WorldWideScience

Sample records for advanced spectrum management

  1. Open pneumothorax: the spectrum and outcome of management based on Advanced Trauma Life Support recommendations.

    Science.gov (United States)

    Kong, V Y; Liu, M; Sartorius, B; Clarke, D L

    2015-08-01

    The current management of open pneumothorax (OPTX) is based on Advanced Trauma Life Support (ATLS) recommendations and consists of the application of a three-way occlusive dressing, followed by intercostal chest drain insertion. Very little is known regarding the spectrum and outcome of this approach, especially in the civilian setting. We conducted a retrospective review of 58 consecutive patients with OPTX over a four-year period managed in a high volume metropolitan trauma service in South Africa. Of the 58 patients included, 95% (55/58) were male, and the mean age for all patients was 21 years. Ninety-seven percent of all injuries were inflicted by knives and the remaining 3% (2/58) of injuries were inflicted by unknown weapons. 59% of injuries were left sided. In six patients (10%) a protocol violation was present in their management. Five of the six patients (83%) in whom protocol violation occurred developed a life-threatening event (tension PTX) compared to none amongst those where the protocol was followed (p < 0.001). There was no mortality as a direct result of management of OPTX following ATLS recommendations. ATLS recommendations for OPTX are safe and effective. Any deviation from this standard practice is associated with avoidable morbidity and potential mortality.

  2. Spectrum 101: An Introduction to Spectrum Management

    Science.gov (United States)

    2004-03-01

    produces a Joint Restricted Frequency List (JRFL). The JFRL consolidates and classifies the spectrum uses that are most critical to operations and to...Management Office JRFL Joint Restricted Frequency List JSC Joint Spectrum Center JSIR Joint Spectrum Interference Resolution JSME Joint Spectrum...Multifunctional Information Distribution System MILSATCOM Military Satellite Communications MOA Memorandum of Agreement MRFL Master Radio Frequency

  3. Cloud based spectrum manager for future wireless regulatory environment

    CSIR Research Space (South Africa)

    Masonta, MT

    2015-12-01

    Full Text Available The regulatory environment in radio frequency spectrum management lags the advancement of wireless technologies, especially in the area of cognitive radio and dynamic spectrum access. In this paper we argue that the solution towards spectrum Pareto...

  4. Electromagnetic spectrum management system

    Science.gov (United States)

    Seastrand, Douglas R.

    2017-01-31

    A system for transmitting a wireless countermeasure signal to disrupt third party communications is disclosed that include an antenna configured to receive wireless signals and transmit wireless counter measure signals such that the wireless countermeasure signals are responsive to the received wireless signals. A receiver processes the received wireless signals to create processed received signal data while a spectrum control module subtracts known source signal data from the processed received signal data to generate unknown source signal data. The unknown source signal data is based on unknown wireless signals, such as enemy signals. A transmitter is configured to process the unknown source signal data to create countermeasure signals and transmit a wireless countermeasure signal over the first antenna or a second antenna to thereby interfere with the unknown wireless signals.

  5. Electromagnetic spectrum management system

    Energy Technology Data Exchange (ETDEWEB)

    Seastrand, Douglas R.

    2017-10-17

    A system for transmitting a wireless countermeasure signal to disrupt third party communications is disclosed that include an antenna configured to receive wireless signals and transmit wireless counter measure signals such that the wireless countermeasure signals are responsive to the received wireless signals. A receiver processes the received wireless signals to create processed received signal data while a spectrum control module subtracts known source signal data from the processed received signal data to generate unknown source signal data. The unknown source signal data is based on unknown wireless signals, such as enemy signals. A transmitter is configured to process the unknown source signal data to create countermeasure signals and transmit a wireless countermeasure signal over the first antenna or a second antenna to thereby interfere with the unknown wireless signals.

  6. Joint Electromagnetic Spectrum Management Operations

    Science.gov (United States)

    2012-03-20

    promulgate command-specific policy and guidance for EMS use, the joint restricted frequency list (JRFL) process, the joint communications–electronics...joint communications–electronics operating instructions (JCEOI) and joint restricted frequency list (JRFL). Examples of FM include providing the...joint restricted frequency list Figure III-4. Joint Frequency Management Office Spectrum Management Process Chapter III III-10 JP 6-01 assignments

  7. 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

  8. 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.

  9. 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.

  10. 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.

  11. Advanced thermal management materials

    CERN Document Server

    Jiang, Guosheng; Kuang, Ken

    2012-01-01

    ""Advanced Thermal Management Materials"" provides a comprehensive and hands-on treatise on the importance of thermal packaging in high performance systems. These systems, ranging from active electronically-scanned radar arrays to web servers, require components that can dissipate heat efficiently. This requires materials capable of dissipating heat and maintaining compatibility with the packaging and dye. Its coverage includes all aspects of thermal management materials, both traditional and non-traditional, with an emphasis on metal based materials. An in-depth discussion of properties and m

  12. Interference management using direct sequence spread spectrum ...

    African Journals Online (AJOL)

    Interference management using direct sequence spread spectrum (DSSS) technique ... Journal of Fundamental and Applied Sciences ... Keywords: DSSS, LTE network; Wi-Fi network; SINR; interference management and interference power.

  13. Advanced alarm management system

    International Nuclear Information System (INIS)

    Easter, J.R.

    1995-01-01

    The Westinghouse Advanced Alarm Management System (AWARE) is one of the Man-Machine Design Interfaces (MMI) which has great flexibility with regard to hardware type and configuration, alarm system concept, plant scope, engineering scope and installation. The AWARE System provides the capability to better manage the quantity prioritization and presentation of real-time process alarm messages in the control room. The messages are specific, precise and dynamic. The AWARE System can provide a large reduction in the number of messages that the control room staff must address at any one time, thus making the alarm message system a useful tool for the operators during situations that normally produce a high volume of messages as well as improving the clarity of the presentation of process abnormalities during small disturbances. The operating staff is now provided with the basis for a better understanding of the current plant state and for taking the appropriate control actions. (2 refs., 3 figs.)

  14. South Africa heading for dynamic spectrum management

    CSIR Research Space (South Africa)

    Lysko, Albert A

    2016-09-01

    Full Text Available  Africa heading for dynamic spectrum management — PolicyTracker: the spectrum management newsletter https://www.policytracker.com/headlines/south­africa­heading­for­dynamic­spectrum­management/?searchterm=lysko 1/2 South Africa heading for dynamic spectrum management Sep 26, 2016 by Albert Lysko South... characteristic of rural areas, which traditionally lag behind more commercially attractive urban areas. The technology is a bridge towards fully dynamic spectrum management and 5G. The ability to manage spectrum dynamically should significantly improve the utilization and availability of spectrum, especially in rural areas, as well as...

  15. 76 FR 61672 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2011-10-05

    ... advice to the Assistant Secretary of Commerce for Communications and Information on spectrum management... Communications and Information on needed reforms to domestic spectrum policies and management in order to... Spectrum Management Advisory Committee Meeting AGENCY: National Telecommunications and Information...

  16. 77 FR 69597 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2012-11-20

    ... advice to the Assistant Secretary of Commerce for Communications and Information on spectrum management... Communications and Information on needed reforms to domestic spectrum policies and management in order to... Spectrum Management Advisory Committee Meeting AGENCY: National Telecommunications and Information...

  17. 77 FR 35941 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2012-06-15

    ... advice to the Assistant Secretary of Commerce for Communications and Information on spectrum management... Communications and Information on needed reforms to domestic spectrum policies and management in order to... Spectrum Management Advisory Committee Meeting AGENCY: National Telecommunications and Information...

  18. 78 FR 35260 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2013-06-12

    ... advice to the Assistant Secretary of Commerce for Communications and Information on spectrum management... Communications and Information on needed reforms to domestic spectrum policies and management in order to... Spectrum Management Advisory Committee Meeting AGENCY: National Telecommunications and Information...

  19. 76 FR 23796 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2011-04-28

    ... advice to the Assistant Secretary of Commerce for Communications and Information on spectrum management... Communications and Information on needed reforms to domestic spectrum policies and management in order to... Spectrum Management Advisory Committee Meeting AGENCY: National Telecommunications and Information...

  20. 78 FR 49260 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2013-08-13

    ... advice to the Assistant Secretary of Commerce for Communications and Information on spectrum management... Communications and Information on needed reforms to domestic spectrum policies and management in order to... Spectrum Management Advisory Committee Meeting AGENCY: National Telecommunications and Information...

  1. 77 FR 48968 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2012-08-15

    ... advice to the Assistant Secretary of Commerce for Communications and Information on spectrum management... Communications and Information on needed reforms to domestic spectrum policies and management in order to... Spectrum Management Advisory Committee Meeting AGENCY: National Telecommunications and Information...

  2. 78 FR 7758 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2013-02-04

    ... advice to the Assistant Secretary of Commerce for Communications and Information on spectrum management... Communications and Information on needed reforms to domestic spectrum policies and management in order to... Spectrum Management Advisory Committee Meeting AGENCY: National Telecommunications and Information...

  3. 78 FR 23541 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2013-04-19

    ... advice to the Assistant Secretary of Commerce for Communications and Information on spectrum management... Communications and Information on needed reforms to domestic spectrum policies and management in order to... Spectrum Management Advisory Committee Meeting AGENCY: National Telecommunications and Information...

  4. 77 FR 5494 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2012-02-03

    ... advice to the Assistant Secretary of Commerce for Communications and Information on spectrum management... Communications and Information on needed reforms to domestic spectrum policies and management in order to... Spectrum Management Advisory Committee Meeting AGENCY: National Telecommunications and Information...

  5. 78 FR 57370 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2013-09-18

    ... advice to the Assistant Secretary of Commerce for Communications and Information on spectrum management... Communications and Information on needed reforms to domestic spectrum policies and management in order to... Spectrum Management Advisory Committee Meeting AGENCY: National Telecommunications and Information...

  6. Economic aspects of spectrum management

    Science.gov (United States)

    Stibolt, R. D.

    1979-01-01

    Problems associated with the allocation of the radio frequency spectrum are addressed. It is observed that the current method very likely does not allocate the resource to those most valuing its use. Ecomonic criteria by which the effectiveness of resource allocation schemes can be judged are set forth and some thoughts on traditional objections to implementation of market characteristics into frequency allocation are offered. The problem of dividing orbit and spectrum between two satellite services sharing the same band but having significantly different system characteristics is discussed. The problem is compounded by the likelihood that one service will commence operation much sooner than the other. Some alternative schemes are offered that, within proper international constraints, could achieve a desired flexibility in the division of orbit and frequency between the two services domestically over the next several years.

  7. Advances in Knowledge Management

    DEFF Research Database (Denmark)

    Razmerita, Liana; Phillips-Wren, Gloria; Jain, Lakhmi C.

    2016-01-01

    This chapter briefly overviews the evolution of KM from a historical perspective and discusses core concepts associated with the management of knowledge, projects and networks. We introduce theoretical perspectives that are used in the KM literature, discuss the concept of a networked-centric col......This chapter briefly overviews the evolution of KM from a historical perspective and discusses core concepts associated with the management of knowledge, projects and networks. We introduce theoretical perspectives that are used in the KM literature, discuss the concept of a networked......-centric collaborative organization, and present future technologies in KM including the management of knowledge using social media and intelligent techniques....

  8. Selective optical contacting for solar spectrum management

    Science.gov (United States)

    Yang, Jianfeng; Chen, Weijian; Wang, Bo; Zhang, Zhilong; Huang, Shujuan; Shrestha, Santosh; Wen, Xiaoming; Patterson, Robert; Conibeer, Gavin

    2017-02-01

    Solar spectrum management using up/down conversion is an important method to improve the photovoltaic energy conversion efficiency. It asks for a monochromatic luminescence absorption at the band edge of the photovoltaic device to reduce both the sub-band-gap and over-band-gap energy losses. Here, we demonstrate an energy selective optical contacting concept to improve the luminescence transfer efficiency for spectrum management. By increasing both the luminescence emission and re-absorption ability through photonic resonance, an efficient photon transfer channel could be established between the luminescence emitter and the photovoltaic component in a near-field region. This concept is not only able to compensate the insufficient band edge absorption ability of the photovoltaic device, but also to break the far-field limitation of luminescence radiation. The energy selection on the optical spectrum naturally imposed by the mode resonance is also helpful to improve the monochromaticity of the luminescence yield. In this paper, a photonic crystal cavity is used to realize the optical contacting concept between a thin silicon film and spectrum converter. The optical power and photon flux transferred between different components are calculated analytically using the electromagnetic Green's function. The corresponding radiative dipole moment is estimated by the fluctuation-dissipation theorem. The example shows an over 80 times enhancement in the luminescence absorbance by the silicon layer, illustrating the great potential of this concept to be applied on nano-structured photovoltaic devices.

  9. Advances in management engineering

    CERN Document Server

    2017-01-01

    This book deals with research in open challenges in Management Engineering in the 21st century, as well as selected opportunities and solutions to remedy them. Management Engineering is an emerging field that extends the analytical methods used in traditional Industrial Engineering and Industrial Organization to address the economic, behavioral and social dimensions of companies and their environments. Management Engineering extends its domain beyond the firm and the market to encompass the modeling and policy design of physical landscapes populated by social agents. The developments of the 21st century have made it necessary to adopt an integrative and global view of the different methodologies and tools that facilitate managers’ decision-making processes, ranging from the strategic to the operational level. This book equips readers with precisely these urgently needed resources.

  10. 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.

  11. Spectrum Utilisation and Management in Cognitive Radio Networks

    DEFF Research Database (Denmark)

    Patil, Kishor P.

    have confirmed this by showing that the considerable amount of radio spectrum is underutilized. Dynamic Spectrum Access (DSA) and the spectrum refarming are the two viable solutions for the problem of spectrum scarcity. In DSA, unlicensed user opportunistically uses the vacant licensed spectrum...... of licensed spectrum provides efficient use of spectrum. Spectrum refarming means the recovery of spectrum from its existing users for the purpose of re-assignment, either for new uses, or for the introduction of new spectrally efficient technologies. Spectrum refarming is a spectrum management tool that can......In recent years, the demand for radio spectrum for wireless communication is growing due to increase in number of users and popularity of data and multimedia services. This has been observed in the recent auctions completed word wide for the vestige of radio spectrum. The radio spectrum has been...

  12. 47 CFR 1.9020 - Spectrum manager leasing arrangements.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Spectrum manager leasing arrangements. 1.9020... Leasing General Policies and Procedures § 1.9020 Spectrum manager leasing arrangements. (a) Overview... may enter into a spectrum manager leasing arrangement, without the need for prior Commission approval...

  13. Resource management for energy and spectrum harvesting sensor networks

    CERN Document Server

    Zhang, Deyu; Zhou, Haibo; Shen, Xuemin (Sherman)

    2017-01-01

    This SpringerBrief offers a comprehensive review and in-depth discussion of the current research on resource management. The authors explain how to best utilize harvested energy and temporally available licensed spectrum. Throughout the brief, the primary focus is energy and spectrum harvesting sensor networks (ESHNs) including energy harvesting (EH)-powered spectrum sensing and dynamic spectrum access. To efficiently collect data through the available licensed spectrum, this brief examines the joint management of energy and spectrum. An EH-powered spectrum sensing and management scheme for Heterogeneous Spectrum Harvesting Sensor Networks (HSHSNs) is presented in this brief. The scheme dynamically schedules the data sensing and spectrum access of sensors in ESHSNs to optimize the network utility, while considering the stochastic nature of EH process, PU activities and channel conditions. This brief also provides useful insights for the practical resource management scheme design for ESHSNs and motivates a ne...

  14. The RF spectrum: managing community health concerns

    International Nuclear Information System (INIS)

    Maclean, I.

    2001-01-01

    In this presentation I would like to share with you the way in which the Australian Communications Authority (ACA) goes about 'managing' community issues relating to the RF spectrum. In particular, I would like to refer to community issues associated with concerns about health. I will refer only briefly to the siting of mobile phone base stations as that will be covered elsewhere. Before getting into the community issues, I would like to provide some context about the ACA and the arrangements it has for regulating radiofrequency electromagnetic radiation (RF EMR). Copyright (2001) Australasian Radiation Protection Society Inc

  15. Autistic spectrum disorders 2: diagnosis and management.

    Science.gov (United States)

    Jones, Alice; Cork, Christine; Chowdhury, Uttom

    2006-04-01

    As many as six in every 1000 children may be affected by an autistic spectrum disorder. The previous article of this two-part series discussed the distinction between autism, Asperger's syndrome and pervasive developmental disorder, and examined the assessment process. This article looks at potential differential diagnoses that must be considered, as well as conditions associated with autism. Many theories about the causes of autism have been suggested, including the MMR vaccine. Recent research has suggested that there is no link between the vaccine and autism. There is no cure for autism, but intervention and management techniques should be aimed at educating parents and carers about the disorder and behavioural interventions to aid the child's skills development.

  16. Advances in water resources management

    CERN Document Server

    Yang, Chih; Wang, Mu-Hao

    2016-01-01

    This volume provides in-depth coverage of such topics as multi-reservoir system operation theory and practice, management of aquifer systems connected to streams using semi-analytical models, one-dimensional model of water quality and aquatic ecosystem-ecotoxicology in river systems, environmental and health impacts of hydraulic fracturing and shale gas, bioaugmentation for water resources protection, wastewater renovation by flotation for water pollution control, determination of receiving water’s reaeration coefficient in the presence of salinity for water quality management, sensitivity analysis for stream water quality management, river ice process, and computer-aided mathematical modeling of water properties. This critical volume will serve as a valuable reference work for advanced undergraduate and graduate students, designers of water resources systems, and scientists and researchers. The goals of the Handbook of Environmental Engineering series are: (1) to cover entire environmental fields, includin...

  17. Advanced gadolinia core and Toshiba advanced reactor management system

    International Nuclear Information System (INIS)

    Miyamoto, Toshiki; Yoshioka, Ritsuo; Ebisuya, Mitsuo

    1988-01-01

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

  18. Data management system advanced development

    Science.gov (United States)

    Douglas, Katherine; Humphries, Terry

    1990-01-01

    The Data Management System (DMS) Advanced Development task provides for the development of concepts, new tools, DMS services, and for the testing of the Space Station DMS hardware and software. It also provides for the development of techniques capable of determining the effects of system changes/enhancements, additions of new technology, and/or hardware and software growth on system performance. This paper will address the built-in characteristics which will support network monitoring requirements in the design of the evolving DMS network implementation, functional and performance requirements for a real-time, multiprogramming, multiprocessor operating system, and the possible use of advanced development techniques such as expert systems and artificial intelligence tools in the DMS design.

  19. Dynamic spectrum management in green cognitive radio cellular networks

    KAUST Repository

    Sboui, Lokman; Ghazzai, Hakim; Rezki, Zouheir; Alouini, Mohamed-Slim

    2018-01-01

    In this paper, we propose a new cellular network operation scheme fulfilling the 5G requirements related to spectrum management and green communications. We focus on cognitive radio cellular networks in which both the primary network (PN

  20. 75 FR 38779 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2010-07-06

    ... DEPARTMENT OF COMMERCE National Telecommunications and Information Administration Commerce... Administration, U.S. Department of Commerce. ACTION: Notice of open meeting. SUMMARY: This notice announces a public meeting of the Commerce Spectrum Management Advisory Committee (Committee). The Committee provides...

  1. 75 FR 7234 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2010-02-18

    ... DEPARTMENT OF COMMERCE National Telecommunications and Information Administration Commerce... Administration, U.S. Department of Commerce. ACTION: Notice of Open Meeting. SUMMARY: This notice announces a public meeting of the Commerce Spectrum Management Advisory Committee (Committee). The Committee provides...

  2. 75 FR 64699 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2010-10-20

    ... DEPARTMENT OF COMMERCE National Telecommunications and Information Administration Commerce... Administration, U.S. Department of Commerce. ACTION: Notice of open meeting. SUMMARY: This notice announces a public meeting of the Commerce Spectrum Management Advisory Committee (Committee). The Committee provides...

  3. 75 FR 21602 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2010-04-26

    ... DEPARTMENT OF COMMERCE National Telecommunications and Information Administration Commerce... Administration, U.S. Department of Commerce. ACTION: Notice of open meeting. SUMMARY: This notice announces a public meeting of the Commerce Spectrum Management Advisory Committee (Committee). The Committee provides...

  4. 75 FR 75968 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2010-12-07

    ... DEPARTMENT OF COMMERCE National Telecommunications and Information Administration Commerce... Administration, U.S. Department of Commerce. ACTION: Notice of open meeting. SUMMARY: This notice announces a public meeting of the Commerce Spectrum Management Advisory Committee (Committee). The Committee provides...

  5. 75 FR 72792 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2010-11-26

    ... DEPARTMENT OF COMMERCE National Telecommunications and Information Administration Commerce... Administration, U.S. Department of Commerce. ACTION: Notice of open meeting by teleconference. SUMMARY: This notice announces a public meeting of the Commerce Spectrum Management Advisory Committee (Committee...

  6. 77 FR 25145 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2012-04-27

    ... DEPARTMENT OF COMMERCE National Telecommunications and Information Administration Commerce... Administration, U.S. Department of Commerce. ACTION: Notice of open meeting. SUMMARY: This notice announces a public meeting of the Commerce Spectrum Management Advisory Committee (Committee). The Committee provides...

  7. Auction based spectrum management of cognitive radio networks

    DEFF Research Database (Denmark)

    Chang, H. B.; Chen, K.-C.; Prasad, Ramjee

    2009-01-01

    (PS-MSs), and we therefore construct a cognitive radio network (CRN) consisting of a PRN with multiple CR-MSs. We propose a spectrum management policy framework such that CR-MSs can compete in utilization of the PRN spectrum bands available to opportunistic transmission of CR-MSs by Vickrey auction...... to the PRN, the overall spectrum utilization, the profit of the service provider, the spectrum access opportunity of the CR-MSs are increased to achieve cowin situation for every party in cognitive radio networks.......Cognitive radio (CR) technology is considered as an effective solution to enhance overall spectrum efficiency, especially primary radio network (PRN) typically having relatively low spectrum utilization. However, to realize CR concept, it is essential to provide enough incentives to PRN and extra...

  8. Recent BWR fuel management reactor physics advances

    International Nuclear Information System (INIS)

    Crowther, R.L.; Congdon, S.P.; Crawford, B.W.; Kang, C.M.; Martin, C.L.; Reese, A.P.; Savoia, P.J.; Specker, S.R.; Welchly, R.

    1982-01-01

    Improvements in BWR fuel management have been under development to reduce uranium and separative work (SWU) requirements and reduce fuel cycle costs, while also maintaining maximal capacity factors and high fuel reliability. Improved reactor physics methods are playing an increasingly important role in making such advances feasible. The improved design, process computer and analysis methods both increase knowledge of the thermal margins which are available to implement fuel management advance, and improve the capability to reliably and efficiently analyze and design for fuel management advances. Gamma scan measurements of the power distributions of advanced fuel assembly and advanced reactor core designs, and improved in-core instruments also are important contributors to improving 3-d predictive methods and to increasing thermal margins. This paper is an overview of the recent advances in BWR reactor physics fuel management methods, coupled with fuel management and core design advances. The reactor physics measurements which are required to confirm the predictions of performance fo fuel management advances also are summarized

  9. Microsoft System Center Configuration Manager advanced deployment

    CERN Document Server

    Coupland, Martyn

    2014-01-01

    If you are an experienced Configuration Manager administrator looking to advance your career or get more from your current environment, then this book is ideal for you. Prior experience of deploying and managing a Configuration Manager site would be helpful in following the examples throughout this book.

  10. Contemporary management of advanced laryngeal cancer.

    Science.gov (United States)

    Britt, Christopher J; Gourin, Christine G

    2017-10-01

    The treatment of advanced laryngeal cancer has undergone a paradigm shift in recent years, with an increase in chemoradiation for organ preservation and a decrease in primary surgery. This review will summarize the contemporary management of advanced laryngeal cancer and discuss treatment-related toxicity and strategies to improve outcomes. NA.

  11. Management of Advanced Laryngeal Cancer

    Directory of Open Access Journals (Sweden)

    Patrick Sheahan

    2014-04-01

    Full Text Available Squamous cell carcinoma of the larynx continues to be the commonest head and neck cancer in many Western countries. The larynx plays a key role for many essential functions, including breathing, voice production, airway protection, and swallowing. The goals of laryngeal cancer treatment are thus to provide best possible oncologic control, while optimizing functional outcomes. In recent decades, the treatment paradigm for advanced laryngeal cancer has shifted from one of primary surgery (total laryngectomy as gold standard, toward non-surgical organ-preserving treatment using radiotherapy or chemoradiotherapy. However, concerns have emerged regarding functional outcomes after chemoradiotherapy, as well as possible decreased overall survival in patients with laryngeal cancer. The purpose of the present review is to review surgical and non-surgical options for treatment of advanced laryngeal cancer, as well as the evidence supporting each of these.

  12. Performance Enhancements for Advanced Database Management Systems

    OpenAIRE

    Helmer, Sven

    2000-01-01

    New applications have emerged, demanding database management systems with enhanced functionality. However, high performance is a necessary precondition for the acceptance of such systems by end users. In this context we developed, implemented, and tested algorithms and index structures for improving the performance of advanced database management systems. We focused on index structures and join algorithms for set-valued attributes.

  13. Advanced Interval Management: A Benefit Analysis

    Science.gov (United States)

    Timer, Sebastian; Peters, Mark

    2016-01-01

    This document is the final report for the NASA Langley Research Center (LaRC)- sponsored task order 'Possible Benefits for Advanced Interval Management Operations.' Under this research project, Architecture Technology Corporation performed an analysis to determine the maximum potential benefit to be gained if specific Advanced Interval Management (AIM) operations were implemented in the National Airspace System (NAS). The motivation for this research is to guide NASA decision-making on which Interval Management (IM) applications offer the most potential benefit and warrant further research.

  14. The Managing Epilepsy Well Network:: Advancing Epilepsy Self-Management.

    Science.gov (United States)

    Sajatovic, Martha; Jobst, Barbara C; Shegog, Ross; Bamps, Yvan A; Begley, Charles E; Fraser, Robert T; Johnson, Erica K; Pandey, Dilip K; Quarells, Rakale C; Scal, Peter; Spruill, Tanya M; Thompson, Nancy J; Kobau, Rosemarie

    2017-03-01

    Epilepsy, a complex spectrum of disorders, affects about 2.9 million people in the U.S. Similar to other chronic disorders, people with epilepsy face challenges related to management of the disorder, its treatment, co-occurring depression, disability, social disadvantages, and stigma. Two national conferences on public health and epilepsy (1997, 2003) and a 2012 IOM report on the public health dimensions of epilepsy highlighted important knowledge gaps and emphasized the need for evidence-based, scalable epilepsy self-management programs. The Centers for Disease Control and Prevention translated recommendations on self-management research and dissemination into an applied research program through the Prevention Research Centers Managing Epilepsy Well (MEW) Network. MEW Network objectives are to advance epilepsy self-management research by developing effective interventions that can be broadly disseminated for use in people's homes, healthcare providers' offices, or in community settings. The aim of this report is to provide an update on the MEW Network research pipeline, which spans efficacy, effectiveness, and dissemination. Many of the interventions use e-health strategies to eliminate barriers to care (e.g., lack of transportation, functional limitations, and stigma). Strengths of this mature research network are the culture of collaboration, community-based partnerships, e-health methods, and its portfolio of prevention activities, which range from efficacy studies engaging hard-to-reach groups, to initiatives focused on provider training and knowledge translation. The MEW Network works with organizations across the country to expand its capacity, help leverage funding and other resources, and enhance the development, dissemination, and sustainability of MEW Network programs and tools. Guided by national initiatives targeting chronic disease or epilepsy burden since 2007, the MEW Network has been responsible for more than 43 scientific journal articles, two

  15. Self-Management Procedures: A Comparison across the Autism Spectrum

    Science.gov (United States)

    Southall, Candice M.; Gast, David L.

    2011-01-01

    Individuals with autism spectrum disorders (ASD) have difficulty generalizing learned behavior to varied environments with independence. This review of 24 empirical studies compares self-management as a systematic procedure for modifying one's own behavior, to increase target behaviors in students with either autistic disorder (AD) or…

  16. 76 FR 27636 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2011-05-12

    ... DEPARTMENT OF COMMERCE National Telecommunications and Information Administration Commerce... Administration, U.S. Department of Commerce. ACTION: Notice of open meeting, room location change. SUMMARY: This notice announces a change in the room location of a public meeting of the Commerce Spectrum Management...

  17. 75 FR 52472 - Spectrum Requirements for Advanced Medical Technologies

    Science.gov (United States)

    2010-08-26

    ... medical devices. Under this framework, the rules for MedRadio service incorporates the MICS ``core'' band... Requirements for Advanced Medical Technologies AGENCY: Federal Communications Commission. ACTION: Final rule.... (Medtronic) regarding rules for the Medical Device Radiocommunication (MedRadio) service. The Commission...

  18. 2013 Summary of Advances in Autism Spectrum Disorder Research

    Science.gov (United States)

    Interagency Autism Coordinating Committee, 2014

    2014-01-01

    Each year, the Interagency Autism Coordinating Committee (IACC) releases its annual list of scientific advances that represent significant progress in the field. The 20 studies selected have given new insight into the complex causes of autism and potential risk factors, studied clues that could lead to earlier diagnosis, and evaluated promising…

  19. Advanced parental age and the risk of autism spectrum disorder.

    Science.gov (United States)

    Durkin, Maureen S; Maenner, Matthew J; Newschaffer, Craig J; Lee, Li-Ching; Cunniff, Christopher M; Daniels, Julie L; Kirby, Russell S; Leavitt, Lewis; Miller, Lisa; Zahorodny, Walter; Schieve, Laura A

    2008-12-01

    This study evaluated independent effects of maternal and paternal age on risk of autism spectrum disorder. A case-cohort design was implemented using data from 10 US study sites participating in the Centers for Disease Control and Prevention's Autism and Developmental Disabilities Monitoring Network. The 1994 birth cohort included 253,347 study-site births with complete parental age information. Cases included 1,251 children aged 8 years with complete parental age information from the same birth cohort and identified as having an autism spectrum disorder based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria. After adjustment for the other parent's age, birth order, maternal education, and other covariates, both maternal and paternal age were independently associated with autism (adjusted odds ratio for maternal age > or =35 vs. 25-29 years = 1.3, 95% confidence interval: 1.1, 1.6; adjusted odds ratio for paternal age > or =40 years vs. 25-29 years = 1.4, 95% confidence interval: 1.1, 1.8). Firstborn offspring of 2 older parents were 3 times more likely to develop autism than were third- or later-born offspring of mothers aged 20-34 years and fathers aged autism risk with both maternal and paternal age has potential implications for public health planning and investigations of autism etiology.

  20. Management of patients with advanced prostate cancer

    DEFF Research Database (Denmark)

    Gillessen, S; Omlin, A; Attard, G

    2015-01-01

    The first St Gallen Advanced Prostate Cancer Consensus Conference (APCCC) Expert Panel identified and reviewed the available evidence for the ten most important areas of controversy in advanced prostate cancer (APC) management. The successful registration of several drugs for castration......-resistant prostate cancer and the recent studies of chemo-hormonal therapy in men with castration-naïve prostate cancer have led to considerable uncertainty as to the best treatment choices, sequence of treatment options and appropriate patient selection. Management recommendations based on expert opinion...

  1. How Symmetrical Assumptions Advance Strategic Management Research

    DEFF Research Database (Denmark)

    Foss, Nicolai Juul; Hallberg, Hallberg

    2014-01-01

    We develop the case for symmetrical assumptions in strategic management theory. Assumptional symmetry obtains when assumptions made about certain actors and their interactions in one of the application domains of a theory are also made about this set of actors and their interactions in other...... application domains of the theory. We argue that assumptional symmetry leads to theoretical advancement by promoting the development of theory with greater falsifiability and stronger ontological grounding. Thus, strategic management theory may be advanced by systematically searching for asymmetrical...

  2. Advances in urethral stricture management

    Science.gov (United States)

    Gallegos, Maxx A.; Santucci, Richard A.

    2016-01-01

    Urethral stricture/stenosis is a narrowing of the urethral lumen. These conditions greatly impact the health and quality of life of patients. Management of urethral strictures/stenosis is complex and requires careful evaluation. The treatment options for urethral stricture vary in their success rates. Urethral dilation and internal urethrotomy are the most commonly performed procedures but carry the lowest chance for long-term success (0–9%). Urethroplasty has a much higher chance of success (85–90%) and is considered the gold-standard treatment. The most common urethroplasty techniques are excision and primary anastomosis and graft onlay urethroplasty. Anastomotic urethroplasty and graft urethroplasty have similar long-term success rates, although long-term data have yet to confirm equal efficacy. Anastomotic urethroplasty may have higher rates of sexual dysfunction. Posterior urethral stenosis is typically caused by previous urologic surgery. It is treated endoscopically with radial incisions. The use of mitomycin C may decrease recurrence. An exciting area of research is tissue engineering and scar modulation to augment stricture treatment. These include the use of acellular matrices or tissue-engineered buccal mucosa to produce grafting material for urethroplasty. Other experimental strategies aim to prevent scar formation altogether. PMID:28105329

  3. Inventory management with advance capacity information

    NARCIS (Netherlands)

    Jaksic, M.; Fransoo, J.C.; Tan, T.; Kok, de A.G.; Rusjan, B.

    2008-01-01

    One of the important aspects of supply chain management is dealing with demand and supply uncertainty. The uncertainty of future supply can be reduced, if a company is able to obtain advance capacity information (ACI) on future supply/production capacity availability from its supplier. We address a

  4. Inventory management with advance capacity information

    NARCIS (Netherlands)

    Jaksic, M.; Fransoo, J.C.; Tan, T.; Kok, de A.G.; Rusjan, B.

    2011-01-01

    An important aspect of supply chain management is dealing with demand and supply uncertainty. The uncertainty of future supply can be reduced if a company is able to obtain advance capacity information (ACI) about future supply/production capacity availability from its supplier. We address a

  5. Surgical management of advanced ocular adnexal amyloidosis.

    Science.gov (United States)

    Patrinely, J R; Koch, D D

    1992-06-01

    Ocular adnexal amyloidosis is characterized by amyloid deposition within the deep connective tissue layers of the eyelids, conjunctiva, and anterior orbit. Management of advanced cases has traditionally been unsatisfactory, with either no surgery offered because of fear of hemorrhage or an en bloc resection performed of the entire involved area. We present two cases of advanced periorbital amyloidosis successfully managed by preserving the anatomic planes of the eyelids and meticulously debulking the deposits with a spooned curette. Lax eyelid tendons and aponeuroses were simultaneously repaired, and no sacrifice of eyelid tissues was necessary. One patient remained asymptomatic for 2 years after surgery before developing early reaccumulation in the lower eyelids. The other patient required additional eyelid debulking and ptosis revision 8 months after surgery, but was in stable condition at follow-up 2 years after surgery. This technique offers safe, easily repeatable, nondestructive treatment for advanced periocular amyloidosis.

  6. Licensed bases management for advanced nuclear plants

    International Nuclear Information System (INIS)

    O'Connell, J.; Rumble, E.; Rodwell, E.

    2001-01-01

    Prospective Advanced Nuclear Plant (ANP) owners must have high confidence that the integrity of the licensed bases (LB) of a plant will be effectively maintained over its life cycle. Currently, licensing engineers use text retrieval systems, database managers, and checklists to access, update, and maintain vast and disparate licensing information libraries. This paper describes the demonstration of a ''twin-engine'' approach that integrates a program from the emerging class of concept searching tools with a modern Product Data Management System (PDMS) to enhance the management of LB information for an example ANP design. (author)

  7. Licensed bases management for advanced nuclear plants

    Energy Technology Data Exchange (ETDEWEB)

    O' Connell, J [Duke Engineering and Services, Marlborough, MA (United States); Rumble, E; Rodwell, E [EPRI, Palo Alto, CA (United States)

    2001-07-01

    Prospective Advanced Nuclear Plant (ANP) owners must have high confidence that the integrity of the licensed bases (LB) of a plant will be effectively maintained over its life cycle. Currently, licensing engineers use text retrieval systems, database managers, and checklists to access, update, and maintain vast and disparate licensing information libraries. This paper describes the demonstration of a ''twin-engine'' approach that integrates a program from the emerging class of concept searching tools with a modern Product Data Management System (PDMS) to enhance the management of LB information for an example ANP design. (author)

  8. Licensed bases management for advanced nuclear plants

    Energy Technology Data Exchange (ETDEWEB)

    O' Connell, J. [Duke Engineering and Services, Marlborough, MA (United States); Rumble, E.; Rodwell, E. [EPRI, Palo Alto, CA (United States)

    2001-07-01

    Prospective Advanced Nuclear Plant (ANP) owners must have high confidence that the integrity of the licensed bases (LB) of a plant will be effectively maintained over its life cycle. Currently, licensing engineers use text retrieval systems, database managers, and checklists to access, update, and maintain vast and disparate licensing information libraries. This paper describes the demonstration of a ''twin-engine'' approach that integrates a program from the emerging class of concept searching tools with a modern Product Data Management System (PDMS) to enhance the management of LB information for an example ANP design. (author)

  9. Spectrum

    DEFF Research Database (Denmark)

    Høgfeldt Hansen, Leif

    2016-01-01

    The publication functions as a proces description of the development and construction of an urban furniture SPECTRUM in the city of Gwangju, Republic of Korea. It is used as the cataloque for the exhibition of Spectrum.......The publication functions as a proces description of the development and construction of an urban furniture SPECTRUM in the city of Gwangju, Republic of Korea. It is used as the cataloque for the exhibition of Spectrum....

  10. Advanced technologies applied to work management

    International Nuclear Information System (INIS)

    Aldrich, L.R.

    1993-01-01

    Commonwealth Edison Company subscribes to the dose optimization principle and has implemented reasonable efforts to maintain exposures to radiation as far below dose limits as practical consistent with the state of technology, the economics of improvements in relation to the state of technology and the economics of improvements in relation to the benefits to the public health and safety. In an effort to lower collective exposures, Commonwealth Edison Company has focused on improving performance in four key areas which have proven to contribute to lower personnel exposures - Management Controls, Work practices, Source Term Reduction and Technological Advancements. This paper focuses on the advanced technologies that the Commonwealth Edison Company has employed in the areas of work planning, work performance and work monitoring to manage our occupational dose control

  11. Advanced water chemistry management in power plants

    International Nuclear Information System (INIS)

    Regis, V.; Sigon, F.

    1995-01-01

    Advanced water management based on low external impact cycle chemistry technologies and processes, effective on-line water control and monitoring, has been verified to improve water utilization and to reduce plant liquid supply and discharge. Simulations have been performed to optimize system configurations and performances, with reference to a 4 x 320 MWe/once-through boiler/AVT/river cooled power plant, to assess the effectiveness of membrane separation technologies allowing waste water reuse, to enhance water management system design and to compare these solutions on a cost/benefit analysis. 6 refs., 3 figs., 3 tabs

  12. Management of Patients with Advanced Prostate Cancer

    DEFF Research Database (Denmark)

    Gillessen, Silke; Attard, Gerhardt; Beer, Tomasz M

    2018-01-01

    some of these topics. OBJECTIVE: To present the report of APCCC 2017. DESIGN, SETTING, AND PARTICIPANTS: Ten important areas of controversy in APC management were identified: high-risk localised and locally advanced prostate cancer; "oligometastatic" prostate cancer; castration-naïve and castration...... literature review or meta-analysis. The outcomes of the voting had varying degrees of support, as reflected in the wording of this article, as well as in the detailed voting results recorded in Supplementary data. CONCLUSIONS: The presented expert voting results can be used for support in areas of management...

  13. Cadmium depletion impacts on hardening neutron spectrum for advanced fuel testing in ATR

    International Nuclear Information System (INIS)

    Chang, Gray S.

    2011-01-01

    For transmuting long-lived isotopes contained in spent nuclear fuel into shorter-lived fission products effectively is in a fast neutron spectrum reactor. In the absence of a fast spectrum test reactor in the United States of America (USA), initial irradiation testing of candidate fuels can be performed in a thermal test reactor that has been modified to produce a test region with a hardened neutron spectrum. A test region is achieved with a Cadmium (Cd) filter which can harden the neutron spectrum to a spectrum similar (although still somewhat softer) to that of the liquid metal fast breeder reactor (LMFBR). A fuel test loop with a Cd-filter has been installed within the East Flux Trap (EFT) of the Advanced Test Reactor (ATR) at the Idaho National Laboratory (INL). A detailed comparison analyses between the cadmium (Cd) filter hardened neutron spectrum in the ATR and the LMFBR fast neutron spectrum have been performed using MCWO. MCWO is a set of scripting tools that are used to couple the Monte Carlo transport code MCNP with the isotope depletion and buildup code ORIGEN-2.2. The MCWO-calculated results indicate that the Cd-filter can effectively flatten the Rim-Effect and reduce the linear heat rate (LHGR) to meet the advanced fuel testing project requirements at the beginning of irradiation (BOI). However, the filtering characteristics of Cd as a strong absorber quickly depletes over time, and the Cd-filter must be replaced for every two typical operating cycles within the EFT of the ATR. The designed Cd-filter can effectively depress the LHGR in experimental fuels and harden the neutron spectrum enough to adequately flatten the Rim-Effect in the test region. (author)

  14. Advanced thermal management technologies for defense electronics

    Science.gov (United States)

    Bloschock, Kristen P.; Bar-Cohen, Avram

    2012-05-01

    Thermal management technology plays a key role in the continuing miniaturization, performance improvements, and higher reliability of electronic systems. For the past decade, and particularly, the past 4 years, the Defense Advanced Research Projects Agency (DARPA) has aggressively pursued the application of micro- and nano-technology to reduce or remove thermal constraints on the performance of defense electronic systems. The DARPA Thermal Management Technologies (TMT) portfolio is comprised of five technical thrust areas: Thermal Ground Plane (TGP), Microtechnologies for Air-Cooled Exchangers (MACE), NanoThermal Interfaces (NTI), Active Cooling Modules (ACM), and Near Junction Thermal Transport (NJTT). An overview of the TMT program will be presented with emphasis on the goals and status of these efforts relative to the current State-of-the-Art. The presentation will close with future challenges and opportunities in the thermal management of defense electronics.

  15. Interference management with partial uplink/downlink spectrum overlap

    KAUST Repository

    Randrianantenaina, Itsikiantsoa

    2016-07-26

    Simultaneous reuse of spectral resources by uplink and downlink, denoted as in-band full duplex (FD) communication, is promoted to double the spectral efficiency when compared to its half-duplex (HD) counterpart. Interference management, however, remains challenging in FD cellular networks, especially when high disparity between uplink and downlink transmission powers exists. The uplink performance can be particularly deteriorated when operating on channels that are simultaneously occupied with downlink transmission. This paper considers a cellular wireless system with partial spectrum overlap between the downlink and uplink. The performance of the system becomes, therefore, a function of the overlap fraction, as well as the power levels of both the uplink and downlink transmissions. The paper considers the problem of maximizing an overall network utility to find the uplink/downlink transmission powers and the spectrum overlap fraction between the uplink and downlink spectrum in each cell, and proposes solving the problem using interior point method. Simulations results confirm the vulnerability of the uplink performance to the FD operation, and show the superiority of the proposed scheme over the FD and HD schemes. The results further show that explicit uplink and downlink performance should be considered for efficient design of cellular networks with overlapping uplink/downlink resources. © 2016 IEEE.

  16. Admission Control and Interference Management in Dynamic Spectrum Access Networks

    Directory of Open Access Journals (Sweden)

    Jorge Martinez-Bauset

    2010-01-01

    Full Text Available We study two important aspects to make dynamic spectrum access work in practice: the admission policy of secondary users (SUs to achieve a certain degree of quality of service and the management of the interference caused by SUs to primary users (PUs. In order to limit the forced termination probability of SUs, we evaluate the Fractional Guard Channel reservation scheme to give priority to spectrum handovers over new arrivals. We show that, contrary to what has been proposed, the throughput of SUs cannot be maximized by configuring the reservation parameter. We also study the interference caused by SUs to PUs. We propose and evaluate different mechanisms to reduce the interference, which are based on simple spectrum access algorithms for both PUs and SUs and channel repacking algorithms for SUs. Numerical results show that the reduction can be of one order of magnitude or more with respect to the random access case. Finally, we propose an adaptive admission control scheme that is able to limit simultaneously the forced termination probability of SUs and what we define as the probability of interference. Our scheme does not require any configuration parameters beyond the probability objectives. Besides, it is simple to implement and it can operate with any arrival process and distribution of the session duration.

  17. Information management systems improve advanced plant design

    International Nuclear Information System (INIS)

    Turk, R.S.; Serafin, S.A.; Leckley, J.B.

    1994-01-01

    Computer-aided engineering tools are proving invaluable in both the design and operation of nuclear power plants. ABB Combustion Engineering's Advanced Light Water Reactor (ALWR) features a computerized Information Management System (IMS) as an integral part of the design. The System 80+IMS represents the most powerful information management tool for Nuclear Power Plants commercially available today. Developed by Duke Power Company specifically for use by nuclear power plant owner operators, the IMS consists of appropriate hardware and software to manage and control information flow for all plant related work or tasks in a systematic, consistent, coordinated and informative manner. A significant feature of this IMS is that it is primarily based on plant data. The principal design tool, PASCE (Plant Application and Systems from Combustion Engineering), is comprised of intelligent databases that describe the design and from which accurate plant drawings are created. Additionally the IMS includes, at its hub, a relational database management system and an associated document management system. The data-based approach and applications associated with the IMS were developed, and have proven highly effective, for plant modifications, configuration management, and operations and maintenance applications at Duke Power Company's operating nuclear plants. This paper presents its major features and benefits. 4 refs

  18. Development of advanced spent fuel management process

    International Nuclear Information System (INIS)

    Park, Seong Won; Shin, Y. J.; Cho, S. H.

    2004-03-01

    The research on spent fuel management focuses on the maximization of the disposal efficiency by a volume reduction, the improvement of the environmental friendliness by the partitioning and transmutation of the long lived nuclides, and the recycling of the spent fuel for an efficient utilization of the uranium source. In the second phase which started in 2001, the performance test of the advanced spent fuel management process consisting of voloxidation, reduction of spent fuel and the lithium recovery process has been completed successfully on a laboratory scale. The world-premier spent fuel reduction hot test of a 5 kgHM/batch has been performed successfully by joint research with Russia and the valuable data on the actinides and FPs material balance and the characteristics of the metal product were obtained with experience to help design an engineering scale reduction system. The electrolytic reduction technology which integrates uranium oxide reduction in a molten LiCl-Li 2 O system and Li 2 O electrolysis is developed and a unique reaction system is also devised. Design data such as the treatment capacity, current density and mass transfer behavior obtained from the performance test of a 5 kgU/batch electrolytic reduction system pave the way for the third phase of the hot cell demonstration of the advanced spent fuel management technology

  19. Spectrum Management Guidelines for National and Service Test and Training Ranges

    Science.gov (United States)

    2017-07-12

    Frequency Management Group RCC 700-17 SPECTRUM MANAGEMENT GUIDELINES FOR NATIONAL AND SERVICE TEST AND TRAINING RANGES DISTRIBUTION...left blank. DOCUMENT 700-01 SPECTRUM MANAGEMENT GUIDELINES FOR NATIONAL AND SERVICE TEST AND TRAINING RANGES July 2017...Prepared by RANGE COMMANDERS COUNCIL FREQUENCY MANAGEMENT GROUP Published by Secretariat Range Commanders Council U.S. Army White

  20. Management accounting for advanced technological environments.

    Science.gov (United States)

    Kaplan, R S

    1989-08-25

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

  1. Use of Advanced Magnetic Resonance Imaging Techniques in Neuromyelitis Optica Spectrum Disorder

    DEFF Research Database (Denmark)

    Kremer, S.; Renard, F.; Achard, S.

    2015-01-01

    Brain parenchymal lesions are frequently observed on conventional magnetic resonance imaging (MRI) scans of patients with neuromyelitis optica (NMO) spectrum disorder but the specific morphological and temporal patterns distinguishing them uneqtaivcally from lesions caused by other disorders have...... not been identified. This literature review summarizes the literature on advanced quantitative imaging measures reported for patients with NMO spectrum disorder, including proton MR spectroscopy, diffusion tensor imaging, magnetization transfer imaging, quantitative MR voltametry, and ultrahigh...... diffusion-weighted imaging and brain tissue volumetry indicate greater white matter than gray matter degradation. These findings could be confirmed by ultrahigh-field MRI. The use of nonconventional MR I techniques may further our understanding of the pathogenic processes hi NMO spectrum disorders and may...

  2. Recent advances in managing differentiated thyroid cancer.

    Science.gov (United States)

    Lamartina, Livia; Grani, Giorgio; Durante, Cosimo; Filetti, Sebastiano

    2018-01-01

    The main clinical challenge in the management of thyroid cancer is to avoid over-treatment and over-diagnosis in patients with lower-risk disease while promptly identifying those patients with more advanced or high-risk disease requiring aggressive treatment. In recent years, novel clinical and molecular data have emerged, allowing the development of new staging systems, predictive and prognostic tools, and treatment approaches. There has been a notable shift toward more conservative management of low- and intermediate-risk patients, characterized by less extensive surgery, more selective use of radioisotopes (for both diagnostic and therapeutic purposes), and less intensive follow-up. Furthermore, the histologic classification; tumor, node, and metastasis (TNM) staging; and American Thyroid Association risk stratification systems have been refined, and this has increased the number of patients in the low- and intermediate-risk categories. There is now a need for new, prospective data to clarify how these changing practices will impact long-term outcomes of patients with thyroid cancer, and new follow-up strategies and biomarkers are still under investigation. On the other hand, patients with more advanced or high-risk disease have a broader portfolio of options in terms of treatments and therapeutic agents, including multitarget tyrosine kinase inhibitors, more selective BRAF or MEK inhibitors, combination therapies, and immunotherapy.

