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Sample records for advance directives

  1. Advanced directives: open issues

    Directory of Open Access Journals (Sweden)

    Gabriella Negrini

    2013-05-01

    Full Text Available BACKGROUND In Italy Advanced directives have not been regulated by law yet. Moreover, there is a confusion of concepts: advanced directives, refusal of treatment, medical futility and euthanasia are not synonymous.DISCUSSION The following aspects are then discussed: object of directives; elapse of time between their expression and their application; knowledge of the directives and their obligatory nature. The refusal of a treatment that can save a person’s life is a critical subject. There are different ethical points of view: according to lay ethics, the patient’s self-determination prevails; the religious viewpoint, instead, says that life is a gift which we cannot dispose of. In any case, the patient will be confronted with the professional autonomy of the doctor. Should the doctor save a patient’s life in any case or should he achieve best clinical practice, in respect of his will? The doctor should interpret the patient’s will but with caution and judgment. An exemption from responsibility should be provided by law for doctors who respect patient’s living will.

  2. Psychiatric Advance Directives: Getting Started

    Science.gov (United States)

    ... News Legal Issues Search for: About PADs A psychiatric advance directive (PAD) is a legal document that ... decisions during a mental health crisis. Getting Started Psychiatric advance directives (PADs) are relatively new legal instruments ...

  3. Eldercare at Home: Advanced Directives

    Science.gov (United States)

    ... permanently? Helping the person fill out a living will (advance directive) A living will states a person's wishes about medical care if ... never be in a situation where another person will have to make decisions ... it is to have an advance directive. However, don't assume that your loved ...

  4. Law, autonomy and advance directives.

    Science.gov (United States)

    Willmott, Lindy; White, Ben; Mathews, Ben

    2010-12-01

    The principle of autonomy underpins legal regulation of advance directives that refuse life-sustaining medical treatment. The primacy of autonomy in this domain is recognised expressly in the case law, through judicial pronouncement, and implicitly in most Australian jurisdictions, through enactment into statute of the right to make an advance directive. This article seeks to justify autonomy as an appropriate principle for regulating advance directives and relies on three arguments: the necessity of autonomy in a liberal democracy; the primacy of autonomy in medical ethics discourse; and the uncontested importance of autonomy in the law on contemporaneous refusal of medical treatment. This article also responds to key criticisms that autonomy is not an appropriate organising principle to underpin legal regulation of advance directives.

  5. Advance directives: survey of primary care patients.

    Science.gov (United States)

    O'Sullivan, Rory; Mailo, Kevin; Angeles, Ricardo; Agarwal, Gina

    2015-04-01

    To establish the prevalence of patients with advance directives in a family practice, and to describe patients' perspectives on a family doctor's role in initiating discussions about advance directives. A self-administered patient questionnaire. A busy urban family medicine teaching clinic in Hamilton, Ont. A convenience sample of adult patients attending the clinic over the course of a typical business week. The prevalence of advance directives in the patient population was determined, and the patients' expectations regarding the role of their family doctors were elucidated. The survey population consisted of 800 participants (a response rate of 72.5%) well distributed across age groups; 19.7% had written advance directives and 43.8% had previously discussed the topic of advance directives, but only 4.3% of these discussions had occurred with family doctors. In 5.7% of cases, a family physician had raised the issue; 72.3% of respondents believed patients should initiate the discussion. Patients who considered advance directives extremely important were significantly more likely to want their family doctors to start the conversation (odds ratio 3.98; P < .05). Advance directives were not routinely addressed in the family practice. Most patients preferred to initiate the discussion of advance directives. However, patients who considered the subject extremely important wanted their family doctors to initiate the discussion. Copyright© the College of Family Physicians of Canada.

  6. Directions in advanced reactor technology

    International Nuclear Information System (INIS)

    Golay, M.W.

    1990-01-01

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

  7. [Theological moral considerations of advance directives].

    Science.gov (United States)

    Virt, G

    1997-01-01

    The forms for advanced directives vary considerably in respect to content and wording. This article intends to develop ethical criteria for such texts, from the moraltheological point of view, also considering the social context.

  8. Preferences for Advance Directives in Korea

    Directory of Open Access Journals (Sweden)

    So-Sun Kim

    2012-01-01

    Full Text Available Background. The goal of advance directives is to help patients retain their dignity and autonomy by making their own decisions regarding end-stage medical treatment. The purpose of this study was to examine preferences of advance directives among general population in Korea. Method. A descriptive cross-sectional survey was performed from October 2007 to June 2008 in Seoul, Korea. A total of 336 city-dwelling adults self-administered the questionnaire and returned it via mail. Data analyses were conducted using SPSS 17.0. Results. Subjects reported the need for healthcare providers' detailed explanations and recommendations regarding end-of-life care. When there is no hope of recovery and death is imminent, most subjects did not want to receive cardiopulmonary resuscitation nor an IV or tube feeding. However, most of the subjects wanted pain management care. Conclusions. The present study showed that many Korean people have an interest in advance directives. The results show that the autonomy and dignity of patient have increased in importance. To provide better end-of-life care, there is a need to educate patients on the definition and intent of an advance directive. Additional proactive communication between patients and their caregivers should be educated to healthcare providers.

  9. A Randomized Controlled Trial Comparing the Letter Project Advance Directive to Traditional Advance Directive.

    Science.gov (United States)

    Periyakoil, Vyjeyanthi S; Neri, Eric; Kraemer, Helena

    2017-09-01

    Simpler alternatives to traditional advance directives that are easy to understand and available in multiple formats and can be initiated by patients and families will help facilitate advance care planning. The goal of this study was to compare the acceptability of the letter advance directive (LAD) to the traditional advance directive (TAD) of the state of California. A web-based, randomized controlled trial was conducted, in which the participants were randomized to one of two types of advance directives (ADs): the LAD (intervention) or the TAD (control). Primary outcomes were participant ratings of the ease, value, and their level of comfort in the AD document they completed. A total of 400 participants completed the study, with 216 randomized to the LAD and 184 to the TAD by a computerized algorithm. Overall, participants preferred the LAD to the TAD (success rate difference [SRD] = 0.46, 95th percentile confidence interval [CI]: 0.36-0.56, p advance directive to be a better alternative to the traditional advance directive form.

  10. [Advance directives, a tool to humanize care].

    Science.gov (United States)

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

    2000-07-01

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

  11. Immunotherapy for advanced melanoma: future directions.

    Science.gov (United States)

    Valpione, Sara; Campana, Luca G

    2016-02-01

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

  12. Geysers advanced direct contact condenser research

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-12-31

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

  13. Older adult opinions of "advance driving directives".

    Science.gov (United States)

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

    2013-01-01

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

  14. Direct Cardiac Reprogramming: Advances in Cardiac Regeneration

    Directory of Open Access Journals (Sweden)

    Olivia Chen

    2015-01-01

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

  15. The Texas Advanced Directive Law: Unfinished Business.

    Science.gov (United States)

    Kapottos, Michael; Youngner, Stuart

    2015-01-01

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

  16. Advance directives and personal identity: what is the problem?

    Science.gov (United States)

    Furberg, Elisabeth

    2012-02-01

    The personal identity problem expresses the worry that due to disrupted psychological continuity, one person's advance directive could be used to determine the care of a different person. Even ethicists, who strongly question the possibility of the scenario depicted by the proponents of the personal identity problem, often consider it to be a very potent objection to the use of advance directives. Aiming to question this assumption, I, in this paper, discuss the personal identity problem's relevance to the moral force of advance directives. By putting the personal identity argument in relation to two different normative frameworks, I aim to show that whether or not the personal identity problem is relevant to the moral force of advance directives, and further, in what way it is relevant, depends entirely on what normative reasons we have for respecting advance directives in the first place.

  17. Advances in direct oxidation methanol fuel cells

    Science.gov (United States)

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

    1993-01-01

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

  18. Advanced DVI for ECC direct bypass mitigation

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  19. Advance Directives in Hospice Healthcare Providers: A Clinical Challenge.

    Science.gov (United States)

    Luck, George R; Eggenberger, Terry; Newman, David; Cortizo, Jacqueline; Blankenship, Derek C; Hennekens, Charles H

    2017-11-01

    On a daily basis, healthcare providers, especially those dealing with terminally ill patients, such as hospice workers, witness how advance directives help ensure the wishes of patients. They also witness the deleterious consequences when patients fail to document the care they desire at their end of life. To the best of our knowledge there are no data concerning the prevalence of advance directives among hospice healthcare providers. We therefore explored the prevalence and factors influencing completion rates in a survey of hospice healthcare providers. Surveys that included 32 items to explore completion rates, as well as barriers, knowledge, and demographics, were e-mailed to 2097 healthcare providers, including employees and volunteers, at a nonprofit hospice. Of 890 respondents, 44% reported having completed an advance directive. Ethnicity, age, relationship status, and perceived knowledge were all significant factors influencing the completion rates, whereas years of experience or working directly with patients had no effect. Procrastination, fear of the subject, and costs were common reasons reported as barriers. Upon completion of the survey, 43% said they will now complete an advance directive, and 45% will talk to patients and families about their wishes. The majority of hospice healthcare providers have not completed an advance directive. These results are very similar to those for other healthcare providers treating patients with terminal diseases, specifically oncologists. Because, at completion, 43% said that they would now complete an advance directive, such a survey of healthcare providers may help increase completion rates. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Recent Advances in High-Performance Direct Methanol Fuel Cells

    Science.gov (United States)

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

    1996-01-01

    Direct methanol fuel cells for portable power applications have been advanced significantly under DARPA- and ARO-sponsored programs over the last five years. A liquid-feed, direct methanol fuel cell developed under these programs, employs a proton exchange membrane as electrolyte and operates on aqueous solutions of methanol with air or oxygen as the oxidant.

  1. Completing advance directives for health care decisions: getting to yes.

    Science.gov (United States)

    Shewchuk, T R

    1998-09-01

    The concept of advance directives for health care decision making has been judicially condoned, legislatively promoted, and systematically implemented by health care institutions, yet the execution rate of advance directives remains low. Physicians should discuss with their patients advance care planning generally and end-of-life issues specifically, preferably when patients are in good health and not when they face an acute medical crisis. The physician-hospital relationship poses particular challenges for the optimal implementation of advance directives that must be addressed. Hospital administrators must improve education of patients and physicians on the value of such documents as well as internal mechanisms to ensure better implementation of directives. Health insurance plans may be better able to ensure optimal gathering and implementation of directives. Patients must become more familiar and more comfortable with advance care planning and the reality of death and dying issues. Full acceptance of the value of directives ultimately rests on achieving full participation of all involved--providers, patients, families, and payors--in this most profound process.

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

    Science.gov (United States)

    Meehan, Karen Anne

    2009-01-01

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

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

    Science.gov (United States)

    1995-06-27

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

  4. [Are advance directives useful for doctors and what for?].

    Science.gov (United States)

    Fournier, Véronique; Berthiau, Denis; Kempf, Emmanuelle; d'Haussy, Julie

    2013-06-01

    In France, the law has introduced the possibility to write advance directives since 2005. In this paper, we will present the results of a study designed for checking how much people over 75 years are interested by this new tool. The inquiry consisted in deep qualitative interviews (around 45') to further understand what people included in the study have to say about advance directives, but also about the conditions of ageing and dying. The study sample was composed of 8 over 75 years subgroups, chosen for being illustrative of different health status and/or disabling status. Finally, a last subgroup was also included, called "referent", because composed of people, all members of the "Association pour le droit à mourir dans la dignité" (ADMD), and as such supposed to be pro-advance directives. Interviews content was analysed through qualitative analysis referent methods ("Analyse qualitative en sciences humaines et sociales", Paillé et Muschielli, "Grounded Theory", Glaser). POPULATION OF THE STUDY: One hundred and eighty-six patients were included (106 female, 80 male, mean age 82.7 ans), 167 in the general group and 19 in the "ADMD" group. Ninety percent in the general group said that they never heard about advance directives before the inquiry. After having been informed by us about what advance directives were for, 83% remained not interested they said, some because they felt they were not personally concerned, others expressed that the tool appears to them inefficient - "things never happen the way you planned it", not useful - "doctors will act as they will decide whatever will be written", or even more potentially dangerous - "writing advance directives might lead doctors not to be as much therapeutically aggressive as for other people". Only 28 persons in the general group (17%), together with the 19 of the ADMD group, said they were interested by advance directives. They all were quite similar according to their personal character: they were quite strong

  5. Advance directives as autonomy enhancers: reality or myth?

    OpenAIRE

    Navarro Michel, Mónica

    2015-01-01

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

  6. Protecting me from my Directive: Ensuring Appropriate Safeguards for Advance Directives in Dementia.

    Science.gov (United States)

    Auckland, Cressida

    2018-02-01

    With one in six people over 80 now suffering from dementia, advance directives provide an important means of empowerment. Upholding directives in the context of dementia, however, raises extra challenges, given the potential for the directive to conflict with an assessment of what is in the person's current best interests. Given the profound harm that tying a person with dementia to their previous wishes can do, it is essential that we have sufficient safeguards in place to ensure that we only uphold such directives where we can be sure they are truly autonomous and are intended to apply to the situation at hand-safeguards which are at present, severely lacking. This article will consider various mechanisms by which safeguards can be built into the legal regime to ensure that the original decision is autonomous, including making it mandatory for the person to undergo a consultation with a healthcare professional, which would involve a contemporaneous capacity assessment. Clinicians must also be confident that the directive applies to the situation at hand. Introducing formalities, including a standardised (though not mandatory) proforma, may help to enhance specificity about when the directive is triggered, and to what treatments it relates, to enable clinicians to better assess the directive's applicability. A national registry for advance directives might also be beneficial. It will be argued that health care professionals will have to play a much greater role in the drafting and registering of advance directives, if we are to feel comfortable in upholding them.

  7. Strategic directions and actions for advanced practice nursing in China

    Directory of Open Access Journals (Sweden)

    Martha N. Hill

    2017-01-01

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

  8. Law on advance health care directives: a medical perspective.

    Science.gov (United States)

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

    2018-01-01

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

  9. Direct electroplating of plastic for advanced electrical applications

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  10. Advance Directives and Powers of Attorney in Intensive Care Patients.

    Science.gov (United States)

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

    2017-06-05

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

  11. Advance directives and outcomes of surrogate decision making before death.

    Science.gov (United States)

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

    2010-04-01

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

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

    Science.gov (United States)

    Sanson, H; Priollet, P

    2016-05-01

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

  13. Directions for advanced use of nuclear power in century XXI

    International Nuclear Information System (INIS)

    Walter, C.E.

    1999-01-01

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

  14. Canadian advanced life support capacities and future directions

    Science.gov (United States)

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

    2009-07-01

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

  15. Advanced materials for alternative fuel capable directly fired heat engines

    Energy Technology Data Exchange (ETDEWEB)

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

    1979-12-01

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

  16. Technological advances in site-directed spin labeling of proteins.

    Science.gov (United States)

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

    2013-10-01

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

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

    Science.gov (United States)

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

    2017-06-01

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

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

    Science.gov (United States)

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

    2015-08-01

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

  19. [Psychiatric advance directives and the role of autonomy].

    Science.gov (United States)

    Ambrosini, Daniel L; Crocker, Anne G

    2009-01-01

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

  20. A multimedia intervention on cardiopulmonary resuscitation and advance directives.

    Science.gov (United States)

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

    1999-09-01

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

  1. Psychiatric advance directives in Australian mental-health legislation.

    Science.gov (United States)

    Ouliaris, Calina; Kealy-Bateman, Warren

    2017-12-01

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

  2. Recovery Act: Advanced Direct Methanol Fuel Cell for Mobile Computing

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-09-03

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

  3. 22 CFR 72.30 - Provisions in a will or advanced directive regarding disposition of remains.

    Science.gov (United States)

    2010-04-01

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

  4. Toolboxes for cyanobacteria: Recent advances and future direction.

    Science.gov (United States)

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

    2018-05-03

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

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

    Science.gov (United States)

    Coleman, Albert M E

    2013-11-01

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

  6. A preliminary investigation of opinions and behaviors regarding advance directives for medical care.

    Science.gov (United States)

    Elpern, E H; Yellen, S B; Burton, L A

    1993-03-01

    Advance directives are a means of promoting patient autonomy in end-of-life decisions but are used infrequently. A recent federal law requires healthcare organizations to provide information to patients about advance directives. This study explored attitudes and behaviors related to the use of advance directives in three areas: familiarity with advance directives, reasons for completing or not completing advance directives and preferences for receiving information about advance directives. A questionnaire was administered by personal interview to a nonrandomized convenience sample of 46 inpatients and 50 outpatients at a large, tertiary care, urban academic medical center in the summer of 1991. Most respondents (77%) had heard of either the living will or durable power of attorney for healthcare, but only 52% correctly understood the purpose of these documents. Twenty-nine percent of the sample had executed an advance directive. Those who had advance directives were older and considered themselves less healthy than did those without advance directives. Unfamiliarity with advance directives and procrastination were cited most often as reasons for not having an advance directive. Most subjects (65%) had spoken with someone, usually a family member or close friend, about preferences for treatment during a critical illness. Although they had rarely discussed advance directives, 83% anticipated that they would be comfortable doing so with a physician or a nurse. Advance directives are used infrequently to document treatment preferences. The success of programs to promote greater use of advance directives depends on a clearer understanding of the factors that influence both decision and action to execute an advance directive. Patients claim to be comfortable in discussing the topic and prefer that such discussions occur in the outpatient setting.

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

    International Nuclear Information System (INIS)

    Fontana, M.H.

    1993-01-01

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

  8. Advanced Methods for Direct Ink Write Additive Manufacturing

    Energy Technology Data Exchange (ETDEWEB)

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

    2018-01-24

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

  9. Is it feasible to discuss an advance directive with a Chinese patient with advanced malignancy? A prospective cohort study.

    Science.gov (United States)

    Wong, S Y; Lo, S H; Chan, C H; Chui, H S; Sze, W K; Tung, Y

    2012-06-01

    Advance directives have been implemented for years in western countries, but the concept is new to Asian cultures. According to traditional Chinese culture, family members usually play a decisive role in a patient's treatment plan. Thus it may be hard to implement an advance directive despite its importance to the treatment of patients. The objectives of this study were to assess the feasibility of advance directive engagement and to explore significant contributing factors to achieving such a goal. Prospective cohort study. Palliative Care Unit of Clinical Oncology, Tuen Mun Hospital, Hong Kong. The subjects of the investigation were adult patients diagnosed to have advanced malignancy and newly referred to the hospice service from 24 April 2009 to 30 July 2009. Data were collected from nursing assessment forms, locally designed advance directive forms, a checklist completed by oncologists, and details available in the electronic hospital record. Of the 191 eligible patients, 120 (63%) had the advance directive, whereas 71 (37%) did not. In the Cox regression model, the patient having insight of a poor prognosis was the most significant factor facilitating advance directive engagement (P=0.001). Any family objection in the discussion of advance directives was also an important factor, though it did not reach statistical significance (P=0.082). Other factors like age, gender, education, religion, financial status, living environment, understanding the diagnosis, bereavement experience, type of cancer, nature of illness, courses of chemotherapy or radiotherapy received, main caregiver, in-house supporter, nurse-led clinic attendance, clinical psychologist consultation, and in-patient hospice nurse coordinator interview were all statistically insignificant. Our study demonstrated that it was feasible to discuss an advance directive with Chinese patients with advanced malignancy. When patients have insight about their poor prognosis and family members have no

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

    Science.gov (United States)

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

    2018-01-01

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

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

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

    Science.gov (United States)

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

    2018-03-03

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

  13. Automated Ecological Assessment of Physical Activity: Advancing Direct Observation.

    Science.gov (United States)

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

    2017-12-01

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

  14. Engaging Patients With Advance Directives Using an Information Visualization Approach.

    Science.gov (United States)

    Woollen, Janet; Bakken, Suzanne

    2016-01-01

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

  15. Automated Ecological Assessment of Physical Activity: Advancing Direct Observation

    Directory of Open Access Journals (Sweden)

    Jordan A. Carlson

    2017-12-01

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

  16. Usefulness of questionnaires on advance directives in haemodialysis units.

    Science.gov (United States)

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

    2017-10-01

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

  17. Advance directives: cancer patients' preferences and family-based decision making.

    Science.gov (United States)

    Xing, Yan-Fang; Lin, Jin-Xiang; Li, Xing; Lin, Qu; Ma, Xiao-Kun; Chen, Jie; Wu, Dong-Hao; Wei, Li; Yin, Liang-Hong; Wu, Xiang-Yuan

    2017-07-11

    Advance directives are a sensitive issue among traditional Chinese people, who usually refrain from mentioning this topic until it is imperative. Medical decisions for cancer patients are made by their families, and these decisions might violate patients' personal will. This study aimed to examine the acceptance of advance directives among Chinese cancer patients and their families and patient participation in this procedure and, finally, to analyze the moral risk involved. While 246 patients and their family members refused official discussion of an advance directive, the remaining 166 patients and their families accepted the concept of an advance directive and signed a document agreeing to give up invasive treatment when the anti-cancer treatment was terminated. Of these, only 24 patients participated in the decision making. For 101 patients, anti-cancer therapy was ended prematurely with as many as 37 patients not told about their potential loss of health interests. Participants were 412 adult cancer patients from 9 leading hospitals across China. An advance directive was introduced to the main decision makers for each patient; if they wished to sign it, the advance directive would be systematically discussed. A questionnaire was given to the oncologists in charge of each patient to evaluate the interaction between families and patients, patients' awareness of their disease, and participation in an advance directive. Advance directives were not widely accepted among Chinese cancer patients unless anti-cancer therapy was terminated. Most cancer patients were excluded from the discussion of an advance directive.

  18. Encounters With Health-Care Providers and Advance Directive Completion by Older Adults.

    Science.gov (United States)

    Koss, Catheryn

    2018-01-01

    The Patient Self-Determination Act (PSDA) requires hospitals, home health agencies, nursing homes, and hospice providers to offer new patients information about advance directives. There is little evidence regarding whether encounters with these health-care providers prompt advance directive completion by patients. To examine whether encounters with various types of health-care providers were associated with higher odds of completing advance directives by older patients. Logistic regression using longitudinal data from the 2012 and 2014 waves of the Health and Retirement Study. Participants were 3752 US adults aged 65 and older who reported not possessing advance directives in 2012. Advance directive was defined as a living will and/or durable power of attorney for health care. Four binary variables measured whether participants had spent at least 1 night in a hospital, underwent outpatient surgery, received home health or hospice care, or spent at least one night in a nursing home between 2012 and 2014. Older adults who received hospital, nursing home, or home health/hospice care were more likely to complete advance directives. Outpatient surgery was not associated with advance directive completion. Older adults with no advance directive in 2012 who encountered health-care providers covered by the PSDA were more likely to have advance directives by 2014. The exception was outpatient surgery which is frequently provided in freestanding surgery centers not subject to PSDA mandates. It may be time to consider amending the PSDA to cover freestanding surgery centers.

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

    Science.gov (United States)

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

    2018-04-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

  1. Advanced health biotechnologies in Thailand: redefining policy directions.

    Science.gov (United States)

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

    2013-01-02

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

  2. Advanced health biotechnologies in Thailand: redefining policy directions

    Directory of Open Access Journals (Sweden)

    Velasco Román Pérez

    2013-01-01

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

  3. Prevalence and Contents of Advance Directives of Patients with ESRD Receiving Dialysis.

    Science.gov (United States)

    Feely, Molly A; Hildebrandt, Daniel; Edakkanambeth Varayil, Jithinraj; Mueller, Paul S

    2016-12-07

    ESRD requiring dialysis is associated with increased morbidity and mortality rates, including increased rates of cognitive impairment, compared with the general population. About one quarter of patients receiving dialysis choose to discontinue dialysis at the end of life. Advance directives are intended to give providers and surrogates instruction on managing medical decision making, including end of life situations. The prevalence of advance directives is low among patients receiving dialysis. Little is known about the contents of advance directives among these patients with advance directives. We retrospectively reviewed the medical records of all patients receiving maintenance in-center hemodialysis at a tertiary academic medical center between January 1, 2007 and January 1, 2012. We collected demographic data, the prevalence of advance directives, and a content analysis of these advance directives. We specifically examined the advance directives for instructions on management of interventions at end of life, including dialysis. Among 808 patients (mean age of 68.6 years old; men =61.2%), 49% had advance directives, of which only 10.6% mentioned dialysis and only 3% specifically addressed dialysis management at end of life. Patients who had advance directives were more likely to be older (74.5 versus 65.4 years old; Phydration (34.3%), and pain management (43.4%) than dialysis (10.6%). Although one-half of the patients receiving dialysis in our study had advance directives, end of life management of dialysis was rarely addressed. Future research should focus on improving discernment and documentation of end of life values, goals, and preferences, such as dialysis-specific advance directives, among these patients. Copyright © 2016 by the American Society of Nephrology.

  4. Advanced Gasoline Turbocharged Direction Injection (GTDI) Engine Development

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-12-31

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

  5. Radiation-induced erectile dysfunction: Recent advances and future directions

    Directory of Open Access Journals (Sweden)

    Javed Mahmood, PhD

    2016-07-01

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

  6. Recent Advances and Future Directions for Quality Engineering

    DEFF Research Database (Denmark)

    Vining, Geoff; Kulahci, Murat; Pedersen, Søren

    2015-01-01

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

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

    African Journals Online (AJOL)

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

  8. Multiaxial ratcheting with advanced kinematic and directional distortional hardening rules

    Czech Academy of Sciences Publication Activity Database

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

    2012-01-01

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

  9. Advanced direct liquefaction concepts for PETC generic units

    Energy Technology Data Exchange (ETDEWEB)

    1992-04-01

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

  10. Preschool life skills: Recent advancements and future directions.

    Science.gov (United States)

    Fahmie, Tara A; Luczynski, Kevin C

    2018-01-01

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

  11. Chronically homeless persons' participation in an advance directive intervention: A cohort study.

    Science.gov (United States)

    Leung, Alexander K; Nayyar, Dhruv; Sachdeva, Manisha; Song, John; Hwang, Stephen W

    2015-09-01

    Chronically homeless individuals have high rates of hospitalization and death, and they may benefit from the completion of advance directives. To determine the rate of advance directive completion using a counselor-guided intervention, identify characteristics associated with advance directive completion, and describe end-of-life care preferences in a group of chronically homeless individuals. Participants completed a survey and were offered an opportunity to complete an advance directive with a trained counselor. A total of 205 residents of a shelter in Canada for homeless men (89.1% of those approached) participated from April to June 2013. Duration of homelessness was ⩾12 months in 72.8% of participants, and 103 participants (50.2%) chose to complete an advance directive. Socio-demographic characteristics, health status, and health care use were not associated with completion of an advance directive. Participants were more likely to complete an advance directive if they reported thinking about death on a daily basis, believed that thinking about their friends and family was important, or reported knowing their wishes for end-of-life care but not having told anyone about these wishes. Among individuals who completed an advance directive, 61.2% named a substitute decision maker, and 94.1% expressed a preference to receive cardiopulmonary resuscitation in the event of a cardiorespiratory arrest if there was a chance of returning to their current state of health. A counselor-guided intervention can achieve a high rate of advance directive completion among chronically homeless persons. Most participants expressed a preference to receive cardiopulmonary resuscitation in the event of a cardiorespiratory arrest. © The Author(s) 2015.

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

    Science.gov (United States)

    Whitlow, Jonathan; Pacelli, Settimio; Paul, Arghya

    2017-09-10

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

  13. Sciences of geodesy I advances and future directions

    CERN Document Server

    Xu, Guochang

    2010-01-01

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

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

    OpenAIRE

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

    2008-01-01

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

  15. Ceramic thermal wind sensor based on advanced direct chip attaching package

    International Nuclear Information System (INIS)

    Zhou Lin; Qin Ming; Chen Shengqi; Chen Bei

    2014-01-01

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

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

    International Nuclear Information System (INIS)

    Siemann, R.H.

    1997-01-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

  18. Advances and Research Directions in Data-Warehousing Technology

    Directory of Open Access Journals (Sweden)

    Mukesh Mohania

    1999-11-01

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

  19. Soil respiration in Mexico: Advances and future directions

    Directory of Open Access Journals (Sweden)

    Alejandro Cueva

    2016-07-01

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

  20. Advancing the Field Elder Abuse: Future Directions and Policy Implications

    Science.gov (United States)

    Dong, XinQi

    2012-01-01

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

  1. Advances in directional borehole radar data analysis and visualization

    Science.gov (United States)

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

    2002-01-01

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

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  3. Promoting advance directives among African Americans: a faith-based model.

    Science.gov (United States)

    Bullock, Karen

    2006-02-01

    Studies show that African Americans are less likely than other ethnic groups to complete advance directives. However, what influences African Americans' decisions to complete or not complete advance directives is unclear. Using a faith-based promotion model, 102 African Americans aged 55 years or older were recruited from local churches and community-based agencies to participate in a pilot study to promote advance care planning. Focus groups were used to collect data on participants' preferences for care, desire to make personal choices, values and attitudes, beliefs about death and dying, and advance directives. A standardized interview was used in the focus groups, and the data were organized and analyzed using NUDIST 4 software (QRS Software, Victoria, Australia). Three fourths of the participants refused to complete advance directives. The following factors influenced the participants' decisions about end-of-life care and completion of an advance directive: spirituality; view of suffering, death, and dying; social support networks; barriers to utilization; and mistrust of the health care system. The dissemination of information apprises individuals of their right to self-determine about their care, but educational efforts may not produce a significant change in behavior toward completion of advance care planning. Thus, ongoing efforts are needed to improve the trust that African Americans have in medical and health care providers.

