Acetazolamide in cerebral diagnosis: Physiological and pathophysiological aspects. Acetazolamid in der zerebrovaskulaeren Diagnostik: Physiologische und pathophysiologische Aspekte

Energy Technology Data Exchange (ETDEWEB)

Lerch, H.; Franke, W.G.; Templin, A. (Medizinische Akademie ' Carl Gustav Carus' , Klinik fuer Nuklearmedizin, Dresden (Germany) Medizinische Akademie ' Carl Gustav Carus' , Klinik fuer Psychiatrie und Neurologie, Abt. Neurologie, Dresden (Germany))

1990-01-01

The sensitivity in the diagnosis of cerebrovascular diseases using radiotracers can be enhanced by the use of the acetazolamide test. In this paper we present and discuss some physiological and pathophysiological aspects of its mechanism. The physiological action of the carboanhydrase inhibitor is like the action of enhanced pCO{sub 2} in the tissue, thus acting at the site of metabolic regulation. The reaction of the vascular bed is influenced in part by subcortical structures. Pathologically the reaction can be disturbed at first by an altered regulation with the vessels being mechanically intact, e.g. in hypoxia or transient ischemia. Secondly, the mechanics of the vessels may be not intact e.g., in atherosclerosis or surrounding edema. Lastly, the vessels have already dilated, e.g. poststenotically. All these facts have to be taken into consideration interpreting an acetazolamid test. (orig.).

[Reduction of omalgia in laparoscopic cholecystectomy: clinical randomized trial ketorolac vs ketorolac and acetazolamide].

Science.gov (United States)

Figueroa-Balderas, Lorena; Franco-López, Francisco; Flores-Álvarez, Efrén; López-Rodríguez, Jorge Luis; Vázquez-García, José Antonio; Barba-Valadez, Claudia Teresa

2013-01-01

Laparoscopy cholecystectomy for the surgical treatment of cholelithiasis has been considered the gold standard. The referred pain to the shoulder (omalgia) may be present to 63% of the patients and limits outpatient management. The study was to evaluate the usefulness of acetazolamide associated with ketorolac for reduction of the omalgia to minimally invasive treatment. We performed a clinical trial, randomized, double blind in patients undergoing laparoscopic cholecystectomy to assess the reduction of post-operative omalgia comparing ketorolac and ketorolaco+acetazolamida. 31 patients in each group were studied. The study group: 250 mg of acetazolamide before anesthetic induction and 30 mg of ketorolac in the immediate postoperative period. one tablet of placebo prior to the anesthetic induction and 30 mg of ketorolac in the immediate postoperative. The presence of omalgia was assessed using the analog visual scale. The variables recorded included: age, sex, flow of carbon dioxide intra-abdominal pressure, surgical time, urgent or elective surgery, omalgia, severity of pain evaluated by analog visual scale, addition analgesia. Both groups were homogeneous and statistical analysis showed no differences in the variables studied. The omalgia in the study group was presented at 9.67% and in the group control was the 58.06% (p < 0.001). 250 mg oral acetazolamide associated 30 mg of ketorolac reduces significantly the development of omalgia in patients undergoing laparoscopic cholecystectomy.

Population pharmacodynamic model of bicarbonate response to acetazolamide in mechanically ventilated chronic obstructive pulmonary disease patients

Science.gov (United States)

2011-01-01

Introduction Acetazolamide is commonly given to chronic obstructive pulmonary disease (COPD) patients with metabolic alkalosis. Little is known of the pharmacodynamics of acetazolamide in the critically ill. We undertook the pharmacodynamic modeling of bicarbonate response to acetazolamide in COPD patients under mechanical ventilation. Methods This observational, retrospective study included 68 invasively ventilated COPD patients who received one or multiple doses of 250 or 500 mg of acetazolamide during the weaning period. Among the 68 investigated patients, 207 time-serum bicarbonate observations were available for analysis. Population pharmacodynamics was modeled using a nonlinear mixedeffect model. The main covariates of interest were baseline demographic data, Simplified Acute Physiology Score II (SAPS II) at ICU admission, cause of respiratory failure, co-prescription of drugs interfering with the acid-base equilibrium, and serum concentrations of protein, creatinin, potassium and chloride. The effect of acetazolamide on serum bicarbonate levels at different doses and in different clinical conditions was subsequently simulated in silico. Results The main covariates interacting with acetazolamide pharmacodynamics were SAPS II at ICU admission (P = 0.01), serum chloride (P 500 mg twice daily is required to reduce serum bicarbonate concentrations > 5 mmol/L in the presence of high serum chloride levels or coadministration of systemic corticosteroids or furosemide. Conclusions This study identified several covariates that influenced acetazolamide pharmacodynamics and could allow a better individualization of acetazolamide dosing when treating COPD patients with metabolic alkalosis. PMID:21917139

Brain carbonic acid acidosis after acetazolamide

DEFF Research Database (Denmark)

Heuser, D; Astrup, J; Lassen, N A

1975-01-01

acidosis by I.V. injection of HCO3-minus. Acetazolamide (25 mg/kg) i.v. was followed by a marked brain acidosis which after 10 min had progressed to a drop in pH of 0.203 plus or minus 0.046 (x bar plus or minus S.D., n equals 8). The slowness ofthe development of acidosis points to a direct effect......In cats in barbiturate anesthesia extracellular pH and potassium were continously recorded from brian cortex by implanted microelectrodes. Implantation of the electrodes preserved the low permeability of the blood-brain-barrier to HCO3-minus and H+ions as indicated by the development of brain...... of the carbonic anhydrase inhibition on the brain tissue. As a further support for this conclusion was considered the finding of a prolonged response time of brain pH to HCO3-minus i.v. to CO2-minus inhalation, and to hyperventilation after the acetazolamide inhibtion. No changes in brain extracelllular potassium...

Association of acetazolamide infusion with headache and cranial artery dilation in healthy volunteers

DEFF Research Database (Denmark)

Arngrim, Nanna; Schytz, Henrik Winther; Asghar, Mohammad Sohail

2014-01-01

under the curve for headache was increased after acetazolamide compared to placebo in the delayed phase (2-12 h) (P=.005). Compared to placebo, arterial circumference increased after acetazolamide in the basilar artery (P=.002) as well as the cerebral (P=.003), cavernous (P=.002), and cervical (P=.005...

Use of acetazolamide in lithium-induced nephrogenic diabetes insipidus: a case report

Directory of Open Access Journals (Sweden)

Ricardo A Macau

2018-02-01

Full Text Available Lithium-induced nephrogenic diabetes insipidus (Li-NDI is a rare and difficult-to-treat condition. A study in mice and two recent papers describe the use of acetazolamide in Li-NDI in 7 patients (a case report and a 6 patient series. We describe the case of a 63-year-old woman with bipolar disorder treated with lithium and no previous history of diabetes insipidus. She was hospitalized due to a bowel obstruction and developed severe dehydration after surgery when she was water deprived. After desmopressin administration and unsuccessful thiazide and amiloride treatment, acetazolamide was administrated to control polyuria and hydroelectrolytic disorders without significant side effects. To our knowledge, this is the third publication on acetazolamide use in Li-NDI patients.

Development of a topical niosomal preparation of acetazolamide: preparation and evaluation.

Science.gov (United States)

Aggarwal, Deepika; Garg, Alka; Kaur, Indu P

2004-12-01

Orally administered acetazolamide has a limited use in glaucoma due to the systemic side effects associated with its use. No topical formulation of acetazolamide is available, mainly because of it having a limited aqueous solubility and poor corneal permeation. To enhance the bioavailability of acetazolamide by the topical route and to improve the corneal permeability of the drug, niosomes of acetazolamide were prepared (employing span 60 and cholesterol) by different methods. Transmission electron microscopy (TEM) of the selected formulation was carried out to study the morphology. Niosomes were also prepared in the presence of dicetyl phosphate and stearylamine to obtain negatively and positively charged vesicles, respectively. It was found that the reverse-phase evaporation method (REV) gave the maximum drug entrapment efficiency (43.75%) as compared with ether injection (39.62%) and film hydration (31.43%) techniques. Drug entrapment efficiency varied with the charge and the percent entrapment efficiency for the REV method was 43.75, 51.23 and 36.26% for neutral, positively charged and negatively charged niosomes, respectively. Corneal permeability studies, however, showed that the percent permeation and the apparent permeability coefficient for the charged niosomes were less than for the neutral ones. A bioadhesive niosomal formulation of acetazolamide was also prepared and compared with the positively charged formulation, considering that both of them would have a prolonged stay in the cul-de-sac because of their expected interactions with mucin. The formulations were also compared based on their intraocular pressure (IOP)-lowering capacity. The positively charged niosomes (REV2), although showing good corneal permeability and pharmacodynamics, were however found to be inappropriate in terms of the corneal cell toxicity. The bioadhesive coated formulation (REV1bio) compared well with REV2 and also showed a much lesser toxicity. Further, the IOP

Effects of acetazolamide on cerebral blood flow and brain tissue oxygenation

DEFF Research Database (Denmark)

Lassen, N A; Friberg, L; Kastrup, J

1987-01-01

Oral administration of 1 g of acetazolamide to 8 normal subjects studied at sea level and in normoxia caused an acute increase in cerebral blood flow (CBF). During the subsequent prolonged oral treatment with 1 g of acetazolamide daily, CBF returned to normal within 2 days. The alveolar CO2 tension...... decreased gradually to 70% of the control value, indicating hyperventilation. At sea level hyperventilation will not increase brain oxygenation significantly in normal man, as the arterial oxygen content only increases minimally, while CBF is unchanged. At high altitude the beneficial effects...... of acetazolamide on the symptoms of acute mountain sickness may well be due to an improved oxygen supply to the brain, as hyperventilation will, at the low ambient PO2, cause a significant increase of the arterial oxygen content, while CBF presumably is unaffected by the drug. During hypoxia at high altitude...

Acetazolamide improves oxygenation in patients with respiratory failure and metabolic alkalosis.

Science.gov (United States)

Gulsvik, Ragnhild; Skjørten, Ingunn; Undhjem, Kenneth; Holø, Lars; Frostad, Anne; Saure, Eirunn Waatevik; Lejlic, Vasvija; Humerfelt, Sjur; Hansen, Gunnar; Bruun Wyller, Torgeir

2013-10-01

Coexistent respiratory failure and metabolic alkalosis is a common finding. Acidotic diuretics cause a fall in pH that may stimulate respiration. The purpose of the study was to evaluate the effectiveness of short-term treatment with acetazolamide for combined respiratory failure and metabolic alkalosis. A randomised, placebo-controlled and double-blind parallel group trial where oral acetazolamide 250 mg three times a day for 5 days were administered to patients hospitalised for respiratory failure because of a pulmonary disease (Pa O2 ≤ 8 kPa and/or Pa CO2 ≥ 7 kPa) who had concurrent metabolic alkalosis [base excess (BE) ≥ 8 mmol/L]. Pa O2 after 5 days was the primary effect variable. Secondary effect variables were Pa CO2 , BE and pH on day 5, and the total number of days in hospital. Of 70 patients enrolled (35 in each group), data from 54 were analysed per protocol, while last observation carried forward was used for the remaining 16. During the 5-day treatment, Pa O2 increased on average 0.81 kPa in the placebo group and 1.41 kPa in the acetazolamide group. After adjustment for baseline skewness, the difference was statistically significant (adjusted mean difference 0.55 kPa, 95% confidence interval 0.03-1.06). Pa CO2 decreased in both groups, but the difference was not statistically significant. As expected, pH and BE decreased markedly in the acetazolamide group. Acetazolamide may constitute a useful adjuvant treatment mainly to be considered in selected patients with respiratory failure combined with prominent metabolic alkalosis or where non-invasive ventilation is insufficient or infeasible. © 2013 John Wiley & Sons Ltd.

Acetazolamide in cerebral diagnosis: Physiological and pathophysiological aspects

International Nuclear Information System (INIS)

Lerch, H.; Franke, W.G.; Templin, A.

1990-01-01

The sensitivity in the diagnosis of cerebrovascular diseases using radiotracers can be enhanced by the use of the acetazolamide test. In this paper we present and discuss some physiological and pathophysiological aspects of its mechanism. The physiological action of the carboanhydrase inhibitor is like the action of enhanced pCO 2 in the tissue, thus acting at the site of metabolic regulation. The reaction of the vascular bed is influenced in part by subcortical structures. Pathologically the reaction can be disturbed at first by an altered regulation with the vessels being mechanically intact, e.g. in hypoxia or transient ischemia. Secondly, the mechanics of the vessels may be not intact e.g., in atherosclerosis or surrounding edema. Lastly, the vessels have already dilated, e.g. poststenotically. All these facts have to be taken into consideration interpreting an acetazolamid test. (orig.) [de

Acetazolamide lowers intracranial pressure and modulates the cerebrospinal fluid secretion pathway in healthy rats

DEFF Research Database (Denmark)

Uldall, Maria; Botfield, Hannah; Jansen-Olesen, Inger

2017-01-01

a maximum reduction at 55min 66±4% (P... in the amount of AQP1 (p=0.0152) and Na/K ATPase (p=0.0411) protein in the membrane fraction of the CP, but not AQP4 (p=0.0649). A single dose of acetazolamide lowers ICP and modulates the CSF secretion pathway in healthy rats - Firstly, by inhibiting the Na/K ATPase to slow the CSF production, secondly...... was collected for qPCR and western blot analysis. The effect of acetazolamide on the Na/K ATPase activity was evaluated in an in vitro assay of primary CP epithelial cells isolated from rats. Acetazolamide significantly lowered ICP within 10min of injection compared to the vehicle group (P

Acetazolamide: a second wind for a respiratory stimulant in the intensive care unit?

Science.gov (United States)

Heming, Nicholas; Urien, Saïk; Faisy, Christophe

2012-08-07

Patients with chronic obstructive pulmonary disease (COPD) are affected by episodes of respiratory exacerbations, some of which can be severe and may necessitate respiratory support. Prolonged invasive mechanical ventilation is associated with increased mortality rates. Persistent failure to discontinue invasive mechanical ventilation is a major issue in patients with COPD. Pure or mixed metabolic alkalosis is a common finding in the intensive care unit (ICU) and is associated with a worse outcome. In patients with COPD, the condition is called post-hypercapnic alkalosis and is a complication of mechanical ventilation. Reversal of metabolic alkalosis may facilitate weaning from mechanical ventilation of patients with COPD. Acetazolamide, a non-specific carbonic anhydrase inhibitor, is one of the drugs employed in the ICU to reverse metabolic alkalosis. The drug is relatively safe, undesirable effects being rare. The compartmentalization of the different isoforms of the carbonic anhydrase enzyme may, in part, explain the lack of evidence of the efficacy of acetazolamide as a respiratory stimulant. Recent findings suggest that the usually employed doses of acetazolamide in the ICU may be insufficient to significantly improve respiratory parameters in mechanically ventilated patients with COPD. Randomized controlled trials using adequate doses of acetazolamide are required to address this issue.

Cerebral blood flow and cerebrovascular response to acetazolamide in patients with chronic alcoholism

OpenAIRE

Oishi, M; Mochizuki, Y; Takasu, T

1997-01-01

Cerebral blood flow and cerebrovascular response to acetazolamide were studied in 12 patients with chronic alcoholism and 12 age matched healthy controls. Blood flows in the cerebral cortex, thalamus, and putamen were significantly lower in the chronic alcoholic group than in the healthy control group. The increase in blood flow caused by acetazolamide did not show any significant difference between the two groups. These findings suggest that the decreased cerebral blood flow i...

Herpes simplex encephalitis: increased retention of Tc-99m HMPAO on acetazolamide enhanced brain perfusion SPECT

International Nuclear Information System (INIS)

Choi, Yun Young; Kim, Kwon Hyung; Kim, Seung Hyun; Cho, Suk Shin

1998-01-01

We present an interesting case of herpes simplex encephalitis, which showed increased upta unilateral temporal cortex on brain perfusion SPECT using Tc-99m HMPAO, but in bilateral tem cortex after acetazolamide administration. A 42-year-old man was admitted via emergency room, due to rapidly progressing hea disorientation and mental changes. On neurologic examination, neck stiffness and Kernig sign noted. CSF examination showed pleocytosis with lymphcyte predominance. MRI showed swelling bilateral temporal lobe with left predominance, suggestive of herpes simplex encephalitis. Baseline/ Acetazolamide brain perfusion SPECT were acquired consecutively at the same position IV administration of 740MBq and additional 1480 MBq of Tc-99m HMPAO respectively. The temporal and inferior frontal cortex showed markedly increased perfusion on the baseline acetazolamide-enhanced SPECT images. The right temporal cortex showed normal uptake on the b SPECT images, and markedly increased uptake after acetazolamide administration, which seemed to the abundant vascularity at the acute inflammation site without marked brain damage. The fo brain perfusion SPECT after 6 months showed perfusion defect in left temporal cortex but norm perfusion in right temporal cortex. Therefore, we can conclude that baseline SPECT is helpful for the prediction of the prognosis acetazolamide SPECT for the evaluation of the extent of herpes simples encephalitis

Assessment of Cerebral Hemodynamic Changes in Pediatric Patients with Moyamoya Disease Using Probabilistic Maps on Analysis of Basal/Acetazolamide Stress Brain Perfusion SPECT

Energy Technology Data Exchange (ETDEWEB)

Lee, Ho Young; Lee, Jae Sung; Kim, Seung Ki; Wang, Kyu Chang; Cho, Byung Kyu; Chung, June Key; Lee, Myung Chul; Lee, Dong Soo [Seoul National University College of Medicine, Seoul (Korea, Republic of)

2008-06-15

To evaluate the hemodynamic changes and the predictive factors of the clinical outcome in pediatric patients with moyamoya disease, we analyzed pre/post basal/acetazolamide stress brain perfusion SPECT with automated volume of interest (VOIs) method. Total fifty six (M:F=33:24, age 6.7{+-}3.2 years) pediatric patients with moyamoya disease, who underwent basal/acetazolamide stress brain perfusion SPECT within 6 before and after revascularization surgery (encephalo-duro-arterio-synangiosis (EDAS) with frontal encephalo-galeo-synangiosis (EGS) and EDAS only followed on contralateral hemisphere), and followed-up more than 6 months after post-operative SPECT, were included. A mean follow-up period after post-operative SPECT was 33{+-}21 months. Each patient's SPECT image was spatially normalized to Korean template with the SPM2. For the regional count normalization, the count of pons was used as a reference region. The basal/acetazolamide-stressed cerebral blood flow (CBF), the cerebral vascular reserve index (CVRI), and the extent of area with significantly decreased basal/acetazolamide- stressed rCBF than age-matched normal control were evaluated on both medial frontal, frontal, parietal, occipital lobes, and whole brain in each patient's images. The post-operative clinical outcome was assigned as good, poor according to the presence of transient ischemic attacks and/or fixed neurological deficits by pediatric neurosurgeon. In a paired t-test, basal/acetazolamide-stressed rCBF and the CVRI were significantly improved after revascularization (p<0.05). The significant difference in the pre-operative basal/acetazolamide-stressed rCBF and the CVRI between the hemispheres where EDAS with frontal EGS was performed and their contralateral counterparts where EDAS only was done disappeared after operation (p<0.05). In an independent student t-test, the pre-operative basal rCBF in the medial frontal gyrus, the post-operative CVRI in the frontal lobe and the parietal

{sup 18}FDG PET and acetazolamide-enhanced {sup 99m}Tc-HMPAO SPET in systemic lupus erythematosus

Energy Technology Data Exchange (ETDEWEB)

Gruenwald, F. [Bonn Univ. (Germany). Inst. fuer Klinische und Experimentelle Nuklearmedizin; Schomburg, A. [Bonn Univ. (Germany). Inst. fuer Klinische und Experimentelle Nuklearmedizin; Badali, A. [Dept. of Dermatology, Univ. of Bonn (Germany); Ruhlmann, J. [Bonn Univ. (Germany). Inst. fuer Klinische und Experimentelle Nuklearmedizin; Pavics, L. [Bonn Univ. (Germany). Inst. fuer Klinische und Experimentelle Nuklearmedizin; Biersack, H.J. [Bonn Univ. (Germany). Inst. fuer Klinische und Experimentelle Nuklearmedizin

1995-09-01

In this report, we present the case of a 70-year-old female patient, suffering from SLE without symptoms of CNS involvement. In addition to a SPET study using technetium-99m hexamethylpropylene amine oxime ({sup 99m}Tc-HMPAO) and a PET scan with fluorine-18 deoxyglucose ({sup 18}FDG), a SPET study after acetazolamide injection was performed in order to assess the cerebral perfusion reserve. While the PET scan showed no major abnormalities, and the baseline SPET study revealed only minor changes, the acetazolamide-enhanced SPET study revealed a marked reduction of the cortical perfusion reserve, particularly in both frontal lobes. It is concluded that ``preclinical`` CNS involvement, mainly caused by pathological mechanisms involving the cerebral blood vessels, can be considered to exist in this patient with SLE. (orig.). With 2 figs.

Cerebral blood flow and end-tidal PCO2 during prolonged acetazolamide treatment in humans

DEFF Research Database (Denmark)

Friberg, L; Kastrup, J; Rizzi, Dominick Albert

1990-01-01

One oral dose of 1,000 mg of acetazolamide caused an acute 38% increase in cerebral blood flow (CBF) in eight healthy volunteers. During the following 10 days the subjects took 1,000 mg acetazolamide daily. CBF normalized within the first 2 days. The drug induced mild hyperventilation, gradually ...... of a transient extracellular acidosis dilating brain arterioles, whereas increased ventilatory drive results from a gradually increasing mild intracellular acidosis in the brain....

Rebound macular edema following oral acetazolamide therapy for juvenile X-linked retinoschisis in an Italian family

Directory of Open Access Journals (Sweden)

Galantuomo MS

2016-11-01

Full Text Available Maria Silvana Galantuomo,1,* Maurizio Fossarello,1 Alberto Cuccu,1 Roberta Farci,1 Markus N Preising,2 Birgit Lorenz,2 Pietro Emanuele Napoli1,* 1Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy; 2Department of Ophthalmology, Faculty of Medicine, Justus-Liebig-University, Giessen, Germany *These authors contributed equally to this work Background: Juvenile X-linked retinoschisis (RS1, OMIM: 312700 is a hereditary vitreoretinal dystrophy characterized by bilateral foveal schisis and, in half of the patients, splitting through the nerve fiber layer in the peripheral retina. In the first decade of life, patients usually develop a decrease in visual acuity. Long-term visual outcomes can be poor due to the limited number of known successful treatments. Purpose: The purposes of this study were to present, for the first time, a p.Arg197Cys missense mutation in the RS1 gene (OMIM: 300839 in a four-generation Italian family with RS1 and to examine the clinical response to the treatment with acetazolamide tablets alone or in combination with dorzolamide eye drops as assessed by spectral-domain optical coherence tomography (SD-OCT. Methods: Eleven individuals, including two brothers with RS1 (patients 1 and 2, underwent a full medical history examination and a comprehensive ocular assessment that involved SD-OCT, fluorescein angiography, electroretinography and DNA analysis. Each RS1 patient received oral acetazolamide (375 mg daily during the first three months. Thereafter, patient 1 continued only with dorzolamide eyedrops three times a day for a period of three months, while patient 2 spontaneously stopped both medications. Results: Sequence analysis of the RS1 gene identified a hemizygous c.589C>T (p.Arg197Cys missense mutation in exon 6, which has not been previously reported in an Italian family. A different response to the medical therapy was observed in the four eyes of the two affected brothers hemizygous for

Effect of acetazolamide on the otolith growth of goldfish

International Nuclear Information System (INIS)

Mugiya, Yasuo

1977-01-01

In order to clarify the involvement of a functional carbonic anhydrase (CA) system in the otolith formation of the goldfish, Carassius auratus, acetazolamide, a specific CA inhibitor, was injected intraperitoneally every 3 or 4 days, and its inhibitory effect on the otolith growth was examined by means of a tetracycline labelling technique. Calcium-45 deposition on the otolith was also examined after a single injection of the drug. Given in multiple doses of 50 mg per Kg of body weight, acetazolamide did not reduce the growth rate of the otolith on either dorsal or ventral side. With multiple doses of 100 mg, however, the dorsal growth was significantly depressed by 17%. The ventral growth was not affected. Similarly, calcium-45 deposition on the otolith was effectively reduced (39%) only when a dose of 100 mg was given. These results suggest that, if involved, the enzyme-catalyzed hydration or hydroxylation of CO 2 is not indispensable to the carbonate formation of the otolith. (auth.)

Prevention of acute mountain sickness by acetazolamide in Nepali porters: a double-blind controlled trial.

Science.gov (United States)

Hillenbrand, Peter; Pahari, Anil K; Soon, Yuen; Subedi, Deepak; Bajracharya, Rajan; Gurung, Puncho; Lal, Barun K; Marahatta, Ramesh; Pradhan, Santosh; Rai, Dilip; Sharma, Shailendra

2006-01-01

This study aimed to determine the efficacy, tolerability, and practicality of acetazolamide for the prevention of acute mountain sickness (AMS) in Nepali trekking porters early in the trekking season. This study was a randomized, double-blind controlled trial with 400 male Nepali porters in the Mount Everest region of Nepal, trekking from Namche Bazaar (3440 m) to Lobuche (4930 m), the study endpoint. Participants were randomized to receive 250 mg acetazolamide daily or placebo, and AMS symptom scores (Lake Louise) were compared in highlanders vs lowlanders. Only 109 (27.2%) of the 400 porters completed the trial (28 highlanders, 81 lowlanders). The rest either dropped out (275/400 porters, 68.8%) or were excluded (16/400 porters, 4%). Acute mountain sickness occurred in 13 (11.9%) of 109 porters; all were lowlanders; 7 were taking acetazolamide, 6 taking placebo. Birthplace, acclimatization in the week before the trial, ascent rate, and rest days were the most important variables affecting the incidence of AMS. No highlanders, but 13 (16.1%) of 81 lowlanders had AMS (P = .016). Acclimatization in the pretrial week reduced AMS incidence (P = .013), as did a slower ascent rate (P = .0126), but rest days were the most potent prophylactic variable (P = .0001). Side effects were more frequent in porters taking acetazolamide than in the placebo group (P = .0001), but there were no serious side effects. Acetazolamide was tolerable, but impractical for the routine prevention of AMS in Nepali porters. A good trekking schedule and adequate acclimatization remain the most effective preventive measures. This study identified lowland porters as a high-risk group for developing AMS.

Acetazolamide improves cerebral oxygenation during exercise at high altitude

NARCIS (Netherlands)

Vuyk, J.; Bos, J. van den; Terhell, K.; Bos, R. de; Vletter, A.; Valk, P.; Beuzekom, M. van; Kleef, J. van; Dahan, A.

2006-01-01

Acute mountain sickness is thought to be triggered by cerebral hypoxemia and be prevented by acetazolamide (Actz). The effect of Actz on cerebral oxygenation at altitude remains unknown. In 16 members of the 2005 Dutch Cho Oyu (8201 m, Tibet) expedition, the influence of Actz and exercise (750 mg PO

The effect of oral acetazolamide on cystoid macular edema in hydroxychloroquine retinopathy: a case report.

Science.gov (United States)

Hong, Eun Hee; Ahn, Seong Joon; Lim, Han Woong; Lee, Byung Ro

2017-07-12

Hydroxychloroquine (HCQ) retinopathy can accompany other retinal complications such as cystoid macular edema (CME), which leads to central visual loss. We report a case of CME with HCQ retinopathy that improved with the use of oral acetazolamide, and discussed the possible mechanisms of CME in HCQ retinopathy using multimodal imaging modalities. A 62-year-old patient with systemic lupus erythematosus (SLE) and HCQ retinopathy developed bilateral CME with visual decline. Fluorescein angiography (FA) showed fluorescein leakage in the macular and midperipheral area. After treatment with oral acetazolamide (250 mg/day) for one month, CME was completely resolved, best corrected visual acuity (BCVA) improved from 20/50 to 20/25, and FA examination showed decreased dye leakage in the macular and midperipheral areas. In cases of vision loss in HCQ retinopathy, it is important to consider not only progression of maculopathy, but also development of CME, which can be effectively treated with oral acetazolamide.

An evaluation of a new N-isopropyl-p-[123I] iodoamphetamine double injection method for acetazolamide testing

International Nuclear Information System (INIS)

Mori, Kentaro; Maeda, Minoru; Asegawa, Satoshi; Masuda, Yoko.

1994-01-01

To evaluate the capacity of the cerebrovascular reserve, the acetazolamide test must be used to quantitatively measure the cerebral blood flow (CBF) before and after the administration of acetazolamide. Previously, the authors have explained the rationale for using 5 min SPECT images to quantify the CBF with N-isoprophyl-p-[ 123 I] iodoamphetamine ( 123 I-IMP), and in this study they describe how they devised a 123 I-IMP double injection method for use with the acetazolamide test, and report on the clinical results. First, We measured the brain and arterial 123 I concentrations 10 normal subjects after a 123 I-IMP injection, and noted that after 25 minutes the brain and arterial blood activity had plateaued and stabilized. Thus, by using the background substraction method, We found it possible to quantitatively measure the CBF twice in 30 minutes and have called this technique the double injection method. We have clinically used this double injection method for evaluating the CBF in 5 lacunar stroke patients with no major arterial occlusion and found no statistically significant difference in the CBF values between the first and second CBF measurements. They then applied this double injection method for the acetazolamide testing of 10 stroke patients with an arterial occlusion of stenosis and found that the CBF results compared favorably with the CBF results achieved with the use of the separate injection method. It also should be noted the double injection method was successfully used for clinical CBF measurements without acetazolamide testing. (author)

Effects of acetazolamide on the micro- and macro-vascular cerebral hemodynamics: A diffuse optical and transcranial doppler ultrasound study

OpenAIRE

Zirak P.; Delgado-Mederos R.; Marti-Fabregas J.; Durduran T.

2010-01-01

Acetazolamide (ACZ) was used to stimulate the cerebral vasculature on ten healthy volunteers to assess the cerebral vasomotor reactivity (CVR). We have combined near infrared spectroscopy (NIRS), diffuse correlation spectroscopy (DCS) and transcranial Doppler (TCD) technologies to non-invasively assess CVR in real-time by measuring oxy- and deoxy-hemoglobin concentrations, using NIRS, local cerebral blood flow (CBF), using DCS, and blood flow velocity (CBFV) in the middle cerebral artery, usi...

Brain perfusion SPECT imaging before and during the acetazolamide test using sup 99m Tc-HMPAO

Energy Technology Data Exchange (ETDEWEB)

Matsuda, Hiroshi; Higashi, Sotaro; Kinuya, Keiko; Tsuji, Shiro; Sumiya, Hisashi; Hisada, Kinichi; Yamashita, Junkoh (Kanazawa Univ. (Japan). School of Medicine)

1990-05-01

A new method using brain perfusion {sup 99m}Tc-HMPAO SPECT imaging was developed for evaluating cerebral perfusion reserve by the acetazolamide test with a short period. The first SPECT study was carried out for 13.5 min to obtain SPECT images at the resting state after 3 min postinjection of 555 MBq (15 mCi) of {sup 99m}Tc-HMPAO. At the same time as the start of the first SPECT study, 1 g of acetazolamide was intravenously injected. Immediately after the stop of the 1st SPECT study, 925 MBq (25 mCi) of {sup 99m}Tc-HMPAO from the same vial as in the first study was additionally injected. Three minutes later the second SPECT study was carried out for 10 min. After reconstruction the tomographic images in the first study were subtracted from the images in the second study to obtain those during the acetazolamide test after correction of the time differences in data acquisition between the two studies. This subtraction technique gives independent brain perfusion SPECT images before and during the acetazolamide test. Besides, the regional flow changes during the test were quantitatively analyzed. In conclusion this method seems to be practically useful for evaluating regional brain perfusion before and during drug treatments as a consecutive study with a short period of approximately 30 min. (author).

SPM analysis of cerebrovascular reserve capacity after stimulation with acetazolamide measured by Tc-99m ECD SPECT in normal brain MRI patient

Energy Technology Data Exchange (ETDEWEB)

Lee, M. H.; Yoon, S. N.; Yoon, J. K.; Cho, C. W. [College of Medicine, Univ. of Ajou, Suwon (Korea, Republic of)

2003-07-01

This study was undertaken to evaluate normal response of acetazolamide in normal individuals, whose brain MRI is normal, using SPM99. In total, 10 Tc- 99m ECD brain SPECT were evaluated retrospectively. The half of the patients were male. Their mean age was 47.1 years old with a range of 33-61 years. They all visited our neurology department to evaluate stroke symptom. Their brain MRI was normal. Rest/acetazolamide brain SPECT was perfomed using Tc-99m ECD and the sequential injection and subtraction method. SPECT was acquired using fanbeam collimators and triple-head gamma camera (MultiSPECT III, Siemens medical systems, Inc. Hoffman Estates, III, USA). Chang's attenuation correction was applied their brain SPECT revealed normal rCBF pattern in visual analysis by two nuclear physician and they were diagnosed clinically normal. Using SPM method, we compared rest brain SPECT images with those of acetazolamide brain SPECT and measured the extent of the area with significant perfusion change (P<0.05) in predefined 34 cerebral regions. Acetazolamide brain SPECT showed no significant decreased region in comparison to rest brain SPECT. Only small portion of left mid temporal gyrus revealed increased rCBF on acetazolamide brain SPECT in comparison to rest brain SPECT. It apperas that there is no significant change in rCBF between rest and acetazolamide brain SPECT using Tc-99m ECD. The small number of this study is limitation of our study.

SPECT study of cerebral blood flow reactivity after acetazolamide in patients with transient ischemic attacks

International Nuclear Information System (INIS)

Chollet, F.; Celsis, P.; Clanet, M.; Guiraud-Chaumeil, B.; Rascol, A.; Marc-Vergnes, J.P.

1989-01-01

We investigated 15 patients with one or more transient ischemic attacks (TIAs) in the internal carotid artery territory within the month following the most recent TIA. Cerebral blood flow (CBF) was measured by single-photon emission computed tomography, using intravenous xenon-133 before and after injection of 1 g acetazolamide. Six patients had severe carotid stenosis or occlusion; the other nine patients had no significant carotid lesions. Twenty age-matched volunteers free of neurologic symptoms or history were used as controls. Mean CBF in the sylvian region was not significantly different between patients and controls. Seven patients exhibited a focal hypoperfusion at rest in the symptomatic hemisphere, and their hypoperfused areas were hyporeactive after administration of acetazolamide. Seven other patients exhibited hyporeactive areas after acetazolamide administration while their CBF tomograms at rest were normal. Thus, CBF abnormalities were detected in 14 of the 15 patients. Our findings suggest that CBF measured early after acetazolamide administration could be useful to confirm the clinical diagnosis of TIA. In the nine patients with no significant lesion of the internal carotid artery, the areas of hypoperfusion were small and were probably related to the focal ischemic event. In the six patients with severe lesions of the internal carotid artery, abnormalities were of variable size and intensity but were often large and pronounced. The discrepancy between these two subgroups of patients could be ascribed to the hemodynamic influence of the internal carotid artery lesions. Moreover, our findings may provide some insight into the pathophysiology of TIAs

Near-infrared transillumination back scattering sounding--new method to assess brain microcirculation in patients with chronic carotid artery stenosis.

Directory of Open Access Journals (Sweden)

Andrzej F Frydrychowski

Full Text Available PURPOSE: The purpose of the study was to assess the responses of pial artery pulsation (cc-TQ and subarachnoid width (sas-TQ to acetazolamide challenge in patients with chronic carotid artery stenosis and relate these responses to changes in peak systolic velocity (PSV, cerebral blood flow (CBF, cerebral blood volume (CBV, mean transit time (MTT and time to peak response (TTP. METHODS: Fifteen patients with carotid artery stenosis ≥ 90% on the ipsilateral side and <50% on the contralateral side were enrolled into the study. PSV was assessed using colour-coded duplex sonography, CBF, CBV, MTT and TTP with perfusion computed tomography, cc-TQ and sas-TQ with near-infrared transillumination/backscattering sounding (NIR-T/BSS. RESULTS: Based on the ipsilateral/contralateral cc-TQ ratio after acetazolamide challenge two groups of patients were distinguished: the first group with a ratio ≥ 1 and the second with a ratio <1. In the second group increases in CBF and CBV after the acetazolamide test were significantly higher in both hemispheres (ipsilateral: +33.0% ± 8.1% vs. +15.3% ± 4.4% and +26.3% ± 6.6% vs. +14.3% ± 5.1%; contralateral: +26.8% ± 7.0% vs. +17.6% ± 5.6% and +20.0% ± 7.3% vs. +10.0% ± 3.7%, respectively, cc-TQ was significantly higher only on the ipsilateral side (+37.3% ± 9.3% vs. +26.6% ± 8.6% and the decrease in sas-TQ was less pronounced on the ipsilateral side (-0.7% ± 1.5% vs. -10.2% ± 1.5%, in comparison with the first group. The changes in sas-TQ following the acetazolamide test were consistent with the changes in TTP. CONCLUSIONS: The ipsilateral/contralateral cc-TQ ratio following acetazolamide challenge may be used to distinguish patient groups characterized by different haemodynamic parameters. Further research on a larger group of patients is warranted.

Correlation of cerebrovascular reserve as measured by acetazolamide-challenged perfusion CT with collateral circulation in unilateral high grade carotid stenosis

International Nuclear Information System (INIS)

Hong, Doran; Lee, Young Hen; Seo, Hyung Suk; Je, Bo Kyoung; Suh, Sang Il; Seol, Hae Young; Kim, Jung Hyuk; Lee, Nam Joon; Yang, Kyung Sook

2014-01-01

We correlated cerebrovascular reserve in unilateral high grade carotid artery stenosis or occlusion with a type of collateral circulation using acetazolamide-challenged perfusion CT (ACZ-PCT). Among the patients who underwent ACZ-PCT in our institution, we retrospectively selected the patients with unilateral high grade internal carotid artery or middle cerebral artery stenosis (> 70%) or occlusion; we verified the types of their dominant collateral circulation by digital subtraction angiography or 3T MR-angiography; first, the primary collaterals flow through the circle of Willis; second, the secondary collaterals that flow through the opthalmic artery, the basal artery or other external carotid artery. Using ACZ-PCT, we measured the difference in percentage change of cerebral blood flow of the stenotic hemisphere against contralateral normal hemisphere and compared cerebrovascular reserves of lesional hemisphere, according to the type of collaterals. A total of 28 patients were included. The percentage changes of cerebral blood flow were significantly lower in the stenotic hemisphere than the contralateral hemisphere (14.34 ± 36.43% and 34.53 ± 47.82%, p < 0.001), and in the hemisphere predominantly supplied by secondary collaterals than primary (7.03 ± 32.71% and 24.37 ± 42.03%, p < 0.05), respectively. Cerebrovascular reserves in the ipsilateral hemisphere predominantly supplied by secondary collaterals were more impaired than primary collaterals in patients with unilateral high grade carotid stenosis or occlusion.

ACETAZOLAMIDE IS A MEDICINE FOR THE MEDICATED CORRECTION OF THE SLEEP APNEA AND HYPOPNEA SYNDROME AMONG CHILDREN AND ADULTS

Directory of Open Access Journals (Sweden)

O.V. Bykova

2006-01-01

Full Text Available Sleep apnea and hypopnea syndrome is a life bendangering sleep dis order among both adults and children. The prevalence of the sleep apnea and hypopnea syndrome both in adult and pediatric population may be evaluated only approximately, as not all of the patients, suffering from this pathology, may call some adequate complaints, which, in their turn, help diagnose the disease. For example, only obstructive sleep apnea syndrome according to the data of British epidemiologists is met among the adults at the frequency rate, which can be compared with the prevalence of the bronchial asthma. Since metabolic acidosis caused by the carbonic anhydrase inhibitor of acetazolamide stimulates the ventilation of lungs, the researchers have set forth a supposition that the application of this medicine can be efficient to treat the respiratory disturbances in sleep. There is wide application of acetazolamide for the medicated correction of sleep apnea and hypopnea syndrome of the central genesis among both adults and children. When using acetazolamide for the long term therapy of respiratory disturbances among adult patients, the main issue is the probable growth of tolerance towards the carbonic anhydrase inhibitor along with the continuous longbterm application of the medicine. In pediatry, quite on the contrary, the sleep apnea and hypopnea syndrome is usually a transit problem of the early infancy and it does not require any longbterm drug therapy, which defines specifically high perspectives of the efficient and safe application of acetazolamide for the medicated correction of respiratory disturbances in sleep precisely within this category of patients.Key words: apnea, hypopnea, sleep disorder, acetazolamide, children.

Prediction of cerebral ischemia due to cerebral vasospasm in SAH using SPECT and 123I-IMP with acetazolamide test

International Nuclear Information System (INIS)

Nakagawara, Jyoji; Wada, Keiji; Takeda, Rihei; Usami, Takashi; Hashimoto, Ikuo; Shimazaki, Mitsuteru; Tanaka, Chiharu; Nakamura, Jun-ichi; Suematsu, Katsumi.

1989-01-01

To investigate the possibility of predicting cerebral ischemia due to cerebral vasospasm in subarachnoid hemorrhage (SAH), serial evaluation of the cerebral vasodilatory capacity by the acetazolamide test was conducted, using single photon emission computed tomography (SPECT) and N-isopropyl 123 I-p-iodoamphetamine (IMP), in 17 patients with cerebral vasospasm following early surgery for ruptured aneurysms. The degree of vasospasm measured on the angiograms was classified into the following three types; mild degree (25%>stenosis), moderate degree (25∼50% stenosis), and severe degree(50%acetazolamide was limited until the release of the cerebral vasospasm. Therefore, assessment of cerebral vasodilatory capacity in SAH by the acetazolamide test might predict the appearance and continuation of potential ischemia of the brain caused by the reduction of perfusion pressure due to cerebral vasospasm. (J.P.N.)

Does preoperative measurement of cerebral blood flow with acetazolamide challenge in addition to preoperative measurement of cerebral blood flow at the resting state increase the predictive accuracy of development of cerebral hyperperfusion after carotid endarterectomy? Results from 500 cases with brain perfusion single-photon emission computed tomography study.

Science.gov (United States)

Oshida, Sotaro; Ogasawara, Kuniaki; Saura, Hiroaki; Yoshida, Koji; Fujiwara, Shunro; Kojima, Daigo; Kobayashi, Masakazu; Yoshida, Kenji; Kubo, Yoshitaka; Ogawa, Akira

2015-01-01

The purpose of the present study was to determine whether preoperative measurement of cerebral blood flow (CBF) with acetazolamide in addition to preoperative measurement of CBF at the resting state increases the predictive accuracy of development of cerebral hyperperfusion after carotid endarterectomy (CEA). CBF at the resting state and cerebrovascular reactivity (CVR) to acetazolamide were quantitatively assessed using N-isopropyl-p-[(123)I]-iodoamphetamine (IMP)-autoradiography method with single-photon emission computed tomography (SPECT) before CEA in 500 patients with ipsilateral internal carotid artery stenosis (≥ 70%). CBF measurement using (123)I-IMP SPECT was also performed immediately and 3 days after CEA. A region of interest (ROI) was automatically placed in the middle cerebral artery territory in the affected cerebral hemisphere using a three-dimensional stereotactic ROI template. Preoperative decreases in CBF at the resting state [95% confidence intervals (CIs), 0.855 to 0.967; P = 0.0023] and preoperative decreases in CVR to acetazolamide (95% CIs, 0.844 to 0.912; P state (difference between areas, 0.173; P state (P state increases the predictive accuracy of the development of post-CEA hyperperfusion.

Acetazolamide assisted Tc-99m MAG3 renography to assess renal blood flow reserve

International Nuclear Information System (INIS)

Horita, Yoshio; Hayashida, Kohei; Fukuchi, Kazuki

2003-01-01

The present study examines whether or not baseline and acetazolamide (ACZ) Tc-99m MAG3 renography can assess renal blood flow reserve. Renography proceeded for 50 min after sequential injections of 370 MBq Tc-99m MAG3 for baseline renography and 10 min after a 1,000 mg injection of ACZ for ACZ renography. Effective renal plasma flow of renal cortex (cERPF) in each kidney and the percentage change in cERPF of those parameters (ΔERPF) were obtained before and after the administration of ACZ in 10 subjects without hypertension or diabetes (normal group), in 10 with essential hypertension (hypertensive group) and in 10 who had Type 2 diabetes with hypertension (diabetic group). A placebo test was performed in the 10 without hypertension or diabetes using distilled water instead of ACZ (placebo group). The placebo test performed in the 10 without hypertension or diabetes using distilled water instead of ACZ indicated that the parameter variance between the two types of renogram was below 3.2%. The cERPF of baseline and ACZ Tc-99m MAG3 renography and ΔERPF in the normal, hypertensive and diabetic groups were 89±10 and 110±10 ml/min, 89±14 and 117±22 ml/min, 100±23 and 112±23 ml/min, respectively, and 24.5±13.5%, 26.0±9.7% and 12.3±11.1%, respectively. The difference in the cERPF value was significant in the normal and hypertensive groups whereas this did not change in the diabetic group before or after ACZ administration. We suggested that the ΔERPF determined by baseline and ACZ Tc-99m MAG3 renography is a useful parameter for assessing renal blood flow reserve. (author)

Prediction of cerebral ischemia due to cerebral vasospasm in SAH using SPECT and sup 123 I-IMP with acetazolamide test

Energy Technology Data Exchange (ETDEWEB)

Nakagawara, Jyoji; Wada, Keiji; Takeda, Rihei; Usami, Takashi; Hashimoto, Ikuo; Shimazaki, Mitsuteru; Tanaka, Chiharu; Nakamura, Jun-ichi (Nakamura Memorial Hospital, Sapporo (Japan)); Suematsu, Katsumi

1989-11-01

To investigate the possibility of predicting cerebral ischemia due to cerebral vasospasm in subarachnoid hemorrhage (SAH), serial evaluation of the cerebral vasodilatory capacity by the acetazolamide test was conducted, using single photon emission computed tomography (SPECT) and N-isopropyl {sup 123}I-p-iodoamphetamine (IMP), in 17 patients with cerebral vasospasm following early surgery for ruptured aneurysms. The degree of vasospasm measured on the angiograms was classified into the following three types; mild degree (25%>stenosis), moderate degree (25{approx}50% stenosis), and severe degree(50%acetazolamide was limited until the release of the cerebral vasospasm. Therefore, assessment of cerebral vasodilatory capacity in SAH by the acetazolamide test might predict the appearance and continuation of potential ischemia of the brain caused by the reduction of perfusion pressure due to cerebral vasospasm. (J.P.N.).

Binary and ternary cocrystals of sulfa drug acetazolamide with pyridine carboxamides and cyclic amides.

Science.gov (United States)

Bolla, Geetha; Nangia, Ashwini

2016-03-01

A novel design strategy for cocrystals of a sulfonamide drug with pyridine carboxamides and cyclic amides is developed based on synthon identification as well as size and shape match of coformers. Binary adducts of acetazolamide (ACZ) with lactams (valerolactam and caprolactam, VLM, CPR), cyclic amides (2-pyridone, labeled as 2HP and its derivatives MeHP, OMeHP) and pyridine amides (nicotinamide and picolinamide, NAM, PAM) were obtained by manual grinding, and their single crystals by solution crystallization. The heterosynthons in the binary cocrystals of ACZ with these coformers suggested a ternary combination for ACZ with pyridone and nicotinamide. Novel supramolecular synthons of ACZ with lactams and pyridine carboxamides are reported together with binary and ternary cocrystals for a sulfonamide drug. This crystal engineering study resulted in the first ternary cocrystal of acetazolamide with amide coformers, ACZ-NAM-2HP (1:1:1).

ACETAZOLAMIDE IN PEDIATRIC NEUROLOGY: HISTORY AND PERSPECTIVE OF CILNICAL USE

OpenAIRE

A.N. Boyko; E.I. Gusev; O.V. Bykova; L.M. Kuzenkova; O.I. Maslova

2006-01-01

Resume the up tob date pharmacological and clinical findings have revealed new opportunities for the use of known for a long time pharmaceutical agents in various fields of practical medicine. For more than 50 years acetozolamide, systemic carbonic anhydrase inhibitor, has been used in neurology to correct liquorodynamic disorders. High clinical efficacy and good tolerb ability in longbterm use has made acetazolamide an essential agent in pediatric neurology, along with this the true therapeu...

Acetazolamide on the ventral medulla of the cat increases phrenic output and delays the ventilatory response to CO sub 2

Energy Technology Data Exchange (ETDEWEB)

Coates, E.L.; Aihua Li; Nattie, E.E. (Dartmouth College, Hanover, NH (United States))

1991-03-11

Acetazolamide applied to the surface of the rostral ventrolateral medulla or microinjected beneath the medullary surface in chloralose-urethan-anesthetized, vagotomized, carotid denervated, paralyzed, servo-ventilated cats produced a long-lasting increase in phrenic minute ventilation. Extracellular pH measured beneath the rostral ventrolateral medulla exhibited a long-lasting decrease after surface acetazolamide but was not a good predictor, in each individual animal, of changes in phrenic activity. Medullary carbonic anhydrase inhibition reduced the slope and the half-time of the phrenic response to rapid step CO{sub 2} increases. Conversely, acetazolamide did not effect the phrenic response to steady state CO{sub 2} increases. These data indicate that localized inhibition of medullary carbonic anhydrase causes a centrally mediated increase in ventilation that the authors attribute to medullary tissue acidosis. In addition, these data indicate that medullary carbonic anhydrase may play a role in central CO{sub 2} chemotransduction.

Binary and ternary cocrystals of sulfa drug acetazolamide with pyridine carboxamides and cyclic amides

Directory of Open Access Journals (Sweden)

Geetha Bolla

2016-03-01

Full Text Available A novel design strategy for cocrystals of a sulfonamide drug with pyridine carboxamides and cyclic amides is developed based on synthon identification as well as size and shape match of coformers. Binary adducts of acetazolamide (ACZ with lactams (valerolactam and caprolactam, VLM, CPR, cyclic amides (2-pyridone, labeled as 2HP and its derivatives MeHP, OMeHP and pyridine amides (nicotinamide and picolinamide, NAM, PAM were obtained by manual grinding, and their single crystals by solution crystallization. The heterosynthons in the binary cocrystals of ACZ with these coformers suggested a ternary combination for ACZ with pyridone and nicotinamide. Novel supramolecular synthons of ACZ with lactams and pyridine carboxamides are reported together with binary and ternary cocrystals for a sulfonamide drug. This crystal engineering study resulted in the first ternary cocrystal of acetazolamide with amide coformers, ACZ–NAM–2HP (1:1:1.

Acetazolamide as a vasodilatory stimulus in cerebrovascular diseases and in conditions affecting the cerebral vasculature

NARCIS (Netherlands)

Settakis, G.; Molnár, C.; Kerényi, L.; Kollár, J.; Legemate, D.; Csiba, L.; Fülesdi, B.

2003-01-01

Pathologic processes affecting the brain vessels may damage cerebral vasodilatory capacity. Early detection of cerebral dysfunction plays an important role in the prevention of cerebrovascular diseases. In recent decades acetazolamide (AZ) has frequently been used for this purpose. In the present

Effect of Acetazolamide vs Placebo on Duration of Invasive Mechanical Ventilation Among Patients With Chronic Obstructive Pulmonary Disease: A Randomized Clinical Trial.

Science.gov (United States)

Faisy, Christophe; Meziani, Ferhat; Planquette, Benjamin; Clavel, Marc; Gacouin, Arnaud; Bornstain, Caroline; Schneider, Francis; Duguet, Alexandre; Gibot, Sébastien; Lerolle, Nicolas; Ricard, Jean-Damien; Sanchez, Olivier; Djibre, Michel; Ricome, Jean-Louis; Rabbat, Antoine; Heming, Nicholas; Urien, Saïk; Esvan, Maxime; Katsahian, Sandrine

2016-02-02

Acetazolamide has been used for decades as a respiratory stimulant for patients with chronic obstructive pulmonary disease (COPD) and metabolic alkalosis, but no large randomized placebo-controlled trial is available to confirm this approach. To determine whether acetazolamide reduces mechanical ventilation duration in critically ill patients with COPD and metabolic alkalosis. The DIABOLO study, a randomized, double-blind, multicenter trial, was conducted from October 2011 through July 2014 in 15 intensive care units (ICUs) in France. A total of 382 patients with COPD who were expected to receive mechanical ventilation for more 24 hours were randomized to the acetazolamide or placebo group and 380 were included in an intention-to treat analysis. Acetazolamide (500-1000 mg, twice daily) vs placebo administered intravenously in cases of pure or mixed metabolic alkalosis, initiated within 48 hours of ICU admission and continued during the ICU stay for a maximum of 28 days. The primary outcome was the duration of invasive mechanical ventilation via endotracheal intubation or tracheotomy. Secondary outcomes included changes in arterial blood gas and respiratory parameters, weaning duration, adverse events, use of noninvasive ventilation after extubation, successful weaning, the duration of ICU stay, and in-ICU mortality. Among 382 randomized patients, 380 (mean age, 69 years; 272 men [71.6%]; 379 [99.7%] with endotracheal intubation) completed the study. For the acetazolamide group (n = 187), compared with the placebo group (n = 193), no significant between-group differences were found for median duration of mechanical ventilation (-16.0 hours; 95% CI, -36.5 to 4.0 hours; P = .17), duration of weaning off mechanical ventilation (-0.9 hours; 95% CI, -4.3 to 1.3 hours; P = .36), daily changes of minute-ventilation (-0.0 L/min; 95% CI, -0.2 to 0.2 L/min; P = .72), or partial carbon-dioxide pressure in arterial blood (-0.3 mm Hg; 95% CI, -0.8 to 0.2 mm

Time Course of Cerebrovascular Reactivity in Patients Treated for Unruptured Intracranial Aneurysms: A One-Year Transcranial Doppler and Acetazolamide Follow-Up Study

Directory of Open Access Journals (Sweden)

Marianne Lundervik Bøthun

2018-01-01

Full Text Available Background. Cerebrovascular reactivity (CVR is often impaired in the early phase after aneurysmal subarachnoid hemorrhage. There is, however, little knowledge about the time course of CVR in patients treated for unruptured intracranial aneurysms (UIA. Methods. CVR, assessed by transcranial Doppler and acetazolamide test, was examined within the first postoperative week after treatment for UIA and reexamined one year later. Results. Of 37 patients initially assessed, 34 were reexamined after one year. Bilaterally, baseline and acetazolamide-induced blood flow velocities were higher in the postoperative week compared with one year later (p<0.001. CVR on the ipsilateral side of treatment was lower in the initial examination compared with follow-up (58.9% versus 66.1%, p=0.04. There was no difference in CVR over time on the contralateral side (63.4% versus 65.0%, p=0.65. When mean values of right and left sides were considered there was no difference in CVR between exams. Larger aneurysm size was associated with increased change in CVR (p=0.04, and treatment with clipping was associated with 13.8%-point increased change in CVR compared with coiling (p=0.03. Conclusion. Patients with UIA may have a temporary reduction in CVR on the ipsilateral side after aneurysm treatment. The change in CVR appears more pronounced for larger-sized aneurysms and in patients treated with clipping. We recommend that ipsilateral and contralateral CVR should be assessed separately, as mean values can conceal side-differences.

Comparative study of acetazolamide and spironolactone on body fluid compartments on induction to high altitude

Science.gov (United States)

Singh, M. V.; Jain, S. C.; Rawal, S. B.; Divekar, H. M.; Parshad, Rajinder; Tyagi, A. K.; Sinha, K. C.

1986-03-01

Studies were conducted on 29 male healthy subjects having no previous experience of living at high altitude. These subjects were divided into three groups, i.e., subjects treated with placebo, acetazolamide and spironolactone. These subjects were first studied in Delhi. The drug schedule was started 24 hour prior to the airlift of these subjects to an altitude of 3,500 m and was continued for 48 hour after arrival at high altitude. Total body water, extra cellular water, plasma volume, blood electrolytes, pH, pO2, pCO2 and blood viscosity were determined on 3rd and 12th day of their stay at high altitude. Total body water, extra cellular water intracellular water and plasma volume decreased on high altitude exposure. There was a further slight decrease in these compartments with acetazolamide and spironolactone. It was also observed that spironolactone drives out more water from the extracellular compartment. Loss of plasma water was also confirmed by increased plasma osmolality. Increase in arterial blood pH was noticed on hypoxic exposure but the increase was found less in acetazolamide and spironolactone cases. This decrease in pH is expected to result in better oxygen delivery to the tissues at the low oxygen tension. It was also confirmed because blood pO2 increased in both the groups. No significant change in plasma electrolytes was observed in subjects of various groups. Blood viscosity slightly increased on exposure to high altitude. The degree of rise was found less in the group treated with spironolactone. This study suggests that both the drugs are likely to be beneficial in ameliorating/prevention of AMS syndrome.

Pharmacological modulation of the BOLD response: a study of acetazolamide and glyceryl trinitrate in humans

DEFF Research Database (Denmark)

Asghar, Mohammed Sohail; Hansen, Adam E; Pedersen, Simon

2011-01-01

To examine the effect of acetazolamide, known to increase cerebral blood flow (CBF) and glyceryl trinitrate (GTN), known to increase cerebral blood volume (CBV) on the blood oxygenation level-dependent (BOLD) response in humans using 3 T magnetic resonance imaging (MRI), and to evaluate how...... pharmacological agents may modulate cerebral hemodynamic and thereby possibly the BOLD signal....

Comment on the case report “Possible association between acetazolamide administration during pregnancy and multiple congenital malformations”

Directory of Open Access Journals (Sweden)

Keskin-Arslan E

2016-11-01

Full Text Available Elif Keskin-Arslan,1,2 Yusuf Cem Kaplan1,2 1Department of Pharmacology, School of Medicine, Izmir Katip Celebi University, 2Terafar – Izmir Katip Celebi University Teratology Information, Training and Research Center, Izmir, Turkey We read with interest the case report in the April 2016 issue of Drug Design Development and Therapy by Al-Saleem and Al-Jobair.1 The authors have presented a boy with oligodontia, ectrodactyly, and syndactyly who was exposed to acetazolamide in utero. Although the discussion was well balanced with a mention to possible confounders such as family and obstetric history and lack of a genetic analysis, two important papers regarding prenatal exposure to acetazolamide were not cited by the authors. In this letter, we would like to mention these studies in order to expand the current context provided by Al-Saleem and Al-Jobair.1View the original paper by Al-Saleem and Al-Jobair

Biochemical and ultrastructural changes in rabbit sclera after treatment with 7-methylxanthine, theobromine, acetazolamide, or L-ornithine

Science.gov (United States)

Trier, K.; Olsen, E. B.; Kobayashi, T.; Ribel-Madsen, S. M.

1999-01-01

AIMS—To examine a possible effect of 7-methylxanthine, theobromine, acetazolamide, or L-ornithine on the ultrastructure and biochemical composition of rabbit sclera.
METHODS—Groups of pigmented rabbits, six in each group, were dosed during 10 weeks with one of the substances under investigation, and one untreated group was the control. Samples of anterior and posterior sclera were taken for determination of hydroxyproline, hydroxylysine, proline, proteoglycans, uronic acids and dermatan sulphate, chondroitin sulphate, and hyaluronic acid. Sections were examined with electron microscopy, and the diameter of the individual collagen fibrils was measured.
RESULTS—Treatment with theobromine produced a significant increase in the contents of hydroxylysine, hydroxyproline, and proline in both anterior and posterior sclera, while 7-methylxanthine increased the contents of hydroxyproline and proline selectively in posterior sclera. Acetazolamide, on the other hand, significantly decreased the contents of hydroxyproline and proline in samples from anterior sclera. Uronic acids in both anterior and posterior sclera were significantly reduced by treatment with 7-methylxanthine, and L-ornithine significantly reduced uronic acids in posterior sclera. An inverse correlation between contents of hydroxyproline and uronic acids was found. The mean diameter of collagen fibrils was significantly higher in the posterior sclera from rabbits treated with 7-methylxanthine or theobromine, and significantly lower in rabbits treated with acetazolamide or L-ornithine compared with controls. In the anterior sclera, fibril diameter was significantly reduced in all treatment groups compared with controls. A positive, significant correlation between fibril diameter and content of hydroxyproline and proline was found in posterior sclera.
CONCLUSION—7-Methylxanthine, a metabolite of caffeine, increases collagen concentration and the diameter of collagen fibrils in the posterior

Binary and ternary cocrystals of sulfa drug acetazolamide with pyridine carboxamides and cyclic amides

OpenAIRE

Bolla, Geetha; Nangia, Ashwini

2016-01-01

A novel design strategy for cocrystals of a sulfonamide drug with pyridine carboxamides and cyclic amides is developed based on synthon identification as well as size and shape match of coformers. Binary adducts of acetazolamide (ACZ) with lactams (valerolactam and caprolactam, VLM, CPR), cyclic amides (2-pyridone, labeled as 2HP and its derivatives MeHP, OMeHP) and pyridine amides (nicotinamide and picolinamide, NAM, PAM) were obtained by manual grinding, and their single crystals by solutio...

Evaluation of cerebral vasoreactivity by SPECT and transcranial doppler sonography using the acetazolamide test

Energy Technology Data Exchange (ETDEWEB)

Pavics, L. [Dept. of Nuclear Medicine, Albert Szent-Gyoergyi Medical Univ., Szeged (Hungary); Gruenwald, F. [Bonn Univ. (Germany). Abt. fuer Nuklearmedizin; Barzo, P. [Dept. of Neurosurgery, Albert Szent-Gyoergyi Medical Univ., Szeged (Hungary); Ambrus, E. [Dept. of Nuclear Medicine, Albert Szent-Gyoergyi Medical Univ., Szeged (Hungary); Menzel, C. [Bonn Univ. (Germany). Abt. fuer Nuklearmedizin; Schomburg, A. [Bonn Univ. (Germany). Abt. fuer Nuklearmedizin; Borda, L. [Dept. of Neurosurgery, Albert Szent-Gyoergyi Medical Univ., Szeged (Hungary); Mate, E. [Laszlo Kalmar Kibernetic Lab., Attila Jozsef Univ., Szeged (Hungary); Bodosi, M. [Dept. of Neurosurgery, Albert Szent-Gyoergyi Medical Univ., Szeged (Hungary); Csernay, L. [Dept. of Nuclear Medicine, Albert Szent-Gyoergyi Medical Univ., Szeged (Hungary); Biersack, H.J. [Bonn Univ. (Germany). Abt. fuer Nuklearmedizin

1994-12-01

rCBF SPECT with {sup 99m}Tc-HMPAO was performed prospectively in 29 patients (3 controls and 26 stroke patients) as well as TCD studies in 20 patients (3 controls and 17 stroke patients) before and after 1 g i.v. acetazolamide. The sensitivity of rCBF SPECT increased from 62% to 77% after acetazolamide provocation in stroke patients. In patients with a reversible neurological deficit, the sensitivity under resting conditions was 50% which increased to 71%, while in cases with a permanent deficit it increased from 75% to 83%. In the evaluation of the cerebrovascular reserve capacity the results of rCBF SPECT and TCD coincided in 91% of the hemispheres. The correlation was statistically significant. (orig.) [Deutsch] Bei 29 Patienten (3 Kontrollpersonen, 26 Patienten mit zerebrovaskulaerer Erkrankung) wurde prospektiv die Hirn-SPECT mit {sup 99m}TC-HMPAO und bei 20 Patienten (3 Kontrollpersonen, 17 Patienten mit ZVK) die transkranielle Dopplersonographie (TCD) vor und nach i.v. Gabe von Azetazolamid durchgefuehrt. Die Sensitivitaet der Hirn-SPECT erhoehte sich mit Azetazolamid von 62% auf 77%. Bei Patienten mit reversiblem neurologischem Defizit wurde eine Verbesserung von 50% auf 71%, bei Patienten mit persistierendem Defizit von 75% auf 83% beobachtet. Die Ergebnisse der Hirn-SPECT und der TCD stimmten in der Beurteilung der zerebrovaskulaeren Reservekapazitaet in 91% der Hemisphaeren ueberein. Die Korrelation zwischen den beiden Methoden war statistisch signifikant. (orig.)