  3. Dynamic spectrum management in green cognitive radio cellular networks

    KAUST Repository

    Sboui, Lokman

    2018-02-15

    In this paper, we propose a new cellular network operation scheme fulfilling the 5G requirements related to spectrum management and green communications. We focus on cognitive radio cellular networks in which both the primary network (PN) and the secondary network (SN) are maximizing their operational profits. The PN and the SN are required to respect a CO emissions threshold by switching off one or more lightly loaded base stations (BSs). In addition, the PN accepts to cooperate with the SN by leasing its spectrum in the cells where the PN is turned off. In return, the corresponding SN BSs host the PN users and impose extra roaming fees to the PN. We propose a low-complexity algorithm that maximizes the profit per CO emissions metric while switching on/off the BSs. In the simulations, we show that our proposed algorithm achieves performances close to the exhaustive search method. In addition, we find that the roaming price is a key parameter that affects both PN and SN profits.

  4. Clinical Spectrum, Management and Outcome of Neonatal Candidiasis

    International Nuclear Information System (INIS)

    Khan, E. A.; Choudhry, S.; Fatima, M.; Batool, Z.

    2015-01-01

    Objective: To identify clinical spectrum, management and outcome of neonatal candidiasis. Methods: The retrospective study was conducted at the Shifa International Hospital, Islamabad, Pakistan, and comprised microbiological records of all the babies admitted to the Neonatal Intensive Care Unit from January 2009 to January 2014 that were reviewed to identify those with positive candida cultures. Medical records were analysed for demographic and clinical spectrum features, management and outcome. SPSS 16 was used statistical analysis. Results: Of the total 1550 neonatal admissions, 560 (36 percent) had positive cultures, and, of them, candida was isolated in 49(8.8 percent) neonates. Among them, 13(26 percent) had candida albicans and the rest had candida species. Majority were males 34(70 percent), and preterm with 30(61 percent) being <37 weeks. The mean birth weight was 2000±873 grams. Mean age at admission was 6±7.6 days. Overall, 39(80 percent) had >2 risk factors. The commonest site of isolation was blood in 41(84 percent). Besides, 32 (65 percent) received fluconazole alone for treatment. Mean duration of anti-fungal therapy was 10±5 days (range: 1-21 days). Twelve (24 percent) neonates expired and the cause of death was candida sepsis in 10(20 percent) cases. Mortality was not significantly associated with gender, place of birth, gestation, risk factors, length of stay, prior antibiotic exposure or receipt of antifungal prophylaxis except those who were <1500 grams (p<0.05). Conclusion: Approximately one in ten at-risk neonates may develop candida sepsis with high mortality. Early institution of anti-fungal therapy may prove to be life-saving. (author)

  5. Development of advanced spent fuel management process. System analysis of advanced spent fuel management process

    International Nuclear Information System (INIS)

    Ro, S.G.; Kang, D.S.; Seo, C.S.; Lee, H.H.; Shin, Y.J.; Park, S.W.

    1999-03-01

    The system analysis of an advanced spent fuel management process to establish a non-proliferation model for the long-term spent fuel management is performed by comparing the several dry processes, such as a salt transport process, a lithium process, the IFR process developed in America, and DDP developed in Russia. In our system analysis, the non-proliferation concept is focused on the separation factor between uranium and plutonium and decontamination factors of products in each process, and the non-proliferation model for the long-term spent fuel management has finally been introduced. (Author). 29 refs., 17 tabs., 12 figs

  6. Advances in the management of orbital fractures.

    Science.gov (United States)

    Nguyen, P N; Sullivan, P

    1992-01-01

    Great progress has been made in both the basic science and the clinical knowledge base used in orbital reconstruction. With this, increasing complex orbital reconstructive problems are better managed. The diagnosis, treatment plan, and the actual reconstruction have evolved to a higher level. Several areas of progress are of note: the greater appreciation of the intimate relation between the bony orbit's shape and the position of the globe; application of computer technology in orbital injuries; effect of rigid fixation on autogenous and alloplastic graft; and the use of advanced biocompatible synthetic materials in orbital reconstruction. Although this progress has great impact on treatment of orbital injuries, there are many unanswered challenges in the treatment of the fragile frame of the window to the human soul.

  7. ATF [Advanced Toroidal Facility] data management

    International Nuclear Information System (INIS)

    Kannan, K.L.; Baylor, L.R.

    1988-01-01

    Data management for the Advanced Toroidal Facility (ATF), a stellarator located at Oak Ridge National Laboratory (ORNL), is provided by DMG, a locally developed, VAX-based software system. DMG is a data storage and retrieval software system that provides the user interface to ATF raw and analyzed data. Data are described in terms of data models and data types and are organized as signals into files, which are internally documented. The system was designed with user accessibility, software maintainability, and extensibility as primary goals. Extensibility features include compatibility with ATF as it moves from pulsed to steady-state operation and capability for use of the DMG system with experiments other than ATF. DMG is implemented as a run-time library of routines available as a shareable image. General-purpose and specialized data acquisition and analysis applications have been developed using the DMG system. This paper describes the DMG system and the interfaces to it. 4 refs., 2 figs

  8. Development of advanced spent fuel management process

    International Nuclear Information System (INIS)

    Ro, Seung Gy; Shin, Y. J.; Do, J. B.; You, G. S.; Seo, J. S.; Lee, H. G.

    1998-03-01

    This study is to develop an advanced spent fuel management process for countries which have not yet decided a back-end nuclear fuel cycle policy. The aims of this process development based on the pyroreduction technology of PWR spent fuels with molten lithium, are to reduce the storage volume by a quarter and to reduce the storage cooling load in half by the preferential removal of highly radioactive decay-heat elements such as Cs-137 and Sr-90 only. From the experimental results which confirm the feasibility of metallization technology, it is concluded that there are no problems in aspects of reaction kinetics and equilibrium. However, the operating performance test of each equipment on an engineering scale still remain and will be conducted in 1999. (author). 21 refs., 45 tabs., 119 figs

  9. Advances in the management of diabetic neuropathy.

    Science.gov (United States)

    Várkonyi, Tamás; Körei, Anna; Putz, Zsuzsanna; Martos, Tímea; Keresztes, Katalin; Lengyel, Csaba; Nyiraty, Szabolcs; Stirban, Alin; Jermendy, György; Kempler, Péter

    2017-10-01

    The authors review current advances in the therapy of diabetic neuropathy. The role of glycemic control and management of cardiovascular risk factors in the prevention and treatment of neuropathic complications are discussed. As further options of pathogenetically oriented treatment, recent knowledge on benfotiamine and alpha-lipoic acid is comprehensively reviewed. Alpha-lipoic acid is a powerful antioxidant and clinical trials have proven its efficacy in ameliorating neuropathic signs and symptoms. Benfotiamine acts via the activation of transketolase and thereby inhibits alternative pathways triggered by uncontrolled glucose influx in the cells comprising polyol, hexosamine, protein-kinase-C pathways and formation of advanced glycation end products. Beyond additional forms of causal treatment, choices of symptomatic treatment will be summarized. The latter is mostly represented by the anticonvulsive agents pregabalin and gabapentin as well as duloxetine widely acknowledged as antidepressant. Finally, non-pharmacological therapeutic alternatives are summarized. The authors conclude that combination therapy should be more often suggested to our patients; especially the combination of pathogenetic and symptomatic agents.

  10. Management of pain in advanced disease.

    Science.gov (United States)

    Harris, Dylan G

    2014-06-01

    Pain is common in advanced malignancy but also prevalent in other non-malignant life-limiting diseases such as advanced heart disease; end stage renal failure and multiple sclerosis. Patients with renal or liver impairment need specific consideration, as most analgesics rely on either or both for their metabolism and excretion. Recent evidence-based guidelines and the systematic reviews that have informed their recommendations. The principles of the WHO (World Health Organisation) analgesic ladder are commonly endorsed as a structured approach to the management of pain. For neuropathic pain, the efficacy of different agents is similar and choice of drug more guided by side effects, drug interactions and cost. Evidence supporting the WHO analgesic ladder is disputed and alternatives suggested, but no overwhelming evidence for an alternative approach exists to date. Alternative approaches to the WHO analgesic ladder, new analgesic agents, e.g. rapid onset oral/intranasal fentanyl. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Locally advanced rectal cancer: management challenges

    Directory of Open Access Journals (Sweden)

    Kokelaar RF

    2016-10-01

    Full Text Available RF Kokelaar, MD Evans, M Davies, DA Harris, J Beynon Department of Colorectal Surgery, Singleton Hospital, Swansea, UK Abstract: Between 5% and 10% of patients with rectal cancer present with locally advanced rectal cancer (LARC, and 10% of rectal cancers recur after surgery, of which half are limited to locoregional disease only (locally recurrent rectal cancer. Exenterative surgery offers the best long-term outcomes for patients with LARC and locally recurrent rectal cancer so long as a complete (R0 resection is achieved. Accurate preoperative multimodal staging is crucial in assessing the potential operability of advanced rectal tumors, and resectability may be enhanced with neoadjuvant therapies. Unfortunately, surgical options are limited when the tumor involves the lateral pelvic sidewall or high sacrum due to the technical challenges of achieving histological clearance, and must be balanced against the high morbidity associated with resection of the bony pelvis and significant lymphovascular structures. This group of patients is usually treated palliatively and subsequently survival is poor, which has led surgeons to seek innovative new solutions, as well as revisit previously discarded radical approaches. A small number of centers are pioneering new techniques for resection of beyond-total mesorectal excision tumors, including en bloc resections of the sciatic notch and composite resections of the first two sacral vertebrae. Despite limited experience, these new techniques offer the potential for radical treatment of previously inoperable tumors. This narrative review sets out the challenges facing the management of LARCs and discusses evolving management options. Keywords: rectal cancer, exenteration, pelvic sidewall, sacrectomy

  12. Use of Advanced Magnetic Resonance Imaging Techniques in Neuromyelitis Optica Spectrum Disorder

    Science.gov (United States)

    Kremer, Stephane; Renard, Felix; Achard, Sophie; Lana-Peixoto, Marco A.; Palace, Jacqueline; Asgari, Nasrin; Klawiter, Eric C.; Tenembaum, Silvia N.; Banwell, Brenda; Greenberg, Benjamin M.; Bennett, Jeffrey L.; Levy, Michael; Villoslada, Pablo; Saiz, Albert; Fujihara, Kazuo; Chan, Koon Ho; Schippling, Sven; Paul, Friedemann; Kim, Ho Jin; de Seze, Jerome; Wuerfel, Jens T.

    2016-01-01

    Brain parenchymal lesions are frequently observed on conventional magnetic resonance imaging (MRI) scans of patients with neuromyelitis optica (NMO) spectrum disorder, but the specific morphological and temporal patterns distinguishing them unequivocally from lesions caused by other disorders have not been identified. This literature review summarizes the literature on advanced quantitative imaging measures reported for patients with NMO spectrum disorder, including proton MR spectroscopy, diffusion tensor imaging, magnetization transfer imaging, quantitative MR volumetry, and ultrahigh-field strength MRI. It was undertaken to consider the advanced MRI techniques used for patients with NMO by different specialists in the field. Although quantitative measures such as proton MR spectroscopy or magnetization transfer imaging have not reproducibly revealed diffuse brain injury, preliminary data from diffusion-weighted imaging and brain tissue volumetry indicate greater white matter than gray matter degradation. These findings could be confirmed by ultrahigh-field MRI. The use of nonconventional MRI techniques may further our understanding of the pathogenic processes in NMO spectrum disorders and may help us identify the distinct radiographic features corresponding to specific phenotypic manifestations of this disease. PMID:26010909

  13. Spectrum of care: Current management of childhood autism spectrum disorder (ASD) in New Zealand.

    Science.gov (United States)

    Thabrew, Hiran; Eggleston, Matthew

    2017-07-01

    The purpose of this research was to compare the current status of assessment and intervention for New Zealand children and adolescents who have autism spectrum disorder (ASD) with recommendations outlined in the 2008 New Zealand ASD Guideline. ASD coordinators and New Zealand District Health Board (DHB) staff working with children and adolescents who have ASD were electronically surveyed. Responses were received from 32 staff in 17 (85%) surveyed DHBs. Positive findings included the presence of ASD coordinators in 85% of DHBs, clear pathways for management in 73.1% of DHBs and good communications between paediatric, psychiatric and educational teams in some DHBs regions. Areas for improvement included wait times to assessment, access to longer-term support and intervention for families, and training for staff in ASD and cultural issues. Since the launch of the NZ ASD Guidelines, significant progress has been made. However, further work is needed to ensure services for children and adolescents with ASD are accessible, well-coordinated and focussed on both assessment and intervention.

  14. AN ADVANCED CALIBRATION PROCEDURE FOR COMPLEX IMPEDANCE SPECTRUM MEASUREMENTS OF ADVANCED ENERGY STORAGE DEVICES

    Energy Technology Data Exchange (ETDEWEB)

    William H. Morrison; Jon P. Christophersen; Patrick Bald; John L. Morrison

    2012-06-01

    With the increasing demand for electric and hybrid electric vehicles and the explosion in popularity of mobile and portable electronic devices such as laptops, cell phones, e-readers, tablet computers and the like, reliance on portable energy storage devices such as batteries has likewise increased. The concern for the availability of critical systems in turn drives the availability of battery systems and thus the need for accurate battery health monitoring has become paramount. Over the past decade the Idaho National Laboratory (INL), Montana Tech of the University of Montana (Tech), and Qualtech Systems, Inc. (QSI) have been developing the Smart Battery Status Monitor (SBSM), an integrated battery management system designed to monitor battery health, performance and degradation and use this knowledge for effective battery management and increased battery life. Key to the success of the SBSM is an in-situ impedance measurement system called the Impedance Measurement Box (IMB). One of the challenges encountered has been development of an accurate, simple, robust calibration process. This paper discusses the successful realization of this process.

  15. Management of intestinal obstruction in advanced malignancy

    Directory of Open Access Journals (Sweden)

    Henry John Murray Ferguson

    2015-09-01

    Full Text Available Patients with incurable, advanced abdominal or pelvic malignancy often present to acute surgical departments with symptoms and signs of intestinal obstruction. It is rare for bowel strangulation to occur in these presentations, and spontaneous resolution often occurs, so the luxury of time should be afforded while decisions are made regarding surgery. Cross-sectional imaging is valuable in determining the underlying mechanism and pathology. The majority of these patients will not be suitable for an operation, and will be best managed in conjunction with a palliative medicine team. Surgeons require a good working knowledge of the mechanisms of action of anti-emetics, anti-secretories and analgesics to tailor early management to individual patients, while decisions regarding potential surgery are made. Deciding if and when to perform operative intervention in this group is complex, and fraught with both technical and emotional challenges. Surgery in this group is highly morbid, with no current evidence available concerning quality of life following surgery. The limited evidence concerning operative strategy suggests that resection and primary anastomosis results in improved survival, over bypass or stoma formation. Realistic prognostication and involvement of the patient, care-givers and the multidisciplinary team in treatment decisions is mandatory if optimum outcomes are to be achieved.

  16. Recent advances in autism research as reflected in DSM-5 criteria for autism spectrum disorder.

    Science.gov (United States)

    Lord, Catherine; Bishop, Somer L

    2015-01-01

    This article provides a selective review of advances in scientific knowledge about autism spectrum disorder (ASD), using DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, fifth edition) diagnostic criteria as a framework for the discussion. We review literature that prompted changes to the organization of ASD symptoms and diagnostic subtypes in DSM-IV, and we examine the rationale for new DSM-5 specifiers, modifiers, and severity ratings as well as the introduction of the diagnosis of social (pragmatic) communication disorder. Our goal is to summarize and critically consider the contribution of clinical psychology research, along with that of other disciplines, to the current conceptualization of ASD.

  17. Cognitive communication and cooperative hetnet coexistence selected advances on spectrum sensing, learning, and security approaches

    CERN Document Server

    Bader, Faouzi

    2014-01-01

    This book, written by experts from universities and major industrial research laboratories, is devoted to the very hot topic of cognitive radio and networking for cooperative coexistence of heterogeneous wireless networks. Selected highly relevant advanced research is presented on spectrum sensing and progress toward the realization of accurate radio environment mapping, biomimetic learning for self-organizing networks, security threats (with a special focus on primary user emulation attack), and cognition as a tool for green next-generation networks. The research activities covered include work undertaken within the framework of the European COST Action IC0902, which is geared towards the definition of a European platform for cognitive radio and networks. Communications engineers, R&D engineers, researchers, and students will all benefit from this complete reference on recent advances in wireless communications and the design and implementation of cognitive radio systems and networks.

  18. Advanced Management Communication: An Elective Course in Corporate Communication.

    Science.gov (United States)

    Argenti, Paul A.

    1986-01-01

    Proposes a college-level elective course in advanced management communication that would teach future managers how to communicate with shareholders, the media, financial analysts, and the labor force. (SRT)

  19. Advancing the management of childhood epilepsies.

    Science.gov (United States)

    Cross, J Helen; Kluger, Gerhard; Lagae, Lieven

    2013-07-01

    Childhood epilepsies comprise a heterogeneous group of disorders and syndromes that vary in terms of severity, prognosis and treatment requirements. Effective management requires early, accurate recognition and diagnosis, and a holistic approach that addresses each individual's medical and psychosocial needs within the context of their overall health status and quality of life. With increasing understanding of underlying aetiologies, new approaches to management and treatment are emerging. For example, genetic testing is beginning to provide a tool to aid differential diagnosis and a means of predicting predisposition to particular types of epilepsy. Despite the availability of an increasing number of antiepileptic drugs (AEDs)--due not only to the development of new AEDs, but also to changes in regulatory requirements that have facilitated clinical development--seizure control and tolerability continue to be suboptimal in many patients, and there is therefore a continuing need for new treatment strategies. Surgery and other non-pharmacological treatments (e.g. vagus nerve stimulation, ketogenic diet) are already relatively well established in paediatric epilepsy. New pharmacological treatments include generational advances on existing AEDs and AEDs with novel modes of action, and non-AED pharmacological interventions, such as immunomodulation. Emerging technologies include novel approaches allowing the delivery of medicinal agents to specific areas of the brain, and 'closed-loop' experimental devices employing algorithms that allow treatment (e.g., electrical stimulation) to be targeted both spatially and temporally. Although in early stages of development, cell-based approaches (e.g., focal targeting of adenosine augmentation) and gene therapy may also provide new treatment choices in the future. Copyright © 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  20. Spectrum management for science in the 21st century

    National Research Council Canada - National Science Library

    Committee on Scientific Use of the Radio Spectrum; Committee on Radio Frequencies; National Research Council; Division on Engineering and Physical Sciences; National Research Council

    2010-01-01

    .... The radio spectrum is also being used by radiating, or 'active,' services, ranging from aircraft radars to rapidly expanding consumer services such as cellular telephones and wireless internet...

  1. Management of unresectable, locally advanced pancreatic adenocarcinoma.

    Science.gov (United States)

    Salgado, M; Arévalo, S; Hernando, O; Martínez, A; Yaya, R; Hidalgo, M

    2018-02-01

    The diagnosis of unresectable locally advanced pancreatic adenocarcinoma (LAPC) requires confirmation, through imaging tests, of the unfeasibility of achieving a complete surgical resection, in the absence of metastatic spread. The increase in overall survival (OS), together with an appropriate symptom management is the therapeutic target in LAPC, maintaining an acceptable quality of life and, if possible, increasing the time until the appearance of metastasis. Chemoradiation (CRT) improves OS compared to best support treatment or radiotherapy (RT) but with greater toxicity. No significant increase in OS has been achieved with CRT when compared to chemotherapy (QT) alone in patients without disease progression after four months of treatment with QT. However, a significantly better local control, that is, a significant increase in the time to disease progression was associated with this approach. The greater effectiveness of the schemes FOLFIRINOX and gemcitabine (Gem) + Nab-paclitaxel compared to gemcitabine alone, has been extrapolated from metastatic disease to LAPC, representing a possible alternative for patients with good performance status (ECOG 0-1). In the absence of randomized clinical trials, Gem is the standard treatment in LAPC. If disease control is achieved after 4-6 cycles of QT, the use of CRT for consolidation can be considered an option vs QT treatment maintenance. Capecitabine has a better toxicity profile and effectiveness compared to gemcitabine as a radiosensitizer. After local progression, and without evidence of metastases, treatment with RT or CRT, in selected patients, can support to maintain the regional disease control.

  2. Natural language processing and advanced information management

    Science.gov (United States)

    Hoard, James E.

    1989-01-01

    Integrating diverse information sources and application software in a principled and general manner will require a very capable advanced information management (AIM) system. In particular, such a system will need a comprehensive addressing scheme to locate the material in its docuverse. It will also need a natural language processing (NLP) system of great sophistication. It seems that the NLP system must serve three functions. First, it provides an natural language interface (NLI) for the users. Second, it serves as the core component that understands and makes use of the real-world interpretations (RWIs) contained in the docuverse. Third, it enables the reasoning specialists (RSs) to arrive at conclusions that can be transformed into procedures that will satisfy the users' requests. The best candidate for an intelligent agent that can satisfactorily make use of RSs and transform documents (TDs) appears to be an object oriented data base (OODB). OODBs have, apparently, an inherent capacity to use the large numbers of RSs and TDs that will be required by an AIM system and an inherent capacity to use them in an effective way.

  3. Development of Advanced Spent Fuel Management Process

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Chung Seok; Choi, I. K.; Kwon, S. G. (and others)

    2007-06-15

    As a part of research efforts to develop an advanced spent fuel management process, this project focused on the electrochemical reduction technology which can replace the original Li reduction technology of ANL, and we have successfully built a 20 kgHM/batch scale demonstration system. The performance tests of the system in the ACPF hot cell showed more than a 99% reduction yield of SIMFUEL, a current density of 100 mA/cm{sup 2} and a current efficiency of 80%. For an optimization of the process, the prevention of a voltage drop in an integrated cathode, a minimization of the anodic effect and an improvement of the hot cell operability by a modulation and simplization of the unit apparatuses were achieved. Basic research using a bench-scale system was also carried out by focusing on a measurement of the electrochemical reduction rate of the surrogates, an elucidation of the reaction mechanism, collecting data on the partition coefficients of the major nuclides, quantitative measurement of mass transfer rates and diffusion coefficients of oxygen and metal ions in molten salts. When compared to the PYROX process of INL, the electrochemical reduction system developed in this project has comparative advantages in its application of a flexible reaction mechanism, relatively short reaction times and increased process yields.

  4. Development of Advanced Spent Fuel Management Process

    International Nuclear Information System (INIS)

    Seo, Chung Seok; Choi, I. K.; Kwon, S. G.

    2007-06-01

    As a part of research efforts to develop an advanced spent fuel management process, this project focused on the electrochemical reduction technology which can replace the original Li reduction technology of ANL, and we have successfully built a 20 kgHM/batch scale demonstration system. The performance tests of the system in the ACPF hot cell showed more than a 99% reduction yield of SIMFUEL, a current density of 100 mA/cm 2 and a current efficiency of 80%. For an optimization of the process, the prevention of a voltage drop in an integrated cathode, a minimization of the anodic effect and an improvement of the hot cell operability by a modulation and simplization of the unit apparatuses were achieved. Basic research using a bench-scale system was also carried out by focusing on a measurement of the electrochemical reduction rate of the surrogates, an elucidation of the reaction mechanism, collecting data on the partition coefficients of the major nuclides, quantitative measurement of mass transfer rates and diffusion coefficients of oxygen and metal ions in molten salts. When compared to the PYROX process of INL, the electrochemical reduction system developed in this project has comparative advantages in its application of a flexible reaction mechanism, relatively short reaction times and increased process yields

  5. Impact of advanced fuel cycle options on waste management policies

    International Nuclear Information System (INIS)

    Gordelier, Stan; Cavedon, Jean-Marc

    2006-01-01

    OECD/NEA has performed a study on the impact of advanced fuel cycle options on waste management policies with 33 experts from 12 member countries, 1 non-member country and 2 international organizations. The study extends a series of previous ones on partitioning and transmutation (P and T) issues, focusing on the performance assessments for repositories of high-level waste (HLW) arising from advanced fuel cycles. This study covers a broader spectrum than previous studies, from present industrial practice to fully closed cycles via partially closed cycles (in terms of transuranic elements); 9 fuel cycle schemes and 4 variants. Elements of fuel cycles are considered primarily as sources of waste, the internal mass flows of each scheme being kept for the sake of mass conservation. The compositions, activities and heat loads of all waste flows are also tracked. Their impact is finally assessed on the waste repository concepts. The study result confirms the findings from the previous NEA studies on P and T on maximal reduction of the waste source term and maximal use of uranium resources. In advanced fuel cycle schemes the activity of the waste is reduced by burning first plutonium and then minor actinides and also the uranium consumption is reduced, as the fraction of fast reactors in the park is increased to 100%. The result of the repository performance assessments, analysing the effect of different HLW isotopic composition on repository performance and on repository capacity, shows that the maximum dose released to biosphere at any time in normal conditions remains, for all schemes and for all the repository concepts examined, well below accepted radiation protection thresholds. The major impact is on the detailed concept of the repositories, through heat load and waste volume. Advanced fuel cycles could allow a repository to cover waste produced from 5 to 20 times more electricity generation than PWR once-through cycle. Given the flexibility of the advanced fuel

  6. Advanced Hybrid Particulate Collector Project Management Plan

    Energy Technology Data Exchange (ETDEWEB)

    Miller, S.J.

    1995-11-01

    As the consumption of energy increases, its impact on ambient air quality has become a significant concern. Recent studies indicate that fine particles from coal combustion cause health problems as well as atmospheric visibility impairment. These problems are further compounded by the concentration of hazardous trace elements such as mercury, cadmium, selenium, and arsenic in fine particles. Therefore, a current need exists to develop superior, but economical, methods to control emissions of fine particles. Since most of the toxic metals present in coal will be in particulate form, a high level of fine- particle collection appears to be the best method of overall air toxics control. However, over 50% of mercury and a portion of selenium emissions are in vapor form and cannot be collected in particulate control devices. Therefore, this project will focus on developing technology not only to provide ultrahigh collection efficiency of particulate air toxic emissions, but also to capture vapor- phase trace metals such as mercury and selenium. Currently, the primary state-of-the-art technologies for particulate control are fabric filters (baghouses) and electrostatic precipitators (ESPs). However, they both have limitations that prevent them from achieving ultrahigh collection of fine particulate matter and vapor-phase trace metals. The objective of this project is to develop a highly reliable advanced hybrid particulate collector (AHPC) that can provide > 99.99 % particulate collection efficiency for all particle sizes between 0.01 and 50 14m, is applicable for use with all U.S. coals, and is cost-0443competitive with existing technologies. Phase I of the project is organized into three tasks: Task I - Project Management, Reporting, and Subcontract Consulting Task 2 - Modeling, Design, and Construction of 200-acfm AHPC Model Task 3 - Experimental Testing and Subcontract Consulting

  7. Spectrum access and management for cognitive radio networks

    CERN Document Server

    2017-01-01

    This book presents cutting-edge research contributions that address various aspects of network design, optimization, implementation, and application of cognitive radio technologies. It demonstrates how to make better utilization of the available spectrum, cognitive radios and spectrum access to achieve effective spectrum sharing between licensed and unlicensed users. The book provides academics and researchers essential information on current developments and future trends in cognitive radios for possible integration with the upcoming 5G networks. In addition, it includes a brief introduction to cognitive radio networks for newcomers to the field.

  8. MANAGEMENT AND SURVIVAL IN ADVANCED PROSTATE ...

    African Journals Online (AJOL)

    hi-tech

    2000-05-05

    May 5, 2000 ... Patients: Fifty nine patients with advanced cancer of prostate (extra prostatic locally advanced and metastatic ... Conclusion: Survival in the undifferentiated and poorly differentiated prostrate cancer. Gleasons grades 4 and 5 .... with its pulsatile release from the hypothalamus and desensitises the pituitary ...

  9. The intelligent user interface for NASA's advanced information management systems

    Science.gov (United States)

    Campbell, William J.; Short, Nicholas, Jr.; Rolofs, Larry H.; Wattawa, Scott L.

    1987-01-01

    NASA has initiated the Intelligent Data Management Project to design and develop advanced information management systems. The project's primary goal is to formulate, design and develop advanced information systems that are capable of supporting the agency's future space research and operational information management needs. The first effort of the project was the development of a prototype Intelligent User Interface to an operational scientific database, using expert systems and natural language processing technologies. An overview of Intelligent User Interface formulation and development is given.

  10. Performance of children with autism spectrum disorder on advanced theory of mind tasks.

    Science.gov (United States)

    Brent, Ella; Rios, Patricia; Happé, Francesca; Charman, Tony

    2004-09-01

    Although a number of advanced theory of mind tasks have been developed, there is sparse information on whether performance on different tasks is associated. The study examined the performance of 20 high-functioning 6- to 12-year-old children with autism spectrum disorder and 20 controls on three high-level theory of mind tasks: Strange Stories, Cartoons and the children's version of the Eyes task. The pattern of findings suggests that the three tasks may share differing, non-specific, information-processing requirements in addition to tapping any putative mentalizing ability. They may also indicate a degree of dissociation between social-cognitive and social-perceptual or affective components of the mentalizing system.

  11. Advanced gamma spectrum processing technique applied to the analysis of scattering spectra for determining material thickness

    International Nuclear Information System (INIS)

    Hoang Duc Tam; VNUHCM-University of Science, Ho Chi Minh City; Huynh Dinh Chuong; Tran Thien Thanh; Vo Hoang Nguyen; Hoang Thi Kieu Trang; Chau Van Tao

    2015-01-01

    In this work, an advanced gamma spectrum processing technique is applied to analyze experimental scattering spectra for determining the thickness of C45 heat-resistant steel plates. The single scattering peak of scattering spectra is taken as an advantage to measure the intensity of single scattering photons. Based on these results, the thickness of steel plates is determined with a maximum deviation of real thickness and measured thickness of about 4 %. Monte Carlo simulation using MCNP5 code is also performed to cross check the results, which yields a maximum deviation of 2 %. These results strongly confirm the capability of this technique in analyzing gamma scattering spectra, which is a simple, effective and convenient method for determining material thickness. (author)

  12. Applied behavior analysis: behavior management of children with autism spectrum disorders in dental environments.

    Science.gov (United States)

    Hernandez, Purnima; Ikkanda, Zachary

    2011-03-01

    There are a limited number of studies addressing behavior management techniques and procedural modifications that dentists can use to treat people with an autism spectrum disorder (ASD). The authors conducted a search of the dental and behavioral analytic literature to identify management techniques that address problem behaviors exhibited by children with ASDs in dental and other health-related environments. Applied behavior analysis (ABA) is a science in which procedures are based on the principles of behavior through systematic experimentation. Clinicians have used ABA procedures successfully to modify socially significant behaviors of people with ASD. Basic behavior management techniques currently used in dentistry may not encourage people with cognitive and behavioral disabilities, such as ASD, to tolerate simple in-office dental procedures consistently. Instead, dental care providers often are required to use advanced behavior management techniques to complete simple in-office procedures such as prophylaxis, sealant placement and obtaining radiographs. ABA procedures can be integrated in the dental environment to manage problem behaviors often exhibited by children with an ASD. The authors found no evidence-based procedural modifications that address the behavioral characteristics and problematic behaviors of children with an ASD in a dental environment. Further research in this area should be conducted. Knowledge and in-depth understanding of behavioral principles is essential when a dentist is concerned with modifying behaviors. Using ABA procedures can help dentists manage problem behaviors effectively and systematically when performing routine dental treatment. Being knowledgeable about each patient's behavioral characteristics and the parents' level of involvement is important in the successful integration of the procedures and reduction of in-office time.

  13. Medium usage model for the design of dynamic spectrum management in ISM bands

    NARCIS (Netherlands)

    Witvliet, B.A.; Bentum, M.J.; Schiphorst, R.; Slump, C.H.

    2012-01-01

    This paper presents a new approach for dynamic spectrum management for heterogeneous wireless devices. Local congestion degrades the reliability of wireless applications in the License Exempt bands. This leads to the research questions: (1) how to realize equal spectrum sharing between dissimilar

  14. Reputation Management in Children on the Autism Spectrum

    OpenAIRE

    Cage, Eilidh; Bird, Geoffrey; Pellicano, Elizabeth

    2016-01-01

    Being able to manage reputation is an important social skill, but it is unclear whether autistic children can manage reputation. This study investigated whether 33 autistic children matched to 33 typical children could implicitly or explicitly manage reputation. Further, we examined whether cognitive processes-theory of mind, social motivation, inhibitory control and reciprocity-contribute to reputation management. Results showed that neither group implicitly managed reputation, and there was...

  15. Early Onset Bipolar Spectrum Disorder: Psychopharmacological, Psychological, and Educational Management

    Science.gov (United States)

    McIntosh, David E.; Trotter, Jeffrey S.

    2006-01-01

    Although published research continues to advocate medication as the first line of treatment for early onset bipolar spectrum disorder (EOBSD; N. Lofthouse & M.A. Fristad, 2004), preliminary research demonstrating the utility of cognitive, cognitive-behavioral, and psychoeducational therapies is promising. It appears as if future treatment of EOBSD…

  16. challenges in management of warfarin anti-coagulation in advanced

    African Journals Online (AJOL)

    2013-07-01

    Jul 1, 2013 ... ADVANCED HIV/AIDS PATIENTS WITH VENOUS THROMBOTIC EVENTS – A. CASE SERIES ... Objective: To describe clinical presentations and challenges in the management of. VTE in ..... Performance outcomes of a ...

  17. Advancing Sustainable Materials Management: Facts and Figures Report

    Science.gov (United States)

    Each year EPA releases the Advancing Sustainable Materials Management: Facts and Figures report, formerly called Municipal Solid Waste in the United States: Facts and Figures. It includes information on Municipal Solid Waste generation, recycling, an

  18. Radioactive waste management and advanced nuclear fuel cycle technologies

    International Nuclear Information System (INIS)

    2007-01-01

    In 2007 ENEA's Department of Nuclear Fusion and Fission, and Related Technologies acted according to national policy and the role assigned to ENEA FPN by Law 257/2003 regarding radioactive waste management and advanced nuclear fuel cycle technologies

  19. Advanced and controlled drug delivery systems in clinical disease management

    NARCIS (Netherlands)

    Brouwers, JRBJ

    1996-01-01

    Advanced and controlled drug delivery systems are important for clinical disease management. In this review the most important new systems which have reached clinical application are highlighted. Microbiologically controlled drug delivery is important for gastrointestinal diseases like ulcerative

  20. Barriers to Professional Advancement among Female Managers.

    Science.gov (United States)

    O'Leary, Virginia E.

    It appears that there is nothing inherently associated with femaleness which should preclude the ascendence of women into management positions. However, barriers do exist and they stem from such factors as societal sex-role stereotypes, attitudes toward women in management, attitudes toward female competence, and the prevalence of the male…

  1. Advances in Serials Management. Volume 6.

    Science.gov (United States)

    Hepfer, Cindy, Ed.; Gammon, Julia, Ed.; Malinowski, Teresa, Ed.

    In order to further discussion and support constructive change, this volume presents the following eight papers on various dimensions of serials management: (1) "CD-ROMs, Surveys, and Sales: The OSA [Optical Society of America] Experience" (Frank E. Harris and Alan Tourtlotte); (2) "Management and Integration of Electronic Journals into the…

  2. Advanced Interval Management (IM) Concepts of Operations

    Science.gov (United States)

    Barmore, Bryan E.; Ahmad, Nash'at N.; Underwood, Matthew C.

    2014-01-01

    This document provides a high-level description of several advanced IM operations that NASA is considering for future research and development. It covers two versions of IM-CSPO and IM with Wake Mitigation. These are preliminary descriptions to support an initial benefits analysis

  3. Advanced Radio Resource Management for IMT

    DEFF Research Database (Denmark)

    Monserrat, Jose M.; Sroka, Pawel; Auer, Gunther

    The race towards IMT-Advanced was recently started by ITU-R who distributed a Circular Letter asking for the submission of new technology proposals. The European Celtic project WINNER+ is bridging together experts from industry, academia and government all around Europe to devise this next fourth...

  4. Reputation Management in Children on the Autism Spectrum

    Science.gov (United States)

    Cage, Eilidh; Bird, Geoffrey; Pellicano, Elizabeth

    2016-01-01

    Being able to manage reputation is an important social skill, but it is unclear whether autistic children can manage reputation. This study investigated whether 33 autistic children matched to 33 typical children could implicitly or explicitly manage reputation. Further, we examined whether cognitive processes--theory of mind, social motivation,…

  5. Transformation of a wave energy spectrum from encounter to absolute domain when observing from an advancing ship

    DEFF Research Database (Denmark)

    Nielsen, Ulrik Dam

    2017-01-01

    directly in the encounter domain. The encounter domain is that observed from a ship when it advances in a seaway, whereas the absolute domain is that corresponding to making observations from a fixed point in the inertial frame. Spectrum transformation can be uniquely carried out if the ship sails ”against...

  6. Teaching Advanced Operation of an iPod-Based Speech-Generating Device to Two Students with Autism Spectrum Disorders

    Science.gov (United States)

    Achmadi, Donna; Kagohara, Debora M.; van der Meer, Larah; O'Reilly, Mark F.; Lancioni, Giulio E.; Sutherland, Dean; Lang, Russell; Marschik, Peter B.; Green, Vanessa A.; Sigafoos, Jeff

    2012-01-01

    We evaluated a program for teaching two adolescents with autism spectrum disorders (ASD) to perform more advanced operations on an iPod-based speech-generating device (SGD). The effects of the teaching program were evaluated in a multiprobe multiple baseline across participants design that included two intervention phases. The first intervention…

  7. Evaluation of Advanced Data Centre Power Management Strategies

    NARCIS (Netherlands)

    Postema, Björn F.; Haverkort, Boudewijn R.

    2018-01-01

    In recent work, we proposed a new specification language for power management strategies as an extension to our AnyLogic-based simulation framework for the trade-off analysis of power and performance in data centres. In this paper, we study the quality of such advanced power management strategies

  8. Advanced Fuel Cell System Thermal Management for NASA Exploration Missions

    Science.gov (United States)

    Burke, Kenneth A.

    2009-01-01

    The NASA Glenn Research Center is developing advanced passive thermal management technology to reduce the mass and improve the reliability of space fuel cell systems for the NASA exploration program. An analysis of a state-of-the-art fuel cell cooling systems was done to benchmark the portion of a fuel cell system s mass that is dedicated to thermal management. Additional analysis was done to determine the key performance targets of the advanced passive thermal management technology that would substantially reduce fuel cell system mass.

  9. French programs for advanced waste management options

    Energy Technology Data Exchange (ETDEWEB)

    Salvatores, M [CEA-DRN (France); Schapira, J P [CNRS-IN2P3 (France); Mouney, H [EDF-DE (France)

    1997-11-01

    Several organisms (CEA, CNRS, EdF, etc.) are cooperating in France on Accelerator-Driven Systems (ADS). The major motivation is the investigation of innovative options for the radioactive waste management. The paper describes the ongoing activities and future directions of this cooperative effort in the field of ADS. 11 refs, 3 figs.

  10. Business Management in the advanced information society

    Science.gov (United States)

    Saeki, Akio

    This is a record of the commemorative lecture at the fifth anniversary of the establishment of the JICST Tohoku Branch Office. Lecturer explains about business management in the information age. "Management" originally means sensing and coping with changes. Thus, the business has to get information as quickly as possible and take the best possible measure for the new issues. As it is definitely important for the business to make an appropriate prediction, information including unknown facts is very valuable. Technological prediction is particulary indispensable for the business. It is available, to some extent, by looking back the steps of technological development in the past. As the characteristics of information age, lecturer explains that there will be less information gap in the world, due to the development of telecommunication technology.

  11. Management of advanced hair loss patterns.

    Science.gov (United States)

    Beehner, Michael L

    2013-08-01

    This article covers how to manage patients with extensive hair loss in whom complete, dense coverage is not possible. In addition to discussing planning a transplant pattern for already bald men, I discuss a conservative approach for recognizing and transplanting younger patients who have telltale warning signs that may evolve to extensive hair loss. For both groups, a variant of a frontal forelock-type pattern is usually the best course to follow. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. System and method for advanced power management

    Science.gov (United States)

    Atcitty, Stanley [Albuquerque, NM; Symons, Philip C [Surprise, AZ; Butler, Paul C [Albuquerque, NM; Corey, Garth P [Albuquerque, NM

    2009-07-28

    A power management system is provided that includes a power supply means comprising a plurality of power supply strings, a testing means operably connected to said plurality of power supply strings for evaluating performance characteristics of said plurality of power supply strings, and a control means for monitoring power requirements and comprising a switching means for controlling switching of said plurality of power supply strings to said testing means.

  13. Interference management with partial uplink/downlink spectrum overlap

    KAUST Repository

    Randrianantenaina, Itsikiantsoa; Elsawy, Hesham; Dahrouj, Hayssam; Alouini, Mohamed-Slim

    2016-01-01

    Simultaneous reuse of spectral resources by uplink and downlink, denoted as in-band full duplex (FD) communication, is promoted to double the spectral efficiency when compared to its half-duplex (HD) counterpart. Interference management, however

  14. Analysis of soil-structure interaction and floor response spectrum of reactor building for China advanced research reactor

    International Nuclear Information System (INIS)

    Rong Feng; Wang Jiachun; He Shuyan

    2006-01-01

    Analysis of Soil-Structure Interaction (SSI) and calculation of Floor Response Spectrum (FRS) is substantial for anti-seismic design for China Advanced Research Reactor (CARR) project. The article uses direct method to analyze the seismic reaction of the reactor building in considering soil-structure interaction by establishing two-dimensional soil-structure co-acting model for analyzing and inputting of seismic waves from three directions respectively. The seismic response and floor response spectrum of foundation and floors of the building under different cases have been calculated. (authors)

  15. Advances in the management of intracerebral hemorrhage.

    Science.gov (United States)

    Kuramatsu, J B; Huttner, H B; Schwab, S

    2013-09-01

    Intracerebral hemorrhage (ICH) is one of the most detrimental sub-types of stroke and accounts for 10-15% of all strokes Qureshi et al. (Lancet 373(9675):1632-1644, 2009). ICH has an incidence of 10-30 cases per 100,000 people/year which is increasing and expected to double by the year 2050 Qureshi et al. (N Engl J Med 344 (19):1450-1460, 2001). Mortality rates still remain poor (30-50%) and functional dependency after ICH is high (~75%) van Asch et al. (Lancet Neurol 9 (2):167-176, 2010). Up to now, all randomized controlled trials investigating treatment approaches in ICH have failed to document improvements on clinical endpoints Mayer et al. (N Engl J Med 358 (20):2127-2137, 2008); Brouwers and Goldstein (Neurotherapeutics 9 (1):87-98, 2012). Only a specialized treatment of severely injured patients at dedicated neuro intensive care units [NICU] has been shown to be beneficial Qureshi et al. (Lancet 373(9675):1632-1644, 2009); Suarez et al. (Crit Care Med 32 (11):2311-2317, 2004). Currently, ongoing trials are investigating aggressive blood pressure lowering, hemostatic therapies, different operative strategies, intraventricular thrombolysis as well as neuroprotective approaches, and brain edema therapies. This review will summarize advanced treatment strategies and novel approaches which are currently under investigation.

  16. Advances in the management of follicular lymphoma.

    Science.gov (United States)

    Seiler, Till M; Hiddemann, Wolfgang

    2012-11-01

    Antibody-based therapy has revolutionized treatment strategies in follicular lymphoma. This review focuses on current standards and recent innovations in the management of the disease. Understanding the mechanism of action of antibodies led to the development of next generation CD20 antibodies, antibodies targeting other molecules and bispecific antibodies. With obinutuzumab, a promising next generation of CD20 antibodies has entered phase III of clinical trials. The bispecific T-cell engager blinatumomab combines targeted therapy with immunologic activation of T cells exerting cytotoxic activity on the target cells. Apart from antibodies, small molecules targeting key pathways in lymphoma have shown promising activity in vitro and are currently in clinical development. A wealth of new substances has entered various stages of clinical trials and has yet to show superiority over rituximab-based immunochemotherapy. Intelligent therapeutic regimens containing these drugs have to be developed. Large randomized trials comparing promising treatment options are urgently needed.

  17. Emergency management of ureteral stones: Recent advances

    Directory of Open Access Journals (Sweden)

    Luis Osorio

    2008-01-01

    Full Text Available Most ureteral stones can be observed with reasonable expectation of uneventful stone passage. When an active ureteral stone treatment is warranted, the best procedure to choose is dependent on several factors, besides stone size and location, including operators′ experience, patients′ preference, available equipment and related costs. Placement of double-J stent or nephrostomy tube represents the classical procedures performed in a renal colic due to acute ureteral obstruction when the conservative drug therapy does not resolve the symptoms. These maneuvers are usually followed by ureteroscopy or extracorporeal shockwave lithotripsy, which currently represent the mainstay of treatment for ureteral stones. In this review paper a literature search was performed to identify reports dealing with emergency management of renal colic due to ureteral stones. The main aspects related to this debated issue are analyzed and the advantages and disadvantages of each treatment option are carefully discussed.

  18. Emergency management of ureteral stones: Recent advances.

    Science.gov (United States)

    Osorio, Luis; Lima, Estêvão; Autorino, Riccardo; Marcelo, Filinto

    2008-10-01

    Most ureteral stones can be observed with reasonable expectation of uneventful stone passage. When an active ureteral stone treatment is warranted, the best procedure to choose is dependent on several factors, besides stone size and location, including operators' experience, patients' preference, available equipment and related costs. Placement of double-J stent or nephrostomy tube represents the classical procedures performed in a renal colic due to acute ureteral obstruction when the conservative drug therapy does not resolve the symptoms. These maneuvers are usually followed by ureteroscopy or extracorporeal shockwave lithotripsy, which currently represent the mainstay of treatment for ureteral stones. In this review paper a literature search was performed to identify reports dealing with emergency management of renal colic due to ureteral stones. The main aspects related to this debated issue are analyzed and the advantages and disadvantages of each treatment option are carefully discussed.

  19. Advanced communication skills: conflict management and persuasion.

    Science.gov (United States)

    Ang, Marigene

    2002-11-01

    There is an increasing need in the medical school curriculum to adequately prepare students for professionalism in the workplace. This senior seminar is a four-week course designed to develop fluency in handling conflict and negotiation as well as understanding the elements of persuasive communication. Students used the Meyers-Brigg Personality Inventory as a paradigm for understanding different communication styles. The class was piloted in October and November 2001 and consisted of four modules. In module one, each student was given the Meyers-Brigg Personality Inventory to take. Discussions and exercises provided insight into the student's own communication style as well as styles the individual student might find more problematic. The second module consisted of four sessions focusing on conflict management and negotiating skills. Students were given strategies for dealing with conflict as well as specific approaches for communicating with "difficult" patients. In the subsequent sessions, students had a chance to further incorporate these strategies by (1) discussing in a small-group setting a conflict situation that they had either witnessed or experienced in order to systematically evaluate how to incorporate conflict-management approaches into their particular communication style. (2) Role-playing four conflict situations students' were likely to encounter in their professional lives. Role-plays were videotaped and individual feedback was given immediately after the role-play by the observing students, the patient-actor, and the evaluator, who had been trained to give specific feedback on the conflict strategies. (3) Watching specific videotaped role-plays as a class allowed students to see and give feedback on particularly effective strategies that their colleagues used. The third module was devoted to giving bad news and ways that different people prefer to receive bad news, using the MBTI personality types as examples. The final module outlined the

  20. Decision support tools for advanced energy management

    International Nuclear Information System (INIS)

    Marik, Karel; Schindler, Zdenek; Stluka, Petr

    2008-01-01

    Rising fuel costs boost energy prices, which is a driving force for improving efficiency of operation of any energy generation facility. This paper focuses on enhancing the operation of distributed integrated energy systems (IES), system that bring together all forms of cooling, heating and power (CCHP) technologies. Described methodology can be applied in power generation and district heating companies, as well as in small-scale systems that supply multiple types of utilities to consumers in industrial, commercial, residential and governmental spheres. Dispatching of such system in an optimal way needs to assess large number of production and purchasing schemes in conditions of continually changing market and variable utility demands influenced by many external factors, very often by weather conditions. The paper describes a combination of forecasting and optimization methods that supports effective decisions in IES system management. The forecaster generates the future most probable utility demand several hours or days ahead, derived from the past energy consumer behaviour. The optimizer generates economically most efficient operating schedule for the IES system that matches these forecasted energy demands and respects expected purchased energy prices. (author)

  1. Development of advanced JGIS considering qualify management and project management

    International Nuclear Information System (INIS)

    Kawachi, Susumu; Ohi, Takao; Kawamura, Makoto; Ishihara, Yoshinao; Ebina, Takanori

    2008-03-01

    A system for managing and integrating the technical information of R and D was developed (JGIS: JAEA Geological Disposal Information Integration System). The subjects are to improve the usability as the system and the usability to record the information and the data in order to display the function of the system sufficiently and in order to enable the practical use of the system. In this study the aims are to display the function of JGIS and to enable the researchers as the users to recognize the significance of using JGIS. We built the conceptual design in order to implement the function of quality management and project management to JGIS. We considered that researchers could access the portal site of the research projects which were set as the WBS (Work Breakdown Structure) items and could confirm which WBS item the research project belonged to in the whole plan. We also considered that the research projects could be managed by using the conformity assessment sheets which were adopted for the quality management. The appendix contains the example of application of real projects to JGIS and the user's manual of JGIS (Example of a study of potential impact of natural phenomena). We demonstrated that researchers could confirm which WBS item the research project related to in JGIS and could manage the quality of the research projects by using the conformity assessment sheets in JGIS. (author)

  2. Autism Spectrum Disorders - Diagnosis and Management.

    Science.gov (United States)

    Mukherjee, Sharmila Banerjee

    2017-04-01

    Autism Spectrum Disorder (ASD) is a neuro-developmental disorder commonly seen in children. It is characterized by age inappropriate, impaired social communication and the presence of stereotypic behavior. This disorder is hypothesized to result from cerebral dysfunction arising from a complex interaction between genetic, epigenetic and environmental factors. ASD should be suspected in children failing ASD specific screening tests, in the presence of red flags in social, language and/or play domains, in children with developmental or language delay, abnormal behavior, poor school performance or in those who are at high risk. Comprehensive assessment comprises of a step-wise approach that includes taking a detailed history, performing a holistic examination and observing the child closely in relation to play, social interaction and behavior. Diagnosis is established by application of the diagnostic criteria for ASD of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM V). The degree of severity, intellectual and language impairment and presence of other illnesses should be specified. Functional assessment identifies an individual's strengths and weaknesses. All these are important to formulate a customized intervention plan along with the family. The goal is to build up skills enabling optimal and as far as possible normal functioning while simultaneously reducing maladaptive behavior. This is achieved by a multi-disciplinary team comprising of various personnel experienced in tackling issues in ASD related to their respective areas of expertise. Intervention is primarily non-pharmacological, based on behavioral modification strategies. Drugs are only indicated in the reduction of target symptoms refractory to behavioral intervention. Although there is no cure, timely and appropriate intervention can improve the quality of life significantly.