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

    Directory of Open Access Journals (Sweden)

    Jia Lee, PhD, RN

    2010-12-01

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

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

    Science.gov (United States)

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

    2010-11-01

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

  6. Radiation protection in dental radiology - Recent advances and future directions.

    Science.gov (United States)

    Tsapaki, V

    2017-12-01

    Dental radiology uses X-ray technology to diagnose and design treatment of various clinical problems related to the oral cavity and surrounding tissues. As technology quickly evolves, there are numerous X-ray modalities using different tools in the attempt to best image and treat efficiently these diseases, disorders or other related clinical conditions. The reported numbers of dental X-rays, the fact that these may be under-reported in many countries and because dental X-rays are performed more on younger individuals, whose teeth and dentition are still developing, calls for increased need on radiation protection. The objectives of this paper are to report on the latest technology updates and related radiation protection issues, to present future directions and define gaps. Most of existing radiation protection national and international guidelines are more than a decade old. Update is needed to account for newer technologies such as cone beam computed tomography (CBCT) and digital imaging. Diagnostic Reference Levels (DRLs), a well established method for dose optimization, are not yet defined for CBCT and have to be set for various clinical indications. As far as shielding is concerned, recent data confirm that use of lead apron, even in pregnant patients, or gonadal shielding are not recommended, due to negligible radiation dose reduction. Thyroid lead shielding should be used in case the organ is in or close to the primary beam. Specifically for CBCT, leaded glasses, thyroid collars and collimation (smaller field of view (FOV) especially for paediatric patients) minimize the dose to organs outside the FOV. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Ekore, Rabi Ilemona; Lanre-Abass, Bolatito

    2016-01-01

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

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

    Science.gov (United States)

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

    2012-10-01

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

  9. Advance Directives

    Science.gov (United States)

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

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

    Science.gov (United States)

    Tsai, Franklin C; Strum, Williamson B

    2011-08-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

    Hirayama, Yoko; Otani, Takashi; Matsushima, Masato

    2017-12-01

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

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

    NARCIS (Netherlands)

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

    2010-01-01

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

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

    OpenAIRE

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

    1994-01-01

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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2014-05-01

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

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

    Science.gov (United States)

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

    2004-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Kai Ichiro

    2006-10-01

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

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

    Science.gov (United States)

    Horn, Ruth Judith

    2014-03-01

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

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

    Science.gov (United States)

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

    2008-10-01

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

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

    Science.gov (United States)

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

    2016-08-01

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

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

    Science.gov (United States)

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

    2010-03-01

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

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

    Science.gov (United States)

    Stuart, Peter

    2017-11-28

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

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

    Science.gov (United States)

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

    2015-02-01

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

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

    Science.gov (United States)

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

    2013-10-31

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

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

    Science.gov (United States)

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

    2016-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Carel P van Schaik

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

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

    OpenAIRE

    Ekore, Rabi Ilemona; Lanre-Abass, Bolatito

    2016-01-01

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

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

    International Nuclear Information System (INIS)

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

    1989-01-01

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

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

    Science.gov (United States)

    Peicius, Eimantas; Blazeviciene, Aurelija; Kaminskas, Raimondas

    2017-06-05

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

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2005-10-01

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

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

    Science.gov (United States)

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

    2018-03-12

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

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

    Directory of Open Access Journals (Sweden)

    Nagarsheth NP

    2014-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Ihor Rymaruk

    2012-07-01

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

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

    Science.gov (United States)

    Mahon, Robert N; Hafner, Richard

    2017-01-01

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

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

    International Nuclear Information System (INIS)

    Garibov, A.A.

    2006-01-01

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

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

    Science.gov (United States)

    Zager, B Sue; Yancy, Margaret

    2011-12-01

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

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

    Science.gov (United States)

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

    2012-11-01

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

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

    Science.gov (United States)

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

    2017-07-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-03-01

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

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

    Science.gov (United States)

    Porteri, Corinna

    2018-02-20

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

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

    OpenAIRE

    Ruff, Anna Joëlle

    2012-01-01

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

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

    Science.gov (United States)

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

    2018-02-01

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

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

    Science.gov (United States)

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

    2010-10-21

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

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

    Science.gov (United States)

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

    2017-07-01

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

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

    Science.gov (United States)

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

    2015-11-01

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

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

    Science.gov (United States)

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

    1997-06-01

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

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

    Science.gov (United States)

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

    1998-01-01

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

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

    Science.gov (United States)

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

    2009-02-01

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

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

    Science.gov (United States)

    Searight, H Russell; Gafford, Jennifer

    2005-07-01

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

  12. 41 CFR 302-10.301 - May I receive an advance of funds when payment is made directly to the carrier by my agency?

    Science.gov (United States)

    2010-07-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

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

    Science.gov (United States)

    Abbott, B P; Abbott, R; Abbott, T D; Abernathy, M R; Acernese, F; Ackley, K; Adams, C; Adams, T; Addesso, P; Adhikari, R X; Adya, V B; Affeldt, C; Agathos, M; Agatsuma, K; Aggarwal, N; Aguiar, O D; Aiello, L; Ain, A; Ajith, P; Allen, B; Allocca, A; Altin, P A; Ananyeva, A; Anderson, S B; Anderson, W G; Appert, S; Arai, K; Araya, M C; Areeda, J S; Arnaud, N; Arun, K G; Ascenzi, S; Ashton, G; Ast, M; Aston, S M; Astone, P; Aufmuth, P; Aulbert, C; Avila-Alvarez, A; Babak, S; Bacon, P; Bader, M K M; Baker, P T; Baldaccini, F; Ballardin, G; Ballmer, S W; Barayoga, J C; Barclay, S E; Barish, B C; Barker, D; Barone, F; Barr, B; Barsotti, L; Barsuglia, M; Barta, D; Bartlett, J; Bartos, I; Bassiri, R; Basti, A; Batch, J C; Baune, C; Bavigadda, V; Bazzan, M; Beer, C; Bejger, M; Belahcene, I; Belgin, M; Bell, A S; Berger, B K; Bergmann, G; Berry, C P L; Bersanetti, D; Bertolini, A; Betzwieser, J; Bhagwat, S; Bhandare, R; Bilenko, I A; Billingsley, G; Billman, C R; Birch, J; Birney, R; Birnholtz, O; 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Yu, Hang; Yu, Haocun; Yvert, M; Zadrożny, A; Zangrando, L; Zanolin, M; Zendri, J-P; Zevin, M; Zhang, L; Zhang, M; Zhang, T; Zhang, Y; Zhao, C; Zhou, M; Zhou, Z; Zhu, S J; Zhu, X J; Zucker, M E; Zweizig, J

    2017-03-24

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

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

    Science.gov (United States)

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

    2017-07-26

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

    Riccioni, Luigi; Gristina, Giuseppe

    2015-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Schopper Andrea

    2010-10-01

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

  20. Sigma Team for Advanced Actinide Recycle FY2015 Accomplishments and Directions

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-09-30

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-01

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

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

    Science.gov (United States)

    Carr, Thomas H.; And Others

    1977-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

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

    Science.gov (United States)

    Welch, Marshall; Plaxton-Moore, Star

    2017-01-01

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

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

    Science.gov (United States)

    Lee, JuHee; Jung, Dukyoo; Choi, MoonKi

    2016-01-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Neelesh Soman

    2013-10-01

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

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

    OpenAIRE

    Zhi, Wanqing Iris; Kim, Jenny J.

    2014-01-01

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

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

    CERN Document Server

    Pisano, Aurora; Weichert, Dieter

    2015-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-05-13

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

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

    International Nuclear Information System (INIS)

    DiGennaro, R.; Swain, T.

    1989-08-01

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

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

    International Nuclear Information System (INIS)

    Huettenbrink, K.B.; Schadel, A.

    1986-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Gajewski Piotr

    2016-12-01

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

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

    Science.gov (United States)

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

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

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

    Science.gov (United States)

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

    2017-03-01

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

  16. Investigation of Ruthenium Dissolution in Advanced Membrane Electrode Assemblies for Direct Methanol Based Fuel Cells Stacks

    Science.gov (United States)

    Valdez, T. I.; Firdosy, S.; Koel, B. E.; Narayanan, S. R.

    2005-01-01

    This viewgraph presentation gives a detailed review of the Direct Methanol Based Fuel Cell (DMFC) stack and investigates the Ruthenium that was found at the exit of the stack. The topics include: 1) Motivation; 2) Pathways for Cell Degradation; 3) Cell Duration Testing; 4) Duration Testing, MEA Analysis; and 5) Stack Degradation Analysis.

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

    Science.gov (United States)

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

    2018-04-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  19. Advanced direct liquefaction concepts for PETC generic units. Quarterly technical progress report, January--March 1992

    Energy Technology Data Exchange (ETDEWEB)

    1992-04-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  1. Advancing Direct Corporate Accountability in International Human Rights Law: The Role of State-Owned Enterprises

    OpenAIRE

    Ma, Xili

    2017-01-01

    Resorting to the immensely State-centric international legal system to regulate corporate human rights abuses is often viewed as inadequate. Among many proposals aiming at filling the international regulatory gaps, imposing international human rights obligations directly on corporations is a bold one, which, due to profound doctrinal and practical challenges, has yet to be agreed upon or established. However, State-Owned Enterprises (SOEs), given its prima facie “State-Business nexus” that bl...

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

    Directory of Open Access Journals (Sweden)

    Maria Aparecida Alkimim

    2016-12-01

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

  3. New directions in hypnosis research: strategies for advancing the cognitive and clinical neuroscience of hypnosis

    Science.gov (United States)

    Jensen, Mark P.; Jamieson, Graham A.; Lutz, Antoine; Mazzoni, Giuliana; McGeown, William J.; Santarcangelo, Enrica L.; Demertzi, Athena; De Pascalis, Vilfredo; Bányai, Éva I.; Rominger, Christian; Vuilleumier, Patrik; Faymonville, Marie-Elisabeth; Terhune, Devin B.

    2017-01-01

    This article summarizes key advances in hypnosis research during the past two decades, including (i) clinical research supporting the efficacy of hypnosis for managing a number of clinical symptoms and conditions, (ii) research supporting the role of various divisions in the anterior cingulate and prefrontal cortices in hypnotic responding, and (iii) an emerging finding that high hypnotic suggestibility is associated with atypical brain connectivity profiles. Key recommendations for a research agenda for the next decade include the recommendations that (i) laboratory hypnosis researchers should strongly consider how they assess hypnotic suggestibility in their studies, (ii) inclusion of study participants who score in the middle range of hypnotic suggestibility, and (iii) use of expanding research designs that more clearly delineate the roles of inductions and specific suggestions. Finally, we make two specific suggestions for helping to move the field forward including (i) the use of data sharing and (ii) redirecting resources away from contrasting state and nonstate positions toward studying (a) the efficacy of hypnotic treatments for clinical conditions influenced by central nervous system processes and (b) the neurophysiological underpinnings of hypnotic phenomena. As we learn more about the neurophysiological mechanisms underlying hypnosis and suggestion, we will strengthen our knowledge of both basic brain functions and a host of different psychological functions. PMID:29034102

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-09-15

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

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

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

    Science.gov (United States)

    Cornelius, Christopher J [Albuquerque, NM

    2006-04-04

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

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

    Science.gov (United States)

    Gergel, Tania; Owen, Gareth S

    2015-01-01

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

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

    Science.gov (United States)

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

    2017-11-01

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

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

    International Nuclear Information System (INIS)

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

    1993-01-01

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

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

    Science.gov (United States)

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

    2017-06-12

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

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

    Science.gov (United States)

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

    2016-02-01

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

  12. MOTHER MK II: An advanced direct cycle high temperature gas reactor

    International Nuclear Information System (INIS)

    Hart, R.S.; Kendall, J.M.; Marsden, B.J.

    2003-01-01

    The MOTHER (MOdular Thermal HElium Reactor) power plant concepts employ high temperature gas reactors utilizing TRISO fuel, graphite moderator, and helium coolant, in combination with a direct Brayton cycle for electricity generation. The helium coolant from the reactor vessel passes through a Power Conversion Unit (PCU), which includes a turbine-generator, recuperator, precooler, intercooler and turbine-compressors, before being returned to the reactor vessel. The PCU substitutes for the reactor coolant system pumps and steam generators and most of the Balance Of Plant (BOP), including the steam turbines and condensers, employed by conventional nuclear power plants utilizing water cooled reactors. This provides a compact, efficient, and relatively simple plant configuration. The MOTHER MK I conceptual design, completed in the 1987 - 1989 time frame, was developed to economically meet the energy demands for extracting and processing heavy oil from the tar sands of western Canada. However, considerable effort was made to maximize the market potential beyond this application. Consistent with the remote and very high labour rate environment in the tar sands region, simplification of maintenance procedures and facilitation of 'change-out' in lieu of in situ repair was a design focus. MOTHER MK I had a thermal output of 288 MW and produced 120 MW electrical when operated in the electricity only production mode. An annular Prismatic reactor core was utilized, largely to minimize day-to-day operations activities. Key features of the power conversion system included two Power Conversion Units (144 MW th each), the horizontal orientation of all rotating machinery and major heat exchangers axes, high speed rotating machinery (17,030 rpm for the turbine-compressors and 10,200 rpm for the power turbine-generator), gas (helium) bearings for all rotating machinery, and solid state frequency conversion from 170 cps (at full power) to the grid frequency. Recognizing that the on

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

    Science.gov (United States)

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

    2017-08-01

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

  14. Transcranial Direct Current Stimulation in Stroke Rehabilitation: A Review of Recent Advancements

    Science.gov (United States)

    Gomez Palacio Schjetnan, Andrea; Faraji, Jamshid; Metz, Gerlinde A.; Tatsuno, Masami; Luczak, Artur

    2013-01-01

    Transcranial direct current stimulation (tDCS) is a promising technique to treat a wide range of neurological conditions including stroke. The pathological processes following stroke may provide an exemplary system to investigate how tDCS promotes neuronal plasticity and functional recovery. Changes in synaptic function after stroke, such as reduced excitability, formation of aberrant connections, and deregulated plastic modifications, have been postulated to impede recovery from stroke. However, if tDCS could counteract these negative changes by influencing the system's neurophysiology, it would contribute to the formation of functionally meaningful connections and the maintenance of existing pathways. This paper is aimed at providing a review of underlying mechanisms of tDCS and its application to stroke. In addition, to maximize the effectiveness of tDCS in stroke rehabilitation, future research needs to determine the optimal stimulation protocols and parameters. We discuss how stimulation parameters could be optimized based on electrophysiological activity. In particular, we propose that cortical synchrony may represent a biomarker of tDCS efficacy to indicate communication between affected areas. Understanding the mechanisms by which tDCS affects the neural substrate after stroke and finding ways to optimize tDCS for each patient are key to effective rehabilitation approaches. PMID:23533955

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

    Science.gov (United States)

    Dong, XinQi

    2012-11-01

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

  16. Advanced feeder-free generation of induced pluripotent stem cells directly from blood cells.

    Science.gov (United States)

    Trokovic, Ras; Weltner, Jere; Nishimura, Ken; Ohtaka, Manami; Nakanishi, Mahito; Salomaa, Veikko; Jalanko, Anu; Otonkoski, Timo; Kyttälä, Aija

    2014-12-01

    Generation of validated human induced pluripotent stem cells (iPSCs) for biobanking is essential for exploring the full potential of iPSCs in disease modeling and drug discovery. Peripheral blood mononuclear cells (PBMCs) are attractive targets for reprogramming, because blood is collected by a routine clinical procedure and is a commonly stored material in biobanks. Generation of iPSCs from blood cells has previously been reported using integrative retroviruses, episomal Sendai viruses, and DNA plasmids. However, most of the published protocols require expansion and/or activation of a specific cell population from PBMCs. We have recently collected a PBMC cohort from the Finnish population containing more than 2,000 subjects. Here we report efficient generation of iPSCs directly from PBMCs in feeder-free conditions in approximately 2 weeks. The produced iPSC clones are pluripotent and transgene-free. Together, these properties make this novel method a powerful tool for large-scale reprogramming of PBMCs and for iPSC biobanking. ©AlphaMed Press.

  17. Advancing predictive models for particulate formation in turbulent flames via massively parallel direct numerical simulations

    KAUST Repository

    Bisetti, Fabrizio

    2014-07-14

    Combustion of fossil fuels is likely to continue for the near future due to the growing trends in energy consumption worldwide. The increase in efficiency and the reduction of pollutant emissions from combustion devices are pivotal to achieving meaningful levels of carbon abatement as part of the ongoing climate change efforts. Computational fluid dynamics featuring adequate combustion models will play an increasingly important role in the design of more efficient and cleaner industrial burners, internal combustion engines, and combustors for stationary power generation and aircraft propulsion. Today, turbulent combustion modelling is hindered severely by the lack of data that are accurate and sufficiently complete to assess and remedy model deficiencies effectively. In particular, the formation of pollutants is a complex, nonlinear and multi-scale process characterized by the interaction of molecular and turbulent mixing with a multitude of chemical reactions with disparate time scales. The use of direct numerical simulation (DNS) featuring a state of the art description of the underlying chemistry and physical processes has contributed greatly to combustion model development in recent years. In this paper, the analysis of the intricate evolution of soot formation in turbulent flames demonstrates how DNS databases are used to illuminate relevant physico-chemical mechanisms and to identify modelling needs. © 2014 The Author(s) Published by the Royal Society.

  18. Advances in Virus-Directed Therapeutics against Epstein-Barr Virus-Associated Malignancies

    Directory of Open Access Journals (Sweden)

    Sajal K. Ghosh

    2012-01-01

    Full Text Available Epstein-Barr virus (EBV is the causal agent in the etiology of Burkitt’s lymphoma and nasopharyngeal carcinoma and is also associated with multiple human malignancies, including Hodgkin’s and non-Hodgkin’s lymphoma, and posttransplantation lymphoproliferative disease, as well as sporadic cancers of other tissues. A causal relationship of EBV to these latter malignancies remains controversial, although the episomic EBV genome in most of these cancers is clonal, suggesting infection very early in the development of the tumor and a possible role for EBV in the genesis of these diseases. Furthermore, the prognosis of these tumors is invariably poor when EBV is present, compared to their EBV-negative counterparts. The physical presence of EBV in these tumors represents a potential “tumor-specific” target for therapeutic approaches. While treatment options for other types of herpesvirus infections have evolved and improved over the last two decades, however, therapies directed at EBV have lagged. A major constraint to pharmacological intervention is the shift from lytic infection to a latent pattern of gene expression, which persists in those tumors associated with the virus. In this paper we provide a brief account of new virus-targeted therapeutic approaches against EBV-associated malignancies.

  19. Advancing vector biology research: a community survey for future directions, research applications and infrastructure requirements

    Science.gov (United States)

    Kohl, Alain; Pondeville, Emilie; Schnettler, Esther; Crisanti, Andrea; Supparo, Clelia; Christophides, George K.; Kersey, Paul J.; Maslen, Gareth L.; Takken, Willem; Koenraadt, Constantianus J. M.; Oliva, Clelia F.; Busquets, Núria; Abad, F. Xavier; Failloux, Anna-Bella; Levashina, Elena A.; Wilson, Anthony J.; Veronesi, Eva; Pichard, Maëlle; Arnaud Marsh, Sarah; Simard, Frédéric; Vernick, Kenneth D.

    2016-01-01

    Vector-borne pathogens impact public health, animal production, and animal welfare. Research on arthropod vectors such as mosquitoes, ticks, sandflies, and midges which transmit pathogens to humans and economically important animals is crucial for development of new control measures that target transmission by the vector. While insecticides are an important part of this arsenal, appearance of resistance mechanisms is increasingly common. Novel tools for genetic manipulation of vectors, use of Wolbachia endosymbiotic bacteria, and other biological control mechanisms to prevent pathogen transmission have led to promising new intervention strategies, adding to strong interest in vector biology and genetics as well as vector–pathogen interactions. Vector research is therefore at a crucial juncture, and strategic decisions on future research directions and research infrastructure investment should be informed by the research community. A survey initiated by the European Horizon 2020 INFRAVEC-2 consortium set out to canvass priorities in the vector biology research community and to determine key activities that are needed for researchers to efficiently study vectors, vector-pathogen interactions, as well as access the structures and services that allow such activities to be carried out. We summarize the most important findings of the survey which in particular reflect the priorities of researchers in European countries, and which will be of use to stakeholders that include researchers, government, and research organizations. PMID:27677378

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

    Science.gov (United States)

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

    2010-07-20

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

  1. ADVANCED BYPRODUCT RECOVERY: DIRECT CATALYTIC REDUCTION OF SO2 TO ELEMENTAL SULFUR; FINAL

    International Nuclear Information System (INIS)

    Robert S. Weber

    1999-01-01

    Arthur D. Little, Inc., together with its commercialization partner, Engelhard Corporation, and its university partner Tufts, investigated a single-step process for direct, catalytic reduction of sulfur dioxide from regenerable flue gas desulfurization processes to the more valuable elemental sulfur by-product. This development built on recently demonstrated SO(sub 2)-reduction catalyst performance at Tufts University on a DOE-sponsored program and is, in principle, applicable to processing of regenerator off-gases from all regenerable SO(sub 2)-control processes. In this program, laboratory-scale catalyst optimization work at Tufts was combined with supported catalyst formulation work at Engelhard, bench-scale supported catalyst testing at Arthur D. Little and market assessments, also by Arthur D. Little. Objectives included identification and performance evaluation of a catalyst which is robust and flexible with regard to choice of reducing gas. The catalyst formulation was improved significantly over the course of this work owing to the identification of a number of underlying phenomena that tended to reduce catalyst selectivity. The most promising catalysts discovered in the bench-scale tests at Tufts were transformed into monolith-supported catalysts at Engelhard. These catalyst samples were tested at larger scale at Arthur D. Little, where the laboratory-scale results were confirmed, namely that the catalysts do effectively reduce sulfur dioxide to elemental sulfur when operated under appropriate levels of conversion and in conditions that do not contain too much water or hydrogen. Ways to overcome those limitations were suggested by the laboratory results. Nonetheless, at the end of Phase I, the catalysts did not exhibit the very stringent levels of activity or selectivity that would have permitted ready scale-up to pilot or commercial operation. Therefore, we chose not to pursue Phase II of this work which would have included further bench-scale testing

  2. ADVANCED BYPRODUCT RECOVERY: DIRECT CATALYTIC REDUCTION OF SO2 TO ELEMENTAL SULFUR

    Energy Technology Data Exchange (ETDEWEB)

    Robert S. Weber

    1999-05-01

    Arthur D. Little, Inc., together with its commercialization partner, Engelhard Corporation, and its university partner Tufts, investigated a single-step process for direct, catalytic reduction of sulfur dioxide from regenerable flue gas desulfurization processes to the more valuable elemental sulfur by-product. This development built on recently demonstrated SO{sub 2}-reduction catalyst performance at Tufts University on a DOE-sponsored program and is, in principle, applicable to processing of regenerator off-gases from all regenerable SO{sub 2}-control processes. In this program, laboratory-scale catalyst optimization work at Tufts was combined with supported catalyst formulation work at Engelhard, bench-scale supported catalyst testing at Arthur D. Little and market assessments, also by Arthur D. Little. Objectives included identification and performance evaluation of a catalyst which is robust and flexible with regard to choice of reducing gas. The catalyst formulation was improved significantly over the course of this work owing to the identification of a number of underlying phenomena that tended to reduce catalyst selectivity. The most promising catalysts discovered in the bench-scale tests at Tufts were transformed into monolith-supported catalysts at Engelhard. These catalyst samples were tested at larger scale at Arthur D. Little, where the laboratory-scale results were confirmed, namely that the catalysts do effectively reduce sulfur dioxide to elemental sulfur when operated under appropriate levels of conversion and in conditions that do not contain too much water or hydrogen. Ways to overcome those limitations were suggested by the laboratory results. Nonetheless, at the end of Phase I, the catalysts did not exhibit the very stringent levels of activity or selectivity that would have permitted ready scale-up to pilot or commercial operation. Therefore, we chose not to pursue Phase II of this work which would have included further bench-scale testing

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

    Science.gov (United States)

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

    2015-03-01

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

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

    Science.gov (United States)

    Jegede, Ayodele Samuel; Adegoke, Olufunke Olufunsho

    2016-11-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1990-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Fadila eHadj-Bouziane

    2013-01-01

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

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

    Science.gov (United States)

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

    2010-01-01

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

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

    Science.gov (United States)

    Werner, Perla; Schicktanz, Silke

    2018-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Perla Werner

    2018-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Inés Mª Barrio Cantalejo

    2006-06-01

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

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

    Science.gov (United States)

    Schicktanz, Silke; Raz, Aviad; Shalev, Carmel

    2010-11-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-02-12

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

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

    Science.gov (United States)

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

    2018-04-01

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

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

    Science.gov (United States)

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

    2016-09-01

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

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

    Science.gov (United States)

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

    2018-01-02

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

  16. Advance directives for future dementia can be modified by a brief video presentation on dementia care: An experimental study.

    Directory of Open Access Journals (Sweden)

    Theresia Volhard

    practice of formulating, revising, and supporting advance directives.

  17. Advanced byproduct recovery: Direct catalytic reduction of sulfur dioxide to elemental sulfur. Quarterly report, April 1--June 30, 1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-12-31

    The team of Arthur D. Little, Tufts University and Engelhard Corporation are conducting Phase 1 of a four and a half year, two-phase effort to develop and scale-up an advanced byproduct recovery technology that is a direct, single-stage, catalytic process for converting sulfur dioxide to elemental sulfur. This catalytic process reduces SO{sub 2} over a fluorite-type oxide (such as ceria and zirconia). The catalytic activity can be significantly promoted by active transition metals, such as copper. More than 95% elemental sulfur yield, corresponding to almost complete sulfur dioxide conversion, was obtained over a Cu-Ce-O oxide catalyst as part of an on-going DOE-sponsored, University Coal Research Program. This type of mixed metal oxide catalyst has stable activity, high selectivity for sulfur production, and is resistant to water and carbon dioxide poisoning. Tests with CO and CH{sub 4} reducing gases indicate that the catalyst has the potential for flexibility with regard to the composition of the reducing gas, making it attractive for utility use. The performance of the catalyst is consistently good over a range of SO{sub 2} inlet concentration (0.1 to 10%) indicating its flexibility in treating SO{sub 2} tail gases as well as high concentration streams. The principal objective of the Phase 1 program is to identify and evaluate the performance of a catalyst which is robust and flexible with regard to choice of reducing gas. In order to achieve this goal, the authors have planned a structured program including: Market/process/cost/evaluation; Lab-scale catalyst preparation/optimization studies; Lab-scale, bulk/supported catalyst kinetic studies; Bench-scale catalyst/process studies; and Utility review. Progress is reported from all three organizations.

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

    Science.gov (United States)

    Zhu, Dongming

    2016-01-01

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

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

    Science.gov (United States)

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

    2017-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Francesco Paolo Busardò

    2014-01-01

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

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

    NARCIS (Netherlands)

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

    2014-01-01

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

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

    DEFF Research Database (Denmark)

    Lassen, U; Nielsen, D L; Sørensen, M

    2012-01-01

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

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

    LENUS (Irish Health Repository)

    Coffey, Alice

    2016-01-28

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

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

    Czech Academy of Sciences Publication Activity Database

    Doležal, Adam

    2017-01-01

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

  5. Physician perspectives and compliance with patient advance directives: the role external factors play on physician decision making.

