10,386 HAPU cases were identified among 4.08 million inpatients. The HAPU incidence rate decreased significantly from 11.8 cases per 1,000 inpatients in 2008 to 0.8 cases per 1,000 in 2012 (p CMS non-payment policy as a significant covariate of changing trends in HAPU incidence rates. HAPU incidence rates decreased significantly among 210 UHC AMCs after the enactment of the CMS nonpayment policy. The hospitals appeared to be reacting efficiently to economic policy incentives by improving prevention efforts.

Energy Frontier Research Center, Center for Materials Science of Nuclear Fuels

International Nuclear Information System (INIS)

Allen, Todd R.

2011-01-01

The Office of Science, Basic Energy Sciences, has funded the INL as one of the Energy Frontier Research Centers in the area of material science of nuclear fuels. This document is the required annual report to the Office of Science that outlines the accomplishments for the period of May 2010 through April 2011. The aim of the Center for Material Science of Nuclear Fuels (CMSNF) is to establish the foundation for predictive understanding of the effects of irradiation-induced defects on thermal transport in oxide nuclear fuels. The science driver of the center's investigation is to understand how complex defect and microstructures affect phonon mediated thermal transport in UO2, and achieve this understanding for the particular case of irradiation-induced defects and microstructures. The center's research thus includes modeling and measurement of thermal transport in oxide fuels with different levels of impurities, lattice disorder and irradiation-induced microstructure, as well as theoretical and experimental investigation of the evolution of disorder, stoichiometry and microstructure in nuclear fuel under irradiation. With the premise that thermal transport in irradiated UO2 is a phonon-mediated energy transport process in a crystalline material with defects and microstructure, a step-by-step approach will be utilized to understand the effects of types of defects and microstructures on the collective phonon dynamics in irradiated UO2. Our efforts under the thermal transport thrust involved both measurement of diffusive phonon transport (an approach that integrates over the entire phonon spectrum) and spectroscopic measurements of phonon attenuation/lifetime and phonon dispersion. Our distinct experimental efforts dovetail with our modeling effort involving atomistic simulation of phonon transport and prediction of lattice thermal conductivity using the Boltzmann transport framework.

Iowa Water Center | Iowa Water Center

Science.gov (United States)

Home Iowa State University Extension Iowa Water Center Submitted by mollyd on April 24, 2012 - 09 :42 Advancing the state of water knowledge and management The Iowa Water Center is a part of a nationwide network of university-based water centers created to encourage interdisciplinary water research

A New Method to Directly Observe Tuberculosis Treatment: Skype Observed Therapy, a Patient-Centered Approach.

Science.gov (United States)

Buchman, Tavora; Cabello, Celina

Tuberculosis (TB) treatment completion is in part determined by patient's adherence to long-term drug regimens. To best ensure compliance, directly observed therapy (DOT) is considered the standard of practice. Nassau County Department of Health TB Control is responsible for providing DOT to patients with TB. Tuberculosis Control sought to use and evaluate Skype Observed Therapy (SOT) as an alternative to DOT for eligible patients. The evaluation included analysis of patient's acceptance and adherence to drug regimen using SOT. Tuberculosis Control assessed staff efficiency and cost savings for this program. Percentages of SOT of patients and successful SOT visits, mileage, and travel time savings. Twenty percent of the caseload used SOT and 100% of patients who were eligible opted in. Average SOT success was 79%. Total mileage savings and time saved were $9,929.07 and 614 hours. Because SOT saves cost and time and is a suitable alternative to DOT for patients, it should be considered as part of new policies and practices in TB control programs.

Cusps in the center of galaxies: a real conflict with observations or a numerical artefact of cosmological simulations?

International Nuclear Information System (INIS)

Baushev, A.N.; Valle, L. del; Campusano, L.E.; Escala, A.; Muñoz, R.R.; Palma, G.A.

2017-01-01

Galaxy observations and N-body cosmological simulations produce conflicting dark matter halo density profiles for galaxy central regions. While simulations suggest a cuspy and universal density profile (UDP) of this region, the majority of observations favor variable profiles with a core in the center. In this paper, we investigate the convergency of standard N-body simulations, especially in the cusp region, following the approach proposed by [1]. We simulate the well known Hernquist model using the SPH code Gadget-3 and consider the full array of dynamical parameters of the particles. We find that, although the cuspy profile is stable, all integrals of motion characterizing individual particles suffer strong unphysical variations along the whole halo, revealing an effective interaction between the test bodies. This result casts doubts on the reliability of the velocity distribution function obtained in the simulations. Moreover, we find unphysical Fokker-Planck streams of particles in the cusp region. The same streams should appear in cosmological N-body simulations, being strong enough to change the shape of the cusp or even to create it. Our analysis, based on the Hernquist model and the standard SPH code, strongly suggests that the UDPs generally found by the cosmological N-body simulations may be a consequence of numerical effects. A much better understanding of the N-body simulation convergency is necessary before a 'core-cusp problem' can properly be used to question the validity of the CDM model.

Cusps in the center of galaxies: a real conflict with observations or a numerical artefact of cosmological simulations?

Energy Technology Data Exchange (ETDEWEB)

Baushev, A.N.; Valle, L. del; Campusano, L.E.; Escala, A.; Muñoz, R.R. [Departamento de Astronomía, Universidad de Chile, Casilla 36-D, Correo Central, Santiago (Chile); Palma, G.A., E-mail: baushev@gmail.com, E-mail: ldelvalleb@gmail.com, E-mail: luis@das.uchile.cl, E-mail: aescala@das.uchile.cl, E-mail: rmunoz@das.uchile.cl, E-mail: gpalmaquilod@ing.uchile.cl [Departamento de Física, FCFM, Universidad de Chile, Blanco Encalada 2008, Santiago (Chile)

2017-05-01

Galaxy observations and N-body cosmological simulations produce conflicting dark matter halo density profiles for galaxy central regions. While simulations suggest a cuspy and universal density profile (UDP) of this region, the majority of observations favor variable profiles with a core in the center. In this paper, we investigate the convergency of standard N-body simulations, especially in the cusp region, following the approach proposed by [1]. We simulate the well known Hernquist model using the SPH code Gadget-3 and consider the full array of dynamical parameters of the particles. We find that, although the cuspy profile is stable, all integrals of motion characterizing individual particles suffer strong unphysical variations along the whole halo, revealing an effective interaction between the test bodies. This result casts doubts on the reliability of the velocity distribution function obtained in the simulations. Moreover, we find unphysical Fokker-Planck streams of particles in the cusp region. The same streams should appear in cosmological N-body simulations, being strong enough to change the shape of the cusp or even to create it. Our analysis, based on the Hernquist model and the standard SPH code, strongly suggests that the UDPs generally found by the cosmological N-body simulations may be a consequence of numerical effects. A much better understanding of the N-body simulation convergency is necessary before a 'core-cusp problem' can properly be used to question the validity of the CDM model.

User-Centered Design through Learner-Centered Instruction

Science.gov (United States)

Altay, Burçak

2014-01-01

This article initially demonstrates the parallels between the learner-centered approach in education and the user-centered approach in design disciplines. Afterward, a course on human factors that applies learner-centered methods to teach user-centered design is introduced. The focus is on three tasks to identify the application of theoretical and…

Contributions of the German Research Center for Geosciences (GFZ) to the EPOS (European Plate Observing System) Implementation Phase 2015-18

Science.gov (United States)

Hoffmann, T. L.; Lauterjung, J.

2017-12-01

The European Plate Observing System project is currently approaching the end of year two of its four-year Implementation Phase 2015-18 (EPOS-IP). Under the Horizon 2020 Programme INFRADEV-3, the EPOS cyberinfrastructure is being established as an ERIC (European Research Infrastructure Consortium) and encompasses the implementation of both the EPOS Integrated Core Services (ICS) for solid Earth Science and a multitude of EPOS Thematic Core Services (TCS). During year two, a basic set of ICS and TCS services was developed and implemented, so that in October 2017 the validation phase (year 3) of EPOS is ready to be launched. Up to now, various TCS-Elements have integrated different Service Providers (SD) that are delivering Data, Data Products, Services and Software (DDSS) to their specific scientific community. As one of the 29 awardees of the EC grant, the German Research Center for Geosciences (GFZ) plays an important role in the implementation of EPOS and its Thematic and Integrated Core Services. The presented poster will give an overview of GFZ's participation in the work of nine technical EPOS Work Packages (WP7 ICS Development, WP8 Seismology, WP11 Volcano Observations, WP12 Satellite Data, WP13 Geomagnetic Observations, WP14 Anthropogenic Hazards, WP15 Geological Information and Modelling, WP16 Multi-Scale Laboratories and WP17 Geo Energy Test Beds) as well as in four administrative EPOS Work Packages (WP2 Communication, WP3 Harmonization, WP4 Legal & Governance, and WP5 Financial).

What do health coaches do? Direct observation of health coach activities during medical and patient-health coach visits at 3 federally qualified health centers.

Science.gov (United States)

Johnson, Christopher; Saba, George; Wolf, Jessica; Gardner, Heather; Thom, David H

2018-05-01

To examine activities of health coaches during patient medical visits and when meeting one-on-one with patients at 3 urban federally qualified health centers. Encounters were videotaped and transcribed. Data was analyzed using a matrix analysis approach that allowed a priori identification of expected categories of activity, based on the health coach training model and previously developed conceptual framework, which were modified based on activities observed. A total of 10 medical visits (patient, clinician and health coach), and 8 patient-coach visits were recorded. We identified 9 categories common to both medical and patient-coach visits and 2 categories unique to the medical visit. While observed activities were generally consistent with expected categories, some activities were observed infrequently or not at all. We also observed additional activity categories, including information gathering and personal conversation. The average amount of time spent on some categories of coaching activities differed substantially between medical visits and patient-coach visits. Health coaching activities observed differed in several respects to those expected, and differed between medical visits and coaching only visits. These results provide insights into health coaching behaviors that can be used to inform training and improve utilization of health coaches in practice. Copyright © 2017 Elsevier B.V. All rights reserved.

Location Allocation of Health Care Centers Using Geographical Information System: region 11 of Tehran

OpenAIRE

Mohsen Ahadnejad; Hosein Ghaderi; Mohammad Hadian; Payam Haghighatfard; Banafsheh Darvishi; Elham Haghighatfard; Bitasadat Zegordi; Arash Bordbar

2015-01-01

 Background & Objective: Location allocation of healthcare centers facilitates the accessibility of health services and the lack of proper distribution of these centers leads to increasing problems of citizens' access to these centers. The main objective of this study was to evaluate the distribution of healthcare centers in the region of the study and to determine deprived areas from this services. Materials & Methods: This research is a case study that has b...

Managing Returns in a Catalog Distribution Center

Science.gov (United States)

Gates, Joyce; Stuart, Julie Ann; Bonawi-tan, Winston; Loehr, Sarah

2004-01-01

The research team of the Purdue University in the United States developed an algorithm that considers several different factors, in addition to cost, to help catalog distribution centers process their returns more efficiently. A case study to teach the students important concepts involved in developing a solution to the returns disposition problem…

Long-term observation of the mineral trioxide aggregate extrusion into the periapical lesion： a case series

Institute of Scientific and Technical Information of China (English)

Seok-Woo Chang; Tae-Seok Oh; WooCheol Lee; Gary Shun-Pan Cheung; Hyeon-Cheol Kim

2013-01-01

One-step apexification using mineral trioxide aggregate （MTA） has been reported as an alternative treatment modality with more benefits than the use of long-term calcium hydroxide for teeth with open apex. However, orthograde placement of MTA is a challenging procedure in terms of length control. This case series describes the sequence of events following apical extrusion of MTA into the periapical area during a one-step apexification procedure for maxillary central incisor with an infected immature apex. Detailed long-term observation revealed complete resolution of the periapical radiolucent lesion around the extruded MTA. These cases revealed that direct contact with MTA had no negative effects on healing of the periapical tissues. However, intentional MTA overfilling into the periapical lesion is not to be recommended.

User-centered ecotourism development.

Science.gov (United States)

Talsma, L; Molenbroek, J F M

2012-01-01

The transfer of knowledge in an ecotourism project is never a one-way affair. An approach connected to bottom-up development is the submersion into another culture, while creating a new organizational structure. For co-creation, patterns that are often latent, such as leadership roles, the association with business, or even the color of education can be revealed by carefully facilitated brainstorms or workshops. Especially in countries with a different hierarchical structure, such as Indonesia compared to Holland, a careful analysis is needed before starting cooperation. Although a case is only a temporary view on a situation and not a guarantee for a truly sustainable system, the bottom-up approach tested has interesting starting points for an ecotourism system. Two cases were conducted in Bali, Indonesia, which resulted in guidelines on how to approach user-centered ecotourism development.

Paramagnetic centers in two phases of manganese-doped lanthanum gallate

Science.gov (United States)

Vazhenin, V. A.; Potapov, A. P.; Guseva, V. B.; Artyomov, M. Yu.

2009-05-01

An EPR study of two phases of manganese-doped lanthanum gallate (with a first-order structural transition occurring at 430 K) has revealed Gd3+, Fe3+, and Mn4+ centers at room temperature and 438 K. The parameters of spin Hamiltonians are determined for the Gd3+, Fe3+, and Mn4+ rhombohedral centers in the high-temperature phase (with no other centers found here) and for the monoclinic center Gd3+ in the low-temperature phase. Both in the orthorhombic and in the rhombohedral phase, crystallographic twins (or ferroelastic domains) are observed.

Reverse Stage Shift at a Tertiary Care Center: Escalating Risk in Men Undergoing Radical Prostatectomy

Science.gov (United States)

Silberstein, Jonathan L.; Vickers, Andrew J.; Power, Nicholas E.; Fine, Samson W.; Scardino, Peter T.; Eastham, James A.; Laudone, Vincent P.