  3. Advanced information processing system: Input/output network management software

    Science.gov (United States)

    Nagle, Gail; Alger, Linda; Kemp, Alexander

    1988-01-01

    The purpose of this document is to provide the software requirements and specifications for the Input/Output Network Management Services for the Advanced Information Processing System. This introduction and overview section is provided to briefly outline the overall architecture and software requirements of the AIPS system before discussing the details of the design requirements and specifications of the AIPS I/O Network Management software. A brief overview of the AIPS architecture followed by a more detailed description of the network architecture.

  4. A computer program for estimating the power-density spectrum of advanced continuous simulation language generated time histories

    Science.gov (United States)

    Dunn, H. J.

    1981-01-01

    A computer program for performing frequency analysis of time history data is presented. The program uses circular convolution and the fast Fourier transform to calculate power density spectrum (PDS) of time history data. The program interfaces with the advanced continuous simulation language (ACSL) so that a frequency analysis may be performed on ACSL generated simulation variables. An example of the calculation of the PDS of a Van de Pol oscillator is presented.

  5. Tree crops: Advances in insects and disease management

    Science.gov (United States)

    Advances in next-generation sequencing have enabled genome sequencing to be fast and affordable. Thus today researchers and industries can address new methods in pest and pathogen management. Biological control of insect pests that occur in large areas, such as forests and farming systems of fruit t...

  6. 28 RECENT ADVANCES IN THE MANAGEMENT OF CEREBRO ...

    African Journals Online (AJOL)

    drclement

    have been falling dramatically in recent decades in developed nations, ... 1 December, 2007. Recent Advances In The Management Of Cerebro-Vascular Accident. 29 unlikely to be related to the changing risk factor levels over time. Stroke Types. Stroke is caused .... CADASIL, which stands for cerebral autosomal dominant ...

  7. The ATF [Advanced Toroidal Facility] Data Management System: [Final report

    International Nuclear Information System (INIS)

    Kannan, K.L.; Baylor, L.R.

    1987-01-01

    The Advanced Toroidal Facility (ATF) Data Management System (DMG) is a VAX-based software system that provides unified data access for ATF data acquisition and analysis. The system was designed with user accessibility, software maintainability, and extensibility as primary goals. This paper describes the layered architecture of the system design, the system implementation, use, and the data file structure. 3 refs., 1 fig

  8. Advanced nuclear fuel cycles and radioactive waste management

    International Nuclear Information System (INIS)

    2006-01-01

    This study analyses a range of advanced nuclear fuel cycle options from the perspective of their effect on radioactive waste management policies. It presents various fuel cycle options which illustrate differences between alternative technologies, but does not purport to cover all foreseeable future fuel cycles. The analysis extends the work carried out in previous studies, assesses the fuel cycles as a whole, including all radioactive waste generated at each step of the cycles, and covers high-level waste repository performance for the different fuel cycles considered. The estimates of quantities and types of waste arising from advanced fuel cycles are based on best available data and experts' judgement. The effects of various advanced fuel cycles on the management of radioactive waste are assessed relative to current technologies and options, using tools such as repository performance analysis and cost studies. (author)

  9. Advanced chemistry management system for nuclear power plants

    International Nuclear Information System (INIS)

    Maeda, Katsuji; Kobayashi, Yasuhiro; Nagasawa, Katsumi

    2000-01-01

    Chemistry control in a boiling water reactor (BWR) plant has a close relationship with radiation field buildup, fuel reliability, integrity of plant components and materials, performance of the water treatment systems and radioactive waste generation. Chemistry management in BWR plants has become more important in order to maintain and enhance plant reliability. Adequate chemistry control and management are also essential to establish, maintain, and enhance plant availability. For these reasons, we have developed the advanced chemistry management system for nuclear power plants in order to effectively collect and evaluate a large number of plant operating and chemistry data. (author)

  10. The business model impact of flexible spectrum management and cognitive networks

    NARCIS (Netherlands)

    Delaere, S.; Ballon, P.

    2007-01-01

    Purpose - This paper aims to give a short overview of European Union policy trends towards more flexible forms of spectrum management. Design/methodology/approach - The paper presents a business modelling analysis, scenario construction, policy analysis and roadmapping. It argues that both flexible

  11. Gender Differences in Co-Morbid Psychopathology and Clinical Management in Adults with Autism Spectrum Disorders

    Science.gov (United States)

    Tsakanikos, Elias; Underwood, Lisa; Kravariti, Eugenia; Bouras, Nick; McCarthy, Jane

    2011-01-01

    The present study examined rates of co-morbid psychopathology and clinical management/care pathways in adult females (N = 50) and males (N = 100) with autism spectrum disorders (ASD) and intellectual disability (ID) living in community settings. We also compared a sub-sample (N = 60) with ASD to an age-, gender- and ID-matched control group (N =…

  12. Integrated Common Radio Resource Management with Spectrum Aggregation over Non-Contiguous Frequency Bands

    DEFF Research Database (Denmark)

    Cabral, Orlando; Meucci, Filippo; Mihovska, Albena D.

    2011-01-01

    This paper proposes an integrated Common Radio Resource Management (iCRRM). The iCRRM performs classic CRRM functionalities jointly with Spectrum Aggregation (SA), being able to switch users between non-contiguous frequency bands. The SA scheduling is obtained with an optimised General Multi...

  13. Using Self-Management to Improve the Reciprocal Social Conversation of Children with Autism Spectrum Disorder

    Science.gov (United States)

    Koegel, Lynn Kern; Park, Mi N.; Koegel, Robert L.

    2014-01-01

    Individuals with autism spectrum disorders often exhibit difficulties with reciprocal social conversation, engaging in limited verbal exchanges, even when language structures are intact. This study employed a multiple baseline design to examine the effectiveness of a self-management intervention targeting (1) on-topic responsiveness to a…

  14. Self-Management for Children with High-Functioning Autism Spectrum Disorders

    Science.gov (United States)

    Wilkinson, Lee A.

    2008-01-01

    Supporting children with autism spectrum disorders in the general education classroom presents a unique challenge to the teachers and schools that serve them. This article addresses the utility of self-management as a proactive strategy for increasing the task engagement and compliant behavior of high-functioning students with autism. The author…

  15. Use of advanced magnetic resonance imaging techniques in neuromyelitis optica spectrum disorder

    NARCIS (Netherlands)

    S. Kremer (Stephane); F. Renard (Felix); S. Achard (Sophie); M.A. Lana-Peixoto (Marco A.); J. Palace (Jacqueline); N. Asgari (Nasrin); E.C. Klawiter (Eric C.); S. Tenembaum (Silvia); B. Banwell (Brenda); B.M. Greenberg (Benjamin M.); J.L. Bennett (Jeffrey); M. Levy (Michael); P. Villoslada (Pablo); A. Saiz (Albert Abe); K. Fujihara (Kazuo); K.H. Chan (Koon Ho); S. Schippling (Sven); F. Paul (Friedemann); H.J. Kim (Ho Jin); J. De Seze (Jerome); J.T. Wuerfel (Jens T.); P. Cabre (Philippe); R. Marignier (Romain); T. Tedder (Thomas); E.D. van Pelt - Gravesteijn (Daniëlle); S. Broadley (Simon); T. Chitnis (Tanuja); D. Wingerchuk (Dean); L. Pandit (Lekha); M.I. Leite (M. Isabel); M. Apiwattanakul (Metha); I. Kleiter (Ingo); N. Prayoonwiwat (Naraporn); M. Han (May); K. Hellwig (Kerstin); K. Van Herle (Katja); G. John (Gareth); D.C. Hooper (D. Craig); I. Nakashima (Ichiro); D. Sato (Douglas); M.R. Yeaman (Michael R.); E. Waubant (Emmanuelle); S. Zamvil (Scott); O. Stüve (Olaf); O. Aktas (Orhan); T.J. Smith (Terry J.); A. Jacob (Anu); K. O'Connor (Kevin)

    2015-01-01

    textabstractBrain parenchymal lesions are frequently observed on conventional magnetic resonance imaging (MRI) scans of patients with neuromyelitis optica (NMO) spectrum disorder, but the specific morphological and temporal patterns distinguishing them unequivocally from lesions caused by other

  16. Methods for studying fuel management in advanced gas cooled reactors

    International Nuclear Information System (INIS)

    Buckler, A.N.; Griggs, C.F.; Tyror, J.G.

    1971-07-01

    The methods used for studying fuel and absorber management problems in AGRs are described. The basis of the method is the use of ARGOSY lattice data in reactor calculations performed at successive time steps. These reactor calculations may be quite crude but for advanced design calculations a detailed channel-by-channel representation of the whole core is required. The main emphasis of the paper is in describing such an advanced approach - the ODYSSEUS-6 code. This code evaluates reactor power distributions as a function of time and uses the information to select refuelling moves and determine controller positions. (author)

  17. Advance simulation capability for environmental management (ASCEM) - 59065

    International Nuclear Information System (INIS)

    Dixon, Paul; Keating, Elizabeth; Moulton, David; Williamson, Mark; Collazo, Yvette; Gerdes, Kurt; Freshley, Mark; Gorton, Ian; Meza, Juan

    2012-01-01

    The United States Department Energy (DOE) Office of Environmental Management (EM) determined that uniform application of advanced modeling in the subsurface could help reduce the cost and risks associated with its environmental cleanup mission. In response to this determination, the EM Office of Technology Innovation and Development (OTID), Groundwater and Soil Remediation (GW and S) began the program Advanced Simulation Capability for Environmental Management (ASCEM). ASCEM is a state-of-the-art scientific tool and approach for integrating data and scientific understanding to enable prediction of contaminant fate and transport in natural and engineered systems. This initiative supports the reduction of uncertainties and risks associated with EM?s environmental cleanup and closure programs through better understanding and quantifying the subsurface flow and contaminant transport behavior in complex geological systems. This involves the long-term performance of engineered components, including cementitious materials in nuclear waste disposal facilities that may be sources for future contamination of the subsurface. This paper describes the ASCEM tools and approach and the ASCEM programmatic accomplishments completed in 2010 including recent advances and technology transfer. The US Department of Energy Office of Environmental Management has begun development of an Advanced Simulation Capability for Environmental Management, (ASCEM). This program will provide predictions of the end states of contaminated areas allowing for cost and risk reduction of EM remedial activities. ASCEM will provide the tools and approaches necessary to standardize risk and performance assessments across the DOE complex. Through its Phase One demonstration, the ASCEM team has shown value to the EM community in the areas of High Performance Computing, Data Management, Visualization, and Uncertainty Quantification. In 2012, ASCEM will provide an initial limited release of a community code for

  18. Management Strategies in Advanced Uterine Leiomyosarcoma: Focus on Trabectedin

    Directory of Open Access Journals (Sweden)

    Frédéric Amant

    2015-01-01

    Full Text Available The treatment of advanced uterine leiomyosarcomas (U-LMS represents a considerable challenge. Radiological diagnosis prior to hysterectomy is difficult, with the diagnosis frequently made postoperatively. Whilst a total abdominal hysterectomy is the cornerstone of management of early disease, the role of routine adjuvant pelvic radiotherapy and adjuvant chemotherapy is less clear, since they may improve local tumor control in high risk patients but are not associated with an overall survival benefit. For recurrent or disseminated U-LMS, cytotoxic chemotherapy remains the mainstay of treatment. There have been few active chemotherapy drugs approved for advanced disease, although newer drugs such as trabectedin with its pleiotropic mechanism of actions represent an important addition to the standard front-line systemic therapy with doxorubicin and ifosfamide. In this review, we outline the therapeutic potential and in particular the emerging evidence-based strategy of therapy with trabectedin in patients with advanced U-LMS.

  19. Advanced information technology for training and emergency management

    International Nuclear Information System (INIS)

    Wahlstroem, B.

    1989-01-01

    Modern information technology provides many possibilities for improving both the safety and the availability of nuclear installations. A Nordic research programme was started in 1977, in which several organizations in Denmark, Finland, Norway and Sweden has been participating. The work has on a general level been addressing control rooms, human reliability and information technology for nuclear power plants. The research has had impact on the development of the control room solutions and the training simulators in Finland and also in the other Nordic countries. The present phase of the Nordic cooperation is investigating the use of advanced information technology in emergency management. The paper gives a brief introduction to the use of advance information technology for training and emergency management, which is based on the experience from the Nordic projects and other similar application projects in Finland. The paper includes also references to results from several of the projects. (author)

  20. Regulatory Risk Management of Advanced Nuclear Power Plants

    International Nuclear Information System (INIS)

    George, Glenn R.

    2002-01-01

    Regulatory risk reflects both the likelihood of adverse outcomes during regulatory interactions and the severity of those outcomes. In the arena of advanced nuclear power plant licensing and construction, such adverse outcomes may include, for example, required design changes and construction delays. These, in turn, could significantly affect the economics of the plant and the generation portfolio in which it will operate. In this paper, the author addresses these issues through the lens of risk management. The paper considers various tools and techniques of regulatory risk management, including design diversity and hedging strategies. The effectiveness of alternate approaches is weighed and recommendations are made in several regulatory contexts. (author)

  1. Advanced safety management systems for maintenance of pipeline integrity

    International Nuclear Information System (INIS)

    Borysiewicz, M.; Potempski, S.

    2005-01-01

    One of the duties of the pipeline's operator is to introduce means for protection of human safety and the environment. This should be reflected in preparation of comprehensive Risk Management System with its key element Activity Programme for Management of Pipeline Integrity. In the paper such programme has been described taking into account law regulations and practical activities undertaken in technologically advanced countries (mainly USA and EU), where such solutions are implemented in routine operations. Possible solutions of realization of all elements of the programme, as well as information on utilization of computer aided support have been also included. (authors)

  2. Advanced Inverter Functions and Communication Protocols for Distribution Management

    Energy Technology Data Exchange (ETDEWEB)

    Nagarajan, Adarsh; Palmintier, Bryan; Baggu, Murali

    2016-05-05

    This paper aims at identifying the advanced features required by distribution management systems (DMS) service providers to bring inverter-connected distributed energy resources into use as an intelligent grid resource. This work explores the standard functions needed in the future DMS for enterprise integration of distributed energy resources (DER). The important DMS functionalities such as DER management in aggregate groups, including the discovery of capabilities, status monitoring, and dispatch of real and reactive power are addressed in this paper. It is intended to provide the industry with a point of reference for DER integration with other utility applications and to provide guidance to research and standards development organizations.

  3. Advanced materials for thermal management of electronic packaging

    CERN Document Server

    Tong, Xingcun Colin

    2011-01-01

    The need for advanced thermal management materials in electronic packaging has been widely recognized as thermal challenges become barriers to the electronic industry's ability to provide continued improvements in device and system performance. With increased performance requirements for smaller, more capable, and more efficient electronic power devices, systems ranging from active electronically scanned radar arrays to web servers all require components that can dissipate heat efficiently. This requires that the materials have high capability of dissipating heat and maintaining compatibility

  4. Scalable Multi-group Key Management for Advanced Metering Infrastructure

    OpenAIRE

    Benmalek , Mourad; Challal , Yacine; Bouabdallah , Abdelmadjid

    2015-01-01

    International audience; Advanced Metering Infrastructure (AMI) is composed of systems and networks to incorporate changes for modernizing the electricity grid, reduce peak loads, and meet energy efficiency targets. AMI is a privileged target for security attacks with potentially great damage against infrastructures and privacy. For this reason, Key Management has been identified as one of the most challenging topics in AMI development. In this paper, we propose a new Scalable multi-group key ...

  5. Priorities for Advancing Research on Youth with Autism Spectrum Disorder and Co-Occurring Anxiety

    Science.gov (United States)

    Vasa, Roma A.; Keefer, Amy; Reaven, Judy; South, Mikle; White, Susan W.

    2018-01-01

    Research on anxiety disorders in youth with autism spectrum disorder (ASD) has burgeoned in the past two decades. Yet, critical gaps exist with respect to measuring and treating anxiety in this population. This study used the nominal group technique to identify the most important research priorities on co-occurring anxiety in ASD. An international…

  6. Idiom, Syntax, and Advanced Theory of Mind Abilities in Children with Autism Spectrum Disorders

    Science.gov (United States)

    Whyte, Elisabeth M.; Nelson, Keith E.; Scherf, K. Suzanne

    2014-01-01

    Purpose: When researchers investigate figurative language abilities (including idioms) in children with autism spectrum disorder (ASD), syntax abilities may be more important than once considered. In addition, there are limitations to the overreliance on false-belief tasks to measure theory of mind (TOM) abilities. In the current study, the…

  7. Self-organized spectrum chunk selection algorithm for Local Area LTE-Advanced

    DEFF Research Database (Denmark)

    Kumar, Sanjay; Wang, Yuanye; Marchetti, Nicola

    2010-01-01

    This paper presents a self organized spectrum chunk selection algorithm in order to minimize the mutual intercell interference among Home Node Bs (HeNBs), aiming to improve the system throughput performance compared to the existing frequency reuse one scheme. The proposed algorithm is useful...

  8. Advancing early detection of autism spectrum disorder by applying an integrated two-stage screening approach

    NARCIS (Netherlands)

    Oosterling, Iris J.; Wensing, Michel; Swinkels, Sophie H.; van der Gaag, Rutger Jan; Visser, Janne C.; Woudenberg, Tim; Minderaa, Ruud; Steenhuis, Mark-Peter; Buitelaar, Jan K.

    Background: Few field trials exist on the impact of implementing guidelines for the early detection of autism spectrum disorders (ASD). The aims of the present study were to develop and evaluate a clinically relevant integrated early detection programme based on the two-stage screening approach of

  9. DSM-V Changes for Autism Spectrum Disorder (ASD): Implications for Diagnosis, Management, and Care Coordination for Children With ASDs.

    Science.gov (United States)

    Lobar, Sandra L

    2016-01-01

    The purpose of this article is to highlight issues about diagnosis and management of autism spectrum disorders (ASDs) in all settings, along with care coordination for all children with ASDs. The article outlines differences between the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 4th edition, revised (DSM-IV-TR) and the newer version (DSM-V) for ASDs. These changes may limit the eligibility of some children for services in school, leading to poorer social/academic outcomes, lower rates of employment, and decreased assistance in eventual independent living. Primary care providers identified a lack of knowledge regarding ASDs before the DSM-V was published, describing difficulty in making ASD diagnoses, recognizing early symptoms of developmental concern, and managing care. Care coordination is part of the role of the advanced practice nurse, and lack of understanding of ASD changes in the DSM-V may diminish the ability of advanced practice nurses to screen for ASDs and make the appropriate referrals. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  10. Structural integrity analyses: can we manage the advances?

    International Nuclear Information System (INIS)

    Sauve, R.

    2006-01-01

    Engineering has been one of a number of disciplines in which significant advances in analysis procedures has taken place in the last two decades. In particular, advances in computer technology and engineering software have revolutionized the assessment of component structural integrity for a wide range of applications. A significant development in computational mechanics directly related to computer technology that has had a profound impact on the field of structural integrity is the finite element method. The finite element method has re-defined and expanded the role of structural integrity assessments by providing comprehensive modelling capabilities to engineers involved in design and failure analyses. As computer processing speeds and capacity have increased, so has the role of computer modelling in assessments of component structural integrity. With new product development cycles shrinking, the role of initial testing is being reduced in favour of computer modelling and simulation to assess component life and durability. For ageing structures, the evaluation of remaining life and the impact of degraded structural integrity becomes tractable with the modern advances in computational methods. The areas of structural integrity that have derived great benefit from the advances in numerical techniques include stress analysis, fracture mechanics, dynamics, heat transfer, structural reliability, probabilistic methods and continuum mechanics in general. One of the salient features of the current methods is the ability to handle large complex steady state or transient dynamic problems that exhibit highly non-linear behaviour. With the ever-increasing usage of these advanced methods, the question is posed: Can we manage the advances? Better still are we managing the advances? As with all technological advances that enter mainstream use, comes the need for education, training and certification in the application of these methods, improved quality assurance procedures and

  11. The ITU and managing satellite orbital and spectrum resources in the 21st century

    CERN Document Server

    Allison, Audrey L

    2014-01-01

    Access to satellite orbits and spectrum is managed by the ITU, a United Nations body that strives to extend the benefits of new technologies to the world, while ensuring equitable access to these resources. This book explores how the ITU approaches these dual missions in light of the increasing saturation of the geostationary orbit by a vibrant global satellite industry and the rising interests of developing countries in accessing these limited resources. These issues were the subject of debate at the 2012 World Radiocommunication Conference. This book describes and assesses various regulatory approaches undertaken to manage the increasing requests for access to space and especially access to spectrum and orbital locations in the geosynchronous or “The Clarke” orbit.

  12. Advanced methods of microscope control using μManager software.

    Science.gov (United States)

    Edelstein, Arthur D; Tsuchida, Mark A; Amodaj, Nenad; Pinkard, Henry; Vale, Ronald D; Stuurman, Nico

    μManager is an open-source, cross-platform desktop application, to control a wide variety of motorized microscopes, scientific cameras, stages, illuminators, and other microscope accessories. Since its inception in 2005, μManager has grown to support a wide range of microscopy hardware and is now used by thousands of researchers around the world. The application provides a mature graphical user interface and offers open programming interfaces to facilitate plugins and scripts. Here, we present a guide to using some of the recently added advanced μManager features, including hardware synchronization, simultaneous use of multiple cameras, projection of patterned light onto a specimen, live slide mapping, imaging with multi-well plates, particle localization and tracking, and high-speed imaging.

  13. The development of an advanced information management system

    International Nuclear Information System (INIS)

    Kim, Seung Hwan

    2005-01-01

    Performing a PSA requires a lot of data to analyze, to evaluate the risk, to trace the process of results and to verify the results. KAERI is developing a PSA information database system, AIMS (Advanced Information Management System for PSA). The objective of AIMS development is to integrate and computerize all the distributed information of a PSA into a system and to enhance the accessibility to PSA information for all PSA related activities. We designed the PSA information database system for the following purposes: integrated PSA information management software, sensitivity analysis, quality assurance, anchor to another reliability database. The AIMS consists of a PSA Information database, Information browsing (searching) modules, and PSA automatic quantification manager modules

  14. Advances in battery manufacturing, service, and management systems

    CERN Document Server

    Zhou, Shiyu; Han, Yehui

    2016-01-01

    This book brings together experts in the field to highlight the cutting edge research advances in BM2S2 and to promote an innovative integrated research framework responding to the challenges. There are three major parts included in this book: manufacturing, service, and management. The first part focuses on battery manufacturing systems, including modeling, analysis, design and control, as well as economic and risk analyses. The second part focuses on information technology’s impact on service systems, such as data-driven reliability modeling, failure prognosis, and service decision making methodologies for battery services. The third part addresses battery management systems (BMS) for control and optimization of battery cells, opera ions, and hybrid storage systems to ensure overall performance and safety, as well as EV management.

  15. Advanced methods of microscope control using μManager software

    Directory of Open Access Journals (Sweden)

    Arthur D Edelstein

    2014-07-01

    Full Text Available µManager is an open-source, cross-platform desktop application, to control a wide variety of motorized microscopes, scientific cameras, stages, illuminators, and other microscope accessories. Since its inception in 2005, µManager has grown to support a wide range of microscopy hardware and is now used by thousands of researchers around the world. The application provides a mature graphical user interface and offers open programming interfaces to facilitate plugins and scripts. Here, we present a guide to using some of the recently added advanced µManager features, including hardware synchronization, simultaneous use of multiple cameras, projection of patterned light onto a specimen, live slide mapping, imaging with multi-well plates, particle localization and tracking, and high-speed imaging.

  16. Water quality management of aquifer recharge using advanced tools.

    Science.gov (United States)

    Lazarova, Valentina; Emsellem, Yves; Paille, Julie; Glucina, Karl; Gislette, Philippe

    2011-01-01

    Managed aquifer recharge (MAR) with recycled water or other alternative resources is one of the most rapidly growing techniques that is viewed as a necessity in water-short areas. In order to better control health and environmental effects of MAR, this paper presents two case studies demonstrating how to improve water quality, enable reliable tracing of injected water and better control and manage MAR operation in the case of indirect and direct aquifer recharge. Two water quality management strategies are illustrated on two full-scale case studies, including the results of the combination of non conventional and advanced technologies for water quality improvement, comprehensive sampling and monitoring programs including emerging pollutants, tracer studies using boron isotopes and integrative aquifer 3D GIS hydraulic and hydrodispersive modelling.

  17. The development of an advanced information management system

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Hwan [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    2005-07-01

    Performing a PSA requires a lot of data to analyze, to evaluate the risk, to trace the process of results and to verify the results. KAERI is developing a PSA information database system, AIMS (Advanced Information Management System for PSA). The objective of AIMS development is to integrate and computerize all the distributed information of a PSA into a system and to enhance the accessibility to PSA information for all PSA related activities. We designed the PSA information database system for the following purposes: integrated PSA information management software, sensitivity analysis, quality assurance, anchor to another reliability database. The AIMS consists of a PSA Information database, Information browsing (searching) modules, and PSA automatic quantification manager modules.

  18. Anesthetic management of a child with autistic spectrum disorder and homocysteinemia

    Directory of Open Access Journals (Sweden)

    Deepak Choudhary

    2016-01-01

    Full Text Available Autistic spectrum disorder (ASD is a developmental disability of the central nervous system with rapid worsening. A subset of patients also has mitochondrial dysfunction leading to increased sensitivity to various anesthetic agents. Rarely, gene mutation in these patients results in homocysteinemia which causes higher incidences of thromboembolism, hypoglycemia, and seizures. Anesthetic management of ASD with homocysteinemia and refractory seizures has not been previously reported.

  19. Spectrum Management and Electromagnetic Compatibility Issues in the Department of Defense

    Science.gov (United States)

    1991-01-01

    Interference JEWC Joint Electronic Warfare Center JRFL Joint Restricted Frequency List JSMS Joint Spectrum Management System JT&E Joint Test and Evaluation JTAC...Joint Restricted Frequency List (JRFL) is essentially a list of frequencies prohibited from use by ECM units. Creation and maintenance of the JRFL to...sponsored by CECOM, developed a prototype that primarily acted as an analysis of the restricted frequency list as a predecessor to DECON. Presently the Army

  20. Adaptive management for improving species conservation across the captive-wild spectrum

    Science.gov (United States)

    Canessa, Stefano; Guillera-Arroita, Gurutzeta; Lahoz-Monfort, José J.; Southwell, Darren M; Armstrong, Doug P.; Chadès, Iadine; Lacy, Robert C; Converse, Sarah J.

    2016-01-01

    Conservation of endangered species increasingly envisages complex strategies that integrate captive and wild management actions. Management decisions in this context must be made in the face of uncertainty, often with limited capacity to collect information. Adaptive management (AM) combines management and monitoring, with the aim of updating knowledge and improving decision-making over time. We provide a guide for managers who may realize the potential of AM, but are unsure where to start. The urgent need for iterative management decisions, the existence of uncertainty, and the opportunity for learning offered by often highly-controlled captive environments create favorable conditions for AM. However, experiments and monitoring may be complicated by small sample sizes, and the ability to control the system, including stochasticity and observability, may be limited toward the wild end of the spectrum. We illustrate the key steps to implementing AM in threatened species management using four case studies, including the management of captive programs for cheetah (Acinonyx jubatus) and whooping cranes (Grus americana), of a translocation protocol for Arizona cliffroses Purshia subintegra and of ongoing supplementary feeding of reintroduced hihi (Notiomystis cincta) populations. For each case study, we explain (1) how to clarify whether the decision can be improved by learning (i.e. it is iterative and complicated by uncertainty) and what the management objectives are; (2) how to articulate uncertainty via alternative, testable hypotheses such as competing models or parameter distributions; (3) how to formally define how additional information can be collected and incorporated in future management decisions.

  1. Advanced chemistry management system to optimize BWR chemistry control

    International Nuclear Information System (INIS)

    Maeda, K.; Nagasawa, K.

    2002-01-01

    BWR plant chemistry control has close relationships among nuclear safety, component reliability, radiation field management and fuel integrity. Advanced technology is required to improve chemistry control [1,3,6,7,10,11]. Toshiba has developed TACMAN (Toshiba Advanced Chemistry Management system) to support BWR chemistry control. The TACMAN has been developed as response to utilities' years of requirements to keep plant operation safety, reliability and cost benefit. The advanced technology built into the TACMAN allows utilities to make efficient chemistry control and to keep cost benefit. TACMAN is currently being used in response to the needs for tools those plant chemists and engineers could use to optimize and identify plant chemistry conditions continuously. If an incipient condition or anomaly is detected at early stage, root causes evaluation and immediate countermeasures can be provided. Especially, the expert system brings numerous and competitive advantages not only to improve plant chemistry reliability but also to standardize and systematize know-how, empirical knowledge and technologies in BWR chemistry This paper shows detail functions of TACMAN and practical results to evaluate actual plant. (authors)

  2. Effect of advanced fuel cycles on waste management policies

    International Nuclear Information System (INIS)

    Cavedon, J.M.; Haapalehto, T.

    2005-01-01

    The study aims at analysing a range of future fuel cycle options from the perspective of their impact on waste repository demand and specification. The study would focus on: Assessment of the characteristics of radioactive wastes arising from advanced nuclear fuel cycle options, repository performance analysis studies using source terms for waste arising from such advanced nuclear fuel cycles, identification of new options for waste management and disposal. Three families of fuel cycles having increasing recycling capabilities are assessed. Each cycle is composed of waste generating and management processes. Examples of waste generating processes are fuel factories (7 types) and reprocessing plants (7 types). Packaging and conditioning plants (7) and disposal facilities are examples of waste management processes. The characteristic of all these processes have been described and then total waste flows are summarised. In order to simplify the situation, three waste categories have been defined based on the IAEA definitions in order to emphasize the major effects of different types of waste. These categories are: short-life waste for surface or sub-surface disposal, long-life low heat producing waste for geological disposal, high-level waste for geological disposal. The feasibilities of the fuel cycles are compared in terms of economics, primary resource consumption and amount of waste generated. The effect of high-level waste composition for the repository performance is one of the tools in these comparisons. The results of this will be published as an NEA publication before the end of 2005. (authors)

  3. Development of the Advanced Nuclear Safety Information Management (ANSIM) System

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Jae Min; Ko, Young Cheol; Song, Tai Gil [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2012-05-15

    Korea has become a technically independent nuclear country and has grown into an exporter of nuclear technologies. Thus, nuclear facilities are increasing in significance at KAERI (Korea Atomic Energy Research Institute), and it is time to address the nuclear safety. The importance of nuclear safety cannot be overemphasized. Therefore, a management system is needed urgently to manage the safety of nuclear facilities and to enhance the efficiency of nuclear information. We have established ISP (Information Strategy Planning) for the Integrated Information System of nuclear facility and safety management. The purpose of this paper is to develop a management system for nuclear safety. Therefore, we developed the Advanced Nuclear Safety Information Management system (hereinafter referred to as the 'ANSIM system'). The ANSIM system has been designed and implemented to computerize nuclear safety information for standardization, integration, and sharing in real-time. Figure 1 shows the main home page of the ANSIM system. In this paper, we describe the design requirements, contents, configurations, and utilizations of the ANSIM system

  4. Advances in Technology and Management : Proceedings of the 2012 International Conference on Technology and Management

    CERN Document Server

    2012-01-01

    This book Advances in Technology and Management contains 116 full length papers presented at the International Conference on Technology and Management, held on June 12-13, 2012, Jeju-Island, Korea. The goal of ICTAM 2012 is to bring together researchers working in many different areas of technology and management to foster international collaborations and exchange of new ideas.   This volume can be divided into two sections on the basis of the classification of manuscripts considered. The first section deals with technology. The second section of this volume consists of management.

  5. Advanced construction management for lunar base construction - Surface operations planner

    Science.gov (United States)

    Kehoe, Robert P.

    1992-01-01

    The study proposes a conceptual solution and lays the framework for developing a new, sophisticated and intelligent tool for a lunar base construction crew to use. This concept integrates expert systems for critical decision making, virtual reality for training, logistics and laydown optimization, automated productivity measurements, and an advanced scheduling tool to form a unique new planning tool. The concept features extensive use of computers and expert systems software to support the actual work, while allowing the crew to control the project from the lunar surface. Consideration is given to a logistics data base, laydown area management, flexible critical progress scheduler, video simulation of assembly tasks, and assembly information and tracking documentation.

  6. Performance assessment of advanced engineering workstations for fuel management applications

    International Nuclear Information System (INIS)

    Turinsky, P.J.

    1989-07-01

    The purpose of this project was to assess the performance of an advanced engineering workstation [AEW] with regard to applications to incore fuel management for LWRs. The attributes of most interest to us that define an AEW are parallel computational hardware and graphics capabilities. The AEWs employed were super microcomputers manufactured by MASSCOMP, Inc. These computers utilize a 32-bit architecture, graphics co-processor, multi-CPUs [up to six] attached to common memory and multi-vector accelerators. 7 refs., 33 figs., 4 tabs

  7. Advanced fuels for plutonium management in pressurized water reactors

    International Nuclear Information System (INIS)

    Vasile, A.; Dufour, Ph.; Golfier, H.; Grouiller, J.P.; Guillet, J.L.; Poinot, Ch.; Youinou, G.; Zaetta, A.

    2003-01-01

    Several fuel concepts are under investigation at CEA with the aim of manage plutonium inventories in pressurized water reactors. This options range from the use of mature technologies like MOX adapted in the case of MOX-EUS (enriched uranium support) and COmbustible Recyclage A ILot (CORAIL) assemblies to more innovative technologies using IMF like DUPLEX and advanced plutonium assembly (APA). The plutonium burning performances reported to the electrical production go from 7 to 60 kg (TW h) -1 . More detailed analysis covering economic, sustainability, reliability and safety aspects and their integration in the whole fuel cycle would allow identifying the best candidate

  8. Managing complex, high risk projects a guide to basic and advanced project management

    CERN Document Server

    Marle, Franck

    2016-01-01

    Maximizing reader insights into project management and handling complexity-driven risks, this book explores propagation effects, non-linear consequences, loops, and the emergence of positive properties that may occur over the course of a project. This book presents an introduction to project management and analysis of traditional project management approaches and their limits regarding complexity. It also includes overviews of recent research works about project complexity modelling and management as well as project complexity-driven issues. Moreover, the authors propose their own new approaches, new methodologies and new tools which may be used by project managers and/or researchers and/or students in the management of their projects. These new elements include project complexity definitions and frameworks, multi-criteria approaches for project complexity measurement, advanced methodologies for project management (propagation studies to anticipate potential behaviour of the project, and clustering approaches...

  9. Exploring the Components of Advanced Theory of Mind in Autism Spectrum Disorder

    Science.gov (United States)

    Pedreño, C.; Pousa, E.; Navarro, J. B.; Pàmias, M.; Obiols, J. E.

    2017-01-01

    Performance of a group of 35 youth and adults with High-Functioning Autism (HFA) was compared with a typical developing (TD) group on three Advanced Theory of Mind tests. The distinction between the social-cognitive and social-perceptual components of Theory of Mind was also explored. The HFA group had more difficulties in all tasks. Performance…

  10. The Effects of a Dynamic Spectrum Access Overlay in LTE-Advanced Networks

    Energy Technology Data Exchange (ETDEWEB)

    Juan D. Deaton; Ryan E. lrwin; Luiz A. DaSilva

    2011-05-01

    As early as 2014, wireless network operators spectral capacity will be overwhelmed by a data tsunami brought on by new devices and applications. To augment spectral capacity, operators could deploy a Dynamic Spectrum Access (DSA) overlay. In the light of the many planned Long Term Evolution (LTE) network deployments, the affects of a DSA overlay have not been fully considered into the existing LTE standards. Coalescing many different aspects of DSA, this paper develops the Spectrum Accountability (SA) framework. The SA framework defines specific network element functionality, protocol interfaces, and signaling flow diagrams for LTE to support service requests and enforce rights of responsibilities of primary and secondary users, respectively. We also include a network simulation to quantify the benefits of using DSA channels to augment capacity. Based on our simulation we show that, network operators can benefit up to %40 increase in operating capacity when sharing DSA bands to augment spectral capacity. With our framework, this paper could serve as an guide in developing future LTE network standards that include DSA.

  11. Development of advanced mixed oxide fuels for plutonium management

    International Nuclear Information System (INIS)

    Eaton, S.; Beard, C.; Buksa, J.; Butt, D.; Chidester, K.; Havrilla, G.; Ramsey, K.

    1997-06-01

    A number of advanced Mixed Oxide (MOX) fuel forms are currently being investigated at Los Alamos National Laboratory that have the potential to be effective plutonium management tools. Evolutionary Mixed Oxide (EMOX) fuel is a slight perturbation on standard MOX fuel, but achieves greater plutonium destruction rates by employing a fractional nonfertile component. A pure nonfertile fuel is also being studied. Initial calculations show that the fuel can be utilized in existing light water reactors and tailored to address different plutonium management goals (i.e., stabilization or reduction of plutonium inventories residing in spent nuclear fuel). In parallel, experiments are being performed to determine the feasibility of fabrication of such fuels. Initial EMOX pellets have successfully been fabricated using weapons-grade plutonium

  12. Development of advanced mixed oxide fuels for plutonium management

    International Nuclear Information System (INIS)

    Eaton, S.; Beard, C.; Buksa, J.; Butt, D.; Chidester, K.; Havrilla, G.; Ramsey, K.

    1997-01-01

    A number of advanced Mixed Oxide (MOX) fuel forms are currently being investigated at Los Alamos National Laboratory that have the potential to be effective plutonium management tools. Evolutionary Mixed Oxide (EMOX) fuel is a slight perturbation on standard MOX fuel, but achieves greater plutonium destruction rates by employing a fractional nonfertile component. A pure nonfertile fuel is also being studied. Initial calculations show that the fuel can be utilized in existing light water reactors and tailored to address different plutonium management goals (i.e., stabilization or reduction of plutonium inventories residing in spent nuclear fuel). In parallel, experiments are being performed to determine the feasibility of fabrication of such fuels. Initial EMOX pellets have successfully been fabricated using weapons-grade plutonium. (author)

  13. Management of Heart Failure in Advancing CKD: Core Curriculum 2018.

    Science.gov (United States)

    House, Andrew A

    2018-02-23

    Heart failure and chronic kidney disease have increasing incidence and prevalence owing in part to the aging population and increasing rates of hypertension, diabetes, and other cardiovascular and kidney disease risk factors. The presence of one condition also has a strong influence on the other, leading to greater risks for hospitalization, morbidity, and death, as well as very high health care costs. Despite the frequent coexistence of heart failure and chronic kidney disease, many of the pivotal randomized trials that guide the management of heart failure have excluded patients with more advanced stages of chronic kidney disease. In this Core Curriculum article, management of a challenging, yet not unusual, case of heart failure with reduced ejection fraction in a patient with stage 4 chronic kidney disease provides an opportunity to review the relevant literature and highlight gaps in our knowledge. Copyright © 2018 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  14. Management of advanced pancreatic cancer in daily clinical practice.

    Science.gov (United States)

    Giuliani, Jacopo; Piacentini, Paolo; Bonetti, Andrea

    2016-01-01

    The aim of this outcome study was to evaluate the management of advanced pancreatic cancer in a real-world clinical practice; few such experiences have been reported in the literature. A retrospective analysis was performed of all consecutive patients with advanced pancreatic ductal adenocarcinoma followed at our medical oncology unit between January 2003 and December 2013. We evaluated 78 patients, mostly with metastatic disease (64.1%). Median follow-up was 10.77 months, by which time 74 patients (94.9%) had died. Median overall survival was 8.29 months. Median age was 67 years. In univariate analysis, pain at onset (p = 0.020), ECOG performance status (p<0.001), stage (p = 0.047), first-line chemotherapy (p<0.001), second-line chemotherapy (p<0.001) and weight loss at diagnosis (p = 0.029) were factors that had an impact on overall survival. In multivariate analysis, the presence of pain at onset (p = 0.043), stage (p = 0.003) and second-line chemotherapy (p = 0.004) were confirmed as independent prognostic factors. Our data, derived from daily clinical practice, confirmed advanced pancreatic cancer as an aggressive malignant disease with a very short expected survival. Second-line treatment seems to provide an advantage in terms of overall survival in patients who showed a partial response as their best response to first-line treatment.

  15. Advanced Pulse Oximetry System for Remote Monitoring and Management

    Science.gov (United States)

    Pak, Ju Geon; Park, Kee Hyun

    2012-01-01

    Pulse oximetry data such as saturation of peripheral oxygen (SpO2) and pulse rate are vital signals for early diagnosis of heart disease. Therefore, various pulse oximeters have been developed continuously. However, some of the existing pulse oximeters are not equipped with communication capabilities, and consequently, the continuous monitoring of patient health is restricted. Moreover, even though certain oximeters have been built as network models, they focus on exchanging only pulse oximetry data, and they do not provide sufficient device management functions. In this paper, we propose an advanced pulse oximetry system for remote monitoring and management. The system consists of a networked pulse oximeter and a personal monitoring server. The proposed pulse oximeter measures a patient's pulse oximetry data and transmits the data to the personal monitoring server. The personal monitoring server then analyzes the received data and displays the results to the patient. Furthermore, for device management purposes, operational errors that occur in the pulse oximeter are reported to the personal monitoring server, and the system configurations of the pulse oximeter, such as thresholds and measurement targets, are modified by the server. We verify that the proposed pulse oximetry system operates efficiently and that it is appropriate for monitoring and managing a pulse oximeter in real time. PMID:22933841

  16. Advances in asthma in 2016: Designing individualized approaches to management.

    Science.gov (United States)

    Anderson, William C; Apter, Andrea J; Dutmer, Cullen M; Searing, Daniel A; Szefler, Stanley J

    2017-09-01

    In this year's Advances in Asthma review, we discuss viral infections in asthmatic patients and potential therapeutic agents, the microbiome, novel genetic associations with asthma, air quality and climate effects on asthma, exposures during development and long-term sequelae of childhood asthma, patient-centered outcomes research, and precision medicine. In addition, we discuss application of biomarkers to precision medicine and new information on asthma medications. New evidence indicates that rhinovirus-triggered asthma exacerbations become more severe as the degree of sensitization to dust mite and mouse increase. The 2 biggest drivers of asthma severity are an allergy pathway starting with allergic sensitization and an environmental tobacco smoke pathway. In addition, allergic sensitization and blood eosinophils can be used to select medications for management of early asthma in young children. These current findings, among others covered in this review, represent significant steps toward addressing rapidly advancing areas of knowledge that have implications for asthma management. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  17. An advanced real time energy management system for microgrids

    International Nuclear Information System (INIS)

    Elsied, Moataz; Oukaour, Amrane; Youssef, Tarek; Gualous, Hamid; Mohammed, Osama

    2016-01-01

    This paper presents an advanced Real-Time Energy Management System (RT-EMS) for Microgrid (MG) systems. The proposed strategy of RT-EMS capitalizes on the power of Genetic Algorithms (GAs) to minimize the energy cost and carbon dioxide emissions while maximizing the power of the available renewable energy resources. MATLAB-dSPACE Real-Time Interface Libraries (MLIB/MTRACE) are used as new tools to run the optimization code in Real-Time Operation (RTO). The communication system is developed based on ZigBee communication network which is designed to work in harsh radio environment where the control system is developed based on Advanced Lead-Lag Compensator (ALLC) which its parameters are tuned online to achieve fast convergence and good tracking response. The proposed RT-EMS along with its control and communication systems is experimentally tested to validate the results obtained from the optimization algorithm in a real MG testbed. The simulation and experimental results using real-world data highlight the effectiveness of the proposed RT-EMS for MGs applications. - Highlights: • Real-time energy management system of a typical MG is developed, and analyzed. • RT-EMS considered the nonlinear cost function and emission constraints. • MLIB/MTRACE libraries in dSPACE are used as new tools to run the optimization code. • The communication system is developed based on a Zigbee communication network. • Control system parameters are tuned online to achieve good tracking response.

  18. Advances in radioactive waste management from an international perspective

    International Nuclear Information System (INIS)

    Nash, K.E.; Simmons, G.R.

    1998-01-01

    Nuclear generated electricity, is an important world energy source, currently providing 17% of the world electricity supply. Nuclear energy can be a significant part of the solution to national and international environmental problems such as air pollution and climate change. The main basis for this is the absence of polluting gas emissions namely, NO x , SO x and CO 2 . Nuclear power is considered by most people in the industry to be a sustainable energy source. Many studies have shown that the environmental externality costs of nuclear power production are low compared to other forms of energy generation. For many years the industry has invested its resources in developing comprehensive and permanent waste management solutions and has included all back end costs into its pricing structure. In this respect the industry has been a leader in sustainable development and full cost accounting, well before these reached their current prominence. A comprehensive solution to the problem of nuclear waste, especially related to high level waste has not yet been reached. Critics of nuclear power use this fact to argue that nuclear power is not a sustainable energy source. The purpose of this paper is to examine the extent to which advances in radioactive waste management have been made, and what advances remain to be made, to position nuclear power to meet the energy supply and environment challenges ahead. (author)

  19. Gender Disparities Across the Spectrum of Advanced Cardiac Therapies: Real or Imagined?

    Science.gov (United States)

    Bogaev, Roberta C

    2016-11-01

    Cardiovascular disease has been responsible for more deaths in women than in men each year since 1985. This review discusses federal laws that have influenced the inclusion of women in research and reporting sex-specific differences, then addresses gender differences and gender disparities in four areas of clinical cardiovascular medicine: coronary heart disease, valvular heart disease, electrophysiology, and heart failure. The prevalence of disease in women is highlighted, the clinical characteristics of women at the time of referral for advanced therapies are reviewed, and the clinical outcomes of women are discussed. With the emergence of new technology such as smaller devices and less invasive procedures, more women are being referred for advanced therapies. However, a gap in awareness and diagnosis remains, contributing to later referrals for women. Women who do undergo advanced therapies often have more comorbidities and worse outcomes than men. A call is made to increase awareness, educate healthcare providers, and report more sex-specific data to resolve these gender disparities.

  20. Fast Spectrum Reactors

    CERN Document Server

    Todd, Donald; Tsvetkov, Pavel

    2012-01-01

    Fast Spectrum Reactors presents a detailed overview of world-wide technology contributing to the development of fast spectrum reactors. With a unique focus on the capabilities of fast spectrum reactors to address nuclear waste transmutation issues, in addition to the well-known capabilities of breeding new fuel, this volume describes how fast spectrum reactors contribute to the wide application of nuclear power systems to serve the global nuclear renaissance while minimizing nuclear proliferation concerns. Readers will find an introduction to the sustainable development of nuclear energy and the role of fast reactors, in addition to an economic analysis of nuclear reactors. A section devoted to neutronics offers the current trends in nuclear design, such as performance parameters and the optimization of advanced power systems. The latest findings on fuel management, partitioning and transmutation include the physics, efficiency and strategies of transmutation, homogeneous and heterogeneous recycling, in addit...

  1. Autism spectrum disorders. Recent advances in the research on the impairment in social communication

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Nobumasa [Showa Univ., School of Medicine, Tokyo (Japan); Yamasue, Hidenori; Jinde, Seiichiro [Tokyo Univ., Graduate School of Medicine, Tokyo (Japan); Watanabe, Keiichiro [Tokyo Univ., Health Service Center, Tokyo (Japan); Sadamatsu, Miyuki [Nara Medical Univ., School of Medicine, Kashihara, Nara (Japan)

    2010-09-15

    Since the discovery of early infantile autism (1943), the etiology of the disease has for long been a matter of dispute-from a form of innate schizophrenia, maltreatment by 'refrigerator mother', to dysfunction of speech development. After the re-discovery of Asperger syndrome by Wing (1981), the concept of this diverse syndrome complex has merged to pervasive developmental disorders (PDD) or autism spectrum disorders (ASD). People suffering from Asperger syndrome do not show impairments in speech development, in fact, they have good linguistic abilities. They can explain their own psychopathology, which helps in the understanding of classical autism with profound mental retardation. Currently, ASD is prevalent in 1 of 150 births with strong genetic inheritance. ASD is therefore thought a psychiatric common disease. Asperger syndrome has frequently been the subject of neuroimaging studies, since social communication is an important characteristic of human behavior. This review encompasses a historical and clinical overview of ASD and puts force the current perspectives on the researches in animal models, genetic studies of animal and human samples, and neuroimaging studies. Our current focus is the possible role of oxytocin, which was recently found to have an effect on empathy, in the etiology of ASD. (author)

  2. Autism spectrum disorders. Recent advances in the research on the impairment in social communication

    International Nuclear Information System (INIS)

    Kato, Nobumasa; Yamasue, Hidenori; Jinde, Seiichiro; Watanabe, Keiichiro; Sadamatsu, Miyuki

    2010-01-01

    Since the discovery of early infantile autism (1943), the etiology of the disease has for long been a matter of dispute-from a form of innate schizophrenia, maltreatment by 'refrigerator mother', to dysfunction of speech development. After the re-discovery of Asperger syndrome by Wing (1981), the concept of this diverse syndrome complex has merged to pervasive developmental disorders (PDD) or autism spectrum disorders (ASD). People suffering from Asperger syndrome do not show impairments in speech development, in fact, they have good linguistic abilities. They can explain their own psychopathology, which helps in the understanding of classical autism with profound mental retardation. Currently, ASD is prevalent in 1 of 150 births with strong genetic inheritance. ASD is therefore thought a psychiatric common disease. Asperger syndrome has frequently been the subject of neuroimaging studies, since social communication is an important characteristic of human behavior. This review encompasses a historical and clinical overview of ASD and puts force the current perspectives on the researches in animal models, genetic studies of animal and human samples, and neuroimaging studies. Our current focus is the possible role of oxytocin, which was recently found to have an effect on empathy, in the etiology of ASD. (author)

  3. Cluman: Advanced cluster management for the large-scale infrastructures

    International Nuclear Information System (INIS)

    Babik, Marian; Fedorko, Ivan; Rodrigues, David

    2011-01-01

    The recent uptake of multi-core computing has produced a rapid growth of virtualisation and cloud computing services. With the increased use of the many-core processors this trend will likely accelerate and computing centres will be faced with the management of the tens of thousands of the virtual machines. Furthermore, these machines will likely be geographically distributed and need to be allocated on demand. In order to cope with such complexity we have designed and developed an advanced cluster management system that can execute administrative tasks targeting thousands of machines as well as provide an interactive high-density visualisation of the fabrics. The job management subsystem can perform complex tasks while following their progress and output and report aggregated information back to the system administrators. The visualisation subsystem can display tree maps of the infrastructure elements with data and monitoring information, thus providing a very detailed overview of the large clusters at a glance. The initial experience with development and testing of the system will be presented as well as an evaluation of its performance.