    Science.gov (United States)

    Burkle, Christopher M; Mueller, Paul S; Swetz, Keith M; Hook, C Christopher; Keegan, Mark T

    2012-11-21

    Following passage of the Patient Self Determination Act in 1990, health care institutions that receive Medicare and Medicaid funding are required to inform patients of their right to make their health care preferences known through execution of a living will and/or to appoint a surrogate-decision maker. We evaluated the impact of external factors and perceived patient preferences on physicians' decisions to honor or forgo previously established advance directives (ADs). In addition, physician views regarding legal risk, patients' ability to comprehend complexities involved with their care, and impact of medical costs related to end-of-life care decisions were explored. Attendees of two Mayo Clinic continuing medical education courses were surveyed. Three scenarios based in part on previously court-litigated matters assessed impact of external factors and perceived patient preferences on physician compliance with patient-articulated wishes regarding resuscitation. General questions measured respondents' perception of legal risk, concerns over patient knowledge of idiosyncrasies involved with their care, and impact medical costs may have on compliance with patient preferences. Responses indicating strength of agreement or disagreement with statements were treated as ordinal data and analyzed using the Cochran Armitage trend test. Three hundred eighty-eight of 951 surveys were completed (41% response rate). Eighty percent reported they were likely to honor a patient's AD despite its 5 year age. Fewer than half (41%) would honor the AD of a patient in ventricular fibrillation who had expressed a desire to "pass away in peace." Few (17%) would forgo an AD following a family's request for continued resuscitative treatment. A majority (52%) considered risk of liability to be lower when maintaining someone alive against their wishes than mistakenly failing to provide resuscitative efforts. A large percentage (74%) disagreed that patients could not appreciate complexities

  6. Physician perspectives and compliance with patient advance directives: the role external factors play on physician decision making

    Directory of Open Access Journals (Sweden)

    Burkle Christopher M

    2012-11-01

    Full Text Available Abstract Background Following passage of the Patient Self Determination Act in 1990, health care institutions that receive Medicare and Medicaid funding are required to inform patients of their right to make their health care preferences known through execution of a living will and/or to appoint a surrogate-decision maker. We evaluated the impact of external factors and perceived patient preferences on physicians’ decisions to honor or forgo previously established advance directives (ADs. In addition, physician views regarding legal risk, patients’ ability to comprehend complexities involved with their care, and impact of medical costs related to end-of-life care decisions were explored. Methods Attendees of two Mayo Clinic continuing medical education courses were surveyed. Three scenarios based in part on previously court-litigated matters assessed impact of external factors and perceived patient preferences on physician compliance with patient-articulated wishes regarding resuscitation. General questions measured respondents’ perception of legal risk, concerns over patient knowledge of idiosyncrasies involved with their care, and impact medical costs may have on compliance with patient preferences. Responses indicating strength of agreement or disagreement with statements were treated as ordinal data and analyzed using the Cochran Armitage trend test. Results Three hundred eighty-eight of 951 surveys were completed (41% response rate. Eighty percent reported they were likely to honor a patient’s AD despite its 5 year age. Fewer than half (41% would honor the AD of a patient in ventricular fibrillation who had expressed a desire to “pass away in peace.” Few (17% would forgo an AD following a family’s request for continued resuscitative treatment. A majority (52% considered risk of liability to be lower when maintaining someone alive against their wishes than mistakenly failing to provide resuscitative efforts. A large percentage

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

    Science.gov (United States)

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

    2018-04-01

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

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

    NARCIS (Netherlands)

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

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

  9. Direct coupling of electromembrane extraction to mass spectrometry – Advancing the probe functionality toward measurements of zwitterionic drug metabolites

    DEFF Research Database (Denmark)

    Kige Rye, Torstein; Fuchs, David; Pedersen-Bjergaard, Stig

    2017-01-01

    A triple-flow electromembrane extraction (EME) probe was developed and coupled directly to electrospray-ionization mass spectrometry (ESI-MS). Metabolic reaction mixtures (pH 7.4) containing drug substances and related metabolites were continuously drawn (20 μL/min) into the EME probe in one flow......-nitrophenyl octyl ether (and for some experiments containing 30% triphenyl phosphate (TPP)), and into 20 μL min-1 of formic acid as acceptor phase, which was introduced through a third flow channel. The acceptor phase was pumped directly to the MS system, and the ion intensity of extracted analytes......, the system can potentially be used for direct analysis of various kinds of chemical reactions that have to be run at pH conditions unfavorable for direct analyte extractions....

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

    Directory of Open Access Journals (Sweden)

    Miyoung Kim, RN, PhD, MBA, GNP

    2011-03-01

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

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

    Science.gov (United States)

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

    2014-02-01

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

  12. Direct coupling of electromembrane extraction to mass spectrometry - Advancing the probe functionality toward measurements of zwitterionic drug metabolites.

    Science.gov (United States)

    Rye, Torstein Kige; Fuchs, David; Pedersen-Bjergaard, Stig; Petersen, Nickolaj Jacob

    2017-08-29

    A triple-flow electromembrane extraction (EME) probe was developed and coupled directly to electrospray-ionization mass spectrometry (ESI-MS). Metabolic reaction mixtures (pH 7.4) containing drug substances and related metabolites were continuously drawn (20 μL/min) into the EME probe in one flow channel, and mixed inside the probe with 7.5 μL min -1 of 1 M formic acid as make-up flow from a second flow channel. Following this acidification, the drug substances and their related metabolites were continuously extracted by EME at 400 V, across a supported liquid membrane (SLM) comprising 2-nitrophenyl octyl ether (and for some experiments containing 30% triphenyl phosphate (TPP)), and into 20 μL min -1 of formic acid as acceptor phase, which was introduced through a third flow channel. The acceptor phase was pumped directly to the MS system, and the ion intensity of extracted analytes was followed continuously as function of time. The triple-flow EME probe was used for co-extraction of positively charged parent drugs and their zwitterionic drug metabolites (hydroxyzine and its carboxylic acid metabolite cetirizine; and vortioxetine and its carboxylic acid metabolite Lu AA34443). While the zwitterionic metabolites could not be extracted at pH 7.4, it was shown that by acidifying the sample solution the zwitterionic metabolites could be extracted effectively. Various extraction parameters like make-up flow, extraction voltage and SLM composition were optimized for simultaneous extraction of parent drugs and metabolites. It was found that TPP added to the SLM improved extraction efficiencies of certain drug metabolites. Finally the optimized and characterized triple-flow EME probe was used for online studying the in-vitro metabolism of hydroxyzine and vortioxetine by rat liver microsomes. Due to the automated pre-extraction acidification of the rat liver microsomal solutions, it was possible to continuously monitor formation of the zwitterionic drug

  13. Development of advanced pump impeller fabrication technology using direct nano- ceramic dispersion casting for long time erosion durability

    International Nuclear Information System (INIS)

    Rhee, Chang Kyu; Lee, Min Ku; Park, Jin Ju

    2008-09-01

    Many components of pump impeller of nuclear power plants is generally made of stainless steel and Al-bronze with superior corrosion resistance to sea water. However, they should be replaced by one- to five-year period because of material damage by a very big cavitation impact load, even though their designed durability is twenty years. Especially, in case of Young-Gwang nuclear power plant located at the west sea, damage of components of pump impeller is so critical due to the additional damage by solid particle erosion and hence their replacement period is very short as several months compared to other nuclear power plants. In addition, it is very difficult to maintain and repair the components of pump impeller since there is no database on the exact durability and damage mechanism. Therefore, in this study, fabrication technology of new advanced materials modified by dispersion of nano-carbide and -oxide ceramics into the matrix is developed first. Secondly, technology to estimate the dynamic damage by solid particle erosion is established and hence applied to the prediction of the service life of the components of pump impeller

  14. Preoperative Direct Puncture Embolization of Advanced Juvenile Nasopharyngeal Angiofibroma in Combination with Transarterial Embolization: An Analysis of 22 Consecutive Patients

    International Nuclear Information System (INIS)

    Lv Mingming; Fan, Xin-dong; Su Lixin; Chen Dong

    2013-01-01

    ObjectiveThis study was designed to evaluate the clinical application of preoperative auxiliary embolization for juvenile nasopharyngeal angiofibroma (JNA) by direct puncture embolization (DPE) of the tumor in combination with transarterial embolization (TAE). The study included 22 patients. An 18-gauge needle was used to puncture directly into the tumor, and 20–25 % N-butyl cyanoacrylate was injected under the guidance of fluoroscopy after confirming the placement of the needle into the JNA and no leaking into the surrounding tissue. Tumors were obstructed later via TAE. The supplying arteries of JNA were from branches of the internal carotid and external carotid arteries. Control angiography showed the obliteration of contrast stain in the entire tumor mass and the distal supplying arteries disappeared after DPE in combination with TAE. Surgical resection was performed within 4 days after embolization and none of the patients required blood transfusion. The use of DPE in combination with TAE was a safe, feasible, and efficacious method. It can devascularize effectively the JNAs and reduce intraoperative bleeding when JNAs are extirpated.

  15. Preoperative Direct Puncture Embolization of Advanced Juvenile Nasopharyngeal Angiofibroma in Combination with Transarterial Embolization: An Analysis of 22 Consecutive Patients

    Energy Technology Data Exchange (ETDEWEB)

    Lv Mingming, E-mail: lvmingming001@163.com; Fan, Xin-dong, E-mail: fanxindong@yahoo.com.cn [Shanghai Jiao Tong University School of Medicine, Department of Radiology, Ninth People' s Hospital (China); Su Lixin, E-mail: sulixin1975@126.com [Shanghai Jiao Tong University School of Medicine, Department of Oral and Maxillofacial Surgery, Ninth People' s Hospital (China); Chen Dong, E-mail: chenjsun@public8.sta.net.cn [Shanghai Jiao Tong University School of Medicine, Department of Otolaryngology, Ninth People' s Hospital (China)

    2013-02-15

    ObjectiveThis study was designed to evaluate the clinical application of preoperative auxiliary embolization for juvenile nasopharyngeal angiofibroma (JNA) by direct puncture embolization (DPE) of the tumor in combination with transarterial embolization (TAE). The study included 22 patients. An 18-gauge needle was used to puncture directly into the tumor, and 20-25 % N-butyl cyanoacrylate was injected under the guidance of fluoroscopy after confirming the placement of the needle into the JNA and no leaking into the surrounding tissue. Tumors were obstructed later via TAE. The supplying arteries of JNA were from branches of the internal carotid and external carotid arteries. Control angiography showed the obliteration of contrast stain in the entire tumor mass and the distal supplying arteries disappeared after DPE in combination with TAE. Surgical resection was performed within 4 days after embolization and none of the patients required blood transfusion. The use of DPE in combination with TAE was a safe, feasible, and efficacious method. It can devascularize effectively the JNAs and reduce intraoperative bleeding when JNAs are extirpated.

  16. Advances in Methane Isotope Measurements via Direct Absorption Spectroscopy with Applications to Oil and Gas Source Characterization

    Science.gov (United States)

    Yacovitch, T. I.; Herndon, S. C.; Roscioli, J. R.; Petron, G.; Shorter, J. H.; Jervis, D.; McManus, J. B.; Nelson, D. D.; Zahniser, M. S.; Kolb, C. E., Jr.

    2015-12-01

    Instrumental developments in the measurement of multiple isotopes of methane (12CH4, 13CH4 and 12CH3D) are presented. A first generation 8-micron instrument quantifies 12CH4 and 13CH4 at a 1-second rate via tunable infrared direct absorption spectroscopy (TILDAS). A second generation instrument uses two 3-micron intraband cascade lasers in an Aerodyne dual laser chassis for simultaneous measurement of 12CH4, 13CH4 and 12CH3D. Sensitivity and noise performance improvements are examined. The isotopic signature of methane provides valuable information for emission source identification of this greenhouse gas. A first generation spectrometer has been deployed in the field on a mobile laboratory along with a sophisticated 4-tank calibration system. Calibrations are done on an agressive schedule, allowing for the correction of measured isotope ratios to an absolute isotope scale. Distinct isotopic signatures are found for a number of emission sources in the Denver-Julesburg Basin: oil and gas gathering stations, compressor stations and processing plants; a municipal landfill, and dairy/cattle operations. The isotopic signatures are compared with measured ethane/methane ratios. These direct absorption measurements have larger uncertainties than samples measured via gas chromatography-mass spectrometry, but have several advantages over canister sampling methods: individual sources of short duration are easier to isolate; calibrated isotope ratio results are available immediately; replicate measurements on a single source are easily performed; and the number of sources sampled is not limited by canister availability and processing time.

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

    International Nuclear Information System (INIS)

    Jones, B.G.; Shaheen, S.; Moray, N.

    1997-01-01

    Traditional Single-Sensor-Single Indicator (SSSI) displays are poorly matched to the cognitive abilities of operators, especially for large and complex systems. It is difficult for operators to monitor very large arrays of displays and controls, and to integrate the information displayed therein. In addition, standard operating procedures (SOPs) are bulky (running to many hundreds of pages) and difficult to use, and operators may become lost. For these reasons, and also because it is becoming increasingly difficult to find replacements for aging hardware components, there is a trend towards computerized graphical interfaces for nuclear power plants (NPPs). There is, however, little rational theory for display design in this domain. This report describes some recent theoretical developments and shows how to develop displays which will greatly reduce the cognitive load on the operator and allow the use of perceptual rather than cognitive mechanisms while using SON and to support state diagnosis and fault management. The report outlines the conceptual framework within which such a new approach could be developed, and provides an example of how the operating procedures for the start-up sequence of a NPP could be realized. A detailed description of a set of displays for a graphical interface for the SON of the feedwater system is provided as an example of how the proposed approach could be realized, and a general account of how it would fit into the overall start-up sequence is given. Examples of open-quotes direct perceptionclose quotes or open-quotes ecologicalclose quotes configural state space displays to support the use of the proposed direct manipulation SOP interface are provided, and also a critical discussion which identifies some difficulties which may be anticipated should the general approach herein advocated be adopted

  18. MoS2 nanosheets direct supported on reduced graphene oxide: An advanced electrocatalyst for hydrogen evolution reaction.

    Directory of Open Access Journals (Sweden)

    Jiamu Cao

    Full Text Available Molybdenum disulfide nanosheets/reduced graphene oxide (MoS2 NSs/rGO nanohybrid as a highly effective catalyst for hydrogen evolution reaction (HER have been successfully synthesized by a facile microwave-assisted method. The results clearly reveal that direct grown of MoS2 NSs on rGO have been achieved. Electrochemical tests show that the as-prepared hybrid material exhibited excellent HER activity, with a small Tafel slope of 57 mV dec-1, an overpotential of 130 mV and remarkable cycling stability. After analysis, the observed outstanding catalytic performance can be attributed to the uniform distribution of the MoS2 NSs, which are characterized by the presence of multiple active sites as well as the effective electron transport route provided by the conductive rGO substrate. Moreover, according to the classic theory, the mechanism governing of the catalytic HER on the MoS2 NSs/rGO nanohybrid has been clarified.

  19. Advancing Solar Irradiance Measurement for Climate-Related Studies: Accurate Constraint on Direct Aerosol Radiative Effect (DARE)

    Science.gov (United States)

    Tsay, Si-Chee; Ji, Q. Jack

    2011-01-01

    Earth's climate is driven primarily by solar radiation. As summarized in various IPCC reports, the global average of radiative forcing for different agents and mechanisms, such as aerosols or CO2 doubling, is in the range of a few W/sq m. However, when solar irradiance is measured by broadband radiometers, such as the fleet of Eppley Precision Solar Pyranometers (PSP) and equivalent instrumentation employed worldwide, the measurement uncertainty is larger than 2% (e.g., WMO specification of pyranometer, 2008). Thus, out of the approx. 184 W/sq m (approx.263 W/sq m if cloud-free) surface solar insolation (Trenberth et al. 2009), the measurement uncertainty is greater than +/-3.6 W/sq m, overwhelming the climate change signals. To discern these signals, less than a 1 % measurement uncertainty is required and is currently achievable only by means of a newly developed methodology employing a modified PSP-like pyranometer and an updated calibration equation to account for its thermal effects (li and Tsay, 2010). In this talk, we will show that some auxiliary measurements, such as those from a collocated pyrgeometer or air temperature sensors, can help correct historical datasets. Additionally, we will also demonstrate that a pyrheliometer is not free of the thermal effect; therefore, comparing to a high cost yet still not thermal-effect-free "direct + diffuse" approach in measuring surface solar irradiance, our new method is more economical, and more likely to be suitable for correcting a wide variety of historical datasets. Modeling simulations will be presented that a corrected solar irradiance measurement has a significant impact on aerosol forcing, and thus plays an important role in climate studies.

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

    Science.gov (United States)

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

    2018-04-01

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

  1. Advances in the simulation and automated measurement of well-sorted granular material: 2. Direct measures of particle properties

    Science.gov (United States)

    Buscombe, D.; Rubin, D. M.

    2012-06-01

    In this, the second of a pair of papers on the structure of well-sorted natural granular material (sediment), new methods are described for automated measurements from images of sediment, of: 1) particle-size standard deviation (arithmetic sorting) with and without apparent void fraction; and 2) mean particle size in material with void fraction. A variety of simulations of granular material are used for testing purposes, in addition to images of natural sediment. Simulations are also used to establish that the effects on automated particle sizing of grains visible through the interstices of the grains at the very surface of a granular material continue to a depth of approximately 4 grain diameters and that this is independent of mean particle size. Ensemble root-mean squared error between observed and estimated arithmetic sorting coefficients for 262 images of natural silts, sands and gravels (drawn from 8 populations) is 31%, which reduces to 27% if adjusted for bias (slope correction between observed and estimated values). These methods allow non-intrusive and fully automated measurements of surfaces of unconsolidated granular material. With no tunable parameters or empirically derived coefficients, they should be broadly universal in appropriate applications. However, empirical corrections may need to be applied for the most accurate results. Finally, analytical formulas are derived for the one-step pore-particle transition probability matrix, estimated from the image's autocorrelogram, from which void fraction of a section of granular material can be estimated directly. This model gives excellent predictions of bulk void fraction yet imperfect predictions of pore-particle transitions.

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

    Science.gov (United States)

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

    2017-07-01

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

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

    Science.gov (United States)

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

    2014-06-01

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

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

    Science.gov (United States)

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

    2014-10-01

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

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

    Science.gov (United States)

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

    2012-09-01

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

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

    International Nuclear Information System (INIS)

    Garcia-Segura, Sergi; Brillas, Enric

    2014-01-01

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

  7. Nurses’ perceptions of advance directives

    Directory of Open Access Journals (Sweden)

    Ernestina Silva

    2014-11-01

    Conclusion: Nurses have little experience with AD. They are available to respect the patient's will but did not feel able to address the issue on their own initiative. Most agree that the AD can “fail” if the patient does not reevaluate it periodically. Reflection and debate on the ethical issues surrounding AD should be promoted: promoting patient autonomy, care in vulnerable situations, team decisions and conscientious objection.

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

    Science.gov (United States)

    Fabanich, William A., Jr.

    2014-01-01

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

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

    Science.gov (United States)

    Fabanich, William

    2014-01-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

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

    Science.gov (United States)

    Raz, Aviad; Shalev, Carmel

    2010-01-01

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

  12. Development of the high-order decoupled direct method in three dimensions for particulate matter: enabling advanced sensitivity analysis in air quality models

    Directory of Open Access Journals (Sweden)

    W. Zhang

    2012-03-01

    Full Text Available The high-order decoupled direct method in three dimensions for particulate matter (HDDM-3D/PM has been implemented in the Community Multiscale Air Quality (CMAQ model to enable advanced sensitivity analysis. The major effort of this work is to develop high-order DDM sensitivity analysis of ISORROPIA, the inorganic aerosol module of CMAQ. A case-specific approach has been applied, and the sensitivities of activity coefficients and water content are explicitly computed. Stand-alone tests are performed for ISORROPIA by comparing the sensitivities (first- and second-order computed by HDDM and the brute force (BF approximations. Similar comparison has also been carried out for CMAQ sensitivities simulated using a week-long winter episode for a continental US domain. Second-order sensitivities of aerosol species (e.g., sulfate, nitrate, and ammonium with respect to domain-wide SO2, NOx, and NH3 emissions show agreement with BF results, yet exhibit less noise in locations where BF results are demonstrably inaccurate. Second-order sensitivity analysis elucidates poorly understood nonlinear responses of secondary inorganic aerosols to their precursors and competing species. Adding second-order sensitivity terms to the Taylor series projection of the nitrate concentrations with a 50% reduction in domain-wide NOx or SO2 emissions rates improves the prediction with statistical significance.

  13. Moderate Sustained Virologic Response Rates With 6-Week Combination Directly Acting Anti-Hepatitis C Virus Therapy in Patients With Advanced Liver Disease.

    Science.gov (United States)

    Kattakuzhy, Sarah; Wilson, Eleanor; Sidharthan, Sreetha; Sims, Zayani; McLaughlin, Mary; Price, Angie; Silk, Rachel; Gross, Chloe; Akoth, Elizabeth; McManus, Maryellen; Emmanuel, Benjamin; Shrivastava, Shikha; Tang, Lydia; Nelson, Amy; Teferi, Gebeyehu; Chavez, Jose; Lam, Brian; Mo, Hongmei; Osinusi, Anuoluwapo; Polis, Michael A; Masur, Henry; Kohli, Anita; Kottilil, Shyamasundaran

    2016-02-15

    Treatment of genotype 1 hepatitis C virus (HCV) infection with combination directly acting antivirals (DAA) for 8-24 weeks is associated with high rates of sustained virologic response (SVR). We previously demonstrated that adding a third DAA to ledipasvir and sofosbuvir (LDV/SOF) can result in high SVR rates in patients without cirrhosis. In this study, we investigated whether a similar regimen would yield equivalent rates of cure in patients with advanced liver fibrosis. Fifty patients were enrolled at the Clinical Research Center of the National Institutes of Health and associated healthcare centers. Enrollment and follow-up data from April 2014 to June 2015 are reported here. Eligible participants were aged ≥18 years, had chronic HCV genotype 1 infection (serum HCV RNA ≥2000 IU/mL), and stage 3-4 liver fibrosis. HCV RNA was measured using a reverse-transcription polymerase chain reaction assay. Of patients treated with LDV, SOF, and the NS3/4A protease inhibitor GS-9451 for 6 weeks, 76% (38 of 50; 95% confidence interval, 60%-85%) had SVR achieved 12 weeks after the end of treatment. There was no statistically significant difference in treatment efficacy between treatment-naive patients (72%, 18 of 25) and those with treatment experience (80%; 20 of 25) (P = .51). Overall, 11 patients (22%) experienced virologic relapse, and 1 (2%) was lost to follow-up at 4 weeks after treatment. No serious adverse events, discontinuations, or deaths were associated with this regimen. Adding a third DAA to LDV/SOF may result in a moderate SVR rate, lower than that observed in patients without cirrhosis. Significant liver fibrosis remains an impediment to achieving SVR with short-duration DAA therapy. CT01805882. Published by Oxford University Press for the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  14. More counselling for end-of-life decisions by GPs with own advance directives: A postal survey among German general practitioners.

    Science.gov (United States)

    Schnakenberg, Rieke; Radbruch, Lukas; Kersting, Christine; Frank, Friederike; Wilm, Stefan; Becka, Denise; Weckbecker, Klaus; Bleckwenn, Markus; Just, Johannes M; Pentzek, Michael; Weltermann, Birgitta

    2018-12-01

    Although general practitioners (GPs) are among the preferred contact persons for discussing end-of-life issues including advance directives (ADs), there is little data on how GPs manage such consultations. This postal survey asked German GPs about their counselling for end-of-life decisions. In 2015, a two-sided questionnaire was mailed to 959 GPs. GPs were asked for details of their consultations on ADs: frequency, duration, template use, and whether they have own ADs. Statistical analysis evaluated physician characteristics associated with an above-average number of consultations on AD. The participation rate was 50.3% (n = 482), 70.5% of the GPs were male; the average age was 54 years. GPs had an average of 18 years of professional experience, and 61.4% serve more than 900 patients per three months. Most (96.9%) GPs perform consultations on living wills (LW) and/or powers of attorney (PA), mainly in selected patients (72.3%). More than 20 consultations each on LWs and PAs are performed by 60% and 50% of GPs, respectively. The estimated mean duration of consultations was 21 min for LWs and 16 min for PAs. Predefined templates were used in 72% of the GPs, 50% of GPs had their ADs. A statistical model showed that GPs with ADs and/or a qualification in palliative medicine were more likely to counsel ≥20 patients per year for each document. The study confirmed that nearly all German GPs surveyed provide counselling on ADs. Physicians with ADs counsel more frequently than those without such documents.

  15. Motivational aftercare planning to better care: Applying the principles of advanced directives and motivational interviewing to discharge planning for people with mental illness.

    Science.gov (United States)

    Kisely, Steve; Wyder, Marianne; Dietrich, Josie; Robinson, Gail; Siskind, Dan; Crompton, David

    2017-02-01

    Improving the input of people with mental illness into their recovery plans can potentially lead to better outcomes. In the present study, we evaluated the introduction of motivational aftercare planning (MAP) into the discharge planning of psychiatric inpatients. MAP is a manualized intervention combining motivational interviewing with advance directives. We measured changes in the level of patient input into discharge planning following training staff in the use of MAP. This included the following: (i) documentation of early relapse signs along with successful past responses; (ii) evidence of aftercare planning; and (iii) the use of the patients' own words in the plan. We used a ward-level controlled before-and-after design comparing one intervention ward with two control wards. We used anonymized recovery plans, with a goal of 50 plans per ward before and after the intervention, to look for evidence of patient input into care planning with a standardized checklist. There were also qualitative interviews with individuals discharged from the unit. We reviewed 100 intervention ward plans and 197 control ones (total n = 297). There were no significant differences in recovery plans from intervention and control wards at baseline. Following MAP training, the intervention ward improved significantly (e.g. identification of triggers increased from 52 to 94%, χ 2  = 23.3, d.f. =1, P < 0.001). This did not occur in the control wards. The qualitative data (n = 20 interviews) showed improvements in participants' experiences of discharge planning. MAP increased inpatient input into discharge planning and was valued by participants. The effect on subsequent health service use needs evaluation. © 2016 Australian College of Mental Health Nurses Inc.

  16. Determinants of completion of advance directives: a cross-sectional comparison of 649 outpatients from private practices versus 2158 outpatients from a university clinic.

    Science.gov (United States)

    Pfirstinger, Jochen; Bleyer, Bernhard; Blum, Christian; Rechenmacher, Michael; Wiese, Christoph H; Gruber, Hans

    2017-12-21

    To compare outpatients from private practices and outpatients from a university clinic regarding the determinants of completion of advance directives (AD) in order to generalise results of studies from one setting to the other. Five determinants of completion of AD were studied: familiarity with AD, source of information about AD, prior experiences with own life-threatening diseases or family members in need of care and motives in favour and against completion of AD. Observational cross-sectional study. Private practices and a university clinic in Germany in 2012. 649 outpatients from private practices and 2158 outpatients from 10 departments of a university clinic. Completion of AD, familiarity with AD, sources of information about AD (consultation), prior experiences (with own life-threatening disease and family members in need of care), motives in favour of or against completion of AD, sociodemographic data. Determinants of completion of AD did not differ between outpatients from private practices versus university clinic outpatients. Prior experience with severe disease led to a significantly higher rate of completion of AD (33%/36% with vs 24%/24% without prior experience). Participants with completion of AD had more often received legal than medical consultation before completion, but participants without completion of AD are rather aiming for medical consultation. The motives in favour of or against completion of AD indicated inconsistent patterns. Determinants of completion of AD are comparable in outpatients from private practices and outpatients from a university clinic. Generalisations from university clinic samples towards a broader context thus seem to be legitimate. Only one-third of patients with prior experience with own life-threatening diseases or family members in need of care had completed an AD as expression of their autonomous volition. The participants' motives for or against completion of AD indicate that ADs are considered a kind of

  17. Which online format is most effective for assisting Baby Boomers to complete advance directives? A randomised controlled trial of email prompting versus online education module.

    Science.gov (United States)

    Bradley, Sandra L; Tieman, Jennifer J; Woodman, Richard J; Phillips, Paddy A

    2017-08-29

    Completion of Advance Directives (ADs), being financial and healthcare proxy or instructional documents, is relatively uncommon in Australia. Efforts to increase completion rates include online education and prompting which past literature suggests may be effective. The aim of this randomized controlled trial was to assess computer-based online AD information and email prompting for facilitating completion of ADs by Australian Baby Boomers (b.1946-1965) as well as factors which may impede or assist completion of these documents by this generation when using the online environment. Two hundred eighty-two men and women aged 49-68 years at the time of the trial were randomly assigned to one of 3 intervention groups: education module only; email prompt only; email prompt and education module; and a control group with no education module and no email prompt. The randomized controlled trial was undertaken in participants' location of choice. Randomization and allocation to trial group were carried out by a central computer system. The primary analysis was based on a final total of 189 participants who completed the trial (n = 52 education module only; n = 44 email prompt only; n = 46 email prompt and education module; and n = 47 control). The primary outcome was the number of individuals in any group completing any of the 4 legal ADs in South Australia within 12 months or less from entry into the trial. Frequency analysis was conducted on secondary outcomes such as reasons for non-completion. Mean follow-up post-intervention at 12 months showed that 7% of overall participants completed one or more of the 4 legal ADs but without significant difference between groups (delta = 1%, p = .48 Prompt/Non-Prompt groups, delta = 5%, p = .44 education/non-education groups). Reasons offered for non-completion were too busy (26%) and/or it wasn't the right time (21%). Our results suggest that neither email prompting nor provision of additional educational material

  18. Computational mechanics - Advances and trends; Proceedings of the Session - Future directions of Computational Mechanics of the ASME Winter Annual Meeting, Anaheim, CA, Dec. 7-12, 1986

    Science.gov (United States)

    Noor, Ahmed K. (Editor)

    1986-01-01

    The papers contained in this volume provide an overview of the advances made in a number of aspects of computational mechanics, identify some of the anticipated industry needs in this area, discuss the opportunities provided by new hardware and parallel algorithms, and outline some of the current government programs in computational mechanics. Papers are included on advances and trends in parallel algorithms, supercomputers for engineering analysis, material modeling in nonlinear finite-element analysis, the Navier-Stokes computer, and future finite-element software systems.

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

    Science.gov (United States)

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

    2010-04-30

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

  20. Advanced-fueled fusion reactors suitable for direct energy conversion. Project note: temperature-gradient enhancement of electrical fields in insulators

    International Nuclear Information System (INIS)

    Blum, A.S.; Mancebo, L.

    1976-01-01

    Direct energy converters for use on controlled fusion reactors utilize electrodes operated at elevated voltages and temperatures. The insulating elements that position these electrodes must support large voltages and under some circumstances large thermal gradients. It is shown that even modest thermal gradients can cause major alterations of the electric-field distribution within the insulating element

  1. Direct costs associated with the disease management of patients with unresectable advanced non-small-cell lung cancer in The Netherlands.