2011-01-01

Purpose To evaluate changes in clinical and pathological characteristics of prostate cancer in patients treated surgically at a large tertiary care center in the context of increased use of active surveillance (AS) and minimally invasive surgery (MIS). Materials We performed retrospective review of 6,624 patients with localized prostate cancer who underwent radical prostatectomy from 2000–2010 at Memorial Sloan-Kettering Cancer Center. Patients were stratified by surgical approach (open, laparoscopic or robotic) and risk categories (low, intermediate, or high). Patients with low-risk disease, without intervention and minimum followup of 6 months were considered to have elected AS. Results AS cases increased from <20 per year between 2000–2004 to ≥100 per year between 2007–2009. Over the same decade MIS cases (laparoscopic or robotic) increased from zero to 63% of all surgical cases. The percentage of patients in intermediate- and high-risk categories increased over time, while the percentage in the low-risk category decreased (OR per year 0.91, 95% CI 0.89, 0.92, p <0.0005). The proportion of surgery patients with Gleason 6 tumors decreased over time (OR per year 0.87, 95% CI 0.85, 0.88; p <0.0005) while pathologic stage and Gleason score increased (p <0.0005). The proportion of low-risk cases decreased across all types of surgery, with the largest decrease in robotic surgery (p <0.0005). Conclusions We observed a reverse stage shift in patients undergoing radical prostatectomy since 2000 despite the introduction and rapid proliferation of MIS. These findings may be due to increased use of AS and institutional focus on treatment of higher-risk disease. PMID:21484780

University of Rhode Island Regional Earth Systems Center

Energy Technology Data Exchange (ETDEWEB)

Rothstein, Lewis [Univ. of Rhode Island, Kingston, RI (United States); Cornillon, P. [Univ. of Rhode Island, Kingston, RI (United States)

2017-02-06

The primary objective of this program was to establish the URI Regional Earth System Center (“Center”) that would enhance overall societal wellbeing (health, financial, environmental) by utilizing the best scientific information and technology to achieve optimal policy decisions with maximum stakeholder commitment for energy development, coastal environmental management, water resources protection and human health protection, while accelerating regional economic growth. The Center was to serve to integrate existing URI institutional strengths in energy, coastal environmental management, water resources, and human wellbeing. This integrated research, educational and public/private sector outreach Center was to focus on local, state and regional resources. The centerpiece activity of the Center was in the development and implementation of integrated assessment models (IAMs) that both ‘downscaled’ global observations and interpolated/extrapolated regional observations for analyzing the complexity of interactions among humans and the natural climate system to further our understanding and, ultimately, to predict the future state of our regional earth system. The Center was to begin by first ‘downscaling’ existing global earth systems management tools for studying the causes of local, state and regional climate change and potential social and environmental consequences, with a focus on the regional resources identified above. The Center would ultimately need to address the full feedbacks inherent in the nonlinear earth systems by quantifying the “upscaled” impacts of those regional changes on the global earth system. Through an interacting suite of computer simulations that are informed by observations from the nation’s evolving climate observatories, the Center activities integrates climate science, technology, economics, and social policy into forecasts that will inform solutions to pressing issues in regional climate change science, �

Scanning electron microscopy observations of failures of implant overdenture bars: a case series report.

Science.gov (United States)

Waddell, J Neil; Payne, Alan G T; Swain, Michael V; Kieser, Jules A

2010-03-01

Soldered or cast bars are used as a standard of care in attachment systems supporting maxillary and mandibular implant overdentures. When failures of these bars occur, currently there is a lack of evidence in relation to their specific etiology, location, or nature. To investigate the failure process of a case series of six failed soldered bars, four intact soldered bars, and one intact cast milled bar, which had been supporting implant overdentures. A total of 11 different overdenture bars were removed from patients with different configuration of opposing arches. A failed bar (FB) group (n = 6) had failed soldered overdenture bars, which were recovered from patients following up to 2 years of wear before requiring prosthodontic maintenance and repair. An intact bar (IB) group (n = 5) had both soldered bars and a single cast milled bar, which had been worn by patients for 2 to 5 years prior to receiving other aspects of prosthodontic maintenance. All bars were examined using scanning electron microscopy to establish the possible mode of failure (FB) or to identify evidence of potential failure in the future (IB). Evidence of a progressive failure mode of corrosion fatigue and creep were observed on all the FB and IB usually around the solder areas and nonoxidizing gold cylinder. Fatigue and creep were also observed in all the IB. Where the level of corrosion was substantial, there was no evidence of wear from the matrices of the attachment system. Evidence of an instantaneous failure mode, ductile and brittle overload, was observed on the fracture surfaces of all the FB, within the solder and the nonoxidizing gold cylinders, at the solder/cylinder interface. Corrosion, followed by corrosion fatigue, appears to be a key factor in the onset of the failure process for overdenture bars in this case series of both maxillary and mandibular overdentures. Limited sample size and lack of standardization identify trends only but prevent broad interpretation of the findings.

Positrons annihilation and the Galactic center

International Nuclear Information System (INIS)

Wallyn, Pierre

1992-01-01

The Galactic center has been observed in gamma rays, many times since more than two decades and we do not still have a full comprehensive picture of this region. It is fairly well established that the 511 keV annihilation line has two origins: a steady diffuse emission, which follows more or less the type I supernovae distribution along the Galactic plane and a variable emission coming from the positrons emitted by (at least) one compact object and annihilating in a nearby cold molecular cloud. We present here an analysis of the profiles and intensifies of the 511 keV annihilation line observed in the direction of the Galactic center. We find that a warm medium (temperature of 8000 K) can describe the annihilation of positrons from the diffuse component of the line. The high state observations of the 511 keV line can be explained if the time-variable component is coming from the annihilation of the positrons in a cold medium (temperature around 80 K). This constraint on the annihilation medium temperature supports the association with the molecular cloud G-0.86-0.08 in the direction of 1E1740.7-2942. On may 22, 1989, HEXAGONE detected a narrow 511 keV line and also a broad emission around 170 keV in the direction of the Galactic center. Two weeks before, EXITE observed in the same direction a new transient source EXS 1737.9-2952 which showed a bump around 102 keV. We propose a simple semi-quantitative model which can mimic the bumps as well as its time variations and emphasize the strong similarities between EXS1737.9-2952 and Nova Muscae. We study the behaviour of positron annihilation by charge exchange in the cold phase of the interstellar medium. We calculate formula for the slowing-down time before thermalization of positrons of a given initial energy, for different medium densities. Our scenario explains the lack of detection of the recombination lines from positronium and gives new constraints on their possible observation. (author) [fr

Relating calls to US poison centers for potential exposures to medications to Centers for Disease Control and Prevention reporting of influenza-like illness.

Science.gov (United States)

Beauchamp, Gillian A; McKeown, Nathanael J; Rodriguez, Sergio; Spyker, Daniel A

2016-03-01

The Centers for Disease Control (CDC) monitors influenza like illness (ILI) and the National Poison Data System (NPDS) warehouses call data uploaded by US poison centers regarding reported exposures to medication. We examined the relationship between calls to poison centers regarding reported exposures to medications commonly used to treat ILI and weekly reports of ILI. The CDC reports ILI, by age group, for each of 10 Health and Human Services (HHS) regions. We examined NPDS summary data from calls reported to poison centers regarding reported exposures to acetaminophen, cough/cold medications, and promethazine, for the same weeks, age groups, and HHS regions for influenza seasons 2000-2013. ILI and NPDS exposures were examined using graphical plots, descriptive statistics, stepwise regression analysis, and Geographic Information Systems (GIS). About 5,101,841 influenza-like illness cases were reported to the CDC, and 2,122,940 calls regarding reported exposures to medications commonly used to treat ILI, were reported by poison centers to the NPDS over the 13 flu seasons. Analysis of stepwise models of the linear untransformed data involving 24 NPDS data groups and for 60 ILI measures, over the 13 influenza seasons, demonstrated that reported exposures to medications used to treat ILI correlated with reported cases of ILI with a median R(2 )=( )0.489 (min R(2 )=( )0.248, max R(2 )=( )0.717), with mean ± SD of R(2 )=( )0.494 ± 0.121. Median number of parameters used (degrees of freedom - 1) was 7. NPDS data regarding poison center calls for selected ILI medication exposures were highly correlated with CDC ILI data. Since NPDS data are available in real time, it provides complimentary ILI monitoring. This approach may provide public health value in predicting other illnesses which are not currently as thoroughly monitored.

Promoting Teacher Adoption of GIS Using Teacher-Centered and Teacher-Friendly Design

Science.gov (United States)

Hong, Jung Eun

2014-01-01

This article reports the results of a case study that employed user-centered design to develop training tutorials for helping middle school social studies teachers use Web-based GIS in their classrooms. This study placed teachers in the center of the design process in planning, designing, and developing the tutorials. This article describes how…

Interprofessional academic health center leadership development: the case of the University of Alabama at Birmingham's Healthcare Leadership Academy.

Science.gov (United States)

Savage, Grant T; Duncan, W Jack; Knowles, Kathy L; Nelson, Kathleen; Rogers, David A; Kennedy, Karen N

2014-05-01

The study describes the genesis of the University of Alabama at Birmingham's Healthcare Leadership Academy (HLA), highlights the HLA's outcomes, discloses how the HLA has changed, and delineates future directions for academic health center (AHC) interprofessional leadership training. While interprofessional training is recognized as an important component of the professional education for health professionals, AHCs have not focused on interprofessional leadership training to prepare future AHC leaders. As professional bureaucracies, AHCs require leadership distributed across different professions; these leaders not only should be technical experts, but also skilled at interprofessional teamwork and collaborative governance. The HLA is examined using the case method, which is supplemented with a descriptive analysis of program evaluation data and outcomes. The HLA has created a networked community of AHC leaders; the HLA's interprofessional team projects foster innovative problem solving. Interprofessional leadership training expands individuals' networks and has multiple organizational benefits. © 2014.

U.S. Environmental Protection Agency national network of research centers: A case study in socio-political influences on research

Energy Technology Data Exchange (ETDEWEB)

Morehouse, K. [Environmental Protection Agency, Washington, DC (United States)

1995-12-01

During the 15 years that the U.S. Environmental Protection Agency (EPA) has supported university-based research centers, there have been many changes in mission, operating style, funding level, eligibility, and selection process. Even the definition of the term {open_quotes}research center{close_quotes} is open to debate. Shifting national priorities, political realities, and funding uncertainties have powered the evolution of research centers in EPA, although the agency`s basic philosophy on the purpose and value of this approach to research remains essentially unchanged. Today, EPA manages 28 centers, through the Office of Exploratory Research. These centers are administered under three distinct programs. Each program has its own mission and goals which guide the way individual centers are selected and operated. This paper will describe: (1) EPA`s philosophy of reserach centers, (2) the complicated history of EPA research centers, (3) coordination and interaction among EPA centers and others, (4) opportunities for collaboration, and (5) plans for the future.

Can We Train Military Surgeons in a Civilian Trauma Center?

Science.gov (United States)

Uchino, H; Kong, V Y; Oosthuizen, G V; Bruce, J L; Bekker, W; Laing, G L; Clarke, D L

2018-01-01

The objective of this study was to review the trauma workload and operative exposure in a major South African trauma center and provide a comparison with contemporary experience from major military conflict. All patients admitted to the PMTS following trauma were identified from the HEMR. Basic demographic data including mechanism of injury and body region injured were reviewed. All operative procedures were categorized. The total operative volume was compared with those available from contemporary literature documenting experience from military conflict in Afghanistan. Operative volume was converted to number of cases per year for comparison. During the 4-year study period, 11,548 patients were admitted to our trauma center. Eighty-four percent were male and the mean age was 29 years. There were 4974 cases of penetrating trauma, of which 3820 (77%) were stab wounds (SWs), 1006 (20%) gunshot wounds (GSWs) and the remaining 148 (3%) were animal injuries. There were 6574 cases of blunt trauma. The mechanism of injuries was as follows: assaults 2956, road traffic accidents 2674, falls 664, hangings 67, animal injuries 42, sports injury 29 and other injuries 142. A total of 4207 operations were performed. The volumes per year were equivalent to those reported from the military surgical literature. South Africa has sufficient burden of trauma to train combat surgeons. Each index case as identified from the military surgery literature has a sufficient volume in our center. Based on our work load, a 6-month rotation should be sufficient to provide exposure to almost all the major traumatic conditions likely to be encountered on the modern battlefield.

Archiving oceanographic data at NOAA's National Oceanographic Data Center: A use-case approach

Science.gov (United States)

Biddle, M.; Arzayus, K. M.; Collins, D.; Paver, C. R.; Rutz, S. B.

2012-12-01

Current data holdings at the National Oceanographic Data Center (NODC) include physical, biological and chemical measurements of in situ oceanographic variables, satellite data products, and ocean model simulations. NODC acquires data from a wide variety of partners that span academia, government (including state and federal sources), private industry, and non-profit organizations. NODC provides access to these diverse data collections for both current and future use, to ensure that data consumers have the ability to monitor present and past environmental conditions. Using a flexible archival infrastructure enables NODC to archive almost any type of file format. NODC is deploying web services built upon OPeNDAP, THREDDS, Geoportal, and other standard technologies to enable data integration and application-ready data for a broad spectrum of data consumers. To maximize use of these web services, NODC is working with the oceanographic community to utilize standard formats, such as netCDF, for representing data. This poster outlines use cases which describe how a data provider can 1) establish a relationship with NODC, 2) communicate and document requirements for archiving data, 3) fulfill funding agency data management requirements, and 4) implement an automated process for archiving standard recurring data sets, where applicable. As a result of this interaction, NODC can provide valuable feedback to data providers to improve the quality of their metadata and/or data, provide access to archived data via multiple services, and facilitate data use in various data products to inform scientists and the public about the state of the ocean.

Sensitivity of CTA to dark matter signals from the Galactic Center

Energy Technology Data Exchange (ETDEWEB)

Pierre, Mathias [Département Physique, École Normale Supérieure de Cachan, 61 Avenue du Président Wilson, Cachan, 94230 France (France); Siegal-Gaskins, Jennifer M. [California Institute of Technology, 1200 E. California Blvd., Pasadena, CA, 91125 (United States); Scott, Pat, E-mail: mathias.pierre@ens-cachan.fr, E-mail: jsg@tapir.caltech.edu, E-mail: patscott@physics.mcgill.ca [Department of Physics, McGill University, 3600 Rue University, Montréal, Québec, H3A 2T8 Canada (Canada)

2014-06-01

The Galactic Center is one of the most promising targets for indirect detection of dark matter with gamma rays. We investigate the sensitivity of the upcoming Cherenkov Telescope Array (CTA) to dark matter annihilation and decay in the Galactic Center. As the inner density profile of the Milky Way's dark matter halo is uncertain, we study the impact of the slope of the Galactic density profile, inwards of the Sun, on the prospects for detecting a dark matter signal with CTA. Adopting the Ring Method to define the signal and background regions in an ON-OFF analysis approach, we find that the sensitivity achieved by CTA to annihilation signals is strongly dependent on the inner profile slope, whereas the dependence is more mild in the case of dark matter decay. Surprisingly, we find that the optimal choice of signal and background regions is virtually independent of the assumed density profile. For the fiducial case of a Navarro-Frenk-White profile, we find that CTA will be able to probe annihilation cross-sections well below the canonical thermal relic value for dark matter masses from a few tens of GeV up to ∼ 5 TeV for annihilation to τ{sup +}τ{sup −}, and will achieve only a slightly weaker sensitivity for annihilation to b b-bar or μ{sup +}μ{sup −}. CTA will improve significantly on current sensitivity to annihilation signals for dark matter masses above ∼ 100 GeV, covering parameter space that is complementary to that probed by searches with the Fermi Large Area Telescope. The interpretation of apparent excesses in the measured cosmic-ray electron and positron spectra as signals of dark matter decay will also be testable with CTA observations of the Galactic Center. We demonstrate that both for annihilation and for decay, including spectral information for hard channels (such as μ{sup +}μ{sup −} and τ{sup +}τ{sup −}) leads to enhanced sensitivity for dark matter masses above m{sub DM} ∼ 200 GeV.