Acetazolamide stimulation test in patients with unilateral internal carotid artery stenosis using Tc-99m HMPAO SPECT and transcranial doppler sonography

Energy Technology Data Exchange (ETDEWEB)

Hyun, I. Y.; Na, J. H. [Inha University Hospital, Incheon (Korea, Republic of)

2007-07-01

We compared perfusion reserve by acetazolamide (ACZ) challenged brain perfusion SPECT and cerebral vasoreactivity (CVR) by transcranial Doppler sonography (TCD) in patients with unilateral internal carotid artery stenosis. This study was conducted prospectively in 37 consecutive patients with angiographically proven unilateral internal carotid artery stenosis (stenosis> 50%). We estimated % CVR (100? {l_brace}post-ACZ mean velocity (cm/sec) - Pre-ACZ mean velocity (cm/sec){r_brace} / pre-ACZ mean velocity) by TCD. The % CVR was compared with perfusion reserve of SPECT. The % CVR of MCA and ICA was significantly decreased in the ipsilateral side to the carotid stenosis (p<0.05). The CVR impairment was more severe when cerebral infarct is already developed (p<0.01). There was a significant correlation between the degree of carotid stenosis and the CVR (p<0.01). In the area of impaired perfusion reserve on the SPECT, the estimated CVR by TCD was significantly lower (p<0.05), even to the negative value, implying that there is actually steal phenomenon in that area. ACZ challenge can actually decrease cerebral blood flow in the area of impaired perfusion reserve on brain SPECT. So we should be very cautiously performing in ACZ challenge especially when there is a severe carotid stenosis because there is a possibility of developing hemodynamic stroke.

Effects of acetazolamide on the micro- and macro-vascular cerebral hemodynamics: a diffuse optical and transcranial doppler ultrasound study.

Science.gov (United States)

Zirak, Peyman; Delgado-Mederos, Raquel; Martí-Fàbregas, Joan; Durduran, Turgut

2010-11-19

Acetazolamide (ACZ) was used to stimulate the cerebral vasculature on ten healthy volunteers to assess the cerebral vasomotor reactivity (CVR). We have combined near infrared spectroscopy (NIRS), diffuse correlation spectroscopy (DCS) and transcranial Doppler (TCD) technologies to non-invasively assess CVR in real-time by measuring oxy- and deoxy-hemoglobin concentrations, using NIRS, local cerebral blood flow (CBF), using DCS, and blood flow velocity (CBFV) in the middle cerebral artery, using TCD. Robust and persistent increases in oxy-hemoglobin concentration, CBF and CBFV were observed. A significant agreement was found between macro-vascular (TCD) and micro-vascular (DCS) hemodynamics, between the NIRS and TCD data, and also within NIRS and DCS results. The relative cerebral metabolic rate of oxygen, rCMRO(2), was also determined, and no significant change was observed. Our results showed that the combined diffuse optics-ultrasound technique is viable to follow (CVR) and rCMRO(2) changes in adults, continuously, at the bed-side and in real time.

Effects of cryoprotectants on the structure and thermostability of the human carbonic anhydrase II–acetazolamide complex

International Nuclear Information System (INIS)

Aggarwal, Mayank; Boone, Christopher D.; Kondeti, Bhargav; Tu, Chingkuang; Silverman, David N.; McKenna, Robert

2013-01-01

Here, a case study of the effects of cryoprotectants on the kinetics of carbonic anhydrase II (CA II) and its inhibition by the clinically used inhibitor acetazolamide (AZM) is presented. Protein X-ray crystallography has seen a progressive shift from data collection at cool/room temperature (277–298 K) to data collection at cryotemperature (100 K) because of its ease of crystal preparation and the lessening of the detrimental effects of radiation-induced crystal damage, with 20–25%(v/v) glycerol (GOL) being the preferred choice of cryoprotectant. Here, a case study of the effects of cryoprotectants on the kinetics of carbonic anhydrase II (CA II) and its inhibition by the clinically used inhibitor acetazolamide (AZM) is presented. Comparative studies of crystal structure, kinetics, inhibition and thermostability were performed on CA II and its complex with AZM in the presence of either GOL or sucrose. These results suggest that even though the cryoprotectant GOL was previously shown to be directly bound in the active site and to interact with AZM, it affects neither the thermostability of CA II nor the binding of AZM in the crystal structure or in solution. However, addition of GOL does affect the kinetics of CA II, presumably as it displaces the water proton-transfer network in the active site

Effects of cryoprotectants on the structure and thermostability of the human carbonic anhydrase II–acetazolamide complex

Energy Technology Data Exchange (ETDEWEB)

Aggarwal, Mayank; Boone, Christopher D.; Kondeti, Bhargav; Tu, Chingkuang; Silverman, David N.; McKenna, Robert, E-mail: rmckenna@ufl.edu [University of Florida, 1600 SW Archer Road, PO Box 100245, Gainesville, FL 32610 (United States)

2013-05-01

Here, a case study of the effects of cryoprotectants on the kinetics of carbonic anhydrase II (CA II) and its inhibition by the clinically used inhibitor acetazolamide (AZM) is presented. Protein X-ray crystallography has seen a progressive shift from data collection at cool/room temperature (277–298 K) to data collection at cryotemperature (100 K) because of its ease of crystal preparation and the lessening of the detrimental effects of radiation-induced crystal damage, with 20–25%(v/v) glycerol (GOL) being the preferred choice of cryoprotectant. Here, a case study of the effects of cryoprotectants on the kinetics of carbonic anhydrase II (CA II) and its inhibition by the clinically used inhibitor acetazolamide (AZM) is presented. Comparative studies of crystal structure, kinetics, inhibition and thermostability were performed on CA II and its complex with AZM in the presence of either GOL or sucrose. These results suggest that even though the cryoprotectant GOL was previously shown to be directly bound in the active site and to interact with AZM, it affects neither the thermostability of CA II nor the binding of AZM in the crystal structure or in solution. However, addition of GOL does affect the kinetics of CA II, presumably as it displaces the water proton-transfer network in the active site.

Dynamics of intrarenal pressures and glomerular filtration rate after acetazolamide

DEFF Research Database (Denmark)

Leyssac, P P; Karlsen, F M; Skøtt, O

1991-01-01

-EDTA and lithium. Proximal tubular pressure (Pprox) increased initially by 1.7 +/- 0.1 mmHg after ACZ, causing a decrease in the hydrostatic pressure difference across the glomerular membrane (delta P). EDC increased, and then RBF, glomerular capillary pressure (Pgc), Pprox, and star vessel pressures (Psv) dropped......The dynamics of intrarenal pressures, early distal tubular fluid conductivity (EDC), and renal flood flow (RBF) were studied in rats given acetazolamide (ACZ), an inhibitor of proximal reabsorption. Glomerular filtration rate (GFR) and end-proximal flow were estimated by clearances of 51Cr...... as a result of afferent vasoconstriction. Pprox decreased less than Pgc, resulting in a further decrease in delta P, which after 25-30 s reached a constant level 3-4 mmHg below control. After a transient increase the pressures declined to a new steady state, in which Pprox was equal to control, Pgc...

Hemodynamic evaluation in patients with superficial temporal artery-middle cerebral artery anastomosis; Stable xenon CT-CBF study and acetazolamide

Energy Technology Data Exchange (ETDEWEB)

Touho, Hajime; Karasawa, Jun; Shishido, Hisashi; Morisako, Toshitaka; Yamada, Keisuke; Shibamoto, Keiji [Osaka Neurological Inst., Toyonaka (Japan)

1990-12-01

Sixteen patients with minor completed stroke in the chronic stage underwent superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis. The acetazolamide-activated regional cerebral blood flow (rCBF) was measured 20 minutes after the injection using inhalation of stable xenon and computed tomographic scanning (Xe{sup s} CT-CBF study) pre- and postoperatively. Eleven patients (Group 1) showed immediate improvement in neurological state within a few days of the operation, while five (Group 2) showed no improvements. Preoperative rCBF in the ischemic areas without infarction was 30.8+-3.0 ml/100 gm/min in Group 1 and 53.0+-5.2 ml/100 gm/min in Group 2. Preoperative vasodilatory capacity with acetazolamide in Group 1 was 5.7+-8.6 and significantly increased to 19.8+-4.9 after surgery. In Group 2, pre- and postoperative vasodilatory capacity was 12.7+-3.1 and 14.9+-2.9, respectively, and there was no significant change. These results suggested that minor stroke patients with moderate decrease of affected side rCBF (less than 40 ml/100 gm/min) and with hemodynamic impairment may have the surgical indication for STA-MCA anastomosis. (author).

Ventilatory oscillations at exercise: effects of hyperoxia, hypercapnia, and acetazolamide.

Science.gov (United States)

Hermand, Eric; Lhuissier, François J; Larribaut, Julie; Pichon, Aurélien; Richalet, Jean-Paul

2015-06-01

Periodic breathing has been found in patients with heart failure and sleep apneas, and in healthy subjects in hypoxia, during sleep and wakefulness, at rest and, recently, at exercise. To unravel the cardiorespiratory parameters liable to modulate the amplitude and period of ventilatory oscillations, 26 healthy subjects were tested under physiological (exercise) and environmental (hypoxia, hyperoxia, hyperoxic hypercapnia) stresses, and under acetazolamide (ACZ) treatment. A fast Fourier transform spectral analysis of breath-by-breath ventilation (V˙E) evidenced an increase in V˙E peak power under hypercapnia (vs. normoxia and hyperoxia, P power was positively related to cardiac output (Q˙c) and V˙E in hyperoxia (P oscillations by increasing Q˙c and V˙E, whereas ACZ decreases ventilatory instability in part by a contrasting action on O2 and CO2 sensing. An intrinsic oscillator might modulate ventilation through a complex system where peripheral chemoreflex would play a key role. © 2015 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.

Indomethacin abolishes cerebral blood flow increase in response to acetazolamide-induced extracellular acidosis

DEFF Research Database (Denmark)

Wang, Qian; Paulson, O B; Lassen, N A

1993-01-01

by acetazolamide (Az), a drug that induces brain extracellular acidosis, which triggers its effect on CBF. We compared the results to the inhibitory effect of indomethacin on the CBF increase during hypercapnia. Indomethacin but not diclofenac, another potent cyclooxygenase inhibitor, was found to block almost...... completely the CBF increase caused by Az-induced extracellular acidosis or by CO2, but it did not influence the CBF increase produced by sodium nitroprusside or papaverine. The results suggest that indomethacin exerts its action on CO2 reactivity by a nonprostaglandin-mediated mechanism that directly......Indomethacin is known to attenuate quite markedly the increase in CBF during hypercapnia. Hypercapnia is, in all likelihood, mediated by the acid shift at the level of the smooth muscle cells of the cerebral arterioles. We therefore investigated the effect of indomethacin on the CBF increase caused...

The early diagnostic value of oral acetazolamide load combined with SPECT rCBF imaging in patients with transient ischemia attack in brain

International Nuclear Information System (INIS)

Liu Xintong; Zheng Zhiping; Qiao Suixian; Tang Anwu

2001-01-01

Objective: In order to assess the diagnostic value of acetazolamide (ACZ) combined with rCBF-SPECT imaging in patients with transient ischemia attack (TIA). Methods: SPECT imaging was performed before and after oral ACZ with visual and semiquantitative analysis of the images. Blood gas analysis was done before and after ACZ administration either. Results: After ACZ loading, in normal group, 99 Tc m -ECD was distributed symmetrically on correspondent parts of the brain and rCBF was generally increased. The blood pH was decreased and blood PCO 2 was increased, respectively in TIA group, the positive rate of hypoperfusion foci on SPECT images were increased from 5/6 to 6/6 in symptomatic patients and from 60% to 92% in asymptomatic patients. The total positive rate was 93%. Conclusion: Oral ACZ before SPECT imaging is a simple, reliable way for early diagnosis in patients with TIA

The challenges of risk society for impact assessment

DEFF Research Database (Denmark)

Larsen, Sanne Vammen

2017-01-01

, the challenge of delivering assessments and predictions and the challenge of handling differences of opinion and debate. Through a case example of integration of climate change in strategic environmental assessment, the paper uses empirical evidence from a survey and a series of interviews to carry out......This paper takes its point of departure in Ulrich Beck’s theory of risk society and the aspects that characterise this society. The paper puts forward a hypothe- sis, on which theoretical challenges the characteristics of risk society pose to impact assessment as a decision support tool; namely...... a preliminary discussion of how the theoretical challenges are reflected in practice. The case study results show that the challenge of delivering assessments and predictions in a risk society is reflected in the current state of practice, while the challenge of handling differences of opinion and debate...

Challenges and perspectives of nanoparticle exposure assessment.

Science.gov (United States)

Lee, Ji Hyun; Moon, Min Chaul; Lee, Joon Yeob; Yu, Il Je

2010-06-01

Nanoparticle exposure assessment presents a unique challenge in the field of occupational and environmental health. With the commercialization of nanotechnology, exposure usually starts from the workplace and then spreads to environment and consumer exposure. This report discusses the current trends of nanoparticle exposure assessment, including the definition of nanotechnology relevant terms, essential physicochemical properties for nanomaterial characterization, current international activities related nanomaterial safety, and exposure assessment standard development for nanotechnology. Further this report describes challenges of nanoparticle exposure assessment such as background measurement, metrics of nanoparticle exposure assessment and personal sampling.

Comparison of acetazolamide-enhanced brain SPECT using Tc-99m ECD with cerebral angiography in patients with cerebrovascular disease

International Nuclear Information System (INIS)

Choi, Y. Y.; Moon, D. H.; Ryu, J. S.; Yang, S. H.; Lee, H. K.; Lee, J. H.; Kim, J. S.; Kim, K. A.

1997-01-01

Cerebral vascular reserve can be assessed by development of collateral channels (DCC) on cerebral angiography(CA) or vasoreactivity (VR) on acetazolamide-enhanced brain SPECT (ACZ-SPECT). The purpose of this study was to compare Tc-99m ECD ACZ-SPECT with CA in the evaluation of vascular reserve in patients (pts) with cerebrovascular disease(CVD). Twenty seven patients with CVD, including TIA (n=13), infarction (n=11) and asymptomatic pts (AS, n=3), underwent CA and ACZ-SPECT. Basal and ACZ-SPECT was obtained consecutively, and image subtraction was performed. On CA, degree of DCC was scored 0-3 (0: normal, 3: poor) according to parenchymal staining on delayed film. In ACZ-SPECT, decrease of VR was graded 0-3 (0: normal, 3: more than 30% decrease). The correlation between degree of stenosis, DCC and VR were analyzed. 1) Variable degree of VR or DCC was observed in totally occluded or stenotic cerebral arterial territories. 2) In arterial territories with poor DCC, ACZ-SPECT showed poor VR. However, in 5 out of 11 TIA or AS with good DCC, poor VR was observed. These data suggests that 1) cerebral hemodynamic status cannot be assessed by the degree of stenosis on CA alone. 2) DCC may overestimate the cerebral vascular reserve in patients with TIA or AS. 3) ACZ-SPECT plays a complementary role to CA for evaluation of cerebral hemodynamic status in pts with CVD

Acetazolamide-augmented dynamic BOLD (aczBOLD imaging for assessing cerebrovascular reactivity in chronic steno-occlusive disease of the anterior circulation: An initial experience

Directory of Open Access Journals (Sweden)

Junjie Wu

2017-01-01

Full Text Available The purpose of this study was to measure cerebrovascular reactivity (CVR in chronic steno-occlusive disease using a novel approach that couples BOLD imaging with acetazolamide (ACZ vasoreactivity (aczBOLD, to evaluate dynamic effects of ACZ on BOLD and to establish the relationship between aczBOLD and dynamic susceptibility contrast (DSC perfusion MRI. Eighteen patients with unilateral chronic steno-occlusive disease of the anterior circulation underwent a 20-min aczBOLD imaging protocol, with ACZ infusion starting at 5 min of scan initiation. AczBOLD reactivity was calculated on a voxel-by-voxel basis to generate CVR maps for subsequent quantitative analyses. Reduced CVR was observed in the diseased vs. the normal hemisphere both by qualitative and quantitative assessment (gray matter (GM: 4.13% ± 1.16% vs. 4.90% ± 0.98%, P = 0.002; white matter (WM: 2.83% ± 1.23% vs. 3.50% ± 0.94%, P = 0.005. In all cases BOLD signal began increasing immediately following ACZ infusion, approaching a plateau at ~8.5 min after infusion, with the tissue volume of reduced augmentation increasing progressively with time, peaking at 2.60 min (time range above 95% of the maximum value: 0–4.43 min for the GM and 1.80 min (time range above 95% of the maximum value: 1.40–3.53 min for the WM. In the diseased hemisphere, aczBOLD CVR significantly correlated with baseline DSC time-to-maximum of the residue function (Tmax (P = 0.008 for the WM and normalized cerebral blood flow (P = 0.003 for the GM, and P = 0.001 for the WM. AczBOLD provides a novel, safe, easily implementable approach to CVR measurement in the routine clinical environments. Further studies can establish quantitative thresholds from aczBOLD towards identification of patients at heightened risk of recurrent ischemia and cognitive decline.

Correlative assessment of cerebral blood flow obtained with perfusion CT and positron emission tomography in symptomatic stenotic carotid disease

Energy Technology Data Exchange (ETDEWEB)

Bisdas, Sotirios [JWG University Hospital, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Nemitz, Ole; Becker, Hartmut; Donnerstag, Frank [Hannover Medical School, Department of Neuroradiology, Hannover (Germany); Berding, Georg [Hannover Medical School, Department of Nuclear Medicine, Hannover (Germany); Weissenborn, Karin; Ahl, Bjoern [Hannover Medical School, Department of Neurology, Hannover (Germany)

2006-10-15

Twelve patients with ICA stenosis underwent dynamic perfusion computed tomography (CT) and positron emission tomography (PET) studies at rest and after acetazolamide challenge. Cerebral blood flow (CBF) maps on perfusion CT resulted from a deconvolution of parenchymal time-concentration curves by an arterial input function (AIF) in the anterior cerebral artery as well as in both anterior choroidal arteries. CBF was measured by [{sup 15}O]H{sub 2}O PET using multilinear least-squares minimization procedure based on the one-compartment model. In corresponding transaxial PET scans, CBF values were extracted using standardized ROIs. The baseline perfusion CT-CBF values were lower in perfusion CT than in PET (P>0.05). CBF values obtained by perfusion CT were significantly correlated with those measured by PET before (P<0.05) and after (P<0.01) acetazolamide challenge. Nevertheless, the cerebrovascular reserve capacity was overestimated (P=0.05) using perfusion CT measurements. The AIF selection relative to the side of carotid stenosis did not significantly affect calculated perfusion CT-CBF values. In conclusion, the perfusion CT-CBF measurements correlate significantly with the PET-CBF measurements in chronic carotid stenotic disease and contribute useful information to the evaluation of the altered cerebral hemodynamics. (orig.)

Correlative assessment of cerebral blood flow obtained with perfusion CT and positron emission tomography in symptomatic stenotic carotid disease

International Nuclear Information System (INIS)

Bisdas, Sotirios; Nemitz, Ole; Becker, Hartmut; Donnerstag, Frank; Berding, Georg; Weissenborn, Karin; Ahl, Bjoern

2006-01-01

Twelve patients with ICA stenosis underwent dynamic perfusion computed tomography (CT) and positron emission tomography (PET) studies at rest and after acetazolamide challenge. Cerebral blood flow (CBF) maps on perfusion CT resulted from a deconvolution of parenchymal time-concentration curves by an arterial input function (AIF) in the anterior cerebral artery as well as in both anterior choroidal arteries. CBF was measured by [ 15 O]H 2 O PET using multilinear least-squares minimization procedure based on the one-compartment model. In corresponding transaxial PET scans, CBF values were extracted using standardized ROIs. The baseline perfusion CT-CBF values were lower in perfusion CT than in PET (P>0.05). CBF values obtained by perfusion CT were significantly correlated with those measured by PET before (P<0.05) and after (P<0.01) acetazolamide challenge. Nevertheless, the cerebrovascular reserve capacity was overestimated (P=0.05) using perfusion CT measurements. The AIF selection relative to the side of carotid stenosis did not significantly affect calculated perfusion CT-CBF values. In conclusion, the perfusion CT-CBF measurements correlate significantly with the PET-CBF measurements in chronic carotid stenotic disease and contribute useful information to the evaluation of the altered cerebral hemodynamics. (orig.)

Health technology assessment in Iran: challenges and views

Science.gov (United States)

Olyaeemanesh, Alireza; Doaee, Shila; Mobinizadeh, Mohammadreza; Nedjati, Mina; Aboee, Parisa; Emami-Razavi, Seyed Hassan

2014-01-01

Background: Various decisions have been made on technology application at all levels of the health system in different countries around the world. Health technology assessment is considered as one of the best scientific tools at the service of policy- makers. This study attempts to investigate the current challenges of Iran’s health technology assessment and provide appropriate strategies to establish and institutionalize this program. Methods: This study was carried out in two independent phases. In the first, electronic databases such as Medline (via Pub Med) and Scientific Information Database (SID) were searched to provide a list of challenges of Iran’s health technology assessment. The views and opinions of the experts and practitioners on HTA challenges were studied through a questionnaire in the second phase which was then analyzed by SPSS Software version 16. This has been an observational and analytical study with a thematic analysis. Results: In the first phase, seven papers were retrieved; from which, twenty- two HTA challenges in Iran were extracted by the researchers; and they were used as the base for designing a structured questionnaire of the second phase. The views of the experts on the challenges of health technology assessment were categorized as follows: organizational culture, stewardship, stakeholders, health system management, infrastructures and external pressures which were mentioned in more than 60% of the cases and were also common in the views. Conclusion: The identification and prioritization of HTA challenges which were approved by those experts involved in the strategic planning of the Department of Health Technology Assessment will be a step forward in the promotion of an evidence- based policy- making and in the production of comprehensive scientific evidence. PMID:25695015

Current Status and Challenges in Wind Energy Assessment

DEFF Research Database (Denmark)

Gryning, Sven-Erik; Badger, Jake; Hahmann, Andrea N.

2014-01-01

Here we discuss the status and challenges in the development of atlases for the assessment of the regional and global wind resources. The text more specifically describes a methodology that is under development at DTU Wind Energy in Denmark. As the wind assessment is based on mesoscale modelling,......, some of the specific challenges in mesoscale modelling for wind energy purposes are discussed such as wind profiles and long-term statistics of the wind speed time series. Solutions to these challenges will help secure an economic and effective deployment of wind energy....

Assessment of the hemodynamic changes after EDAS combined with bifrontal EGS in pediatric patients with moyamoya disease

Energy Technology Data Exchange (ETDEWEB)

Song, Yoo Sung; Kim, Yu Kyeong; Lee, Jae Sung; Kim, Seung Ki; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

2007-07-01

To assess the effect of encephaloduroarteriosynangiosis (EDAS) with or without bifrontal encephalogaleosynangiosis (EGS) in children with moyamoya disease, we evaluated cerebral hemodynamic changes using brain Tc-99m HMPAO SPECT. Total 34 pediatric patients (M: F=12:22, mean age;93 yrs) enrolled. Bypass surgery for both hemispheres (EDAS with EGS on one side, and EDAS on the other side) in 25 patients, unilateral EDAS with EGS in 7, and unilateral EDAS only in 2 were underwent. Perfusion SPECT before surgery, and 4 to 18 months after final surgery were done. The vascular territories for ICA, MCA and the brain regions for the frontal, parietal, temporal, and the occipital cortices were determined using standard ROls based on K-SPAM. Additionally, medial frontal cortex was selected to assess the effect of EGS. Basal/acetazolamide challenged cerebral blood flow (CBF), and cerebral vascular index (CVRI) were determined using normalized regional brain uptake to the cerebellum. 24 patients became symptom free, and 6 were improved but having some residual symptoms at the last follow up period. The other 3 were worsened after operation. Overall basal/acetazolamide stress CBF and CVRI for each brain region after surgery were increased, however, only the changes of CVRI were significant. Meanwhile, the improvement of CBF or CVRI in the brain regions ipsilateral to the hemisphere having EDAS with EGS was not significantly different when compared with those for the brain regions with EDAS only. Also, the hemodynamic improvement for the mesial frontal cortex in patients after EDAS with EGS was not significant, and showed no difference with those in patient with EDAS only. Quantitative perfusion SPECT demonstrated the hemodynamic improvement after EDAS with or without EGS in pediatric moyamoya disease. Cerebrovascular reserve showed meaningful improvement after surgery, implicating the effect of vascular anastomosis in ischemic areas.

Assessment of the hemodynamic changes after EDAS combined with bifrontal EGS in pediatric patients with moyamoya disease

International Nuclear Information System (INIS)

Song, Yoo Sung; Kim, Yu Kyeong; Lee, Jae Sung; Kim, Seung Ki; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul

2007-01-01

To assess the effect of encephaloduroarteriosynangiosis (EDAS) with or without bifrontal encephalogaleosynangiosis (EGS) in children with moyamoya disease, we evaluated cerebral hemodynamic changes using brain Tc-99m HMPAO SPECT. Total 34 pediatric patients (M: F=12:22, mean age;93 yrs) enrolled. Bypass surgery for both hemispheres (EDAS with EGS on one side, and EDAS on the other side) in 25 patients, unilateral EDAS with EGS in 7, and unilateral EDAS only in 2 were underwent. Perfusion SPECT before surgery, and 4 to 18 months after final surgery were done. The vascular territories for ICA, MCA and the brain regions for the frontal, parietal, temporal, and the occipital cortices were determined using standard ROls based on K-SPAM. Additionally, medial frontal cortex was selected to assess the effect of EGS. Basal/acetazolamide challenged cerebral blood flow (CBF), and cerebral vascular index (CVRI) were determined using normalized regional brain uptake to the cerebellum. 24 patients became symptom free, and 6 were improved but having some residual symptoms at the last follow up period. The other 3 were worsened after operation. Overall basal/acetazolamide stress CBF and CVRI for each brain region after surgery were increased, however, only the changes of CVRI were significant. Meanwhile, the improvement of CBF or CVRI in the brain regions ipsilateral to the hemisphere having EDAS with EGS was not significantly different when compared with those for the brain regions with EDAS only. Also, the hemodynamic improvement for the mesial frontal cortex in patients after EDAS with EGS was not significant, and showed no difference with those in patient with EDAS only. Quantitative perfusion SPECT demonstrated the hemodynamic improvement after EDAS with or without EGS in pediatric moyamoya disease. Cerebrovascular reserve showed meaningful improvement after surgery, implicating the effect of vascular anastomosis in ischemic areas

Functional improvement after carotid endarterectomy: demonstrated by gait analysis and acetazolamide stress brain perfusion SPECT

International Nuclear Information System (INIS)

Kim, J. S.; Kim, G. E.; Yoo, J. Y.; Kim, D. G.; Moon, D. H.

2005-01-01

Scientific documentation of neurologic improvement following carotid endarterectomy (CEA) has not been established. The purpose of this prospective study is to investigate whether CEA performed for the internal carotid artery flow lesion improves gait and cerebrovascular hemodynamic status in patients with gait disturbance. We prospectively performed pre- and postCEA gait analysis and acetazolamide stress brain perfusion SPECT (Acz-SPECT) with Tc-99m ECD in 91 patients (M/F: 81/10, mean age: 64.1 y) who had gait disturbance before receiving CEA. Gait performance was assessed using a Vicon 370 motion analyzer. The gait improvement after CEA was correlated to cerebrovascular hemodynamic change as well as symptom duration. 12 hemiparetic stroke patients (M/F=9/3, mean age: 51 y) who did not receive CEA as a control underwent gait analysis twice in a week interval to evaluate whether repeat testing of gait performance shows learning effect. Of 91 patients, 73 (80%) patients showed gait improvement (change of gait speed > 10%) and 42 (46%) showed marked improvement (change of gait speed > 20%), but no improvement was observed in control group at repeat test. Post-operative cerebrovascular hemodynamic improvement was noted in 49 (54%) of 91 patients. There was marked gait improvement in patients group with cerebrovascular hemodynamic improvement compared to no change group (p<0.05). Marked gait improvement and cerebrovascular hemodynamic improvement were noted in 53% and 61% of the patient who had less than 3 month history of symptom compared to 31% and 24% of the patients who had longer than 3 months, respectively (p<0.05). Marked gait improvement was obtained in patients who had improvement of cerebrovascular hemodynamic status on Acz-SPECT after CEA. These results suggest functional improvement such as gait can result from the improved perfusion of misery perfusion area, which is viable for a longer period compared to literatures previously reported

Microwave assisted synthesis of some novel acetazolamide cyclocondensed 1,2,3,4-tetrahydropyrimidines as a potent antimicrobial and cytotoxic agents

Directory of Open Access Journals (Sweden)

Karthikeyan Elumalai

2014-03-01

Full Text Available A new series of some novel acetazolamide cyclocondensed 1,2,3,4-tetrahydropyrimidines was prepared by reacting of N-{[5-(acetylamino-1,3,4-thiadiazol-2-yl]sulfonyl}-3-oxobutanamide with urea/thiourea and appropriate aldehyde in the presence of catalytic amount of laboratory made p-toluenesulfonic acid as an efficient catalyst. Confirmation of the chemical structure of the synthesized compounds (12a–n was substantiated by TLC, different spectral data IR, 1H NMR, Mass spectra and elemental analysis were done. The synthesized compounds were evaluated for in-vitro antimicrobial and cytotoxicity against Bacillus subtilis, Escherichia coli and Vero cells. The titled compounds exhibited weak, moderate, or high in-vitro antimicrobial and cytotoxicity. Compounds 12c, 12d, 12g and 12h, exhibited potential antimicrobial and in-vitro cytotoxicity.

Environmental assessment: challenges and opportunities

International Nuclear Information System (INIS)

Hilbig, J.; Moffett, D.; Beri, K.

2007-01-01

As part of a $4.5 billion investment,Bruce Power is refurbishing Bruce A Units 1 and 2, having successfully completed an environmental assessment to return these units to service after a lay-up of almost 10 years. The project includes implementing a series of refurbishments and upgrades which will enhance safety, increase electricity generation capacity and improve reliability for the 30-year extended life of the units. This paper describes four challenges that were successfully managed during the extensive environmental assessment: (i) defining the scope of the Project; (ii) understanding the EA trigger under the Canadian Environmental Assessment Act; (iii) maintaining an effective relationship with the regulatory agencies; and (iv) managing stakeholder communications. (author)

Environmental assessment: challenges and opportunities

International Nuclear Information System (INIS)

Hilbig, J.; Moffett, D.; Beri, K.

2007-01-01

As part of a $4.5 billion investment, Bruce Power is refurbishing Bruce A Units 1 and 2, having successfully completed an environmental assessment to return these units to service after a lay-up of almost 10 years. The project includes implementing a series of refurbishments and upgrades which will enhance safety, increase electricity generation capacity and improve reliability for the 30-year extended life of the units. This paper describes four challenges that were successfully managed during the extensive environmental assessment: (i) defining the scope of the Project; (ii) understanding the EA trigger under the Canadian Environmental Assessment Act; (iii) maintaining an effective relationship with the regulatory agencies; and (iv) managing stakeholder communications. (author)

Effect of bypass on the motor activation SPECT compared to the acetazolamide SPECT

International Nuclear Information System (INIS)

Kawaguchi, Shoichiro; Iwahashi, Hideaki; Sakaki, Toshisuke; Imai, Teruhiko; Ohishi, Hajime

2002-01-01

The authors evaluated and analyzed motor activation single photon emission computed tomography (M-SPECT) in ischemic cerebrovascular disease compared to resting and acetazolamide (ACZ) activated SPECT studies. Seventeen cases with STA-MCA bypass performed for ischemic cerebrovascular disease were examined. The SPECT studies consisting of resting, ACZ activation, and motor activation stages were performed before bypass, at 1 month, and 3 months after bypass. The result of the M-SPECT was expressed as negative or positive. Before bypass: In all 17 cases, SPECT studies of the affected side showed reduction of resting cerebral blood flow (CBF) and reduction of cerebrovascular reserve capacity (CVRC). Eight cases were positive in the M-SPECT study. One week after bypass: The resting CBF increased in seven cases. Four showed preoperative positive M-SPECT. Eight cases showed improvement of the CVRC. Twelve cases were positive in M-SPECT, and two were negative in the preoperative M-SPECT. Three months after bypass: Thirteen cases showed improvement in the resting CBF, and fourteen cases showed improvement of the CVRC. Fourteen cases were positive in the M-SPECT, and among these, 6 were negative in the preoperative M-SPECT. There was a discrepancy between the improvement in CVRC and M-SPECT. M-SPECT study can provide information about the degree of hemodynamic compromise and effect of bypass surgery. (author)

Effect of bypass on the motor activation SPECT compared to the acetazolamide SPECT

Energy Technology Data Exchange (ETDEWEB)

Kawaguchi, Shoichiro; Iwahashi, Hideaki; Sakaki, Toshisuke; Imai, Teruhiko; Ohishi, Hajime [Nara Medical Univ., Kashihara (Japan)

2002-03-01

The authors evaluated and analyzed motor activation single photon emission computed tomography (M-SPECT) in ischemic cerebrovascular disease compared to resting and acetazolamide (ACZ) activated SPECT studies. Seventeen cases with STA-MCA bypass performed for ischemic cerebrovascular disease were examined. The SPECT studies consisting of resting, ACZ activation, and motor activation stages were performed before bypass, at 1 month, and 3 months after bypass. The result of the M-SPECT was expressed as negative or positive. Before bypass: In all 17 cases, SPECT studies of the affected side showed reduction of resting cerebral blood flow (CBF) and reduction of cerebrovascular reserve capacity (CVRC). Eight cases were positive in the M-SPECT study. One week after bypass: The resting CBF increased in seven cases. Four showed preoperative positive M-SPECT. Eight cases showed improvement of the CVRC. Twelve cases were positive in M-SPECT, and two were negative in the preoperative M-SPECT. Three months after bypass: Thirteen cases showed improvement in the resting CBF, and fourteen cases showed improvement of the CVRC. Fourteen cases were positive in the M-SPECT, and among these, 6 were negative in the preoperative M-SPECT. There was a discrepancy between the improvement in CVRC and M-SPECT. M-SPECT study can provide information about the degree of hemodynamic compromise and effect of bypass surgery. (author)

Formulation design of oral pediatric Acetazolamide suspension: dose uniformity and physico-chemical stability study.

Science.gov (United States)

Santoveña, Ana; Suárez-González, Javier; Martín-Rodríguez, Cristina; Fariña, José B

2017-03-01

The formulation of an active pharmaceutical ingredient (API) as oral solution or suspension in pediatrics is a habitual practice, due to the non-existence of many commercialized medicines in pediatric doses. It is also the simplest way to prepare and administer them to this vulnerable population. The design of a formulation that assures the dose and the system stability depends on the physico-chemical properties of the API. In this study, we formulate a class IV API, Acetazolamide (AZM) as suspension for oral administration to pediatric population. The suspension must comply attributes of quality, safety and efficacy for this route of administration. We use simple compounding procedures, as well as fewer pure excipients, as recommended for children. Mass and uniformity content assays and physical and chemical stability studies were performed. To quantify the API an UPLC method was used. We verified the physico-chemical stability of the suspensions and that they passed the mass test of the European Pharmacopeia (EP), but not the dose uniformity test. This reveals that AZM must be formulated as liquid forms with a more complex system of excipients (not usually indicated in pediatrics), or otherwise solid forms capable of assuring uniformity of mass and dose for every dosage unit.

Evaluation of the cerebral vasodilatory capacity by the acetazolamide test before EC-IC bypass surgery in patients with occlusion of the internal carotid artery

DEFF Research Database (Denmark)

Vorstrup, S; Brun, B; Lassen, N A

1986-01-01

Cerebral blood flow (CBF) was measured by xenon-133 inhalation tomography in 18 patients with cerebrovascular disease before and 4 months after extracranial-intracranial bypass surgery. Only patients who showed a reduced CBF in areas that were intact on the CT scan and relevant to the clinical...... the patients with a compromised collateral circulation and hence reduced CBF due to reduced perfusion pressure, a cerebral vasodilatory stress test was performed using acetazolamide (Diamox). In normal subjects, Diamox has been shown to increase tomographic CBF without change of the flow distribution...... pathways. However, an increase in the regional vasodilatory capacity was observed postoperatively in the majority of patients....

A Direct Assessment of Obesogenic Built Environments: Challenges and Recommendations

International Nuclear Information System (INIS)

Gasevic, D.; Vukmirovich, N.; Lear, S.A.; Salim Yusuf; Teo, K.; Chow, C.; Dagenais, G.

2011-01-01

This paper outlines the challenges faced during direct built environment (BE) assessments of 42 Canadian communities of various income and urbanization levels. In addition, we recommend options for overcoming such challenges during BE community assessments. Direct BE assessments were performed utilizing two distinct audit methods: (1) modified version of Irvine-Minnesota Inventory in which a paper version of an audit tool was used to assess BE features and (2) a Physical Activity and Nutrition Features audit tool, where the presence and positions of all environmental features of interest were recorded using a Global-Positioning-System (GPS) unit. This paper responds to the call for the need of creators and users of environmental audit tools to share experiences regarding the usability of tools for BE assessments. The outlined BE assessment challenges plus recommendations for overcoming them can help improve and refine the existing audit tools and aid researchers in future assessments of the BE

Challenge Course Facilitator Technical Skills Assessment Tool Mark

Science.gov (United States)

Wagstaff, William Quinn

2007-01-01

A study was conducted to develop a technical skills assessment tool for the training and development of challenge course facilitators. Researchers accessed two professional on-line listserves to collect a sample size of twenty-seven currently used technical skills assessment tools. The assessment tools were critically analysed by three independent…

Challenges and Praxis in Assessment of Congenital Deafblindness

DEFF Research Database (Denmark)

Dammeyer, Jesper

2017-01-01

The different practices and challenges of assessment of congenital deafblindness have been discussed in the research literature and are reflected in different medical and functional approaches across the world. The aim of this study is to provide an overview of the use of both medical and functio......The different practices and challenges of assessment of congenital deafblindness have been discussed in the research literature and are reflected in different medical and functional approaches across the world. The aim of this study is to provide an overview of the use of both medical...... and functional assessment practices in a Danish sample of 95 adults with congenital deafblindness. Of the participants in this study, 54% reported regular medical assessment of vision loss, 36% reported regular medical assessment of hearing loss, and 43% reported regular functional assessment by use of video......-analysis/observation. Variability in assessment frequency was found, ranging from several times per year to less than once per year. Further, gender, age, ADL abilities, deafblind severity and counselling service were each found to be associated with differences in assessment practice. Findings are discussed and compared...

Challenges and Perspectives of Nanoparticle Exposure Assessment

OpenAIRE

Lee, Ji Hyun; Moon, Min Chaul; Lee, Joon Yeob; Yu, Il Je

2010-01-01

Nanoparticle exposure assessment presents a unique challenge in the field of occupational and environmental health. With the commercialization of nanotechnology, exposure usually starts from the workplace and then spreads to environment and consumer exposure. This report discusses the current trends of nanoparticle exposure assessment, including the definition of nanotechnology relevant terms, essential physicochemical properties for nanomaterial characterization, current international activi...

Acetazolamide Inhibits the Level of Tyrosinase and Melanin: An Enzyme Kinetic, In Vitro, In Vivo, and In Silico Studies.

Science.gov (United States)

Abbas, Qamar; Raza, Hussain; Hassan, Mubashir; Phull, Abdul Rehman; Kim, Song Ja; Seo, Sung-Yum

2017-09-01

Melanin is the major factor that determines skin color and protects from ultraviolet radiation. In present study we evaluated the anti-melanogenesis effect of acetazolamide (ACZ) using four different approaches: enzyme kinetic, in vitro, in vivo and in silico. ACZ demonstrated significant inhibitory activity (IC 50 7.895 ± 0.24 μm) against tyrosinase as compared to the standard drug kojic acid (IC 50 16.84 ± 0.64 μm) and kinetic analyses showed that ACZ is a non-competitive inhibitor without cytotoxic effect. In in vitro experiments, A375 human melanoma cells were treated with 20 or 40 μm of ACZ with or without 50 μm of l-DOPA. Western blot results showed that ACZ significantly (P melanin and it could be used as a lead for developing the drugs for hyperpigmentary disorders and skin whitening. © 2017 Wiley-VHCA AG, Zurich, Switzerland.

Effectiveness of acetazolamide for reversal of metabolic alkalosis in weaning COPD patients from mechanical ventilation.

Science.gov (United States)

Faisy, Christophe; Mokline, Amel; Sanchez, Olivier; Tadié, Jean-Marc; Fagon, Jean-Yves

2010-05-01

To evaluate the effects of a single daily dose of acetazolamide (ACET) on metabolic alkalosis and respiratory parameters in weaning chronic obstructive pulmonary disease (COPD) patients from invasive mechanical ventilation. Case-control study. An 18-bed intensive care unit (ICU) in a university hospital. Twenty-six intubated COPD patients with mixed metabolic alkalosis (serum bicarbonate >26 mmol/l and arterial pH >or=7.38) were compared with a historical control group (n = 26) matched for serum bicarbonate, arterial pH, age, and severity of illness at admission to ICU. ACET administration (500 mg intravenously) was monitored daily according to arterial blood gas analysis from readiness to wean until extubation. ACET was administered 4 (1-11) days throughout the weaning period. Patients with ACET treatment significantly decreased their serum bicarbonate (p = 0.01 versus baseline) and arterial blood pH (p respiratory parameters except PaO(2)/FiO(2) ratio (p = 0.03). ACET patients and their matched controls had similar duration of weaning. Extubation success rate was not significantly different between groups, and causes of reintubation were comparable. ACET used at the dosage of 500 mg per day reduces metabolic alkalosis but has no benefit in terms of improving PaCO(2) or respiratory parameters in weaning COPD patients from mechanical ventilation.

A Perkins Challenge: Assessing Technical Skills in CTE

Science.gov (United States)

Stone, James R., III

2009-01-01

Federal law requires state to develop performance measures and data-collection systems for secondary and postsecondary technical-skill attainment. This poses many challenges, such as defining a technical skills, measurement and when to assess students. In this article, the author outlines various assessment models and looks at the challenges…

Assessing species saturation: conceptual and methodological challenges.

Science.gov (United States)

Olivares, Ingrid; Karger, Dirk N; Kessler, Michael

2018-05-07

Is there a maximum number of species that can coexist? Intuitively, we assume an upper limit to the number of species in a given assemblage, or that a lineage can produce, but defining and testing this limit has proven problematic. Herein, we first outline seven general challenges of studies on species saturation, most of which are independent of the actual method used to assess saturation. Among these are the challenge of defining saturation conceptually and operationally, the importance of setting an appropriate referential system, and the need to discriminate among patterns, processes and mechanisms. Second, we list and discuss the methodological approaches that have been used to study species saturation. These approaches vary in time and spatial scales, and in the variables and assumptions needed to assess saturation. We argue that assessing species saturation is possible, but that many studies conducted to date have conceptual and methodological flaws that prevent us from currently attaining a good idea of the occurrence of species saturation. © 2018 Cambridge Philosophical Society.

The challenges and opportunities in cumulative effects assessment

Energy Technology Data Exchange (ETDEWEB)

Foley, Melissa M., E-mail: mfoley@usgs.gov [U.S. Geological Survey, Pacific Coastal and Marine Science Center, 400 Natural Bridges, Dr., Santa Cruz, CA 95060 (United States); Center for Ocean Solutions, Stanford University, 99 Pacific St., Monterey, CA 93940 (United States); Mease, Lindley A., E-mail: lamease@stanford.edu [Center for Ocean Solutions, Stanford University, 473 Via Ortega, Stanford, CA 94305 (United States); Martone, Rebecca G., E-mail: rmartone@stanford.edu [Center for Ocean Solutions, Stanford University, 99 Pacific St., Monterey, CA 93940 (United States); Prahler, Erin E. [Center for Ocean Solutions, Stanford University, 473 Via Ortega, Stanford, CA 94305 (United States); Morrison, Tiffany H., E-mail: tiffany.morrison@jcu.edu.au [ARC Centre of Excellence for Coral Reef Studies, James Cook University, Townsville, QLD, 4811 (Australia); Murray, Cathryn Clarke, E-mail: cmurray@pices.int [WWF-Canada, 409 Granville Street, Suite 1588, Vancouver, BC V6C 1T2 (Canada); Wojcik, Deborah, E-mail: deb.wojcik@duke.edu [Nicholas School for the Environment, Duke University, 9 Circuit Dr., Durham, NC 27708 (United States)

2017-01-15

The cumulative effects of increasing human use of the ocean and coastal zone have contributed to a rapid decline in ocean and coastal resources. As a result, scientists are investigating how multiple, overlapping stressors accumulate in the environment and impact ecosystems. These investigations are the foundation for the development of new tools that account for and predict cumulative effects in order to more adequately prevent or mitigate negative effects. Despite scientific advances, legal requirements, and management guidance, those who conduct assessments—including resource managers, agency staff, and consultants—continue to struggle to thoroughly evaluate cumulative effects, particularly as part of the environmental assessment process. Even though 45 years have passed since the United States National Environmental Policy Act was enacted, which set a precedent for environmental assessment around the world, defining impacts, baseline, scale, and significance are still major challenges associated with assessing cumulative effects. In addition, we know little about how practitioners tackle these challenges or how assessment aligns with current scientific recommendations. To shed more light on these challenges and gaps, we undertook a comparative study on how cumulative effects assessment (CEA) is conducted by practitioners operating under some of the most well-developed environmental laws around the globe: California, USA; British Columbia, Canada; Queensland, Australia; and New Zealand. We found that practitioners used a broad and varied definition of impact for CEA, which led to differences in how baseline, scale, and significance were determined. We also found that practice and science are not closely aligned and, as such, we highlight opportunities for managers, policy makers, practitioners, and scientists to improve environmental assessment.

The challenges and opportunities in cumulative effects assessment

International Nuclear Information System (INIS)

Foley, Melissa M.; Mease, Lindley A.; Martone, Rebecca G.; Prahler, Erin E.; Morrison, Tiffany H.; Murray, Cathryn Clarke; Wojcik, Deborah

2017-01-01

The cumulative effects of increasing human use of the ocean and coastal zone have contributed to a rapid decline in ocean and coastal resources. As a result, scientists are investigating how multiple, overlapping stressors accumulate in the environment and impact ecosystems. These investigations are the foundation for the development of new tools that account for and predict cumulative effects in order to more adequately prevent or mitigate negative effects. Despite scientific advances, legal requirements, and management guidance, those who conduct assessments—including resource managers, agency staff, and consultants—continue to struggle to thoroughly evaluate cumulative effects, particularly as part of the environmental assessment process. Even though 45 years have passed since the United States National Environmental Policy Act was enacted, which set a precedent for environmental assessment around the world, defining impacts, baseline, scale, and significance are still major challenges associated with assessing cumulative effects. In addition, we know little about how practitioners tackle these challenges or how assessment aligns with current scientific recommendations. To shed more light on these challenges and gaps, we undertook a comparative study on how cumulative effects assessment (CEA) is conducted by practitioners operating under some of the most well-developed environmental laws around the globe: California, USA; British Columbia, Canada; Queensland, Australia; and New Zealand. We found that practitioners used a broad and varied definition of impact for CEA, which led to differences in how baseline, scale, and significance were determined. We also found that practice and science are not closely aligned and, as such, we highlight opportunities for managers, policy makers, practitioners, and scientists to improve environmental assessment.

The challenges and opportunities in cumulative effects assessment

Science.gov (United States)

Foley, Melissa M.; Mease, Lindley A; Martone, Rebecca G; Prahler, Erin E; Morrison, Tiffany H; Clarke Murray, Cathryn; Wojcik, Deborah

2016-01-01

The cumulative effects of increasing human use of the ocean and coastal zone have contributed to a rapid decline in ocean and coastal resources. As a result, scientists are investigating how multiple, overlapping stressors accumulate in the environment and impact ecosystems. These investigations are the foundation for the development of new tools that account for and predict cumulative effects in order to more adequately prevent or mitigate negative effects. Despite scientific advances, legal requirements, and management guidance, those who conduct assessments—including resource managers, agency staff, and consultants—continue to struggle to thoroughly evaluate cumulative effects, particularly as part of the environmental assessment process. Even though 45 years have passed since the United States National Environmental Policy Act was enacted, which set a precedent for environmental assessment around the world, defining impacts, baseline, scale, and significance are still major challenges associated with assessing cumulative effects. In addition, we know little about how practitioners tackle these challenges or how assessment aligns with current scientific recommendations. To shed more light on these challenges and gaps, we undertook a comparative study on how cumulative effects assessment (CEA) is conducted by practitioners operating under some of the most well-developed environmental laws around the globe: California, USA; British Columbia, Canada; Queensland, Australia; and New Zealand. We found that practitioners used a broad and varied definition of impact for CEA, which led to differences in how baseline, scale, and significance were determined. We also found that practice and science are not closely aligned and, as such, we highlight opportunities for managers, policy makers, practitioners, and scientists to improve environmental assessment.

Quantitative assessment of blood flow reserve using {sup 99m}Tc-HMPAO in carotid stenosis

Energy Technology Data Exchange (ETDEWEB)

Garai, I.; Varga, J.; Galuska, L. [Department of Nuclear Medicine, University of Debrecen Medical and Health Centre, Debrecen (Hungary); Szomjak, E. [3. Department of Internal Medicine, University of Debrecen Medical and Health Centre, Debrecen (Hungary); Toth, C.; Olvaszto, S. [1. Department of Surgery, University of Debrecen Medical and Health Centre, Debrecen (Hungary); Bank, J. [Department of Neurology, Kenezy Hospital (Hungary); Ficzere, A. [Department of Neurology, University of Debrecen Medical and Health Centre, Debrecen (Hungary)

2002-02-01

Dynamic imaging of the inflow of technetium-99m hexamethylpropylene amine oxime (HMPAO) to the brain has been proved to allow estimation of the hemispherical cerebral blood flow (CBF) using the Patlak plot. In this study, we compared the hemispherical CBF (in ml/min/100 g) of different patient groups. A total of 25 patients (comprising 13 with migraine and 12 scheduled for endarterectomy owing to angiographically confirmed severe stenosis of the internal carotid artery on at least one side) underwent baseline and acetazolamide {sup 99m}Tc-HMPAO brain perfusion studies. In addition, acetazolamide {sup 99m}Tc-HMPAO studies were performed in 12 healthy subjects (no baseline study was performed for ethical reasons.) Dynamic studies were acquired by means of a dual-detector gamma camera with a large field of view (HELIX, Elscint). Special difference images were created to make definition of the aortic arch and hemispherical brain regions easier and more reproducible. A semi-automatic method was developed to determine the transit time from the aorta to the brain, making the generation of the Patlak plot even more robust. The baseline CBF values did not significantly depend on the disease (P>0.1), whereas the CBF values obtained after acetazolamide provocation did do so (ANOVA, P<0.001). Patients suffering from migraine showed a significant increase in global CBF values after acetazolamide provocation (paired t test, P<0.05), but we could not find any effect of the provocation in patients awaiting carotid endarterectomy, indicating a lack of cerebrovascular reserve capacity. Comparison of the results of the acetazolamide study in patients and the control group revealed the CBF values to be significantly lower in patients with carotid stenosis (two-sample t-test, P<0.001), but not in those with migraine (P>0.1). In summary, using quantitative analysis of {sup 99m}Tc-HMPAO brain studies we could objectively compare the CBF of patients suffering from different diseases

Effect of acetazolamide on post-NIV metabolic alkalosis in acute exacerbated COPD patients.

Science.gov (United States)

Fontana, V; Santinelli, S; Internullo, M; Marinelli, P; Sardo, L; Alessandrini, G; Borgognoni, L; Ferrazza, A M; Bonini, M; Palange, P

2016-01-01

Non-invasive ventilation (NIV) is an effective treatment in patients with acute exacerbation of COPD (AECOPD). However, it may induce post-hypercapnic metabolic alkalosis (MA). This study aims to evaluate the effect of acetazolamide (ACET) in AECOPD patients treated with NIV. Eleven AECOPD patients, with hypercapnic respiratory failure and MA following NIV, were treated with ACET 500 mg for two consecutive days and compared to a matched control group. Patients and controls were non invasively ventilated in a bilevel positive airway pressure (BiPAP) mode to a standard maximal pressure target of 15-20 cmH2O. ACET intra-group analysis showed a significant improvement for PaCO2 (63.9 ± 9.8 vs. 54.9 ± 8.3 mmHg), HCO3- (43.5 ± 5.9 vs. 36.1 ± 5.4 mmol/L) and both arterial pH (7.46 ± 0.06 vs. 7.41 ± 0.06) and urinary pH (6.94 ± 0.77 vs 5.80 ± 0.82), already at day 1. No significant changes in endpoints considered were observed in the control group at any time-point. Inter-group analysis showed significant differences between changes in PaCO2 and HCO3- (delta), both at day 1 and 2. Furthermore, the length of NIV treatment was significantly reduced in the ACET group compared to controls (6 ± 8 vs. 19 ± 19 days). No adverse events were recorded in the ACET and control groups. ACET appears to be effective and safe in AECOPD patients with post-NIV MA.

Usefulness of rate of increase in SPECT counts in one-day method of N-isopropyl-4-iodoamphetamine [123I] SPECT studies at rest and after acetazolamide challenge using a method for estimating time-dependent distribution at rest

International Nuclear Information System (INIS)

Kawamura, Yoshifumi; Ashizaki, Michio; Saida, Shoko; Sugimoto, Hideharu

2008-01-01

When N-isopropyl-4-iodoamphetamine ( 123 I-IMP) single-photon emission computed tomography (SPECT) studies at rest and after acetazolamide (ACZ) challenge are conducted in a day, the time-dependent change in IMP in the brain at rest should be estimated accurately. We devised the method and investigated whether our one-day method for measuring the rate of increase in SPECT counts allowed reduction in the acquisition time. Sequential, 5-min SPECT scans were performed. We estimated the time-dependent change in the brain using the change in slopes of two linear equations derived from the first three SPECT counts. For the one-day method, ACZ was administered 15 min or 20 min after IMP administration. The second IMP was administered 10 min after ACZ administration. Time-dependent changes in the brain were classified into 13 patterns when estimation was started at 5 min after IMP administration and 6 patterns when estimation was started at 10 min, and fitting coefficients were determined. The correlation between actual measurements at 37.5 min and estimates was high with a correlation coefficient of 0.99 or greater. Rates of increase obtained from 20-min data were highly correlated with those obtained from 15-min or 10-min data (r=0.97 or greater). In patients with unilateral cerebrovascular disease, the rate of increase on the unaffected side was 44.4±10.9% when ACZ was administered 15 min later and 48.0±16.0% when ACZ was administered 20 min later, and the rates of increase with different timings of administration were not significantly different. The examination time may be reduced from 50 min to 45 min or 40 min as needed. The rate of increase was not influenced by the time frame for determination or the timing of ACZ administration. These findings suggest that our estimation method is accurate and versatile. (author)

Assessment in Open and Distance Learning System (ODL: A Challenge

Directory of Open Access Journals (Sweden)

S. V. S. Chaudhary

2013-09-01

Full Text Available Assessment is an integral part of the learning process. The traditional practice of assessment has changed to meet the need of the contemporary society. In this paper assessment strategies used in Open and Distance Education are discussed and constructive suggestions are given to meet the challenges of assessment. Recently we experience a paradigm shift in assessment both in face-to-face and ODL system. Content-based testing has shifted to performance-based assessment. Assessment is no longer used for grading and certification, rather it has linked with learning and skill development of the students. Instead of a single paper pencil test, a variety of techniques and methods are being increasingly conducted. In this context assessment in the ODL system has adopted a new shape to provide better assessment judgments to its students and at the same time helping teachers and administrators. Coping with the changing scenario in ODL we face challenges addressed extensively in this article.

Audiovisual quality assessment in communications applications: Current status, trends and challenges

DEFF Research Database (Denmark)

Korhonen, Jari

2010-01-01

Audiovisual quality assessment is one of the major challenges in multimedia communications. Traditionally, algorithm-based (objective) assessment methods have focused primarily on the compression artifacts. However, compression is only one of the numerous factors influencing the perception...... addressed in practical quality metrics is the co-impact of audio and video qualities. This paper provides an overview of the current trends and challenges in objective audiovisual quality assessment, with emphasis on communication applications...

Quality of life at 6 months in the Idiopathic Intracranial Hypertension Treatment Trial.

Science.gov (United States)

Bruce, Beau B; Digre, Kathleen B; McDermott, Michael P; Schron, Eleanor B; Wall, Michael

2016-11-01

To examine the changes in vision-specific and overall health-related quality of life (QOL) at 6 months in participants with idiopathic intracranial hypertension (IIH) and mild visual loss enrolled in the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT) and to determine the signs and symptoms of IIH that mediate the effect of acetazolamide on QOL. We assessed QOL using the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25), the 10-Item NEI-VFQ-25 Neuro-Ophthalmic Supplement, and the 36-Item Short Form Health Survey (SF-36). We examined associations among changes in QOL measures over 6 months, treatment status, and changes in signs and symptoms using linear and structural equation models. Among the 165 participants with IIH (86 randomized to acetazolamide, 79 to placebo), beneficial effects of acetazolamide were seen on all QOL scales evaluated, as well as on the Near Activities (5.60 points, p = 0.03), Social Functioning (3.85 points, p = 0.04), and Mental Health (9.82, p = 0.04) subscales of the NEI-VFQ-25. Positive acetazolamide-related effects on QOL appeared to be primarily mediated by improvements in visual field, neck pain, pulsatile tinnitus, and dizziness/vertigo that outweighed the side effects of acetazolamide. The marked reductions in baseline QOL seen among patients with mild visual loss from IIH are improved by treatment with acetazolamide. When combined with acetazolamide-associated improvements in visual field and other aspects of IIH, our findings with respect to QOL provide further support from the IIHTT in favor of acetazolamide to augment a dietary intervention in the treatment of IIH with mild visual loss (clinicaltrials.gov: NCT01003639). © 2016 American Academy of Neurology.

Towards a Standardized e-Assessment System: Motivations, Challenges and First Findings

Directory of Open Access Journals (Sweden)

Denis Helic

2009-10-01

Full Text Available “Global Learning” with shared learning contents, resources, activities and goals is one of the contributions of Globalization. With the capability to use new Information and Communication Technologies (ICT it is a bit easier to have a technology based learning systems that enable learners to share the learning resources and possibilities. As a result many Learning Management Systems (LMS were developed with divers of platforms and approaches. Consequently, sharing learning resources and components has become a major challenge. E-assessment as a primary activity of any LMS is facing the same challenges and problems. In order to stand on this challenge people in the field of technology enhanced learning have recommended that LMS should conform to specific standards. This paper discuses this challenge, the consequences and limitations of standards in the modern learning settings. Moreover, it shows a service oriented framework for assessment which aims to make the e-assessment systems flexible and also to initiate the term of “Global Learning Assessment” with the possibility of sharing the e-assessment system components.

The importance and challenges of assessing cognition in Indigenous Australians.

Science.gov (United States)

Dingwall, Kylie; Cairney, Sheree

2009-08-01

The aim of this paper was to investigate the importance and challenges involved in conducting serial cognitive assessments among healthy Indigenous adolescents. Cognitive assessments were conducted at fortnightly intervals for 2 months and again at 6 and 12 months among a group of Indigenous students from a boarding school in the Northern Territory. These students were to be the healthy control group in a long-term study of substance abuse. Recruitment and attrition rates were reviewed and related challenges for assessing participants were identified. From the recruited sample (n=49), 18% reported heavy or frequent use of alcohol, cannabis or petrol. Males were more likely to have used these substances compared to females. Attrition increased as the follow-up interval increased with 49 recruits reducing to 32 in the first 2 months and only 15 and 13 of the initial group remaining for the 6 and 12 month follow-ups respectively. Main challenges included (i) appropriateness of tests and assessment processes, (ii) high rates of substance abuse and other illness in the control group and (iii) high attrition rates. The importance of assessing cognition appropriately is highlighted by a lack of information regarding mental health issues in Indigenous populations.

Lessons and challenges from software quality assessment: The ...

African Journals Online (AJOL)

Lessons and challenges from software quality assessment: The case of space systems software. ... esoteric software technologies and paradigms such as object oriented development, etc. ... EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

Challenges of Big Data in Educational Assessment

Science.gov (United States)

Gibson, David C.; Webb, Mary; Ifenthaler, Dirk

2015-01-01

This paper briefly discusses four measurement challenges of data science or "big data" in educational assessments that are enabled by technology: 1. Dealing with change over time via time-based data. 2. How a digital performance space's relationships interact with learner actions, communications and products. 3. How layers of…

Challenges and Strategies for Assessing Specialised Knowledge for Teaching

Science.gov (United States)

Orrill, Chandra Hawley; Kim, Ok-Kyeong; Peters, Susan A.; Lischka, Alyson E.; Jong, Cindy; Sanchez, Wendy B.; Eli, Jennifer A.

2015-01-01

Developing and writing assessment items that measure teachers' knowledge is an intricate and complex undertaking. In this paper, we begin with an overview of what is known about measuring teacher knowledge. We then highlight the challenges inherent in creating assessment items that focus specifically on measuring teachers' specialised knowledge…

Dose response from pharmacological interventions for CBF changes in a baboon model using 99Tcm-HMPAO and SPECT

International Nuclear Information System (INIS)

Dormehl, I.C.; Hugo, N.; Oliver, D.W.

1993-01-01

This study assesses the sensitivity of the baboon model under anaesthesia to determine by single photon emission computed tomography (SPECT) and 99 Tc m -hexamethylpropyleneamine oxime (HMPAO) dose responses from drugs (acetazolamide) with known regional cerebral blood flow (rCBF) effects on humans. Three dosages of acetazolamide were chosen: 250, 500 and 750 mg. The effects of these were studied by conventional SPECT 5 min after intravenous (i.v.) administration and compared to previous studies of rCBF with the baboons under anaesthesia only. An additional study concerned the effect of 500 mg acetazolamide at 15 min after administration. Haemodynamic parameters and blood gases were also monitored. No statistically significant regional effects were noted. The largest increase in CBF (39%) was observed from 500 mg acetazolamide after 5 min. This was statistically significantly different from control values only at a 10% level of confidence; then following a 27% increase above control values after 750 mg (5 min). At 15 min 500 mg yielded values lower by 10% than the high dose. No effects were observed from 250 mg acetazolamide; only pO 2 showed changes which largely confirm the CBF findings. The model did not give significant results at a 5% level of confidence but large fluctuations were observed, also in the haemodynamic and blood gas values. At a 10% level a significant dose response was confirmed for acetazolamide. (author)

Preoperative psychological assessment of patients seeking weight-loss surgery: identifying challenges and solutions

Directory of Open Access Journals (Sweden)

Edwards-Hampton SA

2015-11-01

Full Text Available Shenelle A Edwards-Hampton,1 Sharlene Wedin2 1Department of General Surgery, Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC, 2Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA Abstract: Preoperative psychosocial assessment is the standard of care for patients seeking weight-loss surgery (WLS. However, the assessment procedure varies widely by surgery site. Comprehensive assessments can provide a wealth of information that assists both the patient and the treatment team, anticipate and prepare for challenges associated with extensive behavioral and lifestyle changes that are required postsurgery. In this review, we provide an overview of the purpose of the preoperative psychosocial assessment and domains to be included. Challenges commonly identified in the assessment are discussed, including maladaptive eating behaviors, psychiatric comorbidities, and alcohol use. Potential solutions and approaches to these challenges are provided. Additionally, patient populations requiring special consideration are presented to include adolescents, those with cognitive vulnerabilities, and aging adults. Keywords: bariatric surgery, preoperative assessment, weight-loss surgery, challenges, adolescents, older adults, cognitive impairment, maladaptive eating, alcohol misuse

Challenges in assessing the environmental fate and exposure of nano silver

International Nuclear Information System (INIS)

Whiteley, Cherrie M; Jones, Kevin C; Sweetman, Andy J; Dalla Valle, Matteo

2011-01-01

There are significant challenges in assessing the fate and exposure of nano particles (NPs) owing to the lack of information on their use and potential pathways and sinks in the environment. This paper discusses these issues using nanosilver as a case study. The approach taken is to assess the production of nanosilver, the range of products that utilise its properties, potential environmental release pathways and subsequent fate. Estimates of UK nanosilver released into the environment have been made and sewage sludge identified as an important receiving compartment. This work aims to highlight the on-going challenges faced when assessing NPs in the environment. Using nanosilver as an example, difficulties in assessing production, use and release are discussed. The study also recommends a potential approach to assess the fate and behaviour assessment of nanosilver in the environment.

Personality disorder assessment: the challenge of construct validity.