    Science.gov (United States)

    Pompen, Marjolein; Gok, Murat; Novák, Annoesjka; van Wuijtswinkel, Rob; Biesma, Bonne; Schramel, Franz; Stigt, Jos; Smit, Hans; Postmus, Pieter

    2009-04-01

    Disease management and costs of treatment of patients with unresectable advanced non-small-cell lung cancer (NSCLC) in The Netherlands are not well known. A retrospective medical chart review was performed by collecting data from the time of diagnosis until the time of death or the end of the evaluation period. In addition to the demographic data, information was collected on the overall management of the patient. Hospital resource utilisation data collected included number of outpatient specialist visits, number and length of hospitalisation, type and number of diagnostic and laboratory procedures, type and number of radiotherapy cycles and detailed information on chemotherapy. To evaluate the economic impact of second-line treatment, a distinction was made between patients who received only best supportive care (BSC, group A) and those who received chemotherapy as a second-line treatment in addition to BSC (group B). The study was performed from the hospital perspective and reports on 2005 costs. Of 102 patients, 74 belonged to group A and 28 to group B. Patient management included a multidisciplinary approach, the extent of which depended on symptoms of the disease and presence of metastases. The average total treatment cost per patient per year of unresectable advanced NSCLC in The Netherlands was euro32,840 in group A and euro31,187 in group B. In both groups, hospitalisation was the major cost driver. In group B second-line chemotherapy was the second largest contributor of the costs. In spite of the difference in numbers of treatment lines provided to patients in groups A and B the total average costs per patient per year were comparable. Overall, the management of unresectable advanced NSCLC appeared to conform with current guidelines in The Netherlands. These patients show high medical resource consumption, with hospitalisation being the main cost driver in both groups. As economic arguments are becoming increasingly important in medical decision making on

  2. Advancing non-directive pregnancy options counseling skills: A pilot Study on the use of blended learning with an online module and simulation.

    Science.gov (United States)

    Lupi, Carla; Ward-Peterson, Melissa; Chang, Winnie

    2016-10-01

    Limitations on didactic time pose barriers to teaching non-directive pregnancy options counseling. This study set out to explore the use of an online module to support trainee performance in a pregnancy options counseling standardized-patient exercise implemented among third-year medical students, and to examine the effect of clinical experience on student performance. An online module was developed. A convenience sample of forty-six student performances in a family medicine clerkship participated in a standardized patient exercise. Trained faculty rated performances. Students completed a self-assessment and provided feedback on the online module. Chi-square and Mann-Whitney-U tests were used to analyze data. Three coders qualitatively examined narrative student comments. Thirty-four students passed, 11 achieved a minimal pass, and one failed. The mean global rating from faculty was 2.8 (pass). Students with prior clinical experience significantly outperformed those without on the global rating scale with mean scores of 3.1 compared to 2.7, respectively (p=.044). All students agreed that the online module helped prepare them for the exercise. Qualitative analysis of students' feedback on the module revealed strengths in content and pedagogy. In their self-assessments, all but two students referred to content explicitly conveyed in the module. All students agreed that an online module supported their performance of non-directive pregnancy options counseling skills. Prior clinical experience was associated with improved performance. This module, along with the simulated exercise, can be implemented as a blended learning exercise without additional faculty teaching effort in standardized patient resource centers. Students agreed that an online module facilitates simulated performance of non-directive pregnancy options counseling skills. Future work should compare the impact of this approach to others, and explore the additional training needed to maintain and build on

  3. IMRT and 3D conformal radiotherapy with or without elective nodal irradiation in locally advanced NSCLC: A direct comparison of PET-based treatment planning.

    Science.gov (United States)

    Fleckenstein, Jochen; Kremp, Katharina; Kremp, Stephanie; Palm, Jan; Rübe, Christian

    2016-02-01

    The potential of intensity-modulated radiation therapy (IMRT) as opposed to three-dimensional conformal radiotherapy (3D-CRT) is analyzed for two different concepts of fluorodeoxyglucose positron emission tomography (FDG PET)-based target volume delineation in locally advanced non-small cell lung cancer (LA-NSCLC): involved-field radiotherapy (IF-RT) vs. elective nodal irradiation (ENI). Treatment planning was performed for 41 patients with LA-NSCLC, using four different planning approaches (3D-CRT-IF, 3D-CRT-ENI, IMRT-IF, IMRT-ENI). ENI included a boost irradiation after 50 Gy. For each plan, maximum dose escalation was calculated based on prespecified normal tissue constraints. The maximum prescription dose (PD), tumor control probability (TCP), conformal indices (CI), and normal tissue complication probabilities (NTCP) were analyzed. IMRT resulted in statistically significant higher prescription doses for both target volume concepts as compared with 3D-CRT (ENI: 68.4 vs. 60.9 Gy, p ENI, there was a considerable theoretical increase in TCP (IMRT: 27.3 vs. 17.7 %, p ENI: 12.3 vs. 30.9 % p < 0.0001; IF: 15.9 vs. 24.1 %; p < 0.001). The IMRT technique and IF target volume delineation allow a significant dose escalation and an increase in TCP. IMRT results in an improved sparing of OARs as compared with 3D-CRT at equivalent dose levels.

  4. IMRT and 3D conformal radiotherapy with or without elective nodal irradiation in locally advanced NSCLC. A direct comparison of PET-based treatment planning

    International Nuclear Information System (INIS)

    Fleckenstein, Jochen; Kremp, Katharina; Kremp, Stephanie; Palm, Jan; Ruebe, Christian

    2016-01-01

    The potential of intensity-modulated radiation therapy (IMRT) as opposed to three-dimensional conformal radiotherapy (3D-CRT) is analyzed for two different concepts of fluorodeoxyglucose positron emission tomography (FDG PET)-based target volume delineation in locally advanced non-small cell lung cancer (LA-NSCLC): involved-field radiotherapy (IF-RT) vs. elective nodal irradiation (ENI). Treatment planning was performed for 41 patients with LA-NSCLC, using four different planning approaches (3D-CRT-IF, 3D-CRT-ENI, IMRT-IF, IMRT-ENI). ENI included a boost irradiation after 50 Gy. For each plan, maximum dose escalation was calculated based on prespecified normal tissue constraints. The maximum prescription dose (PD), tumor control probability (TCP), conformal indices (CI), and normal tissue complication probabilities (NTCP) were analyzed. IMRT resulted in statistically significant higher prescription doses for both target volume concepts as compared with 3D-CRT (ENI: 68.4 vs. 60.9 Gy, p < 0.001; IF: 74.3 vs. 70.1 Gy, p < 0.03). With IMRT-IF, a PD of at least 66 Gy was achieved for 95 % of all plans. For IF as compared with ENI, there was a considerable theoretical increase in TCP (IMRT: 27.3 vs. 17.7 %, p < 0.00001; 3D-CRT: 20.2 vs. 9.9 %, p < 0.00001). The esophageal NTCP showed a particularly good sparing with IMRT vs. 3D-CRT (ENI: 12.3 vs. 30.9 % p < 0.0001; IF: 15.9 vs. 24.1 %; p < 0.001). The IMRT technique and IF target volume delineation allow a significant dose escalation and an increase in TCP. IMRT results in an improved sparing of OARs as compared with 3D-CRT at equivalent dose levels. (orig.) [de

  5. First-in-human phase 1 of YS110, a monoclonal antibody directed against CD26 in advanced CD26-expressing cancers.

    Science.gov (United States)

    Angevin, Eric; Isambert, Nicolas; Trillet-Lenoir, Véronique; You, Benoit; Alexandre, Jérôme; Zalcman, Gérard; Vielh, Philippe; Farace, Françoise; Valleix, Fanny; Podoll, Thomas; Kuramochi, Yu; Miyashita, Itaru; Hosono, Osamu; Dang, Nam H; Ohnuma, Kei; Yamada, Taketo; Kaneko, Yutaro; Morimoto, Chikao

    2017-04-25

    YS110 is a humanised IgG1 monoclonal antibody with high affinity to the CD26 antigen. YS110 demonstrated preclinical anti-tumour effects without significant side effects. This FIH study was designed to determine the maximal tolerated dose (MTD) and recommended phase 2 dose (RP2D) to assess the tolerance, pharmacokinetics (PK) and pharmacodynamics profiles of YS110 and preliminary efficacy. YS110 were initially administered intravenously once every 2 weeks (Q2W) for three doses and then, based on PK data, once every week (Q1W) for five doses in patients with CD26-expressing solid tumours. Thirty-three patients (22 mesothelioma) received a median of 3 (range 1-30) YS110 infusions across six dose levels (0.1-6 mg kg -1 ). MTD was not reached and two dose-limiting toxicities (infusion hypersensitivity reactions) led to the institution of a systemic premedication. Low-grade asthenia (30.3%), hypersensitivity (27.3%), nausea (15.2%), flushing (15.2%), chills (12.1%) and pyrexia (12.1%) were reported as ADRs. Pharmacokinetic parameters (AUC and C max ) increased in proportion with the dose. sCD26/DPPIV assays indicated CD26 modulation. Prolonged stable diseases were observed in 13 out of 26 evaluable patients. YS110 is well tolerated up to 6 mg kg -1 Q1W, which has been defined as the RP2D, with encouraging prolonged disease stabilisations observed in a number of patients with advanced/refractory mesothelioma.

  6. SL-401 and SL-501, Targeted Therapeutics Directed at the Interleukin-3 Receptor, Inhibit the Growth of Leukaemic Cells and Stem Cells in Advanced Phase Chronic Myeloid Leukaemia

    Science.gov (United States)

    Frolova, Olga; Benito, Juliana; Brooks, Chris; Wang, Rui-Yu; Korchin, Borys; Rowinsky, Eric K.; Cortes, Jorge; Kantarjian, Hagop; Andreeff, Michael; Frankel, Arthur E.; Konopleva, Marina

    2014-01-01

    SUMMARY While imatinib and other tyrosine kinase inhibitors (TKIs) are highly efficacious in the treatment of chronic myeloid leukaemia (CML), some patients become refractory to these therapies. After confirming that interleukin-3 receptor (IL3R, CD123) is highly expressed on CD34+/CD38− BCR-ABL1+ CML stem cells, we investigated whether targeting IL3R with diphtheria toxin (DT)-IL3 fusion proteins SL-401 (DT388-IL3) and SL-501 (DT388-IL3[K116W]) could eradicate these stem cells. SL-401 and SL-501 inhibited cell growth and induced apoptosis in the KBM5 cell line and its TKI-resistant KBM5-STI subline. Combinations of imatinib with these agents increased apoptosis in KBM5 and in primary CML cells. In six primary CML samples, including CML cells harbouring the ABL1 T315I mutation, SL-401 and SL-501 decreased the absolute numbers of viable CD34+/CD38−/CD123+ CML progenitor cells by inducing apoptosis. IL3-targeting agents reduced clonogenic growth and diminished the fraction of primitive long-term culture-initiating cells in samples from patients with advanced phase CML that were resistant to TKIs or harboured an ABL1 mutation. Survival was also extended in a mouse model of primary TKI-resistant CML blast crisis. These data suggest that the DT-IL3 fusion proteins, SL-401 and SL-501, deplete CML stem cells and may increase the effectiveness of current CML treatment, which principally targets tumour bulk. PMID:24942980

  7. Planning for Advanced Cancer

    Science.gov (United States)

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

  8. Cross-linked hierarchical arrays of Ni2P nanoflakes prepared via directional phosphorization and their applications for advanced alkaline batteries

    Science.gov (United States)

    Mai, Yong-jin; Xia, Xinhui; Jie, Xiao-hua

    2017-11-01

    In this work, we report a facile directional phosphorization method for construction of hierarchical cross-linked Ni2P arrays, which show a multileveled porous architecture. The basic building blocks are numerous nanoflakes with thicknesses of 15-20 nm, which are self-assembled with each other forming the primary porous mushroom-like structure with 1-3 μm. Impressively, the 3D porous channels run through the whole Ni2P arrays. The secondary nanoflakes consist of interconnected nanoparticles of 10-30 nm and lots of nanopores of 10-50 nm. The electrochemical performance of the as-prepared Ni2P arrays is investigated as cathode of alkaline batteries and demonstrated with higher capacities (127 mAhh g-1 at 2.5 A g-1) and better high-rate cycling stability (123 mAhh g-1 2.5 A g-1 after 9000 cycles) than the preformed Ni(OH)2 arrays counterparts (80 mAhh g-1 2.5 A g-1 and 66 mAhh g-1 after 9000 cycles). The enhanced performance is mainly due to the improved surface area & porosity as well as reinforced electrical conductivity.

  9. IMRT and 3D conformal radiotherapy with or without elective nodal irradiation in locally advanced NSCLC. A direct comparison of PET-based treatment planning

    Energy Technology Data Exchange (ETDEWEB)

    Fleckenstein, Jochen; Kremp, Katharina; Kremp, Stephanie; Palm, Jan; Ruebe, Christian [Saarland University Medical School, Department of Radiotherapy and Radiation Oncology, Homburg/Saar (Germany)

    2016-02-15

    The potential of intensity-modulated radiation therapy (IMRT) as opposed to three-dimensional conformal radiotherapy (3D-CRT) is analyzed for two different concepts of fluorodeoxyglucose positron emission tomography (FDG PET)-based target volume delineation in locally advanced non-small cell lung cancer (LA-NSCLC): involved-field radiotherapy (IF-RT) vs. elective nodal irradiation (ENI). Treatment planning was performed for 41 patients with LA-NSCLC, using four different planning approaches (3D-CRT-IF, 3D-CRT-ENI, IMRT-IF, IMRT-ENI). ENI included a boost irradiation after 50 Gy. For each plan, maximum dose escalation was calculated based on prespecified normal tissue constraints. The maximum prescription dose (PD), tumor control probability (TCP), conformal indices (CI), and normal tissue complication probabilities (NTCP) were analyzed. IMRT resulted in statistically significant higher prescription doses for both target volume concepts as compared with 3D-CRT (ENI: 68.4 vs. 60.9 Gy, p < 0.001; IF: 74.3 vs. 70.1 Gy, p < 0.03). With IMRT-IF, a PD of at least 66 Gy was achieved for 95 % of all plans. For IF as compared with ENI, there was a considerable theoretical increase in TCP (IMRT: 27.3 vs. 17.7 %, p < 0.00001; 3D-CRT: 20.2 vs. 9.9 %, p < 0.00001). The esophageal NTCP showed a particularly good sparing with IMRT vs. 3D-CRT (ENI: 12.3 vs. 30.9 % p < 0.0001; IF: 15.9 vs. 24.1 %; p < 0.001). The IMRT technique and IF target volume delineation allow a significant dose escalation and an increase in TCP. IMRT results in an improved sparing of OARs as compared with 3D-CRT at equivalent dose levels. (orig.) [German] Das Potenzial der intensitaetsmodulierten Strahlentherapie (IMRT) soll im Rahmen der FDG-PET basierten Bestrahlungsplanung des lokal fortgeschrittenen nichtkleinzelligen Bronchialkarzinoms (LA-NSCLC) fuer 2 Zielvolumenansaetze (Involved-Field-Bestrahlung, IF) sowie elektive Nodalbestrahlung (ENI) geprueft und mit der 3-D-konformalen Strahlentherapie (3-D

  10. Advanced Technology Direction and Control Communications Systems

    Science.gov (United States)

    1979-07-16

    Leupert amesD./Morrell ~I~ Frederick . euprJae DCPAaol-78-C-1 259] ,. IERFORMlk6 ORGANIZATION NAME AND ADDRESS %a. P ROGRAM ELEMiENT. PROJIECT. TASK AREA...without the change in communicatios LCciniLlucs b•;i,,g aipiarci-IL. A JTIDS net is organized on the principle of time division. Various elements are...sideband (DSB-AI) "* Amplitude modulation, vestigial sideband (VSB-AM) * Frequency sI Shift modulation (FSK) "* Phase shift modulation (PSK) Ti DSB

  11. Behavioral cardiology: current advances and future directions.

    Science.gov (United States)

    Rozanski, Alan

    2014-07-08

    Growing epidemiological evidence identifies key domains relevant to behavioral cardiology, including health behaviors, emotions, mental mindsets, stress management, social connectedness, and a sense of purpose. Each of these domains exists along a continuum, ranging from positive factors that promote health, to negative factors, which are pathophysiological. To date, there has been relatively little translation of this growing knowledge base into cardiology practice. Four initiatives are proposed to meet this challenge: 1) promulgating greater awareness of the potency of psychosocial risks factors; 2) overcoming a current "artificial divide" between conventional and psychosocial risk factors; 3) developing novel cost-effective interventions using Internet and mobile health applications, group-based counseling, and development of tiered-care behavioral management; and 4) in recognition that "one size does not fit all" with respect to behavioral interventions, developing specialists who can counsel patients in multidisciplinary fashion and use evidence-based approaches for promoting patient motivation and execution of health goals. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  12. Study of Default Options in Advance Directives

    Science.gov (United States)

    2015-06-29

    COPD; Severe or Very Severe Airflow Obstruction and/or Receiving or Eligible to Receive Long-term Oxygen Therapy; Idiopathic Pulmonary Fibrosis; Other Interstitial Lung Disease Without Curative Therapy; Congestive Heart Failure; NYHA Class IV or NYHA Class III Plus 1 Hospitalization in the Past Year; Malignancy; Any Stage 3B or 4 Solid Tumor

  13. Advance Directives and Do Not Resuscitate Orders

    Science.gov (United States)

    ... Kids and Teens Pregnancy and Childbirth Women Men Seniors Your Health Resources Healthcare Management End-of-Life Issues Insurance & Bills Self Care Working With Your Doctor Drugs, Procedures & Devices Over-the- ...

  14. Beyond competence: advance directives in dementia research

    NARCIS (Netherlands)

    K.R. Jongsma (Karin); S. van de Vathorst (Suzanne)

    2015-01-01

    textabstractDementia is highly prevalent and incurable. The participation of dementia patients in clinical research is indispensable if we want to find an effective treatment for dementia. However, one of the primary challenges in dementia research is the patients’ gradual loss of the capacity to

  15. Advanced Ceramics

    International Nuclear Information System (INIS)

    1989-01-01

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

  16. "I don't need my patients' opinion to withdraw treatment": patient preferences at the end-of-life and physician attitudes towards advance directives in England and France.

    Science.gov (United States)

    Horn, Ruth

    2014-08-01

    This paper presents the results of a qualitative interview study exploring English and French physicians' moral perspectives and attitudes towards end-of-life decisions when patients lack capacity to make decisions for themselves. The paper aims to examine the importance physicians from different contexts accord to patient preferences and to explore the (potential) role of advance directives (ADs) in each context. The interviews focus on (1) problems that emerge when deciding to withdraw/-hold life-sustaining treatment from both conscious and unconscious patients; (2) decision-making procedures and the participation of proxies/relatives; (3) previous experience with ADs and views on their usefulness; and (4) perspectives on ways in which the decision-making processes in question might be improved. The analysis reveals differences in the way patient preferences are taken into consideration and shows how these differences influence the reasons physicians in each country invoke to justify their reluctance to adhering to ADs. Identifying cultural differences that complicate efforts to develop the practical implementation of ADs can help to inform national policies governing ADs and to better adapt them to practice.

  17. Nuclear imaging: Advances and trends

    International Nuclear Information System (INIS)

    Herk, G. van

    1986-01-01

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

  18. ADVANCE PAYMENTS

    CERN Multimedia

    Human Resources Division

    2002-01-01

    Administrative Circular Nº 8 makes provision for the granting of advance payments, repayable in several monthly instalments, by the Organization to the members of its personnel. Members of the personnel are reminded that these advances are only authorized in exceptional circumstances and at the discretion of the Director-General. In view of the current financial situation of the Organization, and in particular the loans it will have to incur, the Directorate has decided to restrict the granting of such advances to exceptional or unforeseen circumstances entailing heavy expenditure and more specifically those pertaining to social issues. Human Resources Division Tel. 73962

  19. Advance payments

    CERN Multimedia

    Human Resources Division

    2003-01-01

    Administrative Circular N 8 makes provision for the granting of advance payments, repayable in several monthly instalments, by the Organization to the members of its personnel. Members of the personnel are reminded that these advances are only authorized in exceptional circumstances and at the discretion of the Director-General. In view of the current financial situation of the Organization, and in particular the loans it will have to incur, the Directorate has decided to restrict the granting of such advances to exceptional or unforeseen circumstances entailing heavy expenditure and more specifically those pertaining to social issues. Human Resources Division Tel. 73962

  20. Advanced Electronics

    Science.gov (United States)

    2017-07-21

    AFRL-RV-PS- AFRL-RV-PS- TR-2017-0114 TR-2017-0114 ADVANCED ELECTRONICS Ashwani Sharma 21 Jul 2017 Interim Report APPROVED FOR PUBLIC RELEASE...NUMBER Advanced Electronics 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 62601F 6. AUTHOR(S) 5d. PROJECT NUMBER 4846 Ashwani Sharma 5e. TASK NUMBER...Approved for public release; distribution is unlimited. (RDMX-17-14919 dtd 20 Mar 2018) 13. SUPPLEMENTARY NOTES 14. ABSTRACT The Space Electronics

  1. Advanced exhaust nozzle technology

    Energy Technology Data Exchange (ETDEWEB)

    Glidewell, R J; Warburton, R E

    1981-01-01

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

  2. Advanced solid state batteries

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-01-01

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

  3. AdvancED Flex 4

    CERN Document Server

    Tiwari, Shashank; Schulze, Charlie

    2010-01-01

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

  4. Advanced calculus

    CERN Document Server

    Nickerson, HK; Steenrod, NE

    2011-01-01

    ""This book is a radical departure from all previous concepts of advanced calculus,"" declared the Bulletin of the American Mathematics Society, ""and the nature of this departure merits serious study of the book by everyone interested in undergraduate education in mathematics."" Classroom-tested in a Princeton University honors course, it offers students a unified introduction to advanced calculus. Starting with an abstract treatment of vector spaces and linear transforms, the authors introduce a single basic derivative in an invariant form. All other derivatives - gradient, divergent, curl,

  5. Advanced TCA BAckplane Tester

    CERN Document Server

    Oltean, Alexandra Dana; PGNet2005

    2005-01-01

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

  6. Direct Democracy

    DEFF Research Database (Denmark)

    Beramendi, Virginia; Ellis, Andrew; Kaufman, Bruno

    While many books on direct democracy have a regional or national approach, or simply focus on one of the many mechanisms associated with direct democracy, this Handbook delves into a global comparison of direct democracy mechanisms, including referendums, citizens' initiatives, agenda initiatives...... learned. In addition, the uniquely comprehensive world survey outlines direct democracy provisions in 214 countries and territories and indicates which, if any, of these provisions are used by each country or territory at both the national and sub-national levels. Furthermore, the world survey includes...

  7. ADVANCED SULFUR CONTROL CONCEPTS

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-01-01

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

  8. Directing 101.

    Science.gov (United States)

    Pintoff, Ernest

    Providing an introduction to anyone considering directing as a field of study or career, this book takes a broad look at the process of directing and encourages students and professionals alike to look outside of the movie industry for inspiration. Chapters in the book discuss selecting and acquiring material; budgeting and financing; casting and…

  9. Advanced Virgo

    CERN Multimedia

    Virgo, a first-generation interferometric gravitational wave (GW) detector, located in the European Gravitational Observatory, EGO, Cascina (Pisa-Italy) and constructed by the collaboration of French and Italian institutes (CNRS and INFN) has successfully completed its long-duration data taking runs. It is now undergoing a fundamental upgrade that exploits available cutting edges technology to open an exciting new window on the universe, with the first detection of a gravitational wave signal. Advanced Virgo (AdV) is the project to upgrade the Virgo detector to a second-generation instrument. AdV will be able to scan a volume of the Universe 1000 times larger than initial Virgo. AdV will be hosted in the same infrastructures as Virgo. The Advanced VIRGO project is funded and at present carried on by a larger collaboration of institutes belonging to CNRS- France , RMKI - Hungary, INFN- Italy, Nikhef - The Netherlands Polish Academy of Science - Poland.

  10. Advanced Combustion

    Energy Technology Data Exchange (ETDEWEB)

    Holcomb, Gordon R. [NETL

    2013-03-11

    The activity reported in this presentation is to provide the mechanical and physical property information needed to allow rational design, development and/or choice of alloys, manufacturing approaches, and environmental exposure and component life models to enable oxy-fuel combustion boilers to operate at Ultra-Supercritical (up to 650{degrees}C & between 22-30 MPa) and/or Advanced Ultra-Supercritical conditions (760{degrees}C & 35 MPa).

  11. Advanced differential quadrature methods

    CERN Document Server

    Zong, Zhi

    2009-01-01

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

  12. Directing Creativity

    DEFF Research Database (Denmark)

    Darsø, Lotte; Ibbotson, Piers

    2008-01-01

    In this article we argue that leaders facing complex challenges can learn from the arts, specifically that leaders can learn by examining how theatre directors direct creativity through creative constraints. We suggest that perceiving creativity as a boundary phenomenon is helpful for directing it....... Like leaders, who are caught in paradoxical situations where they have to manage production and logistics simultaneously with making space for creativity and innovation, theatre directors need to find the delicate balance between on one hand renewal of perceptions, acting and interaction...... and on the other hand getting ready for the opening night. We conclude that the art of directing creativity is linked to developing competencies of conscious presence, attention and vigilance, whereas the craft of directing creativity concerns communication, framing and choice....

  13. Direct Heat

    Energy Technology Data Exchange (ETDEWEB)

    Lienau, P J

    1990-01-01

    Potential resources and applications of earth heat in the form of geothermal energy are large. United States direct uses amount to 2,100 MWt thermal and worldwide 8,850 MWt above a reference temperature of 35 degrees Celsius. Space and district heating are the major direct uses of geothermal energy. Equipment employed in direct use projects is of standard manufacture and includes downhole and circulation pumps, transmission and distribution pipelines, heat exchangers and convectors, heat pumps and chillers. Direct uses of earth heat discussed are space and district heating, greenhouse heating and fish farming, process and industrial applications. The economic feasibility of direct use projects is governed by site specific factors such as location of user and resource, resource quality, system load factor and load density, as well as financing. Examples are presented of district heating in Klamath Falls, and Elko. Further developments of direct uses of geothermal energy will depend on matching user needs to the resource, and improving load factors and load density.

  14. Advanced calculus

    CERN Document Server

    Friedman, Avner

    2007-01-01

    This rigorous two-part treatment advances from functions of one variable to those of several variables. Intended for students who have already completed a one-year course in elementary calculus, it defers the introduction of functions of several variables for as long as possible, and adds clarity and simplicity by avoiding a mixture of heuristic and rigorous arguments.The first part explores functions of one variable, including numbers and sequences, continuous functions, differentiable functions, integration, and sequences and series of functions. The second part examines functions of several

  15. Advanced calculus

    CERN Document Server

    Fitzpatrick, Patrick M

    2009-01-01

    Advanced Calculus is intended as a text for courses that furnish the backbone of the student's undergraduate education in mathematical analysis. The goal is to rigorously present the fundamental concepts within the context of illuminating examples and stimulating exercises. This book is self-contained and starts with the creation of basic tools using the completeness axiom. The continuity, differentiability, integrability, and power series representation properties of functions of a single variable are established. The next few chapters describe the topological and metric properties of Euclide

  16. Advanced trigonometry

    CERN Document Server

    Durell, C V; Robson, A

    1950-01-01

    This volume will provide a welcome resource for teachers seeking an undergraduate text on advanced trigonometry, when few are readily available. Ideal for self-study, this text offers a clear, logical presentation of topics and an extensive selection of problems with answers. Contents include the properties of the triangle and the quadrilateral; equations, sub-multiple angles, and inverse functions; hyperbolic, logarithmic, and exponential functions; and expansions in power-series. Further topics encompass the special hyperbolic functions; projection and finite series; complex numbers; de Moiv

  17. Directed polymers versus directed percolation

    Science.gov (United States)

    Halpin-Healy, Timothy

    1998-10-01

    Universality plays a central role within the rubric of modern statistical mechanics, wherein an insightful continuum formulation rises above irrelevant microscopic details, capturing essential scaling behaviors. Nevertheless, occasions do arise where the lattice or another discrete aspect can constitute a formidable legacy. Directed polymers in random media, along with its close sibling, directed percolation, provide an intriguing case in point. Indeed, the deep blood relation between these two models may have sabotaged past efforts to fully characterize the Kardar-Parisi-Zhang universality class, to which the directed polymer belongs.

  18. Advanced Clothing System

    Science.gov (United States)

    Broyan, James; Orndoff, Evelyne

    2014-01-01

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

  19. Advanced transport aircraft technology

    Energy Technology Data Exchange (ETDEWEB)

    Winblade, R L

    1980-06-01

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

  20. Advanced SEM imaging

    International Nuclear Information System (INIS)

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

    1998-01-01

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

  1. Advanced SEM imaging

    International Nuclear Information System (INIS)

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

    1998-01-01

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

  2. Advanced Pacemaker

    Science.gov (United States)

    1990-01-01

    Synchrony, developed by St. Jude Medical's Cardiac Rhythm Management Division (formerly known as Pacesetter Systems, Inc.) is an advanced state-of-the-art implantable pacemaker that closely matches the natural rhythm of the heart. The companion element of the Synchrony Pacemaker System is the Programmer Analyzer APS-II which allows a doctor to reprogram and fine tune the pacemaker to each user's special requirements without surgery. The two-way communications capability that allows the physician to instruct and query the pacemaker is accomplished by bidirectional telemetry. APS-II features 28 pacing functions and thousands of programming combinations to accommodate diverse lifestyles. Microprocessor unit also records and stores pertinent patient data up to a year.