Sensitivity of CTA to dark matter signals from the Galactic Center

International Nuclear Information System (INIS)

Pierre, Mathias; Siegal-Gaskins, Jennifer M.; Scott, Pat

2014-01-01

The Galactic Center is one of the most promising targets for indirect detection of dark matter with gamma rays. We investigate the sensitivity of the upcoming Cherenkov Telescope Array (CTA) to dark matter annihilation and decay in the Galactic Center. As the inner density profile of the Milky Way's dark matter halo is uncertain, we study the impact of the slope of the Galactic density profile, inwards of the Sun, on the prospects for detecting a dark matter signal with CTA. Adopting the Ring Method to define the signal and background regions in an ON-OFF analysis approach, we find that the sensitivity achieved by CTA to annihilation signals is strongly dependent on the inner profile slope, whereas the dependence is more mild in the case of dark matter decay. Surprisingly, we find that the optimal choice of signal and background regions is virtually independent of the assumed density profile. For the fiducial case of a Navarro-Frenk-White profile, we find that CTA will be able to probe annihilation cross-sections well below the canonical thermal relic value for dark matter masses from a few tens of GeV up to ∼ 5 TeV for annihilation to τ + τ − , and will achieve only a slightly weaker sensitivity for annihilation to b b-bar or μ + μ − . CTA will improve significantly on current sensitivity to annihilation signals for dark matter masses above ∼ 100 GeV, covering parameter space that is complementary to that probed by searches with the Fermi Large Area Telescope. The interpretation of apparent excesses in the measured cosmic-ray electron and positron spectra as signals of dark matter decay will also be testable with CTA observations of the Galactic Center. We demonstrate that both for annihilation and for decay, including spectral information for hard channels (such as μ + μ − and τ + τ − ) leads to enhanced sensitivity for dark matter masses above m DM ∼ 200 GeV

Management and performance features of cancer centers in Europe: A fuzzy-set analysis

NARCIS (Netherlands)

Wind, Anke; Lobo, Mariana Fernandes; van Dijk, Joris; Lepage-Nefkens, Isabelle; Laranja-Pontes, Jose; da Conceicao Goncalves, Vitor; van Harten, Willem H.; Rocha-Goncalves, Francisco Nuno

2016-01-01

The specific aim of this study is to identify the performance features of cancer centers in the European Union by using a fuzzy-set qualitative comparative analysis (fsQCA). The fsQCA method represents cases (cancer centers) as a combination of explanatory and outcome conditions. This study uses

Challenges in Strategy and Management of Multinational R&D Centers in Emerging Markets: Perspective from a German Headquarters in the Chemical Sector

Directory of Open Access Journals (Sweden)

Osmar Mitsuo Saito

2013-03-01

Full Text Available The expansion of multinational company (MNCs operations abroad represents an observed trend for decades. The news is that in recent years the research and development (R&D activities also have become internationalized, including more intensified focus on emerging countries. Among the implications is the challenge for the MNCs to implement effective organizational structures with the intention to facilitate the articulated coordination of strategies and R&D management between the headquarters and their global R&D centers. The purpose of this study is to evaluate the strategy from the perspective of the corporate headquarters of a multinational company and the challenges in the formulation of the global R&D strategy and management of each center located inemerging and developed markets. For this reason, we developed an empirical research based on qualitative multiple case exploratory study in a German chemical MNC company in its five global R&D centers located in Germany (headquarters, USA, Brazil, China and India. The results suggested the needs to creation of organizational management capabilities for constant re-evaluation of its R&D strategy in order to capture the demands and the temporary windows of opportunities from these markets. These capabilities lead to reducing the strong observed centralization level and assigning more responsibilities to the subsidiaries with global R&D center status.

Current neurotrauma treatment practice in secondary medical service centers

International Nuclear Information System (INIS)

Suehiro, Eiichi; Yoshino, Hiroko; Koizumi, Hiroyasu; Yoneda, Hiroshi; Suzuki, Michiyasu

2011-01-01

Despite neurotrauma treatment practices comprising a significant amount of neurosurgical work for secondary medical service centers, little attention has been placed on neurotrauma cases and evaluation of current neurotrauma treatment practices is limited. Therefore we investigated current neurotrauma practices in our hospital located in a Japanese suburban city. We analyzed 439 patients with traumatic brain injury (TBI) admitted to our hospital between April 2004 and October 2010. Patients were divided into three groups based on the Glasgow Coma Scale (GCS) score on admission: mild TBI (GCS 14-15) in 252 patients (57.4%), moderate TBI (GCS 9-13) in 116 patients (26.4%), and severe TBI (GCS 3-8) in 71 patients (16.2%). Age, gender, alcohol consumption, cause of injury, cranial CT findings, neurosurgical procedure, length of hospital stay, and clinical outcome were analyzed. The average age of the patients was 59.2 years old. Male patients comprised 65%. Alcohol consumption was reported in 81 cases (18.5%), most of them with moderate TBI. Fall (208 cases, 47.4%) was the most frequent cause of injury, followed by traffic accident (115 cases, 26.2%) and high fall (73 cases, 16.6%). Acute subdural hematoma (174 cases, 39.6%) was most frequently seen in cranial CT findings on admission, which significantly increased with severity. A neurosurgical procedure was performed for 70 cases (15.9%), of which 15 (6.0%) were mild TBI and 18 (15.5%) were moderate TBI. The average hospital stay was 20.8 days, which significantly increased with severity. The overall rate of favorable outcome was 82.7%, and mortality was 8.2%; outcome deteriorated with severity. Some mild and moderate TBI cases had deteriorated and required surgery or resulted in death. These findings suggest that cautious treatment is necessary even in mild to moderate TBI cases which are often encountered in secondary medical service centers. (author)

The dynamic cusp at low altitudes: A case study combining Viking, DMSP, and Sondrestrom incoherent scatter radar observations

International Nuclear Information System (INIS)

Watermann, J.; Delabeaujardiere, O.; Lummerzheim, D.; Woch, J.; Newell, P.T.; Potemra, T.A.; Rich, F.J.; Shapshak, M.

1992-01-01

A case study involving data from three satellites and a ground-based radar are presented. Focus is on a detailed discussion of observations of the dynamic cusp made on 24 Sep. 1986 in the dayside high-latitude ionosphere and interior magnetosphere. The relevant data from space-borne and ground-based sensors is presented. They include in-situ particle and field measurements from the DMSP-F7 and Viking spacecraft and Sondrestrom radar observations of the ionosphere. These data are augmented by observations of the IMF and the solar wind plasma. The observations are compared with predictions about the ionospheric response to the observed particle precipitation, obtained from an auroral model. It is shown that observations and model calculations fit well and provide a picture of the ionospheric footprint of the cusp in an invariant latitude versus local time frame. The combination of Viking, Sondrestrom radar, and IMP-8 data suggests that an ionospheric signature of the dynamic cusp was observed. Its spatial variation over time which appeared closely related to the southward component of the IMF was monitored

Prophylactic use of Saccharomyces boulardii probiotics in preventing antibiotic-associated diarrhea: a single center hospital-based case-control study in Serbia

Directory of Open Access Journals (Sweden)

Nikola Panic

2015-12-01

Full Text Available Background. Antibiotic-associated diarrhea (AAD develops through the loss of normal bacterial intestinal flora. We have conducted a case-control study in order to assess whether prophylactic administration of Saccharomyces boulardii (S. boulardii prevents occurrence of AAD among adult hospitalized patients. Methods. Single-center hospital based case-control study was conducted in University Clinic “Dr Dragisa Misovic-Dedinje”, Belgrade, Serbia. Hospital records were screened in order to identify all the patients developing AAD in period January 1. 2010 – August 31. 2015. For every case, one age and gender matched control was randomly selected among patients hospitalized at the same time at the same department who were administered with antibiotics and did not develop AAD. For both cases and controls data were extracted on demographics, medical history, indication for use of antibiotics, antibiotics used, and prophylactic use of S.boulardii probiotics. The relationship between occurrence of AAD and putative risk factors were measured using the odds ratios (ORs and their 95% confidence interval (CI derived from logistic regression analysis. Results. Number of 59 cases and 59 controls were included in the study. Most of AAD cases were associated with old age (mean age of 78.05, and almost half (49.15% were hospitalized on geriatrics department. Most prescribed class of antibiotics among cases was III generation cephalosporins (50.85%, followed by fluoroquinolones (28.81% and trimethoprim-sulfamethoxazole (20.34%. Significantly more cases than controls were treated with carbapenems (16.95% vs. 5.08% respectively, p=0.04. Significantly less cases were administered with prophylactic S. boulardii probiotics (18.64% vs. 42.37% p=0.005. We identified prophylactic use of S. boulardii to act protectively against development of AAD from both univariate (OR: 0.31, 95% CI: 0.14-0.72 and multivariate analysis (OR:0.36, 95% CI: 0.14-0.80. Use of

A radio search for planetary nebulae near the galactic center

International Nuclear Information System (INIS)

Isaacman, R.B.

1980-01-01

Because of galactic center is a hostile environment, and because planetaries are weak radio emitters, it is not clear a priori that one expects to detect any planetary nebulae at all in the nuclear region of the Galaxy. Therefore the expected lifetime and flux density distribution of galactic center nebulae is considered. The principal observational results from the Westerbork data, and the results of some pilot observations with the Very Large Array, which were intended to distinguish planetaries from other radio sources on an individual basis are given. (Auth.)

The Earth Resources Observation Systems data center's training technical assistance, and applications research activities

Science.gov (United States)

Sturdevant, J.A.

1981-01-01

The Earth Resources Observation Systems (EROS) Data Center (EDO, administered by the U.S. Geological Survey, U.S. Department of the Interior, provides remotely sensed data to the user community and offers a variety of professional services to further the understanding and use of remote sensing technology. EDC reproduces and sells photographic and electronic copies of satellite images of areas throughout the world. Other products include aerial photographs collected by 16 organizations, including the U.S. Geological Survey and the National Aeronautics and Space Administration. Primary users of the remotely sensed data are Federal, State, and municipal government agencies, universities, foreign nations, and private industries. The professional services available at EDC are primarily directed at integrating satellite and aircraft remote sensing technology into the programs of the Department of the Interior and its cooperators. This is accomplished through formal training workshops, user assistance, cooperative demonstration projects, and access to equipment and capabilities in an advanced data analysis laboratory. In addition, other Federal agencies, State and local governments, universities, and the general public can get assistance from the EDC Staff. Since 1973, EDC has contributed to the accelerating growth in development and operational use of remotely sensed data for land resource problems through its role as educator and by conducting basic and applied remote sensing applications research. As remote sensing technology continues to evolve, EDC will continue to respond to the increasing demand for timely information on remote sensing applications. Questions most often asked about EDC's research and training programs include: Who may attend an EDC remote sensing training course? Specifically, what is taught? Who may cooperate with EDC on remote sensing projects? Are interpretation services provided on a service basis? This report attempts to define the goals and

Inside a Postpartum Nursing Center: Tradition and Change.

Science.gov (United States)

Yeh, Yueh-Chen; St John, Winsome; Venturato, Lorraine

2016-06-01

The purpose of this study was to explore how traditional ritual practices are incorporated into the context of contemporary healthcare. An ethnographic study was conducted, using observations and interviews with 27 first-time mothers and 3 nurses at a postpartum nursing center in Taipei, Taiwan. Nursing routines, policies and care provision at the center affected the way traditional ritual practices were conducted. New mothers in this study constructed their everyday activities at the center by incorporating and modifying the ritual practices inside and outside the postpartum nursing center setting. Social changes have an influence on traditional postpartum ritual practices so a postpartum nursing center becomes a choice for postpartum women. Thus, health care professionals should value their own functions and roles at the postpartum nursing center since the new mothers regard them as the primary support resource to help them recover from giving birth. Therefore, they need to re-examine their practices from the postpartum women's perspective to provide better support and sensitive care to postpartum women and their families. Copyright © 2016. Published by Elsevier B.V.

Analysis of Business Center Implementation in Banyumas Regency

Directory of Open Access Journals (Sweden)

Lina Rifda Naufalin

2017-06-01

Full Text Available The research aims to help the development of business center as an entrepreneurship laboratory for vocational students in order to increase the number of young entrepreneurs in Indonesia. This study is also  to find out how the implementation of the existing Business Center program in SMK Banyumas District viewed from the aspects of learning, economics, organizational, and capital. Research method used qualitative method and techniques of collecting data used observation and interview. The place of research is in Vocational School 1 Purwokerto and Vocational School 2 Purwokerto. The sampling technique was purposive sampling technique. Validity of data in this research used data triangulation.The result of the research shows that the learning aspect of the implementation of the business center is effective because it becomes the student training center. Economic aspect of the business center is effective to carry out the activities of selling goods, goods production and service, business because it is supported by qualified human resources and internal audits conducted regularly. The aspect of the capital of the business center can be managed effectively.

WFIRST: STScI Science Operations Center (SSOC) Activities and Plans

Science.gov (United States)

Gilbert, Karoline M.; STScI WFIRST Team

2018-01-01

The science operations for the WFIRST Mission will be distributed between Goddard Space Flight Center, the Space Telescope Science Institute (STScI), and the Infrared Processing and Analysis Center (IPAC). The STScI Science Operations Center (SSOC) will schedule and archive all WFIRST observations, will calibrate and produce pipeline-reduced data products for the Wide Field Instrument, and will support the astronomical community in planning WFI observations and analyzing WFI data. During the formulation phase, WFIRST team members at STScI have developed operations concepts for scheduling, data management, and the archive; have performed technical studies investigating the impact of WFIRST design choices on data quality and analysis; and have built simulation tools to aid the community in exploring WFIRST’s capabilities. We will highlight examples of each of these efforts.

Improving Initiation and Tracking of Research Projects at an Academic Health Center: A Case Study.