  4. The management of localized and locally advanced prostate cancer - 1995

    International Nuclear Information System (INIS)

    Forman, Jeffrey D.

    1995-01-01

    Purpose/Objectives: The intent of this course is to review the issues involved in the management of non-metastatic adenocarcinoma of the prostate. - The value of pre-treatment prognostic factors including stage, grade and PSA value will be presented, and their value in determining therapeutic strategies will be discussed. - Controversies involving the simulation process and treatment design will be presented. The value of CT scanning, Beams-Eye View, 3-D planning, intravesicle, intraurethral and rectal contrast will be presented. The significance of prostate and patient movement and strategies for dealing with them will be presented. - The management of low stage, low to intermediate grade prostate cancer will be discussed. The dose, volume and timing of irradiation will be discussed as will the role of neo-adjuvant hormonal therapy, neutron irradiation and brachy therapy. The current status of radical prostatectomy and cryotherapy will be summarized. - Treatment of locally advanced, poorly differentiated prostate cancer will be presented including a discussion of neo-adjuvant and adjuvant hormones, dose-escalation and neutron irradiation. - Strategies for post-radiation failures will be presented including data on cryotherapy, salvage prostatectomy and hormonal therapy (immediate, delayed and/or intermittent). New areas for investigation will be reviewed. - The management of patients post prostatectomy will be reviewed. Data on adjuvant radiation and therapeutic radiation for biochemical or clinically relapsed patients will be presented. This course hopes to present a realistic and pragmatic overview for treating patients with non-metastatic prostatic cancer

  5. Advances in the nutritional and pharmacological management of phenylketonuria

    Science.gov (United States)

    Ney, Denise M.; Blank, Robert D.; Hansen, Karen E.

    2014-01-01

    Structural Abstract Purpose of review The purpose is to discuss advances in the nutritional and pharmacological management of phenylketonuria (PKU). Recent findings Glycomacropeptide (GMP), a whey protein produced during cheese production, is a low-phe intact protein that represents a new dietary alternative to synthetic amino acids (AAs) for people with PKU. Skeletal fragility is a long-term complication of PKU that based on murine research, appears to result from both genetic and nutritional factors. Skeletal fragility in murine PKU is attenuated with the GMP diet, compared with an AA diet, allowing greater radial bone growth. Pharmacologic therapy with tetrahydrobiopterin (BH4), acting as a molecular chaperone for phenylalanine hydroxylase, increases tolerance to dietary phe in some individuals. Large neutral AAs (LNAA) inhibit phe transport across the intestinal mucosa and blood brain barrier; LNAA are most effective for individuals unable to comply with the low-phe diet. Summary Although a low-phe synthetic AA diet remains the mainstay of PKU management, new nutritional and pharmacological treatment options offer alternative approaches to maintain lifelong low phe concentrations. GMP medical foods provide an alternative to AA formula that may improve bone health, and BH4 permits some individuals with PKU to increase tolerance to dietary phe. Further research is needed to characterize the long-term efficacy of these new approaches for PKU management. PMID:24136088

  6. Technological Advances in Huanglongbing (HLB or Citrus Greening Disease Management

    Directory of Open Access Journals (Sweden)

    Krishna Prasad Paudyal

    2015-12-01

    Full Text Available Huanglongbing (HLB, previously citrus greening disease, is the most destructive of citrus species causing major threat to the world citrus industry. The disease was reported from China in 1919 and now known to occur in more than 40 different countries of Asia, Africa, South and North America. Three species of gram negative bacterium namely Candidatus Liberibacter asiaticus, Candidatus Liberibacter africanus and Candidatus Liberibacter americanus are the casual organisms of HLB, respectively prevailing in the continent of Asia, Africa and South America. It is one of the most extensively researched subjects in citriculture world. HLB was detected in 2004 and 2005, respectively in San Paulo of Brazil and Florida of USA: the two leading citrus production hub of the world causing huge economic loss within 5 years of first detection. Since then research on HLB detection and management was further accelerated in American continents. This paper presents the scientific advancement made on detection, spread, economic losses caused by HLB in different parts of the world and controlling management strategies. Remarkable achievements have been made on HLB detection techniques including iodine test, qPCR and more recently in spectroscopy. While efforts are being made to develop resistance varieties using conventional and biotechnological tools management strategy which includes reduction of inoculums source, vector control and replant with disease-free planting materials still remains major option for HLB control. Citrus intercropping with guava have shown promising results for vector reduction.

  7. Advancements in the critical care management of status epilepticus.

    Science.gov (United States)

    Bauerschmidt, Andrew; Martin, Andrew; Claassen, Jan

    2017-04-01

    Status epilepticus has a high morbidity and mortality. There are little definitive data to guide management; however, new recent data continue to improve understanding of management options of status epilepticus. This review examines recent advancements regarding the critical care management of status epilepticus. Recent studies support the initial treatment of status epilepticus with early and aggressive benzodiazepine dosing. There remains a lack of prospective randomized controlled trials comparing different treatment regimens. Recent data support further study of intravenous lacosamide as an urgent-control therapy, and ketamine and clobazam for refractory status epilepticus. Recent data support the use of continuous EEG to help guide treatment for all patients with refractory status epilepticus and to better understand epileptic activity that falls on the ictal-interictal continuum. Recent data also improve our understanding of the relationship between periodic epileptic activity and brain injury. Many treatments are available for status epilepticus and there are much new data guiding the use of specific agents. However, there continues to be a lack of prospective data supporting specific regimens, particularly in cases of refractory status epilepticus.

  8. The Normalized-Rate Iterative Algorithm: A Practical Dynamic Spectrum Management Method for DSL

    Directory of Open Access Journals (Sweden)

    Statovci Driton

    2006-01-01

    Full Text Available We present a practical solution for dynamic spectrum management (DSM in digital subscriber line systems: the normalized-rate iterative algorithm (NRIA. Supported by a novel optimization problem formulation, the NRIA is the only DSM algorithm that jointly addresses spectrum balancing for frequency division duplexing systems and power allocation for the users sharing a common cable bundle. With a focus on being implementable rather than obtaining the highest possible theoretical performance, the NRIA is designed to efficiently solve the DSM optimization problem with the operators' business models in mind. This is achieved with the help of two types of parameters: the desired network asymmetry and the desired user priorities. The NRIA is a centralized DSM algorithm based on the iterative water-filling algorithm (IWFA for finding efficient power allocations, but extends the IWFA by finding the achievable bitrates and by optimizing the bandplan. It is compared with three other DSM proposals: the IWFA, the optimal spectrum balancing algorithm (OSBA, and the bidirectional IWFA (bi-IWFA. We show that the NRIA achieves better bitrate performance than the IWFA and the bi-IWFA. It can even achieve performance almost as good as the OSBA, but with dramatically lower requirements on complexity. Additionally, the NRIA can achieve bitrate combinations that cannot be supported by any other DSM algorithm.

  9. The Normalized-Rate Iterative Algorithm: A Practical Dynamic Spectrum Management Method for DSL

    Science.gov (United States)

    Statovci, Driton; Nordström, Tomas; Nilsson, Rickard

    2006-12-01

    We present a practical solution for dynamic spectrum management (DSM) in digital subscriber line systems: the normalized-rate iterative algorithm (NRIA). Supported by a novel optimization problem formulation, the NRIA is the only DSM algorithm that jointly addresses spectrum balancing for frequency division duplexing systems and power allocation for the users sharing a common cable bundle. With a focus on being implementable rather than obtaining the highest possible theoretical performance, the NRIA is designed to efficiently solve the DSM optimization problem with the operators' business models in mind. This is achieved with the help of two types of parameters: the desired network asymmetry and the desired user priorities. The NRIA is a centralized DSM algorithm based on the iterative water-filling algorithm (IWFA) for finding efficient power allocations, but extends the IWFA by finding the achievable bitrates and by optimizing the bandplan. It is compared with three other DSM proposals: the IWFA, the optimal spectrum balancing algorithm (OSBA), and the bidirectional IWFA (bi-IWFA). We show that the NRIA achieves better bitrate performance than the IWFA and the bi-IWFA. It can even achieve performance almost as good as the OSBA, but with dramatically lower requirements on complexity. Additionally, the NRIA can achieve bitrate combinations that cannot be supported by any other DSM algorithm.

  10. Management Options for Advanced Low or Intermediate Grade Gastroenteropancreatic Neuroendocrine Tumors: Review of Recent Literature

    Directory of Open Access Journals (Sweden)

    Vladimir Neychev

    2017-01-01

    Full Text Available Our understanding of the biology, genetics, and natural history of neuroendocrine tumors (NETs of the gastrointestinal tract and pancreas has improved considerably in the last several decades and the spectrum of available therapeutic options is rapidly expanding. The management of patients with metastatic low or intermediate grade NETs has been revolutionized by the development of new treatment strategies such as molecular targeting therapies with everolimus and sunitinib, somatostatin analogs, tryptophan hydroxylase inhibitors, and peptide receptor radionuclide therapy that can be used alone or as a multimodal approach with or without surgery. To further define and clarify the utility, appropriateness, and the sequence of the growing list of available therapies for this patient population will require more high level evidence; however, data from well-designed randomized phase III clinical trials is rapidly accumulating that will further stimulate development of new management strategies. It is therefore important to thoroughly review emerging evidence and report major findings in frequent updates, which will expand our knowledge and contribute to a better understanding, characterization, and management of advanced NETs.

  11. BALANCED SCORECARD AS AN ADVANCED MANAGEMENT CONCEPT WITHIN THE INTEGRATED QUALITY MANAGEMENT MODEL

    Directory of Open Access Journals (Sweden)

    Stevan Zivojinovic

    2008-03-01

    Full Text Available The significance of >Integratedquality management< (IQM model, originating form St.Gallen-model, is reflected in the need for synergic application of new and advanced concepts of management theory and practise. Balanced score card (BSC within IQM model becomes a catalyst of business success for a modern organization by focusing on organizational variables-business strategy, organization structure and corporate culture. BSC is the leading system of performance tracking and strategy implementation, consistent with other management concepts and methods for managing process improvement. Through BSC, IQM processes' activities correlate with organization business results. BSC management processes enable integration of all decision-making levels, from institutional via strategic to operative, in the process starting from planing, i.e. formulating and implementation of strategy, to feed back by performance measurement and control.

  12. Management of patients with advanced prostate cancer: recommendations of the St Gallen Advanced Prostate Cancer Consensus Conference (APCCC) 2015

    NARCIS (Netherlands)

    Gillessen, S.; Omlin, A.; Attard, G.; Bono, J.S. de; Efstathiou, E.; Fizazi, K.; Halabi, S.; Nelson, P.S.; Sartor, O.; Smith, M.R.; Soule, H.R.; Akaza, H.; Beer, T.M.; Beltran, H.; Chinnaiyan, A.M.; Daugaard, G.; Davis, I.D.; Santis, M. de; Drake, C.G.; Eeles, R.A.; Fanti, S.; Gleave, M.E.; Heidenreich, A.; Hussain, M.; James, N.D.; Lecouvet, F.E.; Logothetis, C.J.; Mastris, K.; Nilsson, S.; Oh, W.K.; Olmos, D.; Padhani, A.R.; Parker, C.; Rubin, M.A.; Schalken, J.A.; Scher, H.I.; Sella, A.; Shore, N.D.; Small, E.J.; Sternberg, C.N.; Suzuki, H; Sweeney, C.J.; Tannock, I.F.; Tombal, B.

    2015-01-01

    The first St Gallen Advanced Prostate Cancer Consensus Conference (APCCC) Expert Panel identified and reviewed the available evidence for the ten most important areas of controversy in advanced prostate cancer (APC) management. The successful registration of several drugs for castration-resistant

  13. Advanced techniques using the plant as indicator of irrigation management

    Directory of Open Access Journals (Sweden)

    Barbara dos Santos Esteves

    2015-05-01

    Full Text Available The methodologies which are considered the most promising for irrigation management are those based on the analysis of the water status of the plants themselves. This justifies the study and improvement of indicators based on automatic and continuous measures to enable real-time monitoring data, as indices from sap flow, dendrometry and leaf turgor pressure techniques. The aim of this paper is to analyze such methodologies in order to demonstrate their principles, advantages and challenges. In conclusion, the methodologies analyzed still have many technological advances and challenges before being presented to the final user. The future research should work these tools for elaboration of technical indexes that allow their simplification, on the instrumental point of view, and the interpretation of their results.

  14. Methods and Systems for Advanced Spaceport Information Management

    Science.gov (United States)

    Fussell, Ronald M. (Inventor); Ely, Donald W. (Inventor); Meier, Gary M. (Inventor); Halpin, Paul C. (Inventor); Meade, Phillip T. (Inventor); Jacobson, Craig A. (Inventor); Blackwell-Thompson, Charlie (Inventor)

    2007-01-01

    Advanced spaceport information management methods and systems are disclosed. In one embodiment, a method includes coupling a test system to the payload and transmitting one or more test signals that emulate an anticipated condition from the test system to the payload. One or more responsive signals are received from the payload into the test system and are analyzed to determine whether one or more of the responsive signals comprises an anomalous signal. At least one of the steps of transmitting, receiving, analyzing and determining includes transmitting at least one of the test signals and the responsive signals via a communications link from a payload processing facility to a remotely located facility. In one particular embodiment, the communications link is an Internet link from a payload processing facility to a remotely located facility (e.g. a launch facility, university, etc.).

  15. Masters Study in Advanced Energy and Fuels Management

    Energy Technology Data Exchange (ETDEWEB)

    Mondal, Kanchan [Southern Illinois Univ., Carbondale, IL (United States)

    2014-12-08

    There are currently three key drivers for the US energy sector a) increasing energy demand and b) environmental stewardship in energy production for sustainability and c) general public and governmental desire for domestic resources. These drivers are also true for energy nation globally. As a result, this sector is rapidly diversifying to alternate sources that would supplement or replace fossil fuels. These changes have created a need for a highly trained workforce with a the understanding of both conventional and emerging energy resources and technology to lead and facilitate the reinvention of the US energy production, rational deployment of alternate energy technologies based on scientific and business criteria while invigorating the overall economy. In addition, the current trends focus on the the need of Science, Technology, Engineering and Math (STEM) graduate education to move beyond academia and be more responsive to the workforce needs of businesses and the industry. The SIUC PSM in Advanced Energy and Fuels Management (AEFM) program was developed in response to the industries stated need for employees who combine technical competencies and workforce skills similar to all PSM degree programs. The SIUC AEFM program was designed to provide the STEM graduates with advanced technical training in energy resources and technology while simultaneously equipping them with the business management skills required by professional employers in the energy sector. Technical training include core skills in energy resources, technology and management for both conventional and emerging energy technologies. Business skills training include financial, personnel and project management. A capstone internship is also built into the program to train students such that they are acclimatized to the real world scenarios in research laboratories, in energy companies and in government agencies. The current curriculum in the SIUC AEFM will help fill the need for training both recent

  16. A low complexity based spectrum management algorithm for ‘Near–Far’ problem in VDSL environment

    Directory of Open Access Journals (Sweden)

    Sunil Sharma

    2015-10-01

    Full Text Available In digital subscriber line (DSL system, crosstalk created by electromagnetic interference among twisted pairs degrades the system performance. Very high bit rate DSL (VDSL, utilizes higher bandwidth of copper cable for data transmission. During upstream transmission, a ‘Near–Far’ problem occurs in VDSL system. In this problem the far end crosstalk (FEXT is produced from near end user degrades the data rate achieved at the far end user. The effect of FEXT can be reduced by properly managing power spectral densities (PSD of transmitters of near and far users. This kind of power allocation is called dynamic spectrum management (DSM. In this paper, a new distributed DSM algorithm is proposed in which power from only those sub channels of near end user are reduced which create interference to far end user. This power back off strategy takes place with the help of power spectral density (PSD masks at interference creating sub channels of near end user. The simulation results of the proposed algorithm show an improvement in terms of data rate and approaches near to that of optimal spectrum balancing (OSB algorithm.

  17. Suitable RF spectrum in ISM band for 2-way advanced metering network in India

    Science.gov (United States)

    Mishra, A.; Khan, M. A.; Gaur, M. S.

    2013-01-01

    The ISM (Industrial Scientific and Medical) bands in the radio frequency space in India offer two alternative spectra to implement wireless network for advanced metering infrastructure (AMI). These bands lie in the range of 2.4GHz and sub-GHz frequencies 865 to 867 MHz This paper aims to examine the suitability of both options by designing and executing experiments in laboratory as well as carrying out field trials on electricity meters to validate the selected option. A parameter, communication effectiveness index (CEI2) is defined to measure the effectiveness of 2 way data communication (packet exchange) between two points under different scenarios of buildings and free space. Both 2.4 GHz and Sub-GHz designs were implemented to compare the results. The experiments were conducted across 3 floors of a building. Validation of the selected option was carried out by conducting a field trial by integrating the selected radio frequency (RF) modem into the single phase electricity meters and installing these meters across three floors of the building. The methodology, implementation details, observations and resulting analytical conclusion are described in the paper.

  18. Innovations in the Endovascular Management of Critical Limb Ischemia: Retrograde Tibiopedal Access and Advanced Percutaneous Techniques.

    Science.gov (United States)

    Mustapha, Jihad A; Diaz-Sandoval, Larry J; Saab, Fadi

    2017-08-01

    Retrograde tibiopedal access and interventions have contributed to advance of endovascular techniques to treat critical limb ischemia (CLI) patients. This review encompasses the spectrum from advanced diagnostic imaging and technical therapeutic approaches for infrapopliteal occlusions, to a discussion of current standards and future directions. Contemporary studies of infrapopliteal angioplasty show suboptimal short-term and 1-year clinical outcomes. Comparative data is needed to shift the focus from PTA to disruptive treatment modalities that can further improve outcomes. Retrograde pedal access has emerged as an important tool to facilitate successfully percutaneous revascularization and limb salvage in patients with CLI. To efficiently approach the complexity of CLI, new thought processes are needed to change the reigning paradigms. Retrograde tibial-pedal access has shown improvement in the rate of successful revascularizations and is an important tool in the amputation-prevention armamentarium. Additional technologies may further improve success rates. Drug-eluting stents have shown better outcomes than PTA in patients with focal infrapopliteal lesions. Registry data have demonstrated the advantage of several atherectomy devices in the tibial arteries. More recently, bioresorbable vascular scaffolds have been used successfully, and further studies with drug-coated balloons are underway. Interventional operators are now even working in the inframalleolar space to reconstitute the plantar arch. Well-conducted studies are needed to generate high-quality evidence in the field of critical limb ischemia management.

  19. Advances in Integrated Vehicle Thermal Management and Numerical Simulation

    Directory of Open Access Journals (Sweden)

    Yan Wang

    2017-10-01

    Full Text Available With the increasing demands for vehicle dynamic performance, economy, safety and comfort, and with ever stricter laws concerning energy conservation and emissions, vehicle power systems are becoming much more complex. To pursue high efficiency and light weight in automobile design, the power system and its vehicle integrated thermal management (VITM system have attracted widespread attention as the major components of modern vehicle technology. Regarding the internal combustion engine vehicle (ICEV, its integrated thermal management (ITM mainly contains internal combustion engine (ICE cooling, turbo-charged cooling, exhaust gas recirculation (EGR cooling, lubrication cooling and air conditioning (AC or heat pump (HP. As for electric vehicles (EVs, the ITM mainly includes battery cooling/preheating, electric machines (EM cooling and AC or HP. With the rational effective and comprehensive control over the mentioned dynamic devices and thermal components, the modern VITM can realize collaborative optimization of multiple thermodynamic processes from the aspect of system integration. Furthermore, the computer-aided calculation and numerical simulation have been the significant design methods, especially for complex VITM. The 1D programming can correlate multi-thermal components and the 3D simulating can develop structuralized and modularized design. Additionally, co-simulations can virtualize simulation of various thermo-hydraulic behaviors under the vehicle transient operational conditions. This article reviews relevant researching work and current advances in the ever broadening field of modern vehicle thermal management (VTM. Based on the systematic summaries of the design methods and applications of ITM, future tasks and proposals are presented. This article aims to promote innovation of ITM, strengthen the precise control and the performance predictable ability, furthermore, to enhance the level of research and development (R&D.

  20. Advanced Simulation Capability for Environmental Management (ASCEM): Early Site Demonstration

    International Nuclear Information System (INIS)

    Meza, Juan; Hubbard, Susan; Freshley, Mark D.; Gorton, Ian; Moulton, David; Denham, Miles E.

    2011-01-01

    The U.S. Department of Energy Office of Environmental Management, Technology Innovation and Development (EM-32), is supporting development of the Advanced Simulation Capability for Environmental Management (ASCEM). ASCEM is a state-of-the-art scientific tool and approach for understanding and predicting contaminant fate and transport in natural and engineered systems. The modular and open source high performance computing tool will facilitate integrated approaches to modeling and site characterization that enable robust and standardized assessments of performance and risk for EM cleanup and closure activities. As part of the initial development process, a series of demonstrations were defined to test ASCEM components and provide feedback to developers, engage end users in applications, and lead to an outcome that would benefit the sites. The demonstration was implemented for a sub-region of the Savannah River Site General Separations Area that includes the F-Area Seepage Basins. The physical domain included the unsaturated and saturated zones in the vicinity of the seepage basins and Fourmile Branch, using an unstructured mesh fit to the hydrostratigraphy and topography of the site. The calculations modeled variably saturated flow and the resulting flow field was used in simulations of the advection of non-reactive species and the reactive-transport of uranium. As part of the demonstrations, a new set of data management, visualization, and uncertainty quantification tools were developed to analyze simulation results and existing site data. These new tools can be used to provide summary statistics, including information on which simulation parameters were most important in the prediction of uncertainty and to visualize the relationships between model input and output.

  1. Advanced Simulation Capability for Environmental Management: Development and Demonstrations - 12532

    Energy Technology Data Exchange (ETDEWEB)

    Freshley, Mark D.; Freedman, Vicky; Gorton, Ian [Pacific Northwest National Laboratory, MSIN K9-33, P.O. Box 999, Richland, WA 99352 (United States); Hubbard, Susan S. [Lawrence Berkeley National Laboratory, 1 Cyclotron Road, MS 50B-4230, Berkeley, CA 94720 (United States); Moulton, J. David; Dixon, Paul [Los Alamos National Laboratory, MS B284, P.O. Box 1663, Los Alamos, NM 87544 (United States)

    2012-07-01

    The U.S. Department of Energy Office of Environmental Management (EM), Technology Innovation and Development is supporting development of the Advanced Simulation Capability for Environmental Management (ASCEM). ASCEM is a state-of-the-art scientific tool and approach for understanding and predicting contaminant fate and transport in natural and engineered systems. The modular and open source high-performance computing tool facilitates integrated approaches to modeling and site characterization that enable robust and standardized assessments of performance and risk for EM cleanup and closure activities. The ASCEM project continues to make significant progress in development of capabilities, which are organized into Platform and Integrated Tool-sets and a High-Performance Computing Multi-process Simulator. The Platform capabilities target a level of functionality to allow end-to-end model development, starting with definition of the conceptual model and management of data for model input. The High-Performance Computing capabilities target increased functionality of process model representations, tool-sets for interaction with Platform, and verification and model confidence testing. The new capabilities are demonstrated through working groups, including one focused on the Hanford Site Deep Vadose Zone. The ASCEM program focused on planning during the first year and executing a prototype tool-set for an early demonstration of individual components. Subsequently, ASCEM has focused on developing and demonstrating an integrated set of capabilities, making progress toward a version of the capabilities that can be used to engage end users. Demonstration of capabilities continues to be implemented through working groups. Three different working groups, one focused on EM problems in the deep vadose zone, another investigating attenuation mechanisms for metals and radionuclides, and a third focusing on waste tank performance assessment, continue to make progress. The project

  2. [Qualitative research of self-management behavior in patients with advanced schistosomiasis].

    Science.gov (United States)

    Wang, Jian-ping; Wang, Xing-ju; Bao, Hui-hong; Zhang, Hong; Xu, Zheng-rong

    2013-10-01

    To explore the self-management behavior of patients with advanced schistosomiasis, so as to provide the evidence for improving clinical nursing. A total of 18 patients with advanced schistosomiasis were interviewed in depth by using a semi structured interview method. The results were analyzed with Miles and Huberman content analysis method. Most of the patients with advanced schistosomiasis had self-management control behavior and were cooperated with medical assistance because of their seriously illness. Based on data analysis, the symptom management, follow-up management, a healthy lifestyle, medication awareness, and emotional management were obtained. The patients with advanced schistosomiasis have self management control behavior. Health care workers should promote the patients, their families and social people to participate in the self-management behavior of advanced schistosomiasis patients.

  3. EDF advanced fuel management strategies for the next century

    International Nuclear Information System (INIS)

    Kocher, A.; Charmensat, P.; Larderet, M.

    1999-01-01

    The French nuclear fleet represents 57 PWRs in operation, accounting for 80 % of France's total electricity production. The performance achieved by EDF reactors, in terms of availability (82.6% in 1997) and good cost control, have allowed to improve the nuclear KWh cost by 2% since 1992. The implementation of longer fuel cycles on the 1300 MW reactors from 1996 has contributed to this improvement and, as competitiveness is one of the main challenges for EDF, improving core management strategies is still at the order of the day. With this aim, a thinking process has been initiated to evaluate the benefit brought by the use of a fuel assembly like ALLIANCE, the new fuel product developed by Framatome-Fragema and FCF (Framatome Cogema Fuels) in close cooperation with EDF. The considered product provides enhanced performance, particularly as regards discharge burnup (at least up to 70 GWd/t) and thermal-hydraulic and mechanical behaviour. Fuel management improvements rely on the expertise gained by Framatome through designing core management strategies in a wide range of operating conditions prevailing in nuclear reactors all over the world. It will however be taken into account the necessity for EDF to adopt a policy of stepwise change owing to the potential impact of a 'series effect' on its numerous units. The proposed paper will describe innovative fuel managements, achievable thanks to advanced fuel assembly performance, that are jointly investigated by EDF and Framatome. It includes the following optimization schemes: extending cycle length by using higher enrichments up to 5%, while keeping the same reload size (1/3 core for example for the 1300 MW reactors); decreasing reload size (from 1/3 to 1/4 core), while keeping the same cycle length, using more enriched (up to 5 %) fuel assemblies; reaching annual cycle, with maximization of fuel cycle cost optimization (1/5 core). Beyond such schemes, combinations of optimized loading patterns and neutronic features of

  4. Interference Management in Full-Duplex Cellular Networks with Partial Spectrum Overlap

    KAUST Repository

    Randrianantenaina, Itsikiantsoa

    2017-03-31

    Full-duplex (FD) communication is promoted to double the spectral efficiency when compared to the halfduplex (HD) counterpart. In the context of cellular networks, however, FD communication exacerbates the aggregate uplink and downlink interference, which diminishes the foreseen FD gains. This paper considers a flexible duplex system, denoted by -duplex (-D) system, wherein a fine-grained bandwidth control for each uplink/downlink channel pair in each base station (BS) is allowed, which also leads to partial spectrum overlap between the uplink and downlink channels. The paper addresses the resulting interference management problem by maximizing a network-wide rate-based utility function subject to uplink/downlink power constraints, so as to determine userto- BS association, user-to-channel scheduling, the UL and DL transmit powers, and the fraction of spectrum overlap between UL and DL for every user, under the assumption that the number of available channels and users are equal. The paper solves such a non-convex mixed-integer optimization problem in an iterative way by decoupling the problem into several subproblems. Particularly, the user-to-BS association problem is solved using a matching algorithm that is a generalization of the stable marriage problem. The scheduling problem is solved by iterative Hungarian algorithm. The power and spectrum overlap problem is solved by successive convex approximation. The proposed iterative strategy guarantees an efficient one-toone user to BS and channel assignment. It further provides optimized flexible duplexing and power allocation schemes for all transceivers. Simulations results show appreciable gains when comparing the proposed solution to different schemes from the literature.

  5. Interference Management in Full-Duplex Cellular Networks with Partial Spectrum Overlap

    KAUST Repository

    Randrianantenaina, Itsikiantsoa; Dahrouj, Hayssam; Elsawy, Hesham; Alouini, Mohamed-Slim

    2017-01-01

    Full-duplex (FD) communication is promoted to double the spectral efficiency when compared to the halfduplex (HD) counterpart. In the context of cellular networks, however, FD communication exacerbates the aggregate uplink and downlink interference, which diminishes the foreseen FD gains. This paper considers a flexible duplex system, denoted by -duplex (-D) system, wherein a fine-grained bandwidth control for each uplink/downlink channel pair in each base station (BS) is allowed, which also leads to partial spectrum overlap between the uplink and downlink channels. The paper addresses the resulting interference management problem by maximizing a network-wide rate-based utility function subject to uplink/downlink power constraints, so as to determine userto- BS association, user-to-channel scheduling, the UL and DL transmit powers, and the fraction of spectrum overlap between UL and DL for every user, under the assumption that the number of available channels and users are equal. The paper solves such a non-convex mixed-integer optimization problem in an iterative way by decoupling the problem into several subproblems. Particularly, the user-to-BS association problem is solved using a matching algorithm that is a generalization of the stable marriage problem. The scheduling problem is solved by iterative Hungarian algorithm. The power and spectrum overlap problem is solved by successive convex approximation. The proposed iterative strategy guarantees an efficient one-toone user to BS and channel assignment. It further provides optimized flexible duplexing and power allocation schemes for all transceivers. Simulations results show appreciable gains when comparing the proposed solution to different schemes from the literature.

  6. Recovery Act. Advanced Load Identification and Management for Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Yi [Eaton Corporation, Menomonee Falls, WI (United States); Casey, Patrick [Eaton Corporation, Menomonee Falls, WI (United States); Du, Liang [Eaton Corporation, Menomonee Falls, WI (United States); He, Dawei [Eaton Corporation, Menomonee Falls, WI (United States)

    2014-02-12

    , in particular, advanced power strips (APSs) was studied. The project evaluated the market potential for Smart Power Strips (SPSs) with load identification and the likely impact of a load identification feature on APS adoption and effectiveness. The project also identified other success factors required for widespread APS adoption and market acceptance. Even though the developed technology is applicable for both residential and commercial buildings, this project is focused on effective plug-in load control and management for commercial buildings, accomplished through effective load identification. The project has completed Smart Receptacle (SR) prototype development with integration of Load ID, Control/Management, WiFi communication, and Web Service. Twenty SR units were built, tested, and demonstrated in the Eaton lab; eight SR units were tested in the National Renewable Energy Lab (NREL) for one-month of field testing. Load ID algorithm testing for extended load sets was conducted within the Eaton facility and at local university campuses. This report is to summarize the major achievements, activities, and outcomes under the execution of the project.

  7. Developing and analyzing long-term fuel management strategies for an advanced Small Modular PWR

    Energy Technology Data Exchange (ETDEWEB)

    Hedayat, Afshin, E-mail: ahedayat@aeoi.org.ir

    2017-03-15

    Highlights: • Comprehensive introduction and supplementary concepts as a review paper. • Developing an integrated long-term fuel management strategy for a SMR. • High reliable 3-D core modeling over fuel pins against the traditional LRM. • Verifying the expert rules of large PWRs for an advanced small PWR. • Investigating large numbers of safety parameters coherently. - Abstract: In this paper, long-term fuel management (FM) strategies are introduced and analyzed for a new advanced Pressurized Light Water Reactor (PWR) type of Small Modular Reactors (SMRs). The FM strategies are developed to be safe and practical for implementation as much as possible. Safety performances, economy of fuel, and Quality Assurance (QA) of periodic equilibrium conditions are chosen as the main goals. Flattening power density distribution over fuel pins is the major method to ensure safety performance; also maximum energy output or permissible discharging burn up indicates economy of fuel fabrication costs. Burn up effects from BOC to EOC have been traced, studied, and highly visualized in both of transport lattice cell calculations and diffusion core calculations. Long-term characteristics are searched to gain periodical equilibrium characteristics. They are fissile changes, neutron spectrum, refueling pattern, fuel cycle length, core excess reactivity, average, and maximum burn up of discharged fuels, radial Power Peaking Factors (PPF), total PPF, radial and axial power distributions, batch effects, and enrichment effects for fine regulations. Traditional linear reactivity model have been successfully simulated and adapted via fine core and burn up calculations. Effects of high burnable neutron poison and soluble boron are analyzed. Different numbers of batches via different refueling patterns have been studied and visualized. Expert rules for large type PWRs have been influenced and well tested throughout accurate equilibrium core calculations.

  8. Caregivers' management of schooling for their children with fetal alcohol spectrum disorder.

    Science.gov (United States)

    Swart, Suretha; Hall, Wendy A; McKee, William T; Ford, Laurie

    2014-11-01

    In this article we describe a grounded theory study of how caregivers of school-aged children with fetal alcohol spectrum disorder (FASD) managed their children's schooling. We completed 30 interviews with 17 caregivers residing in a western Canadian province, as well as document analysis and 25 hours of participant observation. We used constant comparative analysis to construct our substantive theory: intertwining to fit in. The core variable is an iterative cycle caregivers used to resolve their main concerns: preventing their children from failing academically and in social interactions and preventing themselves from being regarded as unacceptable parents. To intertwine to fit in, caregivers used two strategies: orchestrating schooling and keeping up appearances. They also regulated their relationships with their children. "Intertwining to fit in" contributes to the literature on attachment and parenting and extends explanations about caregivers' advocacy for their children with FASD. The theory has implications for school personnel and practitioners, as well as researchers. © The Author(s) 2014.

  9. Retrospective analysis of obstetric and anesthetic management of patients with placenta accreta spectrum disorders.

    Science.gov (United States)

    Riveros-Perez, Efrain; Wood, Cristina

    2018-03-01

    To assess the management and maternal outcomes of placenta accreta spectrum (PAS) disorders. A retrospective chart review was conducted of patients diagnosed with PAS disorders (placenta creta, increta, or percreta) who were treated at a US tertiary care center between February 1, 2011, and January 31, 2016. Obstetric management, anesthetic management, and maternal outcomes were analyzed. A total of 43 cases were identified; placenta previa was diagnosed among 33 (77%). Median age was 33 years (range 23-42). Median blood loss was 1500 mL (interquartile range 1000-2500); blood loss was greatest among the 10 patients with placenta percreta (3250 mL, interquartile range 2200-6000). Transfusion of blood products was necessary among 14 (33%) patients, with no difference in frequency according to the degree of placental invasion (P=0.107). Surgical complications occurred among 10 (23%) patients. Overall, 30 (70%) patients received combined spinal-epidural plus general anesthesia, 4 (9%) received only general anesthesia, and 9 (21%) underwent surgery with combined spinal-epidural anesthesia. One patient experienced difficult airway and another experienced accidental dural puncture. Placenta previa and accreta coexist in many patients, leading to substantial bleeding related to the degree of myometrial invasion. An interdisciplinary team approach plus the use of combined spinal-epidural anesthesia, transitioning to general anesthesia, were advisable and safe. © 2017 International Federation of Gynecology and Obstetrics.

  10. Full-spectrum photon management of solar cell structures for photovoltaic–thermoelectric hybrid systems

    International Nuclear Information System (INIS)

    Xu, Yuanpei; Xuan, Yimin; Yang, Lili

    2015-01-01

    Highlights: • A novel photon management method is proposed for hybrid photovoltaic–thermoelectric systems. • Composite structured surfaces enable creditable ultra-broadband anti-reflection property. • Incorporation of anti-reflection and light-trapping brings spectral absorption and transmission. • The efficient photon management of the structured surface is also omnidirectional. - Abstract: In this paper, a novel ultra-broadband photon management structure is proposed for crystalline silicon thin-film solar cells used in the photovoltaic–thermoelectric hybrid system. Nanostructures are employed on both front and back side. Optical behavior of the structure in ultra-broadband (300–2500 nm) are investigated through the Finite Difference Time Domain method. By combing moth-eye and inverted-parabolic surface, a new composite surface structure is proposed for anti-reflection in the ultra-broadband wavelengths. Front metallic nanoparticles, plasmonic back reflector and metallic gratings are studied for light-trapping and the effect of plasmonic back reflector is validated by the experimental data of the external quantum efficiency. The effects of incident angle are discussed for metallic gratings. Numerical computation shows that the incorporation of anti-reflection and light-trapping can obtain high absorption in the solar cell and ensure the rest incident light transmits to the thermoelectric generator efficiently. This work shows potential full-spectrum utilization of solar energy for various photovoltaic devices related with hybrid photovoltaic–thermoelectric systems

  11. Consensus Statement of the Indian Academy of Pediatrics on Evaluation and Management of Autism Spectrum Disorder.

    Science.gov (United States)

    Dalwai, Samir; Ahmed, Shabina; Udani, Vrajesh; Mundkur, Nandini; Kamath, S S; C Nair, M K

    2017-05-15

    Autism Spectrum Disorder (ASD) is a clinically heterogenous condition with a wide range of etiological factors and causing significant public health burden. ASD poses a serious developmental disadvantage to the child in the form of poor schooling, social function and adult productivity. Thus, framing evidence-based national guidelines is a pressing need. The meeting on formulation of national consensus guidelines on neurodevelopmental disorders was organized by Indian Academy of Paediatrics in Mumbai on 18th and 19th December 2015. The invited experts included Pediatricians, Developmental Pediatricians, Psychiatrists, Remedial Educators, Pediatric Neurologists and Clinical Psychologists. The participants framed guidelines after extensive discussions. Thereafter, a committee was established to review the points discussed in the meeting. To provide consensus guidelines on evaluation and management of ASD in children in India. Intervention should begin as early as possible. A definitive diagnosis is not necessary for commencing intervention. Intervention should target core features of autism i.e. deficits in social communication and interaction, and restricted repetitive patterns of behavior, activities and/ or interests. Intervention should be specific, evidence-based, structured and appropriate to the developmental needs of the child. Management of children should be provided through interdisciplinary teams, coordinated by the Pediatrician. Management of co-morbidities is critical to effectiveness of treatment. Pharmacotherapy may be offered to children when there is a specific target symptom or co-morbid condition.

  12. Recent advances in multidisciplinary management of hepatocellular carcinoma

    Science.gov (United States)

    Gomaa, Asmaa I; Waked, Imam

    2015-01-01

    The incidence of hepatocellular carcinoma (HCC) is increasing, and it is currently the second leading cause of cancer-related death worldwide. Potentially curative treatment options for HCC include resection, transplantation, and percutaneous ablation, whereas palliative treatments include trans-arterial chemoembolization (TACE), radioembolization, and systemic treatments. Due to the diversity of available treatment options and patients’ presentations, a multidisciplinary team should decide clinical management of HCC, according to tumor characteristics and stage of liver disease. Potentially curative treatments are suitable for very-early- and early-stage HCC. However, the vast majority of HCC patients are diagnosed in later stages, where the tumor characteristics or progress of liver disease prevent curative interventions. For patients with intermediate-stage HCC, TACE and radioembolization improve survival and are being evaluated in addition to potentially curative therapies or with systemic targeted therapy. There is currently no effective systemic chemotherapy, immunologic, or hormonal therapy for HCC, and sorafenib is the only approved molecular-targeted treatment for advanced HCC. Other targeted agents are under investigation; trials comparing new agents in combination with sorafenib are ongoing. Combinations of systemic targeted therapies with local treatments are being evaluated for further improvements in HCC patient outcomes. This article provides an updated and comprehensive overview of the current standards and trends in the treatment of HCC. PMID:25866604

  13. Recent advances in surgical management of early lung cancer

    Directory of Open Access Journals (Sweden)

    Shun-Mao Yang

    2017-12-01

    Full Text Available The broad application of low-dose computed tomography screening has resulted in the detection of many more cases of early lung cancer than ever before in modern history. Recent advances in the management of early-stage non-small cell lung cancer have focused on making therapy less traumatic, enhancing recovery, and preserving lung function. In this review, we discuss several new modalities associated with minimally invasive surgery for lung cancer. Firstly, less lung parenchyma resection via sublobar resection has become an acceptable alternative to lobectomy in patients with tumors less than 2 cm in size or with poor cardiopulmonary reserve. Secondly, thoracoscopic surgery using a single-portal or needlescopic approach to decrease chest wall trauma is becoming common practice. Thirdly, less invasive anesthesia, using nonintubated techniques, is feasible and safe and is associated with fewer intubation- and ventilator-associated complications. Fourthly, preoperative or intraoperative image-guided localization is an effective modality for identifying small and deep nodules during thoracoscopic surgery. Keywords: Anesthesia, Lung cancer, Nonintubated, Surgery, Thoracoscopy, Video-assisted thoracoscopic surgery (VATS

  14. Advanced factory managing technology. Sentan kojo kanri gijuts

    Energy Technology Data Exchange (ETDEWEB)

    Matsushita, M [Daicel Chemical Industries, Ltd., Osaka (Japan)

    1994-04-05

    With respect to a managing technology of advanced factories in the Japanese chemical industry, this paper enumerates the following three examples to discuss the ways the future factory technologies should be: operation techniques and problems in a newest ethylene plant, operation supports and facility control in chemical factories, and CIM structuring in beer breweries. The paper describes the operation techniques in an ethylene plant that are broken down into the following: measures for safety and material diversification, environment preservation, means to minimize the required labor, adoption of multi-variables, non-interference control technology for ethylene-propylene columns, and operation techniques that have been introduced with such a new technique as an integrated instrumentation room equipped with a gas leakage detection system. Structuring of CIM in the cited beer brewery has followed the transition of IE-TQC-JIT-FMS-CIM. Although a beer brewery may give somewhat different image from an ordinary chemical plant, the beer brewing process resembles a chemical plant in that it operates reacting machines in batch multiple tanks, and uses instrumentations and controllers using sensors. The key point in the future development is an organic link between market fluctuation and production activities. 1 fig.

  15. Advances and Challenges on Management of Gastrointestinal Stromal Tumors

    Directory of Open Access Journals (Sweden)

    Lin Mei

    2018-05-01

    Full Text Available Gastrointestinal stromal tumors (GISTs originate from interstitial cells of Cajal and account for over 5,000 newly diagnosed cases in the United States. The discovery of activated KIT and PDGFRA mutations and introduction of imatinib revolutionized the treatment strategy and opened up the new era of target therapy for solid tumors. Although surgery remains the primary modality of treatment for curative purpose, almost half of the patients experienced disease recurrence. Tailoring (neo-adjuvant treatment with imatinib is ongoing to meet the need for an effective therapy. Currently, two drugs (sunitinib and regorafenib have obtained Food and Drug Administration approval for GISTs after imatinib failure. However, most of the patients eventually progress due to primary or secondary resistance. Deeper understanding of the molecular mechanisms will guide us to develop personalized strategies in the future. Discussion in this review includes current standard management and the most recent advances and multiple ongoing clinical trials with different approaches. This review will provide further steps to be taken to conquer refractory disease.

  16. Development of Experimental Facilities for Advanced Spent Fuel Management Technology

    Energy Technology Data Exchange (ETDEWEB)

    You, G. S.; Jung, W. M.; Ku, J. H. [and others

    2004-07-01

    The advanced spent fuel management process(ACP), proposed to reduce the overall volume of the PWR spent fuel and improve safety and economy of the long-term storage of spent fuel, is under research and development. This technology convert spent fuels into pure metal-base uranium with removing the highly heat generating materials(Cs, Sr) efficiently and reducing of the decay heat, volume, and radioactivity from spent fuel by 1/4. In the next phase(2004{approx}2006), the demonstration of this technology will be carried out for verification of the ACP in a laboratory scale. For this demonstration, the hot cell facilities of {alpha}-{gamma} type and auxiliary facilities are required essentially for safe handling of high radioactive materials. As the hot cell facilities for demonstration of the ACP, a existing hot cell of {beta}-{gamma} type will be refurbished to minimize construction expenditures of hot cell facility. In this study, the design requirements are established, and the process detail work flow was analysed for the optimum arrangement to ensure effective process operation in hot cell. And also, the basic and detail design of hot cell facility and process, and safety analysis was performed to secure conservative safety of hot cell facility and process.

  17. Advanced Health Management System for the Space Shuttle Main Engine

    Science.gov (United States)

    Davidson, Matt; Stephens, John; Rodela, Chris

    2006-01-01

    Pratt & Whitney Rocketdyne, Inc., in cooperation with NASA-Marshall Space Flight Center (MSFC), has developed a new Advanced Health Management System (AHMS) controller for the Space Shuttle Main Engine (SSME) that will increase the probability of successfully placing the shuttle into the intended orbit and increase the safety of the Space Transportation System (STS) launches. The AHMS is an upgrade o the current Block II engine controller whose primary component is an improved vibration monitoring system called the Real-Time Vibration Monitoring System (RTVMS) that can effectively and reliably monitor the state of the high pressure turbomachinery and provide engine protection through a new synchronous vibration redline which enables engine shutdown if the vibration exceeds predetermined thresholds. The introduction of this system required improvements and modification to the Block II controller such as redesigning the Digital Computer Unit (DCU) memory and the Flight Accelerometer Safety Cut-Off System (FASCOS) circuitry, eliminating the existing memory retention batteries, installation of the Digital Signal Processor (DSP) technology, and installation of a High Speed Serial Interface (HSSI) with accompanying outside world connectors. Test stand hot-fire testing along with lab testing have verified successful implementation and is expected to reduce the probability of catastrophic engine failures during the shuttle ascent phase and improve safely by about 23% according to the Quantitative Risk Assessment System (QRAS), leading to a safer and more reliable SSME.

  18. Emphasizing Spectrum Management for Sustainable Development Research and Applications in Disaster Management

    Science.gov (United States)

    Ambrose, Stephen; Habib, Shahid

    2007-01-01

    NASA's spaceborne Earth and Heliospheric Observatories and airborne sensors provide a plethora of measurements. These measurements are used in science research to understand the climatology of our home planet and the solar fluxes and cycle of the only star in our solar system 'Sun' which is critical driver for the retention of life on Earth. Specifically, these measurements help us to understand the water and energy cycle, the carbon cycle, weather and climate, atmospheric chemistry, solar variability, and solid Earth and interior to feed into sophisticated mathematical models to analyze and predict the Earth's behavior as an integrated system. The main thrust of this research is on improving the prediction capability in the areas of weather, long term climate and solid Earth processes, and further help the humanity and future generations in terms of societal benefits in managing natural disasters, sustainability issues and many more. This work is further linked with our contributions in the Global Earth Observing System of Systems (GEOSS) Specifically, the data and knowledge resulting from the Earth observing systems and analytical models of the Earth can be made available for assimilation into decision support systems to serve society for disaster management. Through partnerships with national and international agencies and organizations, NASA's Science Mission Directorate's, Applied Sciences Program contributes to benchmarking practical uses of observations and predictions from Earth science remote sensing systems research. The objective is to establish innovative solutions using Earth observations and science information to provide decision support that can be adapted in applications of national and international priority. We along with the international community will continue this critical field of investigation by using our existing and future sensors from space, airborne and insitue environment. In our quest to expanding our knowledge, there will be a need

  19. [Development and application of information management system for advanced schistosomiasis chemotherapy and assistance in Jiangxi Province].

    Science.gov (United States)

    Mao, Yuan-Hua; Li, Dong; Ning, An; Qiu, Ling; Xiong, Ji-Jie

    2011-04-01

    To develop the information management system for advanced schistosomiasis chemotherapy and assistance in Jiangxi Province. Based on Access 2003, the system was programmed by Visual Basic 6.0 and packaged by Setup Factory 8.0. In the system, advanced schistosomiasis data were able to be input, printed, indexed, and statistically analyzed. The system could be operated and maintained easily and timely. The information management system for advanced schistosomiasis chemotherapy and assistance in Jiangxi Province is successfully developed.

  20. Control system design specification of advanced spent fuel management process units

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, S. H.; Kim, S. H.; Yoon, J. S

    2003-06-01

    In this study, the design specifications of instrumentation and control system for advanced spent fuel management process units are presented. The advanced spent fuel management process consists of several process units such as slitting device, dry pulverizing/mixing device, metallizer, etc. In this study, the control and operation characteristics of the advanced spent fuel management mockup process devices and the process devices developed in 2001 and 2002 are analysed. Also, a integral processing system of the unit process control signals is proposed, which the operation efficiency is improved. And a redundant PLC control system is constructed which the reliability is improved. A control scheme is proposed for the time delayed systems compensating the control performance degradation caused by time delay. The control system design specification is presented for the advanced spent fuel management process units. This design specifications can be effectively used for the detail design of the advanced spent fuel management process.