  3. Direct marketing

    Directory of Open Access Journals (Sweden)

    Čičić Muris

    2002-01-01

    Full Text Available Direct Marketing (DM is usually treated as unworthy activity, with actions at the edge of legality and activities minded cheating. Despite obvious problems regarding ethics and privacy threat, DM with its size, importance and role in a concept of integrated marketing communication deserves respect and sufficient analysis and review

  4. Advances in Modal Logic

    DEFF Research Database (Denmark)

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

  5. Advanced information society (10)

    Science.gov (United States)

    Masuyama, Keiichi

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

  6. Fusion advanced studies Torus

    International Nuclear Information System (INIS)

    2007-01-01

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

  7. Direct Reactions

    Energy Technology Data Exchange (ETDEWEB)

    Austern, N. [University of Pittsburgh, Pittsburgh, PA (United States)

    1963-01-15

    In order to give a unified presentation of one point of view, these lectures are devoted only to a detailed development of the standard theories of direct reactions, starting from basic principles. Discussion is given of the present status of the theories, of the techniques used for practical calculation, and of possible future developments. The direct interaction (DI) aspects of a reaction are those which involve only a few of the many degrees of freedom of a nucleus. In fact the minimum number of degrees of freedom which must be involved in a reaction are those required to describe the initial and final channels, and DI studies typically consider these degrees of freedom and no others. Because of this simplicity DI theories may be worked out in painstaking detail. DI processes concern only part of the wave function for a problem. The other part involves complicated excitations of many degrees of freedom, and gives the compound nucleus (CN) effects. While it is extremely interesting to learn how to separate DI and CN effects in an orderly manner, if they are both present in a reaction, no suitable method has yet been found. Instead, current work stresses the kinds of reactions and the kinds of final states in which DI effects dominate and in which CN effects may almost be forgotten. The DI cross-sections which are studied are often extremely large, comparable to elastic scattering cross-sections. (author)

  8. Future direction of direct writing

    Science.gov (United States)

    Kim, Nam-Soo; Han, Kenneth N.

    2010-11-01

    Direct write technology using special inks consisting of finely dispersed metal nanoparticles in liquid is receiving an undivided attention in recent years for its wide range of applicability in modern electronic industry. The application of this technology covers radio frequency identification-tag (RFID-tag), flexible-electronics, organic light emitting diodes (OLED) display, e-paper, antenna, bumpers used in flip-chip, underfilling, frit, miniresistance applications and biological uses, artificial dental applications and many more. In this paper, the authors have reviewed various direct write technologies on the market and discussed their advantages and shortfalls. Emphasis has given on microdispensing deposition write (MDDW), maskless mesoscale materials deposition (M3D), and ink-jet technologies. All of these technologies allow printing various patterns without employing a mask or a resist with an enhanced speed with the aid of computer. MDDW and M3D are capable of drawing patterns in three-dimension and MDDW, in particular, is capable of writing nanoinks with high viscosity. However, it is still far away for direct write to be fully implemented in the commercial arena. One of the hurdles to overcome is in manufacturing conductive inks which are chemically and physically stable, capable of drawing patterns with acceptable conductivity, and also capable of drawing patterns with acceptable adhesiveness with the substrates. The authors have briefly discussed problems involved in manufacturing nanometal inks to be used in various writing devices. There are numerous factors to be considered in manufacturing such inks. They are reducing agents, concentrations, oxidation, compact ability allowing good conductivity, and stability in suspension.

  9. General survey of Korean advanced technology

    International Nuclear Information System (INIS)

    1984-05-01

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

  10. Destruction of microcystins (cyanotoxins) by UV-254 nm-based direct photolysis and advanced oxidation processes (AOPs): influence of variable amino acids on the degradation kinetics and reaction mechanisms.

    Science.gov (United States)

    He, Xuexiang; de la Cruz, Armah A; Hiskia, Anastasia; Kaloudis, Triantafyllos; O'Shea, Kevin; Dionysiou, Dionysios D

    2015-05-01

    Hepatotoxic microcystins (MCs) are the most frequently detected group of cyanobacterial toxins. This study investigated the degradation of common MC variants in water, MC-LR, MC-RR, MC-YR and MC-LA, by UV-254 nm-based processes, UV only, UV/H2O2, UV/S2O8(2-) and UV/HSO5(-). Limited direct photolysis of MCs was observed, while the addition of an oxidant significantly improved the degradation efficiency with an order of UV/S2O8(2-) > UV/HSO5(-) > UV/H2O2 at the same initial molar concentration of the oxidant. The removal of MC-LR by UV/H2O2 appeared to be faster than another cyanotoxin, cylindrospermopsin, at either the same initial molar concentration or the same initial organic carbon concentration of the toxin. It suggested a faster reaction of MC-LR with hydroxyl radical, which was further supported by the determined second-order rate constant of MCs with hydroxyl radical. Both isomerization and photohydration byproducts were observed in UV only process for all four MCs; while in UV/H2O2, hydroxylation and diene-Adda double bond cleavage byproducts were detected. The presence of a tyrosine in the structure of MC-YR significantly promoted the formation of monohydroxylation byproduct m/z 1061; while the presence of a second arginine in MC-RR led to the elimination of a guanidine group and the absence of double bond cleavage byproducts. It was therefore demonstrated in this study that the variable amino acids in the structure of MCs influenced not only the degradation kinetics but also the preferable reaction mechanisms. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. NATO Advanced Study Institute on Advanced Physical Oceanographic Numerical Modelling

    CERN Document Server

    1986-01-01

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

  12. Advances in facial reanimation.

    Science.gov (United States)

    Tate, James R; Tollefson, Travis T

    2006-08-01

    Facial paralysis often has a significant emotional impact on patients. Along with the myriad of new surgical techniques in managing facial paralysis comes the challenge of selecting the most effective procedure for the patient. This review delineates common surgical techniques and reviews state-of-the-art techniques. The options for dynamic reanimation of the paralyzed face must be examined in the context of several patient factors, including age, overall health, and patient desires. The best functional results are obtained with direct facial nerve anastomosis and interpositional nerve grafts. In long-standing facial paralysis, temporalis muscle transfer gives a dependable and quick result. Microvascular free tissue transfer is a reliable technique with reanimation potential whose results continue to improve as microsurgical expertise increases. Postoperative results can be improved with ancillary soft tissue procedures, as well as botulinum toxin. The paper provides an overview of recent advances in facial reanimation, including preoperative assessment, surgical reconstruction options, and postoperative management.

  13. Advances in silicon nanophotonics

    DEFF Research Database (Denmark)

    Hvam, Jørn Märcher; Pu, Minhao

    Silicon has long been established as an ideal material for passive integrated optical circuitry due to its high refractive index, with corresponding strong optical confinement ability, and its low-cost CMOS-compatible manufacturability. However, the inversion symmetry of the silicon crystal lattice.......g. in high-bit-rate optical communication circuits and networks, it is vital that the nonlinear optical effects of silicon are being strongly enhanced. This can among others be achieved in photonic-crystal slow-light waveguides and in nano-engineered photonic-wires (Fig. 1). In this talk I shall present some...... recent advances in this direction. The efficient coupling of light between optical fibers and the planar silicon devices and circuits is of crucial importance. Both end-coupling (Fig. 1) and grating-coupling solutions will be discussed along with polarization issues. A new scheme for a hybrid III...

  14. Advances in nanosized zeolites

    Science.gov (United States)

    Mintova, Svetlana; Gilson, Jean-Pierre; Valtchev, Valentin

    2013-07-01

    This review highlights recent developments in the synthesis of nanosized zeolites. The strategies available for their preparation (organic-template assisted, organic-template free, and alternative procedures) are discussed. Major breakthroughs achieved by the so-called zeolite crystal engineering and encompass items such as mastering and using the physicochemical properties of the precursor synthesis gel/suspension, optimizing the use of silicon and aluminium precursor sources, the rational use of organic templates and structure-directing inorganic cations, and careful adjustment of synthesis conditions (temperature, pressure, time, heating processes from conventional to microwave and sonication) are addressed. An on-going broad and deep fundamental understanding of the crystallization process, explaining the influence of all variables of this complex set of reactions, underpins an even more rational design of nanosized zeolites with exceptional properties. Finally, the advantages and limitations of these methods are addressed with particular attention to their industrial prospects and utilization in existing and advanced applications.

  15. Omics Advances in Ecotoxicology.

    Science.gov (United States)

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

    2018-04-03

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

  16. Mirror Advanced Reactor Study (MARS)

    International Nuclear Information System (INIS)

    Logan, B.G.

    1983-01-01

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

  17. Status of advanced bremsstrahlung converters

    International Nuclear Information System (INIS)

    Halbleib, J.A.

    1980-01-01

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

  18. MARS: Mirror Advanced Reactor Study

    International Nuclear Information System (INIS)

    Logan, B.G.

    1984-01-01

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

  19. Microwave and particle beam sources and directed energy concepts

    International Nuclear Information System (INIS)

    Brandt, H.E.

    1989-01-01

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

  20. Introducing advance directives in the Nigerian health care Setting ...

    African Journals Online (AJOL)

    Patients and their families have rights to respect, compassion, attentive and skilled physical and psychosocial care, and spiritual support provided in a holistic manner by the health care team. The four bioethical principles of beneficence, autonomy, non-maleficence and justice should form the framework upon which ...

  1. Living Wills and Advance Directives for Medical Decisions

    Science.gov (United States)

    ... own thoughts and having conversations with others about medical care and end-of-life care are available through the American Bar Association, the Conversation Project and the Center for Practical Bioethics. You should address a number of possible end- ...

  2. Delay differential equations recent advances and new directions

    CERN Document Server

    Balachandran, Balakumar; Gilsinn, David E

    2009-01-01

    This is a cohesive set of contributions from leading experts on the theory and applications of functional and delay differential equations. The book focuses on theory, symbolic, and numerical methods, which show the practical applications of the concepts.

  3. Biomechanics in dermatology: Recent advances and future directions.

    Science.gov (United States)

    Lewinson, Ryan T; Haber, Richard M

    2017-02-01

    Biomechanics is increasingly being recognized as an important research area in dermatology. To highlight only a few examples, biomechanics has contributed to the development of novel topical therapies for aesthetic and medical purposes, enhanced our understanding of the pathogenesis of plantar melanoma, and provided insight into the epidemiology of psoriatic disease. This article summarizes the findings from recent studies to demonstrate the important role that biomechanics may have in dermatologic disease and therapy and places these biomechanical findings in a clinical context for the practicing physician. In addition, areas for future biomechanics research and development in dermatology are discussed. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  4. Preschool Life Skills: Recent Advancements and Future Directions

    Science.gov (United States)

    Fahmie, Tara A.; Luczynski, Kevin C.

    2018-01-01

    Over the past decade, researchers have replicated and extended research on the preschool life skills (PLS) program developed by Hanley, Heal, Tiger, and Ingvarsson (2007). This review summarizes recent research with respect to maximizing skill acquisition, improving generality, evaluating feasibility and acceptability, and testing predictions of…

  5. Youth, Technology and HIV: Recent Advances and Future Directions

    Science.gov (United States)

    Hightow-Weidman, Lisa B.; Muessig, Kathryn E.; Bauermeister, Jose; Zhang, Chen; LeGrand, Sara

    2015-01-01

    Technology, including mobile technologies and social media, offers powerful tools to reach, engage, and retain youth and young adults in HIV prevention and care interventions both in the United States and globally. In this report we focus on HIV, technology, and youth, presenting a synthesis of recently published (Jan 2014-May 2015) observational and experimental studies relevant for understanding and intervening on HIV risk, prevention and care. We present findings from a selection of the 66 relevant citations identified, highlighting studies that demonstrate a novel approach to technology interventions among youth in regard to content, delivery, target population or public health impact. We discuss current trends globally and in the US in how youth are using technology, as well as emergent research issues in this field – including the need for new theories for developing technology-based HIV interventions and new metrics of engagement, exposure, and evaluation. PMID:26385582

  6. Directed Biosynthesis of Oriented Crystalline Cellulose for Advanced Composite Fibers

    Science.gov (United States)

    2012-05-03

    trifluoromethylsulfonyl)amide IL: ionic liquids IR : infra-red MSE: Material Sciences & Engineering ORNL: Oak Ridge National Laboratory PI...biomedical applications, we have investigated approaches for incorporating hydroxyapatite into the cellulose pellicles as bone replacement materials

  7. Crosswell Imaging Technology & Advanced DSR Navigation for Horizontal Directional Drilling

    Energy Technology Data Exchange (ETDEWEB)

    Larry Stolarczyk

    2008-08-08

    The objective of Phase II is to develop and demonstrate real-time measurement-while-drilling (MWD) for guidance and navigation of drill strings during horizontal drilling operations applicable to both short and long holes. The end product of Phase II is a functional drill-string assembly outfitted with a commercial version of Drill String Radar (DSR). Project Objectives Develop and demonstrate a dual-phase methodology of in-seam drilling, imaging, and structure confirmation. This methodology, illustrated in Figure 1, includes: (1) Using RIM to image between drill holes for seam thickness estimates and in-seam structures detection. Completed, February 2005; and (2) Using DSR for real-time MWD guidance and navigation of drillstrings during horizontal drilling operations. Completed, November 2008. As of November 2008, the Phase II portion of Contract DE-FC26-04NT42085 is about 99% complete, including milestones and tasks original outlined as Phase II work. The one percent deficiency results from MSHA-related approvals which have yet to be granted (at the time of reporting). These approvals are pending and are do not negatively impact the scope of work or project objectives.

  8. Study on Advanced Spray-Guided Gasoline Direct Injection Systems

    OpenAIRE

    VAQUERIZO SÁNCHEZ, DANIEL

    2018-01-01

    Resumen Los sistemas de inyección directa han sido uno de los principales puntos focales de la investigación en motores, particularmente en sistemas Diésel, donde la geometría interna, movimiento de aguja y comportamiento del flujo afectan el spray externo y por tanto determinan completamente el proceso de combustión dentro del motor. Debido a regulaciones medioambientales y al potencial de los (más ineficientes) motores "Otto", grandes esfuerzos se están aportando en inv...

  9. Advanced Direct Liquefaction Concepts for PETC Generic Units - Phase II

    Energy Technology Data Exchange (ETDEWEB)

    None

    1997-09-01

    Reported here are the results of Laboratory and Bench- Scale experiments and supporting technical and economic assessments conducted under DOE Contract No. DE- AC22- 91PC91040 during the period April 1, 1997 to June 30, 1997. This contract is with the University of Kentucky Research Foundation which supports work with the University of Kentucky Center for Applied Energy Research, CONSOL, Inc., LDP Associates, and Hydrocarbon Technologies, Inc. This work involves the introduction into the basic two stage liquefaction process several novel concepts which includes dispersed lower- cost catalysts, coal cleaning by oil agglomeration, and distillate hydrotreating and dewaxing. This report includes a data analysis of the ALC- 2 run which was the second continuous run in which Wyodak Black Thunder coal was fed to a two kg/ h bench- scale unit. One of the objectives of that run was to determine the relative activity of several Mo- based coal impregnated catalyst precursors. The precursors included ammonium heptamolybdate (100 mg Mo/ kg dry coal), which was used alone as well as in combination with ferrous sulfate (1% Fe/ dry coal) and nickel sulfate (50 mg Ni/ kg dry coal). The fourth precursor that was tested was phosphomolybdic acid which was used at a level of 100 mg Mo/ kg dry coal. Because of difficulties in effectively separating solids from the product stream, considerable variation in the feed stream occurred. Although the coal feed rate was nearly constant, the amount of recycle solvent varied which resulted in wide variations of resid, unconverted coal and mineral matter in the feed stream. Unfortunately, steady state was not achieved in any of the four conditions that were run. Earlier it was reported that Ni- Mo catalyst appeared to give the best results based upon speculative steady- state yields that were developed.

  10. Advanced Direct Liquefaction Concepts for PETC Generic Units - Phase II

    Energy Technology Data Exchange (ETDEWEB)

    None

    1997-12-01

    The results of Laboratory and Bench-Scale experiments and supporting technical and economic assessments conducted under DOE Contract No. DE-AC22-91PC91040 are reported for the period July 1, 1997 to September 30, 1997. This contract is with the University of Kentucky Research Foundation which supports work with the University of Kentucky Center for Applied Energy Research, CONSOL, Inc., LDP Associates, and Hydrocarbon Technologies, Inc. This work involves the introduction into the basic two stage liquefaction process several novel concepts which include dispersed lower-cost catalysts, coal cleaning by oil agglomeration, and distillate hydrotreating and dewaxing. Results are reported from experiments in which various methods were tested to activate dispersed Mo precursors. Several oxothiomolybdates precursors having S/Mo ratios from two to six were prepared. Another having a S/Mo ratio of eleven was also prepared that contained an excess of sulfur. In the catalyst screening test, none of these precursors exhibited an activity enhancement that might suggest that adding sulfur into the structure of the Mo precursors would be beneficial to the process. In another series of experiments, AHM impregnated coal slurried in the reaction mixture was pretreated withH S/H under pressure and successively heated for 30 min at 120, 250 2 2 and 360 C. THF conversions in the catalyst screening test were not affected while resid conversions o increased such that pretreated coals impregnated with 100 ppm Mo gave conversions equivalent to untreated coals impregnated with 300 ppm fresh Mo. Cobalt, nickel and potassium phosphomolybdates were prepared and tested as bimetallic precursors. The thermal stability of these compounds was evaluated in TG/MS to determine whether the presence of the added metal would stabilize the Keggin structure at reaction temperature. Coals impregnated with these salts showed the Ni and Co salts gave the same THF conversion as PMA while the Ni salt gave higher resid conversion than the other salts and untreated PMA. To activate PMA, a series of sulfided PMA materials was prepared by subjecting the crystalline acid to H S/H at 125-450 C. The chemistries 2 2 o of these partially sulfided materials are reported as well as the reactivity of several impregnated coals. None of the coals impregnated with these sulfided PMA materials gave conversions that exceeded PMA. Reports covering work by the subcontractors for this reporting period have not been received. A report from CONSOL covering a previous reporting period is included.

  11. Telehealth on advanced networks.

    Science.gov (United States)

    Wilson, Laurence S; Stevenson, Duncan R; Cregan, Patrick

    2010-01-01

    We address advanced Internet for complex telehealth applications by reviewing four hospital-based broadband telehealth projects and identifying common threads. These projects were conducted in Australia under a 6-year research project on broadband Internet applications. Each project addressed specific clinical needs and its development was guided by the clinicians involved. Each project was trialed in the field and evaluated against the initial requirements. The four projects covered remote management of a resuscitation team in a district hospital, remote guidance and interpretation of echocardiography, virtual-reality-based instructor-student surgical training, and postoperative outpatient consultations following pediatric surgery. Each was characterized by a high level of interpersonal communication, a high level of clinical expertise, and multiple participants. Each made use of multiple high-quality video and audio links and shared real-time access to clinical data. Four common threads were observed. Each application provided a high level of usability and task focus because the design and use of broadband capability was aimed directly to meet the clinicians' needs. Each used the media quality available over broadband to convey words, gestures, body movements, and facial expressions to support communication and a sense of presence among the participants. Each required a complex information space shared among the participants, including real-time access to stored patient data and real-time interactive access to the patients themselves. Finally, each application supported the social and organizational aspects of their healthcare focus, creating and maintaining relationships between the various participants, and this was done by placing the telehealth application into a wider functioning clinical context. These findings provide evidence for a significantly enhanced role for appropriate telemedicine systems running on advanced networks, in a wider range of clinical

  12. Advanced Chemical Propulsion

    Science.gov (United States)

    Bai, S. Don

    2000-01-01

    Design, propellant selection, and launch assistance for advanced chemical propulsion system is discussed. Topics discussed include: rocket design, advance fuel and high energy density materials, launch assist, and criteria for fuel selection.

  13. NATO Advanced Research Workshop on Molecular Engineering for Advanced Materials

    CERN Document Server

    Schaumburg, Kjeld

    1995-01-01

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

  14. Advanced dementia pain management protocols.

    Science.gov (United States)

    Montoro-Lorite, Mercedes; Canalias-Reverter, Montserrat

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

  15. The Advanced LIGO timing system

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  16. Advanced CANDU reactors

    International Nuclear Information System (INIS)

    Dunn, J.T.; Finlay, R.B.; Olmstead, R.A.

    1988-12-01

    AECL has undertaken the design and development of a series of advanced CANDU reactors in the 700-1150 MW(e) size range. These advanced reactor designs are the product of ongoing generic research and development programs on CANDU technology and design studies for advanced CANDU reactors. The prime objective is to create a series of advanced CANDU reactors which are cost competitive with coal-fired plants in the market for large electricity generating stations. Specific plant designs in the advanced CANDU series will be ready for project commitment in the early 1990s and will be capable of further development to remain competitive well into the next century

  17. Advances in chemical Physics

    CERN Document Server

    Rice, Stuart A

    2011-01-01

    The Advances in Chemical Physics series-the cutting edge of research in chemical physics The Advances in Chemical Physics series provides the chemical physics and physical chemistry fields with a forum for critical, authoritative evaluations of advances in every area of the discipline. Filled with cutting-edge research reported in a cohesive manner not found elsewhere in the literature, each volume of the Advances in Chemical Physics series offers contributions from internationally renowned chemists and serves as the perfect supplement to any advanced graduate class devoted to the study of che

  18. Advances in chemical physics

    CERN Document Server

    Rice, Stuart A

    2012-01-01

    The Advances in Chemical Physics series-the cutting edge of research in chemical physics The Advances in Chemical Physics series provides the chemical physics field with a forum for critical, authoritative evaluations of advances in every area of the discipline. Filled with cutting-edge research reported in a cohesive manner not found elsewhere in the literature, each volume of the Advances in Chemical Physics series serves as the perfect supplement to any advanced graduate class devoted to the study of chemical physics. This volume explores: Quantum Dynamical Resonances in Ch

  19. Advances in chemical physics

    CERN Document Server

    Rice, Stuart A

    2011-01-01

    The Advances in Chemical Physics series-the cutting edge of research in chemical physics The Advances in Chemical Physics series provides the chemical physics and physical chemistry fields with a forum for critical, authoritative evaluations of advances in every area of the discipline. Filled with cutting-edge research reported in a cohesive manner not found elsewhere in the literature, each volume of the Advances in Chemical Physics series offers contributions from internationally renowned chemists and serves as the perfect supplement to any advanced graduate class devoted to the study of che

  20. ACR-700 advanced technologies

    International Nuclear Information System (INIS)

    Tapping, R.L.; Turner, C.W.; Yu, S.K.W.; Olmstead, R.; Speranzini, R.A.

    2004-01-01

    A successful advanced reactor plant will have optimized economics including reduced operating and maintenance costs, improved performance, and enhanced safety. Incorporating improvements based on advanced technologies ensures cost, safety and operational competitiveness of the ACR-700. These advanced technologies include modern configuration management; construction technologies; operational technology for the control centre and information systems for plant monitoring and analysis. This paper summarizes the advanced technologies used to achieve construction and operational improvements to enhance plant economic competitiveness, advances in the operational technology used for reactor control, and presents the development of the Smart CANDU suite of tools and its application to existing operating reactors and to the ACR-700. (author)

  1. Japan's advanced medicine.

    Science.gov (United States)

    Sho, Ri; Narimatsu, Hiroto; Murakami, Masayasu

    2013-10-01

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

  2. Advanced accumulator for PWR

    International Nuclear Information System (INIS)

    Ichimura, Taiki; Chikahata, Hideyuki

    1997-01-01

    Advanced accumulators have been incorporated into the APWR design in order to simplify the safety system configuration and to improve reliability. The advanced accumulators refill the reactor vessel with a large discharge flow rate in a large LOCA, then switch to a small flow rate to continue safety injection for core reflooding. The functions of the conventional accumulator and the low head safety injection pump are integrated into this advanced accumulator. Injection performance tests simulating LOCA conditions and visualization tests for new designs have been carried out. This paper describes the APWR ECCS configuration, the advanced accumulator design and some of the injection performance and visualization test results. It was verified that the flow resistance of the advanced accumulator is independent of the model scale. The similarity law and performance data of the advanced accumulator for applying APWR was established. (author)

  3. Advances in Applied Mechanics

    OpenAIRE

    2013-01-01

    Advances in Applied Mechanics draws together recent significant advances in various topics in applied mechanics. Published since 1948, Advances in Applied Mechanics aims to provide authoritative review articles on topics in the mechanical sciences, primarily of interest to scientists and engineers working in the various branches of mechanics, but also of interest to the many who use the results of investigations in mechanics in various application areas, such as aerospace, chemical, civil, en...

  4. Advanced fuels safety comparisons

    International Nuclear Information System (INIS)

    Grolmes, M.A.

    1977-01-01

    The safety considerations of advanced fuels are described relative to the present understanding of the safety of oxide fueled Liquid Metal Fast Breeder Reactors (LMFBR). Safety considerations important for the successful implementation of advanced fueled reactors must early on focus on the accident energetics issues of fuel coolant interactions and recriticality associated with core disruptive accidents. It is in these areas where the thermal physical property differences of the advanced fuel have the greatest significance

  5. Advanced Photon Source (APS)

    Data.gov (United States)

    Federal Laboratory Consortium — The Advanced Photon Source (APS) at the U.S. Department of Energy's Argonne National Laboratoryprovides this nation's (in fact, this hemisphere's) brightest storage...

  6. Advanced Simulation Center

    Data.gov (United States)

    Federal Laboratory Consortium — The Advanced Simulation Center consists of 10 individual facilities which provide missile and submunition hardware-in-the-loop simulation capabilities. The following...

  7. Advanced Manufacturing Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — The Advanced Manufacturing Laboratory at the University of Maryland provides the state of the art facilities for realizing next generation products and educating the...

  8. Direct Bonded Pontic (Laporan Kasus

    Directory of Open Access Journals (Sweden)

    Suhandi Sidjaja

    2015-10-01

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

  9. KNOWLEDGE UNDERSTANDING AND ADVANCED SEARCHING

    Directory of Open Access Journals (Sweden)

    R Vidya

    2017-04-01

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

  10. Advanced Hydrogen Turbine Development

    Energy Technology Data Exchange (ETDEWEB)

    Joesph Fadok

    2008-01-01

    advanced hydrogen turbine that meets the aggressive targets set forth for the advanced hydrogen turbine, including increased rotor inlet temperature (RIT), lower total cooling and leakage air (TCLA) flow, higher pressure ratio, and higher mass flow through the turbine compared to the baseline. Maintaining efficiency with high mass flow Syngas combustion is achieved using a large high AN2 blade 4, which has been identified as a significant advancement beyond the current state-of-the-art. Preliminary results showed feasibility of a rotor system capable of increased power output and operating conditions above the baseline. In addition, several concepts were developed for casing components to address higher operating conditions. Rare earth modified bond coat for the purpose of reducing oxidation and TBC spallation demonstrated an increase in TBC spallation life of almost 40%. The results from Phase 1 identified two TBC compositions which satisfy the thermal conductivity requirements and have demonstrated phase stability up to temperatures of 1850 C. The potential to join alloys using a bonding process has been demonstrated and initial HVOF spray deposition trials were promising. The qualitative ranking of alloys and coatings in environmental conditions was also performed using isothermal tests where significant variations in alloy degradation were observed as a function of gas composition. Initial basic system configuration schematics and working system descriptions have been produced to define key boundary data and support estimation of costs. Review of existing materials in use for hydrogen transportation show benefits or tradeoffs for materials that could be used in this type of applications. Hydrogen safety will become a larger risk than when using natural gas fuel as the work done to date in other areas has shown direct implications for this type of use. Studies were conducted which showed reduced CO{sub 2} and NOx emissions with increased plant efficiency. An approach to

  11. Advanced Magnetoimpedance Sensors

    KAUST Repository

    Li, Bodong

    2015-02-01

    This thesis is concerned with the advanced topics of thin film magnetoimpedance (MI) sensors. The author proposes and develops novel MI sensors that target on the challenges arising from emerging applications such as flexible electronics, passive wireless sensing, etc. In the study of flexible MI sensor, the investigated sensors of NiFe/Cu/NiFe tri-layersare fabricated on three flexible substrates having different surface roughness: Kapton, standard and premiumphotopaper. Sensitivity versus substrate roughness analysis is carried out for the selection of optimal substrate material. The high magnetic sensing performance is achieved by using Kapton substrate. Stress simulation, incorporated with the theory of magnetostriction effect, reveals the material composition of Ni/Fe being as a key factor of the stress dependent MI effect for the flexible MI sensors. In the development of MI-SAW device for passive wireless magnetic field sensing, NiFe/Cu/NiFe tri-layersand interdigital transducers(IDT) are designed and fabricated on a single piece of LiNbO3substrate, providing a high degree of integration and the advantage of standard microfabrication. The double-electrodeIDT has been utilized and proven to have an optimal sensing performance in comparison to the bi-directional IDT design. The optimized high frequency performance of the thin film MI sensor results in a MI-SAW passive wireless magnetic sensor with high magnetic sensitivity comparing to the MI microwire approach. Benefiting from the high degree of integration of the MI thin film element, in the following study, two additional sensing elements are integrated to the SAW device to have a multifunctional passive wireless sensor with extended temperature and humidity sensing capabilities. Analytical models havebeen developed to eliminate the crossovers of different sensing signals through additional reference IDTs, resulting in a multifunctional passive wireless sensor with the capability of detecting all three

  12. Advanced Geothermal Turbodrill

    Energy Technology Data Exchange (ETDEWEB)

    W. C. Maurer

    2000-05-01

    Approximately 50% of the cost of a new geothermal power plant is in the wells that must be drilled. Compared to the majority of oil and gas wells, geothermal wells are more difficult and costly to drill for several reasons. First, most U.S. geothermal resources consist of hot, hard crystalline rock formations which drill much slower than the relatively soft sedimentary formations associated with most oil and gas production. Second, high downhole temperatures can greatly shorten equipment life or preclude the use of some technologies altogether. Third, producing viable levels of electricity from geothermal fields requires the use of large diameter bores and a high degree of fluid communication, both of which increase drilling and completion costs. Optimizing fluid communication often requires creation of a directional well to intersect the best and largest number of fracture capable of producing hot geothermal fluids. Moineau motor stators made with elastomers cannot operate at geothermal temperatures, so they are limited to the upper portion of the hole. To overcome these limitations, Maurer Engineering Inc. (MEI) has developed a turbodrill that does not use elastomers and therefore can operate at geothermal temperatures. This new turbodrill uses a special gear assembly to reduce the output speed, thus allowing a larger range of bit types, especially tri-cone roller bits, which are the bits of choice for drilling hard crystalline formations. The Advanced Geothermal Turbodrill (AGT) represents a significant improvement for drilling geothermal wells and has the potential to significantly reduce drilling costs while increasing production, thereby making geothermal energy less expensive and better able to compete with fossil fuels. The final field test of the AGT will prepare the tool for successful commercialization.