Science.gov (United States)

Schmidt, Susanne; Goros, Martin; Parsons, Helen M; Saygin, Can; Wan, Hung-Da; Shireman, Paula K; Gelfond, Jonathan A L

2017-09-01

Research service cores at academic health centers are important in driving translational advancements. Specifically, biostatistics and research design units provide services and training in data analytics, biostatistics, and study design. However, the increasing demand and complexity of assigning appropriate personnel to time-sensitive projects strains existing resources, potentially decreasing productivity and increasing costs. Improving processes for project initiation, assigning appropriate personnel, and tracking time-sensitive projects can eliminate bottlenecks and utilize resources more efficiently. In this case study, we describe our application of lean six sigma principles to our biostatistics unit to establish a systematic continual process improvement cycle for intake, allocation, and tracking of research design and data analysis projects. The define, measure, analyze, improve, and control methodology was used to guide the process improvement. Our goal was to assess and improve the efficiency and effectiveness of operations by objectively measuring outcomes, automating processes, and reducing bottlenecks. As a result, we developed a web-based dashboard application to capture, track, categorize, streamline, and automate project flow. Our workflow system resulted in improved transparency, efficiency, and workload allocation. Using the dashboard application, we reduced the average study intake time from 18 to 6 days, a 66.7% reduction over 12 months (January to December 2015).

Analysis of Business Center Implementation in Banyumas Regency

OpenAIRE

Lina Rifda Naufalin; Aldila Dinanti; Aldila Krisnaresanti

2017-01-01

The research aims to help the development of business center as an entrepreneurship laboratory for vocational students in order to increase the number of young entrepreneurs in Indonesia. This study is also to find out how the implementation of the existing Business Center program in SMK Banyumas District viewed from the aspects of learning, economics, organizational, and capital. Research method used qualitative method and techniques of collecting data used observation and interview. The pl...

Time since death and decomposition of the human body: variables and observations in case and experimental field studies.

Science.gov (United States)

Mann, R W; Bass, W M; Meadows, L

1990-01-01

Much of the difficulty in determining the time since death stems from the lack of systematic observation and research on the decomposition rate of the human body. Continuing studies conducted at the University of Tennessee, Knoxville, provide useful information on the impact of carrion insect activity, ambient temperature, rainfall, clothing, burial and depth, carnivores, bodily trauma, body weight, and the surface with which the body is in contact. This paper reports findings and observations accumulated during eight years of research and case studies that may clarify some of the questions concerning bodily decay.

TIGER-NET – enabling an Earth Observation capacity for Integrated Water Resource Management in Africa

DEFF Research Database (Denmark)

Walli, A.; Tøttrup, C.; Naeimi, V.

As part of the TIGER initiative [1] the TIGER-NET project aims to support the assessment and monitoring of water resources from watershed to transboundary basin level delivering indispensable information for Integrated Water Resource Management in Africa through: 1. Development of an open......-source Water Observation and Information Systems (WOIS) for monitoring, assessing and inventorying water resources in a cost-effective manner; 2. Capacity building and training of African water authorities and technical centers to fully exploit the increasing observation capacity offered by current...... and upcoming generations of satellites, including the Sentinel missions. Dedicated application case studies have been developed and demonstrated covering all EO products required by and developed with the participating African water authorities for their water resource management tasks, such as water reservoir...

Satellite observed impacts of wildfires on regional atmosphere composition and shortwave radiative forcing: multiple cases study

Science.gov (United States)

Fu, Y.; Li, R.; Huang, J.; Bergeron, Y.; Fu, Y.

2017-12-01

Emissions of aerosols and trace gases from wildfires and the direct shortwave radiative forcing were studied using multi-satellite/sensor observations from Aqua Moderate-Resolution Imaging Spectroradiometer (MODIS), Aqua Atmospheric Infrared Sounder (AIRS), Aura Ozone Monitoring Instrument (OMI), and Aqua Cloud's and the Earth's Radiant Energy System (CERES). The selected cases occurred in Northeast of China (NEC), Siberia of Russia, California of America have dominant fuel types of cropland, mixed forest and needleleaf forest, respectively. The Fire radiative power (FRP) based emission coefficients (Ce) of aerosol, NOx (NO2+NO), formaldehyde (HCHO), and carbon monoxide (CO) showed significant differences from case to case. 1) the FRP of the cropland case in NEC is strongest, however, the Ce of aerosol is the lowest (20.51 ± 2.55 g MJ-1). The highest Ce of aerosol is 71.34 ± 13.24 g MJ-1 in the needleleaf fire case in California. 2) For NOx, the highest Ce existed in the cropland case in NEC (2.76 ± 0.25 g MJ-1), which is more than three times of those in the forest fires in Siberia and California. 3) The Ce of CO is 70.21±10.97 and 88.38±46.16 g MJ-1 in the forest fires in Western Siberia and California, which are about four times of that in cropland fire. 4) The variation of Ce of HCHO are relatively small among cases. Strong spatial correlations are found among aerosol optical depth (AOD), NOx, HCHO, and CO. The ratios of NOx to AOD, HCHO, and CO in the cropland case in NEC show much higher values than those in other cases. Although huge differences of emissions and composition ratios exist among cases, the direct shortwave (SW) radiative forcing efficiency (SWARFE) of smoke at the top of the atmosphere (TOA) are in good agreement, with the shortwave radiative forcing efficiencies values of 20.09 to 22.93 per unit AOD. Results in this study reveal noteworthy variations of the FRP-based emissions coefficient and relative chemical composition in the smoke

Case management redesign in an urban facility.

Science.gov (United States)

Almaden, Stefany; Freshman, Brenda; Quaye, Beverly

2011-01-01

To explore strategies for improving patient throughput and to redesign case management processes to facilitate level of care transitions and safe discharges. Large Urban Medical Center in South Los Angeles County, with 384 licensed beds that services poor, underserved communities. Both qualitative and quantitative methods were applied. Combined theoretical frameworks were used for needs assessment, intervention strategies, and change management. Observations, interviews, surveys, and database extraction methods were used. The sample consisted of case management staff members and several other staff from nursing, social work, and emergency department staff. Postintervention measures indicated improvement in reimbursements for services, reduction in length of stay, increased productivity, improved patients' access to care, and avoiding unnecessary readmission or emergency department visits. Effective change management strategies must consider multiple factors that influence daily operations and service delivery. Creating accountability by using performance measures associated with patient transitions is highlighted by the case study results. The authors developed a process model to assist in identifying and tracking outcome measures related to patient throughput, front-end assessments, and effective patient care transitions. This model can be used in future research to further investigate best case management practices.

Climate Prediction Center - Monitoring & Data: La Niña Seasonal Maps and

Science.gov (United States)

page National Weather Service NWS logo - Click to go to the NWS home page Climate Prediction Center ±a Case Selection Contact Richard Tinker [rtinker@ncep.noaa.gov], Climate Prediction Center significant climate signals: The La Niña episode, and long-term trends in average temperature and total

Color centers in KCN: ferro-elastic alignment and free optical absorption of phonons

International Nuclear Information System (INIS)

Grillo, M.L.N.

1983-01-01

Some color centers in KCN pure and KCL or KOH doped are studied. The used tecniques for detection of these color centers were optical absorption and electron paramagnetic resonance (EPR). To obtain this color centers crystals were always exposed to X-rays. With an optical absorption technique, one color center was analysed after X-ray irradiation followed by a suitable photochemical process. Throught the EPR technique the F center and three other centers produced by radiation damage were observed through several KCN solid phases. As in the orthorhombic and ferroelastic phase (temperatures between 168K and 83K), the crystals of KCN present one multidomain structure responsable for strong light scattering on the optical absorption spectra and EPR spectra that does not present the resolved lines formed above 168K, one system of aligned domains was obtained through mechanical stress built specifically to be capable of reducing the number of distinct domain, and this allowed us to observe of partially resolved EPR lines. (Auhtor) [pt

High-Altitude Closed Magnetic Loops at Mars Observed by MAVEN

Science.gov (United States)

Xu, Shaosui; Mitchell, David; Luhmann, Janet; Ma, Yingjuan; Fang, Xiaohua; Harada, Yuki; Hara, Takuya; Brain, David; Weber, Tristan; Mazelle, Christian; DiBraccio, Gina A.

2017-11-01

With electron and magnetic field data obtained by the Mars Atmosphere and Volatile EvolutioN (MAVEN) spacecraft, we have identified closed magnetic field lines, with both foot points embedded in the dayside ionosphere, extending up to 6,200 km altitude into the Martian tail. This topology is deduced from photoelectrons produced in the dayside ionosphere being observed traveling both parallel and antiparallel to the magnetic field. At trapped-zone pitch angles (within a range centered on 90° where electrons magnetically reflect before interacting with the atmosphere), cases with either solar wind electrons or photoelectrons have been found, indicating different formation mechanisms for these closed loops. These large closed loops are present in MHD simulations. The case with field-aligned photoelectrons mixed with solar wind electrons having trapped-zone pitch angles is likely to be associated with reconnection, while the case with photoelectrons at all pitch angles is probably due to closed field lines being pulled tailward by the surrounding plasma flow. By utilizing an algorithm for distinguishing photoelectrons from solar wind electrons in pitch angle-resolved energy spectra, we systematically map the spatial distribution and occurrence rate of these closed magnetic loops over the region sampled by the MAVEN orbit. We find that the occurrence rate ranges from a few percent to a few tens of percent outside of the optical shadow and less than one percent within the shadow. These observations can be used to investigate the general magnetic topology in the tail, which is relevant to cold ion escape, reconnection, and flux ropes.

PREFACE: Galactic Center Workshop 2006

Science.gov (United States)

Schödel, Rainer; Bower, Geoffrey C.; Muno, Michael P.; Nayakshin, Sergei; Ott, Thomas

2006-12-01

We are pleased to present the proceedings from the Galactic Center Workshop 2006—From the Center of the Milky Way to Nearby Low-Luminosity Galactic Nuclei. The conference took place in the Physikzentrum, Bad Honnef, Germany, on 18 to 22 April 2006. It is the third workshop of this kind, following the Galactic Center Workshops held 1998 in Tucson, Arizona, and 2002 in Kona, Hawaii. The center of the Milky Way is the only galactic nucleus of a fairly common spiral galaxy that can be observed in great detail. With a distance of roughly 8 kpc, the resolution that can currently be achieved is of the order 40 mpc/8000 AU in the X-ray domain, 2 mpc/400 AU in the near-infrared, and 0.01 mpc/1 AU with VLBI in the millimeter domain. This is two to three orders of magnitude better than for any comparable nearby galaxy, making thus the center of the Milky Way thetemplate object for the general physical interpretation of the phenomena that can be observed in galactic nuclei. We recommend the summary article News from the year 2006 Galactic Centre workshopby Mark Morris and Sergei Nayakshin—who also gave the summary talk of the conference—to the reader in order to obtain a first, concise overview of the results presented at the workshop and some of the currently most exciting—and debated—developments in recent GC research. While the workshops held in 1998 and 2002 were dedicated solely to the center of the Milky Way, the field of view was widened in Bad Honnef to include nearby low-luminosity nuclei. This new feature followed the realization that not only the GC serves as a template for understanding extragalactic nuclei, but that the latter can also provide the context and broader statistical base for understanding the center of our Milky Way. This concerns especially the accretion and emission processes related to the Sagittarius A*, the manifestation of the super massive black hole in the GC, but also the surprising observation of great numbers of massive, young

NASA's Earth Observing Data and Information System

Science.gov (United States)

Mitchell, A. E.; Behnke, J.; Lowe, D.; Ramapriyan, H. K.

2009-12-01

NASA’s Earth Observing System Data and Information System (EOSDIS) has been a central component of NASA Earth observation program for over 10 years. It is one of the largest civilian science information system in the US, performing ingest, archive and distribution of over 3 terabytes of data per day much of which is from NASA’s flagship missions Terra, Aqua and Aura. The system supports a variety of science disciplines including polar processes, land cover change, radiation budget, and most especially global climate change. The EOSDIS data centers, collocated with centers of science discipline expertise, archive and distribute standard data products produced by science investigator-led processing systems. Key to the success of EOSDIS is the concept of core versus community requirements. EOSDIS supports a core set of services to meet specific NASA needs and relies on community-developed services to meet specific user needs. EOSDIS offers a metadata registry, ECHO (Earth Observing System Clearinghouse), through which the scientific community can easily discover and exchange NASA’s Earth science data and services. Users can search, manage, and access the contents of ECHO’s registries (data and services) through user-developed and community-tailored interfaces or clients. The ECHO framework has become the primary access point for cross-Data Center search-and-order of EOSDIS and other Earth Science data holdings archived at the EOSDIS data centers. ECHO’s Warehouse Inventory Search Tool (WIST) is the primary web-based client for discovering and ordering cross-discipline data from the EOSDIS data centers. The architecture of the EOSDIS provides a platform for the publication, discovery, understanding and access to NASA’s Earth Observation resources and allows for easy integration of new datasets. The EOSDIS also has developed several methods for incorporating socioeconomic data into its data collection. Over the years, we have developed several methods for

NASA's Earth Observing Data and Information System

Science.gov (United States)

Mitchell, Andrew E.; Behnke, Jeanne; Lowe, Dawn; Ramapriyan, H. K.

2009-01-01

NASA's Earth Observing System Data and Information System (EOSDIS) has been a central component of NASA Earth observation program for over 10 years. It is one of the largest civilian science information system in the US, performing ingest, archive and distribution of over 3 terabytes of data per day much of which is from NASA s flagship missions Terra, Aqua and Aura. The system supports a variety of science disciplines including polar processes, land cover change, radiation budget, and most especially global climate change. The EOSDIS data centers, collocated with centers of science discipline expertise, archive and distribute standard data products produced by science investigator-led processing systems. Key to the success of EOSDIS is the concept of core versus community requirements. EOSDIS supports a core set of services to meet specific NASA needs and relies on community-developed services to meet specific user needs. EOSDIS offers a metadata registry, ECHO (Earth Observing System Clearinghouse), through which the scientific community can easily discover and exchange NASA s Earth science data and services. Users can search, manage, and access the contents of ECHO s registries (data and services) through user-developed and community-tailored interfaces or clients. The ECHO framework has become the primary access point for cross-Data Center search-and-order of EOSDIS and other Earth Science data holdings archived at the EOSDIS data centers. ECHO s Warehouse Inventory Search Tool (WIST) is the primary web-based client for discovering and ordering cross-discipline data from the EOSDIS data centers. The architecture of the EOSDIS provides a platform for the publication, discovery, understanding and access to NASA s Earth Observation resources and allows for easy integration of new datasets. The EOSDIS also has developed several methods for incorporating socioeconomic data into its data collection. Over the years, we have developed several methods for determining

Fire analog: a comparison between fire plumes and energy center cooling tower plumes

Energy Technology Data Exchange (ETDEWEB)

Orgill, M.M.