  1. Practice and prospect of advanced fuel management and fuel technology application in PWR in China

    International Nuclear Information System (INIS)

    Xiao Min; Zhang Hong; Ma Cang; Bai Chengfei; Zhou Zhou; Wang Lei; Xiao Xiaojun

    2015-01-01

    Since Daya Bay nuclear power plant implemented 18-month refueling strategy in 2001, China has completed a series of innovative fuel management and fuel technology projects, including the Ling Ao Advanced Fuel Management (AFM) project (high-burnup quarter core refueling) and the Ningde 18-month refueling project with gadolinium-bearing fuel in initial core. First, this paper gives brief introduction to China's advanced fuel management and fuel technology experience. Second, it introduces practices of the advanced fuel management in China in detail, which mainly focuses on the implementation and progress of the Ningde 18-month refueling project with gadolinium-bearing fuel in initial core. Finally, the paper introduces the practices of advanced fuel technology in China and gives the outlook of the future advanced fuel management and fuel technology in this field. (author)

  2. Indicated Prevention of Fetal Alcohol Spectrum Disorders in South Africa: Effectiveness of Case Management

    Directory of Open Access Journals (Sweden)

    Marlene M. de Vries

    2015-12-01

    Full Text Available In the Western Cape Province of South Africa (ZA a subculture of binge drinking produces the highest global documented prevalence of fetal alcohol spectrum disorders (FASD. FASD prevention research activities in ZA use the Comprehensive Prevention approach from the United States Institute of Medicine. Case management (CM was delivered as a method of indicated prevention to empower heavy drinking pregnant women to achieve cessation or a reduction in drinking. CM activities incorporated life management, Motivational Interviewing (MI techniques and the Community Reinforcement Approach (CRA. Data were collected at baseline, 6, 12 and 18 months. Mean drinking decreases 6 months into CM; but overall alcohol consumption rose significantly over time to levels higher than baseline at 12 and 18 months. Alcohol consumption drops significantly from before pregnancy to the second and third trimesters. AUDIT scores indicate that problematic drinking decreases significantly even after the vulnerable fetus/baby was born. CM significantly increases client happiness, which correlates with reduced weekend drinking. CM was successful for women with high-risk drinking behaviour, and was effective in helping women stop drinking, or drink less, while pregnant, reducing the risk of FASD.

  3. Indicated Prevention of Fetal Alcohol Spectrum Disorders in South Africa: Effectiveness of Case Management

    Science.gov (United States)

    de Vries, Marlene M.; Joubert, Belinda; Cloete, Marise; Roux, Sumien; Baca, Beth A.; Hasken, Julie M.; Barnard, Ronel; Buckley, David; Kalberg, Wendy O.; Snell, Cudore L.; Marais, Anna-Susan; Seedat, Soraya; Parry, Charles D. H.; May, Philip A.

    2015-01-01

    In the Western Cape Province of South Africa (ZA) a subculture of binge drinking produces the highest global documented prevalence of fetal alcohol spectrum disorders (FASD). FASD prevention research activities in ZA use the Comprehensive Prevention approach from the United States Institute of Medicine. Case management (CM) was delivered as a method of indicated prevention to empower heavy drinking pregnant women to achieve cessation or a reduction in drinking. CM activities incorporated life management, Motivational Interviewing (MI) techniques and the Community Reinforcement Approach (CRA). Data were collected at baseline, 6, 12 and 18 months. Mean drinking decreases 6 months into CM; but overall alcohol consumption rose significantly over time to levels higher than baseline at 12 and 18 months. Alcohol consumption drops significantly from before pregnancy to the second and third trimesters. AUDIT scores indicate that problematic drinking decreases significantly even after the vulnerable fetus/baby was born. CM significantly increases client happiness, which correlates with reduced weekend drinking. CM was successful for women with high-risk drinking behaviour, and was effective in helping women stop drinking, or drink less, while pregnant, reducing the risk of FASD. PMID:26703708

  4. Examination of characteristics and management of children with hearing loss and autism spectrum disorders.

    Science.gov (United States)

    Fitzpatrick, Elizabeth M; Lambert, Linda; Whittingham, JoAnne; Leblanc, Emma

    2014-09-01

    Up to 40% of children with hearing loss present with other developmental disabilities. The purpose of this study was to document the prevalence of autism spectrum disorders (ASD) in children with permanent hearing loss, to describe the audiologic characteristics, and to examine clinical management. Prospective data related to clinical characteristics of children identified with hearing loss and ASD were examined. A retrospective chart review was also conducted to explore clinical management and uptake of amplification. The study included all children in one Canadian region identified with permanent hearing loss and followed from 2002-2010. Of a total of 785 children with permanent hearing loss, 2.2% (n = 17) also received a diagnosis of ASD. The 13 boys and 4 girls presented with a range of audiologic profiles from unilateral to profound bilateral hearing loss. Four of five children with unilateral hearing loss experienced progression to bilateral loss. Amplification was recommended for all but one child and 9 of 16 children continued to use their hearing devices. The higher prevalence rate of ASD in this clinical population is consistent with previous reports. Our findings suggest that some children with autism can derive benefits from the use of amplification.

  5. Advanced Simulation Capability for Environmental Management (ASCEM) Phase II Demonstration

    Energy Technology Data Exchange (ETDEWEB)

    Freshley, M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hubbard, S. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Flach, G. [Savannah River National Lab. (SRNL), Aiken, SC (United States); Freedman, V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Agarwal, D. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Andre, B. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Bott, Y. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Chen, X. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Davis, J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Faybishenko, B. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Gorton, I. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Murray, C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Moulton, D. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Meyer, J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Rockhold, M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Shoshani, A. [LBNL; Steefel, C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Wainwright, H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Waichler, S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2012-09-28

    In 2009, the National Academies of Science (NAS) reviewed and validated the U.S. Department of Energy Office of Environmental Management (EM) Technology Program in its publication, Advice on the Department of Energy’s Cleanup Technology Roadmap: Gaps and Bridges. The NAS report outlined prioritization needs for the Groundwater and Soil Remediation Roadmap, concluded that contaminant behavior in the subsurface is poorly understood, and recommended further research in this area as a high priority. To address this NAS concern, the EM Office of Site Restoration began supporting the development of the Advanced Simulation Capability for Environmental Management (ASCEM). ASCEM is a state-of-the-art scientific approach that uses an integration of toolsets for understanding and predicting contaminant fate and transport in natural and engineered systems. The ASCEM modeling toolset is modular and open source. It is divided into three thrust areas: Multi-Process High Performance Computing (HPC), Platform and Integrated Toolsets, and Site Applications. The ASCEM toolsets will facilitate integrated approaches to modeling and site characterization that enable robust and standardized assessments of performance and risk for EM cleanup and closure activities. During fiscal year 2012, the ASCEM project continued to make significant progress in capabilities development. Capability development occurred in both the Platform and Integrated Toolsets and Multi-Process HPC Simulator areas. The new Platform and Integrated Toolsets capabilities provide the user an interface and the tools necessary for end-to-end model development that includes conceptual model definition, data management for model input, model calibration and uncertainty analysis, and model output processing including visualization. The new HPC Simulator capabilities target increased functionality of process model representations, toolsets for interaction with the Platform, and model confidence testing and verification for

  6. The Effect of Advanced Management Accounting Practices on the Competitive Strategies and Performance

    OpenAIRE

    Rahmi Yücel; Kayhan Ahmetoğulları

    2015-01-01

    This study is based on a sample of 300 managers from the production industry of West Marmara Region. The goal of this study is to examine the interaction among advanced management accounting practices, competitive strategies and company performance. As a result of study, it is found that advanced accounting management practices have a positive effect on the company performance and competitive strategies. In addition, competitive strategies have an effect on the company performance positively....

  7. Managing the Perception of Advanced Technology Risks in Mission Proposals

    Science.gov (United States)

    Bellisario, Sebastian Nickolai

    2012-01-01

    Through my work in the project proposal office I became interested in how technology advancement efforts affect competitive mission proposals. Technology development allows for new instruments and functionality. However, including technology advancement in a mission proposal often increases perceived risk. Risk mitigation has a major impact on the overall evaluation of the proposal and whether the mission is selected. In order to evaluate the different approaches proposals took I compared the proposals claims of heritage and technology advancement to the sponsor feedback provided in the NASA debriefs. I examined a set of Discovery 2010 Mission proposals to draw patterns in how they were evaluated and come up with a set of recommendations for future mission proposals in how they should approach technology advancement to reduce the perceived risk.

  8. Recent Advances In The Management Of Cerebro-Vascular Accident

    African Journals Online (AJOL)

    Benin Journal of Postgraduate Medicine. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 9, No 1 (2007) >. Log in or Register to get access to full text downloads.

  9. Wireless Sensor Network for Advanced Energy Management Solutions

    Energy Technology Data Exchange (ETDEWEB)

    Peter J. Theisen; Bin Lu, Charles J. Luebke

    2009-09-23

    Eaton has developed an advanced energy management solution that has been deployed to several Industries of the Future (IoF) sites. This demonstrated energy savings and reduced unscheduled downtime through an improved means for performing predictive diagnostics and energy efficiency estimation. Eaton has developed a suite of online, continuous, and inferential algorithms that utilize motor current signature analysis (MCSA) and motor power signature analysis (MPSA) techniques to detect and predict the health condition and energy usage condition of motors and their connect loads. Eaton has also developed a hardware and software platform that provided a means to develop and test these advanced algorithms in the field. Results from lab validation and field trials have demonstrated that the developed advanced algorithms are able to detect motor and load inefficiency and performance degradation. Eaton investigated the performance of Wireless Sensor Networks (WSN) within various industrial facilities to understand concerns about topology and environmental conditions that have precluded broad adoption by the industry to date. A Wireless Link Assessment System (WLAS), was used to validate wireless performance under a variety of conditions. Results demonstrated that wireless networks can provide adequate performance in most facilities when properly specified and deployed. Customers from various IoF expressed interest in applying wireless more broadly for selected applications, but continue to prefer utilizing existing, wired field bus networks for most sensor based applications that will tie into their existing Computerized Motor Maintenance Systems (CMMS). As a result, wireless technology was de-emphasized within the project, and a greater focus placed on energy efficiency/predictive diagnostics. Commercially available wireless networks were only utilized in field test sites to facilitate collection of motor wellness information, and no wireless sensor network products were

  10. Clinical Spectrum and Management of Heart Failure in Hypertrophic Cardiomyopathy.

    Science.gov (United States)

    Maron, Barry J; Rowin, Ethan J; Udelson, James E; Maron, Martin S

    2018-05-01

    Heart failure (HF), characterized by excessive exertional dyspnea, is a common complication within the broad clinical spectrum of hypertrophic cardiomyopathy (HCM). HF has become an increasingly prominent management issue with the reduction in sudden deaths due to use of implantable defibrillators in this disease. Exertional dyspnea ranges in severity from mild to severe (New York Heart Association functional classes II to IV) and not uncommonly becomes refractory to medical management, leading to progressive disability, but largely in the absence of pulmonary congestion and volume overload requiring hospitalization. HCM-related HF is most commonly due to dynamic mechanical impedance to left ventricular outflow produced by mitral valve systolic anterior motion, leading to high intracavity pressures. Surgical septal myectomy with low operative mortality (<1%) produces HF reversal and symptom relief in 90% to 95% of patients, while also conveying a survival benefit. Exercise echocardiography has assumed an important role in the evaluation of patients with HCM, i.e., by identifying candidates for septal reduction therapy with refractory HF when outflow gradients are present only with physiological exercise, distinguishing highly symptomatic nonobstructive patients as heart transplant candidates, and predicting future development of progressive HF. Notably, mortality directly attributable to HF has become exceedingly uncommon in HCM (<0.5%/year) in contrast with HF in non-HCM diseases (by 20-fold). In conclusion, HF in HCM is associated with diverse and complex pathophysiology, but a substantially more favorable prognosis than conventional non-HCM HF, and highly amenable to effective treatment options in the vast majority of patients. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  11. Nuclear facilities maintenance in the core of management-advanced trend in IBM Maximo asset management applications

    International Nuclear Information System (INIS)

    Seino, Satoshi; Ujihara, Satoshi; Kikuyama, Kaoru

    2009-01-01

    European and US plant owners have attached importance to plant maintenance, such as prompt grasp of plant states, implementation of maintenance and planning of maintenance programs, as one of asset management. The US advanced trend was introduced in this feature article through the applications of IBM Maximo Asset Management for nuclear facilities maintenance. World trends of nuclear power and related problems, need of nuclear facilities management, key items for introduction of maintenance management systems, required systems for nuclear maintenance management and introduction of functions of the IBM strategic asset management solution-Maximo were described respectively. (T. Tanaka)

  12. [Development of performance evaluation and management system on advanced schistosomiasis medical treatment].

    Science.gov (United States)

    Zhou, Xiao-Rong; Huang, Shui-Sheng; Gong, Xin-Guo; Cen, Li-Ping; Zhang, Cong; Zhu, Hong; Yang, Jun-Jing; Chen, Li

    2012-04-01

    To construct a performance evaluation and management system on advanced schistosomiasis medical treatment, and analyze and evaluate the work of the advanced schistosomiasis medical treatment over the years. By applying the database management technique and C++ programming technique, we inputted the information of the advanced schistosomiasis cases into the system, and comprehensively evaluated the work of the advanced schistosomiasis medical treatment through the cost-effect analysis, cost-effectiveness analysis, and cost-benefit analysis. We made a set of software formula about cost-effect analysis, cost-effectiveness analysis, and cost-benefit analysis. This system had many features such as clear building, easy to operate, friendly surface, convenient information input and information search. It could benefit the performance evaluation of the province's advanced schistosomiasis medical treatment work. This system can satisfy the current needs of advanced schistosomiasis medical treatment work and can be easy to be widely used.

  13. Making the connection: advancing traffic incident management in transportation planning : a primer.

    Science.gov (United States)

    2013-07-01

    "The intent of this primer is to inform and guide traffic incident management (TIM) professionals and transportation planners to initiate and develop collaborative relationships and advance TIM programs through the metropolitan planning process. The ...

  14. Advanced Product Water Removal and Management (APWR) Fuel Cell System, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — The proposed innovation is a passive, self-regulating, gravity-independent Advanced Product Water Removal and management (APWR) system for incorporation into Polymer...

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

    Science.gov (United States)

    2007-01-01

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

  16. Management Of Ischaemic Stroke – Recent Advances | Ogun ...

    African Journals Online (AJOL)

    For effective management of stroke (“brain attack”), stroke units are now in vogue in developed nations. Stroke management in our nation should be reprioritized as a time dependent urgent medical emergency just as is currently stressed for major trauma and acute myocardial infarction (heart attack). Efforts should equally ...

  17. An advanced microcosting system for forecasting and managing radiology expenses

    International Nuclear Information System (INIS)

    Arenson, R.; Viale, R.; VanDerVoorde, F.

    1985-01-01

    The new prospective payment system encourages hospital cost containment and necessitates understanding actual cost for radiology procedures. The automated microcosting system described in this paper, utilizing data from the Radiology Information Management System, hospital expense reports, and payroll management reports, calculates an accurate unit cost for each procedure type. This data is very useful for cost control, enhancement of department efficiency, and planning

  18. Clinical review: surgical management of locally advanced and recurrent colorectal cancer.

    LENUS (Irish Health Repository)

    Courtney, D

    2014-01-01

    Recurrent and locally advanced colorectal cancers frequently require en bloc resection of involved organs to achieve negative margins. The aim of this review is to evaluate the most current literature related to the surgical management of locally advanced and recurrent colorectal cancer.

  19. Advanced Technologies and Data Management Practices in Environmental Science: Lessons from Academia

    Science.gov (United States)

    Hernandez, Rebecca R.; Mayernik, Matthew S.; Murphy-Mariscal, Michelle L.; Allen, Michael F.

    2012-01-01

    Environmental scientists are increasing their capitalization on advancements in technology, computation, and data management. However, the extent of that capitalization is unknown. We analyzed the survey responses of 434 graduate students to evaluate the understanding and use of such advances in the environmental sciences. Two-thirds of the…

  20. An approach to the management of locally advanced breast cancer ...

    African Journals Online (AJOL)

    Locally advanced breast cancer (LABC) comprises a heterogeneous group of diseases. It incorporates a subset of stage IIB (T3N0) disease, stage III disease and inflammatory breast cancer. In the developed world, 7% of breast cancer patients have stage III disease at diagnosis. In developing countries, LABC constitutes ...

  1. Advanced technologies management for retailing : frameworks and cases

    NARCIS (Netherlands)

    Pantano, E.; Timmermans, H.J.P.

    2011-01-01

    The application of advanced technologies to point of sale systems is a promising and relatively unexplored field of study, in particular when considering the introduction of digital content and technologies allowing consumers to interact with products in new ways. Many e-retailers already exploit

  2. Factors Preventing Women's Advancement in Management in Turkey

    Science.gov (United States)

    Sanal, Mustafa

    2008-01-01

    This article examines the reasons why there is relatively very small number of woman administrators in public and private sector in Turkey. We have tried to reveal the factors preventing women's advancement up the organizational ladder. Although there are no legal obstacles against woman administrators in Turkey, such factors as gender…

  3. Concept for a Satellite-Based Advanced Air Traffic Management System : Volume 8. Operational Logic Flow Diagrams for a Generic Advanced Air Traffic Management system

    Science.gov (United States)

    1974-02-01

    The volume presents a description of the services a generic Advanced Air Traffic Management System (AATMS) should provide to the useres of the system to facilitate the safe, efficient flow of traffic. It provides a definition of the functions which t...

  4. Autism spectrum disorder in adults: diagnosis, management, and health services development

    Science.gov (United States)

    Murphy, Clodagh M; Wilson, C Ellie; Robertson, Dene M; Ecker, Christine; Daly, Eileen M; Hammond, Neil; Galanopoulos, Anastasios; Dud, Iulia; Murphy, Declan G; McAlonan, Grainne M

    2016-01-01

    Autism spectrum disorder (ASD) is a common neurodevelopmental disorder characterized by pervasive difficulties since early childhood across reciprocal social communication and restricted, repetitive interests and behaviors. Although early ASD research focused primarily on children, there is increasing recognition that ASD is a lifelong neurodevelopmental disorder. However, although health and education services for children with ASD are relatively well established, service provision for adults with ASD is in its infancy. There is a lack of health services research for adults with ASD, including identification of comorbid health difficulties, rigorous treatment trials (pharmacological and psychological), development of new pharmacotherapies, investigation of transition and aging across the lifespan, and consideration of sex differences and the views of people with ASD. This article reviews available evidence regarding the etiology, legislation, diagnosis, management, and service provision for adults with ASD and considers what is needed to support adults with ASD as they age. We conclude that health services research for adults with ASD is urgently warranted. In particular, research is required to better understand the needs of adults with ASD, including health, aging, service development, transition, treatment options across the lifespan, sex, and the views of people with ASD. Additionally, the outcomes of recent international legislative efforts to raise awareness of ASD and service provision for adults with ASD are to be determined. Future research is required to identify high-quality, evidence-based, and cost-effective models of care. Furthermore, future health services research is also required at the beginning and end of adulthood, including improved transition from youth to adult health care and increased understanding of aging and health in older adults with ASD. PMID:27462160

  5. Triage of the autistic spectrum child utilizing the congruence of case management concepts and Orem's Nursing Theories.

    Science.gov (United States)

    Oliver, Catherine J

    2003-01-01

    The purpose of this project was to design and implement a case management framework for the benefit of children diagnosed with an autistic spectrum disorder (ASD). The process consisted of selecting two children exhibiting symptoms of an ASD and managing them across a continuum of care. Methodological structure was derived from case management standards of practice and Orem's Nursing Theories. Although some objectives sustained a slight delay because of variances, findings revealed successful outcomes based on progression toward measurable case management goals. The children were directed to appropriate school placements and habilitative therapies in an efficient manner. Their parents received support and education related to special needs children. The process yielded assurance that Orem's Nursing Theories and case management concepts articulate seamlessly within nursing care boundaries.

  6. Recent advances in applying decision science to managing national forests

    Science.gov (United States)

    Marcot, Bruce G.; Thompson, Matthew P.; Runge, Michael C.; Thompson, Frank R.; McNulty, Steven; Cleaves, David; Tomosy, Monica; Fisher, Larry A.; Andrew, Bliss

    2012-01-01

    Management of federal public forests to meet sustainability goals and multiple use regulations is an immense challenge. To succeed, we suggest use of formal decision science procedures and tools in the context of structured decision making (SDM). SDM entails four stages: problem structuring (framing the problem and defining objectives and evaluation criteria), problem analysis (defining alternatives, evaluating likely consequences, identifying key uncertainties, and analyzing tradeoffs), decision point (identifying the preferred alternative), and implementation and monitoring the preferred alternative with adaptive management feedbacks. We list a wide array of models, techniques, and tools available for each stage, and provide three case studies of their selected use in National Forest land management and project plans. Successful use of SDM involves participation by decision-makers, analysts, scientists, and stakeholders. We suggest specific areas for training and instituting SDM to foster transparency, rigor, clarity, and inclusiveness in formal decision processes regarding management of national forests.

  7. Automated Contingency Management for Advanced Propulsion Systems, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — Automated Contingency Management (ACM), or the ability to confidently and autonomously adapt to fault conditions with the goal of still achieving mission objectives,...

  8. Advances in Imaging and Management Trends of Traumatic Aortic Injuries

    Energy Technology Data Exchange (ETDEWEB)

    Nagpal, Prashant, E-mail: drprashantnagpal@gmail.com, E-mail: Prashant-nagpal@uiowa.edu; Mullan, Brian F. [University of Iowa Hospitals and Clinics, Department of Radiology (United States); Sen, Indrani [Mayo Clinic, Department of Vascular and Endovascular Surgery (United States); Saboo, Sachin S. [UT Southwestern Medical Center, Department of Radiology (United States); Khandelwal, Ashish [Mayo Clinic, Department of Radiology (United States)

    2017-05-15

    Acute traumatic aortic injury (ATAI) is a life-threatening injury. CT is the imaging tool of choice, and the knowledge of direct and indirect signs of injury, grading system, and current management protocol helps the emergency radiologist to better identify and classify the injury and provide additional details that can impact management options. Newer dual-source CT technology with ultrafast acquisition speed has also influenced the appropriate protocol for imaging in patients with suspected ATAI. This review highlights the imaging protocol in patients with blunt trauma, CT appearance and grading systems of ATAI, management options, and the role of the multidisciplinary team in the management of these patients. We also briefly review the current literature on the definition, treatment, and follow-up protocol in patients with minimal aortic injury.

  9. Recent advances in oceanography and new perspectives in fisheries management

    Digital Repository Service at National Institute of Oceanography (India)

    Kutty, M.K.

    The reason de etre for the swing back to an empirical approach in fisheries management as an interim measure towards developing a truly rational method is discussed. The importance of physical oceanographic and meteorological factors especially...

  10. Advances in Imaging and Management Trends of Traumatic Aortic Injuries

    International Nuclear Information System (INIS)

    Nagpal, Prashant; Mullan, Brian F.; Sen, Indrani; Saboo, Sachin S.; Khandelwal, Ashish

    2017-01-01

    Acute traumatic aortic injury (ATAI) is a life-threatening injury. CT is the imaging tool of choice, and the knowledge of direct and indirect signs of injury, grading system, and current management protocol helps the emergency radiologist to better identify and classify the injury and provide additional details that can impact management options. Newer dual-source CT technology with ultrafast acquisition speed has also influenced the appropriate protocol for imaging in patients with suspected ATAI. This review highlights the imaging protocol in patients with blunt trauma, CT appearance and grading systems of ATAI, management options, and the role of the multidisciplinary team in the management of these patients. We also briefly review the current literature on the definition, treatment, and follow-up protocol in patients with minimal aortic injury.

  11. Advances in Imaging and Management Trends of Traumatic Aortic Injuries.

    Science.gov (United States)

    Nagpal, Prashant; Mullan, Brian F; Sen, Indrani; Saboo, Sachin S; Khandelwal, Ashish

    2017-05-01

    Acute traumatic aortic injury (ATAI) is a life-threatening injury. CT is the imaging tool of choice, and the knowledge of direct and indirect signs of injury, grading system, and current management protocol helps the emergency radiologist to better identify and classify the injury and provide additional details that can impact management options. Newer dual-source CT technology with ultrafast acquisition speed has also influenced the appropriate protocol for imaging in patients with suspected ATAI. This review highlights the imaging protocol in patients with blunt trauma, CT appearance and grading systems of ATAI, management options, and the role of the multidisciplinary team in the management of these patients. We also briefly review the current literature on the definition, treatment, and follow-up protocol in patients with minimal aortic injury.

  12. Advanced business process management in networked E-business scenarios

    NARCIS (Netherlands)

    Grefen, P.W.P.J.; Türetken, O.

    2017-01-01

    In the modern economy, we see a shift towards networked business scenarios. In many contemporary situations, the operation of multiple organizations is tightly coupled in collaborative business networks. To allow this tightly coupled collaboration, business process management (BPM) in these

  13. Asset Management of Roadway Signs Through Advanced Technology

    Science.gov (United States)

    2003-06-01

    This research project aims to ease the process of Roadway Sign asset management. The project utilized handheld computer and global positioning system (GPS) technology to capture sign location data along with a timestamp. This data collection effort w...

  14. Assessing Advanced Airway Management Performance in a National Cohort of Emergency Medical Services Agencies.

    Science.gov (United States)

    Wang, Henry E; Donnelly, John P; Barton, Dustin; Jarvis, Jeffrey L

    2018-05-01

    Although often the focus of quality improvement efforts, emergency medical services (EMS) advanced airway management performance has few national comparisons, nor are there many assessments with benchmarks accounting for differences in agency volume or patient mix. We seek to assess variations in advanced airway management and conventional intubation performance in a national cohort of EMS agencies. We used EMS data from ESO Solutions, a national EMS electronic health record system. We identified EMS emergency responses with attempted advanced airway management (conventional intubation, rapid sequence intubation, sedation-assisted intubation, supraglottic airway insertion, and cricothyroidotomy). We also separately examined cases with initial conventional intubation. We determined EMS agency risk-standardized advanced airway management and initial conventional intubation success rates by using mixed-effects regression models, fitting agency as a random intercept, adjusting for patient age, sex, race, cardiac arrest, or trauma status, and use of rapid sequence or sedation-assisted intubation, and accounting for reliability variations from EMS agency airway volume. We assessed changes in agency advanced airway management and initial conventional intubation performance rank after risk and reliability adjustment. We also identified high and low performers (reliability-adjusted and risk-standardized success confidence intervals falling outside the mean). During 2011 to 2015, 550 EMS agencies performed 57,209 advanced airway management procedures. Among 401 EMS agencies with greater than or equal to 10 advanced airway management procedures, there were a total of 56,636 procedures. Median reliability-adjusted and risk-standardized EMS agency advanced airway management success was 92.9% (interquartile range 90.1% to 94.8%; minimum 58.2%; maximum 99.0%). There were 56 advanced airway management low-performing and 38 high-performing EMS agencies. Among 342 agencies with

  15. Autism spectrum disorder in adults: diagnosis, management, and health services development

    Directory of Open Access Journals (Sweden)

    Murphy CM

    2016-07-01

    Full Text Available Clodagh M Murphy,1,2 C Ellie Wilson,1–3 Dene M Robertson,1,2 Christine Ecker,1,4 Eileen M Daly,1,2 Neil Hammond,1,2 Anastasios Galanopoulos,1,2 Iulia Dud,1,2 Declan G Murphy,1,2 Grainne M McAlonan1,2 1Sackler Institute for Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, 2Behavioural and Developmental Psychiatry Clinical Academic Group, Behavioural Genetics Clinic, National Adult Autism Service, South London and Maudsley Foundation NHS Trust, London, UK; 3Individual Differences, Language and Cognition Lab, Department of Developmental and Educational Psychology, University of Seville, Spain; 4Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Goethe-University, Frankfurt am Main, Germany Abstract: Autism spectrum disorder (ASD is a common neurodevelopmental disorder characterized by pervasive difficulties since early childhood across reciprocal social communication and restricted, repetitive interests and behaviors. Although early ASD research focused primarily on children, there is increasing recognition that ASD is a lifelong neurodevelopmental disorder. However, although health and education services for children with ASD are relatively well established, service provision for adults with ASD is in its infancy. There is a lack of health services research for adults with ASD, including identification of comorbid health difficulties, rigorous treatment trials (pharmacological and psychological, development of new pharmacotherapies, investigation of transition and aging across the lifespan, and consideration of sex differences and the views of people with ASD. This article reviews available evidence regarding the etiology, legislation, diagnosis, management, and service provision for adults with ASD and considers what is needed to support adults with ASD as they age. We conclude

  16. Advances in service and operations for ATLAS data management

    International Nuclear Information System (INIS)

    Stewart, Graeme A; Garonne, Vincent; Lassnig, Mario; Molfetas, Angelos; Barisits, Martin; Calvet, Ivan; Beermann, Thomas; Megino, Fernando Barreiro; Campana, Simone; Zhang, Donal; Tykhonov, Andrii; Serfon, Cedric; Oleynik, Danila; Petrosyan, Artem

    2012-01-01

    ATLAS has recorded almost 5PB of RAW data since the LHC started running at the end of 2009. Many more derived data products and complimentary simulation data have also been produced by the collaboration and, in total, 70PB is currently stored in the Worldwide LHC Computing Grid by ATLAS. All of this data is managed by the ATLAS Distributed Data Management system, called Don Quixote 2 (DQ2). DQ2 has evolved rapidly to help ATLAS Computing operations manage these large quantities of data across the many grid sites at which ATLAS runs and to help ATLAS physicists get access to this data. In this paper we describe new and improved DQ2 services: popularity; space monitoring and accounting; exclusion service; cleaning agents; deletion agents. We describe the experience of data management operation in ATLAS computing, showing how these services enable management of petabyte scale computing operations. We illustrate the coupling of data management services to other parts of the ATLAS computing infrastructure, in particular showing how feedback from the distributed analysis system in ATLAS has enabled dynamic placement of the most popular data, helping users and groups to analyse the increasing data volumes on the grid.

  17. Advances in service and operations for ATLAS data management

    Science.gov (United States)

    Stewart, Graeme A.; Garonne, Vincent; Lassnig, Mario; Molfetas, Angelos; Barisits, Martin; Zhang, Donal; Calvet, Ivan; Beermann, Thomas; Barreiro Megino, Fernando; Tykhonov, Andrii; Campana, Simone; Serfon, Cedric; Oleynik, Danila; Petrosyan, Artem; ATLAS Collaboration

    2012-06-01

    ATLAS has recorded almost 5PB of RAW data since the LHC started running at the end of 2009. Many more derived data products and complimentary simulation data have also been produced by the collaboration and, in total, 70PB is currently stored in the Worldwide LHC Computing Grid by ATLAS. All of this data is managed by the ATLAS Distributed Data Management system, called Don Quixote 2 (DQ2). DQ2 has evolved rapidly to help ATLAS Computing operations manage these large quantities of data across the many grid sites at which ATLAS runs and to help ATLAS physicists get access to this data. In this paper we describe new and improved DQ2 services: popularity; space monitoring and accounting; exclusion service; cleaning agents; deletion agents. We describe the experience of data management operation in ATLAS computing, showing how these services enable management of petabyte scale computing operations. We illustrate the coupling of data management services to other parts of the ATLAS computing infrastructure, in particular showing how feedback from the distributed analysis system in ATLAS has enabled dynamic placement of the most popular data, helping users and groups to analyse the increasing data volumes on the grid.

  18. Management of Advanced-Phase Chronic Myelogenous Leukemia.

    Science.gov (United States)

    Radich, Jerald P

    2016-05-01

    Chronic myelogenous leukemia represents the poster child of successful precision medicine in cancer, with amazing survival results achieved with targeted tyrosine kinase inhibitors (TKIs) in many patients with chronic-phase disease. Unfortunately, however, this good news has not extended to patients in blast crisis, for whom survival has not clearly been improved with TKIs. During his presentation at the NCCN 21st Annual Conference, Jerald P. Radich, MD, briefly explored the biology behind advanced-stage disease and several of the molecular findings in disease progression. He also reviewed some of the therapeutic options in advanced disease, emphasizing that transplantation, although fraught with some difficulties, offers the best long-term prognosis for patients in blast crisis. Copyright © 2016 by the National Comprehensive Cancer Network.

  19. Advances in Remote Sensing for Vegetation Dynamics and Agricultural Management

    Science.gov (United States)

    Tucker, Compton; Puma, Michael

    2015-01-01

    Spaceborne remote sensing has led to great advances in the global monitoring of vegetation. For example, the NASA Global Inventory Modeling and Mapping Studies (GIMMS) group has developed widely used datasets from the Advanced Very High Resolution Radiometer (AVHRR) sensors as well as the Moderate Resolution Imaging Spectroradiometer (MODIS) map imagery and normalized difference vegetation index datasets. These data are valuable for analyzing vegetation trends and variability at the regional and global levels. Numerous studies have investigated such trends and variability for both natural vegetation (e.g., re-greening of the Sahel, shifts in the Eurasian boreal forest, Amazonian drought sensitivity) and crops (e.g., impacts of extremes on agricultural production). Here, a critical overview is presented on recent developments and opportunities in the use of remote sensing for monitoring vegetation and crop dynamics.

  20. Potential applications of advanced information technology in emergency management

    International Nuclear Information System (INIS)

    Andersson, H.; Holmstrom, C.

    1987-01-01

    Within nuclear-, offshore- and petrochemical industries there is always a potential risk for severe incidents and accidents. It is a commonly shared belief that timely and correct decisions in these situations could either prevent an incident to develop into a severe accident or to mitigate the negative consequences of an accident. It is also a common belief that in those cases where poor decisions have been taken it has been because of insufficient access to information and expert knowledge when the decisions were taken. These are the background experiences for the joint Nordic research program on the use of advanced information technology in emergency preparedness organizations. Important initial research tasks in the program have been to identify and specify the needs for advanced information technology applications in emergency preparedness organizations. So far a couple of studies aiming for a needs assessment of advanced information technologies in nuclear power emergency preparedness organizations in Sweden and Finland have been completed. The conclusions from these studies are presented in this paper

  1. Management of Locally Advanced Cancer Cervix an Indian Perspective.

    Science.gov (United States)

    Singh, J K; Chauhan, Richa

    2015-01-01

    Cervical cancer has a major impact on the lives of Indian women with an estimated 122, 844 new cases of cervical cancer in the year 2012. About 80% of these cases present in a locally advanced stage leading to high morbidity and mortality. Because of lack of public awareness and infrastructure for screening and early detection in developing countries, this late presentation is likely to continue in the coming years. Radiation therapy has been the treatment of choice for patients with locally advanced cancer cervix. Many clinical trials and meta-analyses have shown a significant improvement in overall and progression-free survival with decreased local and distant recurrences with the use of concurrent chemotherapy with radiation. Most of these trials have been done in women from developed countries where the patient and disease profile are entirely different from ours. Recently, few trials from India have also shown promising results in locally advanced cancer cervix with concurrent chemoradiotherapy but toxicities remain a major concern. Further exploration is required for the use of concurrent chemo radiation prior to incorporating it into routine clinical practice.

  2. Advanced imaging in acute stroke management-Part I: Computed tomographic.

    Science.gov (United States)

    Saini, Monica; Butcher, Ken

    2009-01-01

    Neuroimaging is fundamental to stroke diagnosis and management. Non-contrast computed tomography (NCCT) has been the primary imaging modality utilized for this purpose for almost four decades. Although NCCT does permit identification of intracranial hemorrhage and parenchymal ischemic changes, insights into blood vessel patency and cerebral perfusion are limited. Advances in reperfusion strategies have made identification of potentially salvageable brain tissue a more practical concern. Advances in CT technology now permit identification of acute and chronic arterial lesions, as well as cerebral blood flow deficits. This review outlines principles of advanced CT image acquisition and its utility in acute stroke management.

  3. [Advances in low impact development technology for urban stormwater management].

    Science.gov (United States)

    Liu, Wen; Chen, Wei-ping; Peng, Chi

    2015-06-01

    Low impact development ( LID), as an innovative technology for stormwater management, is effective to mitigate urban flooding and to detain pollutants. This paper systemically introduced the LID technology system, and summarized the reduction effects of three typical LID facilities (i.e. , bio-retention, green roof and permeable pavement) on stormwater runoff and main pollutants in recent literature, as well as research outcomes and experiences of LID technology on model simulation, cost-benefit analysis and management system. On this basis, we analyzed the problems and limitations of current LID technology studies. Finally, some suggestions about future research directions, appropriate design and scientific management were put forth. This work intended to provide scientific basis and suggestions for widespread use and standard setting of LID technology in China by referencing overseas studies.

  4. The advancement of regulation fee, budget system, and set-up time management

    Energy Technology Data Exchange (ETDEWEB)

    Jung, J. S.; Choi, E. S.; Cho, J. I.; Jung, S. C.; Lee, J. H. [Caleb and Company, Seoul (Korea, Republic of)

    2001-07-15

    Analyze the government's charging fee amendment and suggest the national regulation fee system. Suggest the future business portfolio based in the current business analysis. Design the advanced budget code structure, the performance management of the project budget and the survice level agreement between divisions. Develop the time management and the methodology of the standard man-hour calculation.

  5. Managing occupations in everyday life for people with advanced cancer living at home

    DEFF Research Database (Denmark)

    Peoples, Hanne; Brandt, Åse; Wæhrens, Eva Elisabet Ejlersen

    2017-01-01

    occupations in everyday life and 2) Self-developed strategies to manage occupations. Significance: The findings suggest that people with advanced cancer should be supported to a greater extent in finding ways to manage familiar as well as new and more personally meaningful occupations to enhance quality...

  6. Advances in Financial Risk Management and Economic Policy Uncertainty: An Overview

    NARCIS (Netherlands)

    S.M. Hammoudeh (Shawkat); M.J. McAleer (Michael)

    2014-01-01

    markdownabstract__Abstract__ Financial risk management is difficult at the best of times, but especially so in the presence of economic uncertainty and financial crises. The purpose of this special issue on “Advances in Financial Risk Management and Economic Policy Uncertainty” is to highlight

  7. Advancing Management Innovation: Synthesizing Processes, Levels of Analysis, and Change Agents

    NARCIS (Netherlands)

    Volberda, H.W.; van den Bosch, F.; Mihalache, R.O.

    2014-01-01

    Despite the mounting evidence that innovation in management can fuel competitive advantage, we still know relatively little about how firms introduce new ways of managing. The goal of this introductory essay—and the Themed Section it introduces—is to advance this knowledge. To this end, we first

  8. Advances in probabilistic databases for uncertain information management

    CERN Document Server

    Yan, Li

    2013-01-01

    This book covers a fast-growing topic in great depth and focuses on the technologies and applications of probabilistic data management. It aims to provide a single account of current studies in probabilistic data management. The objective of the book is to provide the state of the art information to researchers, practitioners, and graduate students of information technology of intelligent information processing, and at the same time serving the information technology professional faced with non-traditional applications that make the application of conventional approaches difficult or impossible.

  9. Color quality management in advanced flat panel display engines

    Science.gov (United States)

    Lebowsky, Fritz; Neugebauer, Charles F.; Marnatti, David M.

    2003-01-01

    During recent years color reproduction systems for consumer needs have experienced various difficulties. In particular, flat panels and printers could not reach a satisfactory color match. The RGB image stored on an Internet server of a retailer did not show the desired colors on a consumer display device or printer device. STMicroelectronics addresses this important color reproduction issue inside their advanced display engines using novel algorithms targeted for low cost consumer flat panels. Using a new and genuine RGB color space transformation, which combines a gamma correction Look-Up-Table, tetrahedrization, and linear interpolation, we satisfy market demands.

  10. Managing occupations in everyday life for people with advanced cancer living at home.

    Science.gov (United States)

    Peoples, Hanne; Brandt, Åse; Wæhrens, Eva E; la Cour, Karen

    2017-01-01

    People with advanced cancer are able to live for extended periods of time. Advanced cancer can cause functional limitations influencing the ability to manage occupations. Although studies have shown that people with advanced cancer experience occupational difficulties, there is only limited research that specifically explores how these occupational difficulties are managed. To describe and explore how people with advanced cancer manage occupations when living at home. A sub-sample of 73 participants from a larger occupational therapy project took part in the study. The participants were consecutively recruited from a Danish university hospital. Qualitative interviews were performed at the homes of the participants. Content analysis was applied to the data. Managing occupations were manifested in two main categories; (1) Conditions influencing occupations in everyday life and (2) Self-developed strategies to manage occupations. The findings suggest that people with advanced cancer should be supported to a greater extent in finding ways to manage familiar as well as new and more personally meaningful occupations to enhance quality of life.

  11. Management of cancer-associated thrombosis in people with advanced disease.

    Science.gov (United States)

    Noble, Simon; Johnson, Miriam J

    2012-06-01

    The management of venous thromboembolism in the cancer population is clearly established. Low molecular weight heparin has a greater efficacy than warfarin in the treatment of cancer-associated thrombosis and is recommended as the preferred therapy. However, the evidence informing these recommendations excluded patients with poor prognosis or performance status, thrombocytopenia, bleeding or brain metastases. Furthermore, there is limited data on the management of venous thromboembolism resistant to anticoagulation, a phenomenon frequently encountered in the advanced cancer population. This paper will review the management of cancer-associated thrombosis with a particular focus on challenging clinical situations faced by palliative care teams looking after patients with advanced disease.

  12. Advances in the science and technology of ocean management

    CERN Document Server

    Smith, Hance

    2002-01-01

    This book reviews key developments in the field of marine science and technology. It focuses on three major themes such as the importance of technical developments in ocean management, the application of these developments to specific sea uses ranging from fish farming to the disposal of industrial waste, and the long-term issues that such developments raise.

  13. Recent advances in the Management of Diabetes Mellitus | Sanusi ...

    African Journals Online (AJOL)

    Life style modi cation, oral hypoglycaemic agents, insulin therapy and islet cell transplantation are some of the approaches in the management of diabetes mellitus. Several classes of oral hypoglycemic agents like sulfonylureas, biguanides and alpha-glucosidase inhibitors are available for the treatment of type II diabetes ...

  14. Advances in integrated fire management in central Mexico

    Science.gov (United States)

    Dante Arturo Rodríguez Trejo; Arturo Cruz Reyes

    2013-01-01

    This paper reports on the research and operational results of efforts made by some rural communities, the National Forestry Commission (CONAFOR), the Universidad Autónoma Chapingo (UACH) and other organizations to achieve integrated fire management in central Mexico. The research includes the latest results obtained by UACH's Ajusco Project on the subject, in both...

  15. CISM Advanced School on Crashworthiness : Energy Management and Occupant Protection

    CERN Document Server

    2001-01-01

    From the fundamentals of impact mechanics and biomechanics to modern analysis and design techniques in impact energy management and occupant protection this book provides an overview of the application of nonlinear finite elements, conceptual modeling and multibody procedures, impact biomechanics, injury mechanisms, occupant mathematical modeling, and human surrogates in crashworthiness.

  16. Advanced Parental Ages and Low Birth Weight in Autism Spectrum Disorders--Rates and Effect on Functioning

    Science.gov (United States)

    Ben Itzchak, Esther; Lahat, Eli; Zachor, Ditza A.

    2011-01-01

    Objectives: (1) To assess the distribution of parental age and birth weight in a large cohort with autism spectrum disorder (ASD) and to compare them to Israeli national data. (2) To examine possible relationships between these risk factors and functioning. Methods: The study included 529 participants diagnosed with ASD using standardized tests:…

  17. Foundational Report Series: Advanced Distribution Management Systems for Grid Modernization

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Jianhui [Argonne National Lab. (ANL), Argonne, IL (United States)

    2015-09-01

    This report describes the application functions for distribution management systems (DMS). The application functions are those surveyed by the IEEE Power and Energy Society’s Task Force on Distribution Management Systems. The description of each DMS application includes functional requirements and the key features and characteristics in current and future deployments, as well as a summary of the major benefits provided by each function to stakeholders — from customers to shareholders. Due consideration is paid to the fact that the realizable benefits of each function may differ by type of utility, whether investor-owned, cooperative, or municipal. This report is sufficient to define the functional requirements of each application for system procurement (request-for-proposal [RFP]) purposes and for developing preliminary high-level use cases for those functions. However, it should not be considered a design document that will enable a vendor or software developer to design and build actual DMS applications.

  18. Knowledge management and Discovery for advanced Enterprise Knowledge Engineering

    OpenAIRE

    Novi, Daniele

    2014-01-01

    2012 - 2013 The research work addresses mainly issues related to the adoption of models, methodologies and knowledge management tools that implement a pervasive use of the latest technologies in the area of Semantic Web for the improvement of business processes and Enterprise 2.0 applications. The first phase of the research has focused on the study and analysis of the state of the art and the problems of Knowledge Discovery database, paying more attention to the data mining systems. Th...

  19. Advanced thermal management of diesel engines; Neues Thermomanagement beim Dieselmotor

    Energy Technology Data Exchange (ETDEWEB)

    Wenzel, Wolfgang; Becker, Michael [BorgWarner, Ludwigsburg (Germany). Konzernvorentwicklung fuer Pkw-Antriebssysteme; Shutty, John [BorgWarner, Auburn Hills (United States). Regelung und Simulation in der Konzernvorentwicklung

    2013-05-01

    The potential of thermal management with respect to CO{sub 2} reduction is given by faster warm-up of engine and drivetrain, reduced losses from water pump and fan and finally the operation of the engine in an optimal temperature range. In a new approach, BorgWarner applies a variable coolant pump and a controlled coolant valve to a conventional cooling system. Both components, as well as the viscous fan clutch, are controlled by a newly developed controls approach.

  20. Advanced Reactive Power Reserve Management Scheme to Enhance LVRT Capability

    Directory of Open Access Journals (Sweden)

    Hwanik Lee

    2017-10-01

    Full Text Available Abstract: To increase the utilization of wind power in the power system, grid integration standards have been proposed for the stable integration of large-scale wind power plants. In particular, fault-ride-through capability, especially Low-Voltage-Ride-Through (LVRT, has been emphasized, as it is related to tripping in wind farms. Therefore, this paper proposes the Wind power plant applicable-Effective Reactive power Reserve (Wa-ERPR, which combines both wind power plants and conventional generators at the Point of Interconnection (POI. The reactive power capability of the doubly-fed induction generator wind farm was considered to compute the total Wa-ERPR at the POI with reactive power capability of existing generators. By using the Wa-ERPR management algorithm, in case of a violation of the LVRT standards, the amount of reactive power compensation is computed using the Wa-ERPR management scheme. The proposed scheme calculates the Wa-ERPR and computes the required reactive power, reflecting the change of the system topology pre- and post-contingency, to satisfy the LVRT criterion when LVRT regulation is not satisfied at the POI. The static synchronous compensator (STATCOM with the capacity corresponding to calculated amount of reactive power through the Wa-ERPR management scheme is applied to the POI. Therefore, it is confirmed that the wind power plant satisfies the LVRT criteria by securing the appropriate reactive power at the POI, by applying of the proposed algorithm.

  1. Advanced modeling of management processes in information technology

    CERN Document Server

    Kowalczuk, Zdzislaw

    2014-01-01

    This book deals with the issues of modelling management processes of information technology and IT projects while its core is the model of information technology management and its component models (contextual, local) describing initial processing and the maturity capsule as well as a decision-making system represented by a multi-level sequential model of IT technology selection, which acquires a fuzzy rule-based implementation in this work. In terms of applicability, this work may also be useful for diagnosing applicability of IT standards in evaluation of IT organizations. The results of this diagnosis might prove valid for those preparing new standards so that – apart from their own visions – they could, to an even greater extent, take into account the capabilities and needs of the leaders of project and manufacturing teams. The book is intended for IT professionals using the ITIL, COBIT and TOGAF standards in their work. Students of computer science and management who are interested in the issue of IT...

  2. The Use and Management of the Electromagnetic Spectrum, Part I. President's Task Force on Communications Policy. Staff Paper Seven, Part I.

    Science.gov (United States)

    Rostow, Eugene V.

    A staff paper to the President's Task Force on Communications Policy analyses the use of the electromagnetic spectrum for communications and suggests improvements. The evolution of spectrum use and its present federal management are described together with the problem of achieving efficient use in the areas of electromagnetic congestion. Criticism…

  3. Recent advances in the management of neonatal jaundice

    Directory of Open Access Journals (Sweden)

    Watchko JF

    2014-11-01

    Full Text Available Jon F Watchko Division of Newborn Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Magee-Womens Research Institute, Pittsburgh, PA, USA Abstract: Advances in the clinical assessment strategies used to identify neonates at risk for the development of severe hyperbilirubinemia and bilirubin neurotoxicity, as well as the treatment measures to control hyperbilirubinemia in newborns, continue to be made. They include, among others, universal predischarge birth hospitalization bilirubin screening, the confirmation that hemolysis is an important risk factor for bilirubin neurotoxicity, the use of a numeric scoring system to help stage the severity of acute bilirubin encephalopathy, the potential advantages of turquoise-light phototherapy, and the potential role of heme-oxygenase inhibitors in preventing the need for exchange transfusions, all of which are reviewed here. Keywords: phototherapy, exchange transfusion, bilirubin, free bilirubin, bilirubin encephalopathy, kernicterus

  4. Advanced man-machine interface systems and advanced information management systems programs

    International Nuclear Information System (INIS)

    Naser, J.; Gray, S.; Machiels, A.

    1997-01-01

    The Advanced Light Water Reactor (ALWR) Program started in the early 1980's. This work involves the development and NRC review of the ALWR Utility Requirements Documents, the development and design certification of ALWR designs, the analysis of the Early Site Permit process, and the First-of-a-Kind Engineering for two of the ALWR plant designs. ALWRs will embody modern proven technology. However, technologies expected to be used in these plants are changing very rapidly so that additional capabilities will become available that will be beneficial for future plants. To remain competitive on a life-cycle basis in the future, the ALWR must take advantage of the best and most modem technologies available. 1 ref

  5. Advances in chest drain management in thoracic disease

    Science.gov (United States)

    George, Robert S.