  13. Education of advanced practice nurses in Canada.

    Science.gov (United States)

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

    2010-12-01

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

  14. Some new directions in system transient simulation

    International Nuclear Information System (INIS)

    Ransom, V.H.

    1986-01-01

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

  15. Sports Tournament Predictions Using Direct Manipulation

    OpenAIRE

    Vuillemot , Romain; Perin , Charles

    2016-01-01

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

  16. Computational Intelligence Paradigms in Advanced Pattern Classification

    CERN Document Server

    Jain, Lakhmi

    2012-01-01

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

  17. Advance care planning: Beyond the living will.

    Science.gov (United States)

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

    2009-05-01

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

  18. Advances in dental materials.

    Science.gov (United States)

    Fleming, Garry J P

    2014-05-01

    The dental market is replete with new resorative materials marketed on the basis of novel technological advances in materials chemistry, bonding capability or reduced operator time and/or technique sensitivity. This paper aims to consider advances in current materials, with an emphasis on their role in supporting contemporary clinical practice.

  19. Advanced Manufacturing Technologies

    Science.gov (United States)

    Fikes, John

    2016-01-01

    Advanced Manufacturing Technologies (AMT) is developing and maturing innovative and advanced manufacturing technologies that will enable more capable and lower-cost spacecraft, launch vehicles and infrastructure to enable exploration missions. The technologies will utilize cutting edge materials and emerging capabilities including metallic processes, additive manufacturing, composites, and digital manufacturing. The AMT project supports the National Manufacturing Initiative involving collaboration with other government agencies.

  20. Advanced uranium enrichment technologies

    International Nuclear Information System (INIS)

    Merriman, R.

    1983-01-01

    The Advanced Gas Centrifuge and Atomic Vapor Laser Isotope Separation methods are described. The status and potential of the technologies are summarized, the programs outlined, and the economic incentives are noted. How the advanced technologies, once demonstrated, might be deployed so that SWV costs in the 1990s can be significantly reduced is described

  1. Advanced research technology transfer

    International Nuclear Information System (INIS)

    Naraghi, Masud

    1977-01-01

    The importance of advanced research in the less developed countries of the world is described. Advanced research is a way of building from the top; it helps industrial development; it provides ''know-how'' economically; it enhances international understanding; it prevents the brain drain to developed countries and is of mutual benefit. The problems concerned with this type of research are pointed out

  2. Advanced Chemical Propulsion Study

    Science.gov (United States)

    Woodcock, Gordon; Byers, Dave; Alexander, Leslie A.; Krebsbach, Al

    2004-01-01

    A study was performed of advanced chemical propulsion technology application to space science (Code S) missions. The purpose was to begin the process of selecting chemical propulsion technology advancement activities that would provide greatest benefits to Code S missions. Several missions were selected from Code S planning data, and a range of advanced chemical propulsion options was analyzed to assess capabilities and benefits re these missions. Selected beneficial applications were found for higher-performing bipropellants, gelled propellants, and cryogenic propellants. Technology advancement recommendations included cryocoolers and small turbopump engines for cryogenic propellants; space storable propellants such as LOX-hydrazine; and advanced monopropellants. It was noted that fluorine-bearing oxidizers offer performance gains over more benign oxidizers. Potential benefits were observed for gelled propellants that could be allowed to freeze, then thawed for use.

  3. Advanced computations in plasma physics

    International Nuclear Information System (INIS)

    Tang, W.M.

    2002-01-01

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

  4. Center for Advanced Computational Technology

    Science.gov (United States)

    Noor, Ahmed K.

    2000-01-01

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

  5. Current status and future potential for advanced volume reduction technologies

    International Nuclear Information System (INIS)

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

    1984-01-01

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

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

    KAUST Repository

    Ornelas, Catia

    2015-01-01

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

  7. Editorial: Advanced learning technologies

    Directory of Open Access Journals (Sweden)

    Yu-Ju Lan

    2012-03-01

    Full Text Available Recent rapid development of advanced information technology brings high expectations of its potential to improvement and innovations in learning. This special issue is devoted to using some of the emerging technologies issues related to the topic of education and knowledge sharing, involving several cutting edge research outcomes from recent advancement of learning technologies. Advanced learning technologies are the composition of various related technologies and concepts such as mobile technologies and social media towards learner centered learning. This editorial note provides an overview of relevant issues discussed in this special issue.

  8. Advancing Ethical Neuroscience Research.

    Science.gov (United States)

    Borah, B Rashmi; Strand, Nicolle K; Chillag, Kata L

    2016-12-01

    As neuroscience research advances, researchers, clinicians, and other stakeholders will face a host of ethical challenges. The Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) has published two reports that provide recommendations on how to advance research endeavors ethically. The commission addressed, among other issues, how to prioritize different types of neuroscience research and how to include research participants who have impaired consent capacity. The Bioethics Commission's recommendations provide a foundation for ethical guidelines as neuroscience research advances and progresses. © 2016 American Medical Association. All Rights Reserved.

  9. Advanced information society(7)

    Science.gov (United States)

    Chiba, Toshihiro

    Various threats are hiding in advanced informationalized society. As we see car accident problems in motorization society light aspects necessarily accompy shady ones. Under the changing circumstances of advanced informationalization added values of information has become much higher. It causes computer crime, hacker, computer virus to come to the surface. In addition it can be said that infringement of intellectual property and privacy are threats brought by advanced information. Against these threats legal, institutional and insurance measures have been progressed, and newly security industry has been established. However, they are not adequate individually or totally. The future vision should be clarified, and countermeasures according to the visions have to be considered.

  10. Indian advanced nuclear reactors

    International Nuclear Information System (INIS)

    Saha, D.; Sinha, R.K.

    2005-01-01

    For sustainable development of nuclear energy, a number of important issues like safety, waste management, economics etc. are to be addressed. To do this, a number of advanced reactor designs as well as fuel cycle technologies are being pursued worldwide. The advanced reactors being developed in India are the AHWR and the CHTR. Both the reactors use thorium based fuel and have many passive features. This paper describes the Indian advanced reactors and gives a brief account of the international initiatives for the sustainable development of nuclear energy. (author)

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

    Science.gov (United States)

    Holley, Jean L

    2012-06-01

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

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

    African Journals Online (AJOL)

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

  13. High Torque, Direct Drive Electric Motor, Phase II

    Data.gov (United States)

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

  14. Direct Numerical Simulations of Statistically Stationary Turbulent Premixed Flames

    KAUST Repository

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

    2016-01-01

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

  15. Advanced Light Source (ALS)

    Data.gov (United States)

    Federal Laboratory Consortium — The Advanced Light Source (ALS), a world leader in soft x-ray science, generates light in the wavelengths needed for examining the atomic and electronic structure of...

  16. Advance Payment ACO Model

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Advance Payment Model is designed for physician-based and rural providers who have come together voluntarily to give coordinated high quality care to the...

  17. Advanced Welding Concepts

    Science.gov (United States)

    Ding, Robert J.

    2010-01-01

    Four advanced welding techniques and their use in NASA are briefly reviewed in this poster presentation. The welding techniques reviewed are: Solid State Welding, Friction Stir Welding (FSW), Thermal Stir Welding (TSW) and Ultrasonic Stir Welding.

  18. Advanced Missile Signature Center

    Data.gov (United States)

    Federal Laboratory Consortium — The Advanced Missile Signature Center (AMSC) is a national facility supporting the Missile Defense Agency (MDA) and other DoD programs and customers with analysis,...

  19. Advanced walling systems

    CSIR Research Space (South Africa)

    De Villiers, A

    2010-01-01

    Full Text Available The question addressed by this chapter is: How should advanced walling systems be planned, designed, built, refurbished, and end their useful lives, to classify as smart, sustainable, green or eco-building environments?...

  20. [Advanced resuscitation of adults

    DEFF Research Database (Denmark)

    Lippert, F.K.; Lauritsen, T.L.; Torp-Pedersen, C.

    2008-01-01

    International and European Resuscitation Council (ERC) Guidelines for Resuscitation 2005 implicate major changes in resuscitation, including new universal treatment algorithms. This brief summary of Guidelines 2005 for advanced resuscitation of adult cardiac arrest victims is based upon the ERC...

  1. Advanced Chemistry Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — Description/History: Chemistry laboratoryThe Advanced Chemistry Laboratory (ACL) is a unique facility designed for working with the most super toxic compounds known...

  2. Advanced Electron Linacs

    Energy Technology Data Exchange (ETDEWEB)

    Siemann, R.

    2005-02-14

    The research into advanced acceleration concepts for electron linear accelerators being pursued at SLAC is reviewed. This research includes experiments in laser acceleration, plasma wakefield acceleration, and mmwavelength RF driven accelerators.

  3. Advanced Transportation Institute 2008.

    Science.gov (United States)

    2009-02-01

    The seventh version of the Advanced Transportation Institute (ATI-08) was conducted in 2008 to encourage high school students to pursue careers in the field of transportation engineering. The University Transportation Center for Alabama partnered wit...

  4. Advanced Transportation Institute 2009.

    Science.gov (United States)

    2009-09-01

    The eighth version of the Advanced Transportation Institute (ATI-09) was conducted in 2009 to encourage high school students to pursue careers in the field of transportation engineering. The University Transportation Center for Alabama partnered with...

  5. Advanced Microanalysis Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Advanced Microanalysis Facility fully integrates capabilities for chemical and structural analysis of electronic materials and devices for the U.S. Army and DoD....

  6. Ferumoxtran-10 advanced magnetics.

    NARCIS (Netherlands)

    Leenders, W.P.J.

    2003-01-01

    Ferumoxtran-10 (Combidex) is an ultra-small superparamagnetic iron oxide molecular resonance imaging contrast agent under development by Advanced Magnetics Ltd and Guerbet for the principal indication of lymph node imaging.

  7. Advances in Numerical Methods

    CERN Document Server

    Mastorakis, Nikos E

    2009-01-01

    Features contributions that are focused on significant aspects of current numerical methods and computational mathematics. This book carries chapters that advanced methods and various variations on known techniques that can solve difficult scientific problems efficiently.

  8. Advanced Propulsion Study

    National Research Council Canada - National Science Library

    Davis, Eric

    2004-01-01

    ... that show promise of leading to a major advance in Earth-to-orbit (ETO) propulsion. The study also reviewed and evaluated a select number of credible far-term breakthrough propulsion physics concepts pertaining...

  9. Advanced Welding Applications

    Science.gov (United States)

    Ding, Robert J.

    2010-01-01

    Some of the applications of advanced welding techniques are shown in this poster presentation. Included are brief explanations of the use on the Ares I and Ares V launch vehicle and on the Space Shuttle Launch vehicle. Also included are microstructural views from four advanced welding techniques: Variable Polarity Plasma Arc (VPPA) weld (fusion), self-reacting friction stir welding (SR-FSW), conventional FSW, and Tube Socket Weld (TSW) on aluminum.

  10. Joining of advanced materials

    CERN Document Server

    Messler, Robert W

    1993-01-01

    Provides an unusually complete and readable compilation of the primary and secondary options for joining conventional materials in non-conventional ways. Provides unique coverage of adhesive bonding using both organic and inorganic adhesives, cements and mortars. Focuses on materials issues without ignoring issues related to joint design, production processing, quality assurance, process economics, and joining performance in service.Joining of advanced materials is a unique treatment of joining of both conventional and advanced metals andalloys, intermetallics, ceramics, glasses, polymers, a

  11. Advances in atomic spectroscopy

    CERN Document Server

    Sneddon, J

    1997-01-01

    This series describes selected advances in the area of atomic spectroscopy. It is primarily intended for the reader who has a background in atmoic spectroscopy; suitable to the novice and expert. Although a widely used and accepted method for metal and non-metal analysis in a variety of complex samples, Advances in Atomic Spectroscopy covers a wide range of materials. Each Chapter will completely cover an area of atomic spectroscopy where rapid development has occurred.

  12. Advances in bistatic radar

    CERN Document Server

    Willis, Nick

    2007-01-01

    Advances in Bistatic Radar updates and extends bistatic and multistatic radar developments since publication of Willis' Bistatic Radar in 1991. New and recently declassified military applications are documented. Civil applications are detailed including commercial and scientific systems. Leading radar engineers provide expertise to each of these applications. Advances in Bistatic Radar consists of two major sections: Bistatic/Multistatic Radar Systems and Bistatic Clutter and Signal Processing. Starting with a history update, the first section documents the early and now declassified military

  13. Advanced Tokamak Stability Theory

    Science.gov (United States)

    Zheng, Linjin

    2015-03-01

    The intention of this book is to introduce advanced tokamak stability theory. We start with the derivation of the Grad-Shafranov equation and the construction of various toroidal flux coordinates. An analytical tokamak equilibrium theory is presented to demonstrate the Shafranov shift and how the toroidal hoop force can be balanced by the application of a vertical magnetic field in tokamaks. In addition to advanced theories, this book also discusses the intuitive physics pictures for various experimentally observed phenomena.

  14. Advanced Integrated Traction System

    Energy Technology Data Exchange (ETDEWEB)

    Greg Smith; Charles Gough

    2011-08-31

    The United States Department of Energy elaborates the compelling need for a commercialized competitively priced electric traction drive system to proliferate the acceptance of HEVs, PHEVs, and FCVs in the market. The desired end result is a technically and commercially verified integrated ETS (Electric Traction System) product design that can be manufactured and distributed through a broad network of competitive suppliers to all auto manufacturers. The objectives of this FCVT program are to develop advanced technologies for an integrated ETS capable of 55kW peak power for 18 seconds and 30kW of continuous power. Additionally, to accommodate a variety of automotive platforms the ETS design should be scalable to 120kW peak power for 18 seconds and 65kW of continuous power. The ETS (exclusive of the DC/DC Converter) is to cost no more than $660 (55kW at $12/kW) to produce in quantities of 100,000 units per year, should have a total weight less than 46kg, and have a volume less than 16 liters. The cost target for the optional Bi-Directional DC/DC Converter is $375. The goal is to achieve these targets with the use of engine coolant at a nominal temperature of 105C. The system efficiency should exceed 90% at 20% of rated torque over 10% to 100% of maximum speed. The nominal operating system voltage is to be 325V, with consideration for higher voltages. This project investigated a wide range of technologies, including ETS topologies, components, and interconnects. Each technology and its validity for automotive use were verified and then these technologies were integrated into a high temperature ETS design that would support a wide variety of applications (fuel cell, hybrids, electrics, and plug-ins). This ETS met all the DOE 2010 objectives of cost, weight, volume and efficiency, and the specific power and power density 2015 objectives. Additionally a bi-directional converter was developed that provides charging and electric power take-off which is the first step

  15. Rejuvenating direct modulation and direct detection for modern optical communications

    Science.gov (United States)

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

    2018-02-01

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

  16. Advanced TCA Backplane Tester

    CERN Document Server

    Oltean, Alexandra Dana

    2004-01-01

    At the beginning of 2003, the PICMG group adopted the AdvancedTCA (Advanced Telecom Computing Architecture) standard. The 10Gb/s backplane of the AdvancedTCA chassis is well specified in the standard but it remains however a high end product, which can be itself subject to printed circuit board manufacturing control problems that could greatly affect its quality control. In order to study the practical aspects of high speed Ethernet switching at 10Gb/s and to validate the signal integrity of the AdvancedTCA backplane, we developed a Backplane Tester. The tester system is able of running monitored PRBS traffic at 3.125Gb/s over every link on the AdvancedTCA backplane simultaneously and to monitor any possible connectivity failure immediately in terms of link and slot position inside the chassis. The present report presents the architectural hardware design, the control structure and software aspects of the AdvancedTCA Backplane Tester design.

  17. United States advanced technologies

    International Nuclear Information System (INIS)

    Longenecker, J.R.

    1985-01-01

    In the United States, the advanced technologies have been applied to uranium enrichment as a means by which it can be assured that nuclear fuel cost will remain competitive in the future. The United States is strongly committed to the development of advanced enrichment technology, and has brought both advanced gas centrifuge (AGC) and atomic vapor laser isotope separation (AVLIS) programs to a point of significant technical refinement. The ability to deploy advanced technologies is the basis for the confidence in competitive future price. Unfortunately, the development of advanced technologies is capital intensive. The year 1985 is the key year for advanced technology development in the United States, since the decision on the primary enrichment technology for the future, AGC or AVLIS, will be made shortly. The background on the technology selection process, the highlights of AGC and AVLIS programs and the way to proceed after the process selection are described. The key objective is to maximize the sales volume and minimize the operating cost. This will help the utilities in other countries supply low cost energy on a reliable, long term basis. (Kako, I.)

  18. FOREWORD: Focus on Advanced Ceramics Focus on Advanced Ceramics

    Science.gov (United States)

    Ohashi, Naoki

    2011-06-01

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

  19. ADVANCED TECHNOLOGIES OF ELECTRONIC EDUCATIONAL SYSTEMS DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    M. Shishkina

    2011-11-01

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

  20. The Economics of Academic Advancement Within Surgery.

    Science.gov (United States)

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

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

  1. Recruit and ADVANCE

    Science.gov (United States)

    Rosser, Sue V.

    2007-04-01

    Beginning in 2001, the National Science Foundation launched the ADVANCE Initiative, which has now awarded more than 70 million to some thirty institutions for transformations to advance women. Results of studies on how to attract and retain women students and faculty underpinned our ADVANCE Institutional Transformation grant funded by the NSF for 3.7 million for five years, beginning in 2001. As co-principal investigator on this grant, I insured that this research informed the five major threads of the grant: 1) Four termed ADVANCE professors to mentor junior women faculty in each college; 2) Collection of MIT-Report-like data indicators to assess whether advancement of women really occurs during and after the institutional transformation undertaken through ADVANCE; 3) Family-friendly policies and practices to stop the tenure clock and provide active service, modified duties, lactation stations and day care; 4) Mini-retreats to facilitate access for tenure-track women faculty to male decision-makers and administrators for informal conversations and discussion on topics important to women faculty; 5) Removal of subtle gender, racial, and other biases in promotion and tenure. The dynamic changes resulting from the grant in quality of mentoring, new understanding of promotion and tenure, numbers of women retained and given endowed chairs, and emergence of new family friendly policies gave me hope for genuine diversification of leadership in science and technology. As the grant funding ends, the absence of NSF prestige and monitoring, coupled with a change in academic leadership at the top, provide new challenges for institutionalization, recruitment, and advancement of women into leadership positions in science and engineering.

  2. Advanced Oxidation Degradation of Diclofenac

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, William J., E-mail: wcooper@uci.edu [Urban Water Research Center, Department of Civil and Environmental Engineering, University of California, Irvine, CA 92697 (United States); Song Weihua, E-mail: wsong@fudan.edu.cn [Department of Environmental Science & Engineering, Fudan University, Shanghai 200433 (China)

    2012-07-01

    Advanced oxidation/reduction processes (AO/RPs), utilize free radical reactions to directly degrade chemical contaminants as an alternative to traditional water treatment. This study reports the absolute rate constants for reaction of diclofenac sodium and the model compound (2, 6-dichloraniline) with the two major AO/RP radicals; the hydroxyl radical (•OH) and hydrated electron (e{sup -}{sub aq}). The bimolecular reaction rate constants (M{sup -1} s{sup -1}) for diclofenac for •OH was (9.29 ± 0.11) x 10{sup 9}, and, for e- aq was (1.53 ± 0.03) x10{sup 9}. Preliminary degradation mechanisms are suggested based on product analysis using {sup 60}Co γ-irradiation and LC-MS for reaction by-product identification. The toxicity of products was evaluated using the Vibrio fischeri luminescent bacteria method. (author)

  3. Advanced Oxidation Degradation of Diclofenac

    International Nuclear Information System (INIS)

    Cooper, William J.; Song Weihua

    2012-01-01

    Advanced oxidation/reduction processes (AO/RPs), utilize free radical reactions to directly degrade chemical contaminants as an alternative to traditional water treatment. This study reports the absolute rate constants for reaction of diclofenac sodium and the model compound (2, 6-dichloraniline) with the two major AO/RP radicals; the hydroxyl radical (•OH) and hydrated electron (e - aq ). The bimolecular reaction rate constants (M -1 s -1 ) for diclofenac for •OH was (9.29 ± 0.11) x 10 9 , and, for e- aq was (1.53 ± 0.03) x10 9 . Preliminary degradation mechanisms are suggested based on product analysis using 60 Co γ-irradiation and LC-MS for reaction by-product identification. The toxicity of products was evaluated using the Vibrio fischeri luminescent bacteria method. (author)

  4. Advances in Retinal Optical Imaging

    Directory of Open Access Journals (Sweden)

    Yanxiu Li

    2018-04-01

    Full Text Available Retinal imaging has undergone a revolution in the past 50 years to allow for better understanding of the eye in health and disease. Significant improvements have occurred both in hardware such as lasers and optics in addition to software image analysis. Optical imaging modalities include optical coherence tomography (OCT, OCT angiography (OCTA, photoacoustic microscopy (PAM, scanning laser ophthalmoscopy (SLO, adaptive optics (AO, fundus autofluorescence (FAF, and molecular imaging (MI. These imaging modalities have enabled improved visualization of retinal pathophysiology and have had a substantial impact on basic and translational medical research. These improvements in technology have translated into early disease detection, more accurate diagnosis, and improved management of numerous chorioretinal diseases. This article summarizes recent advances and applications of retinal optical imaging techniques, discusses current clinical challenges, and predicts future directions in retinal optical imaging.

  5. Direct selling particularities

    OpenAIRE

    Greifová, Daniela

    2009-01-01

    Bachelor thesis is focused on the parcularities of direct selling, self regulation of this industry, multi-level marketing which is the most used sales method in the field of direct selling. The part of the thesis is dedicated to the issue of customer psychology that is very important for achieving success in direct selling. Main goals are to provide readers with the general view of direct selling and analysis of growing possibilities of the industry in the future.

  6. Recent advancements in conformal gravity

    International Nuclear Information System (INIS)

    O’Brien, James G.; Chaykov, Spasen S.; Moss, Robert J.; Dentico, Jeremy; Stulge, Modestas; Stefanski, Brian

    2017-01-01

    In recent years, due to the lack of direct observed evidence of cold dark matter, coupled with the shrinking parameter space to search for new dark matter particles, there has been increased interest in Alternative Gravitational theories. This paper, addresses three recent advances in conformal gravity, a fourth order renormalizable metric theory of gravitation originally formulated by Weyl, and later advanced by Mannheim and Kazanas. The first section of the paper applies conformal gravity to the rotation curves of the LITTLE THINGS survey, extending the total number of rotation curves successfully fit by conformal gravity to well over 200 individual data sets without the need for additional dark matter. Further, in this rotation curve study, we show how MOND and conformal gravity compare for each galaxy in the sample. Second, we look at the original Zwicky problem of applying the virial theorem to the Coma cluster in order to get an estimate for the cluster mass. However, instead of using the standard Newtonian potential, here we use the weak field approximation of conformal gravity. We show that in the conformal case we can get a much smaller mass estimate and thus there is no apparent need to include dark matter. We then show that this calculation is in agreement with the observational data from other well studied clusters. Last, we explore the calculation of the deflection of starlight through conformal gravity, as a first step towards applying conformal gravity to gravitaitonal lensing. (paper)

  7. Directed Energy Weapons

    Science.gov (United States)

    2007-12-01

    future business . In defense systems, the key to future business is the existence of funded programs. Military commanders understand the lethality and...directed energp capabilities that can provide visibiliy into the likey futur business case for sustaining directed energy industry capabilities...the USD (I) staff to be afocalpointfor advocating improvement in all dimensions of directed energy intelligence. - The Director, Defense Inteligence

  8. Advanced reactor development

    International Nuclear Information System (INIS)

    Till, C.E.

    1989-01-01

    Consideration is given to what the aims of advanced reactor development have to be, if a new generation of nuclear power is really to play an important role in man's energy generation activities in a fragile environment. The background given briefly covers present atmospheric evidence, the current situation in nuclear power, how reactors work and what can go wrong with them, and the present magnitudes of world energy generation. The central part of the paper describes what is currently being done in advanced reactor development and what can be expected from various systems and various elements of it. A vigorous case is made that three elements must be present in any advanced reactor development: (1) breeding; (2) passive safety; and (3) shorter-live nuclear waste. All three are possible. In the right advanced reactor systems the ways of achieving them are known. But R and D is necessary. That is the central argument made in the paper. Not advanced reactor prototype construction at this point, but R and D itself. (author)

  9. Advanced thermally stable jet fuels

    Energy Technology Data Exchange (ETDEWEB)

    Schobert, H.H.

    1999-01-31

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

  10. The advanced controls program at Oak Ridge National Laboratory

    International Nuclear Information System (INIS)

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

    1990-01-01

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

  11. Advancement & Promotion Review: 2003

    CERN Multimedia

    2003-01-01

    Advancement, exceptional advancement and promotion decisions were made at the end of June, following the procedures published in Weekly Bulletin No. 13/2003. These decisions were included, where applicable, in the salaries for the month of July 2003. The award of the periodic step was communicated to staff by the salary shown on the July salary slip. All other decisions are communicated by separate notification. The names of staff receiving exceptional advancements or promotions are now published on the HR Division website and are accessible for consultation only at the following address: http://cern.ch/hr-div/internal/personnel/advlist_2003.asp It is recalled that change of career path proposals submitted to the Technical Engineers and Administrative Careers Committee (TEACC) or to Human Resources Division are being examined with a view to preparing the latters' recommendations by the end of September 2003. Final decisions will be applied retroactively to 1 July 2003. Human Resources Division Tel:...

  12. Advanced Hydrogen Turbine Development

    Energy Technology Data Exchange (ETDEWEB)

    Marra, John [Siemens Energy, Inc., Orlando, FL (United States)

    2015-09-30

    Under the sponsorship of the U.S. Department of Energy (DOE) National Energy Technology Laboratories, Siemens has completed the Advanced Hydrogen Turbine Development Program to develop an advanced gas turbine for incorporation into future coal-based Integrated Gasification Combined Cycle (IGCC) plants. All the scheduled DOE Milestones were completed and significant technical progress was made in the development of new technologies and concepts. Advanced computer simulations and modeling, as well as subscale, full scale laboratory, rig and engine testing were utilized to evaluate and select concepts for further development. Program Requirements of: A 3 to 5 percentage point improvement in overall plant combined cycle efficiency when compared to the reference baseline plant; 20 to 30 percent reduction in overall plant capital cost when compared to the reference baseline plant; and NOx emissions of 2 PPM out of the stack. were all met. The program was completed on schedule and within the allotted budget

  13. Advanced Magnetic Nanostructures

    CERN Document Server

    Sellmyer, David

    2006-01-01

    Advanced Magnetic Nanostructures is devoted to the fabrication, characterization, experimental investigation, theoretical understanding, and utilization of advanced magnetic nanostructures. Focus is on various types of 'bottom-up' and 'top-down' artificial nanostructures, as contrasted to naturally occurring magnetic nanostructures, such as iron-oxide inclusions in magnetic rocks, and to structures such as perfect thin films. Chapter 1 is an introduction into some basic concepts, such as the definitions of basic magnetic quantities. Chapters 2-4 are devoted to the theory of magnetic nanostructures, Chapter 5 deals with the characterization of the structures, and Chapters 6-10 are devoted to specific systems. Applications of advanced magnetic nanostructures are discussed in Chapters11-15 and, finally, the appendix lists and briefly discusses magnetic properties of typical starting materials. Industrial and academic researchers in magnetism and related areas such as nanotechnology, materials science, and theore...

  14. Advanced servomanipulator development

    International Nuclear Information System (INIS)

    Kuban, D.P.