1977-10-01

Thermal plumes or convection columns associated with large fires are compared to thermal plumes from cooling towers and proposed energy centers to evaluate the fire analog concept. Energy release rates of mass fires are generally larger than for single or small groups of cooling towers but are comparable to proposed large energy centers. However, significant physical differences exist between cooling tower plumes and fire plumes. Cooling tower plumes are generally dominated by ambient wind, stability and turbulence conditions. Fire plumes, depending on burning rates and other factors, can transform into convective columns which may cause the fire behavior to become more violent. This transformation can cause strong inflow winds and updrafts, turbulence and concentrated vortices. Intense convective columns may interact with ambient winds to create significant downwind effects such as wakes and Karman vortex streets. These characteristics have not been observed with cooling tower plumes to date. The differences in physical characteristics between cooling tower and fire plumes makes the fire analog concept very questionable even though the approximate energy requirements appear to be satisfied in case of large energy centers. Additional research is suggested in studying the upper-level plume characteristics of small experimental fires so this information can be correlated with similar data from cooling towers. Numerical simulation of fires and proposed multiple cooling tower systems could also provide comparative data.

Effects of Faraday Rotation Observed in Filter Magnetograph Data

Science.gov (United States)

Hagyard, Mona J.; Adams, Mitzi L.; Smith, J. E.; West, Edward A.

1999-01-01

In this paper we analyze the effects of Faraday rotation on the azimuth of the transverse magnetic field from observations taken with the Marshall Space Flight Center's vector magnetograph for a simple sunspot observed on June 9, 1985. Vector magnetograms were obtained over the wavelength interval of 170 mA redward of line center of the Fe I 5250.22 A spectral line to 170 mA to the blue, in steps of 10 mA. These data were analyzed to produce the variation of the azimuth as a function of wavelength at each pixel over the field of vi ew of the sunspot. At selected locations in the sunspot, curves of the observed variation of azimuth with wavelength were compared with model calculations for the amount of Faraday rotation of the azimuth. From these comparisons we derived the amount of rotation as functions of bo th the magnitude and inclination of the sunspot's field and deduced the ranges of these field values for which Faraday rotation presents a significant problem in observations taken near the center of a spectral line.

Youth Empowerment Through the Use of Prison Libraries: Case Studies of the Tangerang Juvenile Detention Center Library and the Salemba Detention Center Library in Indonesia

Directory of Open Access Journals (Sweden)

Rahmi Rahmi

2015-01-01

Full Text Available It is widely acknowledged that libraries play a positive and important role in the lives of prisoners, just as they do with other people.  They do not only provide resources to support various educational, recreational and welfare programs, but they also create opportunities for prisoners to acquire new skills, skills that they may need once they leave prison.  In addition, prison libraries also help address various psychological issues, attitude problems, as well as other difficulties in coping with prison life.  According to the Ministry of Law and Human Rights of Indonesia, as of 2013, there are 4,622 children in 16 different prisons in Indonesia.  Such statistics show that there is a great need for well-resourced and well-staffed libraries inside these prisons in order to support the educational, recreational, and psychological needs of imprisoned children.  It is evident that the existence of prison libraries and its library collections, facilities, as well as other services could serve as effective rehabilitation for the prisoners and the detainees – to help them develop awareness of their own actions, as well as associated risks and consequences. The purpose of this study is to examine the practical, social, recreational, educational, psychological, and spiritual needs of detained juvenile delinquents in regards to using the collections, facilities and services at the Tangerang Juvenile Detention Center Library and the Salemba Detention Center Library. This study is based on informational interviews conducted with the Head Librarians at the Tangerang Juvenile Detention Center Library (JDC and the Salemba Detention Center Library.  During these interviews, various problems and challenges related to ethics, professionalism, and other professional issues associated to working as a prison librarian, were discussed.  Other issues related to staffing, organizational structure, facilities and the resource situation of the Tangerang

Sociopolitical ramifications of nuclear energy centers

International Nuclear Information System (INIS)

Meier, P.M.

1977-01-01

The sociopolitical ramifications of nuclear energy centers, as emerging from a case study in Ocean County, New Jersey, are examined from the standpoint of identifying key issues of public controversy, and with emphasis on implications for national energy planning and the course of nuclear debate. Various dimensions of institutional tension are analyzed, including interstate issues and federal preemption, and the ability of the institutional and political framework to address the many equity issues that are exacerbated by clustered siting. The evolution of public attitudes, and the subsequent mobilization of effective political channels in opposition to proposed NEC's are discussed in light of New Jersey experience. The degree to which energy centers affect public attitudes to nuclear power is identified as the key issue requiring further analysis before widespread implementation of the concept can be advocated

Locating of Rural Health Centers Equipped with Telehealth using GIS: A Case Study on Khorramabad City, Iran

Directory of Open Access Journals (Sweden)

Safdari Reza

2016-10-01

Full Text Available Residents of the rural and remote area always having limitations on accessing properly required service providers. In such condition, the establishment of rural health centers equipped with telehealth, and also the use of GIS for optimal site selection to the centers, would play an important role in facilitating the achievement of quality health services in desired time factor. This study intended to find the optimal sites for building the Rural Health Centers Equipped with remote health facilities in, Khorramabad City, using GIS. During the pilot study, we identified few effective locating criteria and sub-criteria for rural health centers equipped with telehealth, the priorities was also determined in that descriptive study. Further, we prepared a special layer for each criterion on the site selection, and by integrating such layers based on specified rules and patterns, about the spatial analysis , (like distance and density analysis were done. For such methods, we used Arc Map, Arc Catalog and Arc toolbox environments of Arc GIS (version 9.3. Finally, a map was prepared that indicated the possibility of appropriateness for establishing the centers in the study area. Considering a large number of areas, the research team selected the areas which were the appropriate location for build rural health centers which could be equipped with Telehealth.

Limit cycles bifurcating from a perturbed quartic center

Energy Technology Data Exchange (ETDEWEB)

Coll, Bartomeu, E-mail: dmitcv0@ps.uib.ca [Dept. de Matematiques i Informatica, Universitat de les Illes Balears, Facultat de ciencies, 07071 Palma de Mallorca (Spain); Llibre, Jaume, E-mail: jllibre@mat.uab.ca [Dept. de Matematiques, Universitat Autonoma de Barcelona, Edifici Cc 08193 Bellaterra, Barcelona, Catalonia (Spain); Prohens, Rafel, E-mail: dmirps3@ps.uib.ca [Dept. de Matematiques i Informatica, Universitat de les Illes Balears, Facultat de ciencies, 07071 Palma de Mallorca (Spain)

2011-04-15

Highlights: We study polynomial perturbations of a quartic center. We get simultaneous upper and lower bounds for the bifurcating limit cycles. A higher lower bound for the maximum number of limit cycles is obtained. We obtain more limit cycles than the number obtained in the cubic case. - Abstract: We consider the quartic center x{sup .}=-yf(x,y),y{sup .}=xf(x,y), with f(x, y) = (x + a) (y + b) (x + c) and abc {ne} 0. Here we study the maximum number {sigma} of limit cycles which can bifurcate from the periodic orbits of this quartic center when we perturb it inside the class of polynomial vector fields of degree n, using the averaging theory of first order. We prove that 4[(n - 1)/2] + 4 {<=} {sigma} {<=} 5[(n - 1)/2] + 14, where [{eta}] denotes the integer part function of {eta}.

Organizing pneumonia and occupational and environmental risk factors: a case-control study.

Science.gov (United States)

Jobard, Stéphanie; Chaigne, Benjamin; Marchand-Adam, Sylvain; Lasfargues, Gérard; Diot, Elisabeth

2017-11-01

A single-center case-control study was carried out to investigate the relationship between occupational and environmental exposure and organizing pneumonia (OP). Thirty-seven cases of OP, including 25 cases of cryptogenic OP, and 111 controls were included. Occupational exposure was assessed retrospectively by an industrial hygienist and an occupational physician, through semi-quantitative estimates of exposure. An exposure score was calculated for each subject, based on probability, intensity, daily frequency, and duration of exposure for each period of employment. The final cumulative exposure score was obtained by summing exposure scores for all periods of employment. Significant associations with all-cause OP were observed for exposure to tetrachloroethylene (OR 13.33, CI 95% 1.44-123.5) and silica (OR 6.61, CI 95% 1.16-37.71). A significant association with cryptogenic OP was observed only for tetrachloroethylene (OR 31.6, CI 95% 1.64-610.8). No associations were found for environmental exposure. Despite its low statistical power, this work suggests that occupational risk factors could be involved in OP.

Electronic states of on- and off-center donors in quantum rings of finite width

International Nuclear Information System (INIS)

Lima, R.P.A.; Amado, M.

2008-01-01

The electronic states of a hydrogenic donor in two-dimensional quantum rings are calculated by taking into account the finite width of the potential well in the ring. In addition, a strong magnetic field is applied perpendicular to the quantum ring. Using the effective-mass approximation at the Γ valley, the radial Hamiltonian for the envelope-function is exactly diagonalized in the case of on-center donors. The corresponding energy levels for different angular momenta are studied as a function of the applied magnetic field. In the case of off-center donors, a perturbation approach is considered and its limitations are discussed. Finally, we calculate the absorption spectra and oscillator strength for different intraband transitions, specifically for on-center donors

Case Series of an Intraoral Balancing Appliance Therapy on Subjective Symptom Severity and Cervical Spine Alignment

Directory of Open Access Journals (Sweden)

Young Jun Lee

2013-01-01

Full Text Available Objective. The objective of this study was to investigate the effect of a holistic intraoral appliance (OA on cervical spine alignment and subjective symptom severity. Design. An observational study on case series with holistic OA therapy. Setting. An outpatient clinic for holistic temporomandibular joint (TMJ therapy under the supervision of the Pain Center, CHA Biomedical center, CHA University. Subjects. Ambulatory patients presenting with diverse chief complaints in the holistic TMJ clinic. Main Measures. Any immediate change in the curvature of cervical spine and the degree of atlantoaxial rotation was investigated in the images of simple X-ray and computed tomography of cervical spine with or without OA. Changes of subjective symptom severity were also analyzed for the holistic OA therapy cases. Results. A total of 59 cases were reviewed. Alignment of upper cervical spine rotation showed an immediate improvement (. Changes of subjective symptom severity also showed significant improvement (. Conclusion. These cases revealed rudimentary clinical evidence that holistic OA therapy may be related to an alleviated symptom severity and an improved cervical spinal alignment. These results show that further researches may warrant for the holistic TMJ therapy.

Scientific and technical photography at NASA Langley Research Center

Science.gov (United States)

Davidhazy, Andrew

1994-01-01

As part of my assignment connected with the Scientific and Technical Photography & Lab (STPL) at the NASA Langley Research Center I conducted a series of interviews and observed the day to day operations of the STPL with the ultimate objective of becoming exposed first hand to a scientific and technical photo/imaging department for which my school prepares its graduates. I was also asked to share my observations with the staff in order that these comments and observations might assist the STPL to better serve its customers. Meetings with several individuals responsible for various wind tunnels and with a group that provides photo-optical instrumentation services at the Center gave me an overview of the services provided by the Lab and possible areas for development. In summary form these are some of the observations that resulted from the interviews and daily contact with the STPL facility. (1) The STPL is perceived as a valuable and almost indispensable service group within the organization. This comment was invariably made by everyone. Everyone also seemed to support the idea that the STPL continue to provide its current level of service and quality. (2) The STPL generally is not perceived to be a highly technically oriented group but rather as a provider of high quality photographic illustration and documentation services. In spite of the importance and high marks assigned to the STPL there are several observations that merit consideration and evaluation for possible inclusion into the STPL's scope of expertise and future operating practices. (1) While the care and concern for artistic rendition of subjects is seen as laudable and sometimes valuable, the time that this often requires is seen as interfering with keeping the tunnels operating at maximum productivity. Tunnel managers would like to shorten down-time due to photography, have services available during evening hours and on short notice. It may be of interest to the STPL that tunnel managers are

Examining Health Information Technology Implementations: Case of the Patient-Centered Medical Home

Science.gov (United States)

Behkami, Nima A.

2012-01-01

It has been shown that the use of Health Information Technology (HIT) is associated with reduced cost and increased quality of care. This dissertation examined the use of registries in Patient Centered Medical Home (PCMH) practices. A survey questionnaire was sent to a nationwide group of clinics certified for being a PCMH. They were asked to…

Reference Architecture for Multi-Layer Software Defined Optical Data Center Networks

Directory of Open Access Journals (Sweden)

Casimer DeCusatis

2015-09-01

Full Text Available As cloud computing data centers grow larger and networking devices proliferate; many complex issues arise in the network management architecture. We propose a framework for multi-layer; multi-vendor optical network management using open standards-based software defined networking (SDN. Experimental results are demonstrated in a test bed consisting of three data centers interconnected by a 125 km metropolitan area network; running OpenStack with KVM and VMW are components. Use cases include inter-data center connectivity via a packet-optical metropolitan area network; intra-data center connectivity using an optical mesh network; and SDN coordination of networking equipment within and between multiple data centers. We create and demonstrate original software to implement virtual network slicing and affinity policy-as-a-service offerings. Enhancements to synchronous storage backup; cloud exchanges; and Fibre Channel over Ethernet topologies are also discussed.

[Use of psychostimulants in a sexual context: Analysis of cases reported to the French network of Addictovigilance Centers].

Science.gov (United States)

Batisse, Anne; Peyrière, Hélène; Eiden, Céline; Courné, Marie-Anne; Djezzar, Samira

2016-10-01

The "SLAM" phenomenon is an increasingly popular practice, in Paris and London gay scene, defined by 3 characteristics: injection, sexual party and psychostimulant drugs. The French Medical Agency requested a risk assessment of "SLAM" and more broadly of the use of psychostimulants in a sexual context, by the analysis of complications related to this practice notified to the French Network of Addictovigilance Centers. All cases of complications related to "SLAM" practice, including cases of abuse or dependence, and somatic and psychiatric complications, were analysed. Between January 2008 to December 2013, 51 cases were collected. Users were exclusively men, with a mean age of 40 years, having psychostimulants exposure in a sexual context, mainly in men who have sex with men (MSM) context (100%, n=35). The prevalence of human immunodeficiency virus (HIV) infection was 82% (n=32) with a high level of HIV/hepatitis C virus (HCV) co-infection (50%, n=16). The main psychostimulants reported are synthetic cathinones (89.5%). Cathinones users tended to be polydrug users: 62% also reported use other than psychoactive substances (gamma-butyrolactone [GBL], ketamine, methylenedioxyméthamphetamine [MDMA], lysergic acid diethylamide [LSD]…). The main complications were psychiatric disorders in 50% (psychotic symptoms, agitation, anxiety, suicidal ideas or attempt and forensic problems), acute intoxication in 25% (including 3 deaths), dependence and abuse in 17% and infectious complications in 8% (viral seroconversion). Health professionals as well as users should be aware of the physical (cardiovascular) and behavioural (psychic, fast dependence syndrome) toxicity of cathinones. Risk reduction policy must be targeted to the population of MSM with specific interventions both on risky sexual behavior and substance use. Copyright © 2016 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

[Effectiveness of support for asbestos health consultation in health centers].