    2016-01-01

    An adequate chest drainage system aims to drain fluid and air and restore the negative pleural pressure facilitating lung expansion. In thoracic surgery the post-operative use of the conventional underwater seal chest drainage system fulfills these requirements, however they allow great variability amongst practices. In addition they do not offer accurate data and they are often inconvenient to both patients and hospital staff. This article aims to simplify the myths surrounding the management of chest drains following chest surgery, review current experience and explore the advantages of modern digital chest drain systems and address their disease-specific use. PMID:26941971

  6. Recommendations for managing cutaneous disorders associated with advancing age

    Directory of Open Access Journals (Sweden)

    Humbert P

    2016-02-01

    Full Text Available Philippe Humbert,1 Brigitte Dréno,2 Jean Krutmann,3 Thomas Anton Luger,4 Raoul Triller,5 Sylvie Meaume,6 Sophie Seité71Research and Studies Centre on the Integument (CERT, Clinical Investigation Centre (CIC BT506, Department of Dermatology, Besançon University Hospital, University of Franche-Comté, Besançon, France; 2Department of Dermato-Cancerology, Nantes University Hospital, Nantes, France; 3IUF-Leibniz Research Institute for Environmental Medicine, Heinrich-Heine-University, Düsseldorf, Germany; 4Department of Dermatology, University of Münster, Münster, Germany; 5International Centre of Dermatology, Hertford British Hospital, Levallois, France; 6Geriatric Service, Wounds and Healing, Rothschild Hôspital, Paris, France; 7La Roche-Posay Dermatological Laboratories, Asnières, FranceAbstract: The increasingly aged population worldwide means more people are living with chronic diseases, reduced autonomy, and taking various medications. Health professionals should take these into consideration when managing dermatological problems in elderly patients. Accordingly, current research is investigating the dermatological problems associated with the loss of cutaneous function with age. As cell renewal slows, the physical and chemical barrier function declines, cutaneous permeability increases, and the skin becomes increasingly vulnerable to external factors. In geriatric dermatology, the consequences of cutaneous aging lead to xerosis, skin folding, moisture-associated skin damage, and impaired wound healing. These problems pose significant challenges for both the elderly and their carers. Most often, nurses manage skin care in the elderly. However, until recently, little attention has been paid to developing appropriate, evidence-based, skincare protocols. The objective of this paper is to highlight common clinical problems with aging skin and provide some appropriate advice on cosmetic protocols for managing them. A review of the

  7. 20th International Symposium on Advancement of Construction Management and Real Estate

    CERN Document Server

    Zheng, Sheng; Luo, Jiaojiao; Wang, Wei; Mo, Zhibin; Shan, Liping

    2017-01-01

    These conference proceedings offer an outstanding resource for academics and professionals, sharing essential findings on the latest developments in real estate and construction management. The subject is “Advancement of Construction Management and Real Estate” in the context of new-type urbanization. The Chinese Research Institute of Construction Management (CRIOCM), working in close collaboration with Zhejiang University, organized CRIOCM2015, the 20th International Symposium. Written by academics and professionals from all over the world, these proceedings discuss the latest achievements, research outputs and advances between frontier disciplines in the field of construction management and real estate. They cover a wide range of topics, including new-type urbanization, land development and land use, urban development and management, the real estate market and housing policies. The discussions will provide an important reference source on the implementation of new-type urbanization in China and abroad.

  8. Management of Human Immunodeficiency Virus Infection in Advanced Age

    Science.gov (United States)

    Greene, Meredith; Justice, Amy C.; Lampiris, Harry W.; Valcour, Victor

    2013-01-01

    Importance Human immunodeficiency virus (HIV)-positive patients treated with antiretroviral therapy now have increased life expectancy and develop chronic illnesses that are often seen in older HIV-negative patients. Objective To address emerging issues related to aging with HIV. Screening older adults for HIV, diagnosis of concomitant diseases, management of multiple comorbid medical illnesses, social isolation, polypharmacy, and factors associated with end-of-life care are reviewed. Evidence Acquisition Published guidelines and consensus statements were reviewed. PubMed and PsycINFO were searched between January 2000 and February 2013. Articles not appearing in the search that were referenced by reviewed articles were also evaluated. Findings The population of older HIV-positive patients is rapidly expanding. It is estimated that by 2015 one-half of the individuals in the United States with HIV will be older than age 50. Older HIV-infected patients are prone to having similar chronic diseases as their HIV-negative counterparts, as well as illnesses associated with co-infections. Medical treatments associated with these conditions, when added to an antiretroviral regimen, increase risk for polypharmacy. Care of aging HIV-infected patients involves a need to balance a number of concurrent comorbid medical conditions. Conclusions and Relevance HIV is no longer a fatal disease. Management of multiple comorbid diseases is a common feature associated with longer life expectancy in HIV-positive patients. There is a need to better understand how to optimize the care of these patients. PMID:23549585

  9. Recent advances in understanding and managing body dysmorphic disorder

    Science.gov (United States)

    Krebs, Georgina; Fernández de la Cruz, Lorena; Mataix-Cols, David

    2017-01-01

    Body dysmorphic disorder (BDD) is a relatively common and disabling psychiatric disorder characterised by excessive and persistent preoccupation with perceived defects or flaws in one's appearance, which are unnoticeable to others, and associated repetitive behaviours (eg, mirror checking). The disorder generally starts in adolescence, but often goes unnoticed and is severely underdiagnosed. Left untreated, BDD typically persists and causes marked functional impairment in multiple domains. This clinical review considers recent advances in the epidemiology and classification of BDD, including its reclassification in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders under the new ‘Obsessive–Compulsive and Related Disorders’ chapter. Key issues in assessment are outlined including the use of validated screening instruments to minimise misdiagnosis and the importance of risk assessment in this population given the high rates of suicidality and inappropriate use of cosmetic treatments. In addition, current knowledge regarding the causes and mechanisms underlying BDD are summarised. The recommended treatments for BDD are outlined, namely cognitive behavioural therapy (CBT) and antidepressants, such as selective serotonin reuptake inhibitors. Both CBT and pharmacotherapy have been shown to be efficacious treatments for BDD in adult populations, and evidence is emerging to support their use in young people. Although the majority of patients improve with existing evidence-based treatment, a large proportion are left with clinically significant residual symptoms. Priorities for future research are therefore discussed including the need to further refine and evaluate existing interventions with the goal of improving treatment outcomes and to increase their availability. PMID:28729345

  10. Management of vascular lesions using advanced laser technology

    Directory of Open Access Journals (Sweden)

    Christofer Tzermias

    2017-04-01

    Full Text Available One of the most widely used cutaneous applications of Light Amplification by Stimulated Emission of Radiation (laser concerns the treatment of vascular lesions. During the past two decades, very significant advances in the application of laser technology in dermatology have occurred, with selective photothermolysis being the most important. This review focuses on the application of modern laser devices (Pulsed Dye Laser, or PDL; potassium titanyl phosphate laser, or KTP; diode laser; and neodymium-doped yttrium-aluminium-garnet laser, or Nd:YAG, as well as the combination of laser and photodynamic therapy (PDT for the treatment of vascular lesions. In particular, both congenital (haemangiomas and port-wine stains and acquired vascular lesions (facial and leg telangiectasias, rosacea, Poikiloderma of Civatte, spider angioma, pyogenic granuloma, and venous lakes are discussed. The review of many recent research studies demonstrates that modern applications of lasers in dermatology constitute the finest method for the treatment of vascular lesions, combining the advantages of invasive therapy with the security offered by non-invasive therapy, while in certain cases they are the single and only choice for the treatment of these lesions.

  11. Biomaterials and Advanced Technologies for Hemostatic Management of Bleeding.

    Science.gov (United States)

    Hickman, DaShawn A; Pawlowski, Christa L; Sekhon, Ujjal D S; Marks, Joyann; Gupta, Anirban Sen

    2018-01-01

    Bleeding complications arising from trauma, surgery, and as congenital, disease-associated, or drug-induced blood disorders can cause significant morbidities and mortalities in civilian and military populations. Therefore, stoppage of bleeding (hemostasis) is of paramount clinical significance in prophylactic, surgical, and emergency scenarios. For externally accessible injuries, a variety of natural and synthetic biomaterials have undergone robust research, leading to hemostatic technologies including glues, bandages, tamponades, tourniquets, dressings, and procoagulant powders. In contrast, treatment of internal noncompressible hemorrhage still heavily depends on transfusion of whole blood or blood's hemostatic components (platelets, fibrinogen, and coagulation factors). Transfusion of platelets poses significant challenges of limited availability, high cost, contamination risks, short shelf-life, low portability, performance variability, and immunological side effects, while use of fibrinogen or coagulation factors provides only partial mechanisms for hemostasis. With such considerations, significant interdisciplinary research endeavors have been focused on developing materials and technologies that can be manufactured conveniently, sterilized to minimize contamination and enhance shelf-life, and administered intravenously to mimic, leverage, and amplify physiological hemostatic mechanisms. Here, a comprehensive review regarding the various topical, intracavitary, and intravenous hemostatic technologies in terms of materials, mechanisms, and state-of-art is provided, and challenges and opportunities to help advancement of the field are discussed. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. Recent advances in management and treatment of hereditary angioedema.

    Science.gov (United States)

    Sardana, Niti; Craig, Timothy J

    2011-12-01

    Hereditary angioedema (HAE) is a rare autosomal-dominant disease characterized by recurrent self-limiting episodes of skin and mucosal edema. Morbidity and mortality are significant, and new and pending therapies are now available to reduce the risk associated with the disease. To update the reader on new advances in HAE to improve patient care. We performed a literature search of Ovid, PubMed, and Google to develop this review. Articles that are necessary for the understanding and use of the new therapeutic options for HAE were chosen, and studies of high quality were used to support the use of therapies, and in most cases, results from phase III studies were used. Until recently, therapy for HAE attacks in the United States consisted of symptom relief with narcotics, hydration, and fresh-frozen plasma, which contains active C1 inhibitor. Therapy to prevent HAE attacks has been confined to androgens and, occasionally, antifibrinolytic agents; however, both drug groups have significant adverse effects. The approval of C1-inhibitor concentrate for prevention and acute therapy has improved efficacy and safety. Ecallantide has also been approved for therapy of attacks, and icatibant is expected to be approved in the next few months for attacks. Recombinant C1 inhibitor is presently in phase III studies and should be available for attacks in the near future. In this article we review the changing therapeutic options available for patients in 2011 and beyond.

  13. Advances and controversies in the management of medullary thyroid carcinoma.

    Science.gov (United States)

    Maia, Ana Luiza; Wajner, Simone Magagnin; Vargas, Carla Vaz Ferreira

    2017-01-01

    Medullary thyroid carcinoma (MTC) comprises approximately 4% of all malignant thyroid neoplasms. Although the majority of patients have a good prognosis, a subgroup of patients develops progressive disease and requires systemic therapy. Here, we focused on the current MTC therapeutic approaches and discussed the advantages and disadvantages of molecular targeted therapies. Targeted molecular therapies that inhibit RET and other tyrosine kinase receptors involved in angiogenesis have been shown to improve progression-free survival in patients with advanced MTC. Two drugs, vandetanib and cabozantinib, have been approved for the treatment of progressive or symptomatic MTC, and several others have exhibited variable efficacy. No tyrosine kinase inhibitor has been shown to improve survival. Although no definitive recommendation can currently be made, cumulative data indicate that knowledge of the tumor mutational profile may facilitate improvements in targeted therapy for MTC. Tyrosine kinase inhibitors are effective therapeutic agents for the treatment of progressive MTC. Nevertheless, it is not clear who will benefit the most from therapy, and the decision regarding when and how to initiate the treatment should be made based on the patient's medical history and tumor behavior. Hopefully, in the near future, molecular profiling of MTC can be used to determine the most effective molecular therapeutic target.

  14. Managing One's Symptoms: A Qualitative Study of Low-Income African Americans With Advanced Cancer.

    Science.gov (United States)

    Yeager, Katherine A; Sterk, Claire E; Quest, Tammie E; DiIorio, Colleen; Vena, Catherine; Bauer-Wu, Susan

    2016-01-01

    African Americans endure disproportionately high advanced cancer rates and also are disproportionately represented in the lower socioeconomic strata. These individuals work to manage symptoms in order to function and have a satisfactory quality of life. The purpose of this study was to discover what low-income African American adults with advanced cancer do on a day-to-day basis to relieve and manage symptoms. This study viewed the individuals as experts and asked them not what they are told to do, but rather what they actually do. A purposive sample of 27 individuals participated in semistructured interviews conducted by 2 research interviewers. This qualitative descriptive approach used content analysis to develop themes to describe symptom self-management. Participants described 2 approaches: making continual adjustments and finding stability through spirituality. In seeking comfort from the distress of their symptoms, they were constantly altering their activities and fine-tuning strategies. They adjusted medical regimens and changed the speed and selection of daily activities, including comfort measures and diet modifications. In contrast, their spirituality was a consistent presence in their lives that provided balance to their unstable symptom experience. This study illustrates that people with advanced cancer actively engage in multiple complex self-management strategies in response to symptoms. As providers assess how individuals manage their symptoms, they must find ways to support those efforts. Providers then will recognize the challenges faced by advanced cancer patients in obtaining the best quality of life while managing multiple symptoms, activities, and family responsibilities.

  15. Clinical and pharmacokinetic evaluation of risperidone for the management of autism spectrum disorder

    NARCIS (Netherlands)

    Dinnissen, Mariken; Dietrich, Andrea; van den Hoofdakker, Barbara J.; Hoekstra, Pieter J.

    Introduction: Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is often accompanied by psychiatric comorbidity. Although there is no medication currently available to treat the core symptoms of ASD, risperidone was the first drug to be approved for use in ASD and is still the

  16. Management of children with autism spectrum disorder in the dental setting : Concerns, behavioural approaches and recommendations

    NARCIS (Netherlands)

    Delli, Konstantina; Reichart, Peter A; Bornstein, Michael M; Livas, Christos

    2013-01-01

    Objectives: This article reviews the present literature on the issues encountered while coping with children with autistic spectrum disorder from the dental perspective. The autistic patient profile and external factors affecting the oral health status of this patient population are discussed upon

  17. Diagnosis and management of Neuromyelitis Optica Spectrum Disorder (NMOSD) in Iran

    DEFF Research Database (Denmark)

    Sahraian, Mohammad Ali; Moghadasi, Abdorreza Naser; Azimi, Amir Reza

    2017-01-01

    Neuromyelitis Optica Spectrum Disorder (NMOSD) is a relapsing neuro inflammatory disease of the central nervous system that typically presents with optic neuritis or myelitis and may cause severe disability. The diagnostic criteria have been updated and several immunosuppressive agents have been...

  18. 78 FR 64202 - Meeting To Discuss Lessons Learned From Commerce Spectrum Management Advisory Committee Working...

    Science.gov (United States)

    2013-10-28

    .../csmac . Please direct media inquiries to NTIA's Office of Public Affairs at (202) 482-7002... NTIA and the Federal Communications Commission also participated as observers. \\1\\ See CSMAC, Framework... operations within the two spectrum bands as follows: Working Group 1--1695-1710 MHz Meteorological-Satellite...

  19. Radiation therapy in the management of locally advanced and disseminated breast cancer

    International Nuclear Information System (INIS)

    Chu, F.C.H.

    1980-01-01

    Radiation theraoy should be fully used in the management of advanced breast cancer. Locally advanced primary or recurrent carcinoma, with limited extent, should be treated aggressively, aimed at permanent control. Palliative treatment of incurable or metastatic lesions relieves symptoms and improves patient's quality of survival. Some metastatic lesions involving vital structures may create emergencies. Prompt institution of radiation therapy may reverse the serious complication and save the patient's life

  20. Managing Behavior by Managing the Classroom: Making Learning Accessible for Deaf and Hard of Hearing Students with Autism Spectrum Disorders

    Science.gov (United States)

    Szymanski, Christen A.

    2012-01-01

    The prevalence of Autism Spectrum Disorders (ASD)--a group of developmental disabilities that cause severe problems with socialization, behavior, and communication--continues to grow. In 2008, the year that "Odyssey" focused on autism, the estimated prevalence of ASD for hearing children was 1 in 150 (CDC, 2007), while today estimates suggest…

  1. Advances in the management of PML: focus on natalizumab.

    Science.gov (United States)

    Fox, Robert

    2011-11-01

    Progressive multifocal leukoencephalopathy (PML), a rare opportunistic infection of the central nervous system, occurs mainly in the setting of broad-based and selective immunosuppression. The immunomodulatory agent most often implicated in the development of PML is the monoclonal antibody natalizumab. Management of PML begins with risk stratification. Factors that predict the risk of PML are JC virus (JCV) antibody status, history of chemotherapy use, and cumulative exposure to natalizumab. The risk of natalizumab-related PML increases up to a duration of 36 months of therapy, after which the risk appears to level off. If suspicious for PML, the use of a sensitive JCV polymerase chain reaction assay permits early diagnosis. Immune reconstitution represents the mainstay of treatment for PML. With rapid reversal of immunosuppression followed by immunologic recovery, almost all patients suffer clinical deterioration termed immune reconstitution inflammatory syndrome (IRIS). High-dose corticosteroids are often recommended if a clinical and imaging syndrome resembling IRIS develops after immune restoration.

  2. Advancing data management and analysis in different scientific disciplines

    Science.gov (United States)

    Fischer, M.; Gasthuber, M.; Giesler, A.; Hardt, M.; Meyer, J.; Prabhune, A.; Rigoll, F.; Schwarz, K.; Streit, A.

    2017-10-01

    Over the past several years, rapid growth of data has affected many fields of science. This has often resulted in the need for overhauling or exchanging the tools and approaches in the disciplines’ data life cycles. However, this allows the application of new data analysis methods and facilitates improved data sharing. The project Large-Scale Data Management and Analysis (LSDMA) of the German Helmholtz Association has been addressing both specific and generic requirements in its data life cycle successfully since 2012. Its data scientists work together with researchers from the fields such as climatology, energy and neuroscience to improve the community-specific data life cycles, in several cases even all stages of the data life cycle, i.e. from data acquisition to data archival. LSDMA scientists also study methods and tools that are of importance to many communities, e.g. data repositories and authentication and authorization infrastructure.

  3. Chado controller: advanced annotation management with a community annotation system.

    Science.gov (United States)

    Guignon, Valentin; Droc, Gaëtan; Alaux, Michael; Baurens, Franc-Christophe; Garsmeur, Olivier; Poiron, Claire; Carver, Tim; Rouard, Mathieu; Bocs, Stéphanie

    2012-04-01

    We developed a controller that is compliant with the Chado database schema, GBrowse and genome annotation-editing tools such as Artemis and Apollo. It enables the management of public and private data, monitors manual annotation (with controlled vocabularies, structural and functional annotation controls) and stores versions of annotation for all modified features. The Chado controller uses PostgreSQL and Perl. The Chado Controller package is available for download at http://www.gnpannot.org/content/chado-controller and runs on any Unix-like operating system, and documentation is available at http://www.gnpannot.org/content/chado-controller-doc The system can be tested using the GNPAnnot Sandbox at http://www.gnpannot.org/content/gnpannot-sandbox-form valentin.guignon@cirad.fr; stephanie.sidibe-bocs@cirad.fr Supplementary data are available at Bioinformatics online.

  4. Biology and management of palm dynastid beetles: recent advances.

    Science.gov (United States)

    Bedford, Geoffrey O

    2013-01-01

    Coconut, oil, and date palms are important crops in the tropics and are attacked by dynastids that cause loss of production or death of hosts. Knowledge of their breeding sites has been extended since a previous review in 1980. The fungus Metarhizium anisopliae has potential as a biopesticide against immature stages in friable breeding sites. The molecular biology and ultrastructure of Oryctes rhinoceros Nudivirus (OrNV), disseminated by adults, have been studied, and this pathogen can reduce O. rhinoceros populations and damage when introduced into new locations, especially where damage had been high. New PCR techniques may enable reliable quantification of dosages ingested and hence virulence of different isolates. Male-produced aggregation pheromones have been identified in several species, for which they may have management potential, having been used commercially for trapping O. rhinoceros in oil palm plantations in Southeast Asia, and tested against O. monoceros in Africa.

  5. Biomass supply management for advanced energy: applications in developing countries

    Energy Technology Data Exchange (ETDEWEB)

    Ranney, J W [Joint Institute for Energy and Environment, Knoxville, TN (United States); Perlack, R D [Oak Ridge National Laboratory, Oak Ridge, TN (United States)

    1995-12-01

    Advanced biomass energy systems, including new biomass resource enhancement technologies, should be developed only where compelling situations for investors or communities exist to economically do so. These situations, or minimum viable operating conditions, are assessed from a pragmatic perspective. They are determined by specific circumstances and divergent interests that take time to define and integrate. Customized solutions are necessary and can change quickly with geography and market circumstances New technologies offer more options but are not necessarily the best. The example of energy crop technology is used to demonstrate the interdependencies that exist between new resource enhancement technology and biomass energy systems operations. The ability to genetically increase the energy density of energy crops is compared to other enhancement measures such as increasing the number of tonnes grown per hectare-year, reducing costs per tonne and improving other characteristics. Issues that need to be considered include significant knowledge gaps, lack of commitments in R and D, specificity of conversion system requirements, handling capabilities and opportunity costs. Broader biomass procurement strategies, which may be more important than resource enhancement technologies, are discussed. Biomass cost-supply is utilized as a strong analytical feature to evaluate the effectiveness of biomass procurement strategies and new biomass production technologies. Some past experiences are reviewed. Cost-supply is assessed from the perspective of the whole biomass energy system to expose the interdependencies between production operations, conversion scale and technologies, and community markets and service. Investment limits, for example, may be as important a determinant as the cost-efficiency of a new technology, which, in turn, affects biomass cost-supply-quality requirements. The cost of new technologies can then be compared to the changed performance of the overall

  6. Biomass supply management for advanced energy: applications in developing countries

    International Nuclear Information System (INIS)

    Ranney, J.W.; Perlack, R.D.

    1995-01-01

    Advanced biomass energy systems, including new biomass resource enhancement technologies, should be developed only where compelling situations for investors or communities exist to economically do so. These situations, or minimum viable operating conditions, are assessed from a pragmatic perspective. They are determined by specific circumstances and divergent interests that take time to define and integrate. Customized solutions are necessary and can change quickly with geography and market circumstances New technologies offer more options but are not necessarily the best. The example of energy crop technology is used to demonstrate the interdependencies that exist between new resource enhancement technology and biomass energy systems operations. The ability to genetically increase the energy density of energy crops is compared to other enhancement measures such as increasing the number of tonnes grown per hectare-year, reducing costs per tonne and improving other characteristics. Issues that need to be considered include significant knowledge gaps, lack of commitments in R and D, specificity of conversion system requirements, handling capabilities and opportunity costs. Broader biomass procurement strategies, which may be more important than resource enhancement technologies, are discussed. Biomass cost-supply is utilized as a strong analytical feature to evaluate the effectiveness of biomass procurement strategies and new biomass production technologies. Some past experiences are reviewed. Cost-supply is assessed from the perspective of the whole biomass energy system to expose the interdependencies between production operations, conversion scale and technologies, and community markets and service. Investment limits, for example, may be as important a determinant as the cost-efficiency of a new technology, which, in turn, affects biomass cost-supply-quality requirements. The cost of new technologies can then be compared to the changed performance of the overall

  7. Australia's TERN: Advancing Ecosystem Data Management in Australia

    Science.gov (United States)

    Phinn, S. R.; Christensen, R.; Guru, S.

    2013-12-01

    Globally, there is a consistent movement towards more open, collaborative and transparent science, where the publication and citation of data is considered standard practice. Australia's Terrestrial Ecosystem Research Network (TERN) is a national research infrastructure investment designed to support the ecosystem science community through all stages of the data lifecycle. TERN has developed and implemented a comprehensive network of ';hard' and ';soft' infrastructure that enables Australia's ecosystem scientists to collect, publish, store, share, discover and re-use data in ways not previously possible. The aim of this poster is to demonstrate how TERN has successfully delivered infrastructure that is enabling a significant cultural and practical shift in Australia's ecosystem science community towards consistent approaches for data collection, meta-data, data licensing, and data publishing. TERN enables multiple disciplines, within the ecosystem sciences to more effectively and efficiently collect, store and publish their data. A critical part of TERN's approach has been to build on existing data collection activities, networks and skilled people to enable further coordination and collaboration to build each data collection facility and coordinate data publishing. Data collection in TERN is through discipline based facilities, covering long term collection of: (1) systematic plot based measurements of vegetation structure, composition and faunal biodiversity; (2) instrumented towers making systematic measurements of solar, water and gas fluxes; and (3) satellite and airborne maps of biophysical properties of vegetation, soils and the atmosphere. Several other facilities collect and integrate environmental data to produce national products for fauna and vegetation surveys, soils and coastal data, as well as integrated or synthesised products for modelling applications. Data management, publishing and sharing in TERN are implemented through a tailored data

  8. Advances in the Traditional Chinese Medicine-Based Management of Viral Myocarditis.

    Science.gov (United States)

    Cao, Yong; Xu, Xia; Zhang, Peiying

    2015-09-01

    Viral myocarditis (VMC) is a common clinical condition; however, no specific treatment has been available from the perspective of modern western medicine, and typically only symptomatic treatment is provided in clinical settings. The traditional Chinese medicine (TCM) has shown certain advantages in treating VMC. Last few years have witnessed certain advances in the TCM-based research on the etiology and pathogenesis of VMC and its clinical management. This article reviews the clinical advances made in the TCM-based management of VMC in the last 5 years.

  9. Autosomal dominant polycystic kidney disease: recent advances in clinical management [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Zhiguo Mao

    2016-08-01

    Full Text Available The first clinical descriptions of autosomal dominant polycystic kidney disease (ADPKD go back at least 500 years to the late 16th century. Advances in understanding disease presentation and pathophysiology have mirrored the progress of clinical medicine in anatomy, pathology, physiology, cell biology, and genetics. The identification of PKD1 and PKD2, the major genes mutated in ADPKD, has stimulated major advances, which in turn have led to the first approved drug for this disorder and a fresh reassessment of patient management in the 21st century. In this commentary, we consider how clinical management is likely to change in the coming decade.

  10. Advances in Data Management in Remote Sensing and Climate Modeling

    Science.gov (United States)

    Brown, P. G.

    2014-12-01

    Recent commercial interest in "Big Data" information systems has yielded little more than a sense of deja vu among scientists whose work has always required getting their arms around extremely large databases, and writing programs to explore and analyze it. On the flip side, there are some commercial DBMS startups building "Big Data" platform using techniques taken from earth science, astronomy, high energy physics and high performance computing. In this talk, we will introduce one such platform; Paradigm4's SciDB, the first DBMS designed from the ground up to combine the kinds of quality-of-service guarantees made by SQL DBMS platforms—high level data model, query languages, extensibility, transactions—with the kinds of functionality familiar to scientific users—arrays as structural building blocks, integrated linear algebra, and client language interfaces that minimize the learning curve. We will review how SciDB is used to manage and analyze earth science data by several teams of scientific users.

  11. Advances in the endoscopic management of pancreatic collections.

    Science.gov (United States)

    Ruiz-Clavijo, David; de la Higuera, Belen González; Vila, Juan J

    2015-04-16

    Treatment of pancreatic collections has experienced great progress in recent years with the emergence of alternative minimally invasive techniques comparing to the classic surgical treatment. Such techniques have been shown to improve outcomes of morbidity vs surgical treatment. The recent emergence of endoscopic drainage is noteworthy. The advent of endoscopic ultrasonography has been crucial for treatment of these specific lesions. They can be characterized, their relationships with neighboring structures can be evaluated and the drainage guided by this technique has been clearly improved compared with the conventional endoscopic drainage. Computed tomography is the technique of choice to characterize the recently published new classification of pancreatic collections. For this reason, the radiologist's role establishing and classifying in a rigorously manner the collections according to the new nomenclature is essential to making therapeutic decisions. Ideal scenario for comprehensive treatment of these collections would be those centers with endoscopic ultrasound and interventional radiology expertise together with hepatobiliopancreatic surgery. This review describes the different types of pancreatic collections: acute peripancreatic fluid collection, pancreatic pseudocysts, acute necrotic collection and walled-off necrosis; the indications and the contraindications for endoscopic drainage, the drainage technique and their outcomes. The integrated management of pancreatic collections according to their type and evolution time is discussed.

  12. Working towards the advanced management of cultural heritage

    Directory of Open Access Journals (Sweden)

    Giuseppe Farneti

    2012-06-01

    Full Text Available Within the broad framework of public administration reform, the Act of the ministerial directive, 10th May 2001, regarding the “technical/scientific criteria and standards for the functioning and development of museums” constitutes an essential tool in promoting the rapid growth of this sector. In fact, following in the footsteps of Icom's Deontological Code and through the advantageous involvement of regions and local authorities, the document underlines the importance of service quality and defines scopes, criteria and standards for operating and developing museums. On the basis of the subsidiarity principle, regions are the main actors in the implementation of the Directive Act, and in the last few years they have launched progressive plans aimed at increasing quality in museums by implementing standards and initiating accreditation processes. The aim of this study is to analyse the procedure enacted by the region of Emilia-Romagna, referring both to the regulations and the state of the art implementation of standards and its effect on museum management. In implementing the Directive Act, regions must be given more power, so that they are able to foster progressive plans aimed at increasing quality in museums and realizing accreditation processes.

  13. Microgrid Controller and Advanced Distribution Management System Survey Report

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Guodong [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Starke, Michael R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Herron, Andrew N. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2016-07-01

    A microgrid controller, which serves as the heart of a microgrid, is responsible for optimally managing the distributed energy resources, energy storage systems, and responsive demand and for ensuring the microgrid is being operated in an efficient, reliable, and resilient way. As the market for microgrids has blossomed in recently years, many vendors have released their own microgrid controllers to meet the various needs of different microgrid clients. However, due to the absence of a recognized standard for such controllers, vendor-supported microgrid controllers have a range of functionalities that are significantly different from each other in many respects. As a result the current state of the industry has been difficult to assess. To remedy this situation the authors conducted a survey of the functions of microgrid controllers developed by vendors and national laboratories. This report presents a clear indication of the state of the microgrid-controller industry based on analysis of the survey results. The results demonstrate that US Department of Energy funded research in microgrid controllers is unique and not competing with that of industry.

  14. Hepatorenal Syndrome and Novel Advances in its Management

    Directory of Open Access Journals (Sweden)

    Fabrizio Fabrizi

    2013-12-01

    Full Text Available Hepatorenal syndrome is a complication of end stage liver disease. It is a unique form of functional renal failure related to kidney vasoconstriction in the absence of underlying kidney pathology. Hepatorenal syndrome is classified into 2 types: type-1 HRS shows a rapid and progressive decline in renal function with a very poor prognosis (median survival of about 2 weeks; type-2 HRS has a more stable kidney failure, with a median survival of 6 months; its main clinical manifestation is refractory ascites. The most appropriate therapy for HRS is liver transplantation but only a minority of HRS patients undergo the procedure due to the high mortality; survival among liver transplant recipients is lower in HRS than among their counterparts without HRS. A large body of evidence, based on observational studies and randomized controlled trials, has been accumulated in the last decade showing that terlipressin represents a milestone in the management of HRS. According to our meta-analysis of randomized trials comparing terlipressin vs. placebo (five trials, n=243 patients, the pooled rate of patients who reversed HRS by terlipressin was 8.09 (95% CI, 3.52; 18.59 (PP<0.01. Two series of patients with HRS recurrence after the first treatment have recently shown that long-term therapy with terlipressin and albumin is beneficial as a bridge to liver transplant. Nevertheless, recovery of renal function can be achieved in less than 50% of patients with HRS after terlipressin use and the recovery of renal function may also be partial in patients who are defined full responders. Renal replacement therapy should not be considered a first-line therapy for HRS Clinical trials are under way in order to assess efficacy and safety of novel therapeutic agents for the treatment of type-1 and type-2 HRS.

  15. AN ADVANCED TOOL FOR APPLIED INTEGRATED SAFETY MANAGEMENT

    Energy Technology Data Exchange (ETDEWEB)

    Potts, T. Todd; Hylko, James M.; Douglas, Terence A.

    2003-02-27

    WESKEM, LLC's Environmental, Safety and Health (ES&H) Department had previously assessed that a lack of consistency, poor communication and using antiquated communication tools could result in varying operating practices, as well as a failure to capture and disseminate appropriate Integrated Safety Management (ISM) information. To address these issues, the ES&H Department established an Activity Hazard Review (AHR)/Activity Hazard Analysis (AHA) process for systematically identifying, assessing, and controlling hazards associated with project work activities during work planning and execution. Depending on the scope of a project, information from field walkdowns and table-top meetings are collected on an AHR form. The AHA then documents the potential failure and consequence scenarios for a particular hazard. Also, the AHA recommends whether the type of mitigation appears appropriate or whether additional controls should be implemented. Since the application is web based, the information is captured into a single system and organized according to the >200 work activities already recorded in the database. Using the streamlined AHA method improved cycle time from over four hours to an average of one hour, allowing more time to analyze unique hazards and develop appropriate controls. Also, the enhanced configuration control created a readily available AHA library to research and utilize along with standardizing hazard analysis and control selection across four separate work sites located in Kentucky and Tennessee. The AHR/AHA system provides an applied example of how the ISM concept evolved into a standardized field-deployed tool yielding considerable efficiency gains in project planning and resource utilization. Employee safety is preserved through detailed planning that now requires only a portion of the time previously necessary. The available resources can then be applied to implementing appropriate engineering, administrative and personal protective equipment

  16. Spotlight on advances in VTE management: CALLISTO and EINSTEIN CHOICE.

    Science.gov (United States)

    Bach, Miriam; Bauersachs, Rupert

    2016-09-28

    Venous thromboembolism (VTE) is associated with numerous complications and high mortality rates. Patients with cancer are at high risk of developing cancer-associated thrombosis (CAT), and VTE recurrence is common. Evidence supporting use of non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) in patients with cancer is lacking - direct comparisons between NOACs and low-molecular-weight heparin (LMWH) are needed, along with patient-reported outcomes. Cancer Associated thrombosis - expLoring soLutions for patients through Treatment and Prevention with RivarOxaban (CALLISTO) is an international research programme exploring the potential of the direct, oral factor Xa inhibitor rivaroxaban for the prevention and treatment of CAT, supplementing existing data from EINSTEIN DVT and EINSTEIN PE. Here, we focus on four CALLISTO studies: A Study to Evaluate the Efficacy and Safety of Rivaroxaban Venous Thromboembolism Prophylaxis in Ambulatory Cancer Participants receiving Chemotherapy (CASSINI), Anticoagulation Therapy in SELECTeD Cancer Patients at Risk of Recurrence of Venous Thromboembolism (SELECT-D), Rivaroxaban in the Treatment of Venous Thromboembolism in Cancer Patients - a Randomized Phase III Study (CONKO-011) and a database analysis. Optimal anticoagulation duration for VTE treatment has always been unclear. Following favourable results for rivaroxaban 20 mg once-daily (Q. D.) for secondary VTE prevention (EINSTEIN EXT), EINSTEIN CHOICE is assessing rivaroxaban safety and (20 mg Q. D. or 10 mg Q. D.) vs acetylsalicylic acid (ASA), and will investigate whether an alternative rivaroxaban dose (10 mg Q. D.) could offer long-term VTE protection. It is anticipated that results from these studies will provide important answers and expand upon current evidence for rivaroxaban in VTE management.

  17. Regional approaches to the management of patients with advanced, radioactive iodine-refractory differentiated thyroid carcinoma.

    Science.gov (United States)

    Brose, Marcia S; Smit, Johannes; Capdevila, Jaume; Elisei, Rossella; Nutting, Christopher; Pitoia, Fabian; Robinson, Bruce; Schlumberger, Martin; Shong, Young Kee; Takami, Hiroshi

    2012-09-01

    For patients with advanced, radioactive iodine-refractory differentiated thyroid cancer, current treatment guidelines recommend clinical trial enrollment or small-molecule kinase inhibitor therapy. However, details of patient management vary between countries depending on trial availability and national regulatory policies. Insufficient clinical trial data and variable disease characteristics challenge the creation of universal guidelines, and treatment plans often reflect regional influences. A multidisciplinary, multiregional panel of experts met to discuss regional approaches to managing patients with advanced, radioactive iodine-refractory differentiated thyroid cancer and the potential impact of emerging therapies on current treatment strategies. Despite process-oriented regional differences, the decision-making strategies were similar. Multidisciplinary teams used to manage high-risk patients varied in composition across regions, particularly regarding the responsible physician's specialty. Cytotoxic chemotherapy was viewed as limited in clinical benefit, and targeted agents as attractive, based on promising data. Panel members support clinical trial enrollment as the preferred treatment strategy for managing these patients.

  18. Coordinated Dynamic Spectrum Management of LTE-U and Wi-Fi Networks

    OpenAIRE

    Sagari, Shweta; Baysting, Samuel; Saha, Dola; Seskar, Ivan; Trappe, Wade; Raychaudhuri, Dipankar

    2015-01-01

    This paper investigates the co-existence of Wi-Fi and LTE in emerging unlicensed frequency bands which are intended to accommodate multiple radio access technologies. Wi-Fi and LTE are the two most prominent access technologies being deployed today, motivating further study of the inter-system interference arising in such shared spectrum scenarios as well as possible techniques for enabling improved co-existence. An analytical model for evaluating the baseline performance of co-existing Wi-Fi...

  19. Trends in Energy Management Technology - Part 4: Review ofAdvanced Applications in Energy Management, Control, and InformationSystems

    Energy Technology Data Exchange (ETDEWEB)

    Yee, Gaymond; Webster, Tom

    2003-08-01

    In this article, the fourth in a series, we provide a review of advanced applications in Energy Management, Control, and Information Systems (EMCIS). The available features for these products are summarized and analyzed with regard to emerging trends in EMCIS and potential benefits to the Federal sector. The first article [1] covered enabling technologies for emerging energy management systems. The second article [2] serves as a basic reference for building control system (BCS) networking fundamentals and includes an assessment of current approaches to open communications. The third article [3] evaluated several products that exemplify the current state of practice in EMCIS. It is important for energy managers in the Federal sector to have a high level of knowledge and understanding of these complex energy management systems. This series of articles provides energy practitioners with some basic informational and educational tools to help make decisions relative to energy management systems design, specification, procurement, and energy savings potential.

  20. Health plans' disease management programs: extending across the medical and behavioral health spectrum?

    Science.gov (United States)

    Merrick, Elizabeth Levy; Horgan, Constance M; Garnick, Deborah W; Hodgkin, Dominic; Morley, Melissa

    2008-01-01

    Although the disease management industry has expanded rapidly, there is little nationally representative data regarding medical and behavioral health disease management programs at the health plan level. National estimates from a survey of private health plans indicate that 90% of health plan products offered disease management for general medical conditions such as diabetes but only 37% had depression programs. The frequency of specific depression disease management activities varied widely. Program adoption was significantly related to product type and behavioral health contracting. In health plans, disease management has penetrated more slowly into behavioral health and depression program characteristics are highly variable.

  1. Advancing Flood Risk Communication and Management through Collaboration and Public Participation

    OpenAIRE

    Cheung, Wing

    2017-01-01

    Flooding has been a pressing problem for communities around the world. The problem is expected to worsen due to climate change and sea level rise. Despite decades of research on risk communication and management, the toll of flooding continues to mount. In order to advance flood management to minimize future damages, there is a need to foster collaboration among research communities, promote the genuine engagement of local stakeholders, and co-develop targeted risk communication and mitigatio...

  2. A New Advanced Logistics Supply Chain for Food Management Based on Green Logistics Theory

    OpenAIRE

    Lanqing Liu

    2013-01-01

    The study aims to investigate the advanced logistics supply chain for food management using green logistics. To protect the food logistics environment and prevent the environmental pollution, it is crucial to establish powerful modern supply chains to support the food management in transportation. The construction speed of the food companies is very fast; however, the food supply lags behind the food companies. As a result, the environmental pollution caused in the food logistics becomes seve...

  3. GPs' views on managing advanced chronic kidney disease in primary care: a qualitative study.

    Science.gov (United States)

    Tonkin-Crine, Sarah; Santer, Miriam; Leydon, Geraldine M; Murtagh, Fliss E M; Farrington, Ken; Caskey, Fergus; Rayner, Hugh; Roderick, Paul

    2015-07-01

    Chronic kidney disease (CKD) has become a significant part of the GP's workload since the introduction of the National Institute for Health and Care Excellence guidelines in 2008. Patients with advanced CKD (stages G4 and G5) often have comorbidities, varied disease progression, and are likely to be older. GPs may experience difficulties with management decisions for patients with advanced CKD, including when to refer to nephrology. To explore GPs' views of managing patients with advanced CKD and referral to secondary care. Qualitative study with GPs in four areas of England: London, Bristol, Birmingham, and Stevenage. Semi-structured interviews with 19 GPs. Transcribed interviews were thematically analysed. GPs had little experience of managing patients with advanced CKD, including those on dialysis or having conservative care (treatment without dialysis or a transplant), and welcomed guidance. Some GPs referred patients based on renal function alone and some used wider criteria including age and multimorbidity. GPs reported a tension between national guidance and local advice, and some had learnt from experience that patients were discharged back to primary care. GPs with more experience of managing CKD referred patients later, or sometimes not at all, if there were no additional problems and if dialysis was seen as not in the patient's interests. GPs want guidance on managing older patients with advanced CKD and comorbidities, which better incorporates agreement between local and national recommendations to clarify referral criteria. GPs are not generally aware of conservative care programmes provided by renal units, however, they appear happy to contribute to such care or alternatively, lead conservative management with input from renal teams. © British Journal of General Practice 2015.

  4. Building leadership capacity in advanced nurse practitioners - the role of organisational management.

    Science.gov (United States)

    Elliott, Naomi

    2017-01-01

    To highlight the organisation-level management's role in building leadership capacity in advanced nurse practitioners and the need for appropriate supports to increase their becoming leaders. Little is published about the role of organisation-level management in building leadership capacity and in developing the next generation of nurse leaders. In times of economic constraint, organisations need to focus their efforts on targeted leadership initiatives. Advanced nurse practitioners are ideally positioned to act as leaders both within and beyond the health care organisation. From the available research evidence, several support structures and mechanisms are identified as enablers for advanced nurse practitioners to enact their leadership role. Health care organisations need to include building leadership capacity as a priority in their strategic plan and take action to build-up the level of advanced nurse practitioner leadership. Nurse executives have a vital role in influencing the organisation's strategic plan and making a business case for prioritising leadership capacity building within advanced nurse practitioners. A challenge for nurse executives faced with competing service and leadership development demands, involves strategic decision-making regarding whether the advanced nurse practitioner's role is limited to service delivery or its potential in leading health care reforms is realised. © 2016 John Wiley & Sons Ltd.

  5. Advance features in the SPAN and SPAN/XRF gamma ray and X ray spectrum analysis software

    International Nuclear Information System (INIS)

    Wang Liyu

    1998-01-01

    This paper describes the advanced techniques, integral peak background, experimental peak shape and complex peak shape, which have been used successfully in the software packages SPAN and SPAN/XRF to process gamma ray and X ray spectra from HPGe and Si(Li) detector. Main features of SPAN and SPAN/XRF are also described. The software runs on PC and has convenient graphical capabilities and a powerful user interface. (author)

  6. VEHIL: a test facility for validation of fault management systems for advanced driver assistance systems

    NARCIS (Netherlands)

    Gietelink, O.J.; Ploeg, J.; Schutter, de B.; Verhaegen, M.H.

    2004-01-01

    We present a methodological approach for the validation of fault management systems for Advanced Driver Assistance Systems (ADAS). For the validation process the unique VEHIL facility, developed by TNO Automotive and currently situated in Helmond, The Netherlands, is applied. The VEHIL facility

  7. Managing occupations in everyday life for people with advanced cancer at home

    DEFF Research Database (Denmark)

    Peoples, Hanne; Brandt, Åse; Wæhrens, Eva Elisabet Ejlersen

    “Everyday life under change” and two sub-categories 1) Appling strategies to manage occupations in everyday life and 2) Preserving a meaningful everyday life. Significance: The findings suggest that people with advanced cancer, to a greater extent, should be supported in exploring familiar as well as new...

  8. Alternative Fuels and Advanced Vehicles: Resources for Fleet Managers (Clean Cities) (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Brennan, A.

    2011-04-01

    A discussion of the tools and resources on the Clean Cities, Alternative Fuels and Advanced Vehicles Data Center, and the FuelEconomy.gov Web sites that can help vehicle fleet managers make informed decisions about implementing strategies to reduce gasoline and diesel fuel use.

  9. New developments in the management of advanced melanoma - role of pembrolizumab

    DEFF Research Database (Denmark)

    Improta, Giuseppina; Leone, Isabella; Donia, Marco

    2015-01-01

    Cancer immunotherapy is now recognized to be fundamental in modern oncology, because immune system recruitment may represent a powerful and innovative strategy in cancer therapy. Pembrolizumab, a highly selective humanized monoclonal antibody directly blocking the interaction between programmed...... inhibitor. This review will focus on the clinical development and use of pembrolizumab in the clinical practice and in the management of advanced melanoma....

  10. The journal Perspectivas em Gestão & Conhecimento (PG&C: Creation, editorial management and spectrum of topics published

    Directory of Open Access Journals (Sweden)

    Luciana Ferreira da Costa

    2015-04-01

    Full Text Available Objective. Presents the spectrum of topics published in the scientific journal “Perspectivas em Gestão & Conhecimento” (PG&C identified by the frequency of occurrence of keywords in the articles. Method. The study used thematic category analysis. So were determined as job categories the journal characterization of items for your general data, editorial management process and the main subjects of the articles taken from the keywords, a qualitative-narrative approach, with quantitative data input Results. This results express the trend of converging studies between the Administration and Information Science. Conclusions. Concludes that the scientific journal PG&C has established itself as a vehicle for national reference for various areas dealing with the management and knowledge as inter-relational object of study, not failing to recognize the visibility and international interest.

  11. Career advancement in Public Employment in Colombia, a look at the Colombian State Management System

    Directory of Open Access Journals (Sweden)

    Mónica Lilly Serrato Moreno

    2014-12-01

    Full Text Available In Colombia, a public employee doesn’t seem to have rights to career advancement based on merit and experience. The current public hiring system seems to ignore experience, interest and effort made by an employee, at the time of considering a potential advancement to an upper-level position, which would assign new tasks and greater responsibilities. That is why there is a need for the implementation of different mechanisms, to increase employees’ career advancement possibilities based on merits accredited with tasks such as academic papers, institutional project management and public policy management, academic degrees, as well as experience, research and time of service. This paper, developed with a critical perspective of the problem, proposes alternatives to overcome this challenge.

  12. Contemporary management of locally advanced rectal cancer: Resolving issues, controversies and shifting paradigms.

    Science.gov (United States)

    Nacion, Aeris Jane D; Park, Youn Young; Kim, Nam Kyu

    2018-02-01

    Advancements in rectal cancer treatment have resulted in improvement only in locoregional control and have failed to address distant relapse, which is the predominant mode of treatment failure in rectal cancer. As the efficacy of conventional chemoradiotherapy (CRT) followed by total mesorectal excision (TME) reaches a plateau, the need for alternative strategies in locally advanced rectal cancer (LARC) has grown in relevance. Several novel strategies have been conceptualized to address this issue, including: 1) neoadjuvant induction and consolidation chemotherapy before CRT; 2) neoadjuvant chemotherapy alone to avoid the sequelae of radiation; and 3) nonoperative management for patients who achieved pathological or clinical complete response after CRT. This article explores the issues, recent advances and paradigm shifts in the management of LARC and emphasizes the need for a personalized treatment plan for each patient based on tumor stage, location, gene expression and quality of life.

  13. Model-Based Spectrum Management. Part 1: Modeling and Computation Manual, Version 2.0

    Science.gov (United States)

    2013-12-01

    Frequency list : ( 790.0125, 790.0375, 790.0525, … , 794.9875) (i.e. signals spaced every 25 kHz starting at 790.0125 MHz and ending at 794.9875...20 dB below peak. When a frequency list is used, this bandwidth is applied for every signal within the range. When a signal falls partially in the...power is 0 2 dBm Hz m⋅ . System 1 Spectrum mask: (-0.0125, -20, -0.0075, 0, 0.00750, 0, 0.0125, -20) Frequency list : ( 190.0125, 190.0375

  14. Improving management of patients with autism spectrum disorder having scheduled surgery: optimizing practice.

    Science.gov (United States)

    Thompson, Debbie Gearner; Tielsch-Goddard, Anna

    2014-01-01

    Surgical preparation for children with autism spectrum disorders can be a challenge to perioperative staff because of the unique individual needs and behaviors in this population. Most children with autism function best in predictable, routine environments, and being in the hospital and other health care settings can create a stressful situation. This prospective, descriptive, quality improvement project was conducted to optimize best practices for perioperative staff and better individualize the plan of care for the autistic child and his or her family. Forty-three patients with a diagnosis of autism or autistic spectrum disorder were seen over 6 months at a suburban pediatric hospital affiliated with a major urban pediatric hospital and had an upcoming scheduled surgery or procedure requiring anesthesia. Caregivers were interviewed before and after surgery to collect information to better help their child cope with their hospital visit. In an evaluation of project outcomes, data were tabulated and summarized and interview data were qualitatively coded for emerging themes to improve the perioperative process for the child. Findings showed that staff members were able to recognize potential and actual stressors and help identify individual needs of surgical patients with autism. The families were pleased and appreciative of the individual attention and focus on their child's special needs. Investigators also found increased staff interest in optimizing the surgical experience for autistic children. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

  15. On Green Cognitive Radio Cellular Networks: Dynamic Spectrum and Operation Management

    KAUST Repository

    Sboui, Lokman

    2016-07-18

    We study a profit maximization problem related to cognitive radio cellular networks in an environmentally- friendly framework. The objective of the primary network (PN) and secondary network (SN) is to maximize their profits while respecting a certain carbon dioxide (CO2) emissions threshold. In this study, the PN can switch off some of its base stations (BSs) powered by mircogrids, and hence leases the spectrum in the corresponding cells, to reduce its footprint. The corresponding users are roamed to the SN infrastructure. In return, the SN receives a certain roaming cost and its users can freely exploit the spectrum. We study two scenarios in which the profits are either separately or jointly maximized. In the disjoint maximization problem, two low complexity algorithms for PN and SN BS on/off switching are proposed to maximize the profit per CO2 emissions utility and determine the amount of the shared bandwidth. In the joint maximization approach, the low complexity algorithm is based on maximizing the sum of weighted profits per CO2. Selected numerical results illustrate the collaboration performance versus various system parameters. We show that the proposed algorithms achieve performances close to those obtained with the exhaustive search method, and that the roaming price and the renewable energy availability are crucial parameters that control the collaboration of both networks.