Science.gov (United States)

Clark, L A; Livesley, W J; Morey, L

1997-01-01

We begin with a review of the data that challenge the current categorical system for classifying personality disorder, focusing on the central assessment issues of convergent and discriminant validity. These data indicate that while there is room for improvement in assessment, even greater change is needed in conceptualization than in instrumentation. Accordingly, we then refocus the categorical-dimensional debate in assessment terms, and place it in the broader context of such issues as the hierarchical structure of personality, overlap and distinctions between normal and abnormal personality, sources of information in personality disorder assessment, and overlap and discrimination of trait and state assessment. We conclude that more complex conceptual models that can incorporate both biological and environmental influences on the development of adaptive and maladaptive personality are needed.

Assessment of Cerebrovascular Reserve before and after STA-MCA Bypass Surgery by SPECT and SPM Analysis

International Nuclear Information System (INIS)

O, Joo-Hyun; Jang, Kyung-Sool; Yoo, Ie-Ryung

2007-01-01

The purpose of this study was to objectively assess the efficacy of superficial temporal artery to middle cerebral artery (STA-MCA) bypass surgery using Technetium (Tc)-99m-ethyl cysteinate dimer (ECD) single photon emission computed tomography (SPECT) in patients who underwent STA-MCA bypass surgery. Brain perfusion SPECT images obtained at baseline and after the administration of acetazolamide were reconstructed using statistical parametric mapping in 23 patients, both before and after STA-MCA bypass surgery. The clinical outcomes of the surgery were also recorded and compared with the hemodynamic changes. A voxel with an uncorrected p-value of less than 0.001 was considered to be statistically significant. SPECT images of the territory supplied by the bypass graft showed an increase in both cerebrovascular flow and reserve at baseline, and the increase was significantly higher following the administration of acetazolamide. All patients showed improvement of clinical symptoms and increased blood flow to the left temporal, parietal, and frontal cortices as well as the thalamus. Brain SPECT effectively and objectively demonstrated the improved outcomes of STA-MCA bypass surgery, and thus may be used in postoperative analyses

Adverse Side Effects of Psychotropic Medication and Challenging Behavior: Pilot Work Assessing Impact.

Science.gov (United States)

Valdovinos, Maria G; Schieber, Elizabeth; McMahon, Meara; Beard, Lisa; Wilkinson, Alyssa; Carpenter, Jaimie

2017-12-01

Psychotropic medications are often prescribed to reduce challenging behavior in individuals with intellectual and developmental disabilities (IDD). Functional analyses (FAs) have demonstrated utility in assessing medication impact on behavior; however, the impact of adverse side effects (ASE) on challenging behavior is under-assessed. The purpose of this study was to develop a methodology, similar to FAs, to explore potential medication ASE impact on challenging behavior in seven individuals with IDD. Results revealed response rate differences in designed ASE conditions for most participants. Outcomes support further development and use of this methodology to assess the presence and impact of ASEs.

Assessing the persistence of pharmaceuticals in the aquatic environment: Challenges and needs

Directory of Open Access Journals (Sweden)

Qingwei Bu

2016-09-01

Full Text Available Chemical’s persistence is known to be an important parameter applied for decades to identify persistent organic pollutants in hazard and/or risk assessments. Nevertheless it is greatly challenged in the case of emerging contaminants such as pharmaceuticals because the persistence of these chemicals could be more affected by environmental conditions. This fact brings more challenges to the current system for evaluating the persistence of chemical contaminants. In this paper, challenges in assessing the persistence of pharmaceuticals were identified, and more importantly research needs were addressed based on the existing data and knowledge.

Effects of chronic acetazolamide administration on gas exchange and acid-base control in pulmonary circulation in exercising horses.

Science.gov (United States)

Vengust, M; Stämpfli, H; De Moraes, A N; Teixeiro-Neto, F; Viel, L; Heigenhauser, G

2010-11-01

Carbonic anhydrase (CA) catalyses the hydration/dehydration reaction of CO(2) and increases the rate of Cl(-) and HCO(3)(-) exchange between the erythrocytes and plasma. Therefore, chronic inhibition of CA has a potential to attenuate CO(2) output and induce greater metabolic and respiratory acidosis in exercising horses. To determine the effects of Carbonic anhydrase inhibition on CO(2) output and ionic exchange between erythrocytes and plasma and their influence on acid-base balance in the pulmonary circulation (across the lung) in exercising horses with and without CA inhibition. Six horses were exercised to exhaustion on a treadmill without (Con) and with CA inhibition (AczTr). CA inhibition was achieved with administration of acetazolamide (10 mg/kg bwt t.i.d. for 3 days and 30 mg/kg bwt before exercise). Arterial, mixed venous blood and CO(2) output were sampled at rest and during exercise. An integrated physicochemical systems approach was used to describe acid base changes. AczTr decreased the duration of exercise by 45% (P changes across the lung with exception of lactate. CO(2) and chloride changes in erythrocytes across the lung seem to be the major contributors to acid-base and ions balance in pulmonary circulation in exercising horses. © 2010 EVJ Ltd.

Challenges in implementing a Planetary Boundaries based Life-Cycle Impact Assessment methodology

DEFF Research Database (Denmark)

Ryberg, Morten; Owsianiak, Mikolaj; Richardson, Katherine

2016-01-01

of resolving the challenges and developing such methodology is discussed. The challenges are related to technical issues, i.e., modelling and including the Earth System processes and their control variables as impact categories in Life-Cycle Impact Assessment and to theoretical considerations with respect...... to the interpretation and use of Life-Cycle Assessment results in accordance with the Planetary Boundary framework. The identified challenges require additional research before a Planetary Boundaries based Life-Cycle Impact Assessment method can be developed. Research on modelling the impacts on Earth System processes......Impacts on the environment from human activities are now threatening to exceed thresholds for central Earth System processes, potentially moving the Earth System out of the Holocene state. To avoid such consequences, the concept of Planetary Boundaries was defined in 2009, and updated in 2015...

Ethical challenges in assessment centres in South Africa

Directory of Open Access Journals (Sweden)

Vuyani R. Muleya

2017-09-01

Full Text Available Orientation: Assessment Centres (ACs are used globally for the selection and development of candidates. Limited empirical evidence exists of the ethical challenges encountered in the use of ACs, especially in South Africa (SA. Research purpose: Firstly, to explore possible ethical challenges related to ACs in SA from the vantage point of the practitioner and, secondly, to search for possible solutions to these. Motivation for the study: Decisions based on AC outcomes have profound implications for participants and organisations, and it is essential to understand potential ethical challenges to minimise these, specifically in the SA context, given its socio-political history, multiculturalism, diversity and pertinent legal considerations. Research design, approach and method: A qualitative, interpretative research design was chosen. Data were collected by means of a semi-structured survey that was completed by 96 AC practitioners who attended an AC conference. Content analysis and thematic interpretation were used to make sense of the data. The preliminary findings were assessed by a focus group of purposively selected subject-matter experts (n = 16 who provided informed insights, which were incorporated into the final findings. The focus group suggested ways in which specific ethical challenges may be addressed. Main findings: The findings revealed many ethical challenges that can be better understood within a broad framework encompassing 10 themes: Universal ethical values; multicultural global contexts; the regulatory-legal framework for ACs in SA; characteristics of the assessor; psychometric properties of the AC; characteristics of the participant; bias and prejudice; governance of the AC process; ethical culture of the employer organisation and the evasive nature of ethics as a concept. Practical and managerial implications: Considerable risk exists for the unethical use of ACs. An awareness of possible areas of risk may assist AC

Opportunities and challenges for multicriteria assessment of food system sustainability

Directory of Open Access Journals (Sweden)

Hugo F. Alrøe

2016-03-01

Full Text Available The focus of the Special Feature on "Multicriteria assessment of food system sustainability" is on the complex challenges of making and communicating overall assessments of food systems sustainability based on multiple and varied criteria. Four papers concern the choice and development of appropriate tools for making multicriteria sustainability assessments that handle built-in methodological conflicts and trade-offs between different assessment objectives. They underscore the value of linking diverse methods and tools, or nesting and stepping their deployment, to help build resilience and sustainability. They conclude that there is no one tool, one framework, or one indicator set that is appropriate for the different purposes and contexts of sustainability assessment. The process of creating the assessment framework also emerges as important: if the key stakeholders are not given a responsible and full role in the development of any assessment tool, it is less likely to be fit for their purpose and they are unlikely to take ownership or have confidence in it. Six other papers reflect on more fundamental considerations of how assessments are based in different scientific perspectives and on the role of values, motivation, and trust in relation to assessments in the development of more sustainable food systems. They recommend a radical break with the tradition of conducting multicriteria assessment from one hegemonic perspective to considering multiple perspectives. Collectively the contributions to this Special Feature identify three main challenges for improved multicriteria assessment of food system sustainability: (i how to balance different types of knowledge to avoid that the most well-known, precise, or easiest to measure dimensions of sustainability gets the most weight; (ii how to expose the values in assessment tools and choices to allow evaluation of how they relate to the ethical principles of sustainable food systems, to societal

Use of new scientific developments in regulatory risk assessments: challenges and opportunities.

Science.gov (United States)

Tarazona, Jose V

2013-07-01

Since the 1990s, science based ecological risk assessments constitute an essential tool for supporting decision making in the regulatory context. Using the European REACH Regulation as example, this article presents the challenges and opportunities for new scientific developments within the area of chemical control and environmental protection. These challenges can be sorted out in 3 main related topics (sets). In the short term, the challenges are directly associated with the regulatory requirements, required for facilitating a scientifically sound implementation of the different obligations for industry and authorities. It is important to mention that although the actual tools are different due to the regulatory requirements, the basic needs are still the same as those addressed in the early 1990s: understanding the ecological relevance of the predicted effects, including the uncertainty, and facilitating the link with the socio-economic assessment. The second set of challenges covers the opportunities for getting an added value from the regulatory efforts. The information compiled through REACH registration and notification processes is analyzed as source for new integrative developments for assessing the combined chemical risk at the regional level. Finally, the article discusses the challenge of inverting the process and developing risk assessment methods focusing on the receptor, the individual or ecosystem, instead of on the stressor or source. These approaches were limited in the past due to the lack of information, but the identification and dissemination of standard information, including uses, manufacturing sites, physical-chemical, environmental, ecotoxicological, and toxicological properties as well as operational conditions and risk management measures for thousands of chemicals, combined by the knowledge gathered through large scale monitoring programs and spatial information systems is generating new opportunities. The challenge is liking

Challenges in assessment and decision making in intercountry adoption

OpenAIRE

O'Brien, Valerie

2006-01-01

This paper addresses the challenges facing ICA assessment and decision making in Irish adoption practice? The following questions are addressed •How can a balance be struck between legislative, procedural and best practice parameters in decision making? •Are the models used in assessment and decision making at variance or fitting with the balance required between these parameters? •In moving forward from 2008, what are there issues that need particular attention?

Challenges posed by diversity: looking at language and assessment

Directory of Open Access Journals (Sweden)

Kari Smith

2010-09-01

Full Text Available It is common in many institutions of higher education to have a diverse student population with respect to language and culture in addition to diversity in ability and talent. For many students the language of instruction is not their first language, a situation which offers numerous challenges for the students as well as for the hosting universities. Students have different reasons to undertake an education in a foreign language, a fact which requires higher education institutions to be flexible in addressing the needs of these students. Thus assessment becomes a major challenge. This presentation discusses gains and losses related to studying in an additional language with a special focus on assessment issues. A small study carried out in Israel among Arab and Jewish students of English as a foreign language is presented to illustrate issues discussed. The presentation concludes with a few recommendations.

Addressing challenges in single species assessments via a simple state-space assessment model

DEFF Research Database (Denmark)

Nielsen, Anders

Single-species and age-structured fish stock assessments still remains the main tool for managing fish stocks. A simple state-space assessment model is presented as an alternative to (semi) deterministic procedures and the full parametric statistical catch at age models. It offers a solution...... to some of the key challenges of these models. Compared to the deterministic procedures it solves a list of problems originating from falsely assuming that age classified catches are known without errors and allows quantification of uncertainties of estimated quantities of interest. Compared to full...

Faculty and Career Advising: Challenges, Opportunities, and Outcome Assessment

Science.gov (United States)

Vespia, Kristin M.; Freis, Stephanie D.; Arrowood, Rebecca M.

2018-01-01

Psychology prioritizes students' professional or career development by including it as one of the five undergraduate learning goals. Faculty advisors are critical to that development but likely feel less prepared for the role. Departments face challenges assessing associated student learning outcomes. We introduce an instrument programs can use to…

Assessment approaches in massive open online courses: Possibilities, challenges and future directions

Science.gov (United States)

Xiong, Yao; Suen, Hoi K.

2018-03-01

The development of massive open online courses (MOOCs) has launched an era of large-scale interactive participation in education. While massive open enrolment and the advances of learning technology are creating exciting potentials for lifelong learning in formal and informal ways, the implementation of efficient and effective assessment is still problematic. To ensure that genuine learning occurs, both assessments for learning (formative assessments), which evaluate students' current progress, and assessments of learning (summative assessments), which record students' cumulative progress, are needed. Providers' more recent shift towards the granting of certificates and digital badges for course accomplishments also indicates the need for proper, secure and accurate assessment results to ensure accountability. This article examines possible assessment approaches that fit open online education from formative and summative assessment perspectives. The authors discuss the importance of, and challenges to, implementing assessments of MOOC learners' progress for both purposes. Various formative and summative assessment approaches are then identified. The authors examine and analyse their respective advantages and disadvantages. They conclude that peer assessment is quite possibly the only universally applicable approach in massive open online education. They discuss the promises, practical and technical challenges, current developments in and recommendations for implementing peer assessment. They also suggest some possible future research directions.

Fit for high altitude: are hypoxic challenge tests useful?

Directory of Open Access Journals (Sweden)

Matthys Heinrich

2011-02-01

Full Text Available Abstract Altitude travel results in acute variations of barometric pressure, which induce different degrees of hypoxia, changing the gas contents in body tissues and cavities. Non ventilated air containing cavities may induce barotraumas of the lung (pneumothorax, sinuses and middle ear, with pain, vertigo and hearing loss. Commercial air planes keep their cabin pressure at an equivalent altitude of about 2,500 m. This leads to an increased respiratory drive which may also result in symptoms of emotional hyperventilation. In patients with preexisting respiratory pathology due to lung, cardiovascular, pleural, thoracic neuromuscular or obesity-related diseases (i.e. obstructive sleep apnea an additional hypoxic stress may induce respiratory pump and/or heart failure. Clinical pre-altitude assessment must be disease-specific and it includes spirometry, pulsoximetry, ECG, pulmonary and systemic hypertension assessment. In patients with abnormal values we need, in addition, measurements of hemoglobin, pH, base excess, PaO2, and PaCO2 to evaluate whether O2- and CO2-transport is sufficient. Instead of the hypoxia altitude simulation test (HAST, which is not without danger for patients with respiratory insufficiency, we prefer primarily a hyperoxic challenge. The supplementation of normobaric O2 gives us information on the acute reversibility of the arterial hypoxemia and the reduction of ventilation and pulmonary hypertension, as well as about the efficiency of the additional O2-flow needed during altitude exposure. For difficult judgements the performance of the test in a hypobaric chamber with and without supplemental O2-breathing remains the gold standard. The increasing numbers of drugs to treat acute pulmonary hypertension due to altitude exposure (acetazolamide, dexamethasone, nifedipine, sildenafil or to other etiologies (anticoagulants, prostanoids, phosphodiesterase-5-inhibitors, endothelin receptor antagonists including mechanical aids to

Fit for high altitude: are hypoxic challenge tests useful?

Science.gov (United States)

Matthys, Heinrich

2011-02-28

Altitude travel results in acute variations of barometric pressure, which induce different degrees of hypoxia, changing the gas contents in body tissues and cavities. Non ventilated air containing cavities may induce barotraumas of the lung (pneumothorax), sinuses and middle ear, with pain, vertigo and hearing loss. Commercial air planes keep their cabin pressure at an equivalent altitude of about 2,500 m. This leads to an increased respiratory drive which may also result in symptoms of emotional hyperventilation. In patients with preexisting respiratory pathology due to lung, cardiovascular, pleural, thoracic neuromuscular or obesity-related diseases (i.e. obstructive sleep apnea) an additional hypoxic stress may induce respiratory pump and/or heart failure. Clinical pre-altitude assessment must be disease-specific and it includes spirometry, pulsoximetry, ECG, pulmonary and systemic hypertension assessment. In patients with abnormal values we need, in addition, measurements of hemoglobin, pH, base excess, PaO2, and PaCO2 to evaluate whether O2- and CO2-transport is sufficient.Instead of the hypoxia altitude simulation test (HAST), which is not without danger for patients with respiratory insufficiency, we prefer primarily a hyperoxic challenge. The supplementation of normobaric O2 gives us information on the acute reversibility of the arterial hypoxemia and the reduction of ventilation and pulmonary hypertension, as well as about the efficiency of the additional O2-flow needed during altitude exposure. For difficult judgements the performance of the test in a hypobaric chamber with and without supplemental O2-breathing remains the gold standard. The increasing numbers of drugs to treat acute pulmonary hypertension due to altitude exposure (acetazolamide, dexamethasone, nifedipine, sildenafil) or to other etiologies (anticoagulants, prostanoids, phosphodiesterase-5-inhibitors, endothelin receptor antagonists) including mechanical aids to reduce periodical or

Psychophysiological Assessment in Pilots Performing Challenging Simulated and Real Flight Maneuvers.

Science.gov (United States)

Johannes, Bernd; Rothe, Stefanie; Gens, André; Westphal, Soeren; Birkenfeld, Katja; Mulder, Edwin; Rittweger, Jörn; Ledderhos, Carla

2017-09-01

The objective assessment of psychophysiological arousal during challenging flight maneuvers is of great interest to aerospace medicine, but remains a challenging task. In the study presented here, a vector-methodological approach was used which integrates different psychophysiological variables, yielding an integral arousal index called the Psychophysiological Arousal Value (PAV). The arousal levels of 15 male pilots were assessed during predetermined, well-defined flight maneuvers performed under simulated and real flight conditions. The physiological data, as expected, revealed inter- and intra-individual differences for the various measurement conditions. As indicated by the PAV, air-to-air refueling (AAR) turned out to be the most challenging task. In general, arousal levels were comparable between simulator and real flight conditions. However, a distinct difference was observed when the pilots were divided by instructors into two groups based on their proficiency in AAR with AWACS (AAR-Novices vs. AAR-Professionals). AAR-Novices had on average more than 2000 flight hours on other aircrafts. They showed higher arousal reactions to AAR in real flight (contact: PAV score 8.4 ± 0.37) than under simulator conditions (7.1 ± 0.30), whereas AAR-Professionals did not (8.5 ± 0.46 vs. 8.8 ± 0.80). The psychophysiological arousal value assessment was tested in field measurements, yielding quantifiable arousal differences between proficiency groups of pilots during simulated and real flight conditions. The method used in this study allows an evaluation of the psychophysiological cost during a certain flying performance and thus is possibly a valuable tool for objectively evaluating the actual skill status of pilots.Johannes B, Rothe S, Gens A, Westphal S, Birkenfeld K, Mulder E, Rittweger J, Ledderhos C. Psychophysiological assessment in pilots performing challenging simulated and real flight maneuvers. Aerosp Med Hum Perform. 2017; 88(9):834-840.

Significance and challenges of stereoselectivity assessing methods in drug metabolism

Directory of Open Access Journals (Sweden)

Zhuowei Shen

2016-02-01

Full Text Available Stereoselectivity in drug metabolism can not only influence the pharmacological activities, tolerability, safety, and bioavailability of drugs directly, but also cause different kinds of drug–drug interactions. Thus, assessing stereoselectivity in drug metabolism is of great significance for pharmaceutical research and development (R&D and rational use in clinic. Although there are various methods available for assessing stereoselectivity in drug metabolism, many of them have shortcomings. The indirect method of chromatographic methods can only be applicable to specific samples with functional groups to be derivatized or form complex with a chiral selector, while the direct method achieved by chiral stationary phases (CSPs is expensive. As a detector of chromatographic methods, mass spectrometry (MS is highly sensitive and specific, whereas the matrix interference is still a challenge to overcome. In addition, the use of nuclear magnetic resonance (NMR and immunoassay in chiral analysis are worth noting. This review presents several typical examples of drug stereoselective metabolism and provides a literature-based evaluation on current chiral analytical techniques to show the significance and challenges of stereoselectivity assessing methods in drug metabolism.

An assessment of open source promotion in addressing ICT acceptance challenges in Tanzania

CSIR Research Space (South Africa)

Kinyondo, J

2012-05-01

Full Text Available challenges. This study is an assessment of such OS promotion efforts in addressing ICT acceptance challenges in Tanzania specifically. The research design includes case studies done on four OS communities using document analysis, a questionnaire, interviews...

Carbonic anhydrase (acetazolamide-sensitive esterase) activity in the blood, gill and kidney of the thermally acclimated rainbow trout, Salmo gairdneri

Energy Technology Data Exchange (ETDEWEB)

Houston, A.H.; McCarty, L.S.

1978-04-01

Gill, kidney and blood levels of acetazolamide-sensitive esterase (carbonic anhydrase) activity were estimated at acclimation temperature and at a common temperature (25/sup 0/C) in rainbow trout acclimated to 2, 10, and 18/sup 0/C. Plasma levels of sodium, potassium and chloride were also examined for possible acclimatory variations. Plasma sodium and chloride levels, and the sodium:chloride ratio were unaffected by thermal acclimation; potassium concentrations were significantly elevated at 18/sup 0/C. Significant, but modest changes in renal and branchial carbonic anhydrase activity were observed under physiologically realistic incubation temperature conditions. Blood carbonic anhydrase activity was sharply elevated at higher acclimation temperatures. The data are discussed in relation to the hypothesis that carbonic anhydrase in this relatively stenothermal freshwater salmonid, through its intimate association with the coupled HCO/sub 3//sup -//Cl/sup -/ and H/sup +/ + NH/sub 4//sup +//Na/sup +/ exchange systems may provide for relatively thermostable basal rates of sodium and chloride uptake from the medium and recovery from urine. The renal, and more notably the branchial (Na/sup +//K/sup +/)-simulated ATPase systems, and erythrocytic carbonic anhydrase may then serve primarily as high-temperature amplifiers of sodium and chloride recruitment respectively.

Regulatory forum opinion piece*: immunotoxicology assessments in nonhuman primates--challenges and opportunities.

Science.gov (United States)

Lebrec, Hervé N

2013-01-01

The immune system has been recognized for decades as a potential "target organ" of toxicity. Immune system activation can result in cytokine release resulting in severe systemic toxicity. Immunosuppression can result in impaired host defense and an increase in opportunistic infection, reemergence of latent infection, poor responses to vaccination, or increased risk of certain cancers. Several regulatory documents have addressed various aspects of immunotoxicity assessments. Nonhuman primates (NHPs) and in particular macaques are often the only relevant species for biotechnology-derived investigational new drugs based on cross-reactivity with human and NHP targets. This article reviews the challenges and opportunities associated with monitoring immune function in NHPs in the context of regulatory expectations. The article emphasizes how a comprehensive assessment of immunotoxicity remains a challenge due to interanimal variability associated with certain parameters (e.g., T-dependent antibody response)and it identifies gaps, such as the stage of development of certain assays (e.g., cytotoxic T-cell function). Despite these challenges, a thorough assessment of target biology-driven theoretical risks, in combination with proper integration of all information from the standard toxicology studies, and the refinement of certain assays should enable proper risk assessment. To this effect, emphasis should be placed on leveraging predictive in vitro assays using human cells.

Planning Environmental Impact Assessment Orienting Sustainable Development:Opportunities and Challenges

Institute of Scientific and Technical Information of China (English)

Sun Yanjun; Chen Xingeng; Bao Yun; Peng Xiaochun; Gao Changbo

2005-01-01

Strategic Environmental Assessment is a frontier subject in the field of Environmental Impact Assessment. In the past two decades, especially in recent years, much more importance has been attached to Strategic Environmental Assessment. The Environmental Impact Assessment Law of the P.R.China which was promulgated provides a great opportunity for the development of Planning Environmental Impact Assessment and brings great challenges for the development of traditional Project Environmental Impact Assessment and Planning Environmental Impact Assessment at the same time.In order to promote the implementation of"The EIA Law", the inherent limitations of Project Environmental Impact Assessment must be identified sufficiendy and the theory research and practice of Planning Environmental Impact Assessment should be strengthened as well. Measures should be taken currendy to enforce the operation system. The authors wish to offer a few references to the progress and implementation of Planning Environmental Impact Assessment in China.

Sequential change of hemodynamic reserve in patients with major cerebral artery occlusion of severe stenosis

Energy Technology Data Exchange (ETDEWEB)

Hasegawa, Y.; Yamaguchi, T.; Tsuchiya, T. (National Cardiovascular Center, Osaka (Japan). Cerebrovascular Div.); Minematsu, K. (National Cardiovascular Center, Osaka (Japan). Research Inst.); Nishimura, T. (National Cardiovascular Inst., Osaka (Japan). Dept. of Diagnostic Radiology)

1992-02-01

To identify regional vasodilatory capacity and its sequential change, we evaluated prospectively a total of 78 acetazolamide tests in 51 patients with occlusion or greater than 75% stenosis of the carotid or middle cerebral arteries. The relative distribution of cerebral blood flow was determined by single photon emission computed tomography using N-isopropyl-p-({sup 123}I)-iodoamphetamine before and after intravenous injection of acetazolamide. Reduced vasodilatory capacity was demonstrated in 20 patients (38%), including 5 patients with hemodynamic transient ischemic attacks or infarction. Follow-up acetazolamide tests revealed asymptomatic progression of the arterial lesion (from stenosis to occlusion) in 1 patient and almost complete improvement of vasodilatory capacity in 5 patients, including 3 without surgical intervention. During an average follow-up period of 18.5 months, 4 patients died from cardiac causes or neoplasm; no neurovascular events occurred. Much larger numbers of patients with longer observation periods will be necessary to clarify the contribution of chronic hemodynamic failure to subsequent stroke. However, the present data indicate that the acetazolamide test is useful for assessing the course of high grade stenosis or occlusion of major cerebral arteries. (orig.).

Further studies on the intermediary metabolism of bone in vitro and a monoclonal cell line (MMB-1) derived from bone: effects of parathyroid hormone and acetazolamide

International Nuclear Information System (INIS)

Nichols, F.C.

1981-01-01

The mechanism/mechanisms by which PTH affects Ca homeostasis between blood and bone have not been clearly established. Most studies of metabolic acid production in bone took place during the late 1950s and early 1960s. Since that time, assay techniques for metabolic acid production have been improved for greater sensitivity, more has been learned as to how PTH mediates its cellular responses, and techniques for cell isolation and culture have dramatically improved. These improvements have made possible new approaches to the study of short term effects of PTH on metabolic acid production in bone. Chapter 1 explores the potential of bone to utilize substrates other than glucose for metabolic energy transfer. Chapter 2 characterizes glucose metabolism in mouse calvaria in vitro and explores effects of PTH, acetazolamide, and C1 13,850 on calvaria oxidative metabolism. Chapter 3 describes PTH effects on glucose metabolism of MMB-1 cells, a monoclonal cell line reported to possess osteoblast-like characteristics

Noninvasive regional cerebral blood flow measurements at pre- and post-acetazolamide test using 99mTc-ECD

International Nuclear Information System (INIS)

Matsuda, Hiroshi; Nakano, Seigo; Tanaka, Masaaki.

1996-01-01

A technique for serial noninvasive cerebral blood flow measurements at pre- and post-acetazolamide (Diamox) test was newly developed using 99m Tc-ECD without blood sampling. Baseline mean cerebral blood flow (mCBF) was measured from graphical analysis of time activity curves for brain and aortic arch obtained from radionuclide angiography by injection of 370-555 MBq 99m Tc-ECD. The first SPECT study was performed immediately after intravenous administration of 1 g of Diamox, then baseline regional cerebral blood flow (rCBF) was calculated using Lassen's correction algorithm. Immediately after the stop of the first SPECT study, additional 555-740 MBq of 99m Tc-ECD was administered, thereafter the second SPECT study was started. Post-Diamox SPECT images were obtained by subtraction of the first baseline images from the second images. Using Lassen's algorithm, post-Diamox mCBF was estimated from the baseline mCBF, the baseline mean SPECT counts, and post-Diamox mean SPECT counts corrected for administered dose and imaging time. Post-Diamox rCBF was obtained from the post-Diamox mCBF and the post-Diamox mean SPECT counts using Lassen's algorithm. Coefficient variation was shown 2.7% and 3.5%: mCBF and rCBF, respectively in test-retest results in six patients without Diamox administration. Nine demented patients without vascular disorders showed significant mCBF increase of 35.7% on the average by post-Diamox. In conclusion, this simplified method is practically useful for measuring CBF at pre- and post-Diamox test within short period of time without any blood sample. (author)

Regulatory review of safety cases and safety assessments - associated challenges

International Nuclear Information System (INIS)

Bennett, D.G.; Ben Belfadhel, M.; Metcalf, P.E.

2006-01-01

Regulatory reviews of safety cases and safety assessments are essential for credible decision making on the licensing or authorization of radioactive waste disposal facilities. Regulatory review also plays an important role in developing the safety case and in establishing stakeholders' confidence in the safety of the facility. Reviews of safety cases for radioactive waste disposal facilities need to be conducted by suitably qualified and experienced staff, following systematic and well planned review processes. Regulatory reviews should be sufficiently comprehensive in their coverage of issues potentially affecting the safety of the disposal system, and should assess the safety case against clearly established criteria. The conclusions drawn from a regulatory review, and the rationale for them should be reproducible and documented in a transparent and traceable way. Many challenges are faced when conducting regulatory reviews of safety cases. Some of these relate to issues of project and programme management, and resources, while others derive from the inherent difficulties of assessing the potential long term future behaviour of engineered and environmental systems. The paper describes approaches to the conduct of regulatory reviews and discusses some of the challenges faced. (author)

Use of the accelerating rotarod for assessment of motor performance decrement induced by potential anticonvulsant compounds in nerve agent poisoning. (Reannouncement with new availability information)

Energy Technology Data Exchange (ETDEWEB)

Capacio, B.R.; Harris, L.W.; Anderson, D.R.; Lennox, W.J.; Gales, V.

1992-12-31

The accelerating rotarod was used to assess motor performance decrement in rats after administration of candidate anticonvulsant compounds (acetazolamide, amitriptyline, chlordiazepoxide, diazepan, diazepam-lysine, lorazepam, loprazolam, midazolam, phenobarbital and scopolamine) against nerve agent poisoning. AH compounds were tested as the commercially available injectable preparation except for diazepam-lysine and loprazolam, which are not FDA approved. A peak effect time, as well as a dose to decrease performance time by 50% from control (PDD50), was determined. The calculated PDD50 (micrometer ol/kg) values and peak effect tunes were midazolam, 1.16 at 15 min; loprazolam, 1.17 at 15 min; diazepam-lysine, 4.17 at 30 min; lorazepwn, 4.98 at 15 min; diazepam, 5.27 at 15 min; phenobarbital, 101.49 at 45 min; chlordiazepoxide, 159.21 at 30 min; scopolamine, amitriptyline and acetazolamide did not demonstrate a performance decrement at any of the doses tested. The PDD50 values were compared with doses which have been utilized against nerve agent-induced convulsions or published ED50 values from standard anticonvulsant screening tests (maximal electroshock MES and subcutaneous pentylenetetrazol (scMET)). I serve agents, anticonvulsants, diazepam, accelerating rotarod, motor performance.

The challenge of assessing social dimensions of avoided deforestation: Examples from Cambodia

International Nuclear Information System (INIS)

Pasgaard, M.

2013-01-01

Reduced Emissions from Deforestation and Forest Degradation in developing countries (REDD +) has moved to the central stage of the climate change debate by being promoted as a significant, cheap, and quick win–win strategy to reduce greenhouse gas emissions and thereby mitigate climate change. In order to be successful in reducing emissions while providing the projected social and environmental co-benefits, REDD + needs to overcome key challenges of insecure forest tenure and inequity in the distribution of benefits. Such challenges threaten to affect the livelihoods and well-being in the local communities and in turn the effectiveness of REDD+. While REDD + programs will affect the participating communities, there is limited knowledge as to what social impacts these projects may bring to the local population. Similarly, assessment of these social dimensions has received little attention until recently, and is consequently out of sync with the realities of REDD + projects. The present paper aims to shed light on the methodological and contextual challenges in the assessment of the social dimensions of REDD+. Some of the main social concerns of REDD + are outlined with an emphasis on the uniqueness and complexity of REDD + interventions. Recently proposed approaches to assess social impacts in REDD + are critically assessed in terms of the diversity of frameworks proposed, choice of social indicators, and data collection requirements. Specifically, these methodological implications are further discussed in the light of the social dimensions and the prescribed regulations of REDD + in a Cambodian context. - Highlights: ► Insecure tenure and inequitable benefit sharing are main social concerns in REDD +. ► Two guides to social assessments in REDD + are critically reviewed. ► Mismatch between social assessment requirements and the reality of REDD + is analyzed. ► Concrete, topical examples from Cambodian REDD + are used. ► Support the claim to add

Hanford Site Cleanup Challenges and Opportunities for Science and Technology - A Strategic Assessment

International Nuclear Information System (INIS)

Johnson, W.; Reichmuth, B.; Wood, T.; Glasper, M.; Hanson, J.

2002-01-01

In November 2000, the U.S. Department of Energy (DOE) Richland Operations Office (RL) initiated an effort to produce a single, strategic perspective of RL Site closure challenges and potential Science and Technology (S and T) opportunities. This assessment was requested by DOE Headquarters (HQ), Office of Science and Technology, EM-50, as a means to provide a site level perspective on S and T priorities in the context of the Hanford 2012 Vision. The objectives were to evaluate the entire cleanup lifecycle (estimated at over $24 billion through 2046), to identify where the greatest uncertainties exist, and where investments in S and T can provide the maximum benefit. The assessment identified and described the eleven strategic closure challenges associated with the cleanup of the Hanford Site. The assessment was completed in the spring of 2001 and provided to DOE-HQ and the Hanford Site Technology Coordination Group (STCG) for review and input. It is the first step in developing a Site-level S and T strategy for RL. To realize the full benefits of this assessment, RL and Site contractors will work with the Hanford STCG to ensure: identified challenges and opportunities are reflected in project baselines; detailed S and T program-level road maps reflecting both near- and long-term investments are prepared using this assessment as a starting point; and integrated S and T priorities are incorporated into Environmental Management (EM) Focus Areas, Environmental Management Science Program (EMSP) and other research and development (R and D) programs to meet near-term and longer-range challenges. Hanford is now poised to begin the detailed planning and road mapping necessary to ensure that the integrated Site level S and T priorities are incorporated into the national DOE S and T program and formally incorporated into the relevant project baselines. DOE-HQ's response to this effort has been very positive and similar efforts are likely to be undertaken at other sites

Teaching Thinking Skills in Context-Based Learning: Teachers' Challenges and Assessment Knowledge

Science.gov (United States)

Avargil, Shirly; Herscovitz, Orit; Dori, Yehudit Judy

2012-04-01

For an educational reform to succeed, teachers need to adjust their perceptions to the reform's new curricula and strategies and cope with new content, as well as new teaching and assessment strategies. Developing students' scientific literacy through context-based chemistry and higher order thinking skills was the framework for establishing a new chemistry curriculum for Israeli high school students. As part of this endeavor, we developed the Taste of Chemistry module, which focuses on context-based chemistry, chemical understanding, and higher order thinking skills. Our research objectives were (a) to identify the challenges and difficulties chemistry teachers faced, as well as the advantages they found, while teaching and assessing the Taste of Chemistry module; and (b) to investigate how they coped with teaching and assessing thinking skills that include analyzing data from graphs and tables, transferring between multiple representations and, transferring between chemistry understanding levels. Research participants included eight teachers who taught the module. Research tools included interviews, classroom observations, teachers-designed students' assignments, and developers-designed students' assignments. We documented different challenges teachers had faced while teaching the module and found that the teachers developed different ways of coping with these challenges. Developing teachers' assessment knowledge (AK) was found to be the highest stage in teachers' professional growth, building on teachers' content knowledge (CK), pedagogy knowledge (PK), and pedagogical-content knowledge (PCK). We propose the use of assignments designed by teachers as an instrument for determining their professional growth.

Assessing and Managing Natural Resource Damages: Continuing Challenges and Opportunities

Science.gov (United States)

Barnthouse, Lawrence W.; Stahl, Ralph G.

2017-05-01

In a 2002 paper, we discussed the technical challenges associated with quantifying natural resource injuries, service losses and damages, and suggested some actions that might help to overcome them. An important suggestion was to consider using some of the approaches in ecological risk assessment to help evaluate potential natural resource injuries, and ultimately in some cases to help translate those injuries into natural resource service loss. This was based on the observation that ecological risk assessment and natural resource damage assessments use much of the same types of data, but at that time the experience base with ecological risk assessment was greater than for natural resource damage assessments. We also discussed some of the issues in applying the then current Department of Interior natural resource damage assessments regulations. Since our 2002 publication the scientific literature, relevant regulations, the global context and more have changed. In the current paper we focus on the technical and regulatory changes in natural resource damage assessments practice since 2002, and use recent reports and publications to illustrate those changes and identify new directions in natural resource damage assessments.

Challenges in assessing food environments in northern and remote communities in Canada.

Science.gov (United States)

Skinner, Kelly; Burnett, Kristin; Williams, Patricia; Martin, Debbie; Stothart, Christopher; LeBlanc, Joseph; Veeraraghavan, Gigi; Sheedy, Amanda

2016-06-09

Effective tools for retail food environments in northern and remote communities are lacking. This paper examines the challenges of conducting food environment assessments in northern and remote communities in Canada encountered during our experience with a food costing project. One of the goals of the Paying for Nutrition in the North project is to develop guidelines to improve current food costing tools for northern Canada. Paying for Nutrition illustrates the complex context of measuring food environments in northern and remote communities. Through the development of a food costing methodology guide to assess northern food environments, several contextual issues emerged, including retail store oligopolies in communities; the importance of assessing food quality; informal social food economies; and the challenge of costing the acquisition and consumption of land- and water-based foods. Food environment measures designed for northern and remote communities need to reflect the geographic context in which they are being employed and must include input from local residents.

The challenge of assessing social dimensions of avoided deforestation: Examples from Cambodia

Energy Technology Data Exchange (ETDEWEB)

Pasgaard, M., E-mail: mase@life.ku.dk

2013-01-15

Reduced Emissions from Deforestation and Forest Degradation in developing countries (REDD +) has moved to the central stage of the climate change debate by being promoted as a significant, cheap, and quick win-win strategy to reduce greenhouse gas emissions and thereby mitigate climate change. In order to be successful in reducing emissions while providing the projected social and environmental co-benefits, REDD + needs to overcome key challenges of insecure forest tenure and inequity in the distribution of benefits. Such challenges threaten to affect the livelihoods and well-being in the local communities and in turn the effectiveness of REDD+. While REDD + programs will affect the participating communities, there is limited knowledge as to what social impacts these projects may bring to the local population. Similarly, assessment of these social dimensions has received little attention until recently, and is consequently out of sync with the realities of REDD + projects. The present paper aims to shed light on the methodological and contextual challenges in the assessment of the social dimensions of REDD+. Some of the main social concerns of REDD + are outlined with an emphasis on the uniqueness and complexity of REDD + interventions. Recently proposed approaches to assess social impacts in REDD + are critically assessed in terms of the diversity of frameworks proposed, choice of social indicators, and data collection requirements. Specifically, these methodological implications are further discussed in the light of the social dimensions and the prescribed regulations of REDD + in a Cambodian context. - Highlights: Black-Right-Pointing-Pointer Insecure tenure and inequitable benefit sharing are main social concerns in REDD +. Black-Right-Pointing-Pointer Two guides to social assessments in REDD + are critically reviewed. Black-Right-Pointing-Pointer Mismatch between social assessment requirements and the reality of REDD + is analyzed. Black

A comparative study of perfusion CT and 99mTc-Hmpao spect measurement to assess cerebrovascular reserve capacity in patients with internal carotid artery occlusion

Directory of Open Access Journals (Sweden)

Eicker S

2011-11-01

Full Text Available Abstract Background and purpose Patients with internal carotid artery (ICA occlusion can demonstrate impaired cerebral vascular reserve (CVR. The detection of CVR using single photon emission CT (SPECT is nowadays widely accepted as a predictor in the diagnostic pathway in patients considered for cerebral revascularization. Recently perfusion CT (PCT gained widely acceptance in stroke imaging The present study was aimed at comparing the results of perfusion CT (PCT and 99mTc-HMPAO SPECT with acetazolamide challenge in patients with ICA occlusion. Methods 13 patients were included in the prospective evaluation. Both PCT and 99mTc-HMPAO SPECT were performed before and after the administration of acetazolamide. In detail, regional cerebral blood flow (rCBF, regional cerebral blood volume (rCBV, adapted time to peak (Tmax and mean transit times (MTT were compared with SPECT data. Results 99mTc-HMPAO SPECT demonstrated an impairment of CVR in six patients. A preserved CVR was present in seven patients. All patients with impaired CVR proven by SPECT had a delayed MTT (mean +2.98 s and a delayed Tmax (mean + 5.9 s, (both p Conclusion The prospective study demonstrated a highly significant correlation of perfusion parameters as' detected by 99mTc-HMPAO SPECT and the Tmax as detected by PCT in patients with ICA occlusion. Therefore this easy-to-perform technique seems to be an adequate method for the evaluation of cerebral perfusion in patients with ICA occlusion.

Technical challenges in the qualitative ecological risk assessments performed on the Hanford Site operable units

International Nuclear Information System (INIS)

Probasco, K.M.

1994-01-01

Qualitative Risk Assessments (QRAS) have been selected as the method for providing the risk-driver indications for interim, remedial, and cleanup actions for the Hanford Site operable units' ecological risk assessments. This expedited response action path has been developed for the Hanford Site to facilitate time-critical decisions and generate immediate emergency cleanup actions. Tight budgets and aggressive time schedules are a major factor in the development of the QRA process. The QRA is a quick way to find immediate threats and a good precursor to a full risk assessment. However, numerous technical challenges have been identified with the QRA approach. The QRA approach differs from a baseline risk assessment in several ways. The main differences involve the use of data that have previously been gathered from the site, and the development of a ''bias-for-action'' document that would reveal qualitative risks from the contaminants identified at the operable units. Technical challenges concerning the ecological portion of these QRAs have raised questions about using the ORA for decision-making and may have weakened the validity of its use in the established procedural framework. Challenges involving such issues as the extrapolation of the contaminant data, data validation and screening techniques, receptor selections, and the final risk characterization outcome threaten the feasibility of the QRA as a decision-making tool. This discussion provides insight into resolving technical challenges and may be a ''lessons-learned'' device for those interested in the QRA approach. Ultimately, these challenges are proving to be learning tools for scientists, regulators, and ecologists and are identifying the data gaps and research direction for future ecological baseline risk assessments

Health impact assessment in China: Emergence, progress and challenges

Energy Technology Data Exchange (ETDEWEB)

Huang Zheng, E-mail: huangzhg@mails.tjmu.edu.cn

2012-01-15

The values, concepts and approaches of health impact assessment (HIA) were outlined in the Gothenburg consensus paper and some industrialized countries have implemented HIA for many years. HIA has played an important role in environmental protection in China, however, the emergence, progress and challenges of HIA in China have not been well described. In this paper, the evolution of HIA in China was analyzed and the challenges of HIA were presented based on the author's experiences. HIA contributed to decision-making for large capital construction projects, such as the Three Gorges Dam project, in its emergence stage. Increasing attention has been given to HIA in recent years due to supportive policies underpinning development of the draft HIA guidelines in 2008. However enormous challenges lie ahead in ensuring the institutionalization of HIA into project, program and policy decision-making process due to limited scope, immature tools and insufficient professionals in HIA practice. HIA should broaden its horizons by encompassing physical, chemical, biological and socio-economic aspects and constant attempts should be made to integrate HIA into the decision-making process, not only for projects and programs but also for policies as well.

Whither Risk Assessment: New Challenges and Opportunities a Third of a Century After the Red Book.

Science.gov (United States)

Greenberg, Michael; Goldstein, Bernard D; Anderson, Elizabeth; Dourson, Michael; Landis, Wayne; North, D Warner

2015-11-01

Six multi-decade-long members of SRA reflect on the 1983 Red Book in order to examine the evolving relationship between risk assessment and risk management; the diffusion of risk assessment practice to risk areas such as homeland security and transportation; the quality of chemical risk databases; challenges from other groups to elements at the core of risk assessment practice; and our collective efforts to communicate risk assessment to a diverse set of critical groups that do not understand risk, risk assessment, or many other risk-related issues. The authors reflect on the 10 recommendations in the Red Book and present several pressing challenges for risk assessment practitioners. © 2015 Society for Risk Analysis.

Assessment of immigrant certified nursing assistants' communication when responding to standardized care challenges.

Science.gov (United States)

Massey, Meredith; Roter, Debra L

2016-01-01

Certified nursing assistants (CNAs) provide 80% of the hands-on care in US nursing homes; a significant portion of this work is performed by immigrants with limited English fluency. This study is designed to assess immigrant CNA's communication behavior in response to a series of virtual simulated care challenges. A convenience sample of 31 immigrant CNAs verbally responded to 9 care challenges embedded in an interactive computer platform. The responses were coded with the Roter Interaction Analysis System (RIAS), CNA instructors rated response quality and spoken English was rated. CNA communication behaviors varied across care challenges and a broad repertoire of communication was used; 69% of response content was characterized as psychosocial. Communication elements (both instrumental and psychosocial) were significant predictors of response quality for 5 of 9 scenarios. Overall these variables explained between 13% and 36% of the adjusted variance in quality ratings. Immigrant CNAs responded to common care challenges using a variety of communication strategies despite fluency deficits. Virtual simulation-based observation is a feasible, acceptable and low cost method of communication assessment with implications for supervision, training and evaluation of a para-professional workforce. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

"It Is Complicated!": Practices and Challenges of Generic Skills Assessment in Vietnamese Universities

Science.gov (United States)

Nghia, Tran Le Huu

2018-01-01

Contributing to a lack of studies related to generic skills (GS) assessment, especially in non-Western university contexts, this article reports a study that explored practices and challenges of assessing students' GS in the Business Administration programmes in six Vietnamese universities. Content analysis of interviews with 41 teachers of skills…

Developing School Heads as Instructional Leaders in School-Based Assessment: Challenges and Next Steps

Science.gov (United States)

Lingam, Govinda Ishwar; Lingam, Narsamma

2016-01-01

The study explored challenges faced by school leaders in the Pacific nation of Solomon Islands in school-based assessment, and the adequacy of an assessment course to prepare them. A questionnaire including both open and closed-ended questions elicited relevant data from the school leaders. Modelling best practices in school-based assessment was…

Assessment of herbal medicinal products: Challenges, and opportunities to increase the knowledge base for safety assessment

International Nuclear Information System (INIS)

Jordan, Scott A.; Cunningham, David G.; Marles, Robin J.

2010-01-01

Although herbal medicinal products (HMP) have been perceived by the public as relatively low risk, there has been more recognition of the potential risks associated with this type of product as the use of HMPs increases. Potential harm can occur via inherent toxicity of herbs, as well as from contamination, adulteration, plant misidentification, and interactions with other herbal products or pharmaceutical drugs. Regulatory safety assessment for HMPs relies on both the assessment of cases of adverse reactions and the review of published toxicity information. However, the conduct of such an integrated investigation has many challenges in terms of the quantity and quality of information. Adverse reactions are under-reported, product quality may be less than ideal, herbs have a complex composition and there is lack of information on the toxicity of medicinal herbs or their constituents. Nevertheless, opportunities exist to capitalise on newer information to increase the current body of scientific evidence. Novel sources of information are reviewed, such as the use of poison control data to augment adverse reaction information from national pharmacovigilance databases, and the use of more recent toxicological assessment techniques such as predictive toxicology and omics. The integration of all available information can reduce the uncertainty in decision making with respect to herbal medicinal products. The example of Aristolochia and aristolochic acids is used to highlight the challenges related to safety assessment, and the opportunities that exist to more accurately elucidate the toxicity of herbal medicines.

Assessing Curriculum Planning for Humanities Inquiry: The Challenges and Opportunities of Poster Presentation

Science.gov (United States)

Wallace, Heather D.; Preston, Lou; Harvie, Kate M.

2016-01-01

Authentic assessment has been promoted in teacher education as a means of addressing the challenge that pre-service teachers often face in translating theory into practice. In this article, we outline one approach to authentic assessment that utilises a poster format to present a humanities inquiry sequence. Drawing on a practice-based research…

Preclinical assessment of HIV vaccines and microbicides by repeated low-dose virus challenges.

Directory of Open Access Journals (Sweden)

Roland R Regoes

2005-08-01

Full Text Available Trials in macaque models play an essential role in the evaluation of biomedical interventions that aim to prevent HIV infection, such as vaccines, microbicides, and systemic chemoprophylaxis. These trials are usually conducted with very high virus challenge doses that result in infection with certainty. However, these high challenge doses do not realistically reflect the low probability of HIV transmission in humans, and thus may rule out preventive interventions that could protect against "real life" exposures. The belief that experiments involving realistically low challenge doses require large numbers of animals has so far prevented the development of alternatives to using high challenge doses.Using statistical power analysis, we investigate how many animals would be needed to conduct preclinical trials using low virus challenge doses. We show that experimental designs in which animals are repeatedly challenged with low doses do not require unfeasibly large numbers of animals to assess vaccine or microbicide success.Preclinical trials using repeated low-dose challenges represent a promising alternative approach to identify potential preventive interventions.

Challenges of assessing fire and burn severity using field measures, remote sensing and modelling

Science.gov (United States)

Penelope Morgan; Robert E. Keane; Gregory K. Dillon; Theresa B. Jain; Andrew T. Hudak; Eva C. Karau; Pamela G. Sikkink; Zachery A. Holden; Eva K. Strand

2014-01-01

Comprehensive assessment of ecological change after fires have burned forests and rangelands is important if we are to understand, predict and measure fire effects. We highlight the challenges in effective assessment of fire and burn severity in the field and using both remote sensing and simulation models. We draw on diverse recent research for guidance on assessing...

Combination of carbonic anhydrase inhibitor, acetazolamide, and sulforaphane, reduces the viability and growth of bronchial carcinoid cell lines

International Nuclear Information System (INIS)

Mokhtari, Reza Bayat; Kumar, Sushil; Islam, Syed S; Yazdanpanah, Mehrdad; Adeli, Khosrow; Cutz, Ernest; Yeger, Herman

2013-01-01

Bronchial carcinoids are pulmonary neuroendocrine cell-derived tumors comprising typical (TC) and atypical (AC) malignant phenotypes. The 5-year survival rate in metastatic carcinoid, despite multiple current therapies, is 14-25%. Hence, we are testing novel therapies that can affect the proliferation and survival of bronchial carcinoids. In vitro studies were used for the dose–response (AlamarBlue) effects of acetazolamide (AZ) and sulforaphane (SFN) on clonogenicity, serotonin-induced growth effect and serotonin content (LC-MS) on H-727 (TC) and H-720 (AC) bronchial carcinoid cell lines and their derived NOD/SCID mice subcutaneous xenografts. Tumor ultra structure was studied by electron microscopy. Invasive fraction of the tumors was determined by matrigel invasion assay. Immunohistochemistry was conducted to study the effect of treatment(s) on proliferation (Ki67, phospho histone-H3) and neuroendocrine phenotype (chromogranin-A, tryptophan hydroxylase). Both compounds significantly reduced cell viability and colony formation in a dose-dependent manner (0–80 μM, 48 hours and 7 days) in H-727 and H-720 cell lines. Treatment of H-727 and H-720 subcutaneous xenografts in NOD/SCID mice with the combination of AZ + SFN for two weeks demonstrated highly significant growth inhibition and reduction of 5-HT content and reduced the invasive capacity of H-727 tumor cells. In terms of the tumor ultra structure, a marked reduction in secretory vesicles correlated with the decrease in 5-HT content. The combination of AZ and SFN was more effective than either single agent. Since the effective doses are well within clinical range and bioavailability, our results suggest a potential new therapeutic strategy for the treatment of bronchial carcinoids

Progress and Challenges in Assessing NOAA Data Management

Science.gov (United States)

de la Beaujardiere, J.

2016-12-01

The US National Oceanic and Atmospheric Administration (NOAA) produces large volumes of environmental data from a great variety of observing systems including satellites, radars, aircraft, ships, buoys, and other platforms. These data are irreplaceable assets that must be properly managed to ensure they are discoverable, accessible, usable, and preserved. A policy framework has been established which informs data producers of their responsibilities and which supports White House-level mandates such as the Executive Order on Open Data and the OSTP Memorandum on Increasing Access to the Results of Federally Funded Scientific Research. However, assessing the current state and progress toward completion for the many NOAA datasets is a challenge. This presentation will discuss work toward establishing assessment methodologies and dashboard-style displays. Ideally, metrics would be gathered though software and be automatically updated whenever an individual improvement was made. In practice, however, some level of manual information collection is required. Differing approaches to dataset granularity in different branches of NOAA yield additional complexity.

Assessing Biobehavioural Self-Regulation and Coregulation in Early Childhood: The Parent-Child Challenge Task.

Science.gov (United States)

Lunkenheimer, Erika; Kemp, Christine J; Lucas-Thompson, Rachel G; Cole, Pamela M; Albrecht, Erin C

2017-01-01

Researchers have argued for more dynamic and contextually relevant measures of regulatory processes in interpersonal interactions. In response, we introduce and examine the effectiveness of a new task, the Parent-Child Challenge Task, designed to assess the self-regulation and coregulation of affect, goal-directed behavior, and physiology in parents and their preschoolers in response to an experimental perturbation. Concurrent and predictive validity was examined via relations with children's externalizing behaviors. Mothers used only their words to guide their 3-year-old children to complete increasingly difficult puzzles in order to win a prize ( N = 96). A challenge condition was initiated mid-way through the task with a newly introduced time limit. The challenge produced decreases in parental teaching and dyadic behavioral variability and increases in child negative affect and dyadic affective variability, measured by dynamic systems-based methods. Children rated lower on externalizing showed respiratory sinus arrhythmia (RSA) suppression in response to challenge, whereas those rated higher on externalizing showed RSA augmentation. Additionally, select task changes in affect, behavior, and physiology predicted teacher-rated externalizing behaviors four months later. Findings indicate the Parent-Child Challenge Task was effective in producing regulatory changes and suggest its utility in assessing biobehavioral self-regulation and coregulation in parents and their preschoolers.

Evaluation of time dependency of the acetazolamide effect on cerebral hemodynamics as measured by {sup 99m}Tc-ECD single-photon emission computed tomography

Energy Technology Data Exchange (ETDEWEB)

Takaki, Akihiro; Urata, Joji; Okada, Kazuhiro; Takaki, Rie [Saiseikai Kumamoto Hospital (Japan). Diagnostic Imaging Center; Mizuta, Yoshihiko; Murakami, Masaji; Yonehara, Toshiroh; Hirano, Teruyuki; Fujioka, Shodo

2001-01-01

Kuwabara et al. have examined the cerebral artery dilation with acetazolamide (ACZ) challenge test using PET. And, they reported that ACZ reaction came out time dependently. We have developed a unique SPECT's method using Technetium-99m ethyl cysteinate dimer ({sup 99m}Tc-ECD) to verify the results obtained by Kuwabara et al. One thousand MBq of {sup 99m}Tc-ECD was exactly divided into three syringes. Each of which was intravenous infused (IV) at rest, 7.5, and 20 minutes after ACZ administration. Data collection was started using dynamic SPECT immediately after {sup 99m}Tc-ECD IV at rest. Using necessary data only, SPECT images representing each of the three {sup 99m}Tc-ECD IV was reconstructed. SPECT counts were obtained by the ROI method from each images to calculate relative CBF from rest to 7.5 and 20 minutes after ACZ administration. The 18 hemispheres of nine patients in the negative control group in whom ACZ was not loaded, CBF was stable during the three evaluation. The measurement error our method was estimated as small. The 18 hemispheres of nine patients in the positive control group who has normal vasodilatory reserve, CBF was increased by 26.2{+-}8.1% at 7.5 minutes and 29.3{+-}13.1% at 20 minutes after ACZ administration. Seven patients with and chronic stage unilateral internal carotid artery severe stenosis and/or occlusion were evaluated as the test group. Case of unaffected side, CBF was increased by 17.6{+-}6.9% at 7.5 minutes and 24.8{+-}11.3% 20 minutes after ACZ administration. And, increase rate of CBF in the affected side was 2.8{+-}1.6% at 7.5 minutes and 17.3{+-}5.0% at 20 minutes after ACZ administration. In the affected side, timing of the maximum CBF increase caused by ACZ was remarkably delayed. Our method based on {sup 99m}Tc-ECD SPECT also revealed delayed cerebral artery dilation in the affected side. It was suggested that ACZ reaction came out time dependently, as reported by Kuwabara et al. (author)

Functional Assessment Based Parent Intervention in Reducing Children’s Challenging Behaviors: Exploratory Study of Group Training

OpenAIRE

Angel Fettig; Michaelene M. Ostrosky

2014-01-01

This study examined the effects of group parent training on children’s challenging behaviors in home settings. Eight parents of young children with challenging behaviors were trained in a large group setting on using functional assessment to design interventions that fit the strengths and needs of individual families. The training included information sharing and collaborating with parents on designing functional-assessment based interventions. An Interrupted Time Series Design was used to ex...

Assessing the consequences of unrealistic optimism: Challenges and recommendations.

Science.gov (United States)

Shepperd, James A; Pogge, Gabrielle; Howell, Jennifer L

2017-04-01

Of the hundreds of studies published on unrealistic optimism (i.e., expecting a better personal future than is reasonably likely), most have focused on demonstrating the phenomenon, examining boundary conditions, or documenting causes. Few studies have examined the consequences of unrealistic optimism. In this article, we provide an overview of the measurement of unrealistic optimism, review possible consequences, and identify numerous challenges confronting investigators attempting to understand the consequences. Assessing the consequences of unrealistic optimism is tricky, and ultimately probably impossible when researchers assess unrealistic optimism at the group level (which reveals if a group of people is displaying unrealistic optimism on average) rather than the individual level (which reveals whether a specific individual displays unrealistic optimism). We offer recommendations to researchers who wish to examine the consequences of unrealistic optimism. Copyright © 2016 Elsevier Inc. All rights reserved.

Drug-induced hypotension SEP test and acetazolamide test using sup 133 Xe SPECT in patients with occlusive carotid disease; Selection of candidates for extracranial-intracranial bypass

Energy Technology Data Exchange (ETDEWEB)

Kuroda, Satoshi; Kamiyama, Hiroyasu; Abe, Hiroshi; Takigawa, Shugo [Hokkaido Univ., Sapporo (Japan). School of Medicine; Mitsumori, Kenji; Nomura, Mikio; Saitoh, Hisatoshi

1991-01-01

The correlation between the drug-induced hypotension somatosensory evoked potential (SEP) test and regional cerebral blood flow changes after acetazolamide administration was studied. Fourteen patients presenting with transient ischemic attack, reversible ischemic neurological deficits, or minor completed stroke were evaluated. All patients had no or only localized low-density areas on computed tomographic scans, and unilateral occlusion or severe stenosis of the internal carotid or middle cerebral artery on cerebral angiograms. The Diamox asymmetry enhancement (DAE) was studied to detect reduced cerebral perfusion reserve in the affected hemispheres. The DAE was 7.9+-5.8% in seven patients positive in the SEP test, significantly higher than -1.5+-2.9% in patients negative in the SEP test. Postoperative SEP tests were negative in all five patients who underwent extracranial-intracranial (EC-IC) bypass surgery, suggesting that the EC-IC bypass improved the cerebral perfusion reserve in the affected hemispheres. The DAE decreased significantly in four of these patients. This study disclosed a significant correlation between the drug-induced hypotension SEP test and DAE. These parameters are considered important for evaluating patients with hemodynamic compromise and/or suitable candidates for EC-IC bypass. (author).

Evaluation of acetazolamine response in patients with cerebellar ataxia using dynamic quantitative F-18-FDG PET

International Nuclear Information System (INIS)

Kim, Y. K.; Lee, D. S.; Lee, J. S.; Kim, M. H.; Lee, K. M.; Yeo, J. S.; Chung, J. K.; Lee, M. C.

2001-01-01

Cerebellar Ataxia (CA) usually shows dramatic response to acetazolamide treatment. But few cases of acetazolamide unresponse CA were reported recently. Using dynamic FDG PET, we tried to evaluate the metabolic abnormality and its drug response in CA. Quantitative F-18-FDG PET was performed prior and after treatment of acetazolamide (250 mg qid for 10 days) in two patient suspected episodic cerebellar ataxia. Using Model-based clustering method, the regional cerebral glucose metabolic rate (rCMRglu) was calculated. Two patients showed different treatment response to acetazolamide. In one patient who showed markedly reduced frequency of the ataxic attack after treatment. FDG PET showed that mean cerebellar glucose metabolism was increased after treatment (ΔrCMRglu:9%). However, in the other who showed poor response to acetazolamide, FDG PET showed the more decrease metabolism in cerebellar metabolism after treatment (ΔrCMRglu:-17%). The change of the cerebellar glucose metabolism on FDG PET reflected the symptomatic improvement after acetazolamide in these two CA patients. We could expected that FDG PET might be a very useful tool to quantitatively predict the treatment response in CA and other neurologic disorder

Meeting the challenges in the development of risk-benefit assessment of foods

DEFF Research Database (Denmark)

Nauta, Maarten; Andersen, Rikke; Pilegaard, Kirsten

2018-01-01

challenges are identified and discussed. They include the variety of different definitions and terminologies used in the underlying research disciplines, the differences between the “bottom-up” and the “top-down” approaches and the need for clear risk-benefit questions. The frequent lack of data......Background Risk-benefit assessment (RBA) of foods aims to assess the combined negative and positive health effects associated with food intake. RBAs integrate chemical and microbiological risk assessment with risk and benefit assessment in nutrition. Scope and Approach Based on the past experiences...... interdisciplinary consensus, reconsideration of methodological approaches and health metrics based on a categorisation of risk-benefit questions, and the performance of case studies to experience the feasibility of the proposed approaches....

Information and Communications Technology (ICT) in Nigeria Educational Assessment System--Emerging Challenges

Science.gov (United States)

Aworanti, Olatunde Awotokun

2016-01-01

This paper examines Information and Communications Technology (ICT) in Nigeria educational assessment system with its emerging challenges. This is inevitable following the globalisation trend which has brought drastic changes in the world of technology. The essence of the paper is to describe the present status of ICT in the Nigeria educational…

THE ASSESSMENT OF CYBERBULLYING: THE PRESENT SITUATION AND FUTURE CHALLENGE

Directory of Open Access Journals (Sweden)

Beatriz Lucas-Molina

2016-01-01

Full Text Available In the last decade there has been a significant increase in the interest of the educational and scientific community on cyberbullying, a new form of peer abuse and intimidation. Despite the widespread proliferation of studies and assessment tools on the phenomenon, there are still major conceptual and methodological gaps. This paper offers a comprehensive and updated review of the results of research on the definition of the construct, its prevalence and its impact on the people involved. Finally, it focuses specifically on the assessment of the construct and provides a brief review of the general and psychometric characteristics of the instruments used in some of the most relevant national and international studies conducted on the subject. This work places special emphasis on the present and future challenges and concludes with a number of general recommendations intended to guide the correct selection and/or construction of assessment instruments in this field of study.

Risk assessment of cryogenic installations – implementation, applicability of methodologies and challenges at CERN

CERN Multimedia

CERN. Geneva

2016-01-01

For the safe design of a cryogenic installation, it is essential to carry out a comprehensive hazard identification and risk estimate in order to put in place the necessary control measures for an adequate risk mitigation. According to CERN Safety Rules, it is mandatory that the organic unit owning a cryogenic facility conducts and documents a risk assessment. This requirement is also given by the European Directive 2014/68/EU to manufacturers of pressure equipment. During the talk, some of the challenges CERN faces in the development of risk assessments across the broad array of activities involving cryogenic equipment in the organization will be discussed. Challenges such as the choice of the best-suited risk assessment methodology based on the features and complexity of the installation/activities, the efforts to develop tools to facilitate hazard identification, risk analysis and definition of related measures to protect the health and safety of workers, such as streamlined guidelines, forms and check...