Science.gov (United States)

Nagamatsu, Yasuko

2011-09-01

In this research, we aimed to evaluate the support for asbestos health consultation in health centers. In this exploratory descriptive study, a self-administered original questionnaire was developed and used. Among all 517 health centers, valid responses were returned from 323 (62.5%) consenting centers. Consultations in the previous year ranged from 0-108 cases, with a facility median of 3.0 cases. Among staff members, 86.4% did not receive training and 35.4% had never used the manual. Workplaces that use asbestos within their jurisdiction were recognized by 39.2% of staff members, and 16.7% of these members always supported consultants psychologically. The staff members were not confident about asbestos health consultation: 71.2% for general questions, 76.2% for questions about asbestos-related diseases, and 76.4% for questions about risk of asbestos-related diseases; 51.4% were not confident about the Asbestos-Related Health Damage Relief System. Health center staff members who were significantly more confident were those who had more staff to work with; dealt with many consultations in the previous year; recognized the workplaces using asbestos within their jurisdiction; often used the manual and often psychologically supported consultants. According to the covariance structure analysis model, the 'use of support systems' consisting of 'the use of manual', 'training attendance' and 'recognition of workplaces that use asbestos' positively affected the frequency of psychological support (peffective in building the confidence of health center staff in relation to asbestos health consultation, although the use of these support systems was low.

Estimating Tropical Cyclone Precipitation from Station Observations

Institute of Scientific and Technical Information of China (English)

REN Fumin; WANG Yongmei; WANG Xiaoling; LI Weijing

2007-01-01

In this paper, an objective technique for estimating the tropical cyclone (TC) precipitation from station observations is proposed. Based on a comparison between the Original Objective Method (OOM) and the Expert Subjective Method (ESM), the Objective Synoptic Analysis Technique (OSAT) for partitioning TC precipitation was developed by analyzing the western North Pacific (WNP) TC historical track and the daily precipitation datasets. Being an objective way of the ESM, OSAT overcomes the main problems in OOM,by changing two fixed parameters in OOM, the thresholds for the distance of the absolute TC precipitation (D0) and the TC size (D1), into variable parameters.Case verification for OSAT was also carried out by applying CMORPH (Climate Prediction Center MORPHing technique) daily precipitation measurements, which is NOAA's combined satellite precipitation measurement system. This indicates that OSAT is capable of distinguishing simultaneous TC precipitation rain-belts from those associated with different TCs or with middle-latitude weather systems.

Relationship between the Prediction Accuracy of Tsunami Inundation and Relative Distribution of Tsunami Source and Observation Arrays: A Case Study in Tokyo Bay

Science.gov (United States)

Takagawa, T.

2017-12-01

A rapid and precise tsunami forecast based on offshore monitoring is getting attention to reduce human losses due to devastating tsunami inundation. We developed a forecast method based on the combination of hierarchical Bayesian inversion with pre-computed database and rapid post-computing of tsunami inundation. The method was applied to Tokyo bay to evaluate the efficiency of observation arrays against three tsunamigenic earthquakes. One is a scenario earthquake at Nankai trough and the other two are historic ones of Genroku in 1703 and Enpo in 1677. In general, rich observation array near the tsunami source has an advantage in both accuracy and rapidness of tsunami forecast. To examine the effect of observation time length we used four types of data with the lengths of 5, 10, 20 and 45 minutes after the earthquake occurrences. Prediction accuracy of tsunami inundation was evaluated by the simulated tsunami inundation areas around Tokyo bay due to target earthquakes. The shortest time length of accurate prediction varied with target earthquakes. Here, accurate prediction means the simulated values fall within the 95% credible intervals of prediction. In Enpo earthquake case, 5-minutes observation is enough for accurate prediction for Tokyo bay, but 10-minutes and 45-minutes are needed in the case of Nankai trough and Genroku, respectively. The difference of the shortest time length for accurate prediction shows the strong relationship with the relative distance from the tsunami source and observation arrays. In the Enpo case, offshore tsunami observation points are densely distributed even in the source region. So, accurate prediction can be rapidly achieved within 5 minutes. This precise prediction is useful for early warnings. Even in the worst case of Genroku, where less observation points are available near the source, accurate prediction can be obtained within 45 minutes. This information can be useful to figure out the outline of the hazard in an early

Excitation of nanowire surface plasmons by silicon vacancy centers in nanodiamonds

DEFF Research Database (Denmark)

Kumar, Shailesh; Davydov, Valery A.; Agafonov, Viatcheslav N.

2017-01-01

Silicon vacancy (SiV) centers in diamonds have emerged as a very promising candidate for quantum emitters due to their narrow emission line resulting in their indistinguishability. While many different quantum emitters have already been used for the excitation of various propagating plasmonic modes......, the corresponding exploitation of SiV centers has remained so far uncharted territory. Here, we report on the excitation of surface plasmon modes supported by silver nanowires using SiV centers in nanodiamonds. The coupling of SiV center fluorescence to surface plasmons is observed, when a nanodiamond situated...

Case report

African Journals Online (AJOL)

Raoul

2009-10-15

Oct 15, 2009 ... Meckel's diverticulum: a case report from the University Hospital Center ... The Pan African Medical Journal - ISSN 1937-8688. ... Usually discovered incidentally; it is often the cause of acute abdominal emergencies. It may present as intestinal obstruction with volvulus, intussusceptions or peritonitis due to ...

A case of basilar artery aneurysm rupture from 1836: lessons in clinical observation and the natural history of the disease.

Science.gov (United States)

Demetriades, Andreas K; Horiguchi, Takashi; Goodrich, James T; Kawase, Takeshi

2014-11-01

Although credit is given to Sir William Gull for highlighting the clinical picture of subarachnoid hemorrhage in 1859, we discuss a case presented by Mr. Egerton A. Jennings, Fellow of the Linnaean Society, published 23 years earlier in the 1836 edition of the Transactions of the Provincial Medical and Surgical Association. This case, probably the first reported in the English language of a basilar aneurysm rupture, is of medico-historical interest. Jennings provided a remarkably accurate and detailed description of the patient, who experienced coma as a result of the severity of subarachnoid hemorrhage. The detailed clinical observations on initial assessment and the description of the patient's deterioration to the time of death are a succinct representation of the natural history of this disease. The author's discussion provides evidence of a philosophy committed to medical education and progress at the time based on principles of rational observation, meticulous clinical acumen, insight into experimental physiology, and the awareness of ethical boundaries. In provincial 1836 England, similar to most of Europe, cerebral localization was elementary. Nonetheless, this case report highlights the attempt at linking structure to function by means of observation on the effects of lesioning. It provides evidence of an established thought process already in progress in England in the 19th century. It is characteristic that this thought process came from a surgical practitioner. The cultivation of practical observation in British surgical culture would allow the late 19th century surgeon scientists to match the contributions of British neurologists with landmark steps in the development and establishment of neurosurgery. Copyright © 2014 Elsevier Inc. All rights reserved.

Tumors of the liver; a ten year study in Children Medical Center

Directory of Open Access Journals (Sweden)

Farahmand F

2007-06-01

Full Text Available Background: The aim of this study was to review the frequency, histopathology and outcome in children with tumors of the liver. Methods: Included in this retrospective/descriptive study were 30 children treated for liver tumors from 1375-1384 (ca. 1996-2005, at Children’s Hospital Medical Center, Tehran, Iran. We included the clinical, radiologic, and pathologic data of our patients, focusing on the frequency, etiology and outcome. Results: Patient ages ranged from three months to 12 years (median 3.8 years, with 18 males (60% and 12 females (40%. Of these, 17 patients had hepatoblastoma (55.66%, including 13 males and four females, with an age range of six months to five years. Four cases (13.33% had neuroblastoma. Hepatocellular carcinoma (HCC was found in three cases (10%, all of whom were carriers of hepatitis B. Two cases (6.66% were diagnosed with mesenchymal hamartoma, two cases (6.66% with hemangioendothelioma and two cases (6.66% with rhabdomyosarcoma and leiomyosarcoma of the biliary tract. Abdominal swelling and hepatomegaly were seen in all of patients. Jaundice was observed in two cases. Serum alpha-fetoprotein levels greater than 500 ng/ml were seen in 17 cases (56.66%. All patients were receiving specific treatment. The three-year survival rate was 65% for hepatoblastoma and 2% for HCC Conclusion: With the introduction of specific treatment, the survival rate for children with tumors of the liver has significantly increased. Further improvement can be achieved using diagnostic biopsy for hepatoblastoma, although it may result in complications, and preoperative chemotherapy followed by complete surgical excision (per International Society of Pediatric Oncology guidelines, yielding an outstanding survival rate of 80%.

Community health centers and primary care access and quality for chronically-ill patients - a case-comparison study of urban Guangdong Province, China.

Science.gov (United States)

Shi, Leiyu; Lee, De-Chih; Liang, Hailun; Zhang, Luwen; Makinen, Marty; Blanchet, Nathan; Kidane, Ruth; Lindelow, Magnus; Wang, Hong; Wu, Shaolong

2015-11-30

Reform of the health care system in urban areas of China has prompted concerns about the utilization of Community Health Centers (CHC). This study examined which of the dominant primary care delivery models, i.e., the public CHC model, the 'gate-keeper' CHC model, or the hospital-owned CHC models, was most effective in enhancing access to and quality of care for patients with chronic illness. The case-comparison design was used to study nine health care organizations in Guangzhou, Dongguan, and Shenzhen cities within Guangdong province, China. 560 patients aged 50 or over with hypertension or diabetes who visited either CHCs or hospitals in these three cities were surveyed by using face-to-face interviews. Bivariate analyses were performed to compare quality and value of care indicators among subjects from the three cities. Multivariate analyses were used to assess the association between type of primary care delivery and quality as well as value of chronic care after controlling for patients' demographic and health status characteristics. Patients from all three cities chose their current health care providers primarily out of concern for quality of care (both provider expertise and adequate medical equipment), patient-centered care, and insurance plan requirement. Compared with patients from Guangzhou, those from Dongguan performed significantly better on most quality and value of care indicators. Most of these indicators remained significantly better even after controlling for patients' demographic and health status characteristics. The Shenzhen model (hospital-owned and -managed CHC) was generally effective in enhancing accessibility and continuity. However, coordination suffered due to seemingly duplicating primary care outpatients at the hospital setting. Significant associations between types of health care facilities and quality of care were also observed such that patients from CHCs were more likely to be satisfied with traveling time and follow-up care by

Technology Transfer Challenges: A Case Study of User-Centered Design in NASA's Systems Engineering Culture

Science.gov (United States)

Quick, Jason

2009-01-01

The Upper Stage (US) section of the National Aeronautics and Space Administration's (NASA) Ares I rocket will require internal access platforms for maintenance tasks performed by humans inside the vehicle. Tasks will occur during expensive critical path operations at Kennedy Space Center (KSC) including vehicle stacking and launch preparation activities. Platforms must be translated through a small human access hatch, installed in an enclosed worksite environment, support the weight of ground operators and be removed before flight - and their design must minimize additional vehicle mass at attachment points. This paper describes the application of a user-centered conceptual design process and the unique challenges encountered within NASA's systems engineering culture focused on requirements and "heritage hardware". The NASA design team at Marshall Space Flight Center (MSFC) initiated the user-centered design process by studying heritage internal access kits and proposing new design concepts during brainstorming sessions. Simultaneously, they partnered with the Technology Transfer/Innovative Partnerships Program to research inflatable structures and dynamic scaffolding solutions that could enable ground operator access. While this creative, technology-oriented exploration was encouraged by upper management, some design stakeholders consistently opposed ideas utilizing novel, untested equipment. Subsequent collaboration with an engineering consulting firm improved the technical credibility of several options, however, there was continued resistance from team members focused on meeting system requirements with pre-certified hardware. After a six-month idea-generating phase, an intensive six-week effort produced viable design concepts that justified additional vehicle mass while optimizing the human factors of platform installation and use. Although these selected final concepts closely resemble heritage internal access platforms, challenges from the application of the

Asynchronous asymmetric form of heterogeneous osteopetrosis: initial case expanded and a new case

International Nuclear Information System (INIS)

Young, L.W.; Lachman, R.S.

2001-01-01

We have discovered additional serial radiographs and clinical information on the initial case of ''regional osteopetrosis tarda'' that has been included in several editions of Caffey's Pediatric X-Ray Diagnosis. A definite second case was found after a search of radiology teaching files of other selected medical centers and the International Skeletal Dysplasia Registry. Analysis of the sequential unusual radiographic findings of the initial case and the equivalent compelling findings of the second case justifies renewed attention to an asynchronous asymmetric form of heterogeneous osteopetrosis. (orig.)

Targeting the environmental assessment of veterinary drugs with the multi-species-soil system (MS{center_dot}3) agricultural soil microcosms: the ivermectin case study

Energy Technology Data Exchange (ETDEWEB)

Carbonell-Martin, G.; Pro-Gonzalez, J.; Aragones-Grunert, P.; Babib-Vich, M. M.; Fernandez-Rorija, C.; Tarazona-Lafarga, J. V.

2011-07-01

The environmental risk assessment of the veterinary pharmaceutical ivermectin is receiving significant attention. This paper assesses the capacity of the MS{center_dot}3 soil microcosm as a tool for targeting the environmental impact assessment of veterinary drugs, using ivermectin as model. Two screening MS{center_dot}3 were performed using different European soils; one with a soil collected in an agricultural station near to Madrid, Spain and a second with a soil collected in a farm area close to York, UK. Soils were fortified with ivermectin at the following ranges: 0.01-10 mg kg{sup -}1 and 0.1-100 mg kg{sup -}1 in the Madrid and York studies, respectively. The effects on earthworms, plants and soil microorganisms were assessed in the Madrid soil. Toxicity tests on aquatic organisms (algae, cladocerans and in vitro fish cell line RTLW1) were also conducted with the leachates. No effects were observed in earthworms and plants at any tested concentration; reduction in the respiration rate (< 5%) of soil microorganisms was detected. Earthworm/soil bioconcentration factors decreased with the increase in soil concentrations and were higher for the York soil. Effects on daphnids were observed in tested leachates; based on measured levels of ivermectin in the leachates an EC50 of about 0.5{mu}gL{sup -}1 can be estimated. Comparisons based on toxicity data and equilibrium partitioning confirmed that the main risk is expected to be related to the high sensitivity of cladocerans. The results confirm that MS{center_dot}3 systems are cost-effective tools for assessing the impact of veterinary pharmaceuticals when applied to agricultural land, as previously demonstrated for antimicrobials. (Author) 39 refs.