  16. On Green Cognitive Radio Cellular Networks: Dynamic Spectrum and Operation Management

    KAUST Repository

    Sboui, Lokman; Ghazzai, Hakim; Rezki, Zouheir; Alouini, Mohamed-Slim

    2016-01-01

    We study a profit maximization problem related to cognitive radio cellular networks in an environmentally- friendly framework. The objective of the primary network (PN) and secondary network (SN) is to maximize their profits while respecting a certain carbon dioxide (CO2) emissions threshold. In this study, the PN can switch off some of its base stations (BSs) powered by mircogrids, and hence leases the spectrum in the corresponding cells, to reduce its footprint. The corresponding users are roamed to the SN infrastructure. In return, the SN receives a certain roaming cost and its users can freely exploit the spectrum. We study two scenarios in which the profits are either separately or jointly maximized. In the disjoint maximization problem, two low complexity algorithms for PN and SN BS on/off switching are proposed to maximize the profit per CO2 emissions utility and determine the amount of the shared bandwidth. In the joint maximization approach, the low complexity algorithm is based on maximizing the sum of weighted profits per CO2. Selected numerical results illustrate the collaboration performance versus various system parameters. We show that the proposed algorithms achieve performances close to those obtained with the exhaustive search method, and that the roaming price and the renewable energy availability are crucial parameters that control the collaboration of both networks.

  17. Theoretical Framework of Advanced Training in the Field of Conflict Management in Organization

    Directory of Open Access Journals (Sweden)

    Kilmashkina T.N.

    2018-01-01

    Full Text Available In this paper, we consider the theoretical framework for creating an advanced training course for professionals working in various organizations whose functional duties include activities aimed at managing conflict situations occurring within the organization. The article also considers such problem concepts as: essence and causes of conflicts, types of conflicts in the organization; organizational, psychological, sociological and cultural ways of managing conflicts in the organization. The proposed theoretical model of advanced professional training is constructed within the framework of the competence approach which, in this case, is based on the notion that a participant in the program should master a certain set of special competencies that include knowledge, skills and abilities necessary for the effective process management of various conflict situations.

  18. Antennas Designed for Advanced Communications for Air Traffic Management (AC/ATM) Project

    Science.gov (United States)

    Zakrajsek, Robert J.

    2000-01-01

    The goal of the Advanced Communications for Air Traffic Management (AC/ATM) Project at the NASA Glenn Research Center at Lewis Field is to enable a communications infrastructure that provides the capacity, efficiency, and flexibility necessary to realize a mature free-flight environment. The technical thrust of the AC/ATM Project is targeted at the design, development, integration, test, and demonstration of enabling technologies for global broadband aeronautical communications. Since Ku-band facilities and equipment are readily available, one of the near-term demonstrations involves a link through a Kuband communications satellite. Two conformally mounted antennas will support the initial AC/ATM communications links. Both of these are steered electronically through monolithic microwave integrated circuit (MMIC) amplifiers and phase shifters. This link will be asymmetrical with the downlink to the aircraft (mobile vehicle) at a throughput rate of greater than 1.5 megabits per second (Mbps), whereas the throughput rate of the uplink from the aircraft will be greater than 100 kilobits per second (kbps). The data on the downlink can be narrow-band, wide-band, or a combination of both, depending on the requirements of the experiment. The AC/ATM project is purchasing a phased-array Ku-band transmitting antenna for the uplink from the test vehicle. Many Ku-band receiving antennas have been built, and one will be borrowed for a short time to perform the initial experiments at the NASA Glenn Research Center at Lewis Field. The Ku-band transmitting antenna is a 254-element MMIC phased-array antenna being built by Boeing Phantom Works. Each element can radiate 100 mW. The antenna is approximately 43-cm high by 24-cm wide by 3.3-cm thick. It can be steered beyond 60 from broadside. The beamwidth varies from 6 at broadside to 12 degrees at 60 degrees, which is typical of phased-array antennas. When the antenna is steered to 60 degrees, the beamwidth will illuminate

  19. The spectrum of Castleman's disease: Mimics, radiologic pathologic correlation and role of imaging in patient management

    International Nuclear Information System (INIS)

    Madan, Rachna; Chen, Jey-Hsin; Trotman-Dickenson, Beatrice; Jacobson, Francine; Hunsaker, Andetta

    2012-01-01

    Castleman's disease (CD) is a rare benign lymphoid disorder with variable clinical course. The two principal histologic subtypes of CD are hyaline-vascular and plasma cell variants and the major clinicoradiological entities are unicentric and multicentric CD. Management of CD is tailored to clinicoradiologic subtype. In this review, we describe the CT, MR and PET/CT findings in Castleman's disease which can help suggest a diagnosis of CD as well as emphasize role of imaging in management of patients with CD.

  20. Understanding and managing sleep disruption in children with fetal alcohol spectrum disorder.

    Science.gov (United States)

    Hanlon-Dearman, Ana; Chen, Maida Lynn; Olson, Heather Carmichael

    2018-04-01

    Accumulating evidence has revealed high rates of sleep disruption among children with fetal alcohol spectrum disorder (FASD). Multiple animal and clinical studies have found a clear association between sleep problems and prenatal alcohol exposure, and recent research is beginning to characterize the types and extent of sleep disruption in FASD. Nevertheless, sleep disruption in children with FASD often goes unrecognized or is treated without referring to an evidence base. Children's disrupted sleep interferes with parental sleep and increases caregiver burden, which is of particular importance for families raising children with FASD, a group with very high levels of caregiving stress. The literature supporting an association between sleep problems and deficits in emotional, behavioral, and cognitive function in children is compelling, but needs further investigation in children with FASD. This paper will review the current state of knowledge on sleep in FASD and recommend a rational approach to sleep interventions for affected children and their families.

  1. Disease spectrum and management of children admitted with acute respiratory infection in Viet Nam.

    Science.gov (United States)

    Nguyen, T K P; Nguyen, D V; Truong, T N H; Tran, M D; Graham, S M; Marais, B J

    2017-06-01

    To assess the acute respiratory infection (ARI) disease spectrum, duration of hospitalisation and outcome in children hospitalised with an ARI in Viet Nam. We conducted a retrospective descriptive study of ARI admissions to primary (Hoa Vang District Hospital), secondary (Da Nang Hospital for Women and Children) and tertiary (National Hospital of Paediatrics in Ha Noi) level hospitals in Viet Nam over 12 months (01/09/2015 to 31/08/2016). Acute respiratory infections accounted for 27.9% (37 436/134 061) of all paediatric admissions; nearly half (47.6%) of all children admitted to Hoa Vang District Hospital. Most (64.6%) of children hospitalised with an ARI were Viet Nam, characterised by prolonged hospitalisation for relatively mild disease. There is huge potential to reduce unnecessary hospital admission and cost. © 2017 John Wiley & Sons Ltd.

  2. Pre-hospital advanced airway management by anaesthesiologists: is there still room for improvement?

    Science.gov (United States)

    Sollid, Stephen J M; Heltne, Jon Kenneth; Søreide, Eldar; Lossius, Hans Morten

    2008-07-21

    Endotracheal intubation is an important part of pre-hospital advanced life support that requires training and experience, and should only be performed by specially trained personnel. In Norway, anaesthesiologists serve as Helicopter Emergency Medical Service HEMS physicians. However, little is known about how they themselves evaluate the quality and safety of pre-hospital advanced airway management. Using a semi-structured questionnaire, we interviewed anaesthesiologists working in the three HEMS programs covering Western Norway. We compared answers from specialists and non-specialists as well as full- and part-time HEMS physicians. Of the 17 available respondents, most (88%) felt that their continuous exposure to intubations was not sufficient. Additional training was mainly acquired through other clinical practice and mannequin- or cadaver-based skills training. Of the respondents, 77% and 35% reported having experienced difficult and failed intubations, respectively. Further, 59% reported knowledge of airway management-related deaths in their HEMS program. Significantly more full- than part-time HEMS physicians had experienced these problems. All respondents had airway back-up equipment in their service, but 29% were not familiar with all the equipment. The majority of anaesthesiologists working as HEMS physicians view pre-hospital advanced airway management as a high-risk procedure. Relevant airway management competencies for HEMS physicians in Norway seem to be insufficiently trained and maintained. A better-defined level of competence with better training methods and systems seems warranted.

  3. Pre-hospital advanced airway management by anaesthesiologists: Is there still room for improvement?

    Directory of Open Access Journals (Sweden)

    Søreide Eldar

    2008-07-01

    Full Text Available Abstract Background Endotracheal intubation is an important part of pre-hospital advanced life support that requires training and experience, and should only be performed by specially trained personnel. In Norway, anaesthesiologists serve as Helicopter Emergency Medical Service HEMS physicians. However, little is known about how they themselves evaluate the quality and safety of pre-hospital advanced airway management. Method Using a semi-structured questionnaire, we interviewed anaesthesiologists working in the three HEMS programs covering Western Norway. We compared answers from specialists and non-specialists as well as full- and part-time HEMS physicians. Results Of the 17 available respondents, most (88% felt that their continuous exposure to intubations was not sufficient. Additional training was mainly acquired through other clinical practice and mannequin- or cadaver-based skills training. Of the respondents, 77% and 35% reported having experienced difficult and failed intubations, respectively. Further, 59% reported knowledge of airway management-related deaths in their HEMS program. Significantly more full- than part-time HEMS physicians had experienced these problems. All respondents had airway back-up equipment in their service, but 29% were not familiar with all the equipment. Conclusion The majority of anaesthesiologists working as HEMS physicians view pre-hospital advanced airway management as a high-risk procedure. Relevant airway management competencies for HEMS physicians in Norway seem to be insufficiently trained and maintained. A better-defined level of competence with better training methods and systems seems warranted.

  4. Self-management and transitions in women with advanced breast cancer.

    Science.gov (United States)

    Schulman-Green, Dena; Bradley, Elizabeth H; Knobf, M Tish; Prigerson, Holly; DiGiovanna, Michael P; McCorkle, Ruth

    2011-10-01

    Self-management involves behaviors that individuals perform to handle health conditions. Self-management may be particularly challenging during transitions-shifts from one life phase or status to another, for example, from cure- to noncure-oriented care-because they can be disruptive and stressful. Little is known about individuals' experiences with self-management, especially during transitions. Our purpose was to describe experiences of self-management in the context of transitions among women with advanced breast cancer. We interviewed a purposive sample of 15 women with metastatic breast cancer about their self-management preferences, practices, and experiences, including how they managed transitions. Interviews were recorded and transcribed. The qualitative method of interpretive description was used to code and analyze the data. Participants' mean age was 52 years (range 37-91 years); most were White (80%), married (80%), and college educated (60%). Self-management practices related to womens' health and to communication with loved ones and providers. Participants expressed a range of preferences for participation in self-management. Self-management included developing skills, becoming empowered, and creating supportive networks. Barriers to self-management included symptom distress, difficulty obtaining information, and lack of knowledge about the cancer trajectory. Women identified transitions as shifts in physical, emotional, and social well-being, as when their cancer progressed and there was a need to change therapy. Transitions often prompted changes in how actively women self-managed and were experienced as positive, negative, and neutral. Self-management preferences can vary. Providers should explore and revisit patients' preferences and ability to self-manage over time, particularly during transitions. Copyright © 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  5. Pairing of near-ultraviolet solar cells with electrochromic windows for smart management of the solar spectrum

    Science.gov (United States)

    Davy, Nicholas C.; Sezen-Edmonds, Melda; Gao, Jia; Lin, Xin; Liu, Amy; Yao, Nan; Kahn, Antoine; Loo, Yueh-Lin

    2017-08-01

    Current smart window technologies offer dynamic control of the optical transmission of the visible and near-infrared portions of the solar spectrum to reduce lighting, heating and cooling needs in buildings and to improve occupant comfort. Solar cells harvesting near-ultraviolet photons could satisfy the unmet need of powering such smart windows over the same spatial footprint without competing for visible or infrared photons, and without the same aesthetic and design constraints. Here, we report organic single-junction solar cells that selectively harvest near-ultraviolet photons, produce open-circuit voltages eclipsing 1.6 V and exhibit scalability in power generation, with active layers (10 cm2) substantially larger than those typical of demonstration organic solar cells (0.04-0.2 cm2). Integration of these solar cells with a low-cost, polymer-based electrochromic window enables intelligent management of the solar spectrum, with near-ultraviolet photons powering the regulation of visible and near-infrared photons for natural lighting and heating purposes.

  6. The role of business information management in advanced integrated environmental management systems

    DEFF Research Database (Denmark)

    Ulhøi, John Parm

    2000-01-01

    investments in the individual company. Secondly, based on the above, to calculate and assess some typical quantifiable savings, e.g. on energy and raw materials, over a period of four years (after the implementation of the integrated environmental management system). In line with other similar investigations......, the study shows that the implementation of systematic and integrated environmental management systems results in significant savings. This supports the general, albeit rarely tested, hypothesis that it pays to be an environmentally responsible enterprise....

  7. Full-spectrum light management by pseudo-disordered moth-eye structures for thin film solar cells.

    Science.gov (United States)

    Liu, Xiaojun; Da, Yun; Xuan, Yimin

    2017-08-07

    In this paper, the role of pseudo-disordered moth-eye structures on the optical features for application to thin-film solar cells is investigated to realize the superior light management for the full-spectrum solar energy utilization, compared with some ordered structures. Without loss of generality, the c-Si thin film solar cell is taken as the example. The results demonstrate that the fluctuations introduced into the geometry parameters of moth-eye elements can lead to the remarkable absorption enhancement in the wavelength region of 0.3-1.1 μm and high transmission in the wavelength range of 1.1-2.5 μm. Two mechanisms including the increasing spectral density of modes and the intensive forescattering intensity are identified to be responsible for the absorption enhancement. In addition, the optical characteristics of the moth-eye surface with both disordered height and disordered diameter are insensitive to the incident angle.

  8. IPAD 2: Advances in Distributed Data Base Management for CAD/CAM

    Science.gov (United States)

    Bostic, S. W. (Compiler)

    1984-01-01

    The Integrated Programs for Aerospace-Vehicle Design (IPAD) Project objective is to improve engineering productivity through better use of computer-aided design and manufacturing (CAD/CAM) technology. The focus is on development of technology and associated software for integrated company-wide management of engineering information. The objectives of this conference are as follows: to provide a greater awareness of the critical need by U.S. industry for advancements in distributed CAD/CAM data management capability; to present industry experiences and current and planned research in distributed data base management; and to summarize IPAD data management contributions and their impact on U.S. industry and computer hardware and software vendors.

  9. MAXILLOFACIAL TRAUMA MANAGEMENT IN POLYTRAUMATIZED PATIENTS – THE USE OF ADVANCED TRAUMA LIFE SUPPORT (ATLS PRINCIPLES.

    Directory of Open Access Journals (Sweden)

    Elitsa G. Deliverska

    2013-03-01

    Full Text Available Management of the multiply injured patient requires a co-ordinated multi-disciplinary approach in order to optimise patients’ outcome. A working knowledge of the sort of problems these patients encounter is therefore vital to ensure that life-threatening injuries are recognised and treated in a timely pattern and that more minor associated injuries are not omitted. This article outlines the management of polytraumatized patients using the Advanced Trauma Life Support (ATLS principles and highlights the areas of specific involvement of the engaged medical team. Advanced Trauma Life Support is generally regarded as the gold standard and is founded on a number of well known principles, but strict adherence to protocols may have its drawbacks when facial trauma co-exists. These can arise in the presence of either major or minor facial injuries, and oral and maxillofacial surgeons need to be aware of the potential problems.

  10. [Organization of anesthesia management and advanced life support at military medical evacuation levels].

    Science.gov (United States)

    Shchegolev, A V; Petrakov, V A; Savchenko, I F

    2014-07-01

    Anesthesia management and advanced life support for the severely wounded personnel at military medical evacuation levels in armed conflict (local war) is time-consuming and resource-requiring task. One of the mathematical modeling methods was used to evaluate capabilities of anesthesia and intensive care units at tactical level. Obtained result allows us to tell that there is a need to make several system changes of the existing system of anesthesia management and advanced life support for the severely wounded personnel at military medical evacuation levels. In addition to increasing number of staff of anesthesiology-critical care during the given period of time another solution should be the creation of an early evacuation to a specialized medical care level by special means while conducting intensive monitoring and treatment.

  11. Potential biomarker panels in overall breast cancer management: advancements by multilevel diagnostics.

    Science.gov (United States)

    Girotra, Shantanu; Yeghiazaryan, Kristina; Golubnitschaja, Olga

    2016-09-01

    Breast cancer (BC) prevalence has reached an epidemic scale with half a million deaths annually. Current deficits in BC management include predictive and preventive approaches, optimized screening programs, individualized patient profiling, highly sensitive detection technologies for more precise diagnostics and therapy monitoring, individualized prediction and effective treatment of BC metastatic disease. To advance BC management, paradigm shift from delayed to predictive, preventive and personalized medical services is essential. Corresponding step forwards requires innovative multilevel diagnostics procuring specific panels of validated biomarkers. Here, we discuss current instrumental advancements including genomics, proteomics, epigenetics, miRNA, metabolomics, circulating tumor cells and cancer stem cells with a focus on biomarker discovery and multilevel diagnostic panels. A list of the recommended biomarker candidates is provided.

  12. Advanced Monitoring Systems Initiative Project Achievements for Environmental Restoration and Waste Management

    International Nuclear Information System (INIS)

    Hohman, E.H.; Lohrstorfer, C.L.; Venedam, R.J.; Weeks, S.J.; Fannin, C.R.

    2006-01-01

    The Advanced Monitoring Systems Initiative (AMSI) project has been in existence since 2002. In this short time period, AMSI has successfully developed, tested and/or demonstrated over 30 advanced sensors and monitoring systems for applications in environmental restoration, waste management and other areas of national interest. This presentation summarizes the AMSI project, and gives examples of recent successes. The purpose of the presentation is to make Symposium attendees aware of AMSI's capabilities and experience, for possible use in the future. Example successes include the following: - Automated hexavalent chromium (Cr(VI)) monitoring in wells alongside the Columbia River; - Atmospheric chemical sensor array for remote, real-time plume tracking; - Wireless sensor platform for long-term monitoring of subsurface moisture; - Embedded piezo-resistive micro-cantilever (EPM) units for carbon tetrachloride (CCl 4 ) and hydrogen cyanide (HCN) detection; - 'iHistorian' for efficient, real-time data management of chemical releases. (authors)

  13. The Potential Role of Probiotics in the Management of Childhood Autism Spectrum Disorders

    Directory of Open Access Journals (Sweden)

    J. William Critchfield

    2011-01-01

    Full Text Available Gastrointestinal (GI dysfunction has been reported in a substantial number of children with autism spectrum disorders (ASD. Activation of the mucosal immune response and the presence of abnormal gut microbiota are repeatedly observed in these children. In children with ASD, the presence of GI dysfunction is often associated with increased irritability, tantrums, aggressive behaviour, and sleep disturbances. Moreover, modulating gut bacteria with short-term antibiotic treatment can lead to temporary improvement in behavioral symptoms in some individuals with ASD. Probiotics can influence microbiota composition and intestinal barrier function and alter mucosal immune responses. The administration of probiotic bacteria to address changes in the microbiota might, therefore, be a useful novel therapeutic tool with which to restore normal gut microbiota, reduce inflammation, restore epithelial barrier function, and potentially ameliorate behavioural symptoms associated with some children with ASD. In this review of the literature, support emerges for the clinical testing of probiotics in ASD, especially in the context of addressing GI symptoms.

  14. Operations management system advanced automation: Fault detection isolation and recovery prototyping

    Science.gov (United States)

    Hanson, Matt

    1990-01-01

    The purpose of this project is to address the global fault detection, isolation and recovery (FDIR) requirements for Operation's Management System (OMS) automation within the Space Station Freedom program. This shall be accomplished by developing a selected FDIR prototype for the Space Station Freedom distributed processing systems. The prototype shall be based on advanced automation methodologies in addition to traditional software methods to meet the requirements for automation. A secondary objective is to expand the scope of the prototyping to encompass multiple aspects of station-wide fault management (SWFM) as discussed in OMS requirements documentation.

  15. Application of advanced thermal management technologies to the ATLAS SCT barrel module baseboards

    Energy Technology Data Exchange (ETDEWEB)

    Apsimon, R.J. [Rutherford Appleton Laboratory, Chilton, Didcot, Oxfordshire OX11 OQX (United Kingdom); Batchelor, L.E. [Rutherford Appleton Laboratory, Chilton, Didcot, Oxfordshire OX11 OQX (United Kingdom); Beck, G.A. [Department of Physics, Queen Mary University of London, Mile End Road, London E1 4NS (United Kingdom); Canard, P. [European Laboratory for Particle Physics (CERN), 1211 Geneva 23 (Switzerland); Carter, A.A. [Department of Physics, Queen Mary University of London, Mile End Road, London E1 4NS (United Kingdom)]. E-mail: a.a.carter@qmul.ac.uk; Carter, J.R. [Cavendish Laboratory, University of Cambridge, J.J. Thomson Avenue, Cambridge CB3 0HE (United Kingdom); Davis, V.R. [Rutherford Appleton Laboratory, Chilton, Didcot, Oxfordshire OX11 OQX (United Kingdom); Oliveira, R. de [European Laboratory for Particle Physics (CERN), 1211 Geneva 23 (Switzerland); Gibson, M.D. [Rutherford Appleton Laboratory, Chilton, Didcot, Oxfordshire OX11 OQX (United Kingdom); Hominal, L. [European Laboratory for Particle Physics (CERN), 1211 Geneva 23 (Switzerland); Ilie, D.M. [Department of Physics, Queen Mary University of London, Mile End Road, London E1 4NS (United Kingdom); Ilie, S.D. [European Laboratory for Particle Physics (CERN), 1211 Geneva 23 (Switzerland); Leboube, C.G. [European Laboratory for Particle Physics (CERN), 1211 Geneva 23 (Switzerland); Mistry, J. [Department of Physics, Queen Mary University of London, Mile End Road, London E1 4NS (United Kingdom); Morin, J. [Department of Physics, Queen Mary University of London, Mile End Road, London E1 4NS (United Kingdom); Morris, J.; Nagai, K. [Department of Physics, Queen Mary University of London, Mile End Road, London E1 4NS (United Kingdom); Sexton, I.; Thery, X. [European Laboratory for Particle Physics (CERN), 1211 Geneva 23 (Switzerland); Tyndel, M. [Rutherford Appleton Laboratory, Chilton, Didcot, Oxfordshire OX11 OQX (United Kingdom)

    2006-09-15

    The paper describes the application of advanced thermal management technologies to the design and production of the barrel module baseboard of the SemiConductor Tracker (SCT) of the ATLAS experiment at the Large Hadron Collider (LHC). The barrel modules contain silicon microstrip sensors and readout ASICs for tracking charged particles, and the baseboard forms the central element of the module, providing both its necessary thermal management and its mechanical structure. The baseboard requirements and specifications are given, and design and fabrication details are described. The properties of the 3000 baseboards successfully produced for the SCT are summarised.

  16. Groundwater Management in Mining Areas. Proceedings of the 2nd Image-Train Advanced Study Course

    International Nuclear Information System (INIS)

    Prokop, G.; Younger, P.; Roehl, K.E.

    2004-01-01

    Innovative Management of Groundwater Resources in Europe - training and RTD coordination (IMAGE-TRAIN) has the ambition to improve cooperation and interaction between ongoing research projects in the field of soil and groundwater contamination and to communicate new technology achievements to young scientists by means of training courses. The 2nd IMAGE-TRAIN advanced study course focussed on mine water management. This report includes reviews papers of the key-note lectures dealing with flooded mines, mine water pollution, in-situ remediation technologies (uranium mine), and mine water regulation. Those reviews of INIS database scope are indexed separately. (nevyjel)

  17. Do women top managers help women advance? A panel study using EEO-1 records

    OpenAIRE

    Kurtulus, Fidan Ana; Tomaskovic-Devey, Donald

    2011-01-01

    The goal of this study is to examine whether women in the highest levels of firms' management ranks help reduce barriers to women's advancement in the workplace. Using a panel of over 20,000 private-sector firms across all industries and states during 1990-2003 from the U.S. Equal Employment Opportunity Commission, we explore the influence of women in top management on subsequent female representation in lower-level managerial positions in U.S. firms. Our key findings show that an increase in...

  18. Recent Advances in Managing Acute Pancreatitis [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Nigeen Janisch

    2015-12-01

    Full Text Available This article will review the recent advances in managing acute pancreatitis. Supportive care has long been the standard of treatment for this disease despite extensive, but ultimately unsuccessful, efforts to develop disease-specific pharmacologic therapies. The primary interventions center on aggressive fluid resuscitation, initiation of early enteral nutrition, targeted antibiotic therapy, and the management of complications. In this article, we will detail treatment of acute pancreatitis with a focus on intravenous fluid resuscitation, enteral feeding, and the current evidence behind the use of antibiotics and other pharmacologic therapies.

  19. Advances in Agronomic Management of Indian Mustard (Brassica juncea (L. Czernj. Cosson: An Overview

    Directory of Open Access Journals (Sweden)

    Kapila Shekhawat

    2012-01-01

    Full Text Available India is the fourth largest oilseed economy in the world. Among the seven edible oilseeds cultivated in India, rapeseed-mustard contributes 28.6% in the total oilseeds production and ranks second after groundnut sharing 27.8% in the India’s oilseed economy. The mustard growing areas in India are experiencing the vast diversity in the agro climatic conditions and different species of rapeseed-mustard are grown in some or other part of the country. Under marginal resource situation, cultivation of rapeseed-mustard becomes less remunerative to the farmers. This results in a big gap between requirement and production of mustard in India. Therefore site-specific nutrient management through soil-test recommendation based should be adopted to improve upon the existing yield levels obtained at farmers field. Effective management of natural resources, integrated approach to plant-water, nutrient and pest management and extension of rapeseed-mustard cultivation to newer areas under different cropping systems will play a key role in further increasing and stabilizing the productivity and production of rapeseed-mustard. The paper reviews the advances in proper land and seedbed preparation, optimum seed and sowing, planting technique, crop geometry, plant canopy, appropriate cropping system, integrated nutrient management and so forth to meet the ever growing demand of oil in the country and to realize the goal of production of 24 million tonnes of oilseed by 2020 AD through these advanced management techniques.

  20. Human-system safety methods for development of advanced air traffic management systems

    International Nuclear Information System (INIS)

    Nelson, William R.

    1999-01-01

    The Idaho National Engineering and Environmental Laboratory (INEEL) is supporting the National Aeronautics and Space Administration in the development of advanced air traffic management (ATM) systems as part of the Advanced Air Transportation Technologies program. As part of this program INEEL conducted a survey of human-system safety methods that have been applied to complex technical systems, to identify lessons learned from these applications and provide recommendations for the development of advanced ATM systems. The domains that were surveyed included offshore oil and gas, commercial nuclear power, commercial aviation, and military. The survey showed that widely different approaches are used in these industries, and that the methods used range from very high-level, qualitative approaches to very detailed quantitative methods such as human reliability analysis (HRA) and probabilistic safety assessment (PSA). In addition, the industries varied widely in how effectively they incorporate human-system safety assessment in the design, development, and testing of complex technical systems. In spite of the lack of uniformity in the approaches and methods used, it was found that methods are available that can be combined and adapted to support the development of advanced air traffic management systems (author) (ml)

  1. Managing Risk on a Technology Development Project/Advanced Mirror System Demonstrator

    Science.gov (United States)

    Byberg, Alicia; Russell, J. Kevin; Stahl, Phil (Technical Monitor)

    2002-01-01

    The risk management study applied to the Advanced Mirror System Demonstrator (AMSD), a precursor mirror technology development for the Next Generation Space Telescope (NGST) is documented. The AMSD will be developed as a segment of a lightweight primary mirror system that can be produced at a low cost and with a short manufacturing schedule. The technology gained from the program will support the risk mitigation strategy for the NGST, as well as other government agency space mirror programs.

  2. Advanced transport operating system software upgrade: Flight management/flight controls software description

    Science.gov (United States)

    Clinedinst, Winston C.; Debure, Kelly R.; Dickson, Richard W.; Heaphy, William J.; Parks, Mark A.; Slominski, Christopher J.; Wolverton, David A.

    1988-01-01

    The Flight Management/Flight Controls (FM/FC) software for the Norden 2 (PDP-11/70M) computer installed on the NASA 737 aircraft is described. The software computes the navigation position estimates, guidance commands, those commands to be issued to the control surfaces to direct the aircraft in flight based on the modes selected on the Advanced Guidance Control System (AGSC) mode panel, and the flight path selected via the Navigation Control/Display Unit (NCDU).

  3. [Modern operations management in workflow operation. Spectrum of responsibilities and challenges for the future].

    Science.gov (United States)

    Riedl, S

    2002-02-01

    The operating unit is one of the cost-intensive facilities in a surgical clinic with a pacemaking function for most of the internal procedures. The power of performance of the operating unit is based on the co-operation of all disciplines and professions involved. The key to management of the operating unit is not only to co-ordinate the daily procedures, but also to interact with support personnel. To ensure successful OR management, the internal structure of the OR must fit the clinical tasks and the available quantity of personnel in each profession must be co-ordinated. Sufficient utilization of resources and equipment must be guaranteed without cost-intensive over-capacities and patient flow must be orientated to OR capacities. The development of such a business structure requires the management to clearly define the goal, to know the actual on-site data in detail with regard to the idiosyncratic workings of each speciality and to clearly assign the competence of each member of the team working in the OR. Co-ordination of the operating unit is the main task of OR management, which must ensure the following: transparent and co-ordinated schedule management in the various operative specialities, goal-directed changes of the schedule with incorporation of emergencies, as well as effective organization of staff. In order to realize these tasks, it is reasonable to implement interdisciplinary rules of procedures. In addition, the assignment of a neutral decision-making body within the OR and the creation of an information center for all OR personnel. The challenge of OR organization in the future is to implement more effective documentation systems and active controlling within the OR. One can ensure adequate utilization of resources in the OR with prospectively oriented planning. Better transparence of operations in the OR contributes to increased efficiency. Implementation of quality management is the foundation for a successfully operating surgical hospital. Not

  4. Design manual for management of solid by-products from advanced coal technologies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-10-01

    Developing coal conversion technologies face major obstacles in byproduct management. This project has developed several management strategies based on field trials of small-scale landfills in an earlier phase of the project, as well as on published/unpublished sources detailing regulatory issues, current industry practice, and reuse opportunities. Field testing, which forms the basis for several of the disposal alternatives presented in this design manual, was limited to byproducts from Ca-based dry SO{sub 2} control technologies, circulating fluidized bed combustion ash, and bubbling bed fluidized bed combustion ash. Data on byproducts from other advanced coal technologies and on reuse opportunities are drawn from other sources (citations following Chapter 3). Field results from the 5 test cases examined under this project, together with results from other ongoing research, provide a basis for predictive modeling of long-term performance of some advanced coal byproducts on exposure to ambient environment. This manual is intended to provide a reference database and development plan for designing, permitting, and operating facilities where advanced coal technology byproducts are managed.

  5. Recent advances in managing/understanding meningioma [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Nawal Shaikh

    2018-04-01

    Full Text Available Meningiomas are the most common adult primary intracranial tumor. Despite their higher incidence, there have not—until recently—been as many advances in understanding and managing meningiomas. Thus far, two broad classes of meningiomas have emerged on the basis of their mutational profile: those driven by neurofibromatosis 2 (NF2 inactivation and those with non-NF2 driver gene alterations, such as mammalian target of rapamycin and Hedgehog, Wingless/b-catenin, Notch, transforming growth factor-b receptor, mitogen-activated protein kinase, and phospholipase C pathway alterations. In addition to improvements in molecular diagnostics, advances in imaging are being studied to better predict tumor behavior, stratify risk, and potentially monitor for disease response. Management consists primarily of surgery and radiation therapy and there has been limited success from medical therapies, although novel targeted agents are now in clinical trials. Advances in imaging and understanding of the genetic makeup of meningiomas demonstrate the huge potential in revolutionizing the classification, diagnosis, management, and prognosis of meningiomas..

  6. Spanish consensus for the management of patients with advanced radioactive iodine refractory differentiated thyroid cancer.

    Science.gov (United States)

    Riesco-Eizaguirre, Garcilaso; Galofré, Juan Carlos; Grande, Enrique; Zafón Llopis, Carles; Ramón y Cajal Asensio, Teresa; Navarro González, Elena; Jiménez-Fonseca, Paula; Santamaría Sandi, Javier; Gómez Sáez, José Manuel; Capdevila, Jaume

    2016-04-01

    Approximately one third of the patients with differentiated thyroid cancer (DTC) who develop structurally-evident metastatic disease are refractory to radioactive iodine (RAI). Most deaths from thyroid cancer occur in these patients. The main objective of this consensus is to address the most controversial aspects of management of these patients. On behalf of the Spanish Society of Endocrinology & Nutrition (SEEN) and the Spanish Group for Orphan and Infrequent Tumors (GETHI), the Spanish Task Force for Thyroid Cancer, consisting of endocrinologists and oncologists, reviewed the relevant literature and prepared a series of clinically relevant questions related to management of advanced RAI-refractory DTC. Ten clinically relevant questions were identified by the task force. In answering to these 10 questions, the task force included recommendations regarding the best definition of refractoriness; the best therapeutic options including watchful waiting, local therapies, and systemic therapy (e.g. kinase inhibitors), when sodium iodide symporter (NIS) restoration may be expected; and how recent advances in molecular biology have increased our understanding of the disease. In response to our appointment as a task force by the SEEN and GHETI, we developed a consensus to help in clinical management of patients with advanced RAI-refractory DTC. We think that this consensus will provide helpful and current recommendations that will help patients with this disorder to get optimal medical care. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  7. Recent advances in the use of acoustics across the frequency spectrum in the oil and gas industry

    Science.gov (United States)

    Zeroug, Smaine; Bose, Sandip

    2018-04-01

    Acoustics enjoys a wide array of applicability in the Oil and Gas industry. Signals with very low-frequencies (tens of Hertz) are routinely used on surface to image the earth subsurface delineating hydrocarbon reservoirs while signals with mid-frequencies (thousands of Hertz) to high-frequencies (hundreds of kilo Hertz) are used in deep boreholes to probe rock mechanical properties and evaluate completion hardware. This article reviews a few recent advances in these applications spanning both measurement concepts and processing and inversion approaches. Three applications are covered, going from high to low frequencies. The first relates to an ultrasonic imager deployed in open boreholes to probe the laminated structure of unconventional shale rock formations at depth of more than 3000 m. The imager yields rock compressional and shear wavespeed images as a function of depth and azimuth revealing a host of geomechanical manifestations of the borehole shape and near-wellbore region at an unprecedented centimetric spatial resolution. The quantitative images have bearing on rock strength and local stresses as they relate to the hydraulic fracturing of these shale formations. The second relates to the interpretation of the complex sonic response in a well cased with double steel strings cemented to the rock formation for the purpose of evaluating the integrity of the cement placed between the outer string and formation. Here, machine learning-based approaches are employed with training on modeling and experimental datasets to develop effective and wellsite diagnosis for the condition of the cement sheath. The third relates to the seismic imaging domain and the deployment of novel accelerometers added to hydrophones on marine seismic cables to capture the subsurface-reflected pressure signals and their spatial gradients. The combination of the two sensors provides the means to deghost the signal from the sea surface reflection, and more importantly, reconstruct the

  8. Profile of children diagnosed with autistic spectrum disorder managed at a tertiary child development unit.

    Science.gov (United States)

    Lian, Wee Bin; Ho, Selina Kah Ying

    2012-12-01

    There has been a rising trend in childhood developmental and behavioural disorders (CDABD). This study reports the profile of children with autistic spectrum disorders (ASD) initially referred for evaluation of CDABD. The CDABD database prospectively collected data of all consenting children referred in 2003 to the then Child Development Unit at KK Women's and Children's Hospital. All received medical consultation, followed by further assessments and intervention. Patients were tracked for one year. Among 542 referred children, 32% (n = 170) received a diagnosis of ASD one year after the first consultation. Most were male, with a male to female ratio of 4.5:1. The median age at the first consultation was 41 (19,109) months. The main presenting concern was a delay in the development of speech and language skills in 78% of the children. A significant number had behavioural (63%) and social interaction (34%) issues. Criteria for the diagnosis of ASD according to the Diagnostic Statistical Manual IV-Revised were fulfilled in almost 90%. With the remaining refusing or deferring evaluation, only 74% received a psychological assessment. ASD was assessed to be severe or moderate in 86% of the children. Three-quarters remained on follow-up one year after the first consultation. The majority were referred for either centre- or school-based intervention programmes, with 70% assessed to have improved at the one-year mark. This is the first presentation of local data that aids programme planning and resource allocation. Children with ASD have varied outcomes. It is important to identify and intervene early in order to optimise development and functionality.

  9. Characteristics, aetiological spectrum and management of valvular heart disease in a Tunisian cardiovascular centre.

    Science.gov (United States)

    Triki, Faten; Jdidi, Jihen; Abid, Dorra; Tabbabi, Nada; Charfeddine, Selma; Ben Kahla, Sahar; Hentati, Mourad; Abid, Leila; Kammoun, Samir

    Valvular heart diseases occur frequently in Tunisia, but no precise statistics are available. To analyse the characteristics of patients with abnormal valvular structure and function, and to identify the aetiological spectrum, treatment and outcomes of valvular heart disease in a single cardiovascular centre in Tunisia. This retrospective study included patients with abnormal valvular structure and function, who were screened by transthoracic echocardiography at a single cardiology department between January 2010 and December 2013. Data on baseline characteristics, potential aetiology, treatment strategies and discharge outcomes were collected from medical records. There were 959 patients with a significant valvular heart disease (mean age 53±17years; female/male ratio 0.57). Valvular heart disease was native in 77% of patients. Mitral stenosis was the most frequent lesion (44.1%), followed by multiple valve disease (22.3%). Rheumatic origin (66.6%) was the most frequent aetiology, followed by degenerative (17.2%) or ischaemic (8.1%) causes, endocarditis (1.4%) and congenital (0.9%) causes. Native valve disease was severe in 589 patients (61.4%). Percutaneous mitral balloon valvuloplasty was performed in 36.9% of patients with mitral stenosis. Among patients with severe valvular heart disease, surgical treatment was indicated for 446 (75.7%) patients. Only 161 (36.1%) patients were finally operated. Postoperative mortality was 13.6% for all valvular heart diseases. This retrospective study has shown that the main cause of valvular heart disease in Tunisia is rheumatic fever. Mitral stenosis and multiple valve disease are the most frequent valvular heart diseases in Tunisia. Percutaneous mitral balloon valvuloplasty and prosthetic valve replacement are the preferred treatment methods for valvular heart disease. Copyright © 2016. Published by Elsevier Masson SAS.

  10. Advances and challenges for nutrient management in china in the 21st century.

    Science.gov (United States)

    Sims, J T; Ma, L; Oenema, O; Dou, Z; Zhang, F S

    2013-07-01

    Managing agricultural nutrients to provide a safe and secure food supply while protecting the environment remains one of the great challenges for the 21st century. The fourth International Nutrient Management Symposium (INMS), held in 2011 at the University of Delaware, addressed these issues via presentations, panel sessions, and field tours focused on latest technologies and policies available to increase nutrient use efficiency. Participants from the United States, Europe, Canada, and China discussed global trends and challenges, balancing food security and the environment in countries with struggling and emerging economics, nutrient management and transport at the catchment scale, new technologies for managing fertilizer and manure nutrients, and adaptive nutrient management practices for farm to watershed scales. A particular area of interest at the fourth INMS was nutrient management progress and challenges in China over the past 40 years. China's food security challenges and rapidly growing economy have led to major advances in agricultural production systems but also created severe nutrient pollution problems. This special collection of papers from the fourth INMS gives an overview of the remarkable progress China has made in nutrient management and highlights major challenges and changes in agri-environmental policies and practices needed today. Lessons learned in China are of value to both developing and developed countries facing the common task of providing adequate food for an expanding world population, while protecting air and water quality and restoring damaged ecosystems. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  11. Developing a common framework for integrated solid waste management advances in Managua, Nicaragua.

    Science.gov (United States)

    Olley, Jane E; IJgosse, Jeroen; Rudin, Victoria; Alabaster, Graham

    2014-09-01

    This article describes the municipal solid waste management system in Managua, Nicaragua. It updates an initial profile developed by the authors for the 2010 UN-HABITAT publication Solid Waste Management in the World's Cities and applies the methodology developed in that publication. In recent years, the municipality of Managua has been the beneficiary of a range of international cooperation projects aimed at improving municipal solid waste management in the city. The article describes how these technical assistance and infrastructure investments have changed the municipal solid waste management panorama in the city and analyses the sustainability of these changes. The article concludes that by working closely with the municipal government, the UN-HABITAT project Strengthening Capacities for Solid Waste Management in Managua was able to unite these separate efforts and situate them within a strategic framework to guide the evolution of the municipal solid waste management system in the forthcoming years. The creation of this multi-stakeholder platform allowed for the implementation of joint activities and ensured coherence in the products generated by the different projects. This approach could be replicated in other cities and in other sectors with similar effect. Developing a long term vision was essential for the advancement of municipal solid waste management in the city. Nevertheless, plan implementation may still be undermined by the pressures of the short term municipal administrative government, which emphasize operational over strategic investment. © The Author(s) 2014.

  12. Clinicians' Perspectives on Managing Symptom Clusters in Advanced Cancer: A Semistructured Interview Study.

    Science.gov (United States)

    Dong, Skye T; Butow, Phyllis N; Agar, Meera; Lovell, Melanie R; Boyle, Frances; Stockler, Martin; Forster, Benjamin C; Tong, Allison

    2016-04-01

    Managing symptom clusters or multiple concurrent symptoms in patients with advanced cancer remains a clinical challenge. The optimal processes constituting effective management of symptom clusters remain uncertain. To describe the attitudes and strategies of clinicians in managing multiple co-occurring symptoms in patients with advanced cancer. Semistructured interviews were conducted with 48 clinicians (palliative care physicians [n = 10], oncologists [n = 6], general practitioners [n = 6], nurses [n = 12], and allied health providers [n = 14]), purposively recruited from two acute hospitals, two palliative care centers, and four community general practices in Sydney, Australia. Transcripts were analyzed using thematic analysis and adapted grounded theory. Six themes were identified: uncertainty in decision making (inadequacy of scientific evidence, relying on experiential knowledge, and pressure to optimize care); attunement to patient and family (sensitivity to multiple cues, prioritizing individual preferences, addressing psychosocial and physical interactions, and opening Pandora's box); deciphering cause to guide intervention (disaggregating symptoms and interactions, flexibility in assessment, and curtailing investigative intrusiveness); balancing complexities in medical management (trading off side effects, minimizing mismatched goals, and urgency in resolving severe symptoms); fostering hope and empowerment (allaying fear of the unknown, encouraging meaning making, championing patient empowerment, and truth telling); and depending on multidisciplinary expertise (maximizing knowledge exchange, sharing management responsibility, contending with hierarchical tensions, and isolation and discontinuity of care). Management of symptom clusters, as both an art and a science, is currently fraught with uncertainty in decision making. Strengthening multidisciplinary collaboration, continuity of care, more pragmatic planning of clinical trials to address more than one

  13. Systemic Right Ventricle in Adults With Congenital Heart Disease: Anatomic and Phenotypic Spectrum and Current Approach to Management.

    Science.gov (United States)

    Brida, Margarita; Diller, Gerhard-Paul; Gatzoulis, Michael A

    2018-01-30

    The systemic right ventricle (SRV) is commonly encountered in congenital heart disease representing a distinctly different model in terms of its anatomic spectrum, adaptation, clinical phenotype, and variable, but overall guarded prognosis. The most common clinical scenarios where an SRV is encountered are complete transposition of the great arteries with previous atrial switch repair, congenitally corrected transposition of the great arteries, double inlet right ventricle mostly with previous Fontan palliation, and hypoplastic left heart syndrome palliated with the Norwood-Fontan protocol. The reasons for the guarded prognosis of the SRV in comparison with the systemic left ventricle are multifactorial, including distinct fibromuscular architecture, shape and function, coronary artery supply mismatch, intrinsic abnormalities of the tricuspid valve, intrinsic or acquired conduction abnormalities, and varied SRV adaptation to pressure or volume overload. Management of the SRV remains an ongoing challenge because SRV dysfunction has implications on short- and long-term outcomes for all patients irrespective of underlying cardiac morphology. SRV dysfunction can be subclinical, underscoring the need for tertiary follow-up and timely management of target hemodynamic lesions. Catheter interventions and surgery have an established role in selected patients. Cardiac resynchronization therapy is increasingly used, whereas pharmacological therapy is largely empirical. Mechanical assist device and heart transplantation remain options in end-stage heart failure when other management strategies have been exhausted. The present report focuses on the SRV with its pathological subtypes, pathophysiology, clinical features, current management strategies, and long-term sequelae. Although our article touches on issues applicable to neonates and children, its main focus is on adults with SRV. © 2018 American Heart Association, Inc.

  14. Management of advanced colon cancer in a community hospital--impact of age on clinical management and survival.

    Science.gov (United States)

    Mogili, Sujatha; Yousaf, Mobeen; Nadaraja, Nagendra; Woodlock, Timothy

    2012-09-01

    Colon cancer is more common in the elderly than in younger and middle-aged people. Cancer clinical trials focus more on younger patients and the management of elderly patients with advanced disease is still unclear. We studied all patients presenting with colon adenocarcinoma metastasis to liver at a community teaching hospital from Dec 2000 through Dec 2007 by a retrospective review of Tumor Registry data and patient chart review with focus on age, clinical management, decision making, and survival. Sixty-seven patients with a median age of 69 and a male to female ratio of 31:36 were identified. The patients with obstructive symptoms and Eastern Cooperative Oncology Group performance status on presentation though varied little by age, smaller proportion of elderly patients underwent resection of the primary bowel tumor in the presence of liver metastases with ten of 16 (63%) aged 80 or greater being managed without surgery. The percentage of patient's preference to physician's preference for patients not undergoing the primary bowel resection increased for older age group. Median survival decreased significantly with age (p management, decision-making autonomy, and survival are apparent in this study, and there was an increasing trend of patient's involvement in decision making as the age increases and, thus, affecting the age-related clinical management.

  15. Comparison of maternal and neonatal outcomes for patients with placenta accreta spectrum between online-to-offline management model with standard care model.

    Science.gov (United States)

    Sun, Wen; Yu, Lin; Liu, Shiliang; Chen, Yanhong; Chen, Juanjuan; Wen, Shi Wu; Chen, Dunjin

    2018-03-01

    Online-to-offline is a new model for emergent medical service with the ability to connect care providers with patients on instant basis. This study aims to evaluate maternal and neonatal outcomes in patients with placenta accreta spectrum managed by an online-to-offline care model. Starting from January 1, 2015, management of patients with placenta accreta spectrum was changed from standard care model into an online-to-offline care model through "Wechat" in Guangzhou Medical Centre for Critical Obstetrical Care. This study compared maternal and neonatal outcomes in patients affected by placenta accreta spectrum between 2015 (online-to-offline model) and 2014 (standard care model). A total of 209 cases of placenta accrete spectrum were treated in our center in 2015 and 218 such cases were treated in 2014. Patients treated in 2015 had lower rate of hysterectomy (14.83% versus 20.64%) and shorter hospital stay (7 days versus 8 days). The average interval from admission to emergency cesarean section for critically ill patients was 38.5 min in 2015 versus 50.7 min in 2014. Patients affected by placenta accreta spectrum managed by online-to-offline care model have reduced risk of hysterectomy, shorter hospital stay, and shorter response time from admission to emergency cesarean section. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. Epidemiology and management of insomnia in children with autistic spectrum disorders.

    Science.gov (United States)

    Miano, Silvia; Ferri, Raffaele

    2010-04-01

    Insomnia is the predominant sleep concern in children with autistic spectrum disorder (ASD), and its nature is most likely multifactorial, with neurochemical (abnormalities in serotonergic transmission or melatonin levels), psychiatric (anxiety), and behavioral (poor sleep habits) etiological factors involved. Children with ASD experience sleep problems similar to those of typically developing children, although the prevalence is markedly higher, occurring in 44-83% of school-aged children with ASD. Caregivers usually report that insomnia is the most frequent sleep disorder, described as disorders of initiating and maintaining sleep, restless sleep, bedtime resistance, co-sleeping, alterations of sleep hygiene, and early awakenings in the morning. Many actigraphic studies have added information on sleep disorders, confirming the questionnaire findings in the majority of cases. There are relatively few polysomnographic data for ASD, compared with questionnaire studies, and most of these studies reported a reduction in total sleep time and more undifferentiated sleep in the youngest patients. These findings were associated with several sleep microstructure alterations during rapid eye movement (REM) sleep, and with non-REM (NREM) sleep microstructure changes that appeared to be related to cognitive impairment rather than to the autistic core. Moreover, few data about other less frequent sleep disorders, such as periodic limb movements disorder and obstructive sleep apnea syndrome, bruxism, and the influence of epilepsy and EEG abnormalities, are available. Both pharmacologic and behavioral interventions have been suggested for the treatment of sleep problems in autistic children. The most common types of behavioral interventions are complete extinction (removing reinforcement to reduce a behavior) and various forms of graduated extinction. Melatonin has shown promising results in the treatment of insomnia in children with ASD. Although controlled studies are limited

  17. A call for inclusion of work-related diabetes distress in the spectrum of diabetes management

    DEFF Research Database (Denmark)

    Hansen, Ulla M; Olesen, Kasper; Browne, Jessica L

    2018-01-01

    AIM: Diabetes distress captures a range of emotional responses and reactions to life with diabetes and is considered a part of the experience of managing diabetes and its treatment. Given the importance of the social context of work life for people of working age we set out to explore whether wor...... captures an aspect of distress so far unaccounted for in workers with type 1 diabetes. Further studies are needed to strengthen the conceptual basis of work-related diabetes distress, explore its clinical usefulness and clarify its risk factors.......AIM: Diabetes distress captures a range of emotional responses and reactions to life with diabetes and is considered a part of the experience of managing diabetes and its treatment. Given the importance of the social context of work life for people of working age we set out to explore whether work......-related diabetes distress is a distinct and important dimension of diabetes-related emotional distress in working people with type 1 diabetes. METHODS: A questionnaire with self-reported measures of psychosocial health and well-being at work was completed by 1126 working people with type 1 diabetes from...