Eastern Baltic cod in distress: biological changes and challenges for stock assessment

DEFF Research Database (Denmark)

Eero, Margit; Hjelm, Joakim; Behrens, Jane

2015-01-01

The eastern Baltic (EB) cod (Gadus morhua) stock was depleted and overexploited for decades until the mid-2000s, when fishing mortality rapidly declined and biomass started to increase, as shown by stock assessments. These positive developments were partly assigned to effective management measures...... that the stock is in distress. In this study, we (i) summarize the knowledge of recent changes in cod biology and ecosystem conditions, (ii) describe the subsequent challenges for stock assessment, and (iii) highlight the key questions where answers are urgently needed to understand the present stock status...

ASSESSMENT OF QUALITY OF LIFE: PRESENT AND FUTURE METHODOLOGICAL CHALLENGES

Directory of Open Access Journals (Sweden)

Isabel Benítez

2016-01-01

Full Text Available The growing importance of quality of life in diverse domains, such as health, school performance and social participation, has led to the development of new conceptualisations and assessments of the construct. This diversity of perspectives brings about many benefits, but it also creates an obstacle for the formulation of a single unifying definition of the construct and, therefore, an agreed instrument or assessment framework. The aim of this study is to discuss the current methodological challenges in the measurement of quality of life. Firstly, we provide a brief description of the construct as defined in various areas, then we examine the new methodological developments and different applications. We also present an overview of the different possibilities for future developments in defining and measuring quality of life in national and international studies.

Conceptual and methodological challenges to integrating SEA and cumulative effects assessment

International Nuclear Information System (INIS)

Gunn, Jill; Noble, Bram F.

2011-01-01

The constraints to assessing and managing cumulative environmental effects in the context of project-based environmental assessment are well documented, and the potential benefits of a more strategic approach to cumulative effects assessment (CEA) are well argued; however, such benefits have yet to be clearly demonstrated in practice. While it is widely assumed that cumulative effects are best addressed in a strategic context, there has been little investigation as to whether CEA and strategic environmental assessment (SEA) are a 'good fit' - conceptually or methodologically. This paper identifies a number of conceptual and methodological challenges to the integration of CEA and SEA. Based on results of interviews with international experts and practitioners, this paper demonstrates that: definitions and conceptualizations of CEA are typically weak in practice; approaches to effects aggregation vary widely; a systems perspective lacks in both SEA and CEA; the multifarious nature of SEA complicates CEA; tiering arrangements between SEA and project-based assessment are limited to non-existing; and the relationship of SEA to regional planning remains unclear.

A study of acetazolamide-induced changes in cerebral blood flow using {sup 99m}Tc HMPAO SPECT in patients with cerebrovascular disease

Energy Technology Data Exchange (ETDEWEB)

Asenbaum, S. [Neurological Clinic, Univ. Vienna (Austria); Reinprecht, A. [Neurosurgical Clinic, Univ. Vienna (Austria); Bruecke, T. [Neurological Clinic, Univ. Vienna (Austria); Wenger, S. [Neurological Clinic, Univ. Vienna (Austria); Podreka, I. [Neurological Clinic, Univ. Vienna (Austria); Deecke, L. [Neurological Clinic, Univ. Vienna (Austria)

1995-01-01

For semiquantification of SPECT studies we tried to calculate cerebral {sup 99m}Tc-HMPAO uptake related to injected dose and estimated brain volume. The method was applied to SPECT investigations of 27 patients who had a least one ischaemic attack and a confirmed 80-100% stenosis of the corresponding internal carotid artery (ICA). Vascular reactivity was tested by parenteral administration of acetazolamide (AZ). Increase in HMPAO uptake after AZ was evident in both hemispheres, although the increase (AZ effect) was significantly lower in the affected hemisphere (+24% versus +28%). No interhemispheric uptake differences were seen in patients with largely normal SPECT studies, although local asymmetries in HMPAO deposition were visible. Patients with low density lesions on CT and with a well-demarcated lesion in the same location on SPECT revealed interhemispheric uptake differences, with lower uptake on the affected side. This was not due solely to alterations in the lesion, but also to reduced HMPAO uptake and AZ effect in the surrounding area. The AZ effect showed no correlation with angiographic findings, indicating no major haemodynamic influence of the ICA stenosis on cerebral hemisphere perfusion. Calculated cerebral HMPAO uptake changes after AZ administration were in good accordance with absolute cerebral blood flow measurements, and made interindividual comparisons possible. However, as changes in the area around an infarct or local reduction in vascular reserve may not be reproduced adequately by uptake calculations, visual inspection is still necessary. (orig.)

Dealing with Health and Health Care System Challenges in China: assessing health determinants and health care reforms

NARCIS (Netherlands)

H. Zhang (Hao)

2017-01-01

markdownabstractThis dissertation investigates the challenges faced by China around 2010 in two domains – population health and the health care system. Specifically, chapters 2 and 3 are devoted to health challenges, explaining the female health disadvantage in later life and assessing the effect

Management Challenges in Developing Performance Assessments and Effectively Communicating Their Results - 13612

Energy Technology Data Exchange (ETDEWEB)

Thomas, Steve; Mahoney, Mark [Savannah River Remediations LLC, Building 705-1C, Savannah River Site, Aiken, SC 29808 (United States)

2013-07-01

The end of the Cold War has left a legacy of approximately 37 million gallons of radioactive waste in the aging waste tanks at the Department of Energy's Savannah River Site (SRS). A robust program is in place to remove waste from these tanks, treat the waste to separate into a relatively small volume of high level waste and a large volume of low-level waste, and to actively dispose of the low-level waste on-site and close the cleaned waste tanks and associated ancillary structures. To support performance-based, risk-informed decision making, performance assessments have been developed for the low-level waste disposal facility and for the SRS Tank Farms. Although these performance assessments share many similar features, the nature of the hazards and associated containments differ. As a management team, we are challenged to effectively communicate both the similarities and differences of these performance assessments, how they should be used to support sound decision making for treatment, disposal and waste tank cleaning decisions, and in defending their respective assumptions to the regulatory community and the public but, equally important, to our own corporate decision makers and operations personnel. Effective development and defense of these performance assessments, and effective interpretation and communication of the results are key to making cost-effective, pragmatic decisions for the safe disposal of the low-level waste and stabilization and operational closure of the cleaned tanks and associated structures. This paper will focus on the importance and challenges in communicating key attributes, conclusions and operational implications within a company. (authors)

The effect of EC-IC bypass surgery on resting cerebral blood flow and cerebrovascular reserve capacity studied with stable Xe-CT and acetazolamide test

Energy Technology Data Exchange (ETDEWEB)

Yamashita, T.; Kashiwagi, S.; Nakano, S.; Takasago, T.; Abiko, S.; Shiroyama, Y.; Hayashi, M.; Ito, H. (Yamaguchi Univ. School of Medicine (Japan). Dept. of Neurosurgery)

1991-06-01

Cerebral blood flow (CBF) and cerebrovascular reserve capacity (CRC) were measured by stable xenon computerized tomography (Xe-CT) and acetazolamide test in 15 patients with cerebrovascular disease before and after extracranial-intracranial (EC-IC) bypass surgery for minor stroke, reversible ischemic neurological deficit or transient ischemic attack. All had angiographically shown occlusive lesions of the major arterial trunk. In the present series, global analysis showed that the bypass did not increase the resting rCBF, but did increase the rCRC. We divided the patients into four groups according to the preoperative resting rCBF and rCRC. All 3 patients with normal resting rCBF and reduced rCRC showed postoperative improvement of rCRC. Of 6 patients with reduced CBF and reduced CRC, three had postoperative increase in resting CBF and four had increased CRC. One of two patients with reduced CBF and normal CRC showed only an increase in CRC. We propose that reduced CRC or reduced CBF with reduced CRC are criteria for selection of candidates for bypass surgery. We conclude that Xe-CT with the Diamox test is a useful and simple method for evaluating cerebral hemodynamics. Preoperative grouping with a combination of preoperative resting rCBF and preoperative rCRC is useful for predicting the effect of EC-IC bypass surgery. (orig.).

The changing face of nanomaterials: Risk assessment challenges along the value chain.

Science.gov (United States)

Mattsson, Mats-Olof; Simkó, Myrtill

2017-03-01

Risk assessment (RA) of manufactured nanomaterials (MNM) is essential for regulatory purposes and risk management activities. Similar to RA of "classical" chemicals, MNM RA requires knowledge about exposure as well as of hazard potential and dose response relationships. What makes MNM RA especially challenging is the multitude of materials (which is expected to increase substantially in the future), the complexity of MNM value chains and life cycles, the accompanying possible changes in material properties over time and in contact with various environmental and organismal milieus, and the difficulties to obtain proper exposure data and to consider the proper dose metric. This article discusses these challenges and also critically overviews the current state of the art regarding MNM RA approaches. Copyright © 2016 Elsevier Inc. All rights reserved.

Engineering Risk Assessment of Space Thruster Challenge Problem

Science.gov (United States)

Mathias, Donovan L.; Mattenberger, Christopher J.; Go, Susie

2014-01-01

The Engineering Risk Assessment (ERA) team at NASA Ames Research Center utilizes dynamic models with linked physics-of-failure analyses to produce quantitative risk assessments of space exploration missions. This paper applies the ERA approach to the baseline and extended versions of the PSAM Space Thruster Challenge Problem, which investigates mission risk for a deep space ion propulsion system with time-varying thruster requirements and operations schedules. The dynamic mission is modeled using a combination of discrete and continuous-time reliability elements within the commercially available GoldSim software. Loss-of-mission (LOM) probability results are generated via Monte Carlo sampling performed by the integrated model. Model convergence studies are presented to illustrate the sensitivity of integrated LOM results to the number of Monte Carlo trials. A deterministic risk model was also built for the three baseline and extended missions using the Ames Reliability Tool (ART), and results are compared to the simulation results to evaluate the relative importance of mission dynamics. The ART model did a reasonable job of matching the simulation models for the baseline case, while a hybrid approach using offline dynamic models was required for the extended missions. This study highlighted that state-of-the-art techniques can adequately adapt to a range of dynamic problems.

Anti-glaucoma potential of Heliotropium indicum Linn in experimentally-induced glaucoma.

Science.gov (United States)

Kyei, Samuel; Koffuor, George Asumeng; Ramkissoon, Paul; Owusu-Afriyie, Osei

2015-01-01

Heliotropium indicum is used as a traditional remedy for hypertension in Ghana. The aim of the study was to evaluate the anti-glaucoma potential of an aqueous whole plant extract of H. indicum to manage experimentally-induced glaucoma. The percentage change in intraocular pressure (IOP), after inducing acute glaucoma (15 mLkg(-1) of 5 % dextrose, i.v.), in New Zealand White rabbits pretreated with Heliotropium indicum aqueous extract (HIE) (30-300 mgkg(-1)), acetazolamide (5 mgkg(-1)), and normal saline (10 mLkg(-1)) per os were measured. IOPs were also monitored in chronic glaucoma in rabbits (induced by 1 % prednisolone acetate drops, 12 hourly for 21 days) after treatments with the same doses of HIE, acetazolamide, and normal saline for 2 weeks. The anti-oxidant property of the extract was assessed by assaying for glutathione levels in the aqueous humour. Glutamate concentration in the vitreous humour was also determined using ELISA technique. Histopathological assessment of the ciliary bodies was made. The extract significantly reduced intraocular pressure (p ≤ 0.05-0.001) in acute and chronic glaucoma, preserved glutathione levels and glutamate concentration (p ≤ 0.01-0.001). Histological assessment of the ciliary body showed a decrease in inflammatory infiltration in the extract and acetazolamide-treated group compared with the normal saline-treated group. The aqueous whole plant extract of Heliotropium indicum has ocular hypotensive, anti-oxidant and possible neuro-protective effects, which therefore underscore its plausible utility as an anti-glaucoma drug with further investigation.

Challenges in Creating Evidence in Environmental Health Risk Assessments: The Example of Second-Hand Smoke

Directory of Open Access Journals (Sweden)

Florian Fischer

2016-01-01

Full Text Available Public health interventions are directed to influence the (state of a risk factor, either by behavioral or environmental changes. Therefore, environmental health risk assessments are highly relevant for public health decision making and policy development. The credibility of an environmental health risk assessment depends, to a large extent, on the strength of the scientific evidence on which it is based. In this article, the main challenges for assessing the impact of a potential adverse health effect from an environmental pollutant are described. Second-hand smoke (SHS was chosen to illustrate the current state of evidence. The assessment of the impact of potential adverse health effects from environmental risk factors is dependent on several issues, such as the hypothesized health outcome, the nature of the exposure, the dose-response-relationship and the variability and susceptibility of the exposed population. The example of SHS exposure highlights the need for evidence-based public health. Several challenges in terms of study design, assessment methods, as well as data analysis and synthesis with respect to the stratification of results, and consideration of bias and confounding exist. Future research needs to take into account which methods and techniques will be used to generate evidence for population-level decisions.

Comparison between CT perfusion and Tc-99m ECD SPECT in the assessment of cerebrovascular reserve: a case study

International Nuclear Information System (INIS)

Crouch, J.; Wood, C.; Campbell, A.; McCarthy, M.; Dunne, M.; Bynevelt, M.; Lenzo, N.

2003-01-01

Full text: Brain perfusion is sensitively assessed by cerebral SPECT imaging utilising perfusion agents such as Tc-99m HMPAO and Tc-99m ethyl cysteinate dimer (ECD). Positron emission tomography can accurately assess and quantify brain perfusion and MRI can also be used for perfusion assessment. Both MRI and PET however are currently limited by cost and availability. A new technique utilising CT with contrast has been developed to assess and quantitate cerebral perfusion. The technique utilises arterial input information and deconvolution analysis to develop quantifiable measures of perfusion and contrast transit. The technique has been validated for acute stroke assessment and is being assessed for other possible applications. We present a case study comparison of this technique with cerebral SPECT perfusion using Tc-99m ECD in the assessment of cerebrovasular reserve. In each case, the CT and SPECT studies were performed pre- and post-acetazolamide and the SPECT study was statistically compared with a normal database utilising an automated brain perfusion statistical analysis package (NeurostatT). We discuss the correlation found between techniques, their strengths, weaknesses and possible future roles. Copyright (2003) The Australian and New Zealand Society of Nuclear Medicine Inc

Cultural challenges to implementation of formative assessment in Saudi Arabia: an exploratory study.

Science.gov (United States)

Al-Wassia, Rolina; Hamed, Omayma; Al-Wassia, Heidi; Alafari, Reem; Jamjoom, Reda

2015-04-01

This study investigates challenges that students and faculty face to implement assessment for learning; and the activities, capabilities, enablers, and indicators which could impact performance. The study is a mixed methods research, cross-sectional, exploratory study. The study was organized through two phases of data collection and analysis (QUAL → quan). Based on qualitative focus group discussions (FGD), we first gathered data through field notes. Later, we engaged in analysis using techniques drawn from qualitative data including categorization, theme identification, and connection to existing literature. Based on this analysis, we developed a questionnaire that could provide quantitative measures based on the qualitative FGD. We then administered the questionnaire, and the quantitative data were analyzed to quantitatively test the qualitative findings. Twenty-four faculty and 142 students from the 4th and 5th clinical years participated voluntarily. Their perception of FA and the cultural challenges that hinder its adoption were evaluated through a FGD and a questionnaire. The mean score of understanding FA concept was equal in faculty and students (p = 0.08). The general challenge that scored highest was the need to balance work and academic load in faculty and the need to balance study load and training and mental anxiety in students. There was no difference between faculty and students in perceiving "learning is teacher-centered" (p = 0.481); and "past learning and assessment experience" (p = 0.322). There was a significant difference between them regarding interaction with opposite gender (p discrimination by same faculty gender". The authors suggested a "Framework of Innovation in Endorsing Assessment for Learning". It emphasizes a holisitic approach through all levels of the System: Government, Accreditation Bodies, Policy makers; Institution, and Classroom levels.

Methods and challenges for the health impact assessment of vaccination programs in Latin America

Directory of Open Access Journals (Sweden)

Ana Marli Christovam Sartori

2015-01-01

Full Text Available ABSTRACT OBJECTIVE To describe methods and challenges faced in the health impact assessment of vaccination programs, focusing on the pneumococcal conjugate and rotavirus vaccines in Latin America and the Caribbean. METHODS For this narrative review, we searched for the terms "rotavirus", "pneumococcal", "conjugate vaccine", "vaccination", "program", and "impact" in the databases Medline and LILACS. The search was extended to the grey literature in Google Scholar. No limits were defined for publication year. Original articles on the health impact assessment of pneumococcal and rotavirus vaccination programs in Latin America and the Caribbean in English, Spanish or Portuguese were included. RESULTS We identified 207 articles. After removing duplicates and assessing eligibility, we reviewed 33 studies, 25 focusing on rotavirus and eight on pneumococcal vaccination programs. The most frequent studies were ecological, with time series analysis or comparing pre- and post-vaccination periods. The main data sources were: health information systems; population-, sentinel- or laboratory-based surveillance systems; statistics reports; and medical records from one or few health care services. Few studies used primary data. Hospitalization and death were the main outcomes assessed. CONCLUSIONS Over the last years, a significant number of health impact assessments of pneumococcal and rotavirus vaccination programs have been conducted in Latin America and the Caribbean. These studies were carried out few years after the programs were implemented, meet the basic methodological requirements and suggest positive health impact. Future assessments should consider methodological issues and challenges arisen in these first studies conducted in the region.

Physics challenges for advanced fuel cycle assessment

Energy Technology Data Exchange (ETDEWEB)

Giuseppe Palmiotti; Massimo Salvatores; Gerardo Aliberti

2014-06-01

Advanced fuel cycles and associated optimized reactor designs will require substantial improvements in key research area to meet new and more challenging requirements. The present paper reviews challenges and issues in the field of reactor and fuel cycle physics. Typical examples are discussed with, in some cases, original results.

Physics challenges for advanced fuel cycle assessment

Energy Technology Data Exchange (ETDEWEB)

Salvatores, Massimo; Aliberti, Gerardo; Palmiotti, Giuseppe

2014-06-17

Advanced fuel cycles and associated optimized reactor designs will require substantial improvements in key research area to meet new and more challenging requirements. The present paper reviews challenges and issues in the field of reactor and fuel cycle physics. Typical examples are discussed with, in some cases, original results.

Nanomaterials: a challenge for toxicological risk assessment?

Science.gov (United States)

Haase, Andrea; Tentschert, Jutta; Luch, Andreas

2012-01-01

Nanotechnology has emerged as one of the central technologies in the twenty-first century. This judgment becomes apparent by considering the increasing numbers of people employed in this area; the numbers of patents, of scientific publications, of products on the market; and the amounts of money invested in R&D. Prospects originating from different fields of nanoapplication seem unlimited. However, nanotechnology certainly will not be able to meet all of the ambitious expectations communicated, yet has high potential to heavily affect our daily life in the years to come. This might occur in particular in the field of consumer products, for example, by introducing nanomaterials in cosmetics, textiles, or food contact materials. Another promising area is the application of nanotechnology in medicine fueling hopes to significantly improve diagnosis and treatment of all kinds of diseases. In addition, novel technologies applying nanomaterials are expected to be instrumental in waste remediation and in the production of efficient energy storage devices and thus may help to overcome world's energy problems or to revolutionize computer and data storage technologies. In this chapter, we will focus on nanomaterials. After a brief historic and general overview, current proposals of how to define nanomaterials will be summarized. Due to general limitations, there is still no single, internationally accepted definition of the term "nanomaterial." After elaborating on the status quo and the scope of nanoanalytics and its shortcomings, the current thinking about possible hazards resulting from nanoparticulate exposures, there will be an emphasis on the requirements to be fulfilled for appropriate health risk assessment and regulation of nanomaterials. With regard to reliable risk assessments, until now there is still the remaining issue to be resolved of whether or not specific challenges and unique features exist on the nanoscale that have to be tackled and distinctively

Regulatory assessment of safety culture in nuclear organisations - current trends and challenges

International Nuclear Information System (INIS)

Tronea, M.

2010-01-01

The paper gives an overview of the current practices in the area of regulatory assessment of safety culture in nuclear organisations and of the associated challenges. While the assessment and inspection procedures currently in use by regulatory authorities worldwide are directed primarily at verifying compliance with the licensing basis, there is a recognised need for a more systematic approach to the identification, collection and review of data relevant to the safety culture in licensees' organisations. The paper presents a proposal for using the existing regulatory inspection practices for gathering information relevant to safety culture and for assessing it in an integrated manner. The proposal is based on the latest requirements and guidance issued by the International Atomic Energy Agency (IAEA) on management systems for nuclear facilities and activities, particularly as regards the attributes needed for a strong nuclear safety culture. (author)

Life Cycle Impact Assessment in the Arctic: Challenges and Research Needs

Directory of Open Access Journals (Sweden)

Johan Berg Pettersen

2017-09-01

Full Text Available Life cycle assessment (LCA is increasingly used for environmental assessment of products and production processes to support environmental decision-making both worldwide and in the Arctic. However, there are several weaknesses in the impact assessment methodology in LCA, e.g., related to uncertainties of impact assessment results, absence of spatial differentiation in characterization modeling, and gaps in the coverage of impact pathways of different “archetypal” environments. Searching for a new resource base and areas for operation, marine and marine-based industries are continuously moving north, which underlines the need for better life cycle impact assessment in the Arctic, particularly to aid in industrial environmental management systems and stakeholder communications. This paper aims to investigate gaps and challenges in the application of the currently available impact assessment methods in the Arctic context. A simplified Arctic mining LCA case study was carried out to demonstrate the relevance of Arctic emissions at the midpoint and endpoint levels, as well as possible influences of the Arctic context on the impact assessment results. Results of this study showed that significant research gaps remain in Arctic-dependent life cycle impact assessment, particularly on: (i the possible influences of the Arctic-specific features on characterization factors for impact assessment (such as seasonality, cold climate, precipitation, and marine dependence; and (ii the coverage of impact pathways, especially on the under-addressed marine impacts and marine/near-shore dispersion processes. Addressing those identified research gaps and demand for future Arctic life cycle impact assessment could increase the credibility of LCA as an environmental decision-making support tool for Arctic industries and better support sustainable Arctic development.

Variables and Challenges in Assessing EU Experts’ Performance

Directory of Open Access Journals (Sweden)

Cathrine Holst

2015-03-01

Full Text Available Expert advice in political processes is supposed to improve decisions. If expertise fails in this function, a legitimacy problem occurs: granting political power to experts may be defensible, but only on the grounds that it contributes to enlightening political processes and facilitate problem-solving. The paper provides a theoretical exploration of four variables that are key when assessing the epistemic quality of expert deliberations: the degree to which these deliberations are 1 informed by technical expertise, 2 regulated by epistemically optimal respect and inclusion norms, 3 focused on politically relevant and applicable knowledge, and 4 approaching questions involving moral judgment and standard setting competently. Previous research on the European Commission’s use of expert advice has more or less overlooked the question of experts’ epistemic performance, and this paper discusses the possible reasons for this in light of well-known methodological challenges in studies of elite behaviour; access and bias problems. A discussion of the merits and limitations of different available data on the Commission experts shows that the biggest obstacle in the study of experts’ epistemic performance is rather the problem of epistemic asymmetry, i.e. of how researchers as non-experts can assess the epistemic quality of experts’ contributions and behaviour. The paper offers, finally, a set of strategies to get research going despite this problem.

Assessment of nurse retention challenges and strategies in Lebanese hospitals: the perspective of nursing directors.

Science.gov (United States)

El-Jardali, Fadi; Merhi, Mirvat; Jamal, Diana; Dumit, Nuhad; Mouro, Gladys

2009-05-01

Assess nurse retention challenges and strategies as perceived by nursing directors in Lebanese hospitals. The Kampala Health Workforce Declaration stressed the importance of retaining an effective, responsive and equitably distributed health workforce, particularly nurses. Little is known about nurse retention challenges and strategies in Lebanon. Nursing directors of 76 hospitals participated and were sent a two-page survey on perceived retention challenges and hospital-based retention strategies. Retention challenges included unsatisfactory salary, unsuitable shifts and working hours, as well as better opportunities in other areas within or outside Lebanon. Retention strategies included implementing financial rewards and benefits, a salary scale, staff development, praise and improving work environment. Nursing directors did not address all perceived challenges in their strategies. To better manage the nursing workforce, nursing directors should regularly measure and monitor nurse turnover rates and also their causes and predictors. Nursing directors should develop, implement and evaluate retention strategies. More information is needed on the management and leadership capacities of nursing directors in addition to their span of control. Nursing directors are facing challenges in retaining their nurses. If these problems are not addressed, Lebanon will continue to lose competent and skilled nurses.

A Bibliometric Assessment of Global Ice Bucket Challenge (Amyotrophic Lateral Sclerosis) Research.

Science.gov (United States)

Ram, Shri

2016-10-01

This study is a quantitative and qualitative assessment of the global research trends on amyotrophic lateral sclerosis (ALS) (popularly known as Ice Bucket Challenge), through related literatures retrieved from SCOPUS multidisciplinary database for the period 1974-2013. This study is aimed at analyzing the literature on ALS in terms of document type, language, annual growth, productive country, journal, authors, subject, and most cited articles. The bibliographic data for this study was retrieved from the SCOPUS database using keywords 'amyotrophic lateral sclerosis', 'motor neurone disease', 'Charcot disease', 'Lou Gehrig's disease', 'Ice Bucket Challenge' available in title, abstract, and keyword fields of Scopus database from 1974 to 2013. The literature analysis included 21,750 articles during the period from 1974 to 2013 in different areas of ALS. USA was the most productive country in terms of literature produced, while Neurology was the most productive journal. An intensive awareness created by 'Ice Bucket Challenge' has attracted masses, and an intensive growth of literature is pertinent on ALS. The results of this study are expressed in terms of growth of literature, output of individual countries, and authors, and will be helpful in collaborative research in future.

Statistical image analysis of cerebral blood flow in moyamoya disease

International Nuclear Information System (INIS)

Yamada, Masaru; Yuzawa, Izumi; Suzuki, Sachio; Kurata, Akira; Fujii, Kiyotaka; Asano, Yuji

2007-01-01

The Summary of this study was to investigate pathophysiology of moyamoya disease, we analyzed brain single photon emission tomography (SPECT) images of patients with this disease by using interface software for a 3-dimensional (3D) data extraction format. Presenting symptoms were transient ischemic attack (TIA) in 21 patients and hemorrhage in 6 patients. All the patients underwent brain SPECT scan of 123 I-iofetamine (IMP) at rest and after acetazolamide challenge (17 mg/kg iv, 2-day method). Cerebral blood flow (CBF) was quantitatively measured using arterial blood sampling and an autoradiography model. The group of the patients who presented with TIAs showed decreased CBF in the frontal lobe at rest compared to that of patients with hemorrhage, but Z-score ((mean-patient data)/ standard deviation (SD)) did not reach statistical significance. Significant CBF decrease after acetazolamide challenge was observed in a wider cerebral cortical area in the TIA group than in the hemorrhagic group. The brain region of hemodynamic ischemia (stage II) correlated well with the responsible cortical area for clinical symptoms of TIA. A hemodynamic ischemia stage image clearly represented recovery of reserve capacity after bypass surgery. Statistical evaluation of SPECT may be useful to understand and clarify the pathophysiology of this disease. (author)

Assessment Tools as Drivers for SPI: Short-term Benefits and Long-term Challenges

DEFF Research Database (Denmark)

Mûller, Sune Dueholm; Nørbjerg, Jacob; Cho, Hiu Ngan

2007-01-01

Full scale software process maturity assessments are costly, can have large organizational impact, and are carried out at long (12-24 months) intervals. Consequently, there is a need for techniques and tools to monitor and help manage an SPI project through inexpensive, ongoing progress assessments....... In this paper we present findings from two cases of using such a tool. We have found that the tool does provide useful snapshots of the status of SPI projects, but that long-term use of the tool introduces costs and challenges related to modifying and tailoring the tool to both the organizational context...

Challenges in Risk Assessment: Quantitative Risk Assessment

OpenAIRE

Jacxsens, Liesbeth; Uyttendaele, Mieke; De Meulenaer, Bruno

2016-01-01

The process of risk analysis consists out of three components, risk assessment, risk management and risk communication. These components are internationally well spread by Codex Alimentarius Commission as being the basis for setting science based standards, criteria on food safety hazards, e.g. setting maximum limits of mycotoxins in foodstuffs. However, the technical component risk assessment is hard to elaborate and to understand. Key in a risk assessment is the translation of biological or...

Measurement of cerebral blood flow by single photon emission computed tomography in cases of internal carotid artery occlusion

Energy Technology Data Exchange (ETDEWEB)

Sunada, Ichiro [Osaka City Univ. (Japan). Faculty of Medicine

1989-06-01

Cerebral blood flow (CBF) was measured with {sup 133}xenon inhalation and single photon emission computed tomography in 33 cases of internal carotid artery occlusion, in the resting state and 25 minutes after acetazolamide administration. The patient population consisted of 24 males and nine females with a mean age of 57 years, who presented with transient ischemic attacks or stroke. Acetazolamide inhibits carbonic anhydrase, and CBF increases as a result of dilatation of cerebral arteries due to CO{sub 2} accumulation. The mean CBF was 46 ml/100 g/min on the affected hemisphere and 56 ml/100 g/min on the unaffected hemisphere. The mean CBF value obtained by the same method in 10 normal volunteers was 55 ml/100 g/min. The average increase in CBF after acetazolamide administration was 9% on the affected side and 17% on the unaffected side. The average increase in 10 normal volunteers was 32%. The reduced cerebral arterial reactivity to acetazolamide administration was bilateral in the patient group, suggesting that the cerebral arteries were dilated so as to maintain normal CBF. Extra-intracranial (EC-IC) bypass surgery was performed in nine patients. Preoperatively, the mean CBF was 48 ml/100 g/min on the affected side and 57 ml/100 g/min on the unaffected side. With postoperative acetazolamide administration, the percent increase in CBF rose from 13% to 22% on the affected side and from 17% to 23% on the unaffected side. The bilateral change toward normal in cerebral arterial reactivity to acetazolamide indicates that the dilated cerebral arteries returned to normal after EC-IC bypass surgery. This suggests that bypass surgery is effective in patients with internal carotid artery occlusion in whom ischemia is caused only by hemodynamic factors, and that measurement of CBF via acetazolamide loading is useful in identifying appropriate candidates for bypass surgery.

The challenge of making ozone risk assessment for forest trees more mechanistic

International Nuclear Information System (INIS)

Matyssek, R.; Sandermann, H.; Wieser, G.; Booker, F.; Cieslik, S.; Musselman, R.; Ernst, D.

2008-01-01

Upcoming decades will experience increasing atmospheric CO 2 and likely enhanced O 3 exposure which represents a risk for the carbon sink strength of forests, so that the need for cause-effect related O 3 risk assessment increases. Although assessment will gain in reliability on an O 3 uptake basis, risk is co-determined by the effective dose, i.e. the plant's sensitivity per O 3 uptake. Recent progress in research on the molecular and metabolic control of the effective O 3 dose is reported along with advances in empirically assessing O 3 uptake at the whole-tree and stand level. Knowledge on both O 3 uptake and effective dose (measures of stress avoidance and tolerance, respectively) needs to be understood mechanistically and linked as a pre-requisite before practical use of process-based O 3 risk assessment can be implemented. To this end, perspectives are derived for validating and promoting new O 3 flux-based modelling tools. - Clarifying and linking mechanisms of O 3 uptake and effective dose are research challenges highlighted in view of recent progress and perspectives towards cause-effect based risk assessment

Challenges in Learning for Company‘s Financial Viability Assessment and Management

Directory of Open Access Journals (Sweden)

Nadezda Koleda

2015-06-01

Full Text Available Many entrepreneurs in Latvia are limited in choice of tools for the improvement of their financial literacy. Therefore the training course “Financial literacy of entrepreneurs in the field of financial viability management” was elaborated and tested with the aim to improve the course and reveal the challenges facing different categories of learners. The research was formative as it combined the promotion of learners and trainers’ competencies and behaviours with the research process throughout all the five training cycles. The research methods applied were chosen based on the inner logics and aims of the teaching and learning processes: videorecording of learners’ activities and analysis of the videomaterials; analysis of the learners’ work and reflections. Out of the identified sixteen challenges faced by learners, three were especially crucial and caused further difficulties in coping with different tasks on assessment and management of company’s financial viability. It was concluded that there may be three categories of learners whose training should be organised in different modes taking into account the level of their preparedness in accountancy, tax accounting and financial analysis.

Molecular Descriptors Family on Vertex Cutting: Relationships between Acelazolamide Structures and their Inhibitory Activity

Directory of Open Access Journals (Sweden)

Sorana D. BOLBOACĂ

2009-12-01

Full Text Available Aim: To investigate the relationship between the structural information of acetazolamides and their inhibitory activity on carbonic anhydrase II. Material and Method: A sample of previously reported acetazolamides was studied. A pool of descriptors was calculated based on matrix representation and vertex cut in order to be included in the multiple linear regression analysis. The best performing model in terms of goodness-of-fit was analysed in order to assess its validity and reliability. The model was compared with previously reported models using a series of information and prediction criteria besides the Steiger’s Z test. Results: A model with a 99.77% determination coefficient proved to be the best performing model. The obtained model proved to have a less than 5% average of the absolute difference between the observed and the estimated inhibitory activity. The information and prediction criteria showed that the obtained model was better than the previously reported models. This conclusion is also sustained by the results of Steiger’s Z test (7.78; p = 3.66·10-15. Conclusion: The inhibitory activity on carbonic anhydrase II of acetazolamides proved to be of geometric and topologic nature and depended on the compounds’ melting point, relative atomic mass and atomic electronegativity.

Meaningful and efficient? Enduring challenges to Aboriginal participation in environmental assessment

International Nuclear Information System (INIS)

Udofia, Aniekan; Noble, Bram; Poelzer, Greg

2017-01-01

This paper explores the underlying practice-based challenges to meaningful and efficient Aboriginal participation in environmental assessment (EA) - participation that provides meaningful opportunities for Aboriginal communities to shape EA, yet assures a degree of efficiency for project proponents who need to obtain EA approvals in a timely and financially viable manner. We do so based on an analysis of the EA policy community's experience with uranium exploration and mining in Saskatchewan, Canada. Many of the challenges to meaningful and efficient Aboriginal participation that emerged are multi-dimensional, often concerning participation processes, decision-making, and relationships. Although scholars have explored many of these issues and have proposed numerous solutions, challenges persist in practice. Several other issues also emerged from our study that have received limited attention, including the non-commitment to early and ongoing participation by smaller project proponents, and the EA exemption of exploration projects; the limited availability of information to project developers on local right holders and Aboriginal interests; expectations about the integration of traditional knowledge and land use in EA not aligning with the information that is available to proponents; confusion about who is responsible for initiating early participation and consultation processes; the lack of early relationship building with potentially affected communities, particularly by governments; and the lack of other viable avenues, outside EA, for Aboriginal communities to raise more strategic issues of concern that affect traditional lands and treaty rights.

Global warming and the challenge of international cooperation: an interdisciplinary assessment

International Nuclear Information System (INIS)

Bryner, G.C.

1992-01-01

The book aims to explore the nature of potential climatic change. It seeks to assess the scientific, economic legal and political issues related to the threat of global warming from an interdisciplinary perspective. The seven chapters have the following titles: the challenge of global warming; global warming and ozone depletion - certainties and uncertainties; consequences of global climate change for Earth's biosphere; global energy use and global warming; problems and prospects of institutionalizing ecological interdependence in a world of local independence; political institutions and climate change; and policy options for responding to the threat of global warming. Six chapters are abstracted separately. 158 refs

Is central chemoreceptor sensitive to intracellular rather than extracellular pH?

DEFF Research Database (Denmark)

Lassen, N A

1990-01-01

, however, that the elegant studies by Loeschcke & Ahmad have demonstrated that [pH]e and [pH]i are normally tightly and rapidly coupled (Loeschcke & Ahmad, 1980). For this reason, the stimulus might just as well be the intracellular hydrogen ion concentration in the chemoreceptor area. The administration...... the same decrease in [pH]e and the same increase in CBF. In other words CBF acidosis can quantitatively account for the CBF increase induced by acetazolamide. But CO2 and acetazolamide influence [pH]i quite differently, as CO2 drops [pH]i to almost the same extent as [pH]c, while two recent studies by MR...... spectroscopy have shown that acetazolamide does not drop [pH]i measurably, if tissue hypercapnia is prevented in artificially ventilated rabbits or by the mild spontaneous hyperventilation caused by acetazolamide in normal man.(ABSTRACT TRUNCATED AT 250 WORDS)...

Global challenges in the risk assessment of nanomaterials: Relevance to South Africa

Directory of Open Access Journals (Sweden)

Mary Gulumian

2012-09-01

Full Text Available Internationally, there are efforts to develop standardised toxicity testing and risk assessmentmethods for engineered nanomaterials (ENMs. To this end, health risk assessments need tobe conducted on ENMs synthesised in South Africa. Country-specific risk characterisationrequires specific exposure assessments for those ENMs for which the likelihood exists foroccupational and environmental exposure in that country. A challenge in hazard identificationand risk assessment related to ENMs, regardless of country of origin, is that data on toxicity,carcinogenicity, pharmacokinetics, and occupational or environmental exposure are generallynot available for most ENMs. Although the mechanisms previously identified as importantin the toxicity and carcinogenicity of particles and fibres may be applicable, the possibilityexists that the unusual physicochemical properties of ENMs may give rise to unique, andas yet unidentified, adverse effects. Moreover, generalised exposure scenarios that considerthe life cycle of the agent have not been developed and are needed for the complete riskcharacterisation of ENMs. As health risk assessment is both resource and labour intensive, it isimperative to identify the aims of such an exercise prior to embarking on large-scale projects,to ensure that the data most useful for public health decision-making is provided. Identifyingpriorities in South Africa, in coordination with international efforts, can facilitate the effectiveuse of research efforts for risk assessment and risk management decision-making.

Challenges in assessing college students' conception of duality: the case of infinity

Science.gov (United States)

Babarinsa-Ochiedike, Grace Olutayo

Interpreting students' views of infinity posits a challenge for researchers due to the dynamic nature of the conception. There is diversity and variation among students' process-object perceptions. The fluctuations between students' views however reveal an undeveloped duality conception. This study examined college students' conception of duality in understanding and representing infinity with the intent to design strategies that could guide researchers in categorizing students' views of infinity into different levels. Data for the study were collected from N=238 college students enrolled in Calculus sequence courses (Pre-Calculus, Calculus I through Calculus III) at one of the southwestern universities in the U.S. using self-report questionnaires and semi-structured individual task-based interviews. Data was triangulated using multiple measures analyzed by three independent experts using self-designed coding sheets to assess students' externalization of the duality conception of infinity. Results of this study reveal that college students' experiences in traditional Calculus sequence courses are not supportive of the development of duality conception. On the contrary, it strengthens the singularity perspective on fundamental ideas of mathematics such as infinity. The study also found that coding and assessing college students' conception of duality is a challenging and complex process due to the dynamic nature of the conception that is task-dependent and context-dependent. Practical significance of the study is that it helps to recognize misconceptions and starts addressing them so students will have a more comprehensive view of fundamental mathematical ideas as they progress through the Calculus coursework sequence. The developed duality concept development framework called Action-Process-Object-Duality (APOD) adapted from the APOS theory could guide educators and researchers as they engage in assessing students' conception of duality. The results of this study

Challenges and Opportunities for Integrating Social Science Perspectives into Climate and Global Change Assessments

Science.gov (United States)

Larson, E. K.; Li, J.; Zycherman, A.

2017-12-01

Integration of social science into climate and global change assessments is fundamental for improving understanding of the drivers, impacts and vulnerability of climate change, and the social, cultural and behavioral challenges related to climate change responses. This requires disciplinary and interdisciplinary knowledge as well as integrational and translational tools for linking this knowledge with the natural and physical sciences. The USGCRP's Social Science Coordinating Committee (SSCC) is tasked with this challenge and is working to integrate relevant social, economic and behavioral knowledge into processes like sustained assessments. This presentation will discuss outcomes from a recent SSCC workshop, "Social Science Perspectives on Climate Change" and their applications to sustained assessments. The workshop brought academic social scientists from four disciplines - anthropology, sociology, geography and archaeology - together with federal scientists and program managers to discuss three major research areas relevant to the USGCRP and climate assessments: (1) innovative tools, methods, and analyses to clarify the interactions of human and natural systems under climate change, (2) understanding of factors contributing to differences in social vulnerability between and within communities under climate change, and (3) social science perspectives on drivers of global climate change. These disciplines, collectively, emphasize the need to consider socio-cultural, political, economic, geographic, and historic factors, and their dynamic interactions, to understand climate change drivers, social vulnerability, and mitigation and adaptation responses. They also highlight the importance of mixed quantitative and qualitative methods to explain impacts, vulnerability, and responses at different time and spatial scales. This presentation will focus on major contributions of the social sciences to climate and global change research. We will discuss future directions for

Challenges to institutionalizing strategic environmental assessment: The case of Vietnam

Energy Technology Data Exchange (ETDEWEB)

Slunge, Daniel, E-mail: daniel.slunge@economics.gu.se [Department of Economics, University of Gothenburg, Box 640, S-405 30 Gothenburg (Sweden); Tran, Trang Thi Huyen, E-mail: trang2k@yahoo.com [University of Gothenburg, Box 640, S-405 30 Gothenburg (Sweden)

2014-09-15

Building on new institutional theory, this paper develops an analytical framework for analyzing constraints to the institutionalization of strategic environmental assessment (SEA) at four different institutional levels. The framework is tested in an empirical analysis of the environmental assessment system in Vietnam, which is a frontrunner among developing countries regarding the introduction and use of SEA. Building on interviews with Vietnamese and international experts, as well as an extensive literature review, we identify institutional constraints which challenge the effective use of SEA in Vietnam. We conclude that commonly identified constraints, such as inadequate training, technical guidelines, baseline data and financial resources, are strongly linked to constraints at higher institutional levels, such as incentives to not share information between ministries and severe restrictions on access to information and public participation. Without a thorough understanding of these institutional constraints, there is a risk that attempts to improve the use of SEA are misdirected. Thus, a careful institutional analysis should guide efforts to introduce and improve the use of SEA in Vietnam and other developing countries. The analytical framework for analyzing constraints to institutionalization of SEA presented in this paper represents a systematic effort in this direction. - Highlights: • A framework for analyzing constraints to institutionalizing SEA is developed • Empirical analysis of the strategic environmental assessment system in Vietnam • Constraints in the action arena linked to deeper institutional constraints • Institutional analysis needed prior to introducing SEA in developing countries.

Challenges to institutionalizing strategic environmental assessment: The case of Vietnam

International Nuclear Information System (INIS)

Slunge, Daniel; Tran, Trang Thi Huyen

2014-01-01

Building on new institutional theory, this paper develops an analytical framework for analyzing constraints to the institutionalization of strategic environmental assessment (SEA) at four different institutional levels. The framework is tested in an empirical analysis of the environmental assessment system in Vietnam, which is a frontrunner among developing countries regarding the introduction and use of SEA. Building on interviews with Vietnamese and international experts, as well as an extensive literature review, we identify institutional constraints which challenge the effective use of SEA in Vietnam. We conclude that commonly identified constraints, such as inadequate training, technical guidelines, baseline data and financial resources, are strongly linked to constraints at higher institutional levels, such as incentives to not share information between ministries and severe restrictions on access to information and public participation. Without a thorough understanding of these institutional constraints, there is a risk that attempts to improve the use of SEA are misdirected. Thus, a careful institutional analysis should guide efforts to introduce and improve the use of SEA in Vietnam and other developing countries. The analytical framework for analyzing constraints to institutionalization of SEA presented in this paper represents a systematic effort in this direction. - Highlights: • A framework for analyzing constraints to institutionalizing SEA is developed • Empirical analysis of the strategic environmental assessment system in Vietnam • Constraints in the action arena linked to deeper institutional constraints • Institutional analysis needed prior to introducing SEA in developing countries

Reversibility of cognitive disorder after treatment of dural arteriovenous fistulae

International Nuclear Information System (INIS)

Kai, Yutaka; Ito, Koichi; Kinjo, Tatsuya; Hokama, Youhei; Nagamine, Hideki; Kushi, Sukemitsu; Kinjo, Shigemasa; Tsuchida, Yukihiro; Sugimoto, Kouichi; Yoshii, Yoshihiko; Morioka, Motohiro; Yano, Shigetoshi; Ohmori, Yuki; Kawano, Takayuki; Nakamura, Hideo; Makino, Keishi; Kuratsu, Jun-ichi; Hamada, Jun-ichiro

2009-01-01

Dural arteriovenous fistulae (DAVF) occasionally lead to cognitive disorders whose reversibility after DAVF treatment remains unclear. We studied changes on pre- and post-treatment magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT) scans in ten patients with cognitive disorder due to DAVF. We studied the symptoms, pre- and post-treatment MRI scans, SPECT findings, and mini-mental state examination (MMSE) and treatment results in ten patients with cognitive disorder due to DAVF. They were divided into two groups; the post-treatment MMSE score exceeded 25 points in group 1 (n = 6) and was lower than 24 points in group 2 (n = 4). In the six group 1 patients, pretreatment diffusion-weighted images (DWI) showed hyperintense areas, and SPECT scans demonstrated the preservation of vasoreactivity after acetazolamide challenge. In the four group 2 patients, pretreatment SPECT demonstrated hypoperfusion areas that coincided with the hyperintense areas seen on DWI; there were areas with marked disturbance in vasoreactivity. The post-treatment MMSE score in groups 1 and 2 improved by 13.7 ± 2.4 and 3.8 ± 1.0 points, respectively; the difference was significant at p < 0.01. In patients with cognitive disorder due to DAVF, the preservation of vasoreactivity on SPECT after acetazolamide challenge indicates that their cognitive disorder may be reversible by DAVF treatment. (orig.)

Challenges of electricity production scenarios modelling for life cycle assessment of environmental impacts

International Nuclear Information System (INIS)

Blanc, Isabelle; Beloin-Saint-Pierre, Didier

2013-01-01

This communication presents a first attempt at making a life cycle assessment of prospective electricity production scenarios which were designed in the EnerGEO project. We start by a basic review of system (in this case, scenario) modelling expectations in today's LCA study. We then review some of the challenges of implementation due to the lack of detailed description of present and future electricity production systems. The importance of a detailed description is then shown with an evaluation of uncertainty of life cycle impact assessment results for three scenarios of German electricity production in 2030. The significant uncertainties we found, prevent us from detecting a relevant trend or making any comparison between the three chosen scenarios. We finally come to the conclusion that the LCA methodology will become relevant for the environmental assessment of electricity production scenarios when many more detailed information are accounted to describe future technologies, structures and sources of energy. (orig.)

Challenges of electricity production scenarios modelling for life cycle assessment of environmental impacts

Energy Technology Data Exchange (ETDEWEB)

Blanc, Isabelle; Beloin-Saint-Pierre, Didier [MINES ParisTech, Sophia Antipolis (France). Observation, Impacts, Energy Center

2013-07-01

This communication presents a first attempt at making a life cycle assessment of prospective electricity production scenarios which were designed in the EnerGEO project. We start by a basic review of system (in this case, scenario) modelling expectations in today's LCA study. We then review some of the challenges of implementation due to the lack of detailed description of present and future electricity production systems. The importance of a detailed description is then shown with an evaluation of uncertainty of life cycle impact assessment results for three scenarios of German electricity production in 2030. The significant uncertainties we found, prevent us from detecting a relevant trend or making any comparison between the three chosen scenarios. We finally come to the conclusion that the LCA methodology will become relevant for the environmental assessment of electricity production scenarios when many more detailed information are accounted to describe future technologies, structures and sources of energy. (orig.)

Assessing climate risks across different business sectors and industries: an investigation of methodological challenges at national scale for the UK

Science.gov (United States)

Surminski, Swenja; Di Mauro, Manuela; Baglee, J. Alastair R.; Connell, Richenda K.; Hankinson, Joel; Haworth, Anna R.; Ingirige, Bingunath; Proverbs, David

2018-06-01

Climate change poses severe risks for businesses, which companies as well as governments need to understand in order to take appropriate steps to manage those. This, however, represents a significant challenge as climate change risk assessment is itself a complex, dynamic and geographically diverse process. A wide range of factors including the nature of production processes and value chains, the location of business sites as well as relationships and interdependencies with customers and suppliers play a role in determining if and how companies are impacted by climate risks. This research explores the methodological challenges for a national-scale assessment of climate risks through the lens of the UK Climate Change Risk Assessment (UKCCRA) process and compares the approaches adopted in the first and second UKCCRA (2011, 2016), while also reflecting on international experiences elsewhere. A review of these issues is presented, drawing on a wide body of contemporary evidence from a range of sources including the research disciplines, grey literature and government policy. The study reveals the methodological challenges and highlights six broad themes, namely scale, evidence base, adaptation responses, scope, interdependencies and public policy. The paper concludes by identifying suitable lessons for future national climate risk assessments, which should guide the next phase of research in preparation for UKCCRA3 and those of national-level risk assessments elsewhere. This article is part of the theme issue `Advances in risk assessment for climate change adaptation policy'.

The Challenges of Data Quality and Data Quality Assessment in the Big Data Era

Directory of Open Access Journals (Sweden)

Li Cai

2015-05-01

Full Text Available High-quality data are the precondition for analyzing and using big data and for guaranteeing the value of the data. Currently, comprehensive analysis and research of quality standards and quality assessment methods for big data are lacking. First, this paper summarizes reviews of data quality research. Second, this paper analyzes the data characteristics of the big data environment, presents quality challenges faced by big data, and formulates a hierarchical data quality framework from the perspective of data users. This framework consists of big data quality dimensions, quality characteristics, and quality indexes. Finally, on the basis of this framework, this paper constructs a dynamic assessment process for data quality. This process has good expansibility and adaptability and can meet the needs of big data quality assessment. The research results enrich the theoretical scope of big data and lay a solid foundation for the future by establishing an assessment model and studying evaluation algorithms.

Perceptions and Challenges of Using Emergency Triage Assessment Treatment Guideline in Emergency Department at Muhimbili National Hospital, Tanzania

OpenAIRE

Safari, Sixtus Ruyumbu

2012-01-01

Triage is the process of determining the priority of patients' treatments based on the severity of their conditions. This helps treating patients efficiently when resources are insufficient for all to be treated immediately. Health care providers use ETAT guideline during triaging patients to improve quality of care and reduce morbidity and mortality rates. But the adherence to the guidelines protocol has been a challenge in triage rooms. This paper assessed perspective of HCWs and challenges...

Assessment of bilingual children with inattention, over activity and impulsivity –Challenges and solutions

Directory of Open Access Journals (Sweden)

Meral Özerk

2011-07-01

Full Text Available ADHD is one of the widespread neurological disorders among children. While a substantial amount of research have addressed the issues related to assessment practices and diagnosis criteria among majority language speaking children, ADHD among bilingual children or linguistic minority children has not yet been addressed and discussed so much in the research circles. The percentage of bilingual children with immigrant background in main stream schools in many countries is quite high. Despite this global demographic tendency, underdiagnostisation and assessment of bilingual children with inattention, over activity and impulsivity are being considered to be a psychiatric, psychological and educational challenge. In this paper we address several critical aspects of the assessment practices and medical diagnosis of bilingual children with immigrant background based on a research project. The paper presents also some solutions as an alternative to one-sided intelligence-test based approaches. We stress the importance of multidimensional, multisource and bilingual assessment model for identifying the knowledge-related and language-related elements of the academic learning gap that these children usually experience prior to and during the assessment period.

Lessons learned and new challenges for integrated assessment under the National Environmental Policy Act

Energy Technology Data Exchange (ETDEWEB)

Carnes, S.A.; Reed, R.M.

1995-12-31

One of the first government-sponsored demands for integrated assessment to support decision making in the United States is embodied in the National Environmental Policy Act of 1969 (NEPA). Over the past 25 years, Oak Ridge National Laboratory (ORNL) has supported federal agencies` in evaluating health and environmental impacts as required by NEPA. Many of ORNL`s efforts have focused on complex, programmatic assessments that break new ground and require and integrate expertise from a wide range of technical disciplines. Examples of ORNL projects that illustrate the use of integrated assessment approaches include environmental documentation for: (1) the Department of the Army`s Chemical Stockpile Disposal Program, (2) the Federal Energy Regulatory Commission`s licensing activities related to the Owens River Basin in eastern California and along a 500-mile reach of the upper Ohio River, and (3) the Nuclear Regulatory Commission`s decision regarding restart of the undamaged reactor (Unit 1) at Three Mile Island. Our discussion of these examples illustrates successful integrated assessment approaches and identifies new challenges facing integrated assessment activities.

Challenges and advances in the assessment of the disposition of antibody‐drug conjugates

Science.gov (United States)

Iyer, Suhasini

2015-01-01

Abstract Antibody‐drug conjugates (ADCs) are a rapidly growing therapeutic platform for the treatment of cancer. ADCs consist of a cytotoxic small molecule drug linked to an antibody to provide targeted delivery of the cytotoxic agent to the tumor. Understanding the pharmacokinetics (PK) and pharmacodynamics (PD) of ADCs is crucial in their design to optimize dose and regimen, to maximize efficacy and to minimize toxicity in patients. Significant progress has been made in recent years in this area, however, many fundamental questions still remain. This review discusses factors to consider while assessing the disposition of ADCs, and the unique challenges associated with these therapeutics. Current tools that are available and strategies to enable appropriate assessment are also discussed. © 2015 Genentech Inc. Biopharmaceutics & Drug Disposition Published by John Wiley & Sons Ltd. PMID:25904406

Genome Assembly Forensics: Metrics for Assessing Assembly Correctness (Metagenomics Informatics Challenges Workshop: 10K Genomes at a Time)

Energy Technology Data Exchange (ETDEWEB)

Pop, Mihai

2011-10-13

University of Maryland's Mihai Pop on Genome Assembly Forensics: Metrics for Assessing Assembly Correctness at the Metagenomics Informatics Challenges Workshop held at the DOE JGI on October 12-13, 2011.

The Implementations and Challenges of Continuous Assessment in Public Universities of Eastern Ethiopia

Directory of Open Access Journals (Sweden)

Gemechu Abera

2017-11-01

Full Text Available The study was aimed to investigate the implementations and challenges of continuous assessment in selected Public Universities of Eastern Ethiopia. Descriptive survey research design was employed to carry out this study because it is used to describe the characteristics of a given population in a systematic and accurate fashion. Stratified random sampling technique was employed to collect pertinent information from the respondents through questionnaire and observational checklists. To make the interpretation of the findings easier, the researchers used both descriptive and inferential statistics. The first finding was that almost the implementations of continuous assessment in these selected universities were very poor. The second finding was that there was statistically a significant mean difference among these public universities in utilizing and implementing continuous assessment; the third finding was that there was statistically significant mean difference among these sampled respondents in implementing the three domains of educational objectives; the fourth interesting finding was that the implemented continuous assessment type was highly dominated by cognitive, followed by affective and then psychomotor domains respectively. Finally, it was recommended that instructors should implement continuous assessment not only for the sake of evaluating and marking students’ result but also for the sake of learning skills and practices.

Effects of Coaching on the Implementation of Functional Assessment-Based Parent Intervention in Reducing Challenging Behaviors

Science.gov (United States)

Fettig, Angel; Schultz, Tia R.; Sreckovic, Melissa A.

2015-01-01

This study examined the effects of coaching on the implementation of functional assessment--based parent intervention in reducing children's challenging behaviors. A multiple baseline across participants design was used with three parent-child dyads with children between the ages of 2 and 5 years. The intervention consisted of training and delayed…

Genetically Modified Foods: Promises, Challenges and Safety Assessments

Directory of Open Access Journals (Sweden)

Manouchehr Dadgarnejad

2017-09-01

Full Text Available Background and Objective: Application of genetically modified organisms in the agriculture sector and food industry began since last years of 20th century. Since then this technology has become a central part of the broader public controversy about the advantages and safety of these products. This article has tried to review aspects of these types of organisms and foods.Results and Conclusion: Genetically modified technology has potential to overcome agricultural problems, such as biotic and abiotic issues by enhancing pests and herbicides resistance, drought tolerance, fast ripening, and finally enhancing yield and nutritional quality. Besides these revolutionary advantages, during the last decades some potential human, animal and environmental risks have been taken in account for these organisms or foods. However, no scientific evidence exists adequately about their harmful human or animal effects, and also, some new scientific and management methodologies (new technologies and regulations have been developed to mitigate the environmental risks. Some challenges such as pest adaptation are being solved by refuge technology, gene pyramiding and insertion of best-coupled primers through the known conditions reducing unintended outcomes including silencing, activation or rearrangement of non-target genome pieces. However, it does not mean that no harmful effect will happen in the future. Therefore, it is required that before release of any genetically modified crop, all requested risk assessments be performed, and then post release monitoring be done to follow the possible gene flow and prevent any potential disastrous contaminations to the food chain. Finally, it could be concluded that the safe usage of this technology, by considering all nationally and internationally accepted environmental and health safety assessment protocols, can help us to use advantages of this technology in agriculture, medicine and industry. However, more safety

The challenge of assessing MTech community-based-visual arts ...

African Journals Online (AJOL)

The article explores specific challenges in supervising, accommodating and evaluating diverse candidates who pursue an action-led and community-based research approach rooted within the visual arts. I contend that there is a specific challenge in the field of postgraduate supervision of engaging evaluation strategies.

Challenges in assessing air pollution from residential wood combustion

DEFF Research Database (Denmark)

Olesen, Helge Rørdam

2016-01-01

The paper highlights a number of important challenges in quantifying the impact of residential wood combustion on air quality. The fact that real life emissions are controlled by the behaviour of the users makes it a challenge to determine representative emission factors. Further, in respect...

RESPONSIVENESS, LANGUAGE, AND ALIGNMENT: REFLECTIONS ON SOME CHALLENGES FOR HEALTH TECHNOLOGY ASSESSMENT.

Science.gov (United States)

Dillon, Andrew

2015-01-01

Health systems around the world cope with the challenge of difficult economic times, and the value of health technology assessment (HTA) is increasing. Making the right choices, with limited resources, in the face of increasingly complex technologies requires decisions informed by data and analyses that help us to manage the risks involved. Those who undertake and use HTA can play a greater role in helping decision makers meet these challenges; they need to think how to define innovation and respond to it, how to communicate their analyses, and, critically, how to align their work with the ambitions of their health systems. HTA can become a key health system enabler without compromising its objectivity or independence. It can say that it is too early to determine the value of a new technology when the data simply will not support a safe decision. However, it can also be bold and recommend the managed introduction of new technologies, even when the when the data is immature, provided that the health system understands the risks and there is a plausible case for believing that further research will support the value proposition. The goal for HTA is to be able confidently to do both.

Development of quantification analysis software for measuring regional cerebral blood flow by the modified split-dose method with 123I-IMP before and after acetazolamide loading

International Nuclear Information System (INIS)

Nagaki, Akio; Kobara, Kouichi; Matsutomo, Norikazu

2003-01-01

We developed a quantification analysis software program for measuring regional cerebral blood flow (rCBF) at rest and under acetazolamide (ACZ) stress by the modified split-dose (MSD) method with iodine-123 N-isopropyl-p-iodoamphetamine (IMP) and compared the rCBF values measured by the MSD method and by the split dose 123 I-IMP SPECT (SD) method requiring one continuous withdrawal of arterial blood. Since the MSD method allows the input of two arterial blood sampling parameter values, the background subtraction procedure for obtaining ACZ-induced images in the MSD method is not identical to the procedure in the SD method. With our software program for rCBF quantification, the resting rCBF values determined by the MSD method were closely correlated with the values measured by the SD method (r=0.94), and there was also a good correlation between the ACZ-induced rCBF values obtained by the MSD method and by the SD method (r=0.81). The increase in rCBF under ACZ stress was estimated to be approximately 26% by the SD method and 38% by the MSD method, suggesting that the MSD method tends to overestimate the increase in rCBF under ACZ stress in comparison with the SD method, but the variability of the rCBF values at rest and during ACZ stress analyzed by the MSD method was smaller than the variability with the SD method. Further clinical studies are required to validate our rCBF quantification analysis program for the MSD method. (author)

Exposure assessment and other challenges in non-ionizing radiation studies of childhood leukaemia

International Nuclear Information System (INIS)

Kheifets, L.; Oksuzyan, S.

2008-01-01

Studies of electromagnetic fields (EMF) and the development of childhood leukaemia face unique difficulties. EMF are imperceptible, ubiquitous, have multiple sources, and can vary greatly over time and distances. Childhood leukaemia and high average exposures to magnetic fields are both quite rare. Thus, a major challenge in EMF epidemiology is the small number of highly exposed cases and the necessity for retrospective assessment of exposure. Only studies designed to minimize bias while maximizing our ability to detect an association, should one exist, would have a potential to contribute to our understanding. New approaches are needed; the most promising in the extremely low-frequency range involves a study of a highly exposed cohort of children who have lived in apartments next to built-in transformers or electrical equipment rooms. Another promising avenue is an investigation of possible joint effects of environmental exposures and genetic co-factors. An exposure assessment methodology for residential radiofrequency fields is still in its infancy. Rapid changes in technology and exponential increases in its use make exposure assessment more difficult and urgent. (authors)

Assessment of the impacts of oil: Opportunities and challenges for economic development in Sudan

OpenAIRE

Nour, Samia Satti Osman Mohamed

2011-01-01

This paper provides an assessment of the impacts of oil and discusses the opportunities and challenges for enhancing economic development in Sudan. One advantage of our analysis in this paper is that we provide a more comprehensive analysis using the most recent secondary data to discuss the positive and negative impacts of oil for enhancing economic development in Sudan. We explain that the various positive impacts of oil and the opportunities for enhancing development in Sudan's economy inc...

A study to assess whether fixed-width beam walking provides sufficient challenge to assess balance ability across lower limb prosthesis users.

Science.gov (United States)

Sawers, Andrew; Hafner, Brian J

2018-04-01

To evaluate the feasibility of fixed-width beam walking for assessing balance in lower limb prosthesis users. Cross-sectional. Laboratory. Lower limb prosthesis users. Participants attempted 10 walking trials on three fixed-width beams (18.6, 8.60, and 4.01 wide; 5.5 m long; 3.8 cm high). Beam-walking performance was quantified using the distance walked to balance failure. Heuristic rules applied to each participant's beam-walking distance to classify each beam as "too easy," "too hard," or "appropriately challenging" and determine whether any single beam provided an appropriate challenge to all participants. The number of trials needed to achieve stable beam-walking performance was quantified for appropriately challenging beams by identifying the last inflection point in the slope of each participant's trial-by-trial cumulative performance record. In all, 30 unilateral lower limb prosthesis users participated in the study. Each of the fixed-width beams was either too easy or too hard for at least 33% of the sample. Thus, no single beam was appropriately challenging for all participants. Beam-walking performance was stable by trial 8 for all participants and by trial 6 for 90% of participants. There was no significant difference in the number of trials needed to achieve stable performance among beams ( P = 0.74). Results suggest that a clinical beam-walking test would require multiple beams to evaluate balance across a range of lower limb prosthesis users, emphasizing the need for adaptive or progressively challenging balance tests. While the administrative burden of a multiple-beam balance test may limit clinical feasibility, alternatives to ease this administrative burden are proposed.

Conclusion: challenges for the future.

Science.gov (United States)

North, D W

1993-12-01

The title "Challenges for the Future" implies the challenge to summarize a very complex meeting. Of necessity, I will present a personal impression. My interest is in risk assessment, which I define as a process for summarizing science in support of decision making. Risk assessment is sometimes regarded as arcane numerology, a rigid process of computing risk numbers in which much available science is unused. I am a strong advocate for the broader definition of risk assessment. It is encouraging to learn how much science is becoming available for use in risk assessment for gasoline, its components, and alternative fuels.

Challenges in using a probabilistic safety assessment in a risk informed process (illustrated using risk informed inservice inspection)

International Nuclear Information System (INIS)

Chapman, James R.; Dimitrijevic, Vesna B.