    1985-01-01

    The Advanced Servomanipulator (ASM) System consists of three major components: the ASM slave, the dual arm master controller (DAMC) or master, and the control system. The ASM is remotely maintainable force-reflecting servomanipulator developed at the Oak Ridge National Laboratory (ORNL) as part of the Consolidated Fuel Reprocessing Program. This new manipulator addresses requirements of advanced nuclear fuel reprocessing with emphasis on force reflection, remote maintainability, reliability, radiation tolerance, and corrosion resistance. The advanced servomanipulator is uniquely subdivided into remotely replaceable modules which will permit in situ manipulator repair by spare module replacement. Manipulator modularization and increased reliability are accomplished through a force transmission system that uses gears and torque tubes. Digital control algorithms and mechanical precision are used to offset the increased backlash, friction, and inertia resulting from the gear drives. This results in the first remotely maintainable force-reflecting servomanipulator in the world

  15. Advanced Worker Protection System

    International Nuclear Information System (INIS)

    1996-04-01

    The Advanced Worker Protection System (AWPS) is a liquid-air-based, self-contained breathing and cooling system with a duration of 2 hrs. AWPS employs a patented system developed by Oceaneering Space Systems (OSS), and was demonstrated at their facility in Houston, TX as well as at Kansas State University, Manhattan. The heart of the system is the life-support backpack that uses liquid air to provide cooling as well as breathing gas to the worker. The backpack is combined with advanced protective garments, an advanced liquid cooling garment (LCG), a respirator, and communications and support equipment. The prototype unit development and testing under Phase 1 has demonstrated that AWPS has the ability to meet performance criteria. These criteria were developed with an understanding of both the AWPS capabilities and the DOE decontamination and decommissioning (D and D) activities protection needs

  16. Advances in business ICT

    CERN Document Server

    Pełech-Pilichowski, Tomasz

    2014-01-01

    Futurists and scientists alike profess the coming of a new era in the history – the knowledge era. The notion of knowledge is as old as humans’ self-consciousness, but new challenges appear. The meaning of the word “knowledge” is changing from cognitive notion to a technical term denoting a structured economic resource to be actively managed. This contributed volume is a result of vivid and extremely valuable discussions held at 3rd International Workshop on Advances in Business ICT (ABICT) in Wrocław, Poland, September 9-12, 2012. The workshop focused on Advances in Business ICT approached from a multidisciplinary perspective. It provided an international forum for scientists/experts from academia and industry to discuss and exchange current results, applications, new ideas of ongoing research and experience on all aspects of Business Intelligence. ABICT has also been an opportunity to demonstrate different ideas and tools for developing and supporting organizational creativity, as well as advances ...

  17. Advanced maintenance research programs

    International Nuclear Information System (INIS)

    Marston, T.U.; Gelhaus, F.; Burke, R.

    1985-01-01

    The purpose of this paper is to provide the reader with an idea of the advanced maintenance research program at the Electric Power Research Institute (EPRI). A brief description of the maintenance-related activities is provided as a foundation for the advanced maintenance research projects. The projects can be divided into maintenance planning, preventive maintenance program development and implementation, predictive (or conditional) maintenance, and innovative maintenance techniques. The projects include hardware and software development, human factors considerations, and technology promotion and implementation. The advanced concepts include: the incorporation of artificial intelligence into outage planning; turbine and pump maintenance; rotating equipment monitoring and diagnostics with the aid of expert systems; and the development of mobile robots for nuclear power plant maintenance

  18. Advanced flip chip packaging

    CERN Document Server

    Lai, Yi-Shao; Wong, CP

    2013-01-01

    Advanced Flip Chip Packaging presents past, present and future advances and trends in areas such as substrate technology, material development, and assembly processes. Flip chip packaging is now in widespread use in computing, communications, consumer and automotive electronics, and the demand for flip chip technology is continuing to grow in order to meet the need for products that offer better performance, are smaller, and are environmentally sustainable. This book also: Offers broad-ranging chapters with a focus on IC-package-system integration Provides viewpoints from leading industry executives and experts Details state-of-the-art achievements in process technologies and scientific research Presents a clear development history and touches on trends in the industry while also discussing up-to-date technology information Advanced Flip Chip Packaging is an ideal book for engineers, researchers, and graduate students interested in the field of flip chip packaging.

  19. ADVANCEMENT & PROMOTION REVIEW: 2002

    CERN Multimedia

    2002-01-01

    Advancement, exceptional advancement and promotion decisions were made at the beginning of July, under the new career structure scheme and following the procedures published in Weekly Bulletin No. 11/2002. These decisions were included, where applicable, in the salaries for the month of July 2002. The award of the periodic step was communicated to staff by the salary shown on the July salary slip. All other decisions are communicated by separate notification. The names of staff receiving exceptional advancements or promotions will be published this year on the HR Division website and are accessible for consultation only at the following address : http://cern.ch/hr-div/internal/personnel/advlist.asp It is recalled that change of career path proposals submitted to the Technical Engineers and Administrative Careers Committee (TEACC) or to Human Resources Division are being examined with a view to preparing the latters' recommendations by the end of September 2002. Final decisions will be applied retroactivel...

  20. Sustainability assessment of advanced wastewater treatment technologies

    DEFF Research Database (Denmark)

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

    2008-01-01

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

  1. Laboratory directed research and development

    Energy Technology Data Exchange (ETDEWEB)

    1991-11-15

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

  2. Advanced number theory

    CERN Document Server

    Cohn, Harvey

    1980-01-01

    ""A very stimulating book ... in a class by itself."" - American Mathematical MonthlyAdvanced students, mathematicians and number theorists will welcome this stimulating treatment of advanced number theory, which approaches the complex topic of algebraic number theory from a historical standpoint, taking pains to show the reader how concepts, definitions and theories have evolved during the last two centuries. Moreover, the book abounds with numerical examples and more concrete, specific theorems than are found in most contemporary treatments of the subject.The book is divided into three parts

  3. Advanced router architectures

    CERN Document Server

    Kloth, Axel K

    2005-01-01

    Routers, switches, and transmission equipment form the backbone of the Internet, yet many users and service technicians do not understand how these nodes really work.Advanced Router Architectures addresses how components of advanced routers work together and how they are integrated with each other. This book provides the background behind why these building blocks perform certain functions, and how the function is implemented in general use. It offers an introduction to the subject matter that is intended to trigger deeper interest from the reader. The book explains, for example, why traffic m

  4. Advances in quantum chemistry

    CERN Document Server

    Sabin, John R

    2013-01-01

    Advances in Quantum Chemistry presents surveys of current topics in this rapidly developing field that has emerged at the cross section of the historically established areas of mathematics, physics, chemistry, and biology. It features detailed reviews written by leading international researchers. This volume focuses on the theory of heavy ion physics in medicine.Advances in Quantum Chemistry presents surveys of current topics in this rapidly developing field that has emerged at the cross section of the historically established areas of mathematics, physics, chemistry, and biology. It features

  5. Advanced Techniques in Biophysics

    CERN Document Server

    Arrondo, José Luis R

    2006-01-01

    Technical advancements are basic elements in our life. In biophysical studies, new applications and improvements in well-established techniques are being implemented every day. This book deals with advancements produced not only from a technical point of view, but also from new approaches that are being taken in the study of biophysical samples, such as nanotechniques or single-cell measurements. This book constitutes a privileged observatory for reviewing novel applications of biophysical techniques that can help the reader enter an area where the technology is progressing quickly and where a comprehensive explanation is not always to be found.

  6. Advances in catalysis

    CERN Document Server

    Gates, Bruce C

    2012-01-01

    Advances in Catalysis fills the gap between the journal papers and the textbooks across the diverse areas of catalysis research. For more than 60 years Advances in Catalysis has been dedicated to recording progress in the field of catalysis and providing the scientific community with comprehensive and authoritative reviews. This series in invaluable to chemical engineers, physical chemists, biochemists, researchers and industrial chemists working in the fields of catalysis and materials chemistry. * In-depth, critical, state-of-the-art reviews * Comprehensive, covers of all as

  7. Advances in microwaves 3

    CERN Document Server

    Young, Leo

    2013-01-01

    Advances in Microwaves, Volume 3 covers the advances and applications of microwave signal transmission and Gunn devices. This volume contains six chapters and begins with descriptions of ground-station antennas for space communications. The succeeding chapters deal with beam waveguides, which offer interesting possibilities for transmitting microwave energy, as well as with parallel or tubular beams from antenna apertures. A chapter discusses the electron transfer mechanism and the velocity-field characteristics, with a particular emphasis on the microwave properties of Gunn oscillators. The l

  8. Advanced concepts for acceleration

    International Nuclear Information System (INIS)

    Keefe, D.

    1986-07-01

    Selected examples of advanced accelerator concepts are reviewed. Such plasma accelerators as plasma beat wave accelerator, plasma wake field accelerator, and plasma grating accelerator are discussed particularly as examples of concepts for accelerating relativistic electrons or positrons. Also covered are the pulsed electron-beam, pulsed laser accelerator, inverse Cherenkov accelerator, inverse free-electron laser, switched radial-line accelerators, and two-beam accelerator. Advanced concepts for ion acceleration discussed include the electron ring accelerator, excitation of waves on intense electron beams, and two-wave combinations

  9. Advanced Surface Technology

    DEFF Research Database (Denmark)

    Møller, Per; Nielsen, Lars Pleht

    of the components. It covers everything from biocompatible surfaces of IR absorbent or reflective surfaces to surfaces with specific properties within low friction, hardness, corrosion, colors, etc. The book includes more than 400 pages detailing virtually all analysis methods for examining at surfaces.......This new significant book on advanced modern surface technology in all its variations, is aimed at both teaching at engineering schools and practical application in industry. The work covers all the significant aspects of modern surface technology and also describes how new advanced techniques make...

  10. Advances in chemical physics

    CERN Document Server

    Rice, Stuart A

    2014-01-01

    Advances in Chemical Physics is the only series of volumes available that explores the cutting edge of research in chemical physics. This is the only series of volumes available that presents the cutting edge of research in chemical physics.Includes contributions from experts in this field of research.Contains a representative cross-section of research that questions established thinking on chemical solutions.Structured with an editorial framework that makes the book an excellent supplement to an advanced graduate class in physical chemistry or chemical physics.

  11. MR Neurography: Advances

    International Nuclear Information System (INIS)

    Chhabra, A.; Carrino, J.A.; Trueblood, E.; Lianxin Zhao, L.; Koceski, S.; Shteriev, F.; Lenkinski, L.; Sinclair, Ch.D.J.; Andreisek, G.

    2013-01-01

    High resolution and high field magnetic resonance neurography (MR neurography, MRN) is shown to have excellent anatomic capability. There have been considerable advances in the technology in the last few years leading to various feasibility studies using different structural and functional imaging approaches in both clinical and research settings. This paper is intended to be a useful seminar for readers who want to gain knowledge of the advancements in the MRN pulse sequences currently used in clinical practice as well as learn about the other techniques on the horizon aimed at better depiction of nerve anatomy, pathology, and potential noninvasive evaluation of nerve degeneration or regeneration.

  12. Advancing Physics evaluated

    Science.gov (United States)

    Ogborn, Jon

    2003-07-01

    The first phase of an evaluation of the new AS/A-level course Advancing Physics, sponsored by the Institute of Physics, is now complete. It shows that the course has achieved very high satisfaction ratings from teachers of the course, and that a majority of these teachers see it as achieving its main aims. The first phase of the evaluation was designed to pinpoint aspects of Advancing Physics that offer scope for improvement. Two such aspects have been identified: course planning and use of the CD-ROM material, and arrangements for coursework in the examination.

  13. Applications of Advanced Electromagnetics Components and Systems

    CERN Document Server

    Kouzaev, Guennadi A

    2013-01-01

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

  14. Recent designs for advanced fusion reactor blankets

    International Nuclear Information System (INIS)

    Sze, D.K.

    1994-06-01

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

  15. Advances in steam generator service technology

    International Nuclear Information System (INIS)

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

    1997-01-01

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

  16. Pressure Safety: Advanced Self-Study 30120

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-02-29

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

  17. Advances in radiation protection monitoring

    International Nuclear Information System (INIS)

    1978-01-01

    The requirement to keep radiation exposure as low as reasonably achievable, linked with the growing number of workers whose exposure to radiation must be strictly controlled, requires intensified efforts directed towards the provision of adequate radiation monitoring programmes. This symposium was intended to review the advances that have been made in methods, techniques and instrumentation for radiation protection monitoring. Thus the symposium complemented the detailed consideration that had already been given to two closely related topics, that of environmental monitoring and of monitoring radioactive airborne and liquid discharges from nuclear facilities. The first topic had been dealt with in detail in an Agency symposium held in November 1973 in Warsaw and the second was treated in an Agency symposium held in September 1977 in Portoroz. The present symposium covered a broad range of topics under the following main headings: Monitoring of external exposure (three sessions),Contamination monitoring (three sessions), Radiation monitoring programmes (one session), Calibration, and use of computers (two sessions). An introductory paper described the purpose of radiation protection monitoring and its historical development. It drew attention to the gradual change from the threshold dose hypothesis to the hypothesis of direct proportionality between dose and effect and discussed practical implications of the recommendations recently issued by the International Commission on Radiological Protection (ICRP). It became apparent that guidance on the application of these recommendations is urgently needed. This guidance is presently being prepared by ICRP

  18. Advanced Life Support Project Plan

    Science.gov (United States)

    2002-01-01

    Life support systems are an enabling technology and have become integral to the success of living and working in space. As NASA embarks on human exploration and development of space to open the space frontier by exploring, using and enabling the development of space and to expand the human experience into the far reaches of space, it becomes imperative, for considerations of safety, cost, and crew health, to minimize consumables and increase the autonomy of the life support system. Utilizing advanced life support technologies increases this autonomy by reducing mass, power, and volume necessary for human support, thus permitting larger payload allocations for science and exploration. Two basic classes of life support systems must be developed, those directed toward applications on transportation/habitation vehicles (e.g., Space Shuttle, International Space Station (ISS), next generation launch vehicles, crew-tended stations/observatories, planetary transit spacecraft, etc.) and those directed toward applications on the planetary surfaces (e.g., lunar or Martian landing spacecraft, planetary habitats and facilities, etc.). In general, it can be viewed as those systems compatible with microgravity and those compatible with hypogravity environments. Part B of the Appendix defines the technology development 'Roadmap' to be followed in providing the necessary systems for these missions. The purpose of this Project Plan is to define the Project objectives, Project-level requirements, the management organizations responsible for the Project throughout its life cycle, and Project-level resources, schedules and controls.

  19. History and Advancements

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 15; Issue 9. Colour: History and Advancements. Vinod R Kanetkar. General Article Volume 15 Issue 9 September 2010 pp 794-803. Fulltext. Click here to view fulltext PDF. Permanent link: https://www.ias.ac.in/article/fulltext/reso/015/09/0794-0803 ...

  20. Animal Production Research Advances

    African Journals Online (AJOL)

    Animal Production Research Advances is a peer-review journal established expressly to promote the production of all animal species utilized as food. The journal has an international scope and is intended for professionals in animal production and related sciences. We solicit contributions from animal production and ...

  1. Management of advanced melanoma

    International Nuclear Information System (INIS)

    Nathanson, L.

    1986-01-01

    This book presents papers on the subject of management of advanced melanoma. The topics covered are: non-investigational cytotoxic agents; high-dosage chemotherapy in antologous bone marrow transplantation; Radiotherapy of melanomas; hyperthermia; ureal melanoma; surgical treatment of recurrent a metastatic melanoma; role of interferons in management of melanoma and molecular genetics of melanoma

  2. Advanced classical thermodynamics

    International Nuclear Information System (INIS)

    Emanuel, G.

    1987-01-01

    The theoretical and mathematical foundations of thermodynamics are presented in an advanced text intended for graduate engineering students. Chapters are devoted to definitions and postulates, the fundamental equation, equilibrium, the application of Jacobian theory to thermodynamics, the Maxwell equations, stability, the theory of real gases, critical-point theory, and chemical thermodynamics. Diagrams, graphs, tables, and sample problems are provided. 38 references

  3. Advances in pediatric dentistry.

    Science.gov (United States)

    Yoon, Richard K; Best, Jed M

    2011-07-01

    This article addresses advances in 4 key areas related to pediatric dentistry: (1) caries detection tools, (2) early interventions to arrest disease progression, (3) caries-risk assessment tools, and (4) trends in pediatric procedures and dental materials. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. Advances in tomographic PIV

    NARCIS (Netherlands)

    Novara, M.

    2013-01-01

    This research deals with advanced developments in 3D particle image velocimetry based on the tomographic PIV technique (Tomo-PIV). The latter is a relatively recent measurement technique introduced by Elsinga et al. in 2005, which is based on the tomographic reconstruction of particle tracers in

  5. Advanced Curvature Deformable Mirrors

    Science.gov (United States)

    2010-09-01

    ORGANIZATION NAME(S) AND ADDRESS(ES) University of Hawaii ,Institute for Astronomy,640 North A‘ohoku Place, #209 , Hilo ,HI,96720-2700 8. PERFORMING...Advanced Curvature Deformable Mirrors Christ Ftaclas1,2, Aglae Kellerer2 and Mark Chun2 Institute for Astronomy, University of Hawaii

  6. Cartoons as Advance Organizers

    Science.gov (United States)

    Kovalik, Cindy L.; Williams, Matthew A.

    2011-01-01

    This exploratory study investigated student reaction to the use of cartoons as advance organizers for online discussions in an online course. A convenience sample of 15 students participated in the study by contributing cartoons, participating in online discussions, and completing a survey. Overall, survey results indicated student reaction to the…

  7. Advanced computers and simulation

    International Nuclear Information System (INIS)

    Ryne, R.D.

    1993-01-01

    Accelerator physicists today have access to computers that are far more powerful than those available just 10 years ago. In the early 1980's, desktop workstations performed less one million floating point operations per second (Mflops), and the realized performance of vector supercomputers was at best a few hundred Mflops. Today vector processing is available on the desktop, providing researchers with performance approaching 100 Mflops at a price that is measured in thousands of dollars. Furthermore, advances in Massively Parallel Processors (MPP) have made performance of over 10 gigaflops a reality, and around mid-decade MPPs are expected to be capable of teraflops performance. Along with advances in MPP hardware, researchers have also made significant progress in developing algorithms and software for MPPS. These changes have had, and will continue to have, a significant impact on the work of computational accelerator physicists. Now, instead of running particle simulations with just a few thousand particles, we can perform desktop simulations with tens of thousands of simulation particles, and calculations with well over 1 million particles are being performed on MPPs. In the area of computational electromagnetics, simulations that used to be performed only on vector supercomputers now run in several hours on desktop workstations, and researchers are hoping to perform simulations with over one billion mesh points on future MPPs. In this paper we will discuss the latest advances, and what can be expected in the near future, in hardware, software and applications codes for advanced simulation of particle accelerators

  8. Advanced instrumentation and teleoperation

    International Nuclear Information System (INIS)

    Decreton, M.

    1998-01-01

    SCK-CEN's advanced instrumentation and teleoperation project aims at evaluating the potential of a telerobotic approach in a nuclear environment and, in particular, the use of remote-perception systems. Main achievements in 1997 in the areas of R and D on radiation tolerance for remote sensing, optical fibres and optical-fibre sensors, and computer-aided teleoperation are reported

  9. Advanced Control Engineering

    DEFF Research Database (Denmark)

    Zhou, Jianjun

    1999-01-01

    This book is developed as a textbook for the course Advanced Control Engineering. The book is intended for students in mechanical engineering and its aim is to provide an understanding of modern control theory as well as methodologies and applications for state space modeling and design...

  10. Methodological Advances in Dea

    NARCIS (Netherlands)

    L. Cherchye (Laurens); G.T. Post (Thierry)

    2001-01-01

    textabstractWe survey the methodological advances in DEA over the last 25 years and discuss the necessary conditions for a sound empirical application. We hope this survey will contribute to the further dissemination of DEA, the knowledge of its relative strengths and weaknesses, and the tools

  11. Advanced fire information system

    CSIR Research Space (South Africa)

    Frost, PE

    2007-01-01

    Full Text Available The South African Advanced Fire Information System (AFIS) is the first near real-time satellite-based fire monitoring system in Africa. It was originally developed for, and funded by, the electrical power utility Eskom, to reduce the impact of wild...

  12. Primatology: advanced ape technology.

    Science.gov (United States)

    McGrew, W C

    2004-12-29

    New findings from African rainforests show chimpanzees to have impressively advanced technology. They make tools of vegetation to harvest termites as in East and West Africa, but some apes in Central Africa show different techniques and tool sets geared for different tasks.

  13. Advanced Cruise Control (ACC).

    NARCIS (Netherlands)

    2008-01-01

    Advanced Cruise Control (ACC), also known as adaptive or intelligent cruise control, not only maintains the driver-set vehicle speed, but also adjusts the vehicle's speed to that of a preceding vehicle, and helps to maintain a pre-selected headway time to the vehicle ahead. ACC systems can have a

  14. Advanced Cruise Control (ACC).

    NARCIS (Netherlands)

    2010-01-01

    Advanced Cruise Control (ACC), ook bekend als Adaptive, Active of Intelligent Cruise Control, handhaaft niet alleen de door de bestuurder ingestelde rijsnelheid, maar stemt ook de snelheid van het voertuig af op die van de voorligger. ACC helpt op deze manier om een vooraf bepaalde volgtijd tot de

  15. Advances in Computer Entertainment.

    NARCIS (Netherlands)

    Nijholt, Antinus; Romão, T.; Reidsma, Dennis; Unknown, [Unknown

    2012-01-01

    These are the proceedings of the 9th International Conference on Advances in Computer Entertainment ACE 2012). ACE has become the leading scientific forum for dissemination of cutting-edge research results in the area of entertainment computing. Interactive entertainment is one of the most vibrant

  16. Advances in satellite communications

    CERN Document Server

    Minoli, Daniel

    2015-01-01

    Discussing advances in modulation techniques and HTS spotbeam technologiesSurveying emerging high speed aeronautical mobility services and maritime and other terrestrial mobility servicesAssessing M2M (machine-to-machine) applications, emerging Ultra HD video technologies and new space technology

  17. Advances in Opto Electronics

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Advances in Opto Electronics. Optoelectronics is where electronics was 15 years back. All Optical Amplifiers and Semiconductor Amplifiers. Fastest Semiconductor (InP) switch is at 170GHz- where is terrabit ? MEMS based switches that route traffic at wavelength level ...

  18. Advanced Cardiac Life Support.

    Science.gov (United States)

    Kirkwood Community Coll., Cedar Rapids, IA.

    This document contains materials for an advanced college course in cardiac life support developed for the State of Iowa. The course syllabus lists the course title, hours, number, description, prerequisites, learning activities, instructional units, required text, six references, evaluation criteria, course objectives by units, course…

  19. Advanced Distribution Management System

    OpenAIRE

    Avazov, Artur; Sobinova, Lubov Anatolievna

    2016-01-01

    This article describes the advisability of using advanced distribution management systems in the electricity distribution networks area and considers premises of implementing ADMS within the Smart Grid era. Also, it gives the big picture of ADMS and discusses the ADMS advantages and functionalities.

  20. Advanced Distribution Management System

    Science.gov (United States)

    Avazov, Artur R.; Sobinova, Liubov A.

    2016-02-01

    This article describes the advisability of using advanced distribution management systems in the electricity distribution networks area and considers premises of implementing ADMS within the Smart Grid era. Also, it gives the big picture of ADMS and discusses the ADMS advantages and functionalities.

  1. Advanced Distribution Management System

    Directory of Open Access Journals (Sweden)

    Avazov Artur R.

    2016-01-01

    Full Text Available This article describes the advisability of using advanced distribution management systems in the electricity distribution networks area and considers premises of implementing ADMS within the Smart Grid era. Also, it gives the big picture of ADMS and discusses the ADMS advantages and functionalities.

  2. Advances in statistics

    Science.gov (United States)

    Howard Stauffer; Nadav Nur

    2005-01-01

    The papers included in the Advances in Statistics section of the Partners in Flight (PIF) 2002 Proceedings represent a small sample of statistical topics of current importance to Partners In Flight research scientists: hierarchical modeling, estimation of detection probabilities, and Bayesian applications. Sauer et al. (this volume) examines a hierarchical model...

  3. Advanced Heart Failure

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Advanced Heart Failure Updated:May 9,2017 When heart failure (HF) ... Making This content was last reviewed May 2017. Heart Failure • Home • About Heart Failure • Causes and Risks for ...

  4. Advances in Crash Response

    Centers for Disease Control (CDC) Podcasts

    In this podcast, Dr. Richard C. Hunt, Director of CDC's Division of Injury Response, provides an overview on the benefits of using an Advanced Automatic Collision Notification system, or AACN, to help with emergency triage of people injured in vehicle crashes.

  5. Labour analgesia: Recent advances

    Science.gov (United States)

    Pandya, Sunil T

    2010-01-01

    Advances in the field of labour analgesia have tread a long journey from the days of ether and chloroform in 1847 to the present day practice of comprehensive programme of labour pain management using evidence-based medicine. Newer advances include introduction of newer techniques like combined spinal epidurals, low-dose epidurals facilitating ambulation, pharmacological advances like introduction of remifentanil for patient-controlled intravenous analgesia, introduction of newer local anaesthetics and adjuvants like ropivacaine, levobupivacaine, sufentanil, clonidine and neostigmine, use of inhalational agents like sevoflourane for patient-controlled inhalational analgesia using special vaporizers, all have revolutionized the practice of pain management in labouring parturients. Technological advances like use of ultrasound to localize epidural space in difficult cases minimizes failed epidurals and introduction of novel drug delivery modalities like patient-controlled epidural analgesia (PCEA) pumps and computer-integrated drug delivery pumps have improved the overall maternal satisfaction rate and have enabled us to customize a suitable analgesic regimen for each parturient. Recent randomized controlled trials and Cochrane studies have concluded that the association of epidurals with increased caesarean section and long-term backache remains only a myth. Studies have also shown that the newer, low-dose regimes do not have a statistically significant impact on the duration of labour and breast feeding and also that these reduce the instrumental delivery rates thus improving maternal and foetal safety. Advances in medical technology like use of ultrasound for localizing epidural space have helped the clinicians to minimize the failure rates, and many novel drug delivery modalities like PCEA and computer-integrated PCEA have contributed to the overall maternal satisfaction and safety. PMID:21189877

  6. Advanced Demonstration and Test Reactor Options Study

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-01-01

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

  7. Advanced Demonstration and Test Reactor Options Study

    International Nuclear Information System (INIS)

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

    2017-01-01

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

  8. Directed Energy Anechoic Chamber

    Data.gov (United States)

    Federal Laboratory Consortium — The Directed Energy Anechoic Chamber comprises a power anechoic chamber and one transverse electromagnetic cell for characterizing radiofrequency (RF) responses of...

  9. Records Management Directive

    Data.gov (United States)

    Office of Personnel Management — The Office of Personnel Management (OPM) Records Management Directive provides guidelines for the management of OPM records, and identifies the records management...

  10. [Thalidomide teratogenicity and its direct target identification].

    Science.gov (United States)

    Ito, Takumi; Ando, Hideki; Handa, Hiroshi

    2015-01-01

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

  11. Directional Joint Bilateral Filter for Depth Images

    Directory of Open Access Journals (Sweden)

    Anh Vu Le

    2014-06-01

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

  12. Sports Tournament Predictions Using Direct Manipulation.

    Science.gov (United States)

    Vuillemot, Romain; Perin, Charles

    2016-01-01

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

  13. 7 CFR 1484.57 - Will FAS make advance payments to a Cooperator?

    Science.gov (United States)

    2010-01-01

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

  14. Direct, rapid RNA sequence analysis

    International Nuclear Information System (INIS)

    Peattie, D.A.

    1987-01-01

    The original methods of RNA sequence analysis were based on enzymatic production and chromatographic separation of overlapping oligonucleotide fragments from within an RNA molecule followed by identification of the mononucleotides comprising the oligomer. Over the past decade the field of nucleic acid sequencing has changed dramatically, however, and RNA molecules now can be sequenced in a variety of more streamlined fashions. Most of the more recent advances in RNA sequencing have involved one-dimensional electrophoretic separation of 32 P-end-labeled oligoribonucleotides on polyacrylamide gels. In this chapter the author discusses two of these methods for determining the nucleotide sequences of RNA molecules rapidly: the chemical method and the enzymatic method. Both methods are direct and degradative, i.e., they rely on fragmatic and chemical approaches should be utilized. The single-strand-specific ribonucleases (A, T 1 , T 2 , and S 1 ) provide an efficient means to locate double-helical regions rapidly, and the chemical reactions provide a means to determine the RNA sequence within these regions. In addition, the chemical reactions allow one to assign interactions to specific atoms and to distinguish secondary interactions from tertiary ones. If the RNA molecule is small enough to be sequenced directly by the enzymatic or chemical method, the probing reactions can be done easily at the same time as sequencing reactions

  15. Direct methods in protein crystallography.

    Science.gov (United States)

    Karle, J

    1989-11-01

    It is pointed out that the 'direct methods' of phase determination for small-structure crystallography do not have immediate applicability to macromolecular structures. The term 'direct methods in macromolecular crystallography' is suggested to categorize a spectrum of approaches to macromolecular structure determination in which the analyses are characterized by the use of two-phase and higher-order-phase invariants. The evaluation of the invariants is generally obtained by the use of heavy-atom techniques. The results of a number of the more recent algebraic and probabilistic studies involving isomorphous replacement and anomalous dispersion thus become valid subjects for discussion here. These studies are described and suggestions are also presented concerning future applicability. Additional discussion concerns the special techniques of filtering, the use of non-crystallographic symmetry, some features of maximum entropy and attempts to apply phase-determining formulas to the refinement of macromolecular structure. It is noted that, in addition to the continuing remarkable progress in macromolecular crystallography based on the traditional applications of isomorphous replacement and anomalous dispersion, recent valuable advances have been made in the application of non-crystallographic symmetry, in particular, to virus structures and in applications of filtering. Good progress has also been reported in the application of exact linear algebra to multiple-wavelength anomalous-dispersion investigations of structures containing anomalous scatterers of only moderate scattering power.