Factors affecting tuberculosis case detection in Kersa District, South West Ethiopia

Directory of Open Access Journals (Sweden)

Desalegn Dabaro

2017-12-01

Full Text Available Background: Tuberculosis is one of the deadly communicable diseases which claim the lives of millions in the world. Early case detection and prompt treatment cures the patients, breaks the transmission and improves the control program. Objective: The aim of this study was to investigate the factors affecting tuberculosis case detection in Kersa District, south west Ethiopia. Method: Facility based cross sectional study design was employed in four directly observed treatment short course service providing public health centers. Three hundred eighty four patient folders were reviewed. In-depth interviews was conducted with 18 health care workers including heads of health centers, tuberculosis focal persons, clinicians, laboratory technicians, tuberculosis program coordinator and head of health office. Result: Significant number, 135(35.2% of tuberculosis suspects were not requested for microscopic examination of sputum smear, the laboratory results 21(8.4% of requested patients were not recorded in both patient folders and laboratory registers. Only 10 (4.4% of those examined and recorded were smearing positive. Participants described that the shortage and irregular supply of acid fast bacilli reagents and consumable, inadequate infrastructures, frequent electricity interruption, shortage of trained care providers, negligence of care providers, weakness of laboratory quality assurance system and poor health information use culture were major factors for low case identification. Conclusion: The resource shortage, electricity interruption, low commitment of care providers, weak quality assurance practice and poor health information use culture were major factors for low tuberculosis case identification and should be considered. Keywords: Tuberculosis, Diagnosis, Case detection, Factors

Paramagnetic centers in nanocrystalline TiC/C system

International Nuclear Information System (INIS)

Guskos, N.; Bodziony, T.; Maryniak, M.; Typek, J.; Biedunkiewicz, A.

2008-01-01

Electron paramagnetic resonance is applied to study the defect centers in nanocrystalline titanium carbide dispersed in carbon matrix (TiC x /C) synthesized by the non-hydrolytic sol-gel process. The presence of Ti 3+ paramagnetic centers is identified below 120 K along with a minor contribution from localized defect spins coupled with the conduction electron system in the carbon matrix. The temperature dependence of the resonance intensity of the latter signal indicates weak antiferromagnetic interactions. The presence of paramagnetic centers connected with trivalent titanium is suggested to be the result of chemical disorder, which can be further related to the observed anomalous behavior of conductivity, hardness, and corrosion resistance of nanocrystalline TiC x /C

Risk factors for the acquisition of carbapenem-resistant Escherichia coli at a tertiary care center in South Korea: a matched case-control study.

Science.gov (United States)

Ahn, Jin Young; Song, Je Eun; Kim, Min Hyung; Choi, Heun; Kim, Jae Kyung; Ann, Hea Won; Kim, Jung Ho; Jeon, Yongduk; Jeong, Su Jin; Kim, Sun Bean; Ku, Nam Su; Han, Sang Hoon; Song, Young Goo; Yong, Dongeun; Lee, Kyungwon; Kim, June Myung; Choi, Jun Yong

2014-06-01

Carbapenem resistance among gram-negative bacilli is an emerging threat worldwide. The objective of this study was to identify risk factors for the acquisition of carbapenem-resistant Escherichia coli (CRE). We conducted a matched case-control study comprising 57 cases of acquisition of CRE and 114 controls (1:2 matched) selected from patients with a culture of carbapenem-susceptible E coli between January 2006 and December 2010 at a 2000-bed tertiary care center in South Korea. On univariate analysis, previous use of carbapenem (P carbapenem (odds ratio [OR], 4.56; 95% confidence interval [CI] 1.44-14.46; P = .01) and previous use of fluoroquinolone (OR, 2.81; 95% CI, 1.14-6.99; P = .03) were independent risk factors. At this institute, the antibiotic selective pressure of carbapenems and fluoroquinolones was shown to be an important risk factor for the acquisition of CRE. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Factors associated with family-centered involvement in family practice--a cross-sectional multivariate analysis.

Science.gov (United States)

Deutsch, Tobias; Frese, Thomas; Sandholzer, Hagen

2014-01-01

The importance of a family-centered approach in family practice has been emphasized. Knowledge about factors associated with higher family-centered involvement seems beneficial to stimulate its realization. German office-based family physicians completed a questionnaire addressing several aspects of family-centered care. Logistic regression was used to identify associations with the involvement overall and in different domains: routine inquiry and documentation of family-related information, family orientation regarding diagnosis and treatment, family-oriented dialogues, family conferences, and case-related collaboration with marriage and family therapists. We found significant associations between physicians' family-centered involvement and expected patient receptiveness, perceived impact of the family's influence on health, self-perceived psychosocial family-care competences (overall and concerning concepts for family orientation, psychosocial intervention in family conferences, and the communication of the idea of family counseling), advanced training in psychosocial primary care (PPC), personal acquaintance with family therapists (regarding case-related collaboration), and rural office environment. Increased emphasis on the family's influence on health in medical education and training, the provision of concepts for a family-centered perspective, and versatile skills for psychosocial intervention and inquiry of patient preferences, as well as the strengthening of networking between family physicians and family therapists, might promote the family-centered approach in family practice.

The Toxic Exposure Surveillance System (TESS): Risk assessment and real-time toxicovigilance across United States poison centers

International Nuclear Information System (INIS)

Watson, William A.; Litovitz, Toby L.; Belson, Martin G.; Funk Wolkin, Amy B.; Patel, Manish; Schier, Joshua G.; Reid, Nicole E.; Kilbourne, Edwin; Rubin, Carol

2005-01-01

The Toxic Exposure Surveillance System (TESS) is a uniform data set of US poison centers cases. Categories of information include the patient, the caller, the exposure, the substance(s), clinical toxicity, treatment, and medical outcome. The TESS database was initiated in 1985, and provides a baseline of more than 36.2 million cases through 2003. The database has been utilized for a number of safety evaluations. Consideration of the strengths and limitations of TESS data must be incorporated into data interpretation. Real-time toxicovigilance was initiated in 2003 with continuous uploading of new cases from all poison centers to a central database. Real-time toxicovigilance utilizing general and specific approaches is systematically run against TESS, further increasing the potential utility of poison center experiences as a means of early identification of potential public health threats

The Toxic Exposure Surveillance System (TESS): risk assessment and real-time toxicovigilance across United States poison centers.

Science.gov (United States)

Watson, William A; Litovitz, Toby L; Belson, Martin G; Wolkin, Amy B Funk; Patel, Manish; Schier, Joshua G; Reid, Nicole E; Kilbourne, Edwin; Rubin, Carol

2005-09-01

The Toxic Exposure Surveillance System (TESS) is a uniform data set of US poison centers cases. Categories of information include the patient, the caller, the exposure, the substance(s), clinical toxicity, treatment, and medical outcome. The TESS database was initiated in 1985, and provides a baseline of more than 36.2 million cases through 2003. The database has been utilized for a number of safety evaluations. Consideration of the strengths and limitations of TESS data must be incorporated into data interpretation. Real-time toxicovigilance was initiated in 2003 with continuous uploading of new cases from all poison centers to a central database. Real-time toxicovigilance utilizing general and specific approaches is systematically run against TESS, further increasing the potential utility of poison center experiences as a means of early identification of potential public health threats.

Another look at roles and functions: has hospital case management lost its way?

Science.gov (United States)

Reynolds, John J

2013-01-01

The purpose of this study was to identify the roles, functions, and types of activities that hospital case managers engage in on a day-to-day basis and that leverage the most amounts of time. Previous studies superimpose a priori categories on research tools. Hospital case management. This study analyzes 4,064 spontaneous, unstructured list serve postings from the American Case Management Association Learning Link list serve from August 15, 2011, to August 18, 2012. The study group was a cross section of 415 case management professionals. The data suggest that hospital case managers' time is inordinately leveraged by issues related to observation status/leveling of patients and the Centers for Medicare and Medicaid Services compliance. The data also suggest that hospital case management has taken a conceptual trajectory that has deviated significantly from what was initially conceived (quality, advocacy, and care coordination) and what is publicly purported. Case management education and practical orientation will need to be commensurate with this emerging emphasis. Case management leadership will need to be adept at mitigating the stresses of role confusion, role conflict, and role ambiguity.

Studies of Day Care Center Climate and Its Effect on Children's Social and Emotional Behavior.

Science.gov (United States)

Ekholm, Bodil; Hedin, Anna

School climates at 12 day care centers in Sweden were compared to investigate effects of center climates on children's social and emotional behavior. Observations and interviews conducted at the day care centers revealed differences in center climates related to child-rearing patterns, patterns of interaction, the distribution of power, and in…

Comparison of Direct Instruction and Problem Centered Instruction for Army Institutional Training

Science.gov (United States)

2013-04-01

module were assessed. The hypotheses were that (1) both DI and PCI students’ performance overall would benefit from the training, (2) DI students...collaborative, problem-centered instruction,” these results indicate that, in at least some cases, there may be no benefit of problem-centered...Belanich, J. (2006). Videogame -based training success: The impact of student characteristics - Year 2 (Technical Report 1188). Arlington, VA: U. S

Clinicopathological study of 81 cases of localized and systemic scleroderma.

Science.gov (United States)

Succaria, F; Kurban, M; Kibbi, A-G; Abbas, O

2013-02-01

Scleroderma is a connective tissue disease that includes localized and systemic forms. Our recent encounter with a morphea case exhibiting prominent perineural inflammation microscopically prompted us to assess the features of all patients diagnosed with morphea/scleroderma at our institution. To describe the clinicopathological features of all patients diagnosed with morphea/scleroderma at American University of Beirut Medical Center (AUB-MC) between 1999 and 2010, and compare our findings with those published in the literature. A total of 81 cases (63 women and 18 men) were identified, of which 73 were localized (morphea) and eight were systemic scleroderma. Clinically, plaque type morphea was the most common variant both in adults and children, and seven (9%) cases of morphea were associated with lichen sclerosis et atrophicus (LSA). Histopathologically, perineural inflammation was observed in 49% of cases, and may serve, in addition to other features including lichen sclerosis-like changes (observed in exclusively nine cases of morphea), more diffuse dermal and less subcutaneous sclerosis, and intense inflammation, as clues favouring diagnosis of morphea over systemic sclerosis. The features of morphea/scleroderma patients in this study are generally comparable to those published in the literature, with few differences. Clinically, plaque type morphea was the most common variant both in adults and children and LSA was a frequent association. Histopathologically, perineural inflammation was commonly observed and may serve in addition to lichen sclerosis-like changes and intense inflammation as clues favouring diagnosis of morphea over systemic sclerosis. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

Generalized bibliographic format as used by the Ecological Sciences Information Center

International Nuclear Information System (INIS)

Allison, L.J.; Pfuderer, H.A.; Collier, B.N.

1979-03-01

The purpose of this document is to provide guidance for the preparation of computer input for the information programs being developed by the Ecological Sciences Information Center (ESIC)/Information Center Complex (ICC) of the Oak Ridge National Laboratory (ORNL). Through the use of a generalized system, the data of all the centers of ICC are compatible. Literature included in an information data base has a number of identifying characteristics. Each of these characteristics or data fields can be recognized and searched by the computer. The information for each field must have an alphanumeric label or field descriptor. All of the labels presently used are sets of upper-case letters approximating the name of the field they represent. Presently, there are 69 identified fields; additional fields may be included in the future. The format defined here is designed to facilitate the input of information to the ADSEP program. This program processes data for the ORNL on-line (ORLOOK) search system and is a special case of the ADSEP text input option

Generalized bibliographic format as used by the Ecological Sciences Information Center

Energy Technology Data Exchange (ETDEWEB)

Allison, L.J.; Pfuderer, H.A.; Collier, B.N.

1979-03-01

The purpose of this document is to provide guidance for the preparation of computer input for the information programs being developed by the Ecological Sciences Information Center (ESIC)/Information Center Complex (ICC) of the Oak Ridge National Laboratory (ORNL). Through the use of a generalized system, the data of all the centers of ICC are compatible. Literature included in an information data base has a number of identifying characteristics. Each of these characteristics or data fields can be recognized and searched by the computer. The information for each field must have an alphanumeric label or field descriptor. All of the labels presently used are sets of upper-case letters approximating the name of the field they represent. Presently, there are 69 identified fields; additional fields may be included in the future. The format defined here is designed to facilitate the input of information to the ADSEP program. This program processes data for the ORNL on-line (ORLOOK) search system and is a special case of the ADSEP text input option.

New Emergency control center of Slovenske Elektrarne Bohunice NPP

International Nuclear Information System (INIS)

Pecko, E.

2012-01-01

Emergency preparedness of nuclear power plant and operation assurance in case of a possible emergency calls to have devices for emergency response with equipment for rapid detection and continuous evaluation of anticipated events. Chief executive body designated to manage a nuclear power plant during major events is the emergency committee (EC). Emergency Committee is a part of the Emergency Response Organization (ERO). The following centers are on alert to ensure the activities of the ERO - Emergency Response office: - control room (CR) and emergency control room (ECR); - emergency management center (EMC); - Monitoring Centre (MC); - emergency backup control center (EBCC); - congregations of civil protection (CP) and CP shelters; - communications with warning and notification system (VARVYR). From a historical and practical point of view in the vicinity of Jaslovske Bohunice has been set up a joint emergency control center. The center was located on the territory of the former already inoperative V1 NPP. V1 NPP is currently integrated into the organizational structure of JAVYS. Operating Bohunice V2 NPP plant is a designated part of the Slovenske Elektrarne, a. s., whose majority owner is an Italian operator ENEL. In terms of various relevant factors, it was decided to build a new emergency management center on the territory of operating V2 NPP, meet the current standards.

Observability of Automata Networks: Fixed and Switching Cases.