1999-01-01

Many of the ongoing and expected uses of Probabilistic Safety Assessment (PSA) create new challenges to ensuring that the resulting conclusions are valid. This paper provides a summary of some of these challenges. Work conducted by the authors on Risk-Informed Inservice Inspection (RI-ISI) is used to illustrate these challenges. Means to address all of the challenges are not provided in detail in this paper. Several earlier papers discuss how these challenges can be addressed. References are provided for the interested reader (Chapman JR et al. In: PSA '95, vol. 1, Seoul, 1995: 177-80; Chapman JR et al. In: ICONE-IV, New Orleans, 1996; Dimitrijevic VB et al. In: Croatian Nuclear Society International Conference, Opatija, 1996: 245-54; Dimitrijevic VB et al. In: Croatian Nuclear Society International Conference, Opatija, 1996: 255-62; Dimitrijevic VB. In: Yugoslav Nuclear Society Conference, Belgrade, 1996: 53-61; O'Regan PJ et al. In: PSA '95, Seoul, vol. 1, 1995: 403-5; O'Regan PJ. In: ICONE-IV, vol. 5, New Orleans, 1996: 277-80)

Challenges in Aquatic Physical Habitat Assessment: Improving Conservation and Restoration Decisions for Contemporary Watersheds

Directory of Open Access Journals (Sweden)

Jason A. Hubbart

2017-12-01

Full Text Available Attribution of in-stream biological impairment to anthropogenic activities and prioritization for restoration and/or conservation can be challenging in contemporary mixed-land-use watersheds. Critical information necessary to improve decision making can be costly and labor intensive, and thus unobtainable for many municipalities. A reduced cost, rapid stream physical habitat assessment (rPHA can yield information that, when paired with land use data may reveal causal patterns in aquatic physical habitat degradation, and thus assist targeting sites for restoration. However, a great deal of work is needed to reduce associated costs, and validate the potential of rPHA for documenting fine-scale incremental change in physical habitat conditions in complex contemporary watersheds. The following commentary serves to draw attention to rPHA challenges and research needs including (but not limited to field-based validation and optimization of new remote sensing technologies, evaluation of the accuracy and representativeness of rapid vegetation survey methods, refinement of analytical methods, and consideration of legacy land use impacts and hydrologic system evolution in rPHA results interpretation. Considering the value of rPHA-generated data for improvement of watershed resource management, such challenges constitute timely, high-impact research opportunities for investigators wishing to advance complex, contemporary aquatic ecosystem management.

The Challenge of Assessing Creative Problem Solving in Client-Based Marketing Development Projects: A SOLO Taxonomy Approach

Science.gov (United States)

Jaskari, Minna-Maarit

2013-01-01

Creativity and marketing imagination are essential core competencies for marketers. Therefore, higher marketing education emphasizes creativity in several ways. However, assessing creativity and creative problem solving is challenging and tools for this purpose have not been developed in the context of marketing education. To address this gap, we…

Integrated deterministic and probabilistic safety assessment: Concepts, challenges, research directions

International Nuclear Information System (INIS)

Zio, Enrico

2014-01-01

Highlights: • IDPSA contributes to robust risk-informed decision making in nuclear safety. • IDPSA considers time-dependent interactions among component failures and system process. • Also, IDPSA considers time-dependent interactions among control and operator actions. • Computational efficiency by advanced Monte Carlo and meta-modelling simulations. • Efficient post-processing of IDPSA output by clustering and data mining. - Abstract: Integrated deterministic and probabilistic safety assessment (IDPSA) is conceived as a way to analyze the evolution of accident scenarios in complex dynamic systems, like nuclear, aerospace and process ones, accounting for the mutual interactions between the failure and recovery of system components, the evolving physical processes, the control and operator actions, the software and firmware. In spite of the potential offered by IDPSA, several challenges need to be effectively addressed for its development and practical deployment. In this paper, we give an overview of these and discuss the related implications in terms of research perspectives

Integrated deterministic and probabilistic safety assessment: Concepts, challenges, research directions

Energy Technology Data Exchange (ETDEWEB)

Zio, Enrico, E-mail: enrico.zio@ecp.fr [Ecole Centrale Paris and Supelec, Chair on System Science and the Energetic Challenge, European Foundation for New Energy – Electricite de France (EDF), Grande Voie des Vignes, 92295 Chatenay-Malabry Cedex (France); Dipartimento di Energia, Politecnico di Milano, Via Ponzio 34/3, 20133 Milano (Italy)

2014-12-15

Highlights: • IDPSA contributes to robust risk-informed decision making in nuclear safety. • IDPSA considers time-dependent interactions among component failures and system process. • Also, IDPSA considers time-dependent interactions among control and operator actions. • Computational efficiency by advanced Monte Carlo and meta-modelling simulations. • Efficient post-processing of IDPSA output by clustering and data mining. - Abstract: Integrated deterministic and probabilistic safety assessment (IDPSA) is conceived as a way to analyze the evolution of accident scenarios in complex dynamic systems, like nuclear, aerospace and process ones, accounting for the mutual interactions between the failure and recovery of system components, the evolving physical processes, the control and operator actions, the software and firmware. In spite of the potential offered by IDPSA, several challenges need to be effectively addressed for its development and practical deployment. In this paper, we give an overview of these and discuss the related implications in terms of research perspectives.

Regional cerebral blood flow (rCBF) measurement using D.S.P.E.C.T. and xenon inhalation: first results in distal encephalic juvenile ischemia

International Nuclear Information System (INIS)

Steinling, M.; Guerouaou, D.; Dubois, P.; Bouchez, P.; Arnott, G.; Vergnes, R.

1984-01-01

Xenon inhalation and D.S.P.E.C.T. were used for rCBF measurement in 16 patients with distal encephalic juvenile ischemia. 8 patients immediately had a second study, 15 minutes after IV injection of 500 mg acetazolamide. Results show that rCBF was abnormal in 13 patients, including some who had only minor clinical symptoms. rCBF measurement complemented neuroradiological data in 12 of 16 cases and proved more informative in 7 cases. Our most striking finding is perhaps that no patient responded normally to acetazolamide injection: three failed to respond and five showed complex (heterogeneous responses). Follow up of these patients will perhaps provide information as to the prognostic value of rCBF and acetazolamide reactivity measurements [fr

Effects of competitive red blood cell binding and reduced hematocrit on the blood and plasma levels of [14C]Indapamide in the rat

International Nuclear Information System (INIS)

Lettieri, J.T.; Portelli, S.T.

1983-01-01

The effects of chlorthalidone and acetazolamide on the red blood cell binding of indapamide were investigated. Both drugs caused a substantial decrease in the amount of indapamide bound to the erythrocytes in vitro. This effect was demonstrated by a change in the indapamide blood/plasma ratio from approximately 6 in control samples, to a value of 1 when either of the displacing agents was added. Coadministration of acetazolamide with 14 C-labeled indapamide to rats, resulted in a 5-fold drop in the blood levels of total radioactivity, relative to rats dosed with [ 14 C]indapamide alone. Concomitantly, there was a 2-fold increase in the plasma levels of total radioactivity after acetazolamide coadministration. In rats whose hematocrits had been reduced by extensive bleeding, there were only minor alterations in the blood/plasma partitioning of [ 14 C]indapamide. Thus, chlorthalidone and acetazolamide were able to displace indapamide from erythrocytes in vitro and in vivo, possibly by competition at a carbonic anhydrase binding site. The pharmacokinetics of drugs which are extensively bound to erythrocytes may be significantly altered by the presence of other agents capable of competitive binding

Issues and challenges in the assessment, diagnosis and treatment of cardiovascular risk factors: Assessing the needs of cardiologists

Directory of Open Access Journals (Sweden)

Dupuis Martin

2008-05-01

Full Text Available Abstract Background This needs assessment, initiated by the Academy for Healthcare Education Inc. in cooperation with AXDEV Group Inc., explored the knowledge, attitudes, behavior, and skills of community-based and academic-affiliated U.S. cardiologists in the area of CV risk assessment, treatment, and management from July 2006 to December 2006. Methods The needs assessment used a multistage, mixed-method approach to collect, analyze, and verify data from two independent sources. The exploratory phase collected data from a representative sampling of U.S. cardiologists by means of qualitative panel meetings, one-on-one interviews, and quantitative questionnaires. In the validation phase, 150 cardiologists from across the United States completed a quantitative online questionnaire. Data were analyzed with standardized statistical methods. Results The needs assessment found that cardiologists have areas of weakness pertaining to their interpersonal skills, which may influence patient-physician communication and patient adherence. Cardiologists appeared to have little familiarity with or lend little credence to the concept of relative CV risk. In daily clinical practice, they faced challenges with regard to optimal patient outcome in areas of patient referral from primary-care providers, CV risk assessment and treatment, and patient monitoring. Community-based and academic-affiliated cardiologists appeared to be only moderately interested in educational interventions that pertain to CV risk-reduction strategies. Conclusion Educational interventions that target cardiologists' interpersonal skills to enhance their efficacy may benefit community-based and academic-affiliated specialists. Other desirable educational initiatives should address gaps in the patient referral process, improve patient knowledge and understanding of their disease, and provide supportive educational tools and materials to enhance patient-physician communication.

Challenges with managing hazardous chemicals in the international frame - opportunity for educating on sustainable chemistry and alternatives assessment

DEFF Research Database (Denmark)

Weber, R.; Fantke, Peter

sustainable alternatives. A bottle neck is, however, that chemists, engineers, industrial designers, and policy makers often lack knowledge on green/sustainable chemistry and alternatives assessment. This is particularly a challenge in developing and transition countries. Methodologies and tools are hence...... needed to disseminate information on and guidance on how to phase in more sustainable alternatives. In this presentation, we suggest a comprehensive yet efficient approach of alternatives assessment which could be integrated in the education of stakeholders within the process of the substitution...

Canada's oil sands, opportunities and challenges to 2015 : an energy market assessment

International Nuclear Information System (INIS)

2004-05-01

The National Energy Board monitors the supply of all energy commodities in Canada along with the demand for Canadian energy commodities in domestic and export markets. This report provides an assessment of the current state of the oil sands industry and the potential for growth. It also identifies the major issues and challenges associated with the development of Canada's oil sands, one of the world's largest hydrocarbon resources. Initial production of Canada's oil sands began in 1967. The resource has become more economic to develop in recent years due to higher energy prices and new technologies. The economic potential of Canada's oil sands has been recognized internationally. Canadian oil sands production in 2004 will surpass 160,000 cubic metres per day. By 2015, production is expected to more than double to meet market demands. The challenges facing the industry include higher natural gas prices, capital cost overruns and environmental impacts. The major factors that affect the rate of oil sands development include natural gas supply, energy demand, oil and gas pricing, markets and pipelines, environmental considerations, emerging technologies, geopolitical issues, and labour. This report includes key findings for the following four key components: economic potential and development of the resource base; markets and pipelines; environmental and socio-economic impacts; and, potential spin-off developments in the electricity and petrochemical industries. 26 tabs., 53 figs

Article Commentary: The interRAI Pediatric Home Care (PEDS HC Assessment: Evaluating the Long-term Community-Based Service and Support Needs of Children Facing Special Healthcare Challenges

Directory of Open Access Journals (Sweden)

Charles D. Phillips

2015-01-01

Full Text Available The vast majority of assessment instruments developed to assess children facing special healthcare challenges were constructed to assess children within a limited age range or children who face specific conditions or impairments. In contrast, the interRAI Pediatric Home Care (PEDS HC Assessment Form was specifically designed to assess the long-term community-based service and support needs of children and youth aged from four to 20 years who face a wide range of chronic physical or behavioral health challenges. Initial research indicates that PEDS HC items exhibit good predictive validity–-explaining significant proportions of the variance in parents’ perceptions of needs, case managers’ service authorizations, and Medicaid program expenditures for long-term community-based services and supports. In addition, PEDS HC items have been used to construct scales that summarize the strengths and needs of children facing special healthcare challenges. Versions of the PEDS HC are now being used in Medicaid programs in three states in the United States.

Assessing Cognitive Function in Bipolar Disorder: Challenges and Recommendations for Clinical Trial Design

Science.gov (United States)

Burdick, Katherine E.; Ketter, Terence A.; Goldberg, Joseph F.; Calabrese, Joseph R.

2015-01-01

provided here as a preliminary guide for future trial design. Recommendations comprise exclusion of certain syndromal level comorbid diagnoses and current affective instability, restrictions on numbers and types of medications, and use of pre-screening assessment to ensure enrollment of subjects with adequate objective evidence of baseline cognitive impairment. CONCLUSIONS Clinical trials to address cognitive deficits in bipolar disorder face distinctive design challenges. As such trials move from proof-of-concept to confirmation of clinical efficacy, it will be important to incorporate distinctive design modifications to adequately address these challenges and increase the likelihood of demonstrating cognitive remediation effects. The field is now primed to address these challenges and a comprehensive effort to formalize best practice guidelines will be a critically important next step. PMID:25830456

Assessment of the administrative challenges associated with non ...

African Journals Online (AJOL)

International Journal of Development and Management Review ... embezzlement of pension funds, corrupt practices among pension managers and governments. unwillingness to review pensions as challenges confronting the non-contributory pension ... Key words: Welfare, Pension administration, Systemic corruption.

Challenges when evaluating Product/Service-Systems through Life Cycle Assessment

DEFF Research Database (Denmark)

Kjær, Louise Laumann; Pagoropoulos, Aris; Schmidt, Jannick H.

2016-01-01

the environmental performance of PSS. We identify a set of PSS characteristics that can challenge an LCA study. Three relevant scopes are distinguished, where LCA may be applied: (1) evaluating options within the PSS itself; (2) comparing a PSS with an alternative; and (3) modelling the actual contextual changes...... caused by the PSS. We derive three pronounced challenges when conducting LCA within the three scopes: (i) identifying and defining the reference system; (ii) defining the functional unit; and (iii) setting system boundaries. We elaborate on how these challenges are discussed in current literature....... Recommended future work includes developing adapted guidelines and further empirical case studies that quantify the environmental changes and impacts caused by introducing PSS....

An assessment of BWR [boiling water reactor] Mark-II containment challenges, failure modes, and potential improvements in performance

International Nuclear Information System (INIS)

Kelly, D.L.; Jones, K.R.; Dallman, R.J.; Wagner, K.C.

1990-07-01

This report assesses challenges to BWR Mark II containment integrity that could potentially arise from severe accidents. Also assessed are some potential improvements that could prevent core damage or containment failure, or could mitigate the consequences of such failure by reducing the release of fission products to the environment. These challenges and improvements are analyzed via a limited quantitative risk/benefit analysis of a generic BWR/4 reactor with Mark II containment. Point estimate frequencies of the dominant core damage sequences are obtained and simple containment event trees are constructed to evaluate the response of the containment to these severe accident sequences. The resulting containment release modes are then binned into source term release categories, which provide inputs to the consequence analysis. The output of the consequences analysis is used to construct an overall base case risk profile. Potential improvements and sensitivities are evaluated by modifying the event tree spilt fractions, thus generating a revised risk profile. Several important sensitivity cases are examined to evaluate the impact of phenomenological uncertainties on the final results. 75 refs., 25 figs., 65 tabs

Digital archives, big data and image-based culturomics for social impact assessment: Opportunities and challenges

International Nuclear Information System (INIS)

Sherren, Kate; Parkins, John R.; Smit, Michael; Holmlund, Mona; Chen, Yan

2017-01-01

Social impact assessment (SIA) is well-established but uses conventional approaches that have become less effective in recent decades, particularly in relation to declining survey response rates and a lack of youth engagement. Images from digital archives and social media sources are poised to advance the research and practice of SIA by transcending text-based methods with insights into changing landscapes, and human engagement with them. This viewpoint describes progress, challenges and cautions toward the development of such tools (defined as culturomics), using hydroelectricity cases to illustrate potential approaches. These tools build on foundational work in a range of disciplines, including the humanities and computer science. We describe necessary advances in machine learning, image digitization, and data aggregation and visualization techniques, as well as ways to ensure that such tools are carefully tested, applied and interpreted. Challenges include the automation, acquisition and management of datasets, and using these tools appropriately and equitably. Critically, culturomics of any kind must not be used as a replacement for engagement with people, but as complementary to inclusive stakeholder engagement. - Highlights: •Image-based digital archives and social media present opportunities for new SIA tools. •Application-ready big data approaches are emerging across many fields. •SIA scholars, practitioners and stakeholders should engage with culturomics. •Challenges include automation, digitization, interpretation and justice. •Culturomics of any kind must not replace engagement with people.

Digital assessments – challenges, choices and pitfalls

DEFF Research Database (Denmark)

Simonsen, Eivind Ortind

assessments at the faculty of Health, Aarhus University. Today (2015) we have digitalized approximately 70 % of our assessments, including MCQ (multiple choice) and OSCE (objective structured clinical examination), with 7-800 students assessed each semester. We have developed our own systems...

Qualitative versus quantitative assessment of cerebrovascular reserve capacity

International Nuclear Information System (INIS)

Okuguchi, Taku

2000-01-01

Quantitative studies of cerebral blood flow (CBF) combined with a acetazolamide (ACZ) challenge have defined a subgroup of patients with symptomatic carotid or middle cerebral artery (MCA) occlusive diseases who are at an increased risk for stroke. Recent reports suggest that qualitative CBF techniques could also define the same high-risk subgroup. To evaluate the accuracy of the qualitative method, we compared qualitative ratios with quantitative CBF data, obtained using iodine-123-N-isopropyl-p-iodoamphetamine (IMP) single-photon emission computed tomography (SPECT). We analyzed qualitative and quantitative IMP SPECT images for 50 patients with symptomatic carotid or middle cerebral artery occlusive diseases. Quantitative CBF data were measured by the autoradiographic technique. One region-of-interest within each hemisphere was within the MCA territory. Relative cerebrovascular reserve capacity (CVRC) obtained using qualitative images before and after the intravenous administration of 1 g of ACZ was defined as follows: ( ACZ C occl / ACZ C non )/( baseline C occl / baseline C non ). The threshold for abnormal relative CVRC was defined as less than 1.0. Quantitative CBF was considered abnormal when the response to ACZ (percent change) on the symptomatic side (absolute CVRC) was a decrease of more than 10%. Of 39 patients whose relative CVRC were considered abnormal, 29 (74%) were normal in absolute CVRC (i.e., false positive). Two of 12 (17%) who were not considered compromised by qualitative criteria had abnormal absolute CVRC (i.e., false negative). This study demonstrates that this important subgroup cannot be accurately defined with qualitative methodology. (author)

Qualitative versus quantitative assessment of cerebrovascular reserve capacity

Energy Technology Data Exchange (ETDEWEB)

Okuguchi, Taku [Iwate Medical Univ., Morioka (Japan). School of Medicine

2000-06-01

Quantitative studies of cerebral blood flow (CBF) combined with a acetazolamide (ACZ) challenge have defined a subgroup of patients with symptomatic carotid or middle cerebral artery (MCA) occlusive diseases who are at an increased risk for stroke. Recent reports suggest that qualitative CBF techniques could also define the same high-risk subgroup. To evaluate the accuracy of the qualitative method, we compared qualitative ratios with quantitative CBF data, obtained using iodine-123-N-isopropyl-p-iodoamphetamine (IMP) single-photon emission computed tomography (SPECT). We analyzed qualitative and quantitative IMP SPECT images for 50 patients with symptomatic carotid or middle cerebral artery occlusive diseases. Quantitative CBF data were measured by the autoradiographic technique. One region-of-interest within each hemisphere was within the MCA territory. Relative cerebrovascular reserve capacity (CVRC) obtained using qualitative images before and after the intravenous administration of 1 g of ACZ was defined as follows: ({sub ACZ}C{sub occl}/{sub ACZ}C{sub non})/({sub baseline}C{sub occl}/{sub baseline}C{sub n}= {sub on}). The threshold for abnormal relative CVRC was defined as less than 1.0. Quantitative CBF was considered abnormal when the response to ACZ (percent change) on the symptomatic side (absolute CVRC) was a decrease of more than 10%. Of 39 patients whose relative CVRC were considered abnormal, 29 (74%) were normal in absolute CVRC (i.e., false positive). Two of 12 (17%) who were not considered compromised by qualitative criteria had abnormal absolute CVRC (i.e., false negative). This study demonstrates that this important subgroup cannot be accurately defined with qualitative methodology. (author)

Cerebral circulation and prognosis of the patients with hypoxic encephalopathy

International Nuclear Information System (INIS)

Nogami, Kenichiro; Fujii, Masami; Kashiwagi, Shiro; Sadamitsu Daikai; Maekawa, Tsuyoshi

2000-01-01

Recent progress in cardiopulmonary resuscitation techniques improved the survival rate of patients with acute cardiopulmonary disturbances. However, severe cerebral complications remained frequently in patients who survived the acute stage. Early prediction of cerebral prognosis is important to optimize the management of these patients. We examined the relations between radiological findings (Xe-CT and MRI) and cerebral prognosis. Patients included in this study were selected from all patients with hypoxic encephalopathy admitted to our hospital. There were 11 men and 10 women. Causes of hypoxic encephalopathy were heart disease (11 cases), suffocation (4 cases), CO intoxication (2 cases), asthma (1 case), pneumothorax (1 case), anaphyraxy shock (1 case) and electric shock (1 case). Xe-CT and MRI were carried out 3 weeks after the onset. Cerebral blood flow (CBF) of the patients was measured at rest and 15 minutes after intravenous administration of acetazolamide (1 g). The prognosis was evaluated 3 months after the onset in accordance with Glasgow Outcome Scale (GOS). Low hemispheric CBF (30 ml/100 g/min), poor reactivity of acetazolamide challenge test (10 ml/100 g/min), presence of hyperintensity areas in the basal ganglia in T1 weighted images (T1WI) and T2 weighted images (T2WI) are the factors associated with poor outcome in hypoxic encephalopathy. (author)

Professional development for teachers of students who are deaf or hard of hearing: facing the assessment challenge.

Science.gov (United States)

Cawthon, Stephanie

2009-01-01

Teachers of students with low-incidence disabilities, such as students who are deaf or hard of hearing, face unique challenges in putting education policy into practice. The present article presents professional development findings from the Third Annual National Survey of Accommodations and Assessment for Students Who Are Deaf or Hard of Hearing (Cawthon, Hersh, Kim, & Online Research Lab, in press). A total of 391 participants described professional development they had experienced related to assessment of students who are deaf or hard of hearing. Teachers reported greater exposure to topics in school/district sessions and discussion with their colleagues than in their preparation programs. Teaching at a school for the deaf or teaching students in high school were significant predictors of an increased prevalence of professional development opportunities on assessment-related topics for students who are deaf or hard of hearing.

Optic nerve oxygen tension in pigs and the effect of carbonic anhydrase inhibitors

DEFF Research Database (Denmark)

Stefánsson, E; Jensen, P K; Eysteinsson, T

1999-01-01

To evaluate how the oxygen tension of the optic nerve (ONP(O)2) is affected by the administration of the carbonic anhydrase inhibitors dorzolamide and acetazolamide and by alterations in oxygen and carbon dioxide in the breathing mixture.......To evaluate how the oxygen tension of the optic nerve (ONP(O)2) is affected by the administration of the carbonic anhydrase inhibitors dorzolamide and acetazolamide and by alterations in oxygen and carbon dioxide in the breathing mixture....

Comparison of four methods to evaluate the modifications of the cerebral perfusion in tomo-scintigraphy; Comparaison de quatre methodes d'evaluation des modifications de la perfusion cerebrale en tomoscintigraphie

Energy Technology Data Exchange (ETDEWEB)

Daboussi, A.; Julian, A. [Universite Paul-Sabatier, EA 3033, Radiopharmaceutiques et Traitement de l' Image, 31 - Toulouse (France); Daboussi, A.; Fourcade, O. [Centre Hospitalier Universitaire Purpan, GRC 48 Coordination Anesthesie-Reanimation, 31 - Toulouse (France); Julian, A.; Ouhayoun, E.; Esquerre, J.P.; Payoux, P. [Centre Hospitalier Universitaire Purpan, Service de Medecine Nucleaire, 31 - Toulouse (France); Tremoulet, M. [Centre Hospitalier Universitaire Purpan, Service de Neurochirurgie, 31 - Toulouse (France)

2007-02-15

Introduction: We compared four different methods to assess changes in cerebral blood flow in patients with normal pressure hydrocephalus using cerebral ECD SPECT before and after injection of acetazolamide. Material and methods: Eleven patients underwent cerebral SPECT before and after injection of 1 g of acetazolamide using a {sup 99m}Tc-ECD split-dose protocol with a first injection of 370 MBq and a second of 1 100 MBq. After reconstruction of volumes with Neurogam (Segami) software. we compared visual analysis to semi quantitative analysis provided by Neurogam software. ratios methods and parametric analysis under SPM99 and SPM2. Results: Visual analysis is immediate but frequently misleading. The contribution of Neurogam depends on the reader's skill and may be significant for non expert readers. The manual semi-automatic method is tedious and its results depend on the choice of the areas of interest and reference necessary for activity normalization. At last, the automatic method carried out by SPM is reliable for population analysis, but its efficiency for individual analysis remains to be evaluated. (authors)

Nano-TiO₂--feasibility and challenges for human health risk assessment based on open literature.

Science.gov (United States)

Christensen, Frans M; Johnston, Helinor J; Stone, Vicki; Aitken, Robert J; Hankin, Steve; Peters, Sheona; Aschberger, Karin

2011-06-01

This study aims at investigating feasibility and challenges associated with conducting a human health risk assessment for nano-titanium-dioxide (nano-TiO₂) based on the open literature by following an approach similar to a classical regulatory risk assessment. Gaps in the available data set, both in relation to exposures and hazard, do not allow reaching any definite conclusions that could be used for regulatory decision-making. Results show that repeated inhalation in the workplace and possibly consumer inhalation may cause risks. Also short-term inhalation following spray applications may cause risks. Main future work should focus on generating occupational and consumer inhalation exposure data, as well as toxicity data on absorption following inhalation, repeated dermal contact, and contact with damaged skin. Also relevant seems further information on possible neurotoxicity and genotoxicity/carcinogenicity, as well as establishing a No Observed Adverse Effect Level (NOAEL) for acute inhalation of nano-TiO₂.

Challenges and opportunities in using Life Cycle Assessment and Cradle to Cradle® for biodegradable bio-based polymers: a review

DEFF Research Database (Denmark)

Niero, Monia; Manat, Renil; Møller, Birger Lindberg

2015-01-01

Both Life Cycle Assessment (LCA) and Cradle to Cradle® (C2C) approaches can provide operative insightsin the design of biodegradable bio-based polymers. Some of the challenges shared by both LCA and C2Cthat need further investigation are the use of lab scale data versus primary data from establis......Both Life Cycle Assessment (LCA) and Cradle to Cradle® (C2C) approaches can provide operative insightsin the design of biodegradable bio-based polymers. Some of the challenges shared by both LCA and C2Cthat need further investigation are the use of lab scale data versus primary data from...... establishedtechnologies and the identification of the best option for the end of use stage, e.g. for use as packaging. Weconsider the case of a natural fiber-based composite material obtained from barley straw and present someinsights from both LCA and C2C perspectives in the identification of the best option for its end...

Challenges of using pluripotent stem cells for safety assessments of substances

International Nuclear Information System (INIS)

Vojnits, Kinga; Bremer, Susanne

2010-01-01

Various European Union (EU) legislations request the use of in vitro tests for toxicological evaluations in order to increase the safety of consumer and patients but also to reduce the number vertebrates. The review provides a brief overview on EU legislations in place but without further interpretation. At present several ongoing EU projects address the need of developing predictive in vitro tests including projects assessing the potential of human embryonic stem cell (hESC) lines as basis for a range of toxicity tests. Tests based on human cells would avoid interspecies variations and as such predict more precisely adverse effects to the human body. However, the ethical situation on the use of toxicity tests based on hESCs is still under debate since no harmonization within Europe on the use of hESC lines has been achieved yet. A mutual acceptance of toxicity tests based on hESCs for regulatory applications is therefore challenging. Recent reports on the establishment of induced pluripotent stem cells (iPSC) are pointing to a way out of this dilemma, since these cells have apparently very similar characteristics as hESCs and could serve as basis for the development of toxicity tests. A careful scientific comparison between pluripotent cells of different origin is now needed in order to make final judgments. In any case, the development of reliable and relevant in vitro toxicity tests based on human pluripotent cells requires additional quality assessments of critical parameter that are also summarized within the review.

Personal and professional challenges confronted by hospital staff following hurricane sandy: a qualitative assessment of management perspectives

OpenAIRE

Morris, Andrea M.; Ricci, Karen A.; Griffin, Anne R.; Heslin, Kevin C.; Dobalian, Aram

2016-01-01

Background Adequate hospital staffing during and after a disaster is critical to meet increased health care demands and to ensure continuity of care and patient safety. However, when a disaster occurs, staff may become both victim and responder, decreasing their ability and willingness to report for work. This qualitative study assessed the personal and professional challenges that affected staff decisions to report to work following a natural disaster and examined the role of management in a...

Challenges in coupling LTER with environmental assessments: An insight from potential and reality of the Chinese Ecological Research Network in servicing environment assessments.

Science.gov (United States)

Xia, Shaoxia; Liu, Yu; Yu, Xiubo; Fu, Bojie

2018-08-15

Environmental assessments estimate, evaluate and predict the consequences of natural processes and human activities on the environment. Long-term ecosystem observation and research networks (LTERs) are potentially valuable infrastructure to support environmental assessments. However, very few environmental assessments have successfully incorporated them. In this study, we try to reveal the current status of coupling LTERs with environmental assessments and look at the challenges involved in improving this coupling through exploring the role that Chinese Ecological Research Network (CERN), the LTER of China, currently plays in regional environment assessments. A review of official protocols and standards, regional assessments and CERN researches related to ecosystems and environment shows that there is great potential for coupling CERN with environment assessments. However in practice, CERN does not currently play the expected role. Remote sensing and irregular inventory data are still the main data sources currently used in regional assessments. Several causes led to the present situation: (1) insufficient cross-site research and failure to scale up site-level variables to the regional scale; (2) data barriers resulting from incompatible protocols and low data usability due to lack of data assimilation and scaling; and (3) absence of indicators relevant to human activities in existing monitoring protocols. For these reasons, enhancing cross-site monitoring and research, data assimilation and scaling up are critical steps required to improve coupling of LTER with environmental assessments. Site-focused long-term monitoring should be combined with wide-scale ground surveys and remote sensing to establish an effective connection between different environmental monitoring platforms for regional assessments. It is also necessary to revise the current monitoring protocols to include human activities and their impacts on the ecosystem, or change the LTERs into Long

The neurovestibular challenges of astronauts and balance patients: some past countermeasures and two alternative approaches to elicitation, assessment and mitigation

Directory of Open Access Journals (Sweden)

Ben Lawson

2016-11-01

Full Text Available Astronauts and vestibular patients face analogous challenges to orientation function due to adaptive exogenous (weightlessness-induced or endogenous (pathology-induced alterations in the processing of acceleration stimuli. Given some neurovestibular similarities between these challenges, both affected groups may benefit from shared research approaches and adaptation measurement/improvement strategies. This paper reviews various past strategies and introduces two plausible ground-based approaches, the first of which is a method for eliciting and assessing vestibular adaptation-induced imbalance. Second, we review a strategy for mitigating imbalance associated with vestibular pathology and fostering readaptation. In discussing the first strategy (for imbalance assessment, we review a pilot study wherein imbalance was elicited (among healthy subjects via an adaptive challenge that caused a temporary/reversible disruption. The surrogate vestibular deficit was caused by a brief period of movement-induced adaptation to an altered (rotating gravitoinertial frame of reference. This elicited adaptation and caused imbalance when head movements were made after reentry into the normal (non-rotating frame of reference. We also review a strategy for fall mitigation, viz., a prototype tactile sway feedback device for aiding balance/recovery after disruptions caused by vestibular pathology. We introduce the device and review a preliminary exploration of its effectiveness in aiding clinical balance rehabilitation (discussing the implications for healthy astronauts. Both strategies reviewed in this paper represent cross-disciplinary research spin-offs: the ground-based vestibular challenge and tactile cueing display were derived from aeromedical research to benefit military aviators suffering from flight simulator-relevant aftereffects or inflight spatial disorientation, respectively. These strategies merit further evaluation using clinical and astronaut

Epistemic risks: challenges in assessment and decision making

DEFF Research Database (Denmark)

Kozine, Igor

. There are calls to revisions ranging from the definition of risk and stretching to the use of risk analysis results in decision making. The talk will centre in answering the following questions: Why conventional approach to risk analysis is challenged? What are alternatives? How to operationalise the inclusion...... of epistemic uncertainty in risk analysis? How to make decisions based on risk analysis results?...

Methodological challenges in assessing the environmental status of a marine ecosystem: case study of the Baltic Sea.

Directory of Open Access Journals (Sweden)

Henn Ojaveer

Full Text Available Assessments of the environmental status of marine ecosystems are increasingly needed to inform management decisions and regulate human pressures to meet the objectives of environmental policies. This paper addresses some generic methodological challenges and related uncertainties involved in marine ecosystem assessment, using the central Baltic Sea as a case study. The objectives of good environmental status of the Baltic Sea are largely focusing on biodiversity, eutrophication and hazardous substances. In this paper, we conduct comparative evaluations of the status of these three segments, by applying different methodological approaches. Our analyses indicate that the assessment results are sensitive to a selection of indicators for ecological quality objectives that are affected by a broad spectrum of human activities and natural processes (biodiversity, less so for objectives that are influenced by a relatively narrow array of drivers (eutrophications, hazardous substances. The choice of indicator aggregation rule appeared to be of essential importance for assessment results for all three segments, whereas the hierarchical structure of indicators had only a minor influence. Trend-based assessment was shown to be a useful supplement to reference-based evaluation, being independent of the problems related to defining reference values and indicator aggregation methodologies. Results of this study will help in setting priorities for future efforts to improve environmental assessments in the Baltic Sea and elsewhere, and to ensure the transparency of the assessment procedure.

The Serial Change of Cerebral Hemodynamics by Vascular Territory after Extracranial-Intracranial Bypass Surgery in Patients with Atherosclerosis of Cerebral Arteries

International Nuclear Information System (INIS)

Hong, Il Ki; Kim, Jae Seung; Ahn, Jae Sung; Kwon, Sun Uck; Im, Ki Chun; Lee, Jai Hyuen; Moon, Dae Hyuk

2008-01-01

To assess the effect of extracranial-intracranial (EC-IC) bypass surgery on hemodynamic improvement, we evaluated serial regional cerebral hemodynamic change of the middle cerebral artery (MCA) in symptomatic patients with atherosclerotic occlusion of the internal carotid artery (ICA) or MCA using 99m Tc-ECD acetazolamide stress brain perfusion SPECT (Acetazolamide SPECT). The patients who had suffered a recent stroke with atherosclerotic ICA or MCA occlusion underwent EC-IC bypass surgery and Acetazolamide SPECT at 1 week before and three to six months after surgery. For image analysis, attenuation corrected images were spatially normalized to SPECT templates with SPM2. Anatomical automated labeling was applied to calculate mean counts of each Volume-Of-Interest (VOI). Seven VOIs of bilateral frontal, parietal, temporal regions of the MCA territory and the ipsilateral cerebellum were defined. Using mean counts of 7 VOIs, cerebral perfusion index and perfusion reserve index were calculated. Seventeen patients (M:F=12:5, mean age: 53±2yr) were finally included in the analysis. The cerebral blood flow of the parietal region increased at 1 week (p=0.003) and decreased to the preoperative level at 3-6 months (p=0.003). The cerebrovascular reserve of the frontal and parietal regions increased significantly at 1 week after surgery (p<0.01) and improved further at 3-6 months. Cerebrovascular reserve of the MCA territory was significantly improved at early postoperative period after EC-IC bypass and kept improved state during long-term follow-up, although cerebral blood flow did not significantly improved. Therefore, cerebrovascular reserve may be a good indicator of postoperative hemodynamic improvement resulted from bypass effect

The Serial Change of Cerebral Hemodynamics by Vascular Territory after Extracranial-Intracranial Bypass Surgery in Patients with Atherosclerosis of Cerebral Arteries

Energy Technology Data Exchange (ETDEWEB)

Hong, Il Ki; Kim, Jae Seung; Ahn, Jae Sung; Kwon, Sun Uck; Im, Ki Chun; Lee, Jai Hyuen; Moon, Dae Hyuk [Asan Medial Center, Ulsan University School of Medicine, Seoul (Korea, Republic of)

2008-02-15

To assess the effect of extracranial-intracranial (EC-IC) bypass surgery on hemodynamic improvement, we evaluated serial regional cerebral hemodynamic change of the middle cerebral artery (MCA) in symptomatic patients with atherosclerotic occlusion of the internal carotid artery (ICA) or MCA using {sup 99m}Tc-ECD acetazolamide stress brain perfusion SPECT (Acetazolamide SPECT). The patients who had suffered a recent stroke with atherosclerotic ICA or MCA occlusion underwent EC-IC bypass surgery and Acetazolamide SPECT at 1 week before and three to six months after surgery. For image analysis, attenuation corrected images were spatially normalized to SPECT templates with SPM2. Anatomical automated labeling was applied to calculate mean counts of each Volume-Of-Interest (VOI). Seven VOIs of bilateral frontal, parietal, temporal regions of the MCA territory and the ipsilateral cerebellum were defined. Using mean counts of 7 VOIs, cerebral perfusion index and perfusion reserve index were calculated. Seventeen patients (M:F=12:5, mean age: 53{+-}2yr) were finally included in the analysis. The cerebral blood flow of the parietal region increased at 1 week (p=0.003) and decreased to the preoperative level at 3-6 months (p=0.003). The cerebrovascular reserve of the frontal and parietal regions increased significantly at 1 week after surgery (p<0.01) and improved further at 3-6 months. Cerebrovascular reserve of the MCA territory was significantly improved at early postoperative period after EC-IC bypass and kept improved state during long-term follow-up, although cerebral blood flow did not significantly improved. Therefore, cerebrovascular reserve may be a good indicator of postoperative hemodynamic improvement resulted from bypass effect.

The Problem Behaviour Check List: a short scale to assess challenging behaviours

OpenAIRE

Tyrer, PJ; Nagar, J; Evans, R; Oliver, P; Bassett, P; Liedtka, N; Tarabi, A

2016-01-01

Background Challenging behaviour, especially in intellectual disability, covers a wide range that is in need of further evaluation. Aims To develop a short but comprehensive instrument for all aspects of challenging behaviour. Method In the first part of a two-stage enquiry, a 28-item scale was constructed to examine the components of challenging behaviour. Following a simple factor analysis this was developed further to create a new short scale, the Problem Behaviour Checklist (PBCL). The sc...

Information resources for assessing health effects from chemical exposure: Challenges, priorities, and future issues

Energy Technology Data Exchange (ETDEWEB)

Seigel, S. [National Library of Medicine, Bethesda, MD (United States)

1990-12-31

Issues related to developing information resources for assessing the health effects from chemical exposure include the question of how to address the individual political issues relevant to identifying and determining the timeliness, scientific credibility, and completeness of such kinds of information resources. One of the important ways for agencies to share information is through connection tables. This type of software is presently being used to build information products for some DHHS agencies. One of the challenges will be to convince vendors of data of the importance of trying to make data files available to communities that need them. In the future, information processing will be conducted with neural networks, object-oriented database management systems, and fuzzy-set technologies, and meta analysis techniques.

Meeting challenges related to the dietary assessment of ethnic minority populations.

Science.gov (United States)

Garduño-Diaz, S D; Husain, W; Ashkanani, F; Khokhar, S

2014-08-01

Migrants from the Indian subcontinent comprise the largest minority group in the UK. With the process of migration come alterations in lifestyle and eating habits. The present study aimed to disseminate the valuable information, experiences and challenges faced by researchers who conduct studies with ethnic minority groups in the area of diet and nutritional surveys, with an emphasis on migrant South Asians. The findings reported are the result of research carried out during 2008-2012, involving 1100 face-to-face dietary recalls conducted in the UK among South Asian children (aged 1.5-11 years; n = 300) and adults (≥30 years; n = 100). Factors to consider when planning and carrying out diet and nutrition survey studies among migrant South Asians were identified and include the employment of culture-specific tools, visual aid reinforcement and the involvement of key community members and translators to facilitate recruitment and data collection. One of the best practices found when working with minority groups was the use of incentives and tangible benefits to reward study participants. It was also found that constant communication and follow-up of the study participants improved the quality of the data and the likelihood of maintaining links with community members for future studies. From the results of in-house studies and a revision of practices reported in earlier literature, two 24-h face-to-face dietary recalls are recommended as the optimal method for the dietary assessment of migrant South Asians. To complement this assessment, ethnic-specific food frequency questionnaires such as that developed and successfully implemented among South Asians in the present study must be employed. © 2013 The British Dietetic Association Ltd.

Standardizing assessment practices of undergraduate medical competencies across medical schools: challenges, opportunities and lessons learned from a consortium of medical schools in Uganda.

Science.gov (United States)

Mubuuke, Aloysius Gonzaga; Mwesigwa, Catherine; Maling, Samuel; Rukundo, Godfrey; Kagawa, Mike; Kitara, David Lagoro; Kiguli, Sarah

2014-01-01

Health professions education is gradually moving away from the more traditional approaches to new innovative ways of training aimed at producing professionals with the necessary competencies to address the community health needs. In response to these emerging trends, Medical Education for Equitable Services to All Ugandans (MESAU), a consortium of Ugandan medical schools developed key competencies desirable of graduates and successfully implemented Competency Based Education (CBE) for undergraduate medical students. To examine the current situation and establish whether assessment methods of the competencies are standardized across MESAU schools as well as establish the challenges, opportunities and lessons learned from the MESAU consortium. It was a cross-sectional descriptive study involving faculty of the medical schools in Uganda. Data was collected using focus group discussions and document reviews. Findings were presented in form of themes. Although the MESAU schools have implemented the developed competencies within their curricular, the assessment methods are still not standardized with each institution having its own assessment procedures. Lack of knowledge and skills regarding assessment of the competencies was evident amongst the faculty. The fear for change amongst lecturers was also noted as a major challenge. However, the institutional collaboration created while developing competencies was identified as key strength. Findings demonstrated that despite having common competencies, there is no standardized assessment blue print applicable to all MESAU schools. Continued collaboration and faculty development in assessment is strongly recommended.

The challenges of ecotox testing of nanomaterials and the BPR

DEFF Research Database (Denmark)

Hansen, Steffen Foss

2015-01-01

The European Biocidal Product Regulation (BPR) requires dedicated risk assessment of nanomaterials. When it comes to ecotoxicological testing of nanomaterials, meeting these requirements is especially challenging. Overall, these challenges fall into four overall categories: 1) materials character......The European Biocidal Product Regulation (BPR) requires dedicated risk assessment of nanomaterials. When it comes to ecotoxicological testing of nanomaterials, meeting these requirements is especially challenging. Overall, these challenges fall into four overall categories: 1) materials...... characterization, 2) exposure preparation, 3) monitoring stability and 4) monitoring time. In this paper, the challenges are presented and discussed. There is no easy manner in which to deal with the challenges related to ecotoxicological testing of nanomaterials in the light of the BPR requirements. It short...

Assessment of Micronutrient Status in Critically Ill Children: Challenges and Opportunities

Directory of Open Access Journals (Sweden)

Duy T. Dao

2017-10-01

Full Text Available Micronutrients refer to a group of organic vitamins and inorganic trace elements that serve many functions in metabolism. Assessment of micronutrient status in critically ill children is challenging due to many complicating factors, such as evolving metabolic demands, immature organ function, and varying methods of feeding that affect nutritional dietary intake. Determination of micronutrient status, especially in children, usually relies on a combination of biomarkers, with only a few having been established as a gold standard. Almost all micronutrients display a decrease in their serum levels in critically ill children, resulting in an increased risk of deficiency in this setting. While vitamin D deficiency is a well-known phenomenon in critical illness and can predict a higher need for intensive care, serum concentrations of many trace elements such as iron, zinc, and selenium decrease as a result of tissue redistribution in response to systemic inflammation. Despite a decrease in their levels, supplementation of micronutrients during times of severe illness has not demonstrated clear benefits in either survival advantage or reduction of adverse outcomes. For many micronutrients, the lack of large and randomized studies remains a major hindrance to critically evaluating their status and clinical significance.

The complexity and challenges of determining GHG (greenhouse gas) emissions from grid electricity consumption and conservation in LCA (life cycle assessment) – A methodological review

International Nuclear Information System (INIS)

Soimakallio, Sampo; Kiviluoma, Juha; Saikku, Laura

2011-01-01

The way in which GHG (greenhouse gas) emissions associated with grid electricity consumption is handled in different LCA (life cycle assessment) studies, varies significantly. Apart from differences in actual research questions, methodological choices and data set selection have a significant impact on the outcomes. These inconsistencies result in difficulties to compare the findings of various LCA studies. This review paper explores the issue from a methodological point of view. The perspectives of ALCA (attributional life cycle assessment) and CLCA (consequential life cycle assessment) are reflected. Finally, the paper summarizes the key issues and provides suggestions on the way forward. The major challenge related to both of the LCA categories is to determine the GHG emissions of the power production technologies under consideration. Furthermore, the specific challenge in ALCA is to determine the appropriate electricity production mix, and in CLCA, to identify the marginal technologies affected and related consequences. Significant uncertainties are involved, particularly in future-related LCAs, and these should not be ignored. Harmonization of the methods and data sets for various purposes is suggested, acknowledging that selections might be subjective. -- Highlights: ► Methods to assess GHG emissions from grid electricity consumption in LCA vary. ► We explored the major challenges related to various methods. ► Significant uncertainties are involved particularly in future-related GHG emissions. ► The most appropriate method depends on the equity viewpoints.

[Productivity and academic assessment in the Brazilian public health field: challenges for Human and Social Sciences research].

Science.gov (United States)

Bosi, Maria Lúcia Magalhães

2012-12-01

This article analyzes some challenges for knowledge output in the human and social sciences in the public health field, under the current academic assessment model in Brazil. The article focuses on the qualitative research approach in human and social sciences, analyzing its status in comparison to the other traditions vying for hegemony in the public health field, conjugating the dialogue with the literature, especially the propositions pertaining to the social fields present in the work of Pierre Bourdieu, with elements concerning the field's dynamics, including some empirical data. Challenges identified in the article include hurdles to interdisciplinary dialogue and equity in the production of knowledge, based on recognition of the founding place of human and social sciences in the public health field. The article discusses strategies to reshape the current correlation of forces among centers of knowledge in public health, especially those capable of impacting the committees and agendas that define the accumulation of symbolic and economic capital in the field.

Novel Suicide by Division of a Chronically Infected, Externalised Axillofemoral Graft Presenting Challenges in Prehospital Assessment of Mental Capacity

Directory of Open Access Journals (Sweden)

Lewis G. Stevens

2012-01-01

Full Text Available Assessing a patient's competence to give informed consent in pre-hospital care is difficult. In the presented case an elderly patient attempted suicide by division of a chronically infected and externalised prosthetic arterial graft. He was able to comprehend his situation and understand the consequences of declining treatment. Without prior knowledge of his medical care and psychological state, however, we did not believe we could fully assess the patient's ability to act in his own best interest. After sedation and resuscitation he was transferred to hospital. This case report discusses a unique method of suicide and the challenge of obtaining valid consent in prehospital care.

Ghana's National Health Insurance Scheme: an assessment of problems and challenges

OpenAIRE

Danquah, Jones Kwame Adom

2017-01-01

Despite impressive progress since 2003, huge challenges remain in the effort to improve health outcomes in Ghana and achieve related goals concerning universal coverage, basic needs, equity, inclusion, risk protection and reaching poor and marginalized groups. One of these challenges is how health should be financed – who should pay how much and through what arrangements, given the reality that the services and other actions needed to attain desired health results inevitably involve costs tha...

Effects of early administration of acetazolamide on the duration of mechanical ventilation in patients with chronic obstructive pulmonary disease or obesity-hypoventilation syndrome with metabolic alkalosis. A randomized trial.

Science.gov (United States)

Rialp Cervera, G; Raurich Puigdevall, J M; Morán Chorro, I; Martín Delgado, M C; Heras la Calle, G; Mas Serra, A; Vallverdú Perapoch, I

2017-06-01

Metabolic alkalosis (MA) inhibits respiratory drive and may delay weaning from mechanical ventilation (MV). MA is common in CO 2 -retainer patients that need MV. Acetazolamide (ACTZ) decreases serum bicarbonate concentration and stimulates respiratory drive. This study evaluated the effects of ACTZ on the duration of MV in patients with MA and COPD or obesity hypoventilation syndrome (OHS) intubated with acute respiratory failure. Multicenter, randomized, controlled, double-blind study, with COPD or OHS patients with MV 28 mmol/L and pH > 7.35. Test-treatment, ACTZ 500 mg or placebo, was daily administered if pH > 7.35 and bicarbonate >26 mmol/L. Clinical, respiratory and laboratory parameters were recorded. 47 patients (36 men) were randomized. There were no significant differences between groups in comorbidities, baseline characteristics or arterial blood gases at inclusion. The mean difference in the duration of MV between placebo and ACTZ group was 1.3 days (95%CI, -2.1-4.8; p = 0.44). Kaplan-Meier curves showed no differences in the duration of MV (Log-Rank p = 0.41). Between-group comparison of estimated marginal means (CI 95%) during MV were, respectively: PaCO 2 55 (51-59) vs 48 (47-50) mm Hg, p = 0.002; bicarbonate concentration 34 (32-35) vs 29 (28-30) mmol/L, p < 0.0001; and minute volume 9.7 (8.9-10.4) vs 10.6 (9.2-12.0) L/min, p = 0.26. There were no severe adverse effects with ACTZ administration. Among patients with MA and COPD or OHS, early treatment with ACTZ did not shorten significantly the duration of MV compared with placebo. clinical.trials.gov; NCT01499485; URL:.www.clinicaltrials.gov. Copyright © 2017 Elsevier Ltd. All rights reserved.

Mobility assessment in older people : new possibilities and challenges

NARCIS (Netherlands)

Zijlstra, Wiebren; Aminian, Kamiar

A major challenge for researchers and clinicians who address health issues in the ageing population is to monitor functioning, and to timely initiate interventions that aim to prevent loss of functional abilities and to improve the quality of life of older people. With the progress of technologies

Assessing the criminal capacity of children: a challenge to the capacity of mental health professionals.

Science.gov (United States)

Pillay, Anthony L; Willows, Clive

2015-01-01

With increasing numbers of juveniles accused of serious crimes international concern is growing around the procedural consequences for affected individuals within the context of the law and criminal justice. Issues of culpability in children and adolescents are often raised, with much deliberation and insufficient agreement among legal and child development experts. Exactly when and to what extent juveniles can be held responsible for their action is a matter requiring careful consideration to avoid substantial erring in either direction. Although some international guiding standards and principles have been established, these are rather broad and unable to provide specific prescriptions. In addition, the assessment of criminal capacity in juveniles is a complex task, and one that is not wholly without reliability and validity problems. As in the case of South Africa and a few other countries, mental health specialists are often tasked with conducting developmental assessments to provide courts with expert evidence regarding criminal capacity. This paper examines the concept of criminal capacity in the context of the theory, controversies and challenges that affect this area of psychological focus.

Applying a framework for assessing the health system challenges to scaling up mHealth in South Africa

Directory of Open Access Journals (Sweden)

Leon Natalie

2012-11-01

Full Text Available Abstract Background Mobile phone technology has demonstrated the potential to improve health service delivery, but there is little guidance to inform decisions about acquiring and implementing mHealth technology at scale in health systems. Using the case of community-based health services (CBS in South Africa, we apply a framework to appraise the opportunities and challenges to effective implementation of mHealth at scale in health systems. Methods A qualitative study reviewed the benefits and challenges of mHealth in community-based services in South Africa, through a combination of key informant interviews, site visits to local projects and document reviews. Using a framework adapted from three approaches to reviewing sustainable information and communication technology (ICT, the lessons from local experience and elsewhere formed the basis of a wider consideration of scale up challenges in South Africa. Results Four key system dimensions were identified and assessed: government stewardship and the organisational, technological and financial systems. In South Africa, the opportunities for successful implementation of mHealth include the high prevalence of mobile phones, a supportive policy environment for eHealth, successful use of mHealth for CBS in a number of projects and a well-developed ICT industry. However there are weaknesses in other key health systems areas such as organisational culture and capacity for using health information for management, and the poor availability and use of ICT in primary health care. The technological challenges include the complexity of ensuring interoperability and integration of information systems and securing privacy of information. Finally, there are the challenges of sustainable financing required for large scale use of mobile phone technology in resource limited settings. Conclusion Against a background of a health system with a weak ICT environment and limited implementation capacity, it remains

The Evolution of Integrated Assessment and Emerging Challenges in the Assessment of Human and Natural System Interactions

Science.gov (United States)

Clarke, L.

2017-12-01

Integrated assessment (IA) modeling and research has a long history, spanning over 30 years since its inception and addressing a wide range of contemporary issues along the way. Over the last decade, IA modeling and research has emerged as one of the primary analytical methods for understanding the complex interactions between human and natural systems, from the interactions between energy, water, and land/food systems to the interplay between health, climate, and air pollution. IA modeling and research is particularly well-suited for the analysis of these interactions because it is a discipline that strives to integrate representations of multiple systems into consistent computational platforms or frameworks. In doing so, it explicitly confronts the many tradeoffs that are frequently necessary to manage complexity and computational cost while still representing the most important interactions and overall, coupled system behavior. This talk explores the history of IA modeling and research as a means to better understand its role in the assessment of contemporary issues at the confluence of human and natural systems. It traces the evolution of IA modeling and research from initial exploration of long-term emissions pathways, to the role of technology in the global evolution of the energy system, to the key linkages between land and energy systems and, more recently, the linkages with water, air pollution, and other key systems and issues. It discusses the advances in modeling that have emerged over this evolution and the biggest challenges that still present themselves as we strive to better understand the most important interactions between human and natural systems and the implications of these interactions for human welfare and decision making.

Challenges in Designing Mechatronic Systems

DEFF Research Database (Denmark)

Torry-Smith, Jonas; Qamar, Ahsan; Achiche, Sofiane

2013-01-01

Development of mechatronic products is traditionally carried out by several design experts from different design domains. Performing development of mechatronic products is thus greatly challenging. In order to tackle this, the critical challenges in mechatronics have to be well understood and well...... supported through applicable methods and tools. This paper aims at identifying the major challenges, by conducting a systematic and thorough survey of the most relevant research work in mechatronic design. Solutions proposed in literature are assessed and illustrated through a case study in order...... to investigate if the challenges can be handled appropriately by the methods, tools, and mindsets suggested by the mechatronic community. Using a real world mechatronics case, the paper identifies the areas where further research is required, by showing a clear connection between the actual problems faced during...

Incidence and Symptoms of High Altitude Illness in South Pole Workers: Antarctic Study of Altitude Physiology (ASAP

Directory of Open Access Journals (Sweden)

Paul J. Anderson

2011-01-01

Full Text Available Introduction Each year, the US Antarctic Program rapidly transports scientists and support personnel from sea level (SL to the South Pole (SP, 2835 m providing a unique natural laboratory to quantify the incidence of acute mountain sickness (AMS, patterns of altitude related symptoms and the field effectiveness of acetazolamide in a highly controlled setting. We hypothesized that the combination of rapid ascent (3 hr, accentuated hypobarism (relative to altitude, cold, and immediate exertion would increase altitude illness risk. Methods Medically screened adults (N = 246, age = 37 ± 11 yr, 30% female, BMI = 26 ± 4 kg/m 2 were recruited. All underwent SL and SP physiological evaluation, completed Lake Louise symptom questionnaires (LLSQ, to define AMS, and answered additional symptom related questions (eg, exertional dyspnea, mental status, cough, edema and general health, during the 1st week at altitude. Acetazolamide, while not mandatory, was used by 40% of participants. Results At SP, the barometric pressure resulted in physiological altitudes that approached 3400 m, while T ° C averaged -42, humidity 0.03%. Arterial oxygen saturation averaged 89% ± 3%. Overall, 52% developed LLSQ defined AMS. The most common symptoms reported were exertional dyspnea-(87%, sleeping difficulty-(74%, headache-(66%, fatigue-(65%, and dizziness/lightheadedness-(46%. Symptom severity peaked on days 1-2, yet in >20% exertional dyspnea, fatigue and sleep problems persisted through day 7. AMS incidence was similar between those using acetazolamide and those abstaining (51 vs. 52%, P = 0.87. Those who used acetazolamide tended to be older, have less altitude experience, worse symptoms on previous exposures, and less SP experience. Conclusion The incidence of AMS at SP tended to be higher than previously reports in other geographic locations at similar altitudes. Thus, the SP constitutes a more intense altitude exposure than might be expected considering physical

Standardizing assessment practices of undergraduate medical competencies across medical schools: challenges, opportunities and lessons learned from a consortium of medical schools in Uganda

Science.gov (United States)

Mubuuke, Aloysius Gonzaga; Mwesigwa, Catherine; Maling, Samuel; Rukundo, Godfrey; Kagawa, Mike; Kitara, David Lagoro; Kiguli, Sarah

2014-01-01

Introduction Health professions education is gradually moving away from the more traditional approaches to new innovative ways of training aimed at producing professionals with the necessary competencies to address the community health needs. In response to these emerging trends, Medical Education for Equitable Services to All Ugandans (MESAU), a consortium of Ugandan medical schools developed key competencies desirable of graduates and successfully implemented Competency Based Education (CBE) for undergraduate medical students. Objectives To examine the current situation and establish whether assessment methods of the competencies are standardized across MESAU schools as well as establish the challenges, opportunities and lessons learned from the MESAU consortium. Methods It was a cross-sectional descriptive study involving faculty of the medical schools in Uganda. Data was collected using focus group discussions and document reviews. Findings were presented in form of themes. Results Although the MESAU schools have implemented the developed competencies within their curricular, the assessment methods are still not standardized with each institution having its own assessment procedures. Lack of knowledge and skills regarding assessment of the competencies was evident amongst the faculty. The fear for change amongst lecturers was also noted as a major challenge. However, the institutional collaboration created while developing competencies was identified as key strength. Conclusion Findings demonstrated that despite having common competencies, there is no standardized assessment blue print applicable to all MESAU schools. Continued collaboration and faculty development in assessment is strongly recommended. PMID:25995778

Baseline integrated behavioural and biological assessment among most at-risk populations in six high-prevalence states of India: design and implementation challenges.

Science.gov (United States)

Saidel, Tobi; Adhikary, Rajatashuvra; Mainkar, Mandar; Dale, Jayesh; Loo, Virginia; Rahman, Motiur; Ramesh, Banadakoppa M; Paranjape, Ramesh S

2008-12-01

This paper presents key methodological approaches and challenges in implementing and analysing the first round of the integrated biobehavioural assessment of most-at-risk populations, conducted in conjunction with evaluation of Avahan, the India AIDS initiative. The survey collected data on HIV risk behaviours, sexually transmitted infections and HIV prevalence in 29 districts in six high-prevalence states of India. Groups included female sex workers and clients, men who have sex with men, injecting drug users and truck drivers. Strategies for overcoming some challenges of the large-scale surveys among vulnerable populations, including sampling hidden populations, involvement of the communities targeted by the survey, laboratory and quality control in remote, non-clinic field settings, and data analysis and data use are presented. Satisfying the need for protocols, guidelines and tools that allowed for sufficient standardization, while being tailored enough to fit diverse local situations on such a large scale, with so many implementing partners, emerged as a major management challenge. A major lesson from the first round is the vital importance of investing upfront time in tailoring the sampling methods, data collection instruments, and analysis plan to match measurement objectives. Despite the challenges, the integrated biobehavioural assessment was a huge achievement, and was largely successful in providing previously unavailable information about the HIV situation among populations that are critical to the curtailment of HIV spread in India. Lessons from the first round will be used to evolve the second round into an exercise with increased evaluative capability for Avahan.

Implementing systematic review techniques in chemical risk assessment: Challenges, opportunities and recommendations.

Science.gov (United States)

Whaley, Paul; Halsall, Crispin; Ågerstrand, Marlene; Aiassa, Elisa; Benford, Diane; Bilotta, Gary; Coggon, David; Collins, Chris; Dempsey, Ciara; Duarte-Davidson, Raquel; FitzGerald, Rex; Galay-Burgos, Malyka; Gee, David; Hoffmann, Sebastian; Lam, Juleen; Lasserson, Toby; Levy, Len; Lipworth, Steven; Ross, Sarah Mackenzie; Martin, Olwenn; Meads, Catherine; Meyer-Baron, Monika; Miller, James; Pease, Camilla; Rooney, Andrew; Sapiets, Alison; Stewart, Gavin; Taylor, David

2016-01-01

Systematic review (SR) is a rigorous, protocol-driven approach designed to minimise error and bias when summarising the body of research evidence relevant to a specific scientific question. Taking as a comparator the use of SR in synthesising research in healthcare, we argue that SR methods could also pave the way for a "step change" in the transparency, objectivity and communication of chemical risk assessments (CRA) in Europe and elsewhere. We suggest that current controversies around the safety of certain chemicals are partly due to limitations in current CRA procedures which have contributed to ambiguity about the health risks posed by these substances. We present an overview of how SR methods can be applied to the assessment of risks from chemicals, and indicate how challenges in adapting SR methods from healthcare research to the CRA context might be overcome. Regarding the latter, we report the outcomes from a workshop exploring how to increase uptake of SR methods, attended by experts representing a wide range of fields related to chemical toxicology, risk analysis and SR. Priorities which were identified include: the conduct of CRA-focused prototype SRs; the development of a recognised standard of reporting and conduct for SRs in toxicology and CRA; and establishing a network to facilitate research, communication and training in SR methods. We see this paper as a milestone in the creation of a research climate that fosters communication between experts in CRA and SR and facilitates wider uptake of SR methods into CRA. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Integrated challenge test: a new approach evaluating quantitative risk assessment of Listeria in ready to eat foods

Directory of Open Access Journals (Sweden)

Paolo Matteini

2012-02-01

Full Text Available The study was aimed to predict the maximum concentration of Listeria monocytogenes during the shelf life in chicken liver paté. The prediction has been performed using the integrated challenge test: a test based on the interaction between indigenous lactic flora and L. monocytogenes and their growth parameters. Two different approaches were investigated: the former is based on the time difference between the onset of the L. monocytogenes and the lactic flora stationary phases, while the latter is based on the lactic flora concentration capable to induct the stationary phase of L. monocytogenes. Three different strains of L. monocytogenes, isolated from meat products, were used to perform three challenge tests. Triplicate samples from three different batches of liver paté were inoculated with a single-strain inoculum of 1.8 Log CFU/g. Samples were then stored at 4°C, 8°C and 12°C. Lactobacillus spp. (ISO 15214:1998 and L. monocytogenes (UNI EN ISO 11290-02:2005 plate counts were performed daily on each sample until the stationary phase was reached by both populations. The challenge test results were input in the Combase software to determine the growth parameters, later used for the calculation method. Predictive data were then statically assessed against the results of two additional challenge tests using triplicate samples from two different batches, the same strains and the same single-strain inoculum. Samples from the first batch were stored for 5 days at 4°C + 5 days at 8°C + 5 days at 12°C; samples from the second batch were stored for 3 days at 4°C + 3 days at 8°C + 4 days at 12°C. The results obtained showed that both approaches provided results very close to the reality. Therefore the Integrated challenge test is useful to determine the maximum concentration of L. monocytogenes, by simply knowing the concentration of the concerned microbial populations at a given time.

Environmental fate and exposure models: advances and challenges in 21st century chemical risk assessment.

Science.gov (United States)

Di Guardo, Antonio; Gouin, Todd; MacLeod, Matthew; Scheringer, Martin

2018-01-24

Environmental fate and exposure models are a powerful means to integrate information on chemicals, their partitioning and degradation behaviour, the environmental scenario and the emissions in order to compile a picture of chemical distribution and fluxes in the multimedia environment. A 1995 pioneering book, resulting from a series of workshops among model developers and users, reported the main advantages and identified needs for research in the field of multimedia fate models. Considerable efforts were devoted to their improvement in the past 25 years and many aspects were refined; notably the inclusion of nanomaterials among the modelled substances, the development of models at different spatial and temporal scales, the estimation of chemical properties and emission data, the incorporation of additional environmental media and processes, the integration of sensitivity and uncertainty analysis in the simulations. However, some challenging issues remain and require research efforts and attention: the need of methods to estimate partition coefficients for polar and ionizable chemical in the environment, a better description of bioavailability in different environments as well as the requirement of injecting more ecological realism in exposure predictions to account for the diversity of ecosystem structures and functions in risk assessment. Finally, to transfer new scientific developments into the realm of regulatory risk assessment, we propose the formation of expert groups that compare, discuss and recommend model modifications and updates and help develop practical tools for risk assessment.