  16. Direct dating of human fossils.

    Science.gov (United States)

    Grün, Rainer

    2006-01-01

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

  17. Direct Conversion of Energy.

    Science.gov (United States)

    Corliss, William R.

    This publication is one of a series of information booklets for the general public published by the United States Atomic Energy Commission. Direct energy conversion involves energy transformation without moving parts. The concepts of direct and dynamic energy conversion plus the laws governing energy conversion are investigated. Among the topics…

  18. Decisions Concerning Directional Dependence

    Science.gov (United States)

    von Eye, Alexander; DeShon, Richard P.

    2012-01-01

    In this rejoinder, von Eye and DeShon discuss the decision strategies proposed in their original article ("Directional Dependence in Developmental Research," this issue), as well as the ones proposed by the authors of the commentary (Pornprasertmanit and Little, "Determining Directional Dependency in Causal Associations," this issue). In addition,…

  19. Advanced steel reheat furnace

    Energy Technology Data Exchange (ETDEWEB)

    Moyeda, D.; Sheldon, M.; Koppang, R. [Energy and Environmental Research Corp., Irvine, CA (United States); Lanyi, M.; Li, X.; Eleazer, B. [Air Products and Chemicals, Inc., Allentown, PA (United States)

    1997-10-01

    Energy and Environmental Research Corp. (EER) under a contract from the Department of Energy is pursuing the development and demonstration of an Advanced Steel Reheating Furnace. This paper reports the results of Phase 1, Research, which has evaluated an advanced furnace concept incorporating two proven and commercialized technologies previously applied to other high temperature combustion applications: EER`s gas reburn technology (GR) for post combustion NOx control; and Air Product`s oxy-fuel enrichment air (OEA) for improved flame heat transfer in the heating zones of the furnace. The combined technologies feature greater production throughput with associated furnace efficiency improvements; lowered NOx emissions; and better control over the furnace atmosphere, whether oxidizing or reducing, leading to better control over surface finish.

  20. [Research advances in dendrochronology].

    Science.gov (United States)

    Fang, Ke-Yan; Chen, Qiu-Yan; Liu, Chang-Zhi; Cao, Chun-Fu; Chen, Ya-Jun; Zhou, Fei-Fei

    2014-07-01

    Tree-ring studies in China have achieved great advances since the 1990s, particularly for the dendroclimatological studies which have made some influence around the world. However, because of the uneven development, limited attention has been currently paid on the other branches of dendrochronology. We herein briefly compared the advances of dendrochronology in China and of the world and presented suggestions on future dendrochronological studies. Large-scale tree-ring based climate reconstructions in China are highly needed by employing mathematical methods and a high quality tree-ring network of the ring-width, density, stable isotope and wood anatomy. Tree-ring based field climate reconstructions provide potentials on explorations of climate forcings during the reconstructed periods via climate diagnosis and process simulation.

  1. Advanced information processing system

    Science.gov (United States)

    Lala, J. H.

    1984-01-01

    Design and performance details of the advanced information processing system (AIPS) for fault and damage tolerant data processing on aircraft and spacecraft are presented. AIPS comprises several computers distributed throughout the vehicle and linked by a damage tolerant data bus. Most I/O functions are available to all the computers, which run in a TDMA mode. Each computer performs separate specific tasks in normal operation and assumes other tasks in degraded modes. Redundant software assures that all fault monitoring, logging and reporting are automated, together with control functions. Redundant duplex links and damage-spread limitation provide the fault tolerance. Details of an advanced design of a laboratory-scale proof-of-concept system are described, including functional operations.

  2. Advanced polymers in medicine

    CERN Document Server

    Puoci, Francesco

    2014-01-01

    The book provides an up-to-date overview of the diverse medical applications of advanced polymers. The book opens by presenting important background information on polymer chemistry and physicochemical characterization of polymers. This serves as essential scientific support for the subsequent chapters, each of which is devoted to the applications of polymers in a particular medical specialty. The coverage is broad, encompassing orthopedics, ophthalmology, tissue engineering, surgery, dentistry, oncology, drug delivery, nephrology, wound dressing and healing, and cardiology. The development of polymers that enhance the biocompatibility of blood-contacting medical devices and the incorporation of polymers within biosensors are also addressed. This book is an excellent guide to the recent advances in polymeric biomaterials and bridges the gap between the research literature and standard textbooks on the applications of polymers in medicine.

  3. CANDU advanced fuel cycles

    International Nuclear Information System (INIS)

    Slater, J.B.

    1986-03-01

    This report is based on informal lectures and presentations made on CANDU Advanced Fuel Cycles over the past year or so, and discusses the future role of CANDU in the changing environment for the Canadian and international nuclear power industry. The changing perspectives of the past decade lead to the conclusion that a significant future market for a CANDU advanced thermal reactor will exist for many decades. Such a reactor could operate in a stand-alone strategy or integrate with a mixed CANDU-LWR or CANDU-FBR strategy. The consistent design focus of CANDU on enhanced efficiency of resource utilization combined with a simple technology to achieve economic targets, will provide sufficient flexibility to maintain CANDU as a viable power producer for both the medium- and long-term future

  4. Advanced CCD camera developments

    Energy Technology Data Exchange (ETDEWEB)

    Condor, A. [Lawrence Livermore National Lab., CA (United States)

    1994-11-15

    Two charge coupled device (CCD) camera systems are introduced and discussed, describing briefly the hardware involved, and the data obtained in their various applications. The Advanced Development Group Defense Sciences Engineering Division has been actively designing, manufacturing, fielding state-of-the-art CCD camera systems for over a decade. These systems were originally developed for the nuclear test program to record data from underground nuclear tests. Today, new and interesting application for these systems have surfaced and development is continuing in the area of advanced CCD camera systems, with the new CCD camera that will allow experimenters to replace film for x-ray imaging at the JANUS, USP, and NOVA laser facilities.

  5. Advanced business analytics

    CERN Document Server

    Lev, Benjamin

    2015-01-01

    The book describes advanced business analytics and shows how to apply them to many different professional areas of engineering and management. Each chapter of the book is contributed by a different author and covers a different area of business analytics. The book connects the analytic principles with business practice and provides an interface between the main disciplines of engineering/technology and the organizational, administrative and planning abilities of management. It also refers to other disciplines such as economy, finance, marketing, behavioral economics and risk analysis. This book is of special interest to engineers, economists and researchers who are developing new advances in engineering management but also to practitioners working on this subject.

  6. Advances in soil dynamics

    DEFF Research Database (Denmark)

    Advances in Soil Dynamics, Volume 3, represents the culmination of the work undertaken by the Advances in Soil Dynamics Monograph Committee, PM-45-01, about 15 years ago to summarize important developments in this field over the last 35 years. When this project was initiated, the main goal...... was to abridge major strides made in the general area of soil dynamics during the sixties, seventies, and eighties. However, by about the mid-nineties soil dynamics research in the US and much of the developed world had come to a virtual standstill. Although significant progress was made prior to the mid......-nineties, we still do not have a sound fundamental knowledge of soil-machine and soil-plant interactions. It is the hope of the editors that these three volumes will provide a ready reference for much needed future research in this area....

  7. Advances in atomic spectroscopy

    CERN Document Server

    Sneddon, J

    1998-01-01

    This volume continues the series'' cutting-edge reviews on developments in this field. Since its invention in the 1920s, electrostatic precipitation has been extensively used in industrial hygiene to remove dust and particulate matter from gases before entering the atmosphere. This combination of electrostatic precipitation is reported upon in the first chapter. Following this, chapter two reviews recent advances in the area of chemical modification in electrothermal atomization. Chapter three consists of a review which deal with advances and uses of electrothermal atomization atomic absorption spectrometry. Flow injection atomic spectroscopy has developed rapidly in recent years and after a general introduction, various aspects of this technique are looked at in chapter four. Finally, in chapter five the use of various spectrometric techniques for the determination of mercury are described.

  8. Advanced far infrared detectors

    International Nuclear Information System (INIS)

    Haller, E.E.

    1993-05-01

    Recent advances in photoconductive and bolometric semiconductor detectors for wavelength 1 mm > λ > 50 μm are reviewed. Progress in detector performance in this photon energy range has been stimulated by new and stringent requirements for ground based, high altitude and space-borne telescopes for astronomical and astrophysical observations. The paper consists of chapters dealing with the various types of detectors: Be and Ga doped Ge photoconductors, stressed Ge:Ga devices and neutron transmutation doped Ge thermistors. Advances in the understanding of basic detector physics and the introduction of modern semiconductor device technology have led to predictable and reliable fabrication techniques. Integration of detectors into functional arrays has become feasible and is vigorously pursued by groups worldwide

  9. Advancing work practices

    DEFF Research Database (Denmark)

    Noesgaard, Signe Schack

    2016-01-01

    -executed instructional interventions will advance work practices. Design/methodology/approach The paper synthesizes contemporary social-psychological and educational research in the creation of a model of intervention-based change. In addition, the findings from an empirical study of online teacher professional......Purpose The paper aims to discuss the effectiveness of e-Learning in advancing work practices. The paper investigates the assumption that e-Learning is as effective as face-to-face interventions when stimulating change. It also examines the assumption that well-designed and well...... development simultaneously inspire and exemplify the model. Findings The paper suggests that increased attention to individual motivational drivers is needed, especially post intervention, to help ensure meaningful learning transfer and sustainable behavior change. The importance of individualized on...

  10. Advanced LIGO status

    International Nuclear Information System (INIS)

    Dwyer, S

    2015-01-01

    Advanced LIGO is currently in the final stages of installation and early commissioning. In the design of Advanced LIGO a key goal was the ability to detect gravitational waves from compact object binary inspirals, as these are thought to be the most likely candidates for early detections with ground based interferometers. Special emphasis has been placed on improving the low frequency sensitivity relative to the first generations of LIGO, in addition to improving the high frequency sensitivity by increasing the laser power. The interferometer in Livingston Louisiana has been locked (continuously held within the linear operating range) and noise investigations have begun, and the major installation activities for the interferometer at Hanford, Washington are completed. (paper)

  11. Materials for advanced packaging

    CERN Document Server

    Wong, CP

    2017-01-01

    This second edition continues to be the most comprehensive review on the developments in advanced electronic packaging technologies, with a focus on materials and processing. Recognized experts in the field contribute to 22 updated and new chapters that provide comprehensive coverage on various 3D package architectures, novel bonding and joining techniques, wire bonding, wafer thinning techniques, organic substrates, and novel approaches to make electrical interconnects between integrated circuit and substrates. Various chapters also address advances in several key packaging materials, including: Lead-free solders Flip chip underfills Epoxy molding compounds Conductive adhesives Die attach adhesives/films Thermal interface materials (TIMS) Materials for fabricating embedded passives including capacitors, inductors, and resistors Materials and processing aspects on wafer-level chip scale package (CSP) and MicroElectroMechanical system (MEMS) Contributors also review new and emerging technologies such as Light ...

  12. Advanced alkaline water electrolysis

    International Nuclear Information System (INIS)

    Marini, Stefania; Salvi, Paolo; Nelli, Paolo; Pesenti, Rachele; Villa, Marco; Berrettoni, Mario; Zangari, Giovanni; Kiros, Yohannes

    2012-01-01

    A short review on the fundamental and technological issues relevant to water electrolysis in alkaline and proton exchange membrane (PEM) devices is given. Due to price and limited availability of the platinum group metal (PGM) catalysts they currently employ, PEM electrolyzers have scant possibilities of being employed in large-scale hydrogen production. The importance and recent advancements in the development of catalysts without PGMs are poised to benefit more the field of alkaline electrolysis rather than that of PEM devices. This paper presents our original data which demonstrate that an advanced alkaline electrolyzer with performances rivaling those of PEM electrolyzers can be made without PGM and with catalysts of high stability and durability. Studies on the advantages/limitations of electrolyzers with different architectures do show how a judicious application of pressure differentials in a recirculating electrolyte scheme helps reduce mass transport limitations, increasing efficiency and power density.

  13. Advanced intelligent systems

    CERN Document Server

    Ryoo, Young; Jang, Moon-soo; Bae, Young-Chul

    2014-01-01

    Intelligent systems have been initiated with the attempt to imitate the human brain. People wish to let machines perform intelligent works. Many techniques of intelligent systems are based on artificial intelligence. According to changing and novel requirements, the advanced intelligent systems cover a wide spectrum: big data processing, intelligent control, advanced robotics, artificial intelligence and machine learning. This book focuses on coordinating intelligent systems with highly integrated and foundationally functional components. The book consists of 19 contributions that features social network-based recommender systems, application of fuzzy enforcement, energy visualization, ultrasonic muscular thickness measurement, regional analysis and predictive modeling, analysis of 3D polygon data, blood pressure estimation system, fuzzy human model, fuzzy ultrasonic imaging method, ultrasonic mobile smart technology, pseudo-normal image synthesis, subspace classifier, mobile object tracking, standing-up moti...

  14. Advanced Agriculture system

    Directory of Open Access Journals (Sweden)

    Shrinivas R. Zanwar

    2012-05-01

    Full Text Available This article addresses the advanced system which improves agriculture processes like cultivation on ploughed land, based on robotic platform. We have developed a robotic vehicle having four wheels and steered by DC motor. The advanced autonomous system architecture gives us the opportunity to develop a complete new range of agricultural equipment based on small smart machines. The machine will cultivate the farm by considering particular rows and specific column at fixed distance depending on crop. The obstacle detection problem will also be considered, sensed by infrared sensor. The whole algorithm, calculation, processing, monitoring are designed with motors & sensor interfaced with microcontroller. The result obtained through example activation unit is also presented. The dc motor simulation with feedforward and feedback technique shows precise output. With the help of two examples, a DC motor and a magnetic levitation system, the use of MATLAB and Simulink for modeling, analysis and control is designed.

  15. Advanced Light Source

    International Nuclear Information System (INIS)

    Sah, R.C.

    1983-03-01

    The Advanced Light Source (ALS) is a new synchrotron radiation source which has been proposed by Lawrence Berkeley Laboratory. The ALS will be a key component in a major new research facility, the National Center for Advanced Materials. The ALS will consist of an electron linear accelerator, a booster synchrotron, a 1.3-GeV electron storage ring, and a number of photon beam lines. Most or all photon beam lines will originate from wiggler and undulator magnets placed in the 12 long straight sections of the ALS. A very low electron beam emittance will provide photon beams of unsurpassed spectral brilliance from specially-designed undulators, and a high radiofrequency will produce very short pulse lengths

  16. Silicene: Recent theoretical advances

    KAUST Repository

    Lew Yan Voon, L. C.; Zhu, Jiajie; Schwingenschlö gl, Udo

    2016-01-01

    Silicene is a two-dimensional allotrope of silicon with a puckered hexagonal structure closely related to the structure of graphene and that has been predicted to be stable. To date, it has been successfully grown in solution (functionalized) and on substrates. The goal of this review is to provide a summary of recent theoretical advances in the properties of both free-standing silicene as well as in interaction with molecules and substrates, and of proposed device applications.

  17. Polarized advanced fuel reactors

    International Nuclear Information System (INIS)

    Kulsrud, R.M.

    1987-07-01

    The d- 3 He reaction has the same spin dependence as the d-t reaction. It produces no neutrons, so that if the d-d reactivity could be reduced, it would lead to a neutron-lean reactor. The current understanding of the possible suppression of the d-d reactivity by spin polarization is discussed. The question as to whether a suppression is possible is still unresolved. Other advanced fuel reactions are briefly discussed. 11 refs

  18. Advances in microwaves 8

    CERN Document Server

    Young, Leo

    2013-01-01

    Advances in Microwaves, Volume 8 covers the developments in the study of microwaves. The book discusses the circuit forms for microwave integrated circuits; the analysis of microstrip transmission lines; and the use of lumped elements in microwave integrated circuits. The text also describes the microwave properties of ferrimagnetic materials, as well as their interaction with electromagnetic waves propagating in bounded waveguiding structures. The integration techniques useful at high frequencies; material technology for microwave integrated circuits; specific requirements on technology for d

  19. The Advanced Neutron Source

    International Nuclear Information System (INIS)

    Hayter, J.B.

    1989-01-01

    The Advanced Neutron Source (ANS) is a new user experimental facility planned to be operational at Oak Ridge in the late 1990's. The centerpiece of the ANS will be a steady-state research reactor of unprecedented thermal neutron flux (φ th ∼ 9·10 19 m -2 ·s -1 ) accompanied by extensive and comprehensive equipment and facilities for neutron-based research. 5 refs., 5 figs

  20. 6 Sigma project advance

    International Nuclear Information System (INIS)

    2002-12-01

    This book deals with 6 sigma project advance which introduces 6 sigma project in Changwon special steel, how is failure accepted? CTQ selection which is starting line, definition of performance standard, measurement system check on reliability of measurement data, check of process capacity for current level, establishment of target, optimal design and performance of application, practice of management system for maintain of improved result, CTQ selection, check of measurement system and practice of management system.

  1. Advanced worker protection system

    International Nuclear Information System (INIS)

    Caldwell, B.; Duncan, P.; Myers, J.

    1995-01-01

    The Department of Energy (DOE) is in the process of defining the magnitude and diversity of Decontamination and Decommissioning (D ampersand D) obligations at its numerous sites. The DOE believes that existing technologies are inadequate to solve many challenging problems such as how to decontaminate structures and equipment cost effectively, what to do with materials and wastes generated, and how to adequately protect workers and the environment. Preliminary estimates show a tremendous need for effective use of resources over a relatively long period (over 30 years). Several technologies are being investigated which can potentially reduce D ampersand D costs while providing appropriate protection to DOE workers. The DOE recognizes that traditional methods used by the EPA in hazardous waste site clean up activities are insufficient to provide the needed protection and worker productivity demanded by DOE D ampersand D programs. As a consequence, new clothing and equipment which can adequately protect workers while providing increases in worker productivity are being sought for implementation at DOE sites. This project will result in the development of an Advanced Worker Protection System (AWPS). The AWPS will be built around a life support backpack that uses liquid air to provide cooling as well as breathing gas to the worker. The backpack will be combined with advanced protective garments, advanced liquid cooling garment, respirator, communications, and support equipment to provide improved worker protection, simplified system maintenance, and dramatically improve worker productivity through longer duration work cycles. Phase I of the project has resulted in a full scale prototype Advanced Worker Protection Ensemble (AWPE, everything the worker will wear), with sub-scale support equipment, suitable for integrated testing and preliminary evaluation. Phase II will culminate in a full scale, certified, pre-production AWPS and a site demonstration

  2. Advanced superconducting materials

    International Nuclear Information System (INIS)

    Fluekiger, R.

    1983-11-01

    The superconducting properties of various materials are reviewed in view of their use in high field magnets. The critical current densities above 12 T of conductors based on NbN or PbMo 6 S 8 are compared to those of the most advanced practical conductors based on alloyed by Nb 3 Sn. Different aspects of the mechanical reinforcement of high field conductors, rendered necessary by the strong Lorentz forces (e.g. in fusion magnets), are discussed. (orig.) [de

  3. Advancing mangrove macroecology

    Science.gov (United States)

    Rivera-Monroy, Victor H.; Osland, Michael J.; Day, John W.; Ray, Santanu; Rovai, Andre S.; Day, Richard H.; Mukherjee, Joyita; Rivera-Monroy, Victor H.; Lee, Shing Yip; Kristensen, Erik; Twilley, Robert R.

    2017-01-01

    Mangrove forests provide a wide range of ecosystem services to society, yet they are among the most anthropogenically impacted coastal ecosystems in the world. In this chapter, we discuss and provide examples for how macroecology can advance our understanding of mangrove ecosystems. Macroecology is broadly defined as a discipline that uses statistical analyses to investigate large-scale, universal patterns in the distribution, abundance, diversity, and organization of species and ecosystems, including the scaling of ecological processes and structural and functional relationships. Macroecological methods can be used to advance our understanding of how non-linear responses in natural systems can be triggered by human impacts at local, regional, and global scales. Although macroecology has the potential to gain knowledge on universal patterns and processes that govern mangrove ecosystems, the application of macroecological methods to mangroves has historically been limited by constraints in data quality and availability. Here we provide examples that include evaluations of the variation in mangrove forest ecosystem structure and function in relation to macroclimatic drivers (e.g., temperature and rainfall regimes) and climate change. Additional examples include work focused upon the continental distribution of aboveground net primary productivity and carbon storage, which are rapidly advancing research areas. These examples demonstrate the value of a macroecological perspective for the understanding of global- and regional-scale effects of both changing environmental conditions and management actions on ecosystem structure, function, and the supply of goods and services. We also present current trends in mangrove modeling approaches and their potential utility to test hypotheses about mangrove structural and functional properties. Given the gap in relevant experimental work at the regional scale, we also discuss the potential use of mangrove restoration and

  4. Silicene: Recent theoretical advances

    KAUST Repository

    Lew Yan Voon, L. C.

    2016-04-14

    Silicene is a two-dimensional allotrope of silicon with a puckered hexagonal structure closely related to the structure of graphene and that has been predicted to be stable. To date, it has been successfully grown in solution (functionalized) and on substrates. The goal of this review is to provide a summary of recent theoretical advances in the properties of both free-standing silicene as well as in interaction with molecules and substrates, and of proposed device applications.

  5. Advanced electron beam techniques

    International Nuclear Information System (INIS)

    Hirotsu, Yoshihiko; Yoshida, Yoichi

    2007-01-01

    After 100 years from the time of discovery of electron, we now have many applications of electron beam in science and technology. In this report, we review two important applications of electron beam: electron microscopy and pulsed-electron beam. Advanced electron microscopy techniques to investigate atomic and electronic structures, and pulsed-electron beam for investigating time-resolved structural change are described. (author)

  6. Advanced Environmental Monitoring Technologies

    Science.gov (United States)

    Jan, Darrell

    2004-01-01

    Viewgraphs on Advanced Environmental Monitoring Technologies are presented. The topics include: 1) Monitoring & Controlling the Environment; 2) Illustrative Example: Canary 3) Ground-based Commercial Technology; 4) High Capability & Low Mass/Power + Autonomy = Key to Future SpaceFlight; 5) Current Practice: in Flight; 6) Current Practice: Post Flight; 7) Miniature Mass Spectrometer for Planetary Exploration and Long Duration Human Flight; 8) Hardware and Data Acquisition System; 9) 16S rDNA Phylogenetic Tree; and 10) Preview of Porter.

  7. Advances in optical imaging

    International Nuclear Information System (INIS)

    Bremer, C.; Ntziachristos, V.; Mahmood, U.; Tung, C.H.; Weissleder, R.

    2001-01-01

    Different optical imaging technologies have significantly progressed over the last years. Besides advances in imaging techniques and image reconstruction, new 'smart' optical contrast agents have been developed which can be used to detect molecular targets (such as endogenous enzymes) in vivo. The combination of novel imaging technologies coupled with smart agents bears great diagnostic potential both clinically and experimentally. This overview outlines the basic principles of optical imaging and summarizes the current state of the art. (orig.) [de

  8. Advances in microwaves 7

    CERN Document Server

    Young, Leo

    2013-01-01

    Advances in Microwaves, Volume 7 covers the developments in the study of microwaves. The book discusses the effect of surface roughness on the propagation of the TEM mode, as well as the voltage breakdown of microwave antennas. The text also describes the theory and design considerations of single slotted-waveguide linear arrays and the techniques and theories that led to the achievement of wide bandwidths and ultralow noise temperatures for communication applications. The book will prove invaluable to microwave engineers.

  9. The advanced neutron source

    International Nuclear Information System (INIS)

    Raman, S.; Hayter, J.B.

    1990-01-01

    The Advanced Neutron Source (ANS) is a new user experimental facility planned to be operational at Oak Ridge in the late 1990's. The centerpiece of the ANS will be a steady-state research reactor of unprecedented thermal neutron flux (φ th ∼ 8 x 10 19 m -2 ·s -1 ) accompanied by extensive and comprehensive equipment and facilities for neutron-based research

  10. Machinability of advanced materials

    CERN Document Server

    Davim, J Paulo

    2014-01-01

    Machinability of Advanced Materials addresses the level of difficulty involved in machining a material, or multiple materials, with the appropriate tooling and cutting parameters.  A variety of factors determine a material's machinability, including tool life rate, cutting forces and power consumption, surface integrity, limiting rate of metal removal, and chip shape. These topics, among others, and multiple examples comprise this research resource for engineering students, academics, and practitioners.

  11. Advances in Crash Response

    Centers for Disease Control (CDC) Podcasts

    2009-06-29

    In this podcast, Dr. Richard C. Hunt, Director of CDC's Division of Injury Response, provides an overview on the benefits of using an Advanced Automatic Collision Notification system, or AACN, to help with emergency triage of people injured in vehicle crashes.  Created: 6/29/2009 by National Center for Injury Prevention and Control (NCIPC), Division of Injury Response (DIR).   Date Released: 6/29/2009.

  12. Advance in structural bioinformatics

    CERN Document Server

    Wei, Dongqing; Zhao, Tangzhen; Dai, Hao

    2014-01-01

    This text examines in detail mathematical and physical modeling, computational methods and systems for obtaining and analyzing biological structures, using pioneering research cases as examples. As such, it emphasizes programming and problem-solving skills. It provides information on structure bioinformatics at various levels, with individual chapters covering introductory to advanced aspects, from fundamental methods and guidelines on acquiring and analyzing genomics and proteomics sequences, the structures of protein, DNA and RNA, to the basics of physical simulations and methods for conform

  13. Advances in Computer Entertainment.

    OpenAIRE

    Nijholt, Antinus; Romão, T.; Reidsma, Dennis; Unknown, [Unknown

    2012-01-01

    These are the proceedings of the 9th International Conference on Advances in Computer Entertainment ACE 2012). ACE has become the leading scientific forum for dissemination of cutting-edge research results in the area of entertainment computing. Interactive entertainment is one of the most vibrant areas of interest in modern society and is amongst the fastest growing industries in the world. ACE 2012 will bring together leading researchers and practitioners from academia and industry to prese...

  14. Advanced composites for windmills

    Science.gov (United States)

    Bourquardez, G.

    A development status assessment is conducted for advanced composite construction techniques for windmill blade structures which, as in the case of composite helicopter rotors, promise greater reliability, longer service life, superior performance, and lower costs. Composites in wind turbine applications must bear aerodynamic, inertial and gravitational loads in complex interaction cycles. Attention is given to large Darrieus-type vertical axis windmills, to which composite construction methods may offer highly effective pitch-control mechanisms, especially in the 'umbrella' configuration.

  15. Advances in geophysics

    CERN Document Server

    Sato, Haruo

    2013-01-01

    The critically acclaimed serialized review journal for over 50 years, Advances in Geophysics is a highly respected publication in the field of geophysics. Since 1952, each volume has been eagerly awaited, frequently consulted, and praised by researchers and reviewers alike. Now in its 54th volume, it contains much material still relevant today--truly an essential publication for researchers in all fields of geophysics.Key features: * Contributions from leading authorities * Informs and updates on all the latest developments in the field

  16. Advances in heat transfer

    CERN Document Server

    Hartnett, James P; Cho, Young I; Greene, George A

    2001-01-01

    Heat transfer is the exchange of heat energy between a system and its surrounding environment, which results from a temperature difference and takes place by means of a process of thermal conduction, mechanical convection, or electromagnetic radiation. Advances in Heat Transfer is designed to fill the information gap between regularly scheduled journals and university-level textbooks by providing in-depth review articles over a broader scope than is allowable in either journals or texts.

  17. Delirium in advanced disease

    OpenAIRE

    Harris, Dylan

    2007-01-01

    Delirium in advanced disease, while common, is often not recognised or poorly treated. The aim of management of delirium is to assess and treat reversible causes in combination with environmental, psychological and pharmacological intervention to control symptoms. Delirium presents significant distress and impedes communication between patients and their families at the end of life. A structured approach to recognise, assess and manage delirium is essential for all clinicians caring for patie...

  18. Advanced energy materials (Preface)

    Science.gov (United States)

    Titus, Elby; Ventura, João; Araújo, João Pedro; Campos Gil, João

    2017-12-01

    Advances in material science make it possible to fabricate the building blocks of an entirely new generation of hierarchical energy materials. Recent developments were focused on functionality and areas connecting macroscopic to atomic and nanoscale properties, where surfaces, defects, interfaces and metastable state of the materials played crucial roles. The idea is to combine both, the top-down and bottom-up approach as well as shape future materials with a blend of both the paradigms.

  19. Advanced broadband baffle materials

    International Nuclear Information System (INIS)

    Seals, R.D.

    1991-01-01

    In this paper broadband performance characteristics of robust, light-weight, diffuse-absorptive baffle surfaces fabricated from sputter-deposited beryllium on cross-rolled Be ingot sheet material and on Be foam, plasma sprayed beryllium, plasma sprayed boron-on-beryllium, and chemical vapor deposited boron carbide on graphite are described and compared to Martin Black. An overview of the Optics Manufacturing Operations Development and Integration Laboratory (MODIL) Advanced Optical Baffle Program will be discussed

  20. Technological Advances in Joining

    Science.gov (United States)

    1981-08-01

    joint with the progressively advancing laser beam. Surface tension forces support the molten metal and close the keyhole behind the moving be:zm. Deep... keyhole welds in much the same manner as the electron beam which it so closely resembles. Low-power lasers rated at 1000 watts or less are used for...welding, the arc penetrates through the base metal to form the keyhole . Surface tension forces close the keyhole behind the arc as it progresses along