Science.gov (United States)

Li, Rui; Hong, Yiguang; Wang, Xingyuan

2018-04-01

Automata networks are a class of fully discrete dynamical systems, which have received considerable interest in various different areas. This brief addresses the observability of automata networks and switched automata networks in a unified framework, and proposes simple necessary and sufficient conditions for observability. The results are achieved by employing methods from symbolic computation, and are suited for implementation using computer algebra systems. Several examples are presented to demonstrate the application of the results.

Discharge against medical advice in a pediatric emergency center in the State of Qatar

Directory of Open Access Journals (Sweden)

Hala Abdulateef

2012-05-01

Full Text Available Objective: The objective of this study was to analyze cases that had left the Pediatric Emergency Center Al Sadd, Doha (PEC against medical advice, with the aim of developing policies to help reduce this occurrence. Methodology: All patients that were admitted to the main PEC observation room for treatment and/or investigation and subsequently left against medical advice from February 18, 2007 to June 18, 2007, were followed by a phone call, and a questionnaire, which was completed by the departmental patient representative. Results: 99,133 patients attended the facility during the study period. Of those, 106 left the facility against medical advice. Ninety-four guardians were successfully contacted. 90% of the cases were in children below 2 years of age. In 87% of the cases the mother was the main decision maker for leaving against medical advice. Domestic obligations were the leading cause of DAMA (discharge against medical advice, reported in 45% of the cases. Respondents reported that the consequences of DAMA were well explained by medical staff before they left the facility however, they had not met with the departmental patient representative during their stay. Conclusion:As the majority of DAMA cases occurred in infants, medical staff should address the concerns of this group early on in the course of treatment. Maintaining communication and providing support, in particular for mothers of higher risk groups may help to reduce the rate of DAMA cases.

Case-Control Studies - An Efficient Observational Study Design

NARCIS (Netherlands)

van Stralen, Karlijn J.; Dekker, Friedo W.; Zoccali, Carmine; Jager, Kitty J.

2010-01-01

Case-control studies are an efficient research method for investigating risk factors of a disease. The method involves the comparison of the odds of exposure in a patient group with that of the odds of exposure in a control group. As only a minority of the population is included in the study, less

Observations of Circumstellar Thermochemical Equilibrium: The Case of Phosphorus

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Milam, Stefanie N.; Charnley, Steven B.

2011-01-01

We will present observations of phosphorus-bearing species in circumstellar envelopes, including carbon- and oxygen-rich shells 1. New models of thermochemical equilibrium chemistry have been developed to interpret, and constrained by these data. These calculations will also be presented and compared to the numerous P-bearing species already observed in evolved stars. Predictions for other viable species will be made for observations with Herschel and ALMA.

Home Air Quality And Case Of Pneumonia In Children Under Five Years Old ((In Community Health Center of South Cimahi and Leuwi Gajah, City of Cimahi

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Rilla Fahimah

2014-04-01

Full Text Available Pneumonia is the number one deadliest disease in the world with the prevalence of 44%. In Indonesia, pneumonia in to odler is the leading cause of death, after diarrhea, with proportion 15,5%. Pneumonia is a disease caused by a virus and bacteria influenced by physical and chemical contaminants. The purpose of this study is to analyze indoor air quality with the incidence of pneumonia in children under five years old with cross sectional method. The population in this study is the population living in the region of South Cimahi Public Health Center and Leuwi Gajah Public Health Center. The criteria of selection for the region are: region with the highest population, high pneumonia cases (in the red and yellow area, a coal-fired industrial area, and located near the toll Purbaleunyi. The sample of this research are respondents who live in the region of South Cimahi Public Health Center and Leuwi Gajah Public Health Center with inclusion criteria length of stay ≥1 year with a child under five years old. Significant correlation occur between PM10 and PM2,5 (p 0.05 with pneumonia. Dominant factors that cause pneumonia in infants is PM10 (p 0.036 with a value of OR 4.09 after controlled PM2,5 (p 0.142; OR 2.78, the number of bacteria (p 0.004; OR 0.17 and ventilation the house (p 0.395; OR 0.58.

DX centers in III-V semiconductors under hydrostatic pressure

International Nuclear Information System (INIS)

Wolk, J.A.

1992-11-01

DX centers are deep level defects found in some III-V semiconductors. They have persistent photoconductivity and large difference between thermal and optical ionization energies. Hydrostatic pressure was used to study microstructure of these defects. A new local vibrational mode (LVM) was observed in hydrostatically stressed, Si-doped GaAs. Corresponding infrared absorption peak is distinct from the Si Ga shallow donor LVM peak, which is the only other LVM peak observed in our samples, and is assigned to the Si DX center. Analysis of the relative intensities of the Si DX LVM and the Si shallow donor LVM peaks, combined with Hall effect and resistivity indicate that the Si DX center is negatively charged. Frequency of this new mode provides clues to the structure of this defect. A pressure induced deep donor level in S-doped InP was also discovered which has the properties of a DX center. Pressure at which the new defect becomes more stable than the shallow donor is 82 kbar. Optical ionization energy and energy dependence of the optical absorption cross section was measured for this new effect. Capture barrier from the conduction band into the DX state were also determined. That DX centers can be formed in InP by pressure suggests that DX states should be common in n-type III-V semiconductors. A method is suggested for predicting under what conditions these defects will be the most stable form of the donor impurity

Providing Co-Curricular Support: A Multi-Case Study of Engineering Student Support Centers

Science.gov (United States)

Lee, Walter C., Jr.

2015-01-01

In response to the student retention and diversity issues that have been persistent in undergraduate engineering education, many colleges have developed Engineering Student Support Centers (ESSCs) such as Minority Engineering Programs (MEPs) and Women in Engineering Programs (WEPs). ESSCs provide underrepresented students with co-curricular…

The inner workings of performance management in danish job centers

DEFF Research Database (Denmark)

Pihl-Thingvad, Signe

2016-01-01

The paper discusses how a central Performance Management system in the Danish job centers affects the employees’ perception of accountability, autonomy, common goals and dialogue. Dysfunctional behavioral effects are explored in qualitative analyses based on 4 case studies. Results indicate...... that the expected positive effects of performance management do not materialize at the Danish job centers because focus in the implementation process gradually shifts from results to process goals. This is related to a series of dysfunctional behavioral effects which instead of creating commitment frustrate...

Osseous oligometastases from thymic carcinoma: a case report suggesting the effectiveness of palliative-intent radiotherapy treatment

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Kashima J

2016-02-01

Full Text Available Jumpei Kashima,1 Hirotoshi Horio,1 Yusuke Okuma,1,2 Yukio Hosomi,1 Tsunekazu Hishima3 1Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan; 2Division of Oncology, Research Center for Medical Sciences, Jikei University School of Medicine, Tokyo, Japan; 3Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan Background: Oligometastasis, a recently proposed concept, is defined as an intermediate state of cancer, between localized and systemic disease, that may be well controlled by local ablative treatment. Thymic carcinoma is a rare cancer with a poor prognosis. A definitive management approach has yet to be confirmed by a high level of evidence.Case presentation: We present the case of a 41-year-old female who underwent curative-intent surgery for a stage III squamous cell carcinoma of the thymus. Bone metastases were detected 1 year later by magnetic resonance imaging. These were treated with palliative-intent radiotherapy. Disease progression has not been observed in more than 15 years since the achievement of complete radiological remission.Conclusion: The treatment outcomes in this and other reported cases suggest that some patients with oligometastatic thymic carcinoma may achieve prolonged survival or even cure with low-dose radiotherapy delivered to the metastases. Keywords: oligometastasis, thymic carcinoma, thymic epithelial tumor, bone metastasis

Trends in Teenagers' Nonopiod Substance Exposures Reported to Poison Control Centers, 2010-2015.

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Wright, Brad; Mestan, Samantha; Ahrens, Monica; Bottei, Edward

2018-05-01

To describe current trends in nonopioid substance exposures and associated outcomes among teenagers nationwide. In this cross-sectional study, we used 2010-2015 data from the American Association of Poison Control Centers' National Poison Data System and Poisson tests to document trends in the rate of calls to poison control centers involving adolescents stratified by sex, exposures by substance category, proportion of intentional exposures, and severity of exposures. The number of calls per 1000 persons increased from 5.7 to 6.8 for teenage girls and decreased from 4.7 to 4.3 for boys. Reported exposures to prescription and over-the-counter medications and illicit street drugs increased between 24% and 73%, and reported opioid exposures decreased by 16%. Among teenage girls, intentional exposures increased from 57% to 68%, with cases increasingly managed in health care facilities and more likely to result in worse health outcomes. The increase in intentional nonopioid substance exposures among teenage girls, with serious and potentially life-threatening consequences, is a matter of serious concern. Similar trends were not observed among teenage boys. Copyright © 2017 Elsevier Inc. All rights reserved.

The semi-Hooperon: Gamma-ray and anti-proton excesses in the Galactic Center

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Arcadi, Giorgio; Queiroz, Farinaldo S.; Siqueira, Clarissa

2017-12-01

A puzzling excess in gamma-rays at GeV energies has been observed in the center of our galaxy using Fermi-LAT data. Its origin is still unknown, but it is well fitted by Weakly Interacting Massive Particles (WIMPs) annihilations into quarks with a cross section around 10-26 cm3s-1 with masses of 20-50 GeV, scenario which is promptly revisited. An excess favoring similar WIMP properties has also been seen in anti-protons with AMS-02 data potentially coming from the Galactic Center as well. In this work, we explore the possibility of fitting these excesses in terms of semi-annihilating dark matter, dubbed as semi-Hooperon, with the process WIMP WIMP → WIMP X being responsible for the gamma-ray excess, where X = h , Z. An interesting feature of semi-annihilations is the change in the relic density prediction compared to the standard case, and the possibility to alleviate stringent limits stemming from direct detection searches. Moreover, we discuss which models might give rise to a successful semi-Hooperon setup in the context of Z3,Z4 and extra "dark" gauge symmetries.

Geodetic observations and modeling of magmatic inflation at the Three Sisters volcanic center, central Oregon Cascade Range, USA

Science.gov (United States)

Dzurisin, Daniel; Lisowski, Michael; Wicks, Charles W.; Poland, Michael P.; Endo, Elliot T.

2006-02-01

Tumescence at the Three Sisters volcanic center began sometime between summer 1996 and summer 1998 and was discovered in April 2001 using interferometric synthetic aperture radar (InSAR). Swelling is centered about 5 km west of the summit of South Sister, a composite basaltic-andesite to rhyolite volcano that last erupted between 2200 and 2000 yr ago, and it affects an area ˜20 km in diameter within the Three Sisters Wilderness. Yearly InSAR observations show that the average maximum displacement rate was 3-5 cm/yr through summer 2001, and the velocity of a continuous GPS station within the deforming area was essentially constant from June 2001 to June 2004. The background level of seismic activity has been low, suggesting that temperatures in the source region are high enough or the strain rate has been low enough to favor plastic deformation over brittle failure. A swarm of about 300 small earthquakes ( Mmax = 1.9) in the northeast quadrant of the deforming area on March 23-26, 2004, was the first notable seismicity in the area for at least two decades. The U.S. Geological Survey (USGS) established tilt-leveling and EDM networks at South Sister in 1985-1986, resurveyed them in 2001, the latter with GPS, and extended them to cover more of the deforming area. The 2001 tilt-leveling results are consistent with the inference drawn from InSAR that the current deformation episode did not start before 1996, i.e., the amount of deformation during 1995-2001 from InSAR fully accounts for the net tilt at South Sister during 1985-2001 from tilt-leveling. Subsequent InSAR, GPS, and leveling observations constrain the source location, geometry, and inflation rate as a function of time. A best-fit source model derived from simultaneous inversion of all three datasets is a dipping sill located 6.5 ± 2.5 km below the surface with a volume increase of 5.0 × 10 6 ± 1.5 × 10 6 m 3/yr (95% confidence limits). The most likely cause of tumescence is a pulse of basaltic magma

User-centered design in brain-computer interfaces-a case study.

Science.gov (United States)

Schreuder, Martijn; Riccio, Angela; Risetti, Monica; Dähne, Sven; Ramsay, Andrew; Williamson, John; Mattia, Donatella; Tangermann, Michael

2013-10-01

The array of available brain-computer interface (BCI) paradigms has continued to grow, and so has the corresponding set of machine learning methods which are at the core of BCI systems. The latter have evolved to provide more robust data analysis solutions, and as a consequence the proportion of healthy BCI users who can use a BCI successfully is growing. With this development the chances have increased that the needs and abilities of specific patients, the end-users, can be covered by an existing BCI approach. However, most end-users who have experienced the use of a BCI system at all have encountered a single paradigm only. This paradigm is typically the one that is being tested in the study that the end-user happens to be enrolled in, along with other end-users. Though this corresponds to the preferred study arrangement for basic research, it does not ensure that the end-user experiences a working BCI. In this study, a different approach was taken; that of a user-centered design. It is the prevailing process in traditional assistive technology. Given an individual user with a particular clinical profile, several available BCI approaches are tested and - if necessary - adapted to him/her until a suitable BCI system is found. Described is the case of a 48-year-old woman who suffered from an ischemic brain stem stroke, leading to a severe motor- and communication deficit. She was enrolled in studies with two different BCI systems before a suitable system was found. The first was an auditory event-related potential (ERP) paradigm and the second a visual ERP paradigm, both of which are established in literature. The auditory paradigm did not work successfully, despite favorable preconditions. The visual paradigm worked flawlessly, as found over several sessions. This discrepancy in performance can possibly be explained by the user's clinical deficit in several key neuropsychological indicators, such as attention and working memory. While the auditory paradigm relies

The Model of Community Learning Center Development: A Case Study of PKBM Assolahiyah in West Java

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Ferdinal Asmin

2017-12-01

Full Text Available Sustaining community learning center (CLC as a community activity centerby increasing the community capacity and skill to deal with socio-economics challenges is an important focus to ensure the success of CLC. This study was aimed to describe the sustainability elements of CLC development and analyze the policy elements that influence the sustainability of CLC program, particularly in related to CSR program. This study approach was combining a qualitative approach and quantitative approach with analytic decision method which is never conducted in the previous studies on CLC. Data and information were collected through document studies, observations and structured interviews through questionnaires, then they were analyzed using descriptive analysis and interpretive structural modeling (ISM analysis. From ten elements of CLC sustainability were analyzed, the result of study emphasized to the importance of CLC management capacity enhancement in PKBM Assolahiyah. The result was synthesized into a policy model of CLC development through CSR program. The policy model should involve the roles of government, scientist, and non-governmental organization (NGO to strengthen the CLC development

Large-Eddy Simulation of Shallow Cumulus over Land: A Composite Case Based on ARM Long-Term Observations at Its Southern Great Plains Site