Geriatric gambling disorder: challenges in clinical assessment.

Science.gov (United States)

Smith, Mara; Hategan, Ana; Bourgeois, James A

2017-12-01

To the Editor: The gaming industry is growing rapidly, as is the proportion of older adults aged 65 years or older who participate in gambling (Tse et al., 2012). With casinos tailoring their venues and providing incentives to attract older adults, and with the increasing popularity of "pleasure trips" to casinos organized by retirement homes, plus active promotion of government-operated lotteries in many countries, this trend is likely to continue. Gambling disorder (GD) or "pathological" or "problem" gambling presents a public health concern in the geriatric population. However, ascertainment of its prevalence and diagnostic accuracy have proven challenging. This is largely due to the absence of diagnostic criteria specific to the geriatric age and rating scales validated for use in this population.

A double-blind assessment of additive intolerance in children using a 12 day challenge period at home.

Science.gov (United States)

Wilson, N; Scott, A

1989-05-01

Alleged food-additive intolerance (respiratory, dermatological, behavioural or abdominal) was assessed in 19 children using daily challenge drinks of either, base product alone, base product plus sunset yellow/tartrazine, or base product plus sodium metabisulphite/sodium benzoate. The same type of drink was given for 12 days, double-blind and in random order. During the trial the children were maintained on an additive-free diet under supervision. Diary cards were used to record symptoms and medication usage. If there was an apparent association between symptoms and drink ingredient the trial was repeated, again double-blind. Additive intolerance was confirmed by a consistent deterioration of symptoms in only three children. In one, urticaria was induced by the colourings, in another extremely abnormal behaviour was induced by the preservatives and a third child was only free of asthma and abdominal pain on placebo. This form of individual trial, using 12 daily drinks, overcomes some of the objections to a single challenge study. Despite this, intolerance to the additives was only confirmed in 3/19 children in whom it had been believed to occur.

Increasing clinical relevance in oral radiology: Benefits and challenges when implementing digital assessment.

Science.gov (United States)

de Lange, T; Møystad, A; Torgersen, G R

2018-02-13

The aims of the study were to investigate benefits and challenges in implementing a digital examination and study the clinical relevance of the digital examination in relation to clinical training and practice. The study was based on semi-structured focus-group interviews from two distinct student populations (2016 and 2017) in a bachelor programme in dental hygiene. In addition, conversational data from a plenary discussion from the whole second student population (2017) were collected and analysed. The data were approached on basis of content analysis. A benefit experienced in the digital examination was the ease in typing and editing answers on the computer. This suggests an increased effectiveness in computer-based compared to analogue examinations. An additional advantage was the experienced relevance of the examination related to the clinic. This finding refers not only to the digital presentations of images, but also to the entire setting in the clinic and dental practice. The limitations reported by the students were non-optimal viewing conditions for presenting radiographic images and difficulties in obtaining an overview of the assignments compared to paper-based examinations due to the linear digital examination format. The last finding on lacking overview revealed an influence on student performances which should be taken seriously in designing digital examinations. In conclusion, the digital layout increases efficiency and clinical relevance of examinations to a certain extent. Obstacles were found in limitations related to image presentation and lack of overview of the examination. The latter challenge raises questions related to developing suitable assessment software. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Technology Assessment of the Inspection Readiness Plan in Chemical Weapons Convention Challenge Inspections

National Research Council Canada - National Science Library

Woodley, Anthony

1998-01-01

...) Challenge Inspections. The CWC is an intrusive inspection. The Challenge Inspection allows for a team of international inspectors to inspect on very short notice a naval facility suspected of violating the CWC...

Monitoring techniques for the impact assessment during nuclear and radiological emergencies: current status and the challenges

International Nuclear Information System (INIS)

Pradeepkumar, K.S.; Sharma, D.N.

2003-01-01

Preparedness and response capability for Nuclear and Radiological emergencies, existing world over, are mainly based on the requirement of responding to radiation emergency caused by nuclear or radiological accidents. Cosmos satellite accident, plutonium contamination at Polaris, nuclear accidents like Kystium, Windscale, TMI and Chernobyl, radiological accidents at Goiania etc have demonstrated the requirement of improved radiation monitoring techniques. For quick decision making, state of the art monitoring methodology which can support quantitative and qualitative impact assessment is essential. Evaluation of radiological mapping of the area suspected to be contaminated needs ground based as well as aerial based monitoring systems to predict the level of radioactive contamination on ground. This will help in delineating the area and deciding the required countermeasures, based on the quantity and type of radionuclides responsible for it. The response can be successful with the effective use of i) Early Warning System ii) Mobile Monitoring System and iii) Aerial Gamma Spectrometric System. Selection of the monitoring methodology and survey parameters and assessment of situation using available resources etc. are to be optimized depending on the accident scenario. Recently, many countries and agencies like IAEA have expressed the requirement for responding to other types of nuclear/radiological emergencies i.e, man made radiation emergency situations aimed at harming public at large that can also lead to environmental contamination and significant exposure to public. Reports of lost / misplaced / stolen radioactive sources from many countries are alarming as safety and security of these radioactive sources are under challenge. The monitoring methodology has to take into account of the increase in such demands and more periodic monitoring in suspected locations is to be carried out. Detection of orphan sources possible amidst large heap of metallic scraps may pose

Capacities for the Risk Assessment of GMOs: Challenges to Build Sustainable Systems

Directory of Open Access Journals (Sweden)

Danilo Fernández Ríos

2018-04-01

Full Text Available The need for functional risk assessment bodies in general, and in the biosafety field in particular, demands continued efforts and commitment from regulatory agencies, if results that are sustainable in time are to be achieved. The lack of formal processes that ensure continuity in the application of state of the art scientific criteria, the high rotation in some cases or the lack of experienced professionals, in others, is a challenge to be addressed. Capacity building initiatives with different approaches and degrees of success have been implemented in many countries over the years, supported by diverse governmental and non-governmental organizations. This document summarizes some capacity building experiences in developing countries and concludes that risk assessors taking ownership and regulatory authorities fully committed to developing and retaining highly qualified bodies are a sine qua non to achieve sustainable systems. To this end, it is essential to implement “in-house” continuing education mechanisms supported by external experts and organizations, and inter-institutional cooperation. It has to be noted that these recommendations could only be realized if policy makers understand and appreciate the value of professional, independent regulatory bodies.

Capacities for the Risk Assessment of GMOs: Challenges to Build Sustainable Systems.

Science.gov (United States)

Fernández Ríos, Danilo; Rubinstein, Clara; Vicién, Carmen

2018-01-01

The need for functional risk assessment bodies in general, and in the biosafety field in particular, demands continued efforts and commitment from regulatory agencies, if results that are sustainable in time are to be achieved. The lack of formal processes that ensure continuity in the application of state of the art scientific criteria, the high rotation in some cases or the lack of experienced professionals, in others, is a challenge to be addressed. Capacity building initiatives with different approaches and degrees of success have been implemented in many countries over the years, supported by diverse governmental and non-governmental organizations. This document summarizes some capacity building experiences in developing countries and concludes that risk assessors taking ownership and regulatory authorities fully committed to developing and retaining highly qualified bodies are a sine qua non to achieve sustainable systems. To this end, it is essential to implement "in-house" continuing education mechanisms supported by external experts and organizations, and inter-institutional cooperation. It has to be noted that these recommendations could only be realized if policy makers understand and appreciate the value of professional, independent regulatory bodies.

Work Group report: oral food challenge testing.

Science.gov (United States)

Nowak-Wegrzyn, Anna; Assa'ad, Amal H; Bahna, Sami L; Bock, S Allan; Sicherer, Scott H; Teuber, Suzanne S

2009-06-01

Oral food challenges are procedures conducted by allergists/immunologists to make an accurate diagnosis of immediate, and occasionally delayed, adverse reactions to foods. The timing of the challenge is carefully chosen based on the individual patient history and the results of skin prick tests and food specific serum IgE values. The type of the challenge is determined by the history, the age of the patient, and the likelihood of encountering subjective reactions. The food challenge requires preparation of the patient for the procedure and preparation of the office for the organized conduct of the challenge, for a careful assessment of the symptoms and signs and the treatment of reactions. The starting dose, the escalation of the dosing, and the intervals between doses are determined based on experience and the patient's history. The interpretation of the results of the challenge and arrangements for follow-up after a challenge are important. A negative oral food challenge result allows introduction of the food into the diet, whereas a positive oral food challenge result provides a sound basis for continued avoidance of the food.

Challenges in the Assessment of Medical Devices: The MedtecHTA Project.

Science.gov (United States)

Tarricone, Rosanna; Torbica, Aleksandra; Drummond, Michael

2017-02-01

Assessing medical devices (MDs) raises challenges which require us to reflect on whether current methods are adequate. Major features of devices are: (i) device-operator interaction can generate learning curve effects; (ii) incremental nature of innovation needs to be addressed by careful identification of the alternatives for comparative and incremental cost-effectiveness analysis; and (iii) broader organizational impact in terms of training and infrastructure, coupled with dynamic pricing, requires a more flexible approach to costing. The objective of the MedtecHTA project was to investigate improvements in HTA methods to allow for more comprehensive evaluation of MDs. It consisted of several work packages concerning (i) the available evidence on the currently adopted approaches for regulation and HTA of medical devices; (ii) the geographical variation in access to MDs; (iii) the development of methodological frameworks for conducting comparative effectiveness research and economic evaluation of MDs; and (iv) the organizational impact of MDs. This introductory paper summarizes the main results of the project and draws out the main overarching themes. This supplement represents a comprehensive report of all the main findings of the MedtecHTA project, and it is intended to be the main source for researchers and policy makers wanting information on the project. © 2017 The Authors. Health Economics published by John Wiley & Sons, Ltd. © 2017 The Authors. Health Economics Published by John Wiley & Sons, Ltd.

Mechatronic Design - Still a Considerable Challenge

DEFF Research Database (Denmark)

Torry-Smith, Jonas; Qamar, Ahsan; Achiche, Sofiane

2011-01-01

Development of mechatronic products is traditionally carried out by several design experts from different design domains. Performing development of mechatronic products is thus greatly challenging. In order to tackle this, the critical challenges in mechatronics have to be well understood and well...... supported through applicable methods and tools. This paper aims at identifying the major challenges, by conducting a survey of the most relevant research work in mechatronic design. Solutions proposed in literature are assessed and illustrated through a case study in order to investigate, if the challenges...... can be handled appropriately by the methods, tools, and mindsets suggested by the mechatronic community. Using a real world mechatronics case, the paper identifies the areas where further research is required, by showing a clear connection between the actual problems faced during the design task...

Ecological Momentary Assessment in Behavioral Research: Addressing Technological and Human Participant Challenges.

Science.gov (United States)

Burke, Lora E; Shiffman, Saul; Music, Edvin; Styn, Mindi A; Kriska, Andrea; Smailagic, Asim; Siewiorek, Daniel; Ewing, Linda J; Chasens, Eileen; French, Brian; Mancino, Juliet; Mendez, Dara; Strollo, Patrick; Rathbun, Stephen L

2017-03-15

completing EMA surveys was high, with 88.3% (66,978/75,888) completion of random assessments and around 90% (23,411/25,929 and 23,343/26,010) completion of time-contingent assessments, despite the duration of EMA data collection and challenges with implementation. This work informed us of the necessary preliminary steps to plan and prepare a longitudinal study using smartphone technology and the critical elements to ensure participant engagement in the potentially burdensome protocol, which spanned 12 months. While this was a technology-supported and -programmed study, it required close oversight to ensure all elements were functioning correctly, particularly once human participants became involved. ©Lora E Burke, Saul Shiffman, Edvin Music, Mindi A Styn, Andrea Kriska, Asim Smailagic, Daniel Siewiorek, Linda J Ewing, Eileen Chasens, Brian French, Juliet Mancino, Dara Mendez, Patrick Strollo, Stephen L Rathbun. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 15.03.2017.

Assessing mobile food vendors (a.k.a. street food vendors)—methods, challenges, and lessons learned for future food-environment research

Science.gov (United States)

Lucan, Sean C.; Varona, Monica; Maroko, Andrew R.; Bumol, Joel; Torrens, Luis; Wylie-Rosett, Judith

2013-01-01

most comfort with languages other than English, and reluctance to interact with individuals gathering data are principal challenges to assessment. Strategies to address assessment challenges that emerged form this project may help make mobile-vendor assessments more routine in food-environment research. PMID:23891280

lessons and challenges from software quality assessment

African Journals Online (AJOL)

DJFLEX

www.globaljournalseries.com, Email: info@globaljournalseries.com ... ASSESSMENT: THE CASE OF SPACE SYSTEMS SOFTWARE. ... KEYWORDS: Software, Software Quality ,Quality Standard, Characteristics, ... and communication, etc.

Next-generation sequencing (NGS) for assessment of microbial water quality: current progress, challenges, and future opportunities.

Science.gov (United States)

Tan, BoonFei; Ng, Charmaine; Nshimyimana, Jean Pierre; Loh, Lay Leng; Gin, Karina Y-H; Thompson, Janelle R

2015-01-01

Water quality is an emergent property of a complex system comprised of interacting microbial populations and introduced microbial and chemical contaminants. Studies leveraging next-generation sequencing (NGS) technologies are providing new insights into the ecology of microbially mediated processes that influence fresh water quality such as algal blooms, contaminant biodegradation, and pathogen dissemination. In addition, sequencing methods targeting small subunit (SSU) rRNA hypervariable regions have allowed identification of signature microbial species that serve as bioindicators for sewage contamination in these environments. Beyond amplicon sequencing, metagenomic and metatranscriptomic analyses of microbial communities in fresh water environments reveal the genetic capabilities and interplay of waterborne microorganisms, shedding light on the mechanisms for production and biodegradation of toxins and other contaminants. This review discusses the challenges and benefits of applying NGS-based methods to water quality research and assessment. We will consider the suitability and biases inherent in the application of NGS as a screening tool for assessment of biological risks and discuss the potential and limitations for direct quantitative interpretation of NGS data. Secondly, we will examine case studies from recent literature where NGS based methods have been applied to topics in water quality assessment, including development of bioindicators for sewage pollution and microbial source tracking, characterizing the distribution of toxin and antibiotic resistance genes in water samples, and investigating mechanisms of biodegradation of harmful pollutants that threaten water quality. Finally, we provide a short review of emerging NGS platforms and their potential applications to the next generation of water quality assessment tools.

Next-generation sequencing (NGS for assessment of microbial water quality: current progress, challenges, and future opportunities

Directory of Open Access Journals (Sweden)

BoonFei eTan

2015-09-01

Full Text Available Water quality is an emergent property of a complex system comprised of interacting microbial populations and introduced microbial and chemical contaminants. Studies leveraging next-generation sequencing (NGS technologies are providing new insights into the ecology of microbially mediated processes that influence fresh water quality such as algal blooms, contaminant biodegradation, and pathogen dissemination. In addition, sequencing methods targeting small subunit (SSU rRNA hypervariable regions have allowed identification of signature microbial species that serve as bioindicators for sewage contamination in these environments. Beyond amplicon sequencing, metagenomic and metatranscriptomic analyses of microbial communities in fresh water environments reveal the genetic capabilities and interplay of waterborne microorganisms, shedding light on the mechanisms for production and biodegradation of toxins and other contaminants. This review discusses the challenges and benefits of applying NGS-based methods to water quality research and assessment. We will consider the suitability and biases inherent in the application of NGS as a screening tool for assessment of biological risks and discuss the potential and limitations for direct quantitative interpretation of NGS data. Secondly, we will examine case studies from recent literature where NGS based methods have been applied to topics in water quality assessment, including development of bioindicators for sewage pollution and microbial source tracking, characterizing the distribution of toxin and antibiotic resistance genes in water samples, and investigating mechanisms of biodegradation of harmful pollutants that threaten water quality. Finally, we provide a short review of emerging NGS platforms and their potential applications to the next generation of water quality assessment tools.

Assessing mobile food vendors (a.k.a. street food vendors)--methods, challenges, and lessons learned for future food-environment research.

Science.gov (United States)

Lucan, S C; Varona, M; Maroko, A R; Bumol, J; Torrens, L; Wylie-Rosett, J

2013-08-01

to interact with individuals gathering data are principal challenges to assessment. Strategies to address assessment challenges that emerged form this project may help make mobile-vendor assessments more routine in food-environment research. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Use of 123I-IMP brain SPET to predict outcome following STA-MCA bypass surgery: cerebral blood flow but not vasoreactivity is a predictive parameter

International Nuclear Information System (INIS)

Kume, Norihiko; Hayashida, Kohei; Iwama, Toru; Cho, I.; Matsunaga, N.

1998-01-01

Superficial temporal artery - middle cerebral artery (STA-MCA) bypass surgery might improve the cerebral blood flow (CBF) but fail to reduce the risk of post-surgical events such as ischaemic stroke. In this study, we studied retrospectively whether the risk of post-surgical events corresponded to the change in resting CBF and/or the change in vasoreactivity observed before and after STA-MCA surgery using N-isopropyl-I-123-p-iodoamphetamine ( 123 I-IMP) brain single-photon emission tomography (SPET). 123 I-IMP brain SPET images obtained at rest and following acetazolamide challenge both before and after STA-MCA surgery were studied in 30 patients. Resting CBF was estimated semiquantitatively using the resting count ratios of the middle cerebral artery (MCA) area to the cerebellum. Acetazolamide challenge was assumed to result in an average increase in flow of 40% in the cerebellum. The vasoreactive response was then estimated as the ratio of the change in counts (acetazolamide - rest) to the resting cerebellar counts multiplied by 1.4. We classified 14 patients (50.5±19.3 years) into group I, who had a change in their resting CBF from before to after surgery of >10%, and 16 patients (54.0±18.8 years) into group II, who had a change in their resting CBF from before to after surgery of ≤10%. Oxygen-15 positron emission tomography (PET) studies were performed in five patients from group I and five patients from group II. One post-surgical event occurred in group I while there were eight post-surgical events in group II (P<0.05). Resting CBF improved by 20.4%±7.5% in group I and by 0.9%±6.9% in group II patients after surgery (P<0.001). No significant difference in the improvement in vasoreactivity was observed between group I patients (32.6%±17.7%) and group II patients (24.6%±15.6%) following surgery. Patients in the group I PET subset showed normalization of oxygen extraction fraction (OEF) from 0.59±0.09 before surgery to 0.46±0.06 after surgery (P<0

Human exposure to chemical mixtures: Challenges for the integration of toxicology with epidemiology data in risk assessment.

Science.gov (United States)

Hernández, Antonio F; Tsatsakis, Aristidis M

2017-05-01

Little is known about the potential adverse effects from longterm exposure to complex mixtures at low doses, close to health-based reference values. Traditional chemical-specific risk assessment based on animal testing may be insufficient and the lack of toxicological studies on chemical mixtures remains a major regulatory challenge. Hence, new methodologies on cumulative risk assessment are being developed but still present major limitations. Evaluation of chemical mixture effects requires an integrated and systematic approach and close collaboration across different scientific fields, particularly toxicology, epidemiology, exposure science, risk assessment and statistics for a proper integration of data from all these disciplines. Well designed and conducted epidemiological studies can take advantage of this new paradigm and can provide insight to support the correlation between humans low-dose exposures and diseases, thus avoiding the uncertainty associated with extrapolation across species. In this regard, human epidemiology studies may play a significant role in the new vision of toxicity testing. However, this type of information has not been fully considered in risk assessment, mainly due to the inherent limitations of epidemiologic studies. An integrated approach of in vivo, in vitro and in silico data, together with systematic reviews or meta-analysis of high quality epidemiological studies will improve the robustness of risk assessment of chemical mixtures and will provide a stronger basis for regulatory decisions. The ultimate goal is that experimental and mechanistic data can lend support and biological plausibility to the human epidemiological observations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Assessing the educational needs of Canadian gastroenterologists and gastroenterology nurses: Challenges to optimal care in Crohn’s disease

Science.gov (United States)

Dupuis, Martin; Marshall, John K; Hayes, Sean M; Cytryn, Kayla; Murray, Suzanne

2009-01-01

OBJECTIVE: A national needs assessment of Canadian gastroenterologists and gastroenterology nurses was undertaken to determine the perceived and unperceived educational and performance barriers to caring for patients with Crohn’s disease (CD). METHODS: A triangulated, mixed-method approach (qualitative and quantitative) was used to determine the nature and extent of knowledge gaps and barriers in the care of patients with CD. RESULTS: Qualitative interviews were conducted with nine gastroenterologists, four gastroenterology nurses and nine patients with CD. Based on this exploratory research, a survey was designed and launched nationally (37 gastroenterologists, 36 gastroenterology nurses). Findings indicated that Canadian gastroenterologists and gastroenterology nurses lacked clarity regarding their roles and responsibilities across the continuum of CD care, and face communication gaps within the health care team, undermining their effectiveness. Gastroenterologists identified challenges in optimal diagnosis due to unclear testing and diagnostic criteria. They recognized knowledge gaps when treating patient subgroups and in prescribing biological therapies. Furthermore, gastroenterologists self-identified gaps in skill, knowledge, and confidence in monitoring disease progression and effectively assessing response to therapy. When managing patients with CD, gastroenterologists expressed challenges with patient issues outside their domain of medical expertise, particularly with the skills needed to facilitate effective patient communication and education that would enhance adherence to recommended treatments. CONCLUSIONS: Educational initiatives should address diagnostic and treatment guidelines, as well as enhancement of clinical performance gaps in health care team processes and the patient-professional therapeutic relationship. To impact care and patient outcomes, these initiatives must be relevant to clinical practice settings and applicable to the practice

Recurrent Ataxia in Children and Adolescents.

Science.gov (United States)

Salman, Michael S; Klassen, Samantha F; Johnston, Janine L

2017-07-01

Recurrent ataxia is encountered infrequently in clinical pediatric neurology practise and presents with diagnostic challenges. It is caused by several disorders. Our aims were to describe the epidemiology and clinical features in children with recurrent ataxia. A retrospective review was undertaken in 185 children with chronic ataxia, who presented during 1991 to 2008. Several databases were searched to ensure optimum ascertainment. Patients with brain tumors or isolated disorders of the peripheral nerves or vestibular system were excluded. Recurrent ataxia was reported in 21 patients. Their age range was between 6 and 32.75 years (males=12). The crude period prevalence rate for the 18-year study period was 7.44/100,000. Eight patients had episodic ataxia and seven had inflammatory and metabolic disorders. In the rest the etiology was unknown. Many patients presented with ataxia, dizziness, and vertigo. The frequency and duration of the ataxic episodes varied from several per day to one every few months. Other clinical features included developmental delay and seizures. Neuroimaging in episodic ataxia was normal and abnormal in inflammatory or metabolic disorders. Acetazolamide provided symptomatic relief in patients with episodic ataxia, while steroids were beneficial in patients with an inflammatory etiology. One child with a metabolic disorder died. Recurrent ataxia is an uncommon presentation in children and mortality is rare. Genetic, metabolic, and inflammatory disorders should be considered in these patients. Neuroimaging is essential. Acetazolamide in selected patients provides good symptomatic relief.

Assessing Students in the Margin: Challenges, Strategies, and Techniques

Science.gov (United States)

Russell, Michael; Kavanaugh, Maureen

2011-01-01

The importance of student assessment, particularly for summative purposes, has increased greatly over the past thirty years. At the same time, emphasis on including all students in assessment programs has also increased. Assessment programs, whether they are large-scale, district-based, or teacher developed, have traditionally attempted to assess…

Biogas Production from Sugarcane Waste: Assessment on Kinetic Challenges for Process Designing

Science.gov (United States)

Janke, Leandro; Leite, Athaydes; Nikolausz, Marcell; Schmidt, Thomas; Liebetrau, Jan; Nelles, Michael; Stinner, Walter

2015-01-01

Biogas production from sugarcane waste has large potential for energy generation, however, to enable the optimization of the anaerobic digestion (AD) process each substrate characteristic should be carefully evaluated. In this study, the kinetic challenges for biogas production from different types of sugarcane waste were assessed. Samples of vinasse, filter cake, bagasse, and straw were analyzed in terms of total and volatile solids, chemical oxygen demand, macronutrients, trace elements, and nutritional value. Biochemical methane potential assays were performed to evaluate the energy potential of the substrates according to different types of sugarcane plants. Methane yields varied considerably (5–181 Nm3·tonFM−1), mainly due to the different substrate characteristics and sugar and/or ethanol production processes. Therefore, for the optimization of AD on a large-scale, continuous stirred-tank reactor with long hydraulic retention times (>35 days) should be used for biogas production from bagasse and straw, coupled with pre-treatment process to enhance the degradation of the fibrous carbohydrates. Biomass immobilization systems are recommended in case vinasse is used as substrate, due to its low solid content, while filter cake could complement the biogas production from vinasse during the sugarcane offseason, providing a higher utilization of the biogas system during the entire year. PMID:26404248

Assessment of the Impact of Oil: Opportunities and Challenges for ...

African Journals Online (AJOL)

heavy dependence on oil presents challenges to policy makers, partly because oil is an exhaustible ..... In this section we examine the impact of oil on the Sudanese economy. We first start ... balance of payment, FDI and social development in Sudan. Beginning ..... Therefore the major policy implication from our findings is ...

Challenges in Type 1 diabetes management in South East Asia: Descriptive situational assessment

Directory of Open Access Journals (Sweden)

Jothydev Kesavadev

2014-01-01

Full Text Available Treatment of type 1 diabetes is a challenging issue in South East Asia. Unlike in the developed countries, patients have to procure insulin, glucometer strips and other treatment facilities from their own pockets. Coupled with poor resources are the difficulties with diagnosis, insulin initiation, insulin storage, marital and emotional challenges. Being a disease affecting only a minority of people, it is largely ignored by the governments and policy makers. Comprehensive diagnostic, treatment and team based educational facilities are available only in the speciality diabetes centers in the private sector whereas majority of the subjects with type 1 diabetes are from a poor socio-economic background. Unlike in the Western world, being known as a diabetes patient is a social sigma and poses huge emotional burden living with the disease and getting married. Even with best of the resources, long-term treatment of type 1 diabetes still remains a huge challenge across the globe. In this review, authors from India, Pakistan, Nepal, Sri Lanka, Myanmar and Bangladesh detail the country-specific challenges and discuss the possible solutions.

Challenges in Type 1 diabetes management in South East Asia: Descriptive situational assessment.

Science.gov (United States)

Kesavadev, Jothydev; Sadikot, Shaukat M; Saboo, Banshi; Shrestha, Dina; Jawad, Fatema; Azad, Kishwar; Wijesuriya, Mahendra Arunashanthi; Latt, Tint Swe; Kalra, Sanjay

2014-09-01

Treatment of type 1 diabetes is a challenging issue in South East Asia. Unlike in the developed countries, patients have to procure insulin, glucometer strips and other treatment facilities from their own pockets. Coupled with poor resources are the difficulties with diagnosis, insulin initiation, insulin storage, marital and emotional challenges. Being a disease affecting only a minority of people, it is largely ignored by the governments and policy makers. Comprehensive diagnostic, treatment and team based educational facilities are available only in the speciality diabetes centers in the private sector whereas majority of the subjects with type 1 diabetes are from a poor socio-economic background. Unlike in the Western world, being known as a diabetes patient is a social sigma and poses huge emotional burden living with the disease and getting married. Even with best of the resources, long-term treatment of type 1 diabetes still remains a huge challenge across the globe. In this review, authors from India, Pakistan, Nepal, Sri Lanka, Myanmar and Bangladesh detail the country-specific challenges and discuss the possible solutions.

Assessing School Leadership Challenges in Ghana Using Leadership Practices Inventory

Science.gov (United States)

Edwards, Alexander Kyei; Aboagye, Samuel Kwadwo

2015-01-01

The Ghana Education Service (GES) is facing challenges in school leadership and hence a lot of criticisms on basic school performances. The issue is whether school leadership relates to school performances and that there is the need for transformation leadership. The purpose of this study was to discuss self-reported leadership practices…

Mobility assessment in older people: new possibilities and challenges

OpenAIRE

Zijlstra, Wiebren; Aminian, Kamiar

2007-01-01

A major challenge for researchers and clinicians who address health issues in the ageing population is to monitor functioning, and to timely initiate interventions that aim to prevent loss of functional abilities and to improve the quality of life of older people. With the progress of technologies in the last decades, methods have become available that use body fixed sensors (BFS) to measure aspects of human performance under real-life conditions. These methods are based on the use of miniatu...

Towards sustainability assessment follow-up

Energy Technology Data Exchange (ETDEWEB)

Morrison-Saunders, Angus, E-mail: a.morrison-saunders@murdoch.edu.au [Murdoch University (Australia); North-West University (South Africa); Pope, Jenny, E-mail: jenny@integral-sustainability.net [North-West University (South Africa); Integral Sustainability (Australia); Curtin University (Australia); Bond, Alan, E-mail: alan.bond@uea.ac.uk [North-West University (South Africa); University of East Anglia (United Kingdom); Retief, Francois, E-mail: francois.retief@nwu.ac.za [North-West University (South Africa)

2014-02-15

This paper conceptualises what sustainability assessment follow-up might entail for three models of sustainability assessment: EIA-driven integrated assessment, objectives-led integrated assessment and the contribution to sustainability model. The first two are characterised by proponent monitoring and evaluation of individual impacts and indicators while the latter takes a holistic view based around focused sustainability criteria relevant to the context. The implications of three sustainability challenges on follow-up are also examined: contested time horizons and value changes, trade-offs, and interdisciplinarity. We conclude that in order to meet these challenges some form of adaptive follow-up is necessary and that the contribution to sustainability approach is the best approach. -- Highlights: • We explore sustainability follow-up for three different sustainability models. • Long-time frames require adaptive follow-up and are a key follow-up challenge. • Other key challenges include interdisciplinarity, and trade-offs. • Sustainability follow-up should be a direction of travel and not an outcome. • Only the follow-up for contribution to sustainability model addresses sustainability challenges sufficiently.

Towards sustainability assessment follow-up

International Nuclear Information System (INIS)

Morrison-Saunders, Angus; Pope, Jenny; Bond, Alan; Retief, Francois

2014-01-01

This paper conceptualises what sustainability assessment follow-up might entail for three models of sustainability assessment: EIA-driven integrated assessment, objectives-led integrated assessment and the contribution to sustainability model. The first two are characterised by proponent monitoring and evaluation of individual impacts and indicators while the latter takes a holistic view based around focused sustainability criteria relevant to the context. The implications of three sustainability challenges on follow-up are also examined: contested time horizons and value changes, trade-offs, and interdisciplinarity. We conclude that in order to meet these challenges some form of adaptive follow-up is necessary and that the contribution to sustainability approach is the best approach. -- Highlights: • We explore sustainability follow-up for three different sustainability models. • Long-time frames require adaptive follow-up and are a key follow-up challenge. • Other key challenges include interdisciplinarity, and trade-offs. • Sustainability follow-up should be a direction of travel and not an outcome. • Only the follow-up for contribution to sustainability model addresses sustainability challenges sufficiently

Monitoring challenges and innovative ideas

Energy Technology Data Exchange (ETDEWEB)

O' Neill, R.V.; Hunsaker, C.T.; Levine, D.A.

1990-01-01

Monitoring programs are difficult to design even when they focus on specific problems. Ecosystems are complex, and it is often impossible to predetermine what aspects of system structure or dynamics will respond to a specific insult. It is equally difficult to interpret whether a response is a stabilizing compensatory mechanism or a real loss of capacity to maintain the ecosystem. The problems are compounded in a broad monitoring program designed to assess ecosystem health'' at regional and continental scales. It is challenging in the extreme to monitor ecosystem response, at any scale, to past insults as well as an unknown future array of impacts. The present paper will examine some of the fundamental issues and challenges raised by large-scale monitoring efforts. The challenges will serve as a framework and as an excuse to discuss several important topics in more detail. Following the discussion of challenges, we suggest some basic innovations that could be important across a range of monitoring programs. The innovations include integrative measures, innovative methodology, and creative interpretation. 59 refs., 1 tab.

Assessing the Challenges in Successful Implementation and Adoption of Crop Insurance in Thailand

Directory of Open Access Journals (Sweden)

Shweta Sinha

2016-12-01

Full Text Available The purpose of this paper is to assess the gaps in the adoption of crop insurance in Thailand and suggest possible solutions relating to policy support and framework, implementation mechanisms, technology adoption, and awareness amongst farmers. The methodology includes a literature review, interaction with officials, rice experts and insurance experts, and discussion with farmers. A study was undertaken at province level to assess the impact of using rainfall index as a threshold. Additionally, focused group discussions (FGD were conducted with rice farmers at the village level. Key issues targeted in the FGD were to understand the behavior and practices during droughts, impact of drought on crop yield, methods already in use to reduce the impact, such as plantation of drought-resistant rice, and the adoption of crop insurance. Data availability is a challenge and has led to withdrawal of Weather Index Insurance (WII in 2015. WII have threshold levels based on historical rainfall. Adoption of coping mechanisms, such as drought-resistant rice and irrigation increases the chances of adverse selection. In absence of ground based weather data, a combination of satellite agriculture drought information can be used to make crop insurance more attractive as it would help in reducing basis risk and improving insurers and farmers’ confidence in the product. Discussion with farmers, insurance companies, and the Bank of Agriculture and Agricultural Cooperatives (BAAC in Thailand suggested low awareness among farmers about the potential benefits of weather index insurance products. Relatively low compensation is also an obstacle. Proper marketing and awareness raising campaigns should also accompany the introduction of index-based insurance products.

A pilot study investigating the feasibility of symptom assessment manager (SAM), a Web-based real-time tool for monitoring challenging behaviors.

Science.gov (United States)

Loi, Samantha M; Wanasinghage, Sangeeth; Goh, Anita; Lautenschlager, Nicola T; Darby, David G; Velakoulis, Dennis

2018-04-01

Improving and minimizing challenging behaviors seen in psychiatric conditions, including behavioral and psychological symptoms of dementia are important in the care of people with these conditions. Yet there is a lack of systematic evaluation of these as a part of routine clinical care. The Neuropsychiatric Inventory is a validated and reliable tool for rating the severity and disruptiveness of challenging behaviors. We report on the evaluation of a Web-based symptom assessment manager (SAM), designed to address the limitation of previous tools using some of the Neuropsychiatric Inventory functions, to monitor behaviors by staff caring for people with dementia and other psychiatric conditions in inpatient and residential care settings. The SAM was piloted in an 8-bed inpatient neuropsychiatry unit over 5 months. Eleven nurses and 4 clinicians were trained in usage of SAM. Primary outcomes were usage of SAM and perceived usability, utility, and acceptance of SAM. Secondary outcomes were the frequencies of documented behavior. Usage data were analyzed using chi-square and logistic regression analyses. The SAM was used for all admitted patients regardless of diagnosis, with a usage rate of 64% for nurses regularly employed in the unit. Staff provided positive feedback regarding the utility of SAM. The SAM appeared to offer individualized behavior assessment by providing a quick, structured, and standardized platform for assessing behavior in a real-world setting. Further research would involve trialing SAM with more staff in alternative settings such as in home or residential care settings. Copyright © 2017 John Wiley & Sons, Ltd.

Continuing challenges in nuclear air cleaning

International Nuclear Information System (INIS)

Moeller, D.W.

1976-01-01

The safe operation of nuclear facilities is heavily dependent upon the adequate performance of air cleaning systems. Although many problems have been solved, new questions and new challenges continue to arise. These are well illustrated by weaknesses in air cleaning and ventilating systems revealed by the Browns Ferry fire, and the need to develop additional data on the reliability of such systems, particularly under emergency conditions, as revealed by the Reactor Safety Study. Assessments of the degree to which engineered safety features can compensate for deficiencies in nuclear power plant sites continue to challenge those involved in risk/benefit evaluations. Additional challenges are being generated by the air cleaning requirements associated with the commercial development of the liquid metal fast breeder reactor

A review of multi-risk methodologies for natural hazards: Consequences and challenges for a climate change impact assessment.

Science.gov (United States)

Gallina, Valentina; Torresan, Silvia; Critto, Andrea; Sperotto, Anna; Glade, Thomas; Marcomini, Antonio

2016-03-01

This paper presents a review of existing multi-risk assessment concepts and tools applied by organisations and projects providing the basis for the development of a multi-risk methodology in a climate change perspective. Relevant initiatives were developed for the assessment of multiple natural hazards (e.g. floods, storm surges, droughts) affecting the same area in a defined timeframe (e.g. year, season, decade). Major research efforts were focused on the identification and aggregation of multiple hazard types (e.g. independent, correlated, cascading hazards) by means of quantitative and semi-quantitative approaches. Moreover, several methodologies aim to assess the vulnerability of multiple targets to specific natural hazards by means of vulnerability functions and indicators at the regional and local scale. The overall results of the review show that multi-risk approaches do not consider the effects of climate change and mostly rely on the analysis of static vulnerability (i.e. no time-dependent vulnerabilities, no changes among exposed elements). A relevant challenge is therefore to develop comprehensive formal approaches for the assessment of different climate-induced hazards and risks, including dynamic exposure and vulnerability. This requires the selection and aggregation of suitable hazard and vulnerability metrics to make a synthesis of information about multiple climate impacts, the spatial analysis and ranking of risks, including their visualization and communication to end-users. To face these issues, climate impact assessors should develop cross-sectorial collaborations among different expertise (e.g. modellers, natural scientists, economists) integrating information on climate change scenarios with sectorial climate impact assessment, towards the development of a comprehensive multi-risk assessment process. Copyright © 2015 Elsevier Ltd. All rights reserved.

Getting People Involved: The Benefit of Intellectual Capital Management for Addressing HR Challenges

Science.gov (United States)

Pook, Katja

2011-01-01

Purpose: This paper aims to explore the benefits of intellectual capital assessment for facing current challenges of human resources work and organizational development. Design/methodology/approach: The paper takes findings of studies on challenges in HR work and maps them with features of intellectual capital assessment methods. It is thus a…

The value of measurements of the cerebrovascular reserve capacity (CVRC) for the assessment and prognosis of cerebrovascular disease

International Nuclear Information System (INIS)

Einhaeupl, K.M.; Valdueza, J.M.

1997-01-01

Today, the diagnostic and therapeutic principles in the management of stroke are changing. Prevention of stroke is one of the major fields of research. One important aim of the newly developed diagnostic techniques is the identification of a particular subgroup of patients with compromised cerebral circulation who will benefit from surgical or medical therapies. The assessment of the CVRC with tracer techniques and the acetazolamide test seem to be a realiable and promising method for this purpose: 1. In carotid artery occlusion, the measurement of CVRV facilitates the identification of a subgroup of patients with compromised CVRC who show an improvement of CVRC after EC-IC bypass surgery. The value of bypass surgery for the prevention of stroke however, has to be confirmed by prospective studies. 2. The benefit from carotid surgery for patients with high-grade carotid stenosis and transient ischemic attack has been convincingly demonstrated by several studies. In asymptomatic patients, however, desobliteration of the carotid artery remains controversial. The identification of asymptomatic cases with compromised CVRC probably contributes to the recognition of patients with a high risk of suffering hemodynamic stroke. 3. In vascular dementia, cerebral blood flow measurements at rest alone have not been useful. CVRC measurements may offer a diagnostic advance in this still not well understood disease. (orig.) [de

Educational assessment in Khyber Pakhtunkhwa Pakistan’s North-West Frontier Province: Practices, Issues, and Challenges for Educating Culturally Linguistically Diverse and Exceptional Children

Directory of Open Access Journals (Sweden)

Eirini Gouleta

2015-11-01

Full Text Available This article presents the case of Khyber Pakhtunkhwa (KP, Pakistan’s former North-West Frontier Province, and its provincial educational assessment policies and practices. These policies and practices affect millions of Culturally Linguistically Diverse and Exceptional (CLDE children who live in rural and remote areas, and areas afflicted by conflict and insurgency. The article raises questions about political interference, ethical conduct, and fairness in the administration and marking of the assessments. It discusses efforts for systematic administration and collection of learning assessment data, teacher professional development programs to improve assessment practices, policies which address the educational needs of the diverse students in the province, and challenges and barriers to province-wide sustainable education development. In conclusion, the author offers suggestions and recommendations for policy makers and education stakeholders towards capacity building and improvement of assessment practices for all learners while it attempts to shed light and dispel misconceptions about KP and its people.

Challenges of Ensuring Equity

DEFF Research Database (Denmark)

Pasgaard, Maya

and on a conceptual framework to examine equity in REDD+. Qualitative research with a case study in Cambodia provides the empirical foundation for the thesis, supplemented with a quantitative analysis of climate change research to address the fourth research question. Together, these articles and approaches...... these challenges, specific recomm ndations are summarized in the thesis, namely: better integration of qualitative methods in social assessments, greater emphasis on local inclusion and representativeness in relation to resource access and decision-making, more field research and cross...... social assessments in REDD+ are inadequate due to a dominant positivistic approach to methods and indicators for social assessment, which contrasts the complexities and context of REDD+ projects; 2) The distribution of costs and benefits within communities in Oddar Meanchey is uneven, as the costs...

Report on the first round of the Mock LISA Data Challenges

International Nuclear Information System (INIS)

Arnaud, K A; Auger, G; Babak, S

2007-01-01

The Mock LISA Data Challenges (MLDCs) have the dual purpose of fostering the development of LISA data analysis tools and capabilities, and demonstrating the technical readiness already achieved by the gravitational-wave community in distilling a rich science payoff from the LISA data output. The first round of MLDCs has just been completed: nine challenges consisting of data sets containing simulated gravitational-wave signals produced either by galactic binaries or massive black hole binaries embedded in simulated LISA instrumental noise were released in June 2006 with deadline for submission of results at the beginning of December 2006. Ten groups have participated in this first round of challenges. All of the challenges had at least one entry which successfully characterized the signal to better than 95% when assessed via a correlation with phasing ambiguities accounted for. Here, we describe the challenges, summarize the results and provide a first critical assessment of the entries

Assessing the Challenges Heads of Department Encounter in Instructional Supervision in Ghana. A Case of Selected Senior High Schools in Kwabre East District

Science.gov (United States)

Simpson, Kweku Bedu; Howard, Peggy Maansah Ankai; Peligah, Y. S.; Cann, Lily Obu

2016-01-01

The purpose of the study was to assess the challenges HoDs in Senior High Schools face during instructional supervision. In so doing, the study employed case study and used mixed method approach. In all a total of 92 questionnaires were administered with a response rate of 75.40%. The population consisted of School Heads /Assistant Heads, HoDs and…

Potentials and Challenges of Student Progress Portfolio Innovation ...

African Journals Online (AJOL)

This paper aims at stimulating discussion on Students Progress Portfolio (SPP) Innovation in assessment. It analyses the potential and challenges of SPP as well as how it can be harnessed to improve assessment practices and its contribution to quality education. The paper is based on a recent qualitative research which ...

Change Agents & Impact Assessment

DEFF Research Database (Denmark)

Kørnøv, Lone; Larsen, Sanne Vammen; Hansen, Anne Merrild

2010-01-01

One of the challenges facing impact assessment is finding ways to work in research and practice that allow appropriate action and critical interrogation og action to enable and support sustainable change.......One of the challenges facing impact assessment is finding ways to work in research and practice that allow appropriate action and critical interrogation og action to enable and support sustainable change....

The Promises and Challenges of Ecological Momentary Assessment in Schizophrenia: Development of an Initial Experimental Protocol

Directory of Open Access Journals (Sweden)

Brandon A. Gaudiano

2015-07-01

Full Text Available Severe mental illnesses, including schizophrenia and other psychotic-spectrum disorders, are a major cause of disability worldwide. Although efficacious pharmacological and psychosocial interventions have been developed for treating patients with schizophrenia, relapse rates are high and long-term recovery remains elusive for many individuals. Furthermore, little is still known about the underlying mechanisms of these illnesses. Thus, there is an urgent need to better understand the contextual factors that contribute to psychosis so that they can be better targeted in future interventions. Ecological Momentary Assessment (EMA is a dynamic procedure that permits the measurement of variables in natural settings in real-time through the use of brief assessments delivered via mobile electronic devices (i.e., smartphones. One advantage of EMA is that it is less subject to retrospective memory biases and highly sensitive to fluctuating environmental factors. In the current article, we describe the research-to-date using EMA to better understand fluctuating symptoms and functioning in patients with schizophrenia and other psychotic disorders and potential applications to treatment. In addition, we describe a novel EMA protocol that we have been employing to study the outcomes of patients with schizophrenia following a hospital discharge. We also report the lessons we have learned thus far using EMA methods in this challenging clinical population.

Study on alkaline and acid phosphatase activity in acute uranium intoxication

International Nuclear Information System (INIS)

Bokova, N.V.; Pavlova, V.B.; Stancheva, Yu.A.; Khadzhirusev, S.B.; Kiradzhiev, G.D.

1975-01-01

The protective potential of diethyl barbituric acid sodium salt is studied, in comparison with that of acetazolamide, on kidneys under acute uranium intoxication. Experiments involved rats given intraperitoneal injections with uranyl acetate on 12 successive days up to a total dose of 0.5, 2.0 or 7.0 mg/kg. The resulting effects are measured by chemical assays of serum and urine for alkaline and acid phosphatase and histochemical assays for phosphatase activities in kidneys, kinetics being followed over a 30-day period after total dose administration. Protection of kidneys from toxic uranium effects was found to be of about the same degree with sodium diethyl barbiturate as with acetazolamide. (A.B.)

DIAGNOSTIC CHALLENGES IN ASSESSING POST-TRAUMATIC STRESS DISORDER.

Directory of Open Access Journals (Sweden)

Mariana Arnaudova

2015-12-01

Full Text Available Post-traumatic stress disorder (PTSD is one of those psychiatric disorders that are still away from our attention, understanding, assessment and proper management. What could be the reason as by its name and diagnostic criteria an etiological fact is specified, namely a specific traumatic event. In our paper we aim to share and elicit some difficulties that we have met in consulting, diagnostic and management of people, who have suffered a traumatic event. On the base of a review of current psychiatric classifications and ongoing discussions we briefly summarize and discuss important key points. The definition of the event, associated with PTSD is different in DSM-III (introduced for the fist time in a classification of mental disorders, DSM-IV and ICD-10. DSM-IV is less restrictive and includes events that occur more frequently. In DSM-5, PTSD is placed in chapter “Trauma and Stressor-related disorders” and the accent is on the variable clinical characteristics of psychological distress. Emotional reactions to the traumatic event are no longer part of Criterion A. The clinical presentation varies and a number of intrusive psychological and physiological reactions of distress are described. Here comes a problem- the assessment of the trauma itself and the determination of the basic symptoms, when such an event happens. So, the skills to assess the trauma, to determine and competently attribute these symptoms to the specific event and cluster are of great importance. We conclude that a number of risk and prognostic factors should be considered in the process of assessment, diagnosis and management.

Reference Structures: Stagnation, Progress, and Future Challenges.

Science.gov (United States)

Greenberg, Jane

1997-01-01

Assesses the current state of reference structures in online public access catalogs (OPACs) in a framework defined by stagnation, progress, and future challenges. Outlines six areas for reference structure development. Twenty figures provide illustrations. (AEF)

Hungary Embracing Globalization: The Challenge Of Competitiveness

OpenAIRE

Laszlo Csaba

2007-01-01

This think piece is an attempt to survey the evolution of competitiveness in a small open economy under the angle of costs and benefits of globalization. First a historical survey assesses the road leading to the present sage of transnationalization. Then a situation assessment is presented, followed by a survey of challenges and factors of competitiveness. Finally some general lessons are listed, without attempting to be exhaustive.

US Cyber Challenge Research

Science.gov (United States)

2017-02-01

tactics to prevent future attacks. This project will develop, test, evaluate and assess alternative methods for identifying computer security talent ...RESPONSIBLE PERSON FRANCES ROSE a. REPORT U b. ABSTRACT U c. THIS PAGE U 19b. TELEPHONE NUMBER (Include area code ) N/A Standard Form 298 (Rev. 8...is ever increasing. Meeting the demand for top technical cybersecurity talent is one of the continuing challenges facing military and civilian

Preventing and managing challenging behaviour.

Science.gov (United States)

Hallett, Nutmeg

2018-02-21

Patients exhibiting challenging behaviour, which includes any non-verbal, verbal or physical behaviour, is a significant issue in healthcare settings. Preventing such behaviour and the harm it can cause is important for healthcare organisations and individuals, and involves following a public health model comprised of three tiers: primary, secondary and tertiary prevention. Primary prevention aims to reduce the risk of challenging behaviour occurring in the first instance; secondary prevention involves reducing the risk associated with imminent challenging behaviour and its potential escalation; and tertiary prevention focuses on minimising the physical and emotional harm caused by challenging behaviours, during and after an event. De-escalation should be the first-line response to challenging behaviour, and healthcare staff should use a range of techniques - maintaining safety, self-regulation, effective communication, and assessment and actions - to reduce the incidence of challenging behaviour. In some situations, physical interventions may be required to protect the safety of the individual, healthcare staff and other individuals involved, and healthcare staff should be aware of local policies and procedures for this. Following a serious incident, where there was potential or actual harm to patients and healthcare staff, healthcare organisations should use post-incident reviews to learn from the situation, while healthcare staff should be offered the opportunity for debriefing. Positive responses to challenging behaviour at an organisational and individual level can lead to improved work environments for healthcare staff and optimal patient care and outcomes. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Frequency analysis of CSF flow on cine-MRI in normal pressure hydrocephalus

International Nuclear Information System (INIS)

Miyati, Tosiaki; Kasuga, Toshio; Imai, Hiroshi; Fujita, Hiroshi; Mase, Mitsuhito; Itikawa, Katuhiro

2001-01-01

To clarify the flow dynamics of intracranial cerebrospinal fluid (CSF) in normal pressure hydrocephalus (NPH), frequency analyses of CSF flow measured with an ECG-gated phase contrast cine magnetic resonance imaging (MRI) were performed. The amplitude and phase in the CSF flow spectra in the aqueduct were determined in patients with NPH after a subarachnoid hemorrhage (SAH-NPH group, n=26), an idiopathic NPH (I-NPH group, n=4), an asymptomatic ventricular dilation or a brain atrophy (VD group, n=21), and in healthy volunteers (control group, n=25). The changes of CSF flow spectra were also analyzed 5 and 15 minutes after an intravenous injection of acetazolamide. Moreover, a phase transfer function (PTF) calculated from the spectra of the driving vascular pulsation and CSF flow in the aqueduct were assessed in patients with SAH-NPH and control groups before and after acetazolamide injection. There values were compared with the pressure volume response (PVR). The amplitude of the 1st-3rd harmonics in the SAH-NPH or I-NPH group was significantly larger than in the control or VD group because of a decrease in compliance (increase in PVR). The phase of the 1st harmonic in the SAH-NPH group was significantly different from that in the control or VD group, but no difference was found between the control and VD groups. The amplitude of the 0-3rd harmonics increased, and the phase of the 1st harmonic changed in all groups after an acetazolamide injection. An evaluation of the time course of the direct current of CSF flow provided further information about the compensatory faculty of the cerebrospinal cavity. A PTF of the 1st harmonic in the SAH-NPH group was significantly larger than in the control group, and a positive correlation was noted between PTF of the 1st harmonic and PVR. In conclusion, frequency analyses of CSF flow measured by cine-MRI make it possible to obtain noninvasively a more detailed picture of the pathophysiology of NPH and of changes in intracranial

Frequency analysis of CSF flow on cine-MRI in normal pressure hydrocephalus

Energy Technology Data Exchange (ETDEWEB)

Miyati, Tosiaki; Kasuga, Toshio; Imai, Hiroshi [Kanazawa Univ. (Japan). School of Medicine; Fujita, Hiroshi; Mase, Mitsuhito; Itikawa, Katuhiro

2001-09-01

To clarify the flow dynamics of intracranial cerebrospinal fluid (CSF) in normal pressure hydrocephalus (NPH), frequency analyses of CSF flow measured with an ECG-gated phase contrast cine magnetic resonance imaging (MRI) were performed. The amplitude and phase in the CSF flow spectra in the aqueduct were determined in patients with NPH after a subarachnoid hemorrhage (SAH-NPH group, n=26), an idiopathic NPH (I-NPH group, n=4), an asymptomatic ventricular dilation or a brain atrophy (VD group, n=21), and in healthy volunteers (control group, n=25). The changes of CSF flow spectra were also analyzed 5 and 15 minutes after an intravenous injection of acetazolamide. Moreover, a phase transfer function (PTF) calculated from the spectra of the driving vascular pulsation and CSF flow in the aqueduct were assessed in patients with SAH-NPH and control groups before and after acetazolamide injection. There values were compared with the pressure volume response (PVR). The amplitude of the 1st-3rd harmonics in the SAH-NPH or I-NPH group was significantly larger than in the control or VD group because of a decrease in compliance (increase in PVR). The phase of the 1st harmonic in the SAH-NPH group was significantly different from that in the control or VD group, but no difference was found between the control and VD groups. The amplitude of the 0-3rd harmonics increased, and the phase of the 1st harmonic changed in all groups after an acetazolamide injection. An evaluation of the time course of the direct current of CSF flow provided further information about the compensatory faculty of the cerebrospinal cavity. A PTF of the 1st harmonic in the SAH-NPH group was significantly larger than in the control group, and a positive correlation was noted between PTF of the 1st harmonic and PVR. In conclusion, frequency analyses of CSF flow measured by cine-MRI make it possible to obtain noninvasively a more detailed picture of the pathophysiology of NPH and of changes in intracranial

Applying a developmental approach to quality of life assessment in children and adolescents with psychological disorders: challenges and guidelines.

Science.gov (United States)

Carona, Carlos; Silva, Neuza; Moreira, Helena

2015-02-01

Research on the quality of life (QL) of children/adolescents with psychological disorders has flourished over the last few decades. Given the developmental challenges of QL measurements in pediatric populations, the aim of this study was to ascertain the extent to which a developmental approach to QL assessment has been applied to pedopsychiatric QL research. A systematic literature search was conducted in three electronic databases (PubMed, PsycINFO, SocINDEX) from 1994 to May 2014. Quantitative studies were included if they assessed the self- or proxy-reported QL of children/adolescents with a psychological disorder. Data were extracted for study design, participants, QL instruments and informants, and statistical approach to age-related specificities. The systematic review revealed widespread utilization of developmentally appropriate QL instruments but less frequent use of both self and proxy reports and an inconsistent approach to age group specificities. Methodological guidelines are discussed to improve the developmental validity of QL research for children/adolescents with mental disorders.

Initial Verification and Validation Assessment for VERA

Energy Technology Data Exchange (ETDEWEB)

Dinh, Nam [North Carolina State Univ., Raleigh, NC (United States); Athe, Paridhi [North Carolina State Univ., Raleigh, NC (United States); Jones, Christopher [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Hetzler, Adam [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Sieger, Matt [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2017-04-01

The Virtual Environment for Reactor Applications (VERA) code suite is assessed in terms of capability and credibility against the Consortium for Advanced Simulation of Light Water Reactors (CASL) Verification and Validation Plan (presented herein) in the context of three selected challenge problems: CRUD-Induced Power Shift (CIPS), Departure from Nucleate Boiling (DNB), and Pellet-Clad Interaction (PCI). Capability refers to evidence of required functionality for capturing phenomena of interest while capability refers to the evidence that provides confidence in the calculated results. For this assessment, each challenge problem defines a set of phenomenological requirements against which the VERA software is assessed. This approach, in turn, enables the focused assessment of only those capabilities relevant to the challenge problem. The evaluation of VERA against the challenge problem requirements represents a capability assessment. The mechanism for assessment is the Sandia-developed Predictive Capability Maturity Model (PCMM) that, for this assessment, evaluates VERA on 8 major criteria: (1) Representation and Geometric Fidelity, (2) Physics and Material Model Fidelity, (3) Software Quality Assurance and Engineering, (4) Code Verification, (5) Solution Verification, (6) Separate Effects Model Validation, (7) Integral Effects Model Validation, and (8) Uncertainty Quantification. For each attribute, a maturity score from zero to three is assigned in the context of each challenge problem. The evaluation of these eight elements constitutes the credibility assessment for VERA.

Healthcare-associated infections: challenges to public health in Brazil.

Science.gov (United States)

Padoveze, Maria Clara; Fortaleza, Carlos Magno Castelo Branco

2014-12-01

This study presents a critical evaluation of the scientific literature related to this subject, aiming to assess the policies and administrative issues regarding the prevention and magnitude of healthcare-associated infections and discuss the challenges for their prevention in Brazil. The topics discussed included historical and administrative issues, challenges imposed by the characteristics of the healthcare system and the territorial dimension, laboratorial support limitations, costs, institutional culture, professional qualification, and patient engagement. It is urgent to hold a nationwide discussion among government representatives, institutions, and healthcare workers and users to overcome these challenges.

Effect of STA-proximal MCA bypass. Improvement of cerebral blood flow and metabolism and neuropsychological function

Energy Technology Data Exchange (ETDEWEB)

Ogawa, Akira; Funayama, Masayuki; Miura, Kazuyuki; Ogasawara, Kuniaki; Suzuki, Michiyasu; Kuroda, Kiyoshi; Sasaki, Toshiaki [Iwate Medical Univ., Morioka (Japan). School of Medicine

1998-11-01

We investigated cerebral blood flow (CBF) and metabolism in patients with hemodynamic ischemia by positron emission tomography (PET) and thermal diffusion flow meter. We also studied neuropsychological functions to evaluate the effects of surgical revascularization. Bypass surgery of the superficial temporal artery to the proximal middle cerebral artery was performed on 26 patients satisfying the following categories: stenosis or occlusive lesion in main cerebral arteries; no marked focus of infarction on CT or MRI. PET was performed before and 1 month after the operation, and CBF, the cerebral metabolic rate of oxygen (CMRO{sub 2}) and oxygen extraction fraction (OEF) were analyzed. Cerebrovascular reserve capacity (CVRC) was also calculated after acetazolamide challenge. CBF during the operation was continuously measured with a thermal diffusion flow meter. CO{sub 2} response of CBF was analyzed before and after anastomosis. Neuropsychological functions were evaluated by Hasegawa dementia scale revised (HDS-R), mini-mental state examination (MMSE) and Wechsler adult intelligence scale revised (WAIS-R). Before the operation, increase in OEF accorded with the decrease in CBF, and a significant relationship between both CBF and CVRC, and OEF and CVRC was found. A decrease in CVRC was noted prior to a decrease in CBF and elevation of OEF. CVRC caused by acetazolamide might reflect CO{sub 2} reactivity. Significant improvement of CBF and CVRC, and normalization of OEF were observed after the operation. Also, significant improvement of neuropsychological function was observed by HDS-R and WAIS-R. Disturbance in neuropsychological function might reflect elevation of OEF. (author)

Effect of STA-proximal MCA bypass. Improvement of cerebral blood flow and metabolism and neuropsychological function

International Nuclear Information System (INIS)

Ogawa, Akira; Funayama, Masayuki; Miura, Kazuyuki; Ogasawara, Kuniaki; Suzuki, Michiyasu; Kuroda, Kiyoshi; Sasaki, Toshiaki

1998-01-01

We investigated cerebral blood flow (CBF) and metabolism in patients with hemodynamic ischemia by positron emission tomography (PET) and thermal diffusion flow meter. We also studied neuropsychological functions to evaluate the effects of surgical revascularization. Bypass surgery of the superficial temporal artery to the proximal middle cerebral artery was performed on 26 patients satisfying the following categories: stenosis or occlusive lesion in main cerebral arteries; no marked focus of infarction on CT or MRI. PET was performed before and 1 month after the operation, and CBF, the cerebral metabolic rate of oxygen (CMRO 2 ) and oxygen extraction fraction (OEF) were analyzed. Cerebrovascular reserve capacity (CVRC) was also calculated after acetazolamide challenge. CBF during the operation was continuously measured with a thermal diffusion flow meter. CO 2 response of CBF was analyzed before and after anastomosis. Neuropsychological functions were evaluated by Hasegawa dementia scale revised (HDS-R), mini-mental state examination (MMSE) and Wechsler adult intelligence scale revised (WAIS-R). Before the operation, increase in OEF accorded with the decrease in CBF, and a significant relationship between both CBF and CVRC, and OEF and CVRC was found. A decrease in CVRC was noted prior to a decrease in CBF and elevation of OEF. CVRC caused by acetazolamide might reflect CO 2 reactivity. Significant improvement of CBF and CVRC, and normalization of OEF were observed after the operation. Also, significant improvement of neuropsychological function was observed by HDS-R and WAIS-R. Disturbance in neuropsychological function might reflect elevation of OEF. (author)

The Challenge of Assessing Professional Competence in Work Integrated Learning

Science.gov (United States)

McNamara, Judith

2013-01-01

A fundamental aspect of work integrated learning (WIL) is the development of professional competence, the ability of students to perform in the workplace. Alignment theory therefore suggests that the assessment of WIL should include an assessment of students' demonstration of professional competence in the workplace. The assessment of professional…

Assessing Assessment: In Pursuit of Meaningful Learning

Science.gov (United States)

Rootman-le Grange, Ilse; Blackie, Margaret A. L.

2018-01-01

The challenge of supporting the development of meaningful learning is prevalent in chemistry education research. One of the core activities used in the learning process is assessments. The aim of this paper is to illustrate how the semantics dimension of Legitimation Code Theory can be a helpful tool to critique the quality of assessments and…

Computational fluid dynamics-habitat suitability index (CFD-HSI) modelling as an exploratory tool for assessing passability of riverine migratory challenge zones for fish

Science.gov (United States)

Haro, Alexander J.; Chelminski, Michael; Dudley, Robert W.

2015-01-01

We developed two-dimensional computational fluid hydraulics-habitat suitability index (CFD-HSI) models to identify and qualitatively assess potential zones of shallow water depth and high water velocity that may present passage challenges for five major anadromous fish species in a 2.63-km reach of the main stem Penobscot River, Maine, as a result of a dam removal downstream of the reach. Suitability parameters were based on distribution of fish lengths and body depths and transformed to cruising, maximum sustained and sprint swimming speeds. Zones of potential depth and velocity challenges were calculated based on the hydraulic models; ability of fish to pass a challenge zone was based on the percent of river channel that the contiguous zone spanned and its maximum along-current length. Three river flows (low: 99.1 m3 sec-1; normal: 344.9 m3 sec-1; and high: 792.9 m3 sec-1) were modelled to simulate existing hydraulic conditions and hydraulic conditions simulating removal of a dam at the downstream boundary of the reach. Potential depth challenge zones were nonexistent for all low-flow simulations of existing conditions for deeper-bodied fishes. Increasing flows for existing conditions and removal of the dam under all flow conditions increased the number and size of potential velocity challenge zones, with the effects of zones being more pronounced for smaller species. The two-dimensional CFD-HSI model has utility in demonstrating gross effects of flow and hydraulic alteration, but may not be as precise a predictive tool as a three-dimensional model. Passability of the potential challenge zones cannot be precisely quantified for two-dimensional or three-dimensional models due to untested assumptions and incomplete data on fish swimming performance and behaviours.

Fuel failure assessments based on radiochemistry. Experience feedback and challenges

International Nuclear Information System (INIS)

Petit, C.; Ziabletsev, D.; Zeh, P.

2015-01-01

Significant improvements have been observed in LWR nuclear fuel reliability over the past years. As a result, the number of fuel failures in PWRs and BWRs has recently dramatically decreased. Nevertheless, a few remaining challenges still exist. One of them is that the industry has recently started seeing a relatively new type of fuel failure, so-called 'weak leak failures', which could be characterized by a very small release of gaseous fission products and essentially almost zero release of iodines or any other soluble fission products in the reactor coolant. Correspondingly, the behavior of these weak leakers does not follow typical behavior of a conventional leaker characterized by a proportionality of the amount of released Xe 133 related to the failed rod power. Instead, for a weak leaker, the activity of Xe 133 is directly correlated to the size of the cladding defects of the leaker. The presence of undetected weak leaker in the core may lead to carryover of a leaker into the subsequent cycle. Even if the presence of weak leaker in the core is suspected, it typically requires more effort to identify the leaker which could result in extended duration of the outage and ultimately to economic losses to the utility operating the reactor. To effectively deal with this issue the industry has been facing, several changes have been recently realized, which are different from the methodology of dealing with conventional leaker. These changes include new assessment methods, the need for improved sipping techniques to better identify low release leakers, and correspondingly better equipment to be able to locate small clad defects associated with weak leaker, such as sensitive localization device of failed rods, sensitive eddy current coil for the failed rod, ultra high definition cameras for the failed rod examination and experienced fuel reliability engineers performing cause of failure and rood cause research and analyses. Ultimately, the destructive

Assessment Moderation in an Australian Context: Processes, Practices, and Challenges

Science.gov (United States)

Beutel, Denise; Adie, Lenore; Lloyd, Margaret

2017-01-01

Moderation is a quality assurance process that plays a central role in the teaching, learning, and assessment cycle in higher education. While there is a growing body of research globally on teaching, learning, and, to a lesser degree, assessment in higher education, the process of moderation of assessment has received even less attention. In a…

Adequately Addressing Pediatric Obesity: Challenges Faced by Primary Care Providers.

Science.gov (United States)

Shreve, Marilou; Scott, Allison; Vowell Johnson, Kelly

2017-07-01

To assess the challenges primary care providers encounter when providing counseling for pediatric patients identified as obese. A survey assessed the current challenges and barriers to the screening and treatment of pediatric obesity for providers in northwest Arkansas who provide care to families. The survey consisted of 15 Likert scale questions and 4 open-ended questions. Time, resources, comfort, and cultural issues were reported by providers as the biggest barriers in screening and the treatment of pediatric obesity. All providers reported lack of time as a barrier to providing the care needed for obese children. Cultural barriers of both the provider and client were identified as factors, which negatively affect the care and treatment of obese children. Primary care providers continue to experience challenges when addressing pediatric obesity. In this study, a lack of adequate time to address obesity was identified as the most significant current barrier and may likely be tied to physician resources. Although reimbursement for obesity is increasing, the level of reimbursement does not support the time or the resources needed to treat patients. Many providers reported their patients' cultural view of obesity influenced how they counsel their patients. Increasing providers' knowledge concerning differences in how weight is viewed or valued may assist them in the assessment and care of obese pediatric patients. The challenges identified in previous research continue to limit providers when addressing obesity. Although progress has been made regarding knowledge of guidelines, continuing effort is needed to tackle the remaining challenges. This will allow for earlier identification and intervention, resulting in improved outcomes in pediatric obesity.

Assessing Conceptual Understanding via Literacy-Infused, Inquiry-Based Science among Middle School English Learners and Economically-Challenged Students

Directory of Open Access Journals (Sweden)

Rafael Lara-Alecio

2018-02-01

Full Text Available The overarching purpose of our study was to compare performances of treatment and control condition students who completed a literacy-infused, inquiry-based science intervention through sixth grade as measured by a big idea assessment tool which we refer to as the Big Ideas in Science Assessment (BISA. First, we determine the concurrent validity of the BISA; second, we investigate the differences in the post-test of the BISA between treatment and control English Learners (ELs, controlling for their performance in the pre-test; third, we analyze the differences in the post-test of the BISA between treatment and control non-ELs, controlling for their performance in the pre-test; and fourth, we examine the relationship between students’ English language proficiency as measured by standardized assessment, and their performance in the BISA among ELs and non-ELs, respectively. Our findings indicate: (a literacy-infused science lessons with big ideas, implemented through the tested intervention, improved students’ language acquisition and science concept understanding for ELs and economically challenged students (ECs; (b there was a positive relationship between language and content for both ELs and non-ELs, with a similar magnitude, suggesting that students with a higher level of English proficiency score higher in science assessment; and (c the lesson plans prepared were successful for promoting a literacy-infused science curriculum via a 5E Model (Engage, Explore, Explain, Elaborate, and Evaluate that includes three to five of the Es used daily. A pedagogical approach for a literacy-infused science model with big ideas is proposed.

RFID Technologies : emerging issues and challenges

NARCIS (Netherlands)

Lieshout, M.J. van; Kool, L.

2007-01-01

In this paper we will present the results of a technology and policy assessment we have performed on emerging issues and policy challenges of RFID technologies. RFID is a basic component of the future internet of things. A balanced view on opportunities and threats, on drivers and barriers is needed

Building better environmental risk assessments

Directory of Open Access Journals (Sweden)

Raymond eLayton

2015-08-01

Full Text Available Risk assessment is a reasoned, structured approach to address uncertainty based on scientific and technical evidence. It forms the foundation for regulatory decision making, which is bound by legislative and policy requirements, as well as the need for making timely decisions using available resources. In order to be most useful, environmental risk assessments (ERA for genetically modified (GM crops should provide consistent, reliable, and transparent results across all types of GM crops, traits, and environments. The assessments must also separate essential information from scientific or agronomic data of marginal relevance or value for evaluating risk and complete the assessment in a timely fashion. Challenges in conducting ERAs differ across regulatory systems – examples are presented from Canada, Malaysia, and Argentina. One challenge faced across the globe is the conduct of risk assessments with limited resources. This challenge can be overcome by clarifying risk concepts, placing greater emphasis on data critical to assess environmental risk (for example, phenotypic and plant performance data rather than molecular data, and adapting advances in risk analysis from other relevant disciplines.

Building Better Environmental Risk Assessments

Science.gov (United States)

Layton, Raymond; Smith, Joe; Macdonald, Phil; Letchumanan, Ramatha; Keese, Paul; Lema, Martin

2015-01-01

Risk assessment is a reasoned, structured approach to address uncertainty based on scientific and technical evidence. It forms the foundation for regulatory decision-making, which is bound by legislative and policy requirements, as well as the need for making timely decisions using available resources. In order to be most useful, environmental risk assessments (ERAs) for genetically modified (GM) crops should provide consistent, reliable, and transparent results across all types of GM crops, traits, and environments. The assessments must also separate essential information from scientific or agronomic data of marginal relevance or value for evaluating risk and complete the assessment in a timely fashion. Challenges in conducting ERAs differ across regulatory systems – examples are presented from Canada, Malaysia, and Argentina. One challenge faced across the globe is the conduct of risk assessments with limited resources. This challenge can be overcome by clarifying risk concepts, placing greater emphasis on data critical to assess environmental risk (for example, phenotypic and plant performance data rather than molecular data), and adapting advances in risk analysis from other relevant disciplines. PMID:26301217

Building Better Environmental Risk Assessments.

Science.gov (United States)

Layton, Raymond; Smith, Joe; Macdonald, Phil; Letchumanan, Ramatha; Keese, Paul; Lema, Martin

2015-01-01

Risk assessment is a reasoned, structured approach to address uncertainty based on scientific and technical evidence. It forms the foundation for regulatory decision-making, which is bound by legislative and policy requirements, as well as the need for making timely decisions using available resources. In order to be most useful, environmental risk assessments (ERAs) for genetically modified (GM) crops should provide consistent, reliable, and transparent results across all types of GM crops, traits, and environments. The assessments must also separate essential information from scientific or agronomic data of marginal relevance or value for evaluating risk and complete the assessment in a timely fashion. Challenges in conducting ERAs differ across regulatory systems - examples are presented from Canada, Malaysia, and Argentina. One challenge faced across the globe is the conduct of risk assessments with limited resources. This challenge can be overcome by clarifying risk concepts, placing greater emphasis on data critical to assess environmental risk (for example, phenotypic and plant performance data rather than molecular data), and adapting advances in risk analysis from other relevant disciplines.

Assessment of iron status in settings of inflammation: challenges and potential approaches.

Science.gov (United States)

Suchdev, Parminder S; Williams, Anne M; Mei, Zuguo; Flores-Ayala, Rafael; Pasricha, Sant-Rayn; Rogers, Lisa M; Namaste, Sorrel Ml

2017-12-01

The determination of iron status is challenging when concomitant infection and inflammation are present because of confounding effects of the acute-phase response on the interpretation of most iron indicators. This review summarizes the effects of inflammation on indicators of iron status and assesses the impact of a regression analysis to adjust for inflammation on estimates of iron deficiency (ID) in low- and high-infection-burden settings. We overviewed cross-sectional data from 16 surveys for preschool children (PSC) ( n = 29,765) and from 10 surveys for nonpregnant women of reproductive age (WRA) ( n = 25,731) from the Biomarkers Reflecting the Inflammation and Nutritional Determinants of Anemia (BRINDA) project. Effects of C-reactive protein (CRP) and α1-acid glycoprotein (AGP) concentrations on estimates of ID according to serum ferritin (SF) (used generically to include plasma ferritin), soluble transferrin receptor (sTfR), and total body iron (TBI) were summarized in relation to infection burden (in the United States compared with other countries) and population group (PSC compared with WRA). Effects of the concentrations of CRP and AGP on SF, sTfR, and TBI were generally linear, especially in PSC. Overall, regression correction changed the estimated prevalence of ID in PSC by a median of +25 percentage points (pps) when SF concentrations were used, by -15 pps when sTfR concentrations were used, and by +14 pps when TBI was used; the estimated prevalence of ID in WRA changed by a median of +8 pps when SF concentrations were used, by -10 pps when sTfR concentrations were used, and by +3 pps when TBI was used. In the United States, inflammation correction was done only for CRP concentrations because AGP concentrations were not measured; regression correction for CRP concentrations increased the estimated prevalence of ID when SF concentrations were used by 3 pps in PSC and by 7 pps in WRA. The correction of iron-status indicators for inflammation with the

Assessment of cerebral hemodynamics before and after revascularization in patients with occlusive cerebrovascular disease by means of quantitative IMP-SPECT with double-injection protocol

Energy Technology Data Exchange (ETDEWEB)

Ueno, Makoto; Nishizawa, Sadahiko; Toyoda, Hiroshi; Shimono, Taro; Miyamoto, Susumu; Hashimoto, Nobuo; Konishi, Junji [Kyoto Univ. (Japan). Graduate School of Medicine

2001-06-01

The purpose of this study was to validate a double-injection (DI) method with N-isopropyl-[{sup 123}I]p-iodoamphetamine (IMP) to measure regional cerebral blood flow (rCBF) twice in a single session of dynamic SPECT and to elucidate a possible role of this method to identify patients with occlusive disease of major cerebral arteries, who might benefit from cerebral revascularization procedures (CR). Fourteen patients with occlusion or severe stenosis of the internal carotid or middle cerebral artery were studied before and after CR to assess hemodynamic changes after revascularization treatment. We quantitatively measured rCBF before and after acetazolamide (ACZ) challenge along with cerebrovascular reserve capacity (CVR) with two injections of IMP in a single session of dynamic SPECT scans (DI method). The reliability and reproducibility of the DI method were validated by means of a simulation study and in eight patients who were examined without ACZ challenge to measure baseline rCBF twice. The analysis of simulated noisy data with realistic noise levels showed that the errors of the estimates for the first and the second rCBF and for the increase in rCBF were 2.6%, 8.1% and 10.4%, respectively. In the 8 patients examined by the DI method to measure baseline rCBF twice, the mean and the SD of percentage differences between the two consecutive measurements in rCBF were -1.3% and 5.5%, respectively. Eight out of 14 patients with occlusive disease had at least one region with a CVR less than 10%. They showed a significant increase in resting rCBF after CR, not only in the ipsilateral hemisphere (from 26.1{+-}6.4 to 33.4{+-}4.7) but also in the contralateral one (from 28.3{+-}7.0 to 34.7{+-}4.7) with a recovery of the ipsilateral CVR from 9.3{+-}17.2 to 41.2{+-}20.1%. The remaining six patients with good-moderate CVR did not show an increase in rCBF after CR (from 28.0{+-}2.7 to 28.3{+-}3.4). The three of them with a moderate CVR (10-25%) before CR showed

Development and evaluation of the content validity, practicability and feasibility of the Innovative dementia-oriented Assessment system for challenging behaviour in residents with dementia.

Science.gov (United States)

Halek, Margareta; Holle, Daniela; Bartholomeyczik, Sabine

2017-08-14

One of the most difficult issues for care staff is the manifestation of challenging behaviour among residents with dementia. The first step in managing this type of behaviour is analysing its triggers. A structured assessment instrument can facilitate this process and may improve carers' management of the situation. This paper describes the development of an instrument designed for this purpose and an evaluation of its content validity and its feasibility and practicability in nursing homes. The development process and evaluation of the content validity were based on Lynn's methodology (1998). A literature review (steps 1 + 2) provided the theoretical framework for the instrument and for item formation. Ten experts (step 3) evaluated the first version of the instrument (the Innovative dementia-oriented Assessment (IdA®)) regarding its relevance, clarity, meaningfulness and completeness; content validity indices at the scale-level (S-CVI) and item-level (I-CVI) were calculated. Health care workers (step 4) evaluated the second version in a workshop. Finally, the instrument was introduced to 17 units in 11 nursing homes in a field study (step 5), and 60 care staff members assessed its practicability and feasibility. The IdA® used the need-driven dementia-compromised behaviour (NDB) model as a theoretical framework. The literature review and expert-based panel supported the content validity of the IdA®. At the item level, 77% of the ratings had a CVI greater than or equal to 0.78. The majority of the question-ratings (84%, n = 154) and answer-ratings (69%, n = 122) showed valid results, with none below 0.50. The health care workers confirmed the understandability, completeness and plausibility of the IdA®. Steps 3 and 4 led to further item clarification. The carers in the study considered the instrument helpful for reflecting challenging behaviour and beneficial for the care of residents with dementia. Negative ratings referred to the time required and the

Assessing submarine groundwater discharge (SGD) and nitrate fluxes in highly heterogeneous coastal karst aquifers: Challenges and solutions

Science.gov (United States)

Montiel, Daniel; Dimova, Natasha; Andreo, Bartolomé; Prieto, Jorge; García-Orellana, Jordi; Rodellas, Valentí

2018-02-01

Groundwater discharge in coastal karst aquifers worldwide represents a substantial part of the water budget and is a main pathway for nutrient transport to the sea. Groundwater discharge to the sea manifests under different forms, making its assessment very challenging particularly in highly heterogeneous coastal systems karst systems. In this study, we present a methodology approach to identify and quantify four forms of groundwater discharge in a mixed lithology system in southern Spain (Maro-Cerro Gordo) that includes an ecologically protected coastal area comprised of karstic marble. We found that groundwater discharge to the sea occurs via: (1) groundwater-fed creeks, (2) coastal springs, (3) diffuse groundwater seepage through seabed sediments, and (4) submarine springs. We used a multi-method approach combining tracer techniques (salinity, 224Ra, and 222Rn) and direct measurements (seepage meters and flowmeters) to evaluate the discharge. Groundwater discharge via submarine springs was the most difficult to assess due to their depth (up to 15 m) and extensive development of the springs conduits. We determined that the total groundwater discharge over the 16 km of shoreline of the study area was at least 11 ± 3 × 103 m3 d-1 for the four types of discharge assessed. Groundwater-derived nitrate (NO3-) fluxes to coastal waters over ∼3 km (or 20%) in a highly populated and farmed section of Maro-Cerro Gordo was 641 ± 166 mol d-1, or ∼75% of the total NO3- loading in the study area. We demonstrate in this study that a multi-method approach must be applied to assess all forms of SGD and derived nutrient fluxes to the sea in highly heterogeneous karst aquifer systems.

The development and preliminary validation of the Challenge and Threat in Sport (CAT-Sport) Scale

OpenAIRE

Rossato, C.J.L.; Uphill, M.A.; Swain, J.; Coleman, D.

2016-01-01

This paper outlines the development and preliminary validation of a sport-specific measure of\\ud athletes’ experience of challenge and threat. Three independent studies assess the content\\ud validity, factor structure, criterion validity and internal consistency of the Challenge and\\ud Threat in Sport (CAT-Sport) Scale. In study 1, a group of 25 athletes and 2 experts assessed\\ud the content validity of items derived from existing measures of challenge and threat.\\ud Participants examined a p...

Environmental impact assessment (EIA) in development cooperation. A presentation of development challenges and research issues in developing countries and donor agencies

Energy Technology Data Exchange (ETDEWEB)

Kristoffersen, Harald

1997-12-31

This document discusses some development challenges and research needs related to environmental impact assessment (EIA) in development cooperation. After a general introduction to basic principles of EIA, the document deals with some general conditions for EIA in developing countries and in donor agencies. Through a presentation of experiences with EIA from selected donor agencies (with emphasis on NORAD) the report ends up with focusing on some research issues that may come up with recommendations for improving EIA practices in developing countries and donor agencies. 37 refs., 6 figs., 3 refs.

Personal and professional challenges confronted by hospital staff following hurricane sandy: a qualitative assessment of management perspectives.

Science.gov (United States)

Morris, Andrea M; Ricci, Karen A; Griffin, Anne R; Heslin, Kevin C; Dobalian, Aram

2016-05-05

Adequate hospital staffing during and after a disaster is critical to meet increased health care demands and to ensure continuity of care and patient safety. However, when a disaster occurs, staff may become both victim and responder, decreasing their ability and willingness to report for work. This qualitative study assessed the personal and professional challenges that affected staff decisions to report to work following a natural disaster and examined the role of management in addressing staff needs and concerns. Semi-structured interviews were conducted with individuals who filled key management roles in the United States Department of Veterans Affairs New York Harbor Healthcare System's response to Superstorm Sandy and during the facility's initial recovery phase. All interviews were audio recorded and transcribed. Three major themes were identified: 1) Barriers to reporting ("Barriers"), 2) Facilitators to reporting ("Facilitators"), and 3) Responses to staff needs and concerns ("Responses"). Atlas.ti 7.1.6 software program was used for the management and analysis of the transcripts. Results indicated that staff encountered several barriers that impeded their ability to report to work at mobile vans at the temporarily nonoperational Manhattan campus or at two other VA facilities in Brooklyn and the Bronx in the initial post-Sandy period including transportation problems, personal property damage, and communication issues. In addition, we found evidence of facilitators to reporting as expressed through descriptions of professional duty. Our findings also revealed that management was aware of the challenges that staff was facing and made efforts to reduce barriers and accommodate staff affected by the storm. During and after a disaster event, hospital staff is often confronted with challenges that affect decisions to report for work and perform effectively under potentially harsh conditions. This study examined barriers and facilitators that hospital staff

Frequency analyses of CSF flow on cine MRI in normal pressure hydrocephalus

Energy Technology Data Exchange (ETDEWEB)

Miyati, Tosiaki; Kasuga, Toshio; Koshida, Kichiro; Sanada, Shigeru; Onoguchi, Masahisa [Department of Radiological Technology, School of Health Sciences, Faculty of Medicine, Kanazawa University, 5-11-80, Kodatsuno, Kanazawa, Ishikawa 920-0942 (Japan); Mase, Mitsuhito; Yamada, Kazuo [Department of Neurosurgery, Nagoya City University Medical School, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8602 (Japan); Banno, Tatsuo [Department of Central Radiology, Nagoya City University Hospital, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8602 (Japan); Fujita, Hiroshi [Department of Information Science, Faculty of Engineering, Gifu University, Yanagido 1-1, Gifu 501-1193 (Japan)

2003-05-01

Our objective was to clarify intracranial cerebrospinal fluid (CSF) flow dynamics in normal-pressure hydrocephalus (NPH). Frequency analyses of CSF flow measured with phase-contrast cine MRI were performed. The CSF flow spectra in the aqueduct were determined in patients (n=51) with NPH, brain atrophy or asymptomatic ventricular dilation (VD), and in healthy volunteers (control group; n=25). The changes in CSF flow spectra were also analyzed after intravenous injection of acetazolamide. Moreover, a phase transfer function (PTF) calculated from the spectra of the driving vascular pulsation and CSF flow in the aqueduct were assessed. These values were compared with the pressure volume response (PVR). The amplitude in the NPH group was significantly larger than that in the VD or control group because of a decrease in compliance. The phase in the NPH group was significantly different from that in either the VD or the control group, but no difference was found between the VD and control groups. The amplitude increased in all groups after acetazolamide injection. The PTF in the NPH group was significantly larger than in the control group, and a positive correlation was noted between PTF and PVR. Frequency analyses of CSF flow measured by cine MRI make it possible to noninvasively obtain a more detailed picture of the pathophysiology of NPH. (orig.)

Assessment of endogenous dopamine release by methylphenidate challenge using iodine-123 iodobenzamide single-photon emission tomography

International Nuclear Information System (INIS)

Booij, J.; Korn, P.; Linszen, D.H.; Royen, E.A. van

1997-01-01

This double-blind, placebo-controlled study assessed pharmacologically induced endogenous dopamine (DA) release in healthy male volunteers (n=12). Changes in endogenous DA release after injection of the psychostimulant drug methylphenidate were evaluated by single-photon emission tomography (SPET) and constant infusion of iodine-123 iodobenzamide ([ 123 I[IBZM), a D 2 receptor radioligand that is sensitive to endogenous DA release. Methylphenidate induced displacement of striatal [ 123 I[IBZM binding, resulting in a significantly decrease in the specific to non-specific [ 123 I[IBZM uptake ratio (average: 8.6%) in comparison with placebo (average: -1.9%). Moreover, injection of methylphenidate induced significant behavioural responses on the following items: excitement, anxiety, tension, and mannerisms and posturing. The results of this study demonstrate the feasibility of using constant infusion of [ 123 I[IBZM and SPET imaging to measure endogenous DA release after methylphenidate challenge and to investigate neurochemical aspects of behaviour. (orig.). With 2 figs., 1 tab

Challenging Behaviors in Adults with Intellectual Disability: The Effects of Race and Autism Spectrum Disorders

Science.gov (United States)

Horovitz, Max; Matson, Johnny L.; Hattier, Megan A.; Tureck, Kimberly; Bamburg, Jay W.

2013-01-01

Rates of challenging behaviors were assessed in 175 adults with intellectual disability (ID) or ID and a comorbid autism spectrum disorder (ASD). The relationship between ASD diagnosis, race, and challenging behaviors was assessed using the "Autism Spectrum Disorders-Behavior Problems for Adults (ASD-BPA)." Those with ASD and ID were…

An Assessment of Information Exchange Practices, Challenges, and Opportunities to Support US Disease Surveillance in 3 States.

Science.gov (United States)

Garcia, Macarena C; Garrett, Nedra Y; Singletary, Vivian; Brown, Sheereen; Hennessy-Burt, Tamara; Haney, Gillian; Link, Kimberly; Tripp, Jennifer; Mac Kenzie, William R; Yoon, Paula

2017-12-07

State and local public health agencies collect and use surveillance data to identify outbreaks, track cases, investigate causes, and implement measures to protect the public-s health through various surveillance systems and data exchange practices. The purpose of this assessment was to better understand current practices at state and local public health agencies for collecting, managing, processing, reporting, and exchanging notifiable disease surveillance information. Over an 18-month period (January 2014-June 2015), we evaluated the process of data exchange between surveillance systems, reporting burdens, and challenges within 3 states (California, Idaho, and Massachusetts) that were using 3 different reporting systems. All 3 states use a combination of paper-based and electronic information systems for managing and exchanging data on reportable conditions within the state. The flow of data from local jurisdictions to the state health departments varies considerably. When state and local information systems are not interoperable, manual duplicative data entry and other work-arounds are often required. The results of the assessment show the complexity of disease reporting at the state and local levels and the multiple systems, processes, and resources engaged in preparing, processing, and transmitting data that limit interoperability and decrease efficiency. Through this structured assessment, the Centers for Disease Control and Prevention (CDC) has a better understanding of the complexities for surveillance of using commercial off-the-shelf data systems (California and Massachusetts), and CDC-developed National Electronic Disease Surveillance System Base System. More efficient data exchange and use of data will help facilitate interoperability between National Notifiable Diseases Surveillance Systems.

Developing Strategies for Islamic Banks to Face the Future Challenges of Financial Globalization

OpenAIRE

Al Ajlouni, Ahmed

2004-01-01

Developing Strategies for Islamic Banks to Face the Future Challenges of Financial Globalization Ahmed Al-Ajlouni Abstract This study aims at forming strategic response to assess the ability of Islamic banks in benefiting from the opportunities that may be provided by financial globalization and limits its threats, through assessing the capability of Islamic banks to meet the requirements and challenges of financial globalization, then suggests the suitable strategies that may be ...

Simulating power integration in Latin America to assess challenges, opportunities, and threats

International Nuclear Information System (INIS)

Ochoa, Camila; Dyner, Isaac; Franco, Carlos J.

2013-01-01

Integration of electricity markets started to spread under the world-wide trend to economic liberalization. While some regions are managing better than others, lessons, both political and technical, highlight challenges ahead that need to be overcome. Since the early 2000s, Panama, Colombia, Ecuador, and Peru have decided to integrate their electricity markets, eventually creating an enormous Latin American electricity exchange, ranging from Mexico to Chile. This poses opportunities and threats to the region as it involves cooperation, trust, and the will to overcome difficulties that may arise. In this direction, we developed a system dynamics model, linked to an iterative algorithm, to assess the likely effects of integration on both system expansion and security of supply. The model helps us understand the logic of the long-term system behavior under different policies, assuming Market Coupling as the dispatch mechanism. Based on theoretical grounds and after analyzing simulation results under different scenarios, we conclude that the integration of electricity markets may render important opportunities regarding security of supply and efficiency; and consequently energy might be supplied at lower prices, using “cleaner” technologies. However, benefits largely depend on policy, regulation, and technical issues. - Highlights: • We model the likely long-term dynamics of regional integration in Latin America. • The approach includes a dispatch algorithm linked to a system dynamics model. • The model simulates the evolution of installed capacity and prices. • We conclude: electricity integration may provide security of supply and efficiency. • Benefits of integration largely depend on policy, regulation, and technical issues

Towards Challenge Balancing for Personalised Game Spaces

NARCIS (Netherlands)

Bakkes, S.; Whiteson, S.

2014-01-01

This article focuses on games that can tailor the provided game experience to the individual player (personalised games), typically by effectively utilising player models. A particular challenge in this regard, is utilising player models for assessing online (i.e., while the game is being played)

Platform Performance and Challenges - using Platforms in Lego Company

DEFF Research Database (Denmark)

Munk, Lone; Mortensen, Niels Henrik

2009-01-01

needs focus on the incentive of using the platform. This problem lacks attention in literature, as well as industry, where assessment criteria do not cover this aspect. Therefore, we recommend including user incentive in platform assessment criteria to these challenges. Concrete solution elements...... ensuring user incentive in platforms is an object for future research...

Public lighting in Provence-Alpes-Cote d'Azur - Challenge mapping and assessment at the regional scale. Mapping of public actors and assessment of challenges of outdoor lighting in the Provence-Alpes-Cote d'Azur region (FR)

International Nuclear Information System (INIS)

Verny, Paul; Gourmelen, Stephanie

2016-05-01

This study aimed at providing an overview of the situation regarding challenges and energy performance of public lighting installations in the PACA region, notably in terms of expected energy savings. It also aimed at providing an insight on light pollution due to public lighting in this region, at identifying levers of support to a renovation for a sustainable public lighting, and existing aid for investment, and at determining follow-up indicators. Thus, the authors describe the roles and abilities of the different intervening actors (institutions, communities, etc.), highlight discrepancies among local communities and needs for specific supports, elaborate a method to obtain energy performance and light pollution indicators, and indicate good practices in the field of public lighting renovation. They also assess the efficiency of existing financial support measures, and make some recommendations for public actors for the promotion of a sustainable public lighting

Canadian insights: The challenges of an integrated environmental assessment framework

International Nuclear Information System (INIS)

McCaig, Karen

2005-01-01

The paper draws results from a review of literature to examine the strengths and weaknesses of the integrated environmental assessment framework in Canada with respect to the inclusion of health impact assessment. Insights include the legislative nature, rigid structure and priority for the natural environment that may restrict progress and the pool of government agencies that need to be convinced of the benefits of health impact assessment that may provide a strong structure for compliance in the long term

Non-proliferation and nuclear cooperation - accomplishments and challenges

International Nuclear Information System (INIS)

Marshall, H.R. Jr.

1983-01-01

The purpose of this paper is to assess the accomplishments in non-proliferation and nuclear co-operation since the beginning of President Reagan's administration, and the challenges remaining to be met in those fields. (NEA) [fr

Cerebral blood flow measurement using 123I-IMP graph plot method with SPECT. Comparison with autoradiography method

International Nuclear Information System (INIS)

Shinohara, Yuki; Kamitani, Hideki; Ishibashi, Minako; Ito, Satoru; Ogawa, Toshihide

2011-01-01

The purpose of this study was to evaluate quantification of cerebral blood flow (CBF) values using 123 I-iodoamphetamine (IMP) graph plot (GP) method with single photon emission computed tomography (SPECT), compared with autoradiography (ARG) method. IMP-SPECT by GP combined with ARG method at rest was performed in 40 patients to determine the equation of linear regression for GP method in our institution. In addition, we compared regional CBF (rCBF) values at rest between GP and ARG methods in 10 other patients. Among all 50 patients, acetazolamide (ACZ)-challenged SPECT by GP combined with ARG method using 2-day protocol was performed in 10 patients. We also compared the rCBF values after ACZ challenge between GP and ARG methods in these 10 patients. The equation of linear regression for GP method in our institution was y=1.945x+20.36 (R 2 =0.586, P 2 =0.624, P 2 =0.150, P<0.001). IMP-SPECT by GP method at rest is useful to measure reliable rCBF values without arterial blood sampling, although we need pay attention to interpret the result of 2-day protocol ACZ-challenged SPECT by GP method. (author)

The challenges of training, support and assessment of healthcare support workers: A qualitative study of experiences in three English acute hospitals.

Science.gov (United States)

Sarre, Sophie; Maben, Jill; Aldus, Clare; Schneider, Justine; Wharrad, Heather; Nicholson, Caroline; Arthur, Antony

2018-03-01

current and unprecedented policy focus on training, support and assessment of healthcare support workers, our study suggests improved training would be welcomed by them and their managers. Provision of training, support and assessment could be improved by organisational policy that promotes and protects healthcare support worker training; formalising the provision and availability of on-ward support; and training and IT support provided on a drop-in basis. Challenges in implementation are likely to be faced in all international settings where there is increased reliance on a support workforce. While recent policies in the UK offers scope to overcome some of these challenges there is a risk that some will be exacerbated. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Sustainable Facility Development: Perceived Benefits and Challenges

Science.gov (United States)

Stinnett, Brad; Gibson, Fred

2016-01-01

Purpose: The purpose of this paper is to assess the perceived benefits and challenges of implementing sustainable initiatives in collegiate recreational sports facilities. Additionally, this paper intends to contribute to the evolving field of facility sustainability in higher education. Design/methodology/approach The design included qualitative…

Nuclear safeguards in challenging times [Experts on nuclear safeguards and verification assess the global picture

International Nuclear Information System (INIS)

Park, W.S.; Hillerman, J.

2007-01-01

Meeting at the IAEA's International Safeguards Symposium in October 2006, more than 500 experts from 60-plus countries and organizations addressed current and future challenges related to safeguards concepts, approaches, technologies, and experience. Sessions addressed five main issues driving developments: Current challenges to the safeguards system; Further strengthening safeguards practices and approaches; Improving the collection and analysis of safeguards information; Advances in safeguards techniques and technology; and Future challenges. Every four to five years, the IAEA brings together safeguards experts from all over the world at international symposia. In October 2001, they met in the shadow of 9/11 and the symposium included a special session on the prevention of nuclear terrorism

Challenging Anti-fragile Blockchain Applications

OpenAIRE

González , Miguel Alejandro; Rudametkin , Walter; Monperrus , Martin; Rouvoy , Romain

2017-01-01

International audience; Failures in production are a de facto rule for distributed software systems. In particular, modern distributed systems are composed of heterogeneous building blocks contributed by third parties and guaranteeing the end-to-end resilience is becoming a major challenge. Even though each of these software components can embed fault tolerance or dependability protocols, it remains difficult to assess their effectiveness upon the occurrences of unexpected failures. As part o...

Fostering sustained energy behavior change and increasing energy literacy in a student housing energy challenge

Science.gov (United States)

Brewer, Robert Stephen

We designed the Kukui Cup challenge to foster energy conservation and increase energy literacy. Based on a review of the literature, the challenge combined a variety of elements into an overall game experience, including: real-time energy feedback, goals, commitments, competition, and prizes. We designed a software system called Makahiki to provide the online portion of the Kukui Cup challenge. Energy use was monitored by smart meters installed on each floor of the Hale Aloha residence halls on the University of Hawai'i at Manoa campus. In October 2011, we ran the UH Kukui Cup challenge for the over 1000 residents of the Hale Aloha towers. To evaluate the Kukui Cup challenge, I conducted three experiments: challenge participation, energy literacy, and energy use. Many residents participated in the challenge, as measured by points earned and actions completed through the challenge website. I measured the energy literacy of a random sample of Hale Aloha residents using an online energy literacy questionnaire administered before and after the challenge. I found that challenge participants' energy knowledge increased significantly compared to non-challenge participants. Positive self-reported energy behaviors increased after the challenge for both challenge participants and non-participants, leading to the possibility of passive participation by the non-challenge participants. I found that energy use varied substantially between and within lounges over time. Variations in energy use over time complicated the selection of a baseline of energy use to compare the levels during and after the challenge. The best team reduced its energy use during the challenge by 16%. However, team energy conservation did not appear to correlate to participation in the challenge, and there was no evidence of sustained energy conservation after the challenge. The problems inherent in assessing energy conservation using a baseline call into question this common practice. My research has

Actions taken in response to Fukushima : approaches and challenges

International Nuclear Information System (INIS)

Dermarkar, F.

2012-01-01

This paper discusses actions taken to Mitigating a Beyond Design Basis (BDB) external event and approaches for preventing a BDB Accident. It outlines the challenges in mitigating a BDB Accident and approaches for preventing fuel failure, protecting containment, and integrating BDB Accident Management Guides into existing Accident Management Procedures. Other challenges in BDB External Events are seismic and flooding risks, high wind assessment BDB Accidents (BDBA) and effectiveness of human response under BDBA conditions.

Pseudotumor cerebri syndrome

Science.gov (United States)

... problems. Repeat lumbar punctures are helpful for pregnant women in order to delay surgery until after delivery. Other treatments may include: Fluid or salt restriction Medicines such as corticosteroids, acetazolamide, furosemide, and topiramate ...

Addressing gender inequality in science: the multifaceted challenge of assessing impact

DEFF Research Database (Denmark)

Kalpazidou Schmidt, Evanthia; Cacace, Marina

2017-01-01

that the problem of gender inequality is rooted in so many and interrelated factors that program impact assessment has to be multidimensional and complex. Having a conceptual approach grounded in the notion of complexity as a point of departure, the article presents an innovative impact assessment tool, pointing...... to effective ways to assess the impact of gender equality programs....... on the assessment of 125 programs for gender equality implemented in research organizations in Europe, North America, and Australia, we argue that holistic approaches and multidimensional frames of reference are needed for impact assessment, also to improve program design and policy. Our analysis shows...

Evaluation and validation of a bee venom sting challenge performed by a micro-syringe.

Science.gov (United States)

Cortellini, Gabriele; Severino, Maurizio; Francescato, Elisabetta; Turillazzi, Stefano; Spadolini, Igino; Rogkakou, Anthi; Passalacqua, Giovanni

2012-12-01

The honeybee sting challenge is considered a reliable procedure to evaluate the efficacy of specific immunotherapy, but it is difficult and unpractical to perform in clinical practice, because live insects are required. To assess the feasibility and reliability of a challenge test using a micro-syringe, and compared the procedure with sting challenge. Patients on bee venom immunotherapy and without systemic reactions at field sting were enrolled. They underwent a sting challenge with live bee, and large local reactions were assessed up to 48 hours. Those patients displaying systemic reactions at the sting challenge were excluded from the syringe challenge for ethical reasons. The syringe challenge was done by injecting 0.5 μL fresh unfiltered bee venom at 2 mm depth (the length of the sting left by a bee). The same follow-up as at the first challenge was performed. Bee-specific immunoglobulin E (IgE) and tryptase were measured after each challenge. Nineteen patients underwent the sting challenge with live bees. Four had immediate systemic reactions (urticaria or asthma) and were excluded from the second challenge. The remaining 15 patients with large local reaction underwent the syringe challenge. No significant difference was seen in the maximum area of the large local reactions between the challenge with live bees and the syringe challenge. Also, no change was seen in tryptase and specific antibodies. This preliminary study suggests that the micro-syringe challenge with honeybee venom is feasible and produces results indistinguishable from those of the traditional sting challenge. Copyright © 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Exploring challenges to telehealth communication by specialists in poison information.

Science.gov (United States)

Rothwell, Erin; Ellington, Lee; Planalp, Sally; Crouch, Barbara

2012-01-01

The use of the telephone for providing health care is growing. A significant amount of social meaning is derived from visual information, and the absence of visual stimuli provides unique barriers to communication and increases the risks for misunderstandings and distractions. Understanding challenges to telephone communication can provide insight into training opportunities for overcoming these difficulties and improving patient care. The purpose of this research was to explore through focus groups the challenges of phone communication perceived by specialists in poison information. General types of challenges to effective phone communication included developing new communication skills to compensate for lack of visual information, difficulty assessing caller understanding, difficulty managing caller misunderstandings, maintaining distinctive assessments for routine calls, and managing the multifaceted aspects of job stress. The desire for training to enhance telehealth and cultural competency skills was also mentioned, and these findings might provide guidance for the development of training opportunities for telehealth professionals.

Development Challenges in Bhutan

DEFF Research Database (Denmark)

This book provides essential insights into Bhutan’s developmental challenges. It analyzes and scrutinizes the sovereign state’s developmental approach, including the idea of Gross National Happiness (GNH), which has replaced Gross National Product (GNP) as a measurement of prosperity. The authors...... also explore and deconstruct ideational and cultural aspects of knowledge production and present a critical overall assessment of the political economy of education policy, health, ICT and migration in Bhutan. The book is divided into five parts all taking a critical approach towards inequality: Part...

Letter to Congressional Leaders on Top Defense Management Challenges

National Research Council Canada - National Science Library

2000-01-01

... Budget Committee and you on Department of Defense (DoD) management challenges. The joint letter requested that we update our previous assessments of the most significant management problems facing the DoD...

Benefits from self-assessments in nuclear stations

International Nuclear Information System (INIS)

Hamlin, K.W.

1996-01-01

Effective self-assessment is an essential characteristic of any top-performing organization. It is vital to the success of a commercial nuclear facility. It must be challenging. When done well, it clearly contributes to continuous improvement. A focus on self-assessments in nuclear stations helps define the terminology. An assessment done by an external organization usually fails to provide the added benefits and learning that result from actually performing the self-assessment, from actually experiencing the challenges of a critical self-examination

International Travel: Tips for Staying Healthy

Science.gov (United States)

... sickness (promethazine and acetazolamide). Scissors, tweezers, nail clippers, pocket knife, thermometer, and a mirror. Hand wipes and ... counter Products Procedures & Devices Prescription Medicines Health Tools Dictionary Symptom Checker BMI Calculator myhealthfinder Immunization Schedules Nutrient ...

Solving a methodological challenge in work stress evaluation with the Stress Assessment and Research Toolkit (StART): a study protocol.

Science.gov (United States)

Guglielmi, Dina; Simbula, Silvia; Vignoli, Michela; Bruni, Ilaria; Depolo, Marco; Bonfiglioli, Roberta; Tabanelli, Maria Carla; Violante, Francesco Saverio

2013-06-22

Stress evaluation is a field of strong interest and challenging due to several methodological aspects in the evaluation process. The aim of this study is to propose a study protocol to test a new method (i.e., the Stress Assessment and Research Toolkit) to assess psychosocial risk factors at work. This method addresses several methodological issues (e.g., subjective vs. objective, qualitative vs quantitative data) by assessing work-related stressors using different kinds of data: i) organisational archival data (organisational indicators sheet); ii) qualitative data (focus group); iii) worker perception (questionnaire); and iv) observational data (observational checklist) using mixed methods research. In addition, it allows positive and negative aspects of work to be considered conjointly, using an approach that considers at the same time job demands and job resources. The integration of these sources of data can reduce the theoretical and methodological bias related to stress research in the work setting, allows researchers and professionals to obtain a reliable description of workers' stress, providing a more articulate vision of psychosocial risks, and allows a large amount of data to be collected. Finally, the implementation of the method ensures in the long term a primary prevention for psychosocial risk management in that it aims to reduce or modify the intensity, frequency or duration of organisational demands.

Some Challenges in the Design of Human-Automation Interaction for Safety-Critical Systems

Science.gov (United States)

Feary, Michael S.; Roth, Emilie

2014-01-01

Increasing amounts of automation are being introduced to safety-critical domains. While the introduction of automation has led to an overall increase in reliability and improved safety, it has also introduced a class of failure modes, and new challenges in risk assessment for the new systems, particularly in the assessment of rare events resulting from complex inter-related factors. Designing successful human-automation systems is challenging, and the challenges go beyond good interface development (e.g., Roth, Malin, & Schreckenghost 1997; Christoffersen & Woods, 2002). Human-automation design is particularly challenging when the underlying automation technology generates behavior that is difficult for the user to anticipate or understand. These challenges have been recognized in several safety-critical domains, and have resulted in increased efforts to develop training, procedures, regulations and guidance material (CAST, 2008, IAEA, 2001, FAA, 2013, ICAO, 2012). This paper points to the continuing need for new methods to describe and characterize the operational environment within which new automation concepts are being presented. We will describe challenges to the successful development and evaluation of human-automation systems in safety-critical domains, and describe some approaches that could be used to address these challenges. We will draw from experience with the aviation, spaceflight and nuclear power domains.

From the teachers' eyes: An ethnographic-case study on developing models of Informal Formative Assessments (IFA) and understanding the challenges to effective implementation in science classrooms

Science.gov (United States)

Sezen, Asli

The emphasis on socio-cultural theories of learning has required the understanding of multi-dimensional, dynamic and social nature of acquiring the scientific knowledge and practices. Recent policy documents suggest a focus on formative and dynamic assessment practices that will help understand and improve the complex nature of scientific learning in classrooms. This study focuses on teachers' use of "Informal Formative Assessments (IFA)" aimed at improving students' learning and teachers' frequent recognition of students' learning process. The study was designed as an ethnographic case study of four middle school teachers and their students at a local charter school. The data of the study included (a) teachers' responses to history of teaching questionnaire (b) video and audio records of teachers' assessment practices during two different scientific projects (c) video and audio records of ethnographic interviews with teachers during their reflections on their practices, and (d) field notes taken by the researcher to understand the assessment culture of the school. The analytical tools from sociolinguistics (e.g., transcripts and event maps) were prepared and discourse analysis based in an ethnographic perspective was used to analyze the data. Moreover, Cultural-Historical Activity Theory (CHAT) was also introduced as an alternative data analysis framework for understanding the role of division of labor among the elements of the community on the challenges and the outcomes of IFA practices. The findings from the analysis of the classroom discourse showed three different types of IFA cycles: connected, non-connected, and repeating. The analysis of the teachers' reflections showed that the effectiveness of these cycles did not only depend on whether the cycles were connected, but also on other variables such as the phase of the lessons and student's identities and abilities. Teachers' reflections during researcher-teacher meetings on the concept and the aims of IFA

Microvascular versus macrovascular cerebral vasomotor reactivity in patients with severe internal carotid artery stenosis or occlusion.

Science.gov (United States)

Zirak, Peyman; Delgado-Mederos, Raquel; Dinia, Lavinia; Martí-Fàbregas, Joan; Durduran, Turgut

2014-02-01

In patients with severe internal carotid artery steno-occlusive lesions (ISOL), impaired cerebrovascular reactivity (CVR) is predictive of future ischemic stroke (IS) or transient ischemic attack (TIA). Therefore, the evaluation of CVR in ISOL patients may be a means to evaluate the risk for IS/TIA and decide on an intervention. Our aim was (1) to explore the feasibility of concurrent near-infrared spectroscopy (NIRS-DOS), diffuse correlation spectroscopy, and transcranial Doppler for CVR assessment in ISOL patients, and (2) to compare macrovascular and microvascular CVR in ISOL patients and explore its potential for IS/TIA risk stratification. Twenty-seven ISOL patients were recruited. The changes in continuous microvascular and macrovascular hemodynamics upon acetazolamide injection were used to determine CVR. Oxyhemoglobin (HbO2, by near-infrared spectroscopy), microvascular cerebral blood flow (CBF, by diffuse correlation spectroscopy) and CBF velocity (by transcranial Doppler) showed significant increases upon acetazolamide injection in all subjects (P < .03). Only macrovascular CVR (P = .024) and none of the microvascular measures were significantly dependent on the presence of ISOL. In addition, while CBF was significantly correlated with HbO2, neither of these microvascular measures correlated with macrovascular CBF velocity. We demonstrated the simultaneous, continuous, and noninvasive evaluation of CVR at both the microvasculature and macrovasculature. We found that macrovascular CVR response depends on the presence of ISOL, whereas the microvascular CVR did not significantly depend on the ISOL presence, possibly due to the role of collaterals other than those of the circle of Willis. The concurrent microvascular and macrovascular CVR measurement in the ISOL patients might improve future IS/TIA risk assessment. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

Challenges for extension service to render efficient post-transformer ...

African Journals Online (AJOL)

Ben Stevens

series of ten country papers that sought to assess and benchmark common challenges linked ... Province of South Africa (gender, marital status, educational qualifications .... Standard of extension in South Africa (Norms and Standards, 2005).

Community challenges in biomedical text mining over 10 years: success, failure and the future.

Science.gov (United States)

Huang, Chung-Chi; Lu, Zhiyong

2016-01-01

One effective way to improve the state of the art is through competitions. Following the success of the Critical Assessment of protein Structure Prediction (CASP) in bioinformatics research, a number of challenge evaluations have been organized by the text-mining research community to assess and advance natural language processing (NLP) research for biomedicine. In this article, we review the different community challenge evaluations held from 2002 to 2014 and their respective tasks. Furthermore, we examine these challenge tasks through their targeted problems in NLP research and biomedical applications, respectively. Next, we describe the general workflow of organizing a Biomedical NLP (BioNLP) challenge and involved stakeholders (task organizers, task data producers, task participants and end users). Finally, we summarize the impact and contributions by taking into account different BioNLP challenges as a whole, followed by a discussion of their limitations and difficulties. We conclude with future trends in BioNLP challenge evaluations. Published by Oxford University Press 2015. This work is written by US Government employees and is in the public domain in the US.

A reflective teaching challenge to motivate educational innovation.

Science.gov (United States)

Edwards, Roger A; Kirwin, Jennifer; Gonyeau, Michael; Matthews, S James; Lancaster, Jason; DiVall, Margarita

2014-06-17

To describe a teaching challenge intended to increase faculty use of evidence-based and student-centered instructional strategies in the demanding school of pharmacy context with technology-savvy students. A teaching challenge was created that required faculty members to incorporate a "new-to-you" innovative teaching method in a class, course, or experiential activity. The method was linked to at least 1 of 7 evidence-based principles for effective teaching. Faculty members were exposed to colleagues' teaching strategies via brief voluntary presentations at department meetings. A post-challenge survey provided assessment data about the challenge. Responses to a baseline survey provided additional information about what faculty members were already doing (52% response rate). Eighty-one percent of faculty respondents completed the challenge. A wide array of new strategies (13 categories such as flipped classrooms and social media) was implemented and 75% included the use of technology. Nearly all respondents (96%) thought that participation in the challenge was worth the effort and planned to participate again the following year. All faculty members intended to continue using their new strategy and 56% planned additional modifications with future implementations. The challenge demonstrated how multiple goals of curricular improvement, faculty development, and student-centered instruction could be achieved together. The teaching challenge motivated most of the faculty members to try something new to them. Links between evidence-based principles and day-to-day activities were strengthened. The new-to-you design placed the challenge within reach of faculty members regardless of their background, subject, or experience.

Environmental factors affecting challenge success in vaccination studies

DEFF Research Database (Denmark)

Chettri, J. K.; Skov, J.; Dalsgaard, Inger

2013-01-01

We have tested the efficacies of two different vaccines (a commercial versus an experimental vaccine – both being oil adjuvanted) for rainbow trout against furunculosis caused by Aeromonas salmonicida infections. However, when challenging fish with live bacteria in order to assess protection...

[An assessment of the Family Health Program in municipalities of Northeast Brazil: old and new challenges].

Science.gov (United States)

Rocha, Paulo de Medeiros; Uchoa, Alice da Costa; Rocha, Nadja de Sá Pinto Dantas; Souza, Elizabethe Cristina Fagundes de; Rocha, Marconi de Lima; Pinheiro, Themis Xavier de Albuquerque

2008-01-01

This article presents part of the results from the Baseline Studies, an evaluative research conducted in 21 municipalities with more than 100,000 inhabitants each, in three States of Northeast Brazil. The overall objective was to assess experiences in the implementation of the Family Health Program (FHP), with a focus on inductions in the PROESF. An implementation analysis was performed, using the case study method. The analysis focused on these dimensions: political-institutional, health organization, and comprehensive care. Outstanding advances included: prioritize the FHP in high-risk areas; institutional learning, with qualification of managers and teams; definition of institutional levels for regulating the FHP; and health team-user bonds and positive perceptions concerning the program. Challenges included: strengthening of local policy and decision-making capacity; allocation of primary care resources; greater employment security for human resources; effective implementation of the health care network; strengthening of social participation; upgrading of monitoring and evaluation for decision-making; receptivity; waiting lines for tests, appointments, and hospital admissions; implementation of teamwork; health promotion and inter-sector activities.

Towards an optimal adaptation of exposure to NOAA assessment methodology in Multi-Source Industrial Scenarios (MSIS): the challenges and the decision-making process

Science.gov (United States)

López de Ipiña, JM; Vaquero, C.; Gutierrez-Cañas, C.

2017-06-01

It is expected a progressive increase of the industrial processes that manufacture of intermediate (iNEPs) and end products incorporating ENMs (eNEPs) to bring about improved properties. Therefore, the assessment of occupational exposure to airborne NOAA will migrate, from the simple and well-controlled exposure scenarios in research laboratories and ENMs production plants using innovative production technologies, to much more complex exposure scenarios located around processes of manufacture of eNEPs that, in many cases, will be modified conventional production processes. Here will be discussed some of the typical challenging situations in the process of risk assessment of inhalation exposure to NOAA in Multi-Source Industrial Scenarios (MSIS), from the basis of the lessons learned when confronted to those scenarios in the frame of some European and Spanish research projects.

76 FR 41526 - Centennial Challenges 2011 Strong Tether Challenge

Science.gov (United States)

2011-07-14

... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice (11-063)] Centennial Challenges 2011 Strong... scheduled and teams that wish to compete may register. Centennial Challenges is a program of prize... NASA Centennial Challenges Program please visit: http://www.nasa.gov/challenges . General questions and...

Non-invasive diagnosis in cerebral ischemia by means of magnetic resonance imaging and near-infrared spectroscopy

International Nuclear Information System (INIS)

Piepgras, A.; Gueckel, F.; Laemmler, B.; Weigel, R.; Schmiedek, P.

1994-01-01

We describe the non-invasive assessment of cerebrovascular reserve capacity by means of near-infrared spectroscopy (NIRS) and magnetic resonance imaging. Both methods are compared with transcranial Doppler sonography. There is a good correlation of the three methods in the changes in cerebral oxygen saturation and in blood velocity following acetazolamide stimulation of cerebral blood flow, except found in one patient with unilateral carotid artery occlusion. In this patient we found a decreased cerebrovascular reserve capacity, revealed by a magnetic resonance technique designed to quantify CBV and CBF. We postulate a raised oxygen extraction as raised oxygen extraction as the cause of his changes in oxygen saturation. (orig.) [de

A cross-cultural survey of residents' perceived barriers in questioning/challenging authority.

Science.gov (United States)

Kobayashi, H; Pian-Smith, M; Sato, M; Sawa, R; Takeshita, T; Raemer, D

2006-08-01

To identify perceived barriers to residents' questioning or challenging their seniors, to determine how these barriers affect decisions, and to assess how these barriers differ across cultures. A written questionnaire was administered to residents in teaching hospitals in the US and Japan to assess factors affecting residents' willingness to question or challenge their superiors. The responses were analyzed for statistical significance of differences between the two cultures and to determine the importance of issues affecting decisions. Questionnaires were completed by 175 US and 65 Japanese residents, with an overall response rate of 71%. Trainees from both countries believe that questioning and challenging contribute to safety. The perceived importance of specific beliefs about the workplace differed across cultures in seven out of 22 questions. Residents' decisions to make a challenge were related to the relationships and perceived response of the superiors. There was no statistical difference between the US and Japanese residents in terms of the threshold for challenging their seniors. We have identified attributes of residents' beliefs of communication, including several cross-cultural differences in the importance of values and issues affecting one's decision to question or challenge. In contrast, there was no difference in the threshold for challenging seniors by the Japanese and US residents studied. Changes in organizational and professional culture may be as important, if not more so, than national culture to encourage "speaking up". Residents should be encouraged to overcome barriers to challenging, and training programs should foster improved relationships and communication between trainers and trainees.

An Assessment of Business Schools' Student Retention, Accreditation, and Faculty Scholarship Challenges

Science.gov (United States)

Cavico, Frank J.; Mujtaba, Bahaudin G.

2010-01-01

Business schools' curriculum, faculty and graduates have become a target for many critics as they link the ethical lapses of senior executives to major scandals that have partially led to the financial challenges that the world is facing today. Some claim that business faculty research is not practical and mainly theoretical. This paper discusses…

Alcohol and burden of disease in Australia: the challenge in assessing consumption.

Science.gov (United States)

Ogeil, Rowan P; Room, Robin; Matthews, Sharon; Lloyd, Belinda

2015-04-01

Alcohol consumption is one of the major avoidable risk factors for disease, illness and injury in the Australian community. Population health scientists and economists use estimates of alcohol consumption in burden of disease frameworks to estimate the impact of alcohol on disease, illness and injury. This article highlights challenges associated with estimating alcohol consumption in these models and provides a series of recommendations to improve estimates. Key challenges in measuring alcohol consumption at the population level are identified and discussed with respect to how they apply to burden of disease frameworks. Methodological advances and limitations in the estimation of alcohol consumption are presented with respect to use of survey data, population distributions of alcohol consumption, consideration of 'patterns' of alcohol use including 'bingeing', and capping exposure. Key recommendations for overcoming these limitations are provided. Implications and conclusion: Alcohol-related burden has a significant impact on the health of the Australian population. Improving estimates of alcohol related consumption will enable more accurate estimates of this burden to be determined to inform future alcohol policy by legislators. © 2015 Public Health Association of Australia.

78 FR 19742 - Centennial Challenges: 2014 Night Rover Challenge

Science.gov (United States)

2013-04-02

... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice 13-032] Centennial Challenges: 2014 Night... Centennial Challenges 2014 Night Rover Challenge. SUMMARY: This notice is issued in accordance with 51 U.S.C.... Centennial Challenges is a program of prize competitions to stimulate innovation in technologies of interest...

Challenges of Tuition fee’s decision: Private Universities case in Kosovo

Directory of Open Access Journals (Sweden)

Besa Shahini

2013-12-01

Full Text Available This study assesses Challenges that Private Universities in Kosovo face when employing tuition fee strategies. Data are collected on May - June 2012 through in-depth interview and questioners with supervisors and students of three Private Universities in Kosovo. As of low purchasing power of students and overall economic crises in Kosovo, students are very sensitive to pricing strategies employed and according to fee they evaluate before and after -enrollment assessment. Students’ academic expectations are much higher relative to their low tuition requirements. In transition economies, employing tuition strategies that satisfy both Universities and students is a challenge for higher educational institutions.

The practices and challenges of teacher educators' professional ...

African Journals Online (AJOL)

Teachers' professional development is the core of educational improvement. Thus, the main purpose of this study was to assess the practices and challenges of teacher educators' professional development through Lesson Study in Oromia colleges of teacher education. To this effect, descriptive survey method was used.

77 FR 70835 - Centennial Challenges 2013 Sample Return Robot Challenge

Science.gov (United States)

2012-11-27

... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION Centennial Challenges 2013 Sample Return Robot... Challenge is scheduled and teams that wish to compete may register. Centennial Challenges is a program of... Challenge, please visit: http://challenge.wpi.edu . For general information on the NASA Centennial...

The Terawatt Challenge

Science.gov (United States)

Haegel, Nancy

In response to concerns about accelerating climate change, the world is uniting to both envision and enable a global energy system that supports a sustainable environment and broad economic prosperity. Growth in the technology and the deployment of renewable energy has been dramatic. Evidence can be seen in the growth of photovoltaics (PV) and wind as contributors to worldwide electricity production over the last decade. PV and wind provided 1.2% and 3.7% of global electricity production in 2015, compared to 0.1% and 1.3% respectively in 2005. These numbers indicate both the rapid increase in the rate of deployment, as well as the remaining work to be done to extend this trend to transform a massive energy system and provide a significant fraction of the world's future energy demand with renewable energy. Based on recent trends, it is highly likely that global cumulative PV installation will reach terawatt scale in the next few decades. The challenges, as well as the resulting impact, vary greatly depending on whether we envision 1 TW ( 15% of 2015 global electricity capacity), 3 TW ( 50% of 2015 global electricity capacity) or 10 TW, a level that could drive electrification of transportation and industrial sectors and production of solar fuels. This presentation will draw upon the work of the 2016 GA-SERI (Global Alliance of Solar Energy Research Institutes) Terawatt Workshop to assess the feasibility and summarize the challenges for PV as a primary energy source. These challenges include the continuing demand for improved efficiency and reliability, the required magnitude of capital expenditure, the need for a sustainable industry (both financially and environmentally), as well as needs for grid modernization and consistent policies that support global climate goals. Physicists can play important roles in addressing this full range of challenges, from materials science to public policy, as well as in education of the public and its future leaders.

Assessing the Global Development Agenda (Goal 1 in Uganda: The Progress Made and the Challenges that Persist

Directory of Open Access Journals (Sweden)

E. A. Ndaguba

2016-12-01

Full Text Available The international development agenda (2000-2015 that was hailed in Uganda was unsuccessful and powerless in elevating individuals and groups to a place of comfort through the achievement of the MDGs. Hence, according to a survey of the Directorate of Social Protection in 2012, 67% of citizens of Uganda are either highly vulnerable to remaining in poverty or being poor.  This study therefore assesses the gains of the global development agenda (2000 – 2015 in Uganda. The study relies heavily on review papers, secondary dataset and material, and quasi-quantitative method in analyzing the research aim. Results show that ambiguous and unrealistic targets of the MDGs did not take into cognizance the structures, institutions, and interaction of systems and governance issues in Uganda. Despite these, the gains were also shortchanged as a result of drought, flood, and high prices of commodities, due to low farm production in most (rural areas in Uganda. In addition to the drought and the negative effects of climate change, other challenges include deficient access to markets and market place, lack of motorized and non-motorized load-carrying wheel vehicles, lack of capacity and infrastructure, lack of mechanized farming implements, and the lack of access to credit reduced the potency of the achievement of most of its goals. However, significant strides were attempted and the country was able to achieve several targets, which are worth celebrating. The study contends that the realization of the SDGs will only be wishful thinking, if challenges of rural poverty, governance and institution are not put in check. Shared progress and prosperity as acclaimed by the World Bank will never be visible in Uganda.

76 FR 56819 - Centennial Challenges 2012 Sample Return Robot Challenge

Science.gov (United States)

2011-09-14

... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice (11-079)] Centennial Challenges 2012 Sample... Challenge is scheduled and teams that wish to compete may register. Centennial Challenges is a program of... Challenge, please visit: http://wp.wpi.edu/challenge/ . For general information on the NASA Centennial...

Aspiring Pain Practitioners in India: Assessing Challenges and Building Opportunities

Science.gov (United States)

Bhatnagar, Sushma; Patel, Anuradha; Raja, Srinivasa N

2018-01-01

Background: Pain medicine is a developing specialty, aimed at relieving pain and suffering, enhancing function, and improving the quality of life of patients. Pain is often ignored, under-reported and mismanaged by health-care providers. Aspiring pain physicians in India face many challenges and barriers in advancing their specialty. Objectives: The objective of this study is to determine the challenges in establishing a pain practice in India and to discuss the opportunities and strategies to overcome these barriers. Subjects and Methods: Face-to-face interactive sessions were held with 60 aspiring pain physicians of India who were chosen as registrants to an International Association for the Study of Pain-Indian Society for Study of Pain multidisciplinary evidence-based pain management program conducted at Delhi and Mumbai. The available opportunities, practical issues and the hurdles in becoming a pain specialist were analyzed and summarized in this commentary. Results: The major barriers identified were: (1) Inadequate knowledge and absence of structured, educational and training courses, (2) bureaucratic hurdles, and (3) concerns of opioid misuse and addiction. The opportunities for personal growth and that of the specialty that could be utilized include the creation of a pain resource team, increasing community awareness, changing attitudes of other physicians toward pain specialty, and research and evidence building of the effectiveness of pain management strategies. Conclusion: India needs a structured teaching and training program in the area of pain medicine that is affiliated by the Medical Council of India or other reputed boards of medical education and certification. There is an urgent need to include pain management in the undergraduate and postgraduate medical curriculum. Enhancing community level awareness by public health education campaigns, developing networks of pain physicians, and appropriate marketing of the specialty is needed to make pain

Aspiring Pain Practitioners in India: Assessing Challenges and Building Opportunities.

Science.gov (United States)

Bhatnagar, Sushma; Patel, Anuradha; Raja, Srinivasa N

2018-01-01

Pain medicine is a developing specialty, aimed at relieving pain and suffering, enhancing function, and improving the quality of life of patients. Pain is often ignored, under-reported and mismanaged by health-care providers. Aspiring pain physicians in India face many challenges and barriers in advancing their specialty. The objective of this study is to determine the challenges in establishing a pain practice in India and to discuss the opportunities and strategies to overcome these barriers. Face-to-face interactive sessions were held with 60 aspiring pain physicians of India who were chosen as registrants to an International Association for the Study of Pain-Indian Society for Study of Pain multidisciplinary evidence-based pain management program conducted at Delhi and Mumbai. The available opportunities, practical issues and the hurdles in becoming a pain specialist were analyzed and summarized in this commentary. The major barriers identified were: (1) Inadequate knowledge and absence of structured, educational and training courses, (2) bureaucratic hurdles, and (3) concerns of opioid misuse and addiction. The opportunities for personal growth and that of the specialty that could be utilized include the creation of a pain resource team, increasing community awareness, changing attitudes of other physicians toward pain specialty, and research and evidence building of the effectiveness of pain management strategies. India needs a structured teaching and training program in the area of pain medicine that is affiliated by the Medical Council of India or other reputed boards of medical education and certification. There is an urgent need to include pain management in the undergraduate and postgraduate medical curriculum. Enhancing community level awareness by public health education campaigns, developing networks of pain physicians, and appropriate marketing of the specialty is needed to make pain medicine recognized and utilized as a valuable specialty.

Aspiring pain practitioners in India: Assessing challenges and building opportunities

Directory of Open Access Journals (Sweden)

Sushma Bhatnagar

2018-01-01

Full Text Available Background: Pain medicine is a developing specialty, aimed at relieving pain and suffering, enhancing function, and improving the quality of life of patients. Pain is often ignored, under-reported and mismanaged by health-care providers. Aspiring pain physicians in India face many challenges and barriers in advancing their specialty. Objectives: The objective of this study is to determine the challenges in establishing a pain practice in India and to discuss the opportunities and strategies to overcome these barriers. Subjects and Methods: Face-to-face interactive sessions were held with 60 aspiring pain physicians of India who were chosen as registrants to an International Association for the Study of Pain-Indian Society for Study of Pain multidisciplinary evidence-based pain management program conducted at Delhi and Mumbai. The available opportunities, practical issues and the hurdles in becoming a pain specialist were analyzed and summarized in this commentary. Results: The major barriers identified were: (1 Inadequate knowledge and absence of structured, educational and training courses, (2 bureaucratic hurdles, and (3 concerns of opioid misuse and addiction. The opportunities for personal growth and that of the specialty that could be utilized include the creation of a pain resource team, increasing community awareness, changing attitudes of other physicians toward pain specialty, and research and evidence building of the effectiveness of pain management strategies. Conclusion: India needs a structured teaching and training program in the area of pain medicine that is affiliated by the Medical Council of India or other reputed boards of medical education and certification. There is an urgent need to include pain management in the undergraduate and postgraduate medical curriculum. Enhancing community level awareness by public health education campaigns, developing networks of pain physicians, and appropriate marketing of the specialty is

Hybrid governance of aquaculture: Opportunities and challenges.

Science.gov (United States)

Vince, Joanna; Haward, Marcus

2017-10-01

The development of third party assessment and certification of fisheries and aquaculture has provided new forms of governance in sectors that were traditionally dominated by state based regulation. Emerging market based approaches are driven by shareholder expectations as well as commitment to corporate social responsibility, whereas community engagement is increasingly centered on the questions of social license to operate. Third party assessment and certification links state, market and community into an interesting and challenging hybrid form of governance. While civil society organizations have long been active in pursuing sustainable and safe seafood production, the development of formal non-state based certification provides both opportunities and challenges, and opens up interesting debates over hybrid forms of governance. This paper explores these developments in coastal marine resources management, focusing on aquaculture and the development and operation of the Aquaculture Stewardship Council. It examines the case of salmonid aquaculture in Tasmania, Australia, now Australia's most valuable seafood industry, which remains the focus of considerable community debate over its siting, operation and environmental impact. Copyright © 2017 Elsevier Ltd. All rights reserved.

Families of returned defence force personnel: a changing landscape of challenges.

Science.gov (United States)

Berle, David; Steel, Zachary

2015-08-01

This paper aims to identify the key challenges experienced by the families of defence force personnel following deployment. We undertook a selective review of four post-deployment challenges to the families of defence force personnel: (1) changes to relationships; (2) changes to family member roles and responsibilities; (3) adjustment of children and parenting challenges; and (4) anger, family conflict and violence. Emerging issues in the area of post-deployment adjustment are also discussed. Empirical studies of post-deployment family adjustment are lacking. Each of the reviewed challenges can contribute to psychological difficulties and precipitate contact with mental health services. The challenges faced by defence force personnel when returning from deployment arise within a family context. Clinicians should thoroughly assess these factors in families following deployment, but also recognise family strengths and resilience to these challenges. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Smart grid demonstrators and experiments in France: Economic assessments of smart grids. Challenges, methods, progress status and demonstrators; Contribution of 'smart grid' demonstrators to electricity transport and market architectures; Challenges and contributions of smart grid demonstrators to the distribution network. Focus on the integration of decentralised production; Challenges and contributions of smart grid demonstrators to the evolution of providing-related professions and to consumption practices

International Nuclear Information System (INIS)

Sudret, Thierry; Belhomme, Regine; Nekrassov, Andrei; Chartres, Sophie; Chiappini, Florent; Drouineau, Mathilde; Hadjsaid, Nouredine; Leonard, Cedric; Bena, Michel; Buhagiar, Thierry; Lemaitre, Christian; Janssen, Tanguy; Guedou, Benjamin; Viana, Maria Sebastian; Malarange, Gilles; Hadjsaid, Nouredine; Petit, Marc; Lehec, Guillaume; Jahn, Rafael; Gehain, Etienne

2015-01-01

This publication proposes a set of four articles which give an overview of challenges and contributions of smart grid demonstrators for the French electricity system according to different perspectives and different stakeholders. These articles present the first lessons learned from these demonstrators in terms of technical and technological innovations, of business and regulation models, and of customer behaviour and acceptance. More precisely, the authors discuss economic assessments of smart grids with an overview of challenges, methods, progress status and existing smart grid programs in the World, comment the importance of the introduction of intelligence at hardware, software and market level, highlight the challenges and contributions of smart grids for the integration of decentralised production, and discuss how smart grid demonstrators impact providing-related professions and customer consumption practices

ORIGINAL ARTICLE The Practices and Challenges of Teacher ...

African Journals Online (AJOL)

Temesgen

main purpose of this study was to assess the practices and challenges of ... educators' professional development through Lesson Study in Oromia ... change in a teacher's practice that leads to ... together, learn about, try out, and reflect on ... sharing their individual knowledge and .... Education Bureau, CTEs leaders and.

The value of measurements of the cerebrovascular reserve capacity (CVRC) for the assessment and prognosis of cerebrovascular disease; Der Stellenwert der Messung der zerebrovaskulaeren Reservekapazitaet bei der Beurteilung und Prognose ischaemischer Hirnerkrankungen

Energy Technology Data Exchange (ETDEWEB)

Einhaeupl, K.M. [Klinik und Poliklinik fuer Neurologie, Universitaetsklinikum Charite, Medizinische Fakultaet der Humboldt-Universitaet, Berlin (Germany); Valdueza, J.M. [Klinik und Poliklinik fuer Neurologie, Universitaetsklinikum Charite, Medizinische Fakultaet der Humboldt-Universitaet, Berlin (Germany)

1997-03-01

Today, the diagnostic and therapeutic principles in the management of stroke are changing. Prevention of stroke is one of the major fields of research. One important aim of the newly developed diagnostic techniques is the identification of a particular subgroup of patients with compromised cerebral circulation who will benefit from surgical or medical therapies. The assessment of the CVRC with tracer techniques and the acetazolamide test seem to be a realiable and promising method for this purpose: 1. In carotid artery occlusion, the measurement of CVRV facilitates the identification of a subgroup of patients with compromised CVRC who show an improvement of CVRC after EC-IC bypass surgery. The value of bypass surgery for the prevention of stroke however, has to be confirmed by prospective studies. 2. The benefit from carotid surgery for patients with high-grade carotid stenosis and transient ischemic attack has been convincingly demonstrated by several studies. In asymptomatic patients, however, desobliteration of the carotid artery remains controversial. The identification of asymptomatic cases with compromised CVRC probably contributes to the recognition of patients with a high risk of suffering hemodynamic stroke. 3. In vascular dementia, cerebral blood flow measurements at rest alone have not been useful. CVRC measurements may offer a diagnostic advance in this still not well understood disease. (orig.) [Deutsch] Die Erkennung von Patientengruppen mit besonderer Schlaganfallgefaehrdung, die von konservativen wie chirurgischen Massnahmen profitieren wuerden, ist von hoechster klinischer Relevanz. Mit der Bestimmung der zerebrovaskulaeren Reservekapazitaet (CVRC) mit Acetazolamid besitzen wir einen funktionellen Parameter der zerebralen Haemodynamik, der eine Risikoabschaetzung bezueglich eines Schlaganfalls fuer folgende Indikationen erwarten laesst: 1. Bei Patienten mit einem Karotisverschluss konnte von verschiedenen Arbeitsgruppen gezeigt werden, dass sich

Finding the Words: Medical Students' Reflections on Communication Challenges in Clinic.

Science.gov (United States)

Braverman, Genna; Bereknyei Merrell, Sylvia; Bruce, Janine S; Makoul, Gregory; Schillinger, Erika

2016-11-01

Interpersonal communication is essential to providing excellent patient care and requires ongoing development. Although aspects of medical student interpersonal communication may degrade throughout career progression, it is unknown what specific elements pose challenges. We aimed to characterize clerkship students' perspectives on communication challenges in the outpatient setting to help inform curricular development. Third-year medical students in a required family medicine clerkship were asked to describe a communication challenge they encountered. Open-ended written responses were collected through a mandatory post-clerkship survey. Responses were qualitatively coded using an a priori framework for teaching and assessing communication skills (The SEGUE Framework for Teaching and Assessing Communication Skills) with data-derived additions to the framework, followed by a team-based thematic analysis. We collected 799 reflections written by 518 students from 2007-2014. Three dominant themes emerged from the analysis: challenges with (1) effectively exchanging information with patients, (2) managing emotional aspects of the patient encounter, and (3) negotiating terms of the encounter. Communication curricula focus on content and process of the medical interview, but insufficient time and energy are devoted to psychosocial factors, including aspects of the encounter that are emotionally charged or conflicting. While gaps in students' communication skillsets may be anticipated or observed by educators, this study offers an analysis of students' own perceptions of the challenges they face.

Drugs in Afghanistan: The Challenges With Implementing U.S. Strategy

National Research Council Canada - National Science Library

Liddell, David J

2008-01-01

... the Islamic faith hostage to advance its cause These diametrically opposing views are certain to challenge this country for years to come, requiring our nation to carefully assess threats and judiciously...

Innovative approaches for addressing old challenges in component importance measures

International Nuclear Information System (INIS)

Rocco S, Claudio M.; Ramirez-Marquez, Jose Emmanuel

2012-01-01

Importance measures (IM) are component related indices that allow assessing how a component in a system affects one or more system level performance functions. While several IM have been presented in the literature, challenges still remain with respect to the following: (1) multiple ranking—multiple perspective, (2) multi-component importance and, (3) multi-function importance. To address these challenges, this paper proposes set of innovative solutions based on several available techniques: Hasse diagram, Copeland score and Multi-objective optimization. As such, the purpose of this research is twofold: first propose solutions and second foster new research to address these challenges. Each of the proposed solutions is exemplified with a working example.

Safety assessment of RF and microwave radiation emitted by the mobile telephone base station (MTBS) in Malaysia: experience and challenge

International Nuclear Information System (INIS)

Roha Tukimin; Rozaimah Abd Rahim; Mohamad Amirul Nizam; Mohd Yusof Mohd Ali

2007-01-01

Non-ionising radiation (NIR) is known to be hazardous if the amount received is excessive. It is a fact that NIR, including extremely low frequency (ELF) electromagnetic fields, radiofrequency (RF) and microwave radiation can be found almost everywhere generated by both natural and man-made source. This is due to increase in demand for telecommunication and wireless technology which is become very important and as part of our lives. However, the widespread of the relevant technology contributed more NIR man-made sources exposure to the human. Due to public concern their potential of causing such health hazard, members of public and companies approached and request NIR Group of Nuclear Malaysia to carry out surveys and safety assessments of radiofrequency and microwave radiation emitted by the mobile telephone base station (MTBS) erected near the residential area or installed on the rooftop of the commercial building. Objective of the survey was to assess the presence of radiofrequency and microwave radiation and to identify radiation level which may lead to significant personnel exposure. Findings of the survey was compared to the standard guidelines issued by Malaysian Communication and Multimedia Commission (MCMC) and International Committee on Non-Ionising Radiation Protection (ICNIRP). This paper highlights the works that had been carried out by NIR Group of Nuclear Malaysia from 1997 to 2007. We will share the experience and challenge in carried out the NIR safety assessment at mobile telephone base station. Results of the assessment work will be used to develop non-ionising radiation database for future reference in Malaysia. (Author)

Using Beta-Version mHealth Technology for Team-Based Care Management to Support Stroke Prevention: An Assessment of Utility and Challenges.

Science.gov (United States)

Ramirez, Magaly; Wu, Shinyi; Ryan, Gery; Towfighi, Amytis; Vickrey, Barbara G

2017-05-23

Beta versions of health information technology tools are needed in service delivery models with health care and community partnerships to confirm the key components and to assess the performance of the tools and their impact on users. We developed a care management technology (CMT) for use by community health workers (CHWs) and care managers (CMs) working collaboratively to improve risk factor control among recent stroke survivors. The CMT was expected to enhance the efficiency and effectiveness of the CHW-CM team. The primary objective was to describe the Secondary Stroke Prevention by Uniting Community and Chronic Care Model Teams Early to End Disparities (SUCCEED) CMT and investigate CM and CHW perceptions of the CMT's usefulness and challenges for team-based care management. We conducted qualitative interviews with all users of the beta-version SUCCEED CMT, namely two CMs and three CHWs. They were asked to demonstrate and describe their perceptions of the CMT's ease of use and usefulness for completing predefined key care management activities. They were also probed about their general perceptions of the CMT's information quality, ease of use, usefulness, and impact on CM and CHW roles. Interview transcripts were coded using a priori codes. Coded excerpts were grouped into broader themes and then related in a conceptual model of how the CMT facilitated care management. We also conducted a survey with 14 patients to obtain their perspective on CHW tablet use during CHW-patient interactions. Care managers and community health workers expressed that the CMT helped them keep track of patient interactions and plan their work. It guided CMs in developing and sharing care plans with CHWs. For CHWs, the CMT enabled electronic collection of clinical assessment data, provided decision support, and provided remote access to patients' risk factor values. Long loading times and downtimes due to outages were the most significant challenges encountered. Additional issues

Challenges experienced by debt counsellors in Gauteng

Directory of Open Access Journals (Sweden)

Kgomotso Masilo

2015-09-01

Full Text Available Gauteng, Province of South Africa is experiencing a decreasing number of registered and practising debt counsellors. This paper investigates and assesses the challenges that debt counsellors in Gauteng experiences. Fifteen debt counsellors from three municipalities of Gauteng were interviewed. Data was analysed using ATLAS ti. The paper concluded that though debt counsellors are complying with the regulations in rendering debt counselling service, they still had challenges regarding backlogs in debt review. The paper recommends that debt counsellors should be adequately trained and should restructure their rehabilitation methods on the one hand and the National Credit Regulator should monitor debt counsellors’ practices and assist them with their queries on the other hand.

Challenging behavior and co-morbid psychopathology in adults with intellectual disability and autism spectrum disorders.

Science.gov (United States)

McCarthy, Jane; Hemmings, Colin; Kravariti, Eugenia; Dworzynski, Katharina; Holt, Geraldine; Bouras, Nick; Tsakanikos, Elias

2010-01-01

We investigated the relationship between challenging behavior and co-morbid psychopathology in adults with intellectual disability (ID) and autism spectrum disorders (ASDs) (N=124) as compared to adults with ID only (N=562). All participants were first time referrals to specialist mental health services and were living in community settings. Clinical diagnoses were based on ICD-10 criteria and presence of challenging behavior was assessed with the Disability Assessment Schedule (DAS-B). The analyses showed that ASD diagnosis was significantly associated with male gender, younger age and lower level of ID. Challenging behavior was about four times more likely in adults with ASD as compared to non-ASD adults. In those with challenging behavior, there were significant differences in co-morbid psychopathology between ASD and non-ASD adults. However, after controlling for level of ID, gender and age, there was no association between co-morbid psychopathology and presence of challenging behavior. Overall, the results suggest that presence of challenging behavior is independent from co-morbid psychopathology in adults with ID and ASD. Copyright 2009 Elsevier Ltd. All rights reserved.

Sulfonamide inhibition studies of two β-carbonic anhydrases from the ascomycete fungus Sordaria macrospora, CAS1 and CAS2.

Science.gov (United States)

Vullo, Daniela; Lehneck, Ronny; Pöggeler, Stefanie; Supuran, Claudiu T

2018-12-01

The two β-carbonic anhydrases (CAs, EC 4.2.1.1) recently cloned and purified from the ascomycete fungus Sordaria macrospora, CAS1 and CAS2, were investigated for their inhibition with a panel of 39 aromatic, heterocyclic, and aliphatic sulfonamides and one sulfamate, many of which are clinically used agents. CAS1 was efficiently inhibited by tosylamide, 3-fluorosulfanilamide, and 3-chlorosulfanilamide (K I s in the range of 43.2-79.6 nM), whereas acetazolamide, methazolamide, topiramate, ethoxzolamide, dorzolamide, and brinzolamide were medium potency inhibitors (K I s in the range of 360-445 nM). CAS2 was less sensitive to sulfonamide inhibitors. The best CAS2 inhibitors were 5-amino-1,3,4-thiadiazole-2-sulfonamide (the deacetylated acetazolamide precursor) and 4-hydroxymethyl-benzenesulfonamide, with K I s in the range of 48.1-92.5 nM. Acetazolamide, dorzolamide, ethoxzolamide, topiramate, sulpiride, indisulam, celecoxib, and sulthiame were medium potency CAS2 inhibitors (K I s of 143-857 nM). Many other sulfonamides showed affinities in the high micromolar range or were ineffective as CAS1/2 inhibitors. Small changes in the structure of the inhibitor led to important differences of the activity. As these enzymes may show applications for the removal of anthropically generated polluting gases, finding modulators of their activity may be crucial for designing environmental-friendly CO 2 capture processes.

Cisterna magna microdialysis of 22Na to evaluate ion transport and cerebrospinal fluid dynamics

International Nuclear Information System (INIS)

Knuckey, N.W.; Fowler, A.G.; Johanson, C.E.; Nashold, J.R.; Epstein, M.H.

1991-01-01

Microdialysis is used in vivo for measuring compounds in brain interstitial fluid. The authors describe another application of this technique to the central nervous system, namely microprobe dialysis in the cisterna magna to study the dynamics of ion transport and cerebrospinal fluid (CSF) formation in the rat. The choroid plexus is the major source of CSF, which is produced by active transport of Na from blood into the cerebral ventricles. Formation of CSF is directly proportional to the blood-to-CSF transport of Na. By injecting 22 Na into the systemic circulation and quantifying its movement into CSF by microdialysis, one can reliably estimate alterations in the rate of CSF formation. The sensitivity of this system was determined by administering acetazolamide, a standard inhibitor of CSF production. Because acetazolamide is known to decrease CSF formation by 40% to 50%, the cisternal microdialysis system in animals treated with this drug should detect a corresponding decrease in the amount of 22 Na dialyzed. This hypothesis is supported by the 22 Na uptake curves for control versus treated animals: that is, by the acetazolamide-induced average diminution of about 45% in both the rate and extent of tracer accession to dialysate. Bumetanide, a loop diuretic, reduced by 30% the 22 Na entry into dialysate. Microprobe dialysis of fluid in the cisterna magna is thus a minimally invasive and economical method for evaluating effects of drugs and hormones on the choroid plexus-CSF system

Tackling Dependency: The EU and its Energy Security Challenges

Energy Technology Data Exchange (ETDEWEB)

Larsson, Robert L

2007-10-15

Europe is facing a future of augmenting energy demands, domestic depletion, high prices and other energy-political challenges. Climate change, infrastructure resilience, producers' coercive energy policy and the EU's internal market failures have put stress on the EU's emerging energy policy and inspired the union to address its challenges with greater enthusiasm than before. Some of the EU's challenges call for strategic choices of a magnitude that EU is not used to handle. The aim of this report is therefore to identify, analyse and assess the political side of Europe's energy predicament and import dependency. Against the background of increasing dependence on energy imports, the report tries to answer questions: what are the key dimensions of Europe's energy security and what are their consequences?

Tackling Dependency: The EU and its Energy Security Challenges

International Nuclear Information System (INIS)

Larsson, Robert L.

2007-10-01

Europe is facing a future of augmenting energy demands, domestic depletion, high prices and other energy-political challenges. Climate change, infrastructure resilience, producers' coercive energy policy and the EU's internal market failures have put stress on the EU's emerging energy policy and inspired the union to address its challenges with greater enthusiasm than before. Some of the EU's challenges call for strategic choices of a magnitude that EU is not used to handle. The aim of this report is therefore to identify, analyse and assess the political side of Europe's energy predicament and import dependency. Against the background of increasing dependence on energy imports, the report tries to answer questions: what are the key dimensions of Europe's energy security and what are their consequences?

The Diagnosis of Delirium Superimposed on Dementia: An Emerging Challenge

Science.gov (United States)

Morandi, Alessandro; Davis, Daniel; Bellelli, Giuseppe; Arora, Rakesh C.; Caplan, Gideon A.; Kamholz, Barbara; Kolanowski, Ann; Fick, Donna Marie; Kreisel, Stefan; MacLullich, Alasdair; (UK), MRCP; Meagher, David; Neufeld, Karen; Pandharipande, Pratik P.; Richardson, Sarah; Slooter, Arjen J.C.; Taylor, John P.; Thomas, Christine; Tieges, Zoë; Teodorczuk, Andrew; Voyer, Philippe; Rudolph, James L.

2017-01-01

Delirium occurring in patients with dementia is referred to as delirium superimposed on dementia (DSD). People who are older with dementia and who are institutionalized are at increased risk of developing delirium when hospitalized. In addition, their prior cognitive impairment makes detecting their delirium a challenge. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and the International Statistical Classification of Diseases and Related Health Problems, 10th Revision are considered the standard reference for the diagnosis of delirium and include criteria of impairments in cognitive processes such as attention, additional cognitive disturbances, or altered level of arousal. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and the International Statistical Classification of Diseases and Related Health Problems, 10th Revision does not provide guidance regarding specific tests for assessment of the cognitive process impaired in delirium. Importantly, the assessment or inclusion of preexisting cognitive impairment is also not addressed by these standards. The challenge of DSD gets more complex as types of dementia, particularly dementia with Lewy bodies, which has features of both delirium and dementia, are considered. The objective of this article is to critically review key elements for the diagnosis of DSD, including the challenge of neuropsychological assessment in patients with dementia and the influence of particular tests used to diagnose DSD. To address the challenges of DSD diagnosis, we present a framework for guiding the focus of future research efforts to develop a reliable reference standard to diagnose DSD. A key feature of a reliable reference standard will improve the ability to clinically diagnose DSD in facility-based patients and research studies. PMID:27650668

Quantifying the ventilatory control contribution to sleep apnoea using polysomnography.

Science.gov (United States)

Terrill, Philip I; Edwards, Bradley A; Nemati, Shamim; Butler, James P; Owens, Robert L; Eckert, Danny J; White, David P; Malhotra, Atul; Wellman, Andrew; Sands, Scott A

2015-02-01

Elevated loop gain, consequent to hypersensitive ventilatory control, is a primary nonanatomical cause of obstructive sleep apnoea (OSA) but it is not possible to quantify this in the clinic. Here we provide a novel method to estimate loop gain in OSA patients using routine clinical polysomnography alone. We use the concept that spontaneous ventilatory fluctuations due to apnoeas/hypopnoeas (disturbance) result in opposing changes in ventilatory drive (response) as determined by loop gain (response/disturbance). Fitting a simple ventilatory control model (including chemical and arousal contributions to ventilatory drive) to the ventilatory pattern of OSA reveals the underlying loop gain. Following mathematical-model validation, we critically tested our method in patients with OSA by comparison with a standard (continuous positive airway pressure (CPAP) drop method), and by assessing its ability to detect the known reduction in loop gain with oxygen and acetazolamide. Our method quantified loop gain from baseline polysomnography (correlation versus CPAP-estimated loop gain: n=28; r=0.63, p<0.001), detected the known reduction in loop gain with oxygen (n=11; mean±sem change in loop gain (ΔLG) -0.23±0.08, p=0.02) and acetazolamide (n=11; ΔLG -0.20±0.06, p=0.005), and predicted the OSA response to loop gain-lowering therapy. We validated a means to quantify the ventilatory control contribution to OSA pathogenesis using clinical polysomnography, enabling identification of likely responders to therapies targeting ventilatory control. Copyright ©ERS 2015.

Chaos: Challenges from and to socio-spatial form and policy

Directory of Open Access Journals (Sweden)

Dimitrios S. Dendrinos

1997-01-01

Full Text Available A brief assessment is given of the major accomplishments made through the mathematics of chaos to the understanding of socio-spatial dynamics to date. Certain shortfalls are also presented, mostly associated with model testing and falsifiability which transcend socio-spatial dynamics. Beyond such shortcomings, lie an array of challenges for chaotic dynamics involving specifically socio-spatial form and policy. A few directions on meeting these challenges are suggested including the case of limited chaos.

Challenges in diabetes mellitus type 2 management in Nepal

DEFF Research Database (Denmark)

Gyawali, Bishal; Ferrario, Alessandra; van Teijlingen, Edwin

2016-01-01

references. Results Diabetes mellitus type 2 is emerging as a major health care problem in Nepal, with rising prevalence and its complications especially in urban populations. Several challenges in diabetes management were identified, including high cost of treatment, limited health care facilities, and lack...... on the prevalence, cost and treatment of diabetes mellitus type 2 and its complications in Nepal and to critically assess the challenges to be addressed to contain the epidemic and its negative economic impact. Design A comprehensive review of available evidence and data sources on prevalence, risk factors, cost...

New directions and challenges for the O&M committee

Energy Technology Data Exchange (ETDEWEB)

Pelletier, J.P.

1996-12-01

In the second half of the decade of the nineties, the imperative of finding new ways to improve efficiency while maintaining safety is taking on a new urgency. The looming deregulation of the electric industry and the expected competition in the power production business fuels this urgency. The recently completed ASME research in the area of Risk-Based Inservice Testing offers the Operations and Maintenance (O&M) Committee an opportunity to meet this challenge. This opportunity, however, offers its own challenges. New ways of thinking about inservice testing and new technical skills will be needed to successfully incorporate this technology into Code documents. It will not be adequate to rely solely on incorporation of risk-based methods into the Code to meet this challenge. A thorough self assessment of what O&M does, how it is done, and the value added will help assure that the directions which are pursued do, indeed, meet the challenge ahead.

Challenging the assumptions for thermal sensation scales

DEFF Research Database (Denmark)

Schweiker, Marcel; Fuchs, Xaver; Becker, Susanne

2016-01-01

Scales are widely used to assess the personal experience of thermal conditions in built environments. Most commonly, thermal sensation is assessed, mainly to determine whether a particular thermal condition is comfortable for individuals. A seven-point thermal sensation scale has been used...... extensively, which is suitable for describing a one-dimensional relationship between physical parameters of indoor environments and subjective thermal sensation. However, human thermal comfort is not merely a physiological but also a psychological phenomenon. Thus, it should be investigated how scales for its...... assessment could benefit from a multidimensional conceptualization. The common assumptions related to the usage of thermal sensation scales are challenged, empirically supported by two analyses. These analyses show that the relationship between temperature and subjective thermal sensation is non...

78 FR 49296 - Centennial Challenges 2014 Sample Return Robot Challenge

Science.gov (United States)

2013-08-13

... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice 13-093] Centennial Challenges 2014 Sample... Centennial Challenges 2014 Sample Return Robot Challenge. SUMMARY: This notice is issued in accordance with... compete may register. Centennial Challenges is a program of prize competitions to stimulate innovation in...

Using Challenging Tasks for Formative Assessment on Quadratic Functions with Senior Secondary Students

Science.gov (United States)

Wilkie, Karina J.

2016-01-01

Senior secondary mathematics students who develop conceptual understanding that moves them beyond "rules without reasons" to connections between related concepts are in a strong place to tackle the more difficult mathematics application problems. Current research is examining how the use of challenging tasks at different levels of…

Challenges in relation to assessment of prior learning

DEFF Research Database (Denmark)

Wahlgren, Bjarne; Aarkrog, Vibe

2013-01-01

The paper deals about preliminary results from an on-going project: “From unskilled worker to skilled worker in record time”. The aim of the project is to qualify unskilled workers for skilled positions in record time by drafting up a plan for the training based on assessment of the students’ (the....... Observations and or with the students about the students’ workplace based experiences and learning and 2. Drafting up an individual study plan based on the individual student’s prior learning....

The Mock LISA Data Challenges: from Challenge 1B to Challenge 3

International Nuclear Information System (INIS)

Babak, Stanislav; Porter, Edward K; Gair, Jonathan; Baker, John G; Arnaud, Keith; Benacquista, Matthew J; Cornish, Neil J; Crowder, Jeff; Vallisneri, Michele; Cutler, Curt; Larson, Shane L; Plagnol, Eric; Vecchio, Alberto; Barack, Leor; Blaut, Arkadiusz; Fairhurst, Stephen; Harry, Ian; Gong Xuefei; Khurana, Deepak; Krolak, Andrzej

2008-01-01

The Mock LISA Data Challenges are a programme to demonstrate and encourage the development of LISA data-analysis capabilities, tools and techniques. At the time of this workshop, three rounds of challenges had been completed, and the next was about to start. In this paper we provide a critical analysis of the entries to the latest completed round, Challenge 1B. The entries confirm the consolidation of a range of data-analysis techniques for galactic and massive-black-hole binaries, and they include the first convincing examples of detection and parameter estimation of extreme-mass-ratio inspiral sources. In this paper we also introduce the next round, Challenge 3. Its data sets feature more realistic waveform models (e.g., galactic binaries may now chirp, and massive-black-hole binaries may precess due to spin interactions), as well as new source classes (bursts from cosmic strings, isotropic stochastic backgrounds) and more complicated nonsymmetric instrument noise

Meeting CCS communication challenges head-on: Integrating communications, planning, risk assessment, and project management

Science.gov (United States)

Greenberg, S.; Gauvreau, L.; Hnottavange-Telleen, K.; Finley, R.; Marsteller, S.

2011-01-01

The Midwest Geological Sequestration Consortium, Schlumberger Carbon Services, and Archer Daniels Midland has implemented a comprehensive communications plan at the Illinois Basin - Decatur Project (IBDP), a one million metric tonne Carbon Capture and Storage project in Decatur, IL, USA funded by the U.S. Department of Energy's National Energy Technology Laboratory. The IBDP Communication Plan includes consortium information, funding and disclaimer citations, description of target audiences, media communications guidelines, paper and presentations guidelines, site visit information, crisis communication, on-site photography regulations, and other components. The creation, development, and implementation processes for the IBDP Communication Plan (the Plan) are shared in this paper. New communications challenges, such as how to address add-on research requests, data sharing and management, scope increase, and contract agreements have arisen since the Plan was completed in January 2009, resulting in development of new policies and procedures by project management. Integrating communications planning, risk assessment, and project management ensured that consistent, factual information was developed and incorporated into project planning, and constitutes the basis of public communications. Successful integration has allowed the IBDP to benefit from early identification and mitigation of the potential project risks, which allows more time to effectively deal with unknown and unidentified risks that may arise. Project risks and risks associated with public perception can be managed through careful planning and integration of communication strategies into project management and risk mitigation. ?? 2011 Published by Elsevier Ltd.

The skin in psoriasis: assessment and challenges.

Science.gov (United States)

Oji, Vinzenz; Luger, Thomas A

2015-01-01

The coexistence of psoriasis arthritis (PsA) and psoriasis vulgaris in about 20% of patients with psoriasis leads to a need for rheumatologic-dermatologic team work. We summarise the role of dermatologists in assessment of the skin in psoriasis. Chronic plaque psoriasis must be differentiated from other subtypes such as generalised pustular psoriasis (GPP) or palmoplantar pustulosis (PPP). Therapeutic management is based on the evaluation of the disease severity. Quantitative scoring of skin severity includes calculation of the Psoriasis Area and Severity Index (PASI), body surface area (BSA) as well as the Dermatology Life Quality Index (DLQI). These scoring systems do not replace the traditional dermatologic medical history and physical examination of the patient. The skin should be examined for additional skin diseases; moreover, patients should be monitored for comorbidity, most importantly PsA and cardiovascular comorbidity.

Challenging Authority During an Emergency-the Effect of a Teaching Intervention.

Science.gov (United States)

Friedman, Zeev; Perelman, Vsovolod; McLuckie, Duncan; Andrews, Meghan; Noble, Laura M K; Malavade, Archana; Bould, M Dylan

2017-08-01

Previous research has shown that residents were unable to effectively challenge a superior's wrong decision during a crisis situation, a problem that can contribute to preventable mortality. We aimed to assess whether a teaching intervention enabled residents to effectively challenge clearly wrong clinical decisions made by their staff. Following ethics board approval, second year residents were randomized to a teaching intervention targeting cognitive skills needed to challenge a superior's decision, or a control group receiving general crisis management instruction. Two weeks later, subjects participated in a simulated crisis that presented them with opportunities to challenge clearly wrong decisions in a can't-intubate-can't-ventilate scenario. It was only disclosed that the staff was a confederate during the debriefing. Performances were video recorded and assessed by two raters blinded to group allocation using the modified Advocacy-Inquiry Score. Fifty residents completed the study. The interrater reliability of the modified Advocacy-Inquiry Scores (intraclass correlation coefficient = 0.87) was excellent. The median (interquartile range) best modified Advocacy-Inquiry Score was significantly better in the intervention group 5.0 (4.50-5.62 [4-6]) than in the control group 3.5 (3.0-4.75 [3-6]) (p authority during a life-threatening crisis situation. This educational gap can have significant implications for patients' safety.

Tackling Dependency: The EU and its Energy Security Challenges

Energy Technology Data Exchange (ETDEWEB)

Larsson, Robert L.

2007-10-15

Europe is facing a future of augmenting energy demands, domestic depletion, high prices and other energy-political challenges. Climate change, infrastructure resilience, producers' coercive energy policy and the EU's internal market failures have put stress on the EU's emerging energy policy and inspired the union to address its challenges with greater enthusiasm than before. Some of the EU's challenges call for strategic choices of a magnitude that EU is not used to handle. The aim of this report is therefore to identify, analyse and assess the political side of Europe's energy predicament and import dependency. Against the background of increasing dependence on energy imports, the report tries to answer questions: what are the key dimensions of Europe's energy security and what are their consequences?

Organizing a Community "Biggest Loser" Weight Loss Challenge

Science.gov (United States)

Jensen, Kirstin D.

2013-01-01

The program described here shows how Extension can be a strong collaborative partner in a rural setting in improving the overall health of the community by organizing a three month "Biggest Loser" Weight Loss Challenge. A pre-and post-fitness assessment and bi-weekly weigh-ins were administered. Three healthy lifestyle educational…

New Challenges in 21st-Century Dance Education

Science.gov (United States)

Kassing, Gayle

2010-01-01

To become competent in today's society, individuals need multiliteracies. The 21st-century dancer needs to be an artist, choreographer, educator, and researcher who can meet challenges and make an impact within the profession, as well as across education, the arts, and society. As dance professionals assess how to utilize their resources better…

Needs and challenges for assessing the environmental impacts of engineered nanomaterials (ENMs)

Science.gov (United States)

Romero-Franco, Michelle; Godwin, Hilary A; Bilal, Muhammad

2017-01-01

The potential environmental impact of nanomaterials is a critical concern and the ability to assess these potential impacts is top priority for the progress of sustainable nanotechnology. Risk assessment tools are needed to enable decision makers to rapidly assess the potential risks that may be imposed by engineered nanomaterials (ENMs), particularly when confronted by the reality of limited hazard or exposure data. In this review, we examine a range of available risk assessment frameworks considering the contexts in which different stakeholders may need to assess the potential environmental impacts of ENMs. Assessment frameworks and tools that are suitable for the different decision analysis scenarios are then identified. In addition, we identify the gaps that currently exist between the needs of decision makers, for a range of decision scenarios, and the abilities of present frameworks and tools to meet those needs. PMID:28546894

Needs and challenges for assessing the environmental impacts of engineered nanomaterials (ENMs

Directory of Open Access Journals (Sweden)

Michelle Romero-Franco

2017-05-01

Full Text Available The potential environmental impact of nanomaterials is a critical concern and the ability to assess these potential impacts is top priority for the progress of sustainable nanotechnology. Risk assessment tools are needed to enable decision makers to rapidly assess the potential risks that may be imposed by engineered nanomaterials (ENMs, particularly when confronted by the reality of limited hazard or exposure data. In this review, we examine a range of available risk assessment frameworks considering the contexts in which different stakeholders may need to assess the potential environmental impacts of ENMs. Assessment frameworks and tools that are suitable for the different decision analysis scenarios are then identified. In addition, we identify the gaps that currently exist between the needs of decision makers, for a range of decision scenarios, and the abilities of present frameworks and tools to meet those needs.

75 FR 47316 - Centennial Challenges 2010 Strong Tether Challenge

Science.gov (United States)

2010-08-05

... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION Centennial Challenges 2010 Strong Tether Challenge... teams that wish to compete may register. Centennial Challenges is a program of prize competitions to..., please visit: http://www.spaceward.org/elevator2010-ts . For general information on the NASA Centennial...

Navigation safety and risk assessment challenges in the High North

DEFF Research Database (Denmark)

Marchenko, N.A.; Borch, O.J.; Andreassen, N.

2017-01-01

marine accidents. Therefore, in this study a mostly qualitative analysis and expert judgement is the basis for the risk assessments. Implications for the emergency preparedness system of the region are discussed. The consequences of incidents depend on the incident type, scale and location,....... In this paper we look into the risks of accidents in the Atlantic Arctic based on previous ship accidents and the changes in maritime activity. The risk has to be assessed to ensure a proper level of response in emergency situations. As accidents are rare, there are limited statistics available for Arctic...

Scientific Grand Challenges: Challenges in Climate Change Science and the Role of Computing at the Extreme Scale

Energy Technology Data Exchange (ETDEWEB)

Khaleel, Mohammad A.; Johnson, Gary M.; Washington, Warren M.

2009-07-02

The U.S. Department of Energy (DOE) Office of Biological and Environmental Research (BER) in partnership with the Office of Advanced Scientific Computing Research (ASCR) held a workshop on the challenges in climate change science and the role of computing at the extreme scale, November 6-7, 2008, in Bethesda, Maryland. At the workshop, participants identified the scientific challenges facing the field of climate science and outlined the research directions of highest priority that should be pursued to meet these challenges. Representatives from the national and international climate change research community as well as representatives from the high-performance computing community attended the workshop. This group represented a broad mix of expertise. Of the 99 participants, 6 were from international institutions. Before the workshop, each of the four panels prepared a white paper, which provided the starting place for the workshop discussions. These four panels of workshop attendees devoted to their efforts the following themes: Model Development and Integrated Assessment; Algorithms and Computational Environment; Decadal Predictability and Prediction; Data, Visualization, and Computing Productivity. The recommendations of the panels are summarized in the body of this report.

ASSESSMENT OF BENZOPHENANTHRIDINE AND PROTOPINE ALKALOIDS IN BROILER CHALLENGED AND NOT BY SALMONELLA HEIDELBERG

Directory of Open Access Journals (Sweden)

PFG Previato do Amaral

Full Text Available ABSTRACT Salmonellosis is a globally important zoonosis, and Salmonella Heidelberg is one of the most prevalent serovars in poultry production worldwide, as well as in food poisoning cases. Antimicrobial drugs were previously widely used to face health challenges in animal production; however, since their ban as performance enhancers, many alternative strategies have been proposed. One of these strategies is the use of plant extracts, such as those containing the alkaloids benzophenanthridine and protopine. These compounds have antimicrobial, anti-inflammatory, immunomodulation, and nutritional effects. The objective of the present study was to evaluate the effects of the supply of a product containing benzophenanthridine and protopine (Sangrovit(rWS 100 g/1000 L of drinking water to broilers during different rearing periods 1-21, 1-6 and 6-21 days of age challenged or not with Salmonella Heidelberg at six days of age. There was no effect of the product on the performance, jejunal morphometry, cecal goblet cell counts, or control of Salmonella spp. in broilers challenged or not with Salmonella Heidelberg. However, the group receiving the alkaloids from 1 to 21 days of age, compared with the control group, presented a numerical difference of 28 points in productive efficiency index, which directly impacts live production cost of live broiler, representing savings of R$ 0.11/kg of meat produced.

Serum Antibodies Protect against Intraperitoneal Challenge with Enterotoxigenic Escherichia coli

Directory of Open Access Journals (Sweden)

Xinghong Yang

2011-01-01

Full Text Available To assess whether anticolonization factor antigen I (CFA/I fimbriae antibodies (Abs from enterotoxigenic Escherichia coli (ETEC can protect against various routes of challenge, BALB/c mice were immunized with a live attenuated Salmonella vaccine vector expressing CFA/I fimbriae. Vaccinated mice elicited elevated systemic IgG and mucosal IgA Abs, unlike mice immunized with the empty Salmonella vector. Mice were challenged with wild-type ETEC by the oral, intranasal (i.n., and intraperitoneal (i.p. routes. Naïve mice did not succumb to oral challenge, but did to i.n. challenge, as did immunized mice; however, vaccinated mice were protected against i.p. ETEC challenge. Two intramuscular (i.m. immunizations with CFA/I fimbriae without adjuvant conferred 100% protection against i.p. ETEC challenge, while a single 30 μg dose conferred 88% protection. Bactericidal assays showed that ETEC is highly sensitive to anti-CFA/I sera. These results suggest that parenteral immunization with purified CFA/I fimbriae can induce protective Abs and may represent an alternative method to elicit protective Abs for passive immunity to ETEC.

Rethinking and Restructuring an Assessment System via Effective Deployment of Technology

Science.gov (United States)

Okonkwo, Charity

2010-01-01

Every instructional process involves a strategic assessment system for a complete teaching-learning circle. Assessment system which is seriously challenged calls for a change in the approach. The National Open University of Nigeria (NOUN) assessment system at present is challenged. The large number of students and numerous courses offered by NOUN…

The economic effect and outcome of delaying oral food challenges.

Science.gov (United States)

Couch, Christopher; Franxman, Tim; Greenhawt, Matthew

2016-05-01

Food specific IgE (sIgE) is a useful marker to assess predictability of oral food challenge (OFC) outcome. A threshold of less than 2 kUA/L for peanut, egg, and milk has been proposed as a 50% negative predictive value at which patients may pass an OFC. To assess the economic effect and outcome of delaying OFCs. A retrospective analysis was performed for peanut, egg, and milk OFCs conducted between 2001 and 2012 at a tertiary food allergy referral center. Delayed OFC was defined as greater than 12 months from the time the sIgE level became less than 2 kUA/L. Time to OFC was explored in association with skin prick test result (wheal size), OFC outcome, and the economic effect of delay. Of 319 challenges, 173 OFCs were delayed (54.2%) by a mean time of 35.5 months (range, 13-123 months) vs a mean time of 4.2 months in the 146 challenges that were not delayed (P care system. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Competencies, skills and assessment

DEFF Research Database (Denmark)

Højgaard, Tomas

2009-01-01

This paper is an analysis of the challenge of assessing student learning and how that is affected by using descriptions of competencies as a core element when describing the aims of the learning process. Assessment is modelled as a three step process; characterising, identifying and judging, to a...

Critical Assessment of Metagenome Interpretation

DEFF Research Database (Denmark)

Sczyrba, Alexander; Hofmann, Peter; Belmann, Peter

2017-01-01

Methods for assembly, taxonomic profiling and binning are key to interpreting metagenome data, but a lack of consensus about benchmarking complicates performance assessment. The Critical Assessment of Metagenome Interpretation (CAMI) challenge has engaged the global developer community to benchma...

The Mock LISA Data Challenges: from challenge 3 to challenge 4

International Nuclear Information System (INIS)

Babak, Stanislav; Petiteau, Antoine; Robinson, Emma L; Baker, John G; McWilliams, Sean T; Arnaud, Keith A; Benacquista, Matthew J; Cornish, Neil J; Adams, Matt; Larson, Shane L; Mandel, Ilya; Porter, Edward K; Vallisneri, Michele; Cutler, Curt; Vecchio, Alberto; Blaut, Arkadiusz; Bridges, Michael; Feroz, Farhan; Cohen, Michael; Gair, Jonathan R.

2010-01-01

The Mock LISA Data Challenges are a program to demonstrate LISA data-analysis capabilities and to encourage their development. Each round of challenges consists of one or more datasets containing simulated instrument noise and gravitational waves from sources of undisclosed parameters. Participants analyze the datasets and report best-fit solutions for the source parameters. Here we present the results of the third challenge, issued in April 2008, which demonstrated the positive recovery of signals from chirping galactic binaries, from spinning supermassive-black-hole binaries (with optimal SNRs between ∼10 and 2000), from simultaneous extreme-mass-ratio inspirals (SNRs of 10-50), from cosmic-string-cusp bursts (SNRs of 10-100), and from a relatively loud isotropic background with Ω gw (f) ∼ 10 -11 , slightly below the LISA instrument noise.

The Mock LISA Data Challenges: from challenge 3 to challenge 4

Energy Technology Data Exchange (ETDEWEB)

Babak, Stanislav; Petiteau, Antoine; Robinson, Emma L [Max-Planck-Institut fuer Gravitationsphysik (Albert-Einstein-Institut), Am Muehlenberg 1, D-14476 Golm bei Potsdam (Germany); Baker, John G; McWilliams, Sean T; Arnaud, Keith A [Gravitational Astrophysics Laboratory, NASA Goddard Space Flight Center, 8800 Greenbelt Rd, Greenbelt, MD 20771 (United States); Benacquista, Matthew J [Center for Gravitational Wave Astronomy, University of Texas at Brownsville, Brownsville, TX 78520 (United States); Cornish, Neil J; Adams, Matt [Department of Physics, Montana State University, Bozeman, MT 59717 (United States); Larson, Shane L [Department of Physics, Utah State University, Logan, UT 84322 (United States); Mandel, Ilya [Department of Physics and Astronomy, Northwestern University, Evanston, IL (United States); Porter, Edward K [APC, UMR 7164, University Paris 7 Denis Diderot, 10, rue Alice Domon et Leonie Duquet, 75025 Paris Cedex 13 (France); Vallisneri, Michele; Cutler, Curt [Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 (United States); Vecchio, Alberto [School of Physics and Astronomy, University of Birmingham, Edgbaston, Birmingham B152TT (United Kingdom); Blaut, Arkadiusz [Institute of Theoretical Physics, University of Wroclaw, Wroclaw (Poland); Bridges, Michael; Feroz, Farhan [Astrophysics Group, Cavendish Laboratory, University of Cambridge, Cambridge CB30HE (United Kingdom); Cohen, Michael [Theoretical Astrophysics, California Institute of Technology, Pasadena, CA 91125 (United States); Gair, Jonathan R., E-mail: Michele.Vallisneri@jpl.nasa.go [Institute of Astronomy, University of Cambridge, Cambridge CB30HA (United Kingdom)

2010-04-21

The Mock LISA Data Challenges are a program to demonstrate LISA data-analysis capabilities and to encourage their development. Each round of challenges consists of one or more datasets containing simulated instrument noise and gravitational waves from sources of undisclosed parameters. Participants analyze the datasets and report best-fit solutions for the source parameters. Here we present the results of the third challenge, issued in April 2008, which demonstrated the positive recovery of signals from chirping galactic binaries, from spinning supermassive-black-hole binaries (with optimal SNRs between approx10 and 2000), from simultaneous extreme-mass-ratio inspirals (SNRs of 10-50), from cosmic-string-cusp bursts (SNRs of 10-100), and from a relatively loud isotropic background with OMEGA{sub gw}(f) approx 10{sup -11}, slightly below the LISA instrument noise.

Assessing social-emotional development in children from a longitudinal perspective.

Science.gov (United States)

Denham, S A; Wyatt, T M; Bassett, H H; Echeverria, D; Knox, S S

2009-01-01

This paper provides an overview of methodological challenges related to the epidemiological assessment of social-emotional development in children. Because population-based studies involve large cohorts and are usually multicentre in structure, they have cost, participant burden and other specific issues that affect the feasibility of the types of measures that can be administered. Despite these challenges, accurate in-depth assessment of social-emotional functioning is crucial, based on its importance to child outcomes like mental health, academic performance, delinquency and substance abuse. Five dimensions of social-emotional development in children are defined: (1) social competence; (2) attachment; (3) emotional competence; (4) self-perceived competence; and (5) temperament/personality. Their measurement in a longitudinal study and associated challenges are discussed. Means of making valid, reliable assessments while at the same time minimising the multiple challenges posed in the epidemiological assessment of social-emotional development in children are reviewed.

Cold air challenge and specific airway resistance in preschool children

DEFF Research Database (Denmark)

Nielsen, Kim Gjerum; Bisgaard, Hans

2005-01-01

prognosis in preschool children. Cold air challenge and plethysmographic measurement of specific airway resistance (sRaw) are feasible candidate methods for diagnosis, clinical monitoring and research during this critical period of lung growth and development. Methodology and practical aspects of cold air...... challenge and assessment of sRaw in preschool children are reviewed. Reference values are provided for sRaw and have allowed discrimination between health and respiratory disease, both in cross-sectional and longitudinal studies. Bronchial hyperresponsiveness can be determined with acceptable repeatability...

Differential effects of allergen challenge on large and small airway reactivity in mice.

Directory of Open Access Journals (Sweden)

Chantal Donovan

Full Text Available The relative contributions of large and small airways to hyperresponsiveness in asthma have yet to be fully assessed. This study used a mouse model of chronic allergic airways disease to induce inflammation and remodelling and determine whether in vivo hyperresponsiveness to methacholine is consistent with in vitro reactivity of trachea and small airways. Balb/C mice were sensitised (days 0, 14 and challenged (3 times/week, 6 weeks with ovalbumin. Airway reactivity was compared with saline-challenged controls in vivo assessing whole lung resistance, and in vitro measuring the force of tracheal contraction and the magnitude/rate of small airway narrowing within lung slices. Increased airway inflammation, epithelial remodelling and fibrosis were evident following allergen challenge. In vivo hyperresponsiveness to methacholine was maintained in isolated trachea. In contrast, methacholine induced slower narrowing, with reduced potency in small airways compared to controls. In vitro incubation with IL-1/TNFα did not alter reactivity. The hyporesponsiveness to methacholine in small airways within lung slices following chronic ovalbumin challenge was unexpected, given hyperresponsiveness to the same agonist both in vivo and in vitro in tracheal preparations. This finding may reflect the altered interactions of small airways with surrounding parenchymal tissue after allergen challenge to oppose airway narrowing and closure.

Precision Medicine and PET/Computed Tomography: Challenges and Implementation.

Science.gov (United States)

Subramaniam, Rathan M

2017-01-01

Precision Medicine is about selecting the right therapy for the right patient, at the right time, specific to the molecular targets expressed by disease or tumors, in the context of patient's environment and lifestyle. Some of the challenges for delivery of precision medicine in oncology include biomarkers for patient selection for enrichment-precision diagnostics, mapping out tumor heterogeneity that contributes to therapy failures, and early therapy assessment to identify resistance to therapies. PET/computed tomography offers solutions in these important areas of challenges and facilitates implementation of precision medicine. Copyright © 2016 Elsevier Inc. All rights reserved.

Multicultural development in human services agencies: challenges and solutions.

Science.gov (United States)

Hyde, Cheryl A

2004-01-01

Comprehensive multicultural organizational development (MCOD) is increasingly necessary in human services agencies. This article presents results from an exploratory study that identified challenges and solutions to MCOD, against the backdrop of daily realities of agency life. The author conducted interviews with 20 consultants and 20 practitioners experienced in MCOD. Qualitative analysis revealed four challenges--socioeconomic environment, organizational dynamics, conceptualization of the change effort, and consultant competence; and four solutions--collaborative environmental relations, leadership development, assessment and planning, and consultant selection. Results suggest the complexities of MCOD and ways that human services agencies can sustain such efforts.

Assessing the strength of cardiac and sympathetic baroreflex controls via transfer entropy during orthostatic challenge

Science.gov (United States)

Porta, Alberto; Marchi, Andrea; Bari, Vlasta; De Maria, Beatrice; Esler, Murray; Lambert, Elisabeth; Baumert, Mathias

2017-05-01

The study assesses the strength of the causal relation along baroreflex (BR) in humans during an incremental postural challenge soliciting the BR. Both cardiac BR (cBR) and sympathetic BR (sBR) were characterized via BR sequence approaches from spontaneous fluctuations of heart period (HP), systolic arterial pressure (SAP), diastolic arterial pressure (DAP) and muscle sympathetic nerve activity (MSNA). A model-based transfer entropy method was applied to quantify the strength of the coupling from SAP to HP and from DAP to MSNA. The confounding influences of respiration were accounted for. Twelve young healthy subjects (20-36 years, nine females) were sequentially tilted at 0°, 20°, 30° and 40°. We found that (i) the strength of the causal relation along the cBR increases with tilt table inclination, while that along the sBR is unrelated to it; (ii) the strength of the causal coupling is unrelated to the gain of the relation; (iii) transfer entropy indexes are significantly and positively associated with simplified causality indexes derived from BR sequence analysis. The study proves that causality indexes are complementary to traditional characterization of the BR and suggests that simple markers derived from BR sequence analysis might be fruitfully exploited to estimate causality along the BR. This article is part of the themed issue `Mathematical methods in medicine: neuroscience, cardiology and pathology'.

E-Assessment: Challenges to the Legitimacy of VET Practitioners and Auditors

Science.gov (United States)

Callan, Victor J.; Johnston, Margaret A.; Clayton, Berwyn; Poulsen, Alison L.

2016-01-01

This research examines what practitioners in vocational education and training (VET) organisations and external auditors judge to be the key issues in the current and future use of e-assessment. Applying the framework of legitimacy theory, the study examined the tensions around the use and growth of e-assessment in training organisations, and…

unilateral idiopathic dilated episcleral vein with secondary open

African Journals Online (AJOL)

TAIBAT OTULANA

episcleral vessels in her left eye with no apparent cause. She later developed ... It can occur as a. 12 ... acetazolamide 250mg thrice daily and drops of 0.5% timolol maleate .... Grishaber MC, Dubler B, Knodel C, Killer HE, Flammer J,. Orgul S.

Making effective links to decision-making: Key challenges for health impact assessment

International Nuclear Information System (INIS)

Elliott, Eva; Francis, Sarah

2005-01-01

This paper draws on an exploratory research study to examine the effectiveness of health impact assessments in Wales. Through the review of five case study health impact assessments the research identified a number of benefits of the process in terms of skills and knowledge development amongst participants. The indirect contributions to decision-making were also evident including the way in which health impact assessment provided useful insights into the local community's perspective and raised awareness about the wider determinants of health. The process was also useful in establishing a dialogue between different stakeholders, which indirectly assisted decision-making and implementation. The direct links between health impact assessment and decision-making were more difficult to trace and this paper puts forward a number of suggestions for making those links more transparent. Suggestions include integrating decision-makers and clarifying the intended links to decision-making at the start of the health impact assessment process. Mainstreaming health impact assessment so that it is triggered as a routine part of all decision-making would help ensure it stands the best chance of informing decisions

Access. Challenge for Change/Societe Nouvelle Number Twelve.

Science.gov (United States)

Prinn, Elizabeth, Ed.; Henaut, Dorothy Todd, Ed.

This issue of Access, the journal issued periodically by Challenge for Change/Societe Nouvelle, contains two groups of articles. The first focuses upon the Skyriver Project, relating how a project was developed which used film and video tape as a means of helping Alaskan communities to assess their own needs and to advocate for themselves the…

Challenges to Native American health care.

Science.gov (United States)

Noren, J; Kindig, D; Sprenger, A

1998-01-01

Native American health care programs face complex and unprecedented challenges resulting from the increased assumption of clinical operations by tribal authorities, shortfalls in Federal funding, modifications in state and Federal health and welfare programs, and intensifying involvement with managed care organizations. These challenges are further complicated by service populations that are increasing at a faster rate than the growth in funding. The authors conducted onsite surveys of 39 Native American health programs in 10 states in order to assess the organizational and management problems they faced. The trend toward transfer of health programs from the Indian Health Service to tribal operation seems likely to continue and accelerate. The survey results indicate that in order for programs to be effective in the long run, they will need to be guided by skilled managers able to adapt to these powerful changes in the health care environment.

Self-Assessment: Challenging Students to Take Charge of Learning

Science.gov (United States)

Harada, Violet H.

2010-01-01

Students are frequently unaware that they hold the power of learning in their own hands. Their ability to figure out what they are doing and where they are heading are crucial keys to consciously applying learning strategies, developing effective work habits, and assessing their own performance. The ability to regulate one's own learning means…

Sudan Investment Climate Assessment

OpenAIRE

World Bank

2009-01-01

This report on Sudan's Investment Climate Assessment (ICA) provides a baseline assessment of challenges to productivity, diversification and inclusion. Chapter 1 describes some of the questions underlying the three issues of competitiveness, diversification and broad-based growth. Chapter 2 analyzes firm performance and competitiveness. Chapter 3 discusses markets and trust. Chapter 4 des...

Data quality and practical challenges of thyroid volume assessment by ultrasound under field conditions - observer errors may affect prevalence estimates of goitre

Directory of Open Access Journals (Sweden)

Torheim Liv E

2010-12-01

Full Text Available Abstract Background The ultrasonographic estimation of thyroid size has been advocated as being more precise than palpation to diagnose goitre. However, ultrasound also requires technical proficiency. This study was conducted among Saharawi refugees, where goitre is highly prevalent. The objectives were to assess the overall data quality of ultrasound measurements of thyroid volume (Tvol, including the intra- and inter-observer agreement, under field conditions, and to describe some of the practical challenges encountered. Methods In 2007 a cross-sectional study of 419 children (6-14 years old and 405 women (15-45 years old was performed on a population of Saharawi refugees with prevalent goitre, who reside in the Algerian desert. Tvol was measured by two trained fieldworkers using portable ultrasound equipment (examiner 1 measured 406 individuals, and examiner 2, 418 individuals. Intra- and inter-observer agreement was estimated in 12 children selected from the study population but not part of the main study. In the main study, an observer error was found in one examiner whose ultrasound images were corrected by linear regression after printing and remeasuring a sample of 272 images. Results The intra-observer agreement in Tvol was higher in examiner 1, with an intraclass correlation coefficient (ICC of 0.97 (95% CI: 0.91, 0.99 compared to 0.86 (95% CI: 0.60, 0.96 in examiner 2. The ICC for inter-observer agreement in Tvol was 0.38 (95% CI: -0.20, 0.77. Linear regression coefficients indicated a significant scaling bias in the original measurements of the AP and ML diameter and a systematic underestimation of Tvol (a product of AP, ML, CC and a constant. The agreement between re-measured and original Tvol measured by ICC (95% CI was 0.76 (0.71, 0.81. The agreement between re-measured and corrected Tvol measured by ICC (95% CI was 0.97 (0.96, 0.97. Conclusions An important challenge when using ultrasound to assess thyroid volume under field

Environmental Assessment of R&D Programmes

DEFF Research Database (Denmark)

Lyhne, Ivar; Byriel, Inger Pihl

2013-01-01

cause severe negative environmental impacts. This paper presents an innovative environmental assessment practice on R&D programmes in Denmark. It reports on the challenges and experiences of assessing the Danish R&D programme ForskEL, which promotes R&D projects within the electricity sector......Despite their important role in shaping the technologies of the future, public research and development (R&D) programmes are rarely based on systematic assessments of the environmental effects. R&D programmes thus allocate a huge amount of financial resources to projects, which potentially may....... The programme is characterised by uncertainty about impacts and incomparable project types and technologies. A methodology for dealing with these challenges is presented, and experiences from a testing of the methodology on the 2012 programme are reflected upon. Finally the assessment is discussed in terms...

The Promise and the Challenge of Technology-Facilitated Methods for Assessing Behavioral and Cognitive Markers of Risk for Suicide among U.S. Army National Guard Personnel.

Science.gov (United States)

Baucom, Brian R W; Georgiou, Panayiotis; Bryan, Craig J; Garland, Eric L; Leifker, Feea; May, Alexis; Wong, Alexander; Narayanan, Shrikanth S

2017-03-31

Suicide was the 10th leading cause of death for Americans in 2015 and rates have been steadily climbing over the last 25 years. Rates are particularly high amongst U.S. military personnel. Suicide prevention efforts in the military are significantly hampered by the lack of: (1) assessment tools for measuring baseline risk and (2) methods to detect periods of particularly heightened risk. Two specific barriers to assessing suicide risk in military personnel that call for innovation are: (1) the geographic dispersion of military personnel from healthcare settings, particularly amongst components like the Reserves; and (2) professional and social disincentives to acknowledging psychological distress. The primary aim of this paper is to describe recent technological developments that could contribute to risk assessment tools that are not subject to the limitations mentioned above. More specifically, Behavioral Signal Processing can be used to assess behaviors during interaction and conversation that likely indicate increased risk for suicide, and computer-administered, cognitive performance tasks can be used to assess activation of the suicidal mode. These novel methods can be used remotely and do not require direct disclosure or endorsement of psychological distress, solving two challenges to suicide risk assessment in military and other sensitive settings. We present an introduction to these technologies, describe how they can specifically be applied to assessing behavioral and cognitive risk for suicide, and close with recommendations for future research.

Vertical diplopia and oscillopsia due to midbrain keyhole aqueduct syndrome associated with severe cough.

Science.gov (United States)

Oh, Angela Jinsook; Lanzman, Bryan Alexander; Liao, Yaping Joyce

2018-06-01

Midline structural defects in the neural axis can give rise to neuro-ophthalmic symptoms. We report a rare case of keyhole aqueduct syndrome presenting after two years of severe cough due to gastroesophageal reflux disease. A 58-year-old woman with a 2-year history of daily, severe cough presented to the neuro-ophthalmology clinic with progressive diplopia and oscillopsia. Examination revealed a 1-2 Hz down-beating nystagmus in primary gaze that worsened with left, right, and down gazes. Gaze evoked nystagmus and mild paresis were also seen with up gaze. There was an incomitant left hypertropia due to skew deviation that worsened with right and up gazes and improved with down gaze. She also had a right-sided ptosis and a 3 mm anisocoria not due to cranial nerve 3 paresis or Horner's syndrome. Brain magnetic resonance imaging showed a 1.5 mm × 11.7 mm × 6 mm midline cleft in the ventral midbrain communicating with the cerebral aqueduct, consistent with keyhole aqueduct syndrome. Her nystagmus and diplopia improved with oral acetazolamide treatment, at high doses of 2500-3000 mg per day. We report the first case of midbrain keyhole aqueduct syndrome with ocular motor and other neuro-ophthalmic manifestations associated with severe cough. Although her cough was effectively treated and intracranial pressure measurement was normal, her ophthalmic symptoms continued to progress, which is common in previous cases reported. Treatment with acetazolamide led to significant improvement, supporting the use of acetazolamide in this rare condition.

New directions and challenges for the O ampersand M committee

International Nuclear Information System (INIS)

Pelletier, J.P.

1996-01-01

In the second half of the decade of the nineties, the imperative of finding new ways to improve efficiency while maintaining safety is taking on a new urgency. The looming deregulation of the electric industry and the expected competition in the power production business fuels this urgency. The recently completed ASME research in the area of Risk-Based Inservice Testing offers the Operations and Maintenance (O ampersand M) Committee an opportunity to meet this challenge. This opportunity, however, offers its own challenges. New ways of thinking about inservice testing and new technical skills will be needed to successfully incorporate this technology into Code documents. It will not be adequate to rely solely on incorporation of risk-based methods into the Code to meet this challenge. A thorough self assessment of what O ampersand M does, how it is done, and the value added will help assure that the directions which are pursued do, indeed, meet the challenge ahead

Challenges in conducting research in pediatric long-term care facilities.

Science.gov (United States)

Larson, Elaine L; Cohen, Bevin; Murray, Meghan; Saiman, Lisa

2014-10-01

Children residing in long-term care facilities (LTCFs) have complex medical problems and unique care needs, yet research in this setting is rare. As part of an intervention study to improve patient safety (Keep It Clean for Kids [KICK]), we describe the challenges encountered and recommend approaches to build a successful and sustained collaborative relationship between pediatric LTCFs and the research team. We implemented a program with 5 components: leadership commitment, active staff participation by the creation of KICK teams, workflow assessments, staff training in the World Health Organization's "5 Moments for Hand Hygiene," and electronic monitoring and feedback to staff regarding hand hygiene practices. Major challenges encountered were establishing trust, building research teams, enhancing staff participation, and engaging families and visitors. Approaches to deal with these challenges are discussed. Conducting research in pediatric LTCFs requires sustained commitment to dealing with challenges and establishing collaborative relationships with administrative and frontline staff. © The Author(s) 2014.

Ecological Equivalence Assessment Methods: What Trade-Offs between Operationality, Scientific Basis and Comprehensiveness?

Science.gov (United States)

Bezombes, Lucie; Gaucherand, Stéphanie; Kerbiriou, Christian; Reinert, Marie-Eve; Spiegelberger, Thomas

2017-08-01

In many countries, biodiversity compensation is required to counterbalance negative impacts of development projects on biodiversity by carrying out ecological measures, called offset when the goal is to reach "no net loss" of biodiversity. One main issue is to ensure that offset gains are equivalent to impact-related losses. Ecological equivalence is assessed with ecological equivalence assessment methods taking into account a range of key considerations that we summarized as ecological, spatial, temporal, and uncertainty. When equivalence assessment methods take into account all considerations, we call them "comprehensive". Equivalence assessment methods should also aim to be science-based and operational, which is challenging. Many equivalence assessment methods have been developed worldwide but none is fully satisfying. In the present study, we examine 13 equivalence assessment methods in order to identify (i) their general structure and (ii) the synergies and trade-offs between equivalence assessment methods characteristics related to operationality, scientific-basis and comprehensiveness (called "challenges" in his paper). We evaluate each equivalence assessment methods on the basis of 12 criteria describing the level of achievement of each challenge. We observe that all equivalence assessment methods share a general structure, with possible improvements in the choice of target biodiversity, the indicators used, the integration of landscape context and the multipliers reflecting time lags and uncertainties. We show that no equivalence assessment methods combines all challenges perfectly. There are trade-offs between and within the challenges: operationality tends to be favored while scientific basis are integrated heterogeneously in equivalence assessment methods development. One way of improving the challenges combination would be the use of offset dedicated data-bases providing scientific feedbacks on previous offset measures.

The socio-economic impact assessment for nuclear fuel waste disposal

International Nuclear Information System (INIS)