  18. Understanding requirements of novel healthcare information systems for management of advanced prostate cancer.

    Science.gov (United States)

    Wagholikar, Amol S; Fung, Maggie; Nelson, Colleen C

    2012-01-01

    Effective management of chronic diseases is a global health priority. A healthcare information system offers opportunities to address challenges of chronic disease management. However, the requirements of health information systems are often not well understood. The accuracy of requirements has a direct impact on the successful design and implementation of a health information system. Our research describes methods used to understand the requirements of health information systems for advanced prostate cancer management. The research conducted a survey to identify heterogeneous sources of clinical records. Our research showed that the General Practitioner was the common source of patient's clinical records (41%) followed by the Urologist (14%) and other clinicians (14%). Our research describes a method to identify diverse data sources and proposes a novel patient journey browser prototype that integrates disparate data sources.

  19. Advances in software development for intelligent interfaces for alarm and emergency management consoles

    International Nuclear Information System (INIS)

    Moseley, M.R.; Olson, C.E.

    1986-01-01

    Recent advances in technology allow features like voice synthesis, voice and speech recognition, image understanding, and intelligent data base management to be incorporated in computer driven alarm and emergency management information systems. New software development environments make it possible to do rapid prototyping of custom applications. Three examples using these technologies are discussed. 1) Maximum use is made of high-speed graphics and voice synthesis to implement a state-of-the-art alarm processing and display system with features that make the operator-machine interface efficient and accurate. 2) An application generator which has the capability of ''building'' a specific alarm processing and display application in a matter of a few hours, using the site definition developed in the security planning phase to produce the custom application. 3) A software tool, is described which permits rapid prototyping of human-machine interfaces for a variety of applications including emergency management, alarm display and process information display

  20. Multidisciplinary management of the locally advanced unresectable non-small cell lung cancer

    International Nuclear Information System (INIS)

    Cho, Kwan Ho

    2004-01-01

    locally advanced NSCLC continues to evolve. The current issues in the multidisciplinary management of locally advanced NSCLC will be reviewed in this report

  1. Recommendations of Common Data Elements to Advance the Science of Self-Management of Chronic Conditions.

    Science.gov (United States)

    Moore, Shirley M; Schiffman, Rachel; Waldrop-Valverde, Drenna; Redeker, Nancy S; McCloskey, Donna Jo; Kim, Miyong T; Heitkemper, Margaret M; Guthrie, Barbara J; Dorsey, Susan G; Docherty, Sharron L; Barton, Debra; Bailey, Donald E; Austin, Joan K; Grady, Patricia

    2016-09-01

    Common data elements (CDEs) are increasingly being used by researchers to promote data sharing across studies. The purposes of this article are to (a) describe the theoretical, conceptual, and definition issues in the development of a set of CDEs for research addressing self-management of chronic conditions; (b) propose an initial set of CDEs and their measures to advance the science of self-management; and (c) recommend implications for future research and dissemination. Between July 2014 and December 2015 the directors of the National Institute of Nursing Research (NINR)-funded P20 and P30 centers of excellence and NINR staff met in a series of telephone calls and a face-to-face NINR-sponsored meeting to select a set of recommended CDEs to be used in self-management research. A list of potential CDEs was developed from examination of common constructs in current self-management frameworks, as well as identification of variables frequently used in studies conducted in the centers of excellence. The recommended CDEs include measures of three self-management processes: activation, self-regulation, and self-efficacy for managing chronic conditions, and one measure of a self-management outcome, global health. The self-management of chronic conditions, which encompasses a considerable number of processes, behaviors, and outcomes across a broad range of chronic conditions, presents several challenges in the identification of a parsimonious set of CDEs. This initial list of recommended CDEs for use in self-management research is provisional in that it is expected that over time it will be refined. Comment and recommended revisions are sought from the research and practice communities. The use of CDEs can facilitate generalizability of research findings across diverse population and interventions. © 2016 Sigma Theta Tau International.

  2. Advanced practice nursing for enduring health needs management: a global perspective.

    Science.gov (United States)

    Koskinen, Liisa; Mikkonen, Irma; Graham, Iain; Norman, Linda D; Richardson, Jim; Savage, Eileen; Schorn, Mavis

    2012-07-01

    Advanced practice nursing expertise has been acknowledged worldwide as one response to the challenges arising from changes in society and health care. The roots of advanced practice nursing education are at the University of Colorado where the first known programme started in 1965. In many countries advanced practice nurses (APNs) have taken responsibility for routine patient care formerly carried out by physicians in order to reduce their workload. However, more and more, APNs have taken responsibility for new service areas and quality programmes not previously provided. Chronic disease management is one of these new service areas because long-term diseases are increasingly challenging service systems globally. This article is based on an international APN partnership. The aim of the article is to describe how the partnership will design a 15 ECTS credit course on Enduring Health Need Management as a cross-cultural collaborative endeavour. The adaptation of an inquiry based learning framework will be described drawing on four main principles of the theory: authentic learning communities; student encouragement in analysing gradually more complicated problems; networking in knowledge creation and; student engagement and activity. The cross-cultural online course aims to increase APNs' intercultural competence as well as their global and international work orientation. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Contemporary management of voice and swallowing disorders in patients with advanced lung cancer.

    Science.gov (United States)

    Brady, Grainne C; Carding, Paul N; Bhosle, Jaishree; Roe, Justin W G

    2015-06-01

    Advanced lung cancer can cause changes to swallowing and communication function. Direct tumour invasion, dyspnoea and deconditioning can all impact on swallowing function and communication. Cancer treatment, if administered, may cause or compound symptoms. In this study, the nature of swallowing and communication difficulties in patients with advanced lung cancer will be discussed, and management options including medical management, speech and language therapy (SLT) intervention, and surgical interventions will be considered. Advanced lung cancer can result in voice and swallowing difficulties, which can increase symptom burden and significantly impact on quality of life (QOL). There is a growing evidence base to support the use of injection laryngoplasty under local anaesthetic to offer immediate improvement in voice, swallowing and overall QOL. There is limited literature on the nature and extent of voice and swallowing impairment in patients with lung cancer. Well designed studies with robust and sensitive multidimensional dysphagia and dysphonia assessments are required. Outcome studies examining interventions with clearly defined treatment goals are required. These studies should include both functional and patient-reported outcome measures to develop the evidence base and to ensure that interventions are both timely and appropriate.

  4. Quo vadis radiotherapy? Technological advances and the rising problems in cancer management.

    Science.gov (United States)

    Allen, Barry J; Bezak, Eva; Marcu, Loredana G

    2013-01-01

    Despite the latest technological advances in radiotherapy, cancer control is still challenging for several tumour sites. The survival rates for the most deadly cancers, such as ovarian and pancreatic, have not changed over the last decades. The solution to the problem lies in the change of focus: from local treatment to systemic therapy. The aim of this paper is to present the current status as well as the gaps in radiotherapy and, at the same time, to look into potential solutions to improve cancer control and survival. The currently available advanced radiotherapy treatment techniques have been analysed and their cost-effectiveness discussed. The problem of systemic disease management was specifically targeted. Clinical studies show limited benefit in cancer control from hadron therapy. However, targeted therapies together with molecular imaging could improve treatment outcome for several tumour sites while controlling the systemic disease. The advances in photon therapy continue to be competitive with the much more expensive hadron therapy. To justify the cost effectiveness of proton/heavy ion therapy, there is a need for phase III randomised clinical trials. Furthermore, the success of systemic disease management lies in the fusion between radiation oncology technology and microbiology.

  5. Parents' Opinions about an Intervention to Manage Repetitive Behaviours in Young Children with Autism Spectrum Disorder: A Qualitative Study

    Science.gov (United States)

    Hodgson, Anna R.; Grahame, Victoria; Garland, Deborah; Gaultier, Fiona; Lecouturier, Jan; Le Couteur, Ann

    2018-01-01

    Background: Early intervention for autism spectrum disorder (ASD) tends to focus on enhancing social communication skills. We report data collected via focus group discussions as part of a feasibility and acceptability pilot randomized controlled trial (RCT) about a new parent group intervention to manage restricted and repetitive behaviours (RRB)…

  6. Managing Repetitive Behaviours in Young Children with Autism Spectrum Disorder (ASD): Pilot Randomised Controlled Trial of a New Parent Group Intervention

    Science.gov (United States)

    Grahame, Victoria; Brett, Denise; Dixon, Linda; McConachie, Helen; Lowry, Jessica; Rodgers, Jacqui; Steen, Nick; Le Couteur, Ann

    2015-01-01

    Early intervention for autism spectrum disorder (ASD) tends to focus on enhancing social-communication skills. We report the acceptability, feasibility and impact on child functioning of a new 8 weeks parent-group intervention to manage restricted and repetitive behaviours (RRB) in young children with ASD aged 3-7 years. Forty-five families took…

  7. Melatonin versus Placebo in Children with Autism Spectrum Conditions and Severe Sleep Problems Not Amenable to Behaviour Management Strategies: A Randomised Controlled Crossover Trial

    Science.gov (United States)

    Wright, Barry; Sims, David; Smart, Siobhan; Alwazeer, Ahmed; Alderson-Day, Ben; Allgar, Victoria; Whitton, Clare; Tomlinson, Heather; Bennett, Sophie; Jardine, Jenni; McCaffrey, Nicola; Leyland, Charlotte; Jakeman, Christine; Miles, Jeremy

    2011-01-01

    Twenty-two children with autism spectrum disorders who had not responded to supported behaviour management strategies for severe dysomnias entered a double blind, randomised, controlled crossover trial involving 3 months of placebo versus 3 months of melatonin to a maximum dose of 10 mg. 17 children completed the study. There were no significant…

  8. Management of advanced prostate cancer in senior adults: the new landscape.

    Science.gov (United States)

    Aapro, Matti S

    2012-01-01

    The landscape of treatment for advanced prostate cancer is continually evolving as new therapies are developed and guidelines are constantly updated. However, the management of older men with advanced disease is not optimal. Many men are denied chemotherapy based on their chronological age, not their health status. Androgen-deprivation therapy (ADT) remains the mainstay of first-line treatment of advanced disease. Once the disease becomes resistant to castration, docetaxel-based chemotherapy is the regulatory-approved standard of care, irrespective of age. The place of weekly docetaxel in patients with poor performance status and signs of frailty has to be further evaluated in clinical studies. New treatments are now available, or on the horizon, for disease that progresses during or after docetaxel therapy. Cabazitaxel and abiraterone have been shown to prolong survival, irrespective of age, and are already in clinical use having received regulatory approval. The optimal sequence for these two agents is still unknown, although there is some indication that in patients predicted to be poor responders to abiraterone (high Gleason score, progression during docetaxel therapy, rapid progression to castrate-resistant prostate cancer with ADT) cabazitaxel should be the preferred choice. Further advances are being investigated, with promising data reported from phase III trials.

  9. Sitosterolemia: a review and update of pathophysiology, clinical spectrum, diagnosis, and management

    Directory of Open Access Journals (Sweden)

    Eun-Gyong Yoo

    2016-03-01

    Full Text Available Sitosterolemia is an autosomal recessive disorder characterized by increased plant sterol levels, xanthomas, and accelerated atherosclerosis. Although it was originally reported in patients with normolipemic xanthomas, severe hypercholesterolemia have been reported in patients with sitosterolemia, especially in children. Sitosterolemia is caused by increased intestinal absorption and decreased biliary excretion of sterols resulting from biallelic mutations in either ABCG5 or ABCG8, which encode the sterol efflux transporter ABCG5 and ABCG8. Patients with sitosterolemia show extreme phenotypic heterogeneity, ranging from almost asymptomatic individuals to those with severe hypercholesterolemia leading to accelerated atherosclerosis and premature cardiac death. Hematologic manifestations include hemolytic anemia with stomatocytosis, macrothrombocytopenia, splenomegaly, and abnormal bleeding. The mainstay of therapy includes dietary restriction of both cholesterol and plant sterols and the sterol absorption inhibitor, ezetimibe. Foods rich in plant sterols include vegetable oils, wheat germs, nuts, seeds, avocado, shortening, margarine and chocolate. Hypercholesterolemia in patients with sitosterolemia is dramatically responsive to low cholesterol diet and bile acid sequestrants. Plant sterol assay should be performed in patients with normocholesterolemic xanthomas, hypercholesterolemia with unexpectedly good response to dietary modifications or to cholesterol absorption inhibitors, or hypercholesterolemia with poor response to statins, or those with unexplained hemolytic anemia and macrothrombocytopenia. Because prognosis can be improved by proper management, it is important to find these patients out and diagnose correctly. This review article aimed to summarize recent publications on sitosterolemia, and to suggest clinical indications for plant sterol assay.

  10. Magnetic resonance imaging is often misleading when used as an adjunct to ultrasound in the management of placenta accreta spectrum disorders.

    Science.gov (United States)

    Einerson, Brett D; Rodriguez, Christina E; Kennedy, Anne M; Woodward, Paula J; Donnelly, Meghan A; Silver, Robert M

    2018-06-01

    Magnetic resonance imaging is reported to have good sensitivity and specificity in the diagnosis of placenta accreta spectrum disorders, and is often used as an adjunct to ultrasound. But the additional utility of obtaining magnetic resonance imaging to assist in the clinical management of patients with placenta accreta spectrum disorders, above and beyond the information provided by ultrasound, is unknown. We aimed to determine whether magnetic resonance imaging provides data that may inform clinical management by changing the sonographic diagnosis of placenta accreta spectrum disorders. In all, 78 patients with sonographic evidence or clinical suspicion of placenta accreta spectrum underwent magnetic resonance imaging of the abdomen and pelvis in orthogonal planes through the uterus utilizing T1- and T2-weighted imaging sequences at the University of Utah and the University of Colorado from 1997 through 2017. The magnetic resonance imaging was interpreted by radiologists with expertise in diagnosis of placenta accreta spectrum who had knowledge of the sonographic interpretation and clinical risk factors for placenta accreta spectrum disorders. The primary outcome was a change in diagnosis from sonographic interpretation that could alter clinical management, which was defined a priori. Diagnostic accuracy was verified by surgical and histopathologic diagnosis at the time of delivery. A change in diagnosis that could potentially alter clinical management occurred in 28 (36%) cases. Magnetic resonance imaging correctly changed the diagnosis in 15 (19%), and correctly confirmed the diagnosis in 34 (44%), but resulted in an incorrect change in diagnosis in 13 (17%), and an incorrect confirmation of ultrasound diagnosis in 15 (21%). Magnetic resonance imaging was not more likely to change a diagnosis in the 24 cases of posterior and lateral placental location compared to anterior location (33% vs 37%, P = .84). Magnetic resonance imaging resulted in overdiagnosis in

  11. Factors associated with advance care planning discussions by area agency on aging care managers.

    Science.gov (United States)

    Hazelett, Susan; Baughman, Kristin R; Palmisano, Barbara R; Sanders, Margaret; Ludwick, Ruth E

    2013-12-01

    Initiating advance care planning (ACP) discussions in the home may prevent avoidable hospitalizations by elucidating goals of care. Area agencies on aging care managers (AAACMs) work in the home with high-risk consumers. To determine which AAACM characteristics contribute to an increased frequency of ACP discussions. Cross-sectional investigator-generated surveys administered to AAACMs at 3 AAAs in Ohio. Of 289 AAACMs, 182 (63%) responded. The more experience and comfort AAACMs felt with ACP discussions, the more likely they were to initiate ACP discussions. It may be necessary to build interactive educational experiences where, for example, AAACMs are asked to fill out their own advance directives and/or facilitate others in ACP discussions to improve experience and comfort with ACP discussions.

  12. Concept for a Satellite-Based Advanced Air Traffic Management System : Volume 4. Operational Description and Qualitative Assessment.

    Science.gov (United States)

    1974-02-01

    The volume presents a description of how the Satellite-Based Advanced Air Traffic Management System (SAATMS) operates and a qualitative assessment of the system. The operational description includes the services, functions, and tasks performed by the...

  13. Recent advances in managing idiopathic pulmonary fibrosis [version 1; referees: 4 approved

    Directory of Open Access Journals (Sweden)

    Chiara Scelfo

    2017-11-01

    Full Text Available Idiopathic pulmonary fibrosis (IPF is a rare pulmonary disease with a poor prognosis and severe impact on quality of life. Early diagnosis is still challenging and important delays are registered before final diagnosis can be reached. Available tools fail to predict the variable course of the disease and to evaluate response to antifibrotic drugs. Despite the recent approval of pirfenidone and nintedanib, significant challenges remain to improve prognosis and quality of life. It is hoped that the new insights gained in pathobiology in the last few years will lead to further advances in the diagnosis and management of IPF. Currently, early diagnosis and prompt initiation of treatments reducing lung function loss offer the best hope for improved outcomes. This article aims at providing an overview of recent advances in managing patients with IPF and has a particular focus on how to reach a diagnosis, manage comorbidities and lung transplantation, care for the non-pharmacological needs of patients, and address palliative care.

  14. An Advanced IoT-based System for Intelligent Energy Management in Buildings.

    Science.gov (United States)

    Marinakis, Vangelis; Doukas, Haris

    2018-02-16

    The energy sector is closely interconnected with the building sector and integrated Information and Communication Technologies (ICT) solutions for effective energy management supporting decision-making at building, district and city level are key fundamental elements for making a city Smart. The available systems are designed and intended exclusively for a predefined number of cases and systems without allowing for expansion and interoperability with other applications that is partially due to the lack of semantics. This paper presents an advanced Internet of Things (IoT) based system for intelligent energy management in buildings. A semantic framework is introduced aiming at the unified and standardised modelling of the entities that constitute the building environment. Suitable rules are formed, aiming at the intelligent energy management and the general modus operandi of Smart Building. In this context, an IoT-based system was implemented, which enhances the interactivity of the buildings' energy management systems. The results from its pilot application are presented and discussed. The proposed system extends existing approaches and integrates cross-domain data, such as the building's data (e.g., energy management systems), energy production, energy prices, weather data and end-users' behaviour, in order to produce daily and weekly action plans for the energy end-users with actionable personalised information.

  15. An Advanced IoT-based System for Intelligent Energy Management in Buildings

    Science.gov (United States)

    Doukas, Haris

    2018-01-01

    The energy sector is closely interconnected with the building sector and integrated Information and Communication Technologies (ICT) solutions for effective energy management supporting decision-making at building, district and city level are key fundamental elements for making a city Smart. The available systems are designed and intended exclusively for a predefined number of cases and systems without allowing for expansion and interoperability with other applications that is partially due to the lack of semantics. This paper presents an advanced Internet of Things (IoT) based system for intelligent energy management in buildings. A semantic framework is introduced aiming at the unified and standardised modelling of the entities that constitute the building environment. Suitable rules are formed, aiming at the intelligent energy management and the general modus operandi of Smart Building. In this context, an IoT-based system was implemented, which enhances the interactivity of the buildings’ energy management systems. The results from its pilot application are presented and discussed. The proposed system extends existing approaches and integrates cross-domain data, such as the building’s data (e.g., energy management systems), energy production, energy prices, weather data and end-users’ behaviour, in order to produce daily and weekly action plans for the energy end-users with actionable personalised information. PMID:29462957

  16. An Advanced IoT-based System for Intelligent Energy Management in Buildings

    Directory of Open Access Journals (Sweden)

    Vangelis Marinakis

    2018-02-01

    Full Text Available The energy sector is closely interconnected with the building sector and integrated Information and Communication Technologies (ICT solutions for effective energy management supporting decision-making at building, district and city level are key fundamental elements for making a city Smart. The available systems are designed and intended exclusively for a predefined number of cases and systems without allowing for expansion and interoperability with other applications that is partially due to the lack of semantics. This paper presents an advanced Internet of Things (IoT based system for intelligent energy management in buildings. A semantic framework is introduced aiming at the unified and standardised modelling of the entities that constitute the building environment. Suitable rules are formed, aiming at the intelligent energy management and the general modus operandi of Smart Building. In this context, an IoT-based system was implemented, which enhances the interactivity of the buildings’ energy management systems. The results from its pilot application are presented and discussed. The proposed system extends existing approaches and integrates cross-domain data, such as the building’s data (e.g., energy management systems, energy production, energy prices, weather data and end-users’ behaviour, in order to produce daily and weekly action plans for the energy end-users with actionable personalised information.

  17. Spectrum of clinical presentation and surgical management of intestinal tuberculosis at tertiary care hospital

    International Nuclear Information System (INIS)

    Abro, A.; Siddiqui, F.G.; Memon, A.S.; Akhtar, S.

    2010-01-01

    Background: Tuberculosis can involve gastrointestinal tract anywhere from mouth to anus, the peritoneum and pancreato biliary system. It has varied clinical presentations sometimes mimicking other common abdominal diseases. Tuberculosis continues to be a major problem especially in developing countries, being responsible for 7 - 10 million new cases and 6 per cent of deaths worldwide annually. Objective was to assess and evaluate various clinical presentations and management of intestinal tuberculosis at Liaquat University Hospital, Jamshoro/Hyderabad. Methods: This 3-year descriptive study was conducted on patients with diagnosed intestinal tuberculosis (by histopathology) in Surgical Unit-I, from January 2006 to December 2008. Detailed history and clinical examination was performed in all the cases. Investigations like Blood CP and ESR, Urea, RBS Electrolytes, Serum A/G Ratio, Ultrasound abdomen, X-Ray chest and abdomen were carried out in all the cases while barium meal, follow through and CT Scan abdomen were performed in selected cases. Preoperative assessment of anatomical site and variety of lesions were also noted. Results: A total of 60 patients with diagnosis of intestinal tuberculosis were admitted and operated. Diagnosis was confirmed by histopathology. Among these, 28 (46.7%) were male, and 32 (54.1%) were female. Variable clinical presentations were seen. Majority of patients (46, 76.7%) had abdominal pain, 26 (43.3%) had vomiting; abdominal distension was seen in 22 (36.7%) cases, diarrhoea and constipation in 16 patients (26.7%) and abdominal mass in 14 patients (23.3%). Majority of patients had ulcerostenotic type of tuberculosis. Single stricture of ileum was seen in 15 (25%) while multiple strictures were seen in 13 (21.7%). Ileal perforation was seen in 6 (10%) patients. Weight lo ss was seen in 40 (66.7%) patients, fever 36 (60%), night sweats 30 (50%), anorexia in 30 (50%) and pulmonary tuberculosis in 18 (30%) patients. Resection and

  18. Advanced Concepts and Controversies in Emergency Department Pain Management.

    Science.gov (United States)

    Motov, Sergey M; Nelson, Lewis S

    2016-06-01

    Pain is the most common complaint for which patients come to the emergency department (ED). Emergency physicians are responsible for pain relief in a timely, efficient, and safe manner in the ED. The improvement in our understanding of the neurobiology of pain has balanced the utilization of nonopioid and opioid analgesia, and simultaneously has led to more rational and safer opioid prescribing practices. This article reviews advances in pain management in the ED for patients with acute and chronic pain as well as describes several newer strategies and controversies. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Management of Locally Advanced Renal Cell Carcinoma with Invasion of the Duodenum

    Directory of Open Access Journals (Sweden)

    Andrew T. Schlussel

    2013-01-01

    Full Text Available Renal cell carcinoma (RCC is rare but aggressive, with greater than 20% of patients presenting with stage III or IV, disease. Surgical resection of the primary tumor regardless of stage is the treatment of choice, and en bloc resection of involved organs provides the only potential chance for cure. This case report describes a patient with metastatic right-sided RCC with invasion of the inferior vena cava and duodenum managed by en block resection and pancreaticoduodenectomy. This report will review the workup and treatment of locally advanced RCC, as well as the role of cytoreductive nephrectomy in the setting of metastatic disease.

  20. Managing inter-cell interference with advanced receivers and rank adaptation in 5G small cells

    DEFF Research Database (Denmark)

    Tavares, Fernando Menezes Leitão; Berardinelli, Gilberto; Catania, Davide

    2015-01-01

    -cell interference management. In this paper, we evaluate whether it is possible to rely on such advanced receivers as the main tool to deal with the inter-cell interference problem. We present a system-level performance evaluation in three different dense indoor small cell scenarios using a receiver model...... that includes both interference rejection combining (IRC) and successive interference cancellation (SIC) principles, as well as different rank adaptation strategies. Our results confirm that interference suppression receivers with a supportive system design can indeed represent a valid alternative to frequency...

  1. Advanced Power Converter for Universal and Flexible Power Management in Future Electricity Network

    DEFF Research Database (Denmark)

    Iov, Florin; Blaabjerg, Frede; Bassett, R.

    2007-01-01

    converters for grid connection of renewable sources will be needed. These power converters must be able to provide intelligent power management as well as ancillary services. This paper presents the overall structure and the control aspects of an advanced power converter for universal and flexible power......More "green" power provided by Distributed Generation will enter into the European electricity network in the near future. In order to control the power flow and to ensure proper and secure operation of this future grid, with an increased level of the renewable power, new power electronic...

  2. Advancement on safety management system of nuclear power for safety and non-anxiety of society

    International Nuclear Information System (INIS)

    Yoshikawa, Hidekazu

    2004-01-01

    Advancement on safety management system is investigated to improve safety and non-anxiety of society for nuclear power, from the standpoint of human machine system research. First, the recent progress of R and D works of human machine interface technologies since 1980 s are reviewed and then the necessity of introducing a new approach to promote technical risk communication activity to foster safety culture in nuclear industries. Finally, a new concept of Offsite Operation and Maintenance Support Center (OMSC) is proposed as the core facility to assemble human resources and their expertise in all organizations of nuclear power, for enhancing safety and non-anxiety of society for nuclear power. (author)

  3. Recent Advances in the Pathogenesis and Management of Cast Nephropathy (Myeloma Kidney

    Directory of Open Access Journals (Sweden)

    Stephanie Stringer

    2011-01-01

    Full Text Available Multiple myeloma is an incurable plasma cell malignancy that is often accompanied by renal failure; there are a number of potential causes of this, of which cast nephropathy is the most important. Renal failure is highly significant in myeloma, as patient survival can be stratified by the severity of the renal impairment. Consequently, there is an ongoing focus on the pathological basis of cast nephropathy and the optimal treatment regimens in this setting, including effective chemotherapy regimens to reduce light chain production and emerging extracorporeal techniques to remove circulating light chains. This paper bridges recent advances in the pathogenesis and management of cast nephropathy in multiple myeloma.

  4. Principles and techniques in the design of ADMS+. [advanced data-base management system

    Science.gov (United States)

    Roussopoulos, Nick; Kang, Hyunchul

    1986-01-01

    'ADMS+/-' is an advanced data base management system whose architecture integrates the ADSM+ mainframe data base system with a large number of work station data base systems, designated ADMS-; no communications exist between these work stations. The use of this system radically decreases the response time of locally processed queries, since the work station runs in a single-user mode, and no dynamic security checking is required for the downloaded portion of the data base. The deferred update strategy used reduces overhead due to update synchronization in message traffic.

  5. Optimizing the management of neuromyelitis optica and spectrum disorders in resource poor settings: Experience from the Mangalore demyelinating disease registry

    Directory of Open Access Journals (Sweden)

    Lekha Pandit

    2013-01-01

    Full Text Available Background: In resource-poor settings, the management of neuromyelitis optica (NMO and NMO spectrum (NMOS disorders is limited because of delayed diagnosis and financial constraints. Aim: To device a cost-effective strategy for the management of NMO and related disorders in India. Materials and Methods: A cost-effective and disease-specific protocol was used for evaluating the course and treatment outcome of 70 consecutive patients. Results: Forty-five patients (65% had a relapse from the onset and included NMO (n = 20, recurrent transverse myelitis (RTM; n = 10, and recurrent optic neuritis (ROPN; n = 15. In 38 (84.4% patients presenting after multiple attacks, the diagnosis was made clinically. Only 7 patients with a relapsing course were seen at the onset and included ROPN (n = 5, NMO (n = 1, and RTM (n = 1. They had a second attack after a median interval of 1 ± 0.9 years, which was captured through our dedicated review process. Twenty-five patients had isolated longitudinally extensive transverse myelitis (LETM, of which 20 (80% remained ambulant at follow-up of 3 ± 1.9 years. Twelve patients (17% with median expanded disability status scale (EDSS of 8.5 at entry had a fatal outcome. Serum NMO-IgG testing was done in selected patients, and it was positive in 7 of 18 patients (39%. Irrespective of the NMO-IgG status, the treatment compliant patients (44.4% showed significant improvement in EDSS (P ≤ 0.001. Conclusions : Early clinical diagnosis and treatment compliance were important for good outcome. Isolated LETM was most likely a post-infectious demyelinating disorder in our set-up. NMO and NMOS disorders contributed to 14.9% (45/303 of all demyelinating disorders in our registry.

  6. Nea study on the impact of advanced fuel cycles on waste management policies

    International Nuclear Information System (INIS)

    Cavedon, J.M.

    2007-01-01

    This study was carried out by the ad hoc Expert Group on the Impact of Advanced Fuel Cycles on Waste Management Policies convened under the auspices of the NEA Committee for Technical and Economic Studies on Nuclear Energy Development and the Fuel Cycle (NDC); the Integrated Group on Safety Case from the Radioactive Waste Management Committee provided support in the field of waste repository issues; the Nuclear Science Committee Working Group on Flowsheet Studies also provided some input data. The full report on this study is published as the NEA Report number 5990 - OECD 2006 by OECD Publications - ISBN 92-64-02296-1. The following text is extracted from the Executive Summary of the report. (author)

  7. Lung Cancer Workshop XI: Tobacco-Induced Disease: Advances in Policy, Early Detection and Management.

    Science.gov (United States)

    Mulshine, James L; Avila, Rick; Yankelevitz, David; Baer, Thomas M; Estépar, Raul San Jose; Ambrose, Laurie Fenton; Aldigé, Carolyn R

    2015-05-01

    The Prevent Cancer Foundation Lung Cancer Workshop XI: Tobacco-Induced Disease: Advances in Policy, Early Detection and Management was held in New York, NY on May 16 and 17, 2014. The two goals of the Workshop were to define strategies to drive innovation in precompetitive quantitative research on the use of imaging to assess new therapies for management of early lung cancer and to discuss a process to implement a national program to provide high quality computed tomography imaging for lung cancer and other tobacco-induced disease. With the central importance of computed tomography imaging for both early detection and volumetric lung cancer assessment, strategic issues around the development of imaging and ensuring its quality are critical to ensure continued progress against this most lethal cancer.

  8. Radioactive waste management: the relation between geological disposal and advanced nuclear technologies

    International Nuclear Information System (INIS)

    Schroder, Jantine

    2013-01-01

    Throughout this paper we aim to scope the most pregnant themes, issues and research questions concerning the relation between geological disposal and advanced nuclear technologies in the broad context of radioactive waste management. Especially from a socio-technical point of view the mutual impacts, divergences and complementarities between both strategies seem to have received limited dedicated examination up until today. Specific attention is paid to the main arguments that seem to underpin both research streams, related to how the issue of radioactive waste is contextualized and which problems and solutions are consequently identified and proposed. Ultimately we aim to encourage scientifically integer communication and constructive dialogue between both fields, to investigate the common possibilities of enhancing radioactive waste management as a whole. (authors)

  9. Application of social media in crisis management advanced sciences and technologies for security applications

    CERN Document Server

    Staniforth, Andrew; Waddington, David

    2017-01-01

    This book explores how social media and its advances enables citizens to empower themselves during a crisis. The book addresses the key issues related to crises management and social media as the new platform to assist citizens and first responders dealing with multiple forms of crisis, from major terrorist attacks, larger scale public disorder, large-scale movement of people across borders, and natural disasters. The book is based on the results and knowledge gained during the European Commission ATHENA project which has been addressing critical issues in contemporary crisis management and social media and smart mobile communications. This book is authored by a mix of global contributors from across the landscape of academia, emergency response and experts in government policy and private industry. This title explores and explains that during a modern crisis, the public self-organizes into voluntary groups, adapt quickly to changing circumstances, emerge as leaders and experts and perform life-saving actions...

  10. Advanced Transport Operating System (ATOPS) Flight Management/Flight Controls (FM/FC) software description

    Science.gov (United States)

    Wolverton, David A.; Dickson, Richard W.; Clinedinst, Winston C.; Slominski, Christopher J.

    1993-01-01

    The flight software developed for the Flight Management/Flight Controls (FM/FC) MicroVAX computer used on the Transport Systems Research Vehicle for Advanced Transport Operating Systems (ATOPS) research is described. The FM/FC software computes navigation position estimates, guidance commands, and those commands issued to the control surfaces to direct the aircraft in flight. Various modes of flight are provided for, ranging from computer assisted manual modes to fully automatic modes including automatic landing. A high-level system overview as well as a description of each software module comprising the system is provided. Digital systems diagrams are included for each major flight control component and selected flight management functions.

  11. Anticipatory Water Management in Phoenix using Advanced Scenario Planning and Analyses: WaterSim 5

    Science.gov (United States)

    Sampson, D. A.; Quay, R.; White, D. D.; Gober, P.; Kirkwood, C.

    2013-12-01

    Complexity, uncertainty, and variability are inherent properties of linked social and natural processes; sustainable resource management must somehow consider all three. Typically, a decision support tool (using scenario analyses) is used to examine management alternatives under suspected trajectories in driver variables (i.e., climate forcing's, growth or economic projections, etc.). This traditional planning focuses on a small set of envisioned scenarios whose outputs are compared against one-another in order to evaluate their differing impacts on desired metrics. Human cognition typically limits this to three to five scenarios. However, complex and highly uncertain issues may require more, often much more, than five scenarios. In this case advanced scenario analysis provides quantitative or qualitative methods that can reveal patterns and associations among scenario metrics for a large ensemble of scenarios. From this analysis, then, a smaller set of heuristics that describe the complexity and uncertainty revealed provides a basis to guide planning in an anticipatory fashion. Our water policy and management model, termed WaterSim, permits advanced scenario planning and analysis for the Phoenix Metropolitan Area. In this contribution we examine the concepts of advanced scenario analysis on a large scale ensemble of scenarios using our work with WaterSim as a case study. For this case study we created a range of possible water futures by creating scenarios that encompasses differences in water supplies (our surrogates for climate change, drought, and inherent variability in riverine flows), population growth, and per capital water consumption. We used IPCC estimates of plausible, future, alterations in riverine runoff, locally produced and vetted estimates of population growth projections, and empirical trends in per capita water consumption for metropolitan cities. This ensemble consisted of ~ 30, 700 scenarios (~575 k observations). We compared and contrasted

  12. Advanced information science and object-oriented technology for information management applications

    Energy Technology Data Exchange (ETDEWEB)

    Hummel, J.R.; Swietlik, C.E.

    1996-10-01

    The role of the military has been undergoing rapid change since the fall of the Berlin Wall. The kinds of missions the US military has been asked to participate in have often fallen into the category of {open_quotes}Military Operations Other Than War{close_quotes} and those involving military responses have been more of a surgical nature directed against different kinds of threats, like rogue states or in response to terrorist actions. As a result, the requirements on the military planner and analyst have also had to change dramatically. For example, preparing response options now requires rapid turnaround and a highly flexible simulation capability. This in turn requires that the planner or analyst have access to sophisticated information science and simulation technologies. In this paper, we shall discuss how advanced information science and object-oriented technologies can be used in advanced information management applications. We shall also discuss how these technologies and tools can be applied to DoD applications by presenting examples with a system developed at Argonne, the Dynamic Information Architecture System (DIAS). DIAS has been developed to exploit advanced information science and simulation technologies to provide tools for future planners and analysts.

  13. Management of locally advanced and metastatic colon cancer in elderly patients.

    Science.gov (United States)

    Kurniali, Peter C; Hrinczenko, Borys; Al-Janadi, Anas

    2014-02-28

    Colon cancer is the second leading cause of cancer mortality in the United States with a median age at diagnosis of 69 years. Sixty percent are diagnosed over the age of 65 years and 36% are 75 years or older. At diagnosis, approximately 58% of patients will have locally advanced and metastatic disease, for which systemic chemotherapy has been shown to improve survival. Treatment of cancer in elderly patients is more challenging due to multiple factors, including disabling co-morbidities as well as a decline in organ function. Cancer treatment of elderly patients is often associated with more toxicities that may lead to frequent hospitalizations. In locally advanced disease, fewer older patients receive adjuvant chemotherapy despite survival benefit and similar toxicity when compared to their younger counterparts. A survival benefit is also observed in the palliative chemotherapy setting for elderly patients with metastatic disease. When treating elderly patients with colon cancer, one has to consider drug pharmacokinetics and pharmacodynamics. Since chronological age is a poor marker of a patient's functional status, several methods of functional assessment including performance status and activities of daily living (ADL) or instrumental ADL, or even a comprehensive geriatric assessment, may be used. There is no ideal chemotherapy regimen that fits all elderly patients and so a regimen needs to be tailored for each individual. Important considerations when treating elderly patients include convenience and tolerability. This review will discuss approaches to the management of elderly patients with locally advanced and metastatic colon cancer.

  14. Surgical Management of Advanced and Metastatic Renal Cell Carcinoma: A Multidisciplinary Approach

    Directory of Open Access Journals (Sweden)

    Brian M. Shinder

    2017-05-01

    Full Text Available The past decade has seen a rapid proliferation in the number and types of systemic therapies available for renal cell carcinoma. However, surgery remains an integral component of the therapeutic armamentarium for advanced and metastatic kidney cancer. Cytoreductive surgery followed by adjuvant cytokine-based immunotherapy (predominantly high-dose interleukin 2 has largely given way to systemic-targeted therapies. Metastasectomy also has a role in carefully selected patients. Additionally, neoadjuvant systemic therapy may increase the feasibility of resecting the primary tumor, which may be beneficial for patients with locally advanced or metastatic disease. Several prospective trials examining the role of adjuvant therapy are underway. Lastly, the first immune checkpoint inhibitor was approved for metastatic renal cell carcinoma (mRCC in 2015, providing a new treatment mechanism and new opportunities for combining systemic therapy with surgery. This review discusses current and historical literature regarding the surgical management of patients with advanced and mRCC and explores approaches for optimizing patient selection.

  15. Experimental characterization of the Advanced Liquid Hydrogen Cold Neutron Source spectrum of the NBSR reactor at the NIST Center for Neutron Research

    Energy Technology Data Exchange (ETDEWEB)

    Cook, J.C.; Barker, J.G.; Rowe, J.M.; Williams, R.E. [NIST Center for Neutron Research, National Institute of Standards and Technology, 100 Bureau Drive, Mail Stop 6100, Gaithersburg, MD 20899-6100 (United States); Gagnon, C. [Department of Materials Science and Engineering, University of Maryland, College Park, MD 20742 (United States); Lindstrom, R.M. [Scientist Emeritus, Chemical Sciences Division, National Institute of Standards and Technology, 100 Bureau Drive, Mail Stop 8395, Gaithersburg, MD 20899-8395 (United States); Ibberson, R.M.; Neumann, D.A. [NIST Center for Neutron Research, National Institute of Standards and Technology, 100 Bureau Drive, Mail Stop 6100, Gaithersburg, MD 20899-6100 (United States)

    2015-08-21

    The recent expansion of the National Institute of Standards and Technology (NIST) Center for Neutron Research facility has offered a rare opportunity to perform an accurate measurement of the cold neutron spectrum at the exit of a newly-installed neutron guide. Using a combination of a neutron time-of-flight measurement, a gold foil activation measurement, and Monte Carlo simulation of the neutron guide transmission, we obtain the most reliable experimental characterization of the Advanced Liquid Hydrogen Cold Neutron Source brightness to date. Time-of-flight measurements were performed at three distinct fuel burnup intervals, including one immediately following reactor startup. Prior to the latter measurement, the hydrogen was maintained in a liquefied state for an extended period in an attempt to observe an initial radiation-induced increase of the ortho (o)-hydrogen fraction. Since para (p)-hydrogen has a small scattering cross-section for neutron energies below 15 meV (neutron wavelengths greater than about 2.3 Å), changes in the o- p hydrogen ratio and in the void distribution in the boiling hydrogen influence the spectral distribution. The nature of such changes is simulated with a continuous-energy, Monte Carlo radiation-transport code using 20 K o and p hydrogen scattering kernels and an estimated hydrogen density distribution derived from an analysis of localized heat loads. A comparison of the transport calculations with the mean brightness function resulting from the three measurements suggests an overall o- p ratio of about 17.5(±1) % o- 82.5% p for neutron energies<15 meV, a significantly lower ortho concentration than previously assumed.

  16. Experimental characterization of the Advanced Liquid Hydrogen Cold Neutron Source spectrum of the NBSR reactor at the NIST Center for Neutron Research

    Science.gov (United States)

    Cook, J. C.; Barker, J. G.; Rowe, J. M.; Williams, R. E.; Gagnon, C.; Lindstrom, R. M.; Ibberson, R. M.; Neumann, D. A.

    2015-08-01

    The recent expansion of the National Institute of Standards and Technology (NIST) Center for Neutron Research facility has offered a rare opportunity to perform an accurate measurement of the cold neutron spectrum at the exit of a newly-installed neutron guide. Using a combination of a neutron time-of-flight measurement, a gold foil activation measurement, and Monte Carlo simulation of the neutron guide transmission, we obtain the most reliable experimental characterization of the Advanced Liquid Hydrogen Cold Neutron Source brightness to date. Time-of-flight measurements were performed at three distinct fuel burnup intervals, including one immediately following reactor startup. Prior to the latter measurement, the hydrogen was maintained in a liquefied state for an extended period in an attempt to observe an initial radiation-induced increase of the ortho (o)-hydrogen fraction. Since para (p)-hydrogen has a small scattering cross-section for neutron energies below 15 meV (neutron wavelengths greater than about 2.3 Å), changes in the o- p hydrogen ratio and in the void distribution in the boiling hydrogen influence the spectral distribution. The nature of such changes is simulated with a continuous-energy, Monte Carlo radiation-transport code using 20 K o and p hydrogen scattering kernels and an estimated hydrogen density distribution derived from an analysis of localized heat loads. A comparison of the transport calculations with the mean brightness function resulting from the three measurements suggests an overall o- p ratio of about 17.5(±1) % o- 82.5% p for neutron energies<15 meV, a significantly lower ortho concentration than previously assumed.

  17. RNA interference: Applications and advances in insect toxicology and insect pest management.

    Science.gov (United States)

    Kim, Young Ho; Soumaila Issa, Moustapha; Cooper, Anastasia M W; Zhu, Kun Yan

    2015-05-01

    Since its discovery, RNA interference (RNAi) has revolutionized functional genomic studies due to its sequence-specific nature of post-transcriptional gene silencing. In this paper, we provide a comprehensive review of the recent literature and summarize the current knowledge and advances in the applications of RNAi technologies in the field of insect toxicology and insect pest management. Many recent studies have focused on identification and validation of the genes encoding insecticide target proteins, such as acetylcholinesterases, ion channels, Bacillus thuringiensis receptors, and other receptors in the nervous system. RNAi technologies have also been widely applied to reveal the role of genes encoding cytochrome P450 monooxygenases, carboxylesterases, and glutathione S-transferases in insecticide detoxification and resistance. More recently, studies have focused on understanding the mechanism of insecticide-mediated up-regulation of detoxification genes in insects. As RNAi has already shown great potentials for insect pest management, many recent studies have also focused on host-induced gene silencing, in which several RNAi-based transgenic plants have been developed and tested as proof of concept for insect pest management. These studies indicate that RNAi is a valuable tool to address various fundamental questions in insect toxicology and may soon become an effective strategy for insect pest management. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Advancing the business creed? The framing of decisions about public sector managed care.

    Science.gov (United States)

    Waitzkin, Howard; Yager, Joel; Santos, Richard

    2012-01-01

    Relatively little research has clarified how executives of for-profit healthcare organisations frame their own motivations and behaviour, or how government officials frame their interactions with executives. Because managed care has provided an organisational structure for health services in many countries, we focused our study on executives and government officials who were administering public sector managed care services. Emphasising theoretically the economic versus non-economic motivations that guide economic behaviour, we extended a long-term research project on public sector Medicaid managed care (MMC) in the United States. Our method involved in-depth, structured interviews with chief executive officers of managed care organisations, as well as high-ranking officials of state government. Data analysis involved iterative interpretation of interview data. We found that the rate of profit, which proved relatively low in the MMC programme, occupied a limited place in executives' self-described motivations and in state officials' descriptions of corporation-government interactions. Non-economic motivations included a strong orientation toward corporate social responsibility and a creed in which market processes advanced human wellbeing. Such patterns contradict some of the given wisdom about how corporate executives and government officials construct their reality. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  19. Reusable Rocket Engine Advanced Health Management System. Architecture and Technology Evaluation: Summary

    Science.gov (United States)

    Pettit, C. D.; Barkhoudarian, S.; Daumann, A. G., Jr.; Provan, G. M.; ElFattah, Y. M.; Glover, D. E.

    1999-01-01

    In this study, we proposed an Advanced Health Management System (AHMS) functional architecture and conducted a technology assessment for liquid propellant rocket engine lifecycle health management. The purpose of the AHMS is to improve reusable rocket engine safety and to reduce between-flight maintenance. During the study, past and current reusable rocket engine health management-related projects were reviewed, data structures and health management processes of current rocket engine programs were assessed, and in-depth interviews with rocket engine lifecycle and system experts were conducted. A generic AHMS functional architecture, with primary focus on real-time health monitoring, was developed. Fourteen categories of technology tasks and development needs for implementation of the AHMS were identified, based on the functional architecture and our assessment of current rocket engine programs. Five key technology areas were recommended for immediate development, which (1) would provide immediate benefits to current engine programs, and (2) could be implemented with minimal impact on the current Space Shuttle Main Engine (SSME) and Reusable Launch Vehicle (RLV) engine controllers.

  20. Advances in software development for intelligent interfaces for alarm and emergency management consoles

    International Nuclear Information System (INIS)

    Moseley, M.R.; Olson, C.E.

    1986-01-01

    Recent advances in technology allow features like voice synthesis, voice and speech recognition, image understanding, and intelligent data base management to be incorporated in computer driven alarm and emergency management information systems. New software development environments make it possible to do rapid prototyping of custom applications. Three examples using these technologies are discussed. (1) Maximum use is made of high-speed graphics and voice synthesis to implement a state-of-the-art alarm processing and display system with features that make the operator-machine interface efficient and accurate. Although very functional, this system is not portable or flexible; the software would have to be substantially rewritten for other applications. (2) An application generator which has the capability of ''building'' a specific alarm processing and display application in a matter of a few hours, using the site definition developed in the security planning phase to produce the custom application. This package is based on a standardized choice of hardware, within which it is capable of building a system to order, automatically constructing graphics, data tables, alarm prioritization rules, and interfaces to peripherals. (3) A software tool, the User Interface Management System (UIMS), is described which permits rapid prototyping of human-machine interfaces for a variety of applications including emergency management, alarm display and process information display. The object-oriented software of the UIMS achieves rapid prototyping of a new interface by standardizing to a class library of software objects instead of hardware objects

  1. Efficient Management of Certificate Revocation Lists in Smart Grid Advanced Metering Infrastructure

    Energy Technology Data Exchange (ETDEWEB)

    Cebe, Mumin [Florida Intl Univ., Miami, FL (United States); Akkaya, Kemal [Florida Intl Univ., Miami, FL (United States)

    2017-07-19

    Advanced Metering Infrastructure (AMI) forms a communication network for the collection of power data from smart meters in Smart Grid. As the communication within an AMI needs to be secure, key management becomes an issue due to overhead and limited resources. While using public-keys eliminate some of the overhead of key management, there is still challenges regarding certificates that store and certify the publickeys. In particular, distribution and storage of certificate revocation list (CRL) is major a challenge due to cost of distribution and storage in AMI networks which typically consist of wireless multi-hop networks. Motivated by the need of keeping the CRL distribution and storage cost effective and scalable, in this paper, we present a distributed CRL management model utilizing the idea of distributed hash trees (DHTs) from peer-to-peer (P2P) networks. The basic idea is to share the burden of storage of CRLs among all the smart meters by exploiting the meshing capability of the smart meters among each other. Thus, using DHTs not only reduces the space requirements for CRLs but also makes the CRL updates more convenient. We implemented this structure on ns-3 using IEEE 802.11s mesh standard as a model for AMI and demonstrated its superior performance with respect to traditional methods of CRL management through extensive simulations.

  2. The benefits of an advanced fast reactor fuel cycle for plutonium management

    International Nuclear Information System (INIS)

    Hannum, W.H.; McFarlane, H.F.; Wade, D.C.; Hill, R.N.

    1996-01-01

    The United States has no program to investigate advanced nuclear fuel cycles for the large-scale consumption of plutonium from military and civilian sources. The official U.S. position has been to focus on means to bury spent nuclear fuel from civilian reactors and to achieve the spent fuel standard for excess separated plutonium, which is considered by policy makers to be an urgent international priority. Recently, the National Research Council published a long awaited report on its study of potential separation and transmutation technologies (STATS), which concluded that in the nuclear energy phase-out scenario that they evaluated, transmutation of plutonium and long-lived radioisotopes would not be worth the cost. However, at the American Nuclear Society Annual Meeting in June, 1996, the STATS panelists endorsed further study of partitioning to achieve superior waste forms for burial, and suggested that any further consideration of transmutation should be in the context of energy production, not of waste management. 2048 The U.S. Department of Energy (DOE) has an active program for the short-term disposition of excess fissile material and a 'focus area' for safe, secure stabilization, storage and disposition of plutonium, but has no current programs for fast reactor development. Nevertheless, sufficient data exist to identify the potential advantages of an advanced fast reactor metallic fuel cycle for the long-term management of plutonium. Advantages are discussed

  3. Radiation-resistant requirements analysis of device and control component for advanced spent fuel management process

    Energy Technology Data Exchange (ETDEWEB)

    Song, Tai Gil; Park, G. Y.; Kim, S. Y.; Lee, J. Y.; Kim, S. H.; Yoon, J. S. [Korea Atomic Energy Research Institute, Taejeon (Korea)

    2002-02-01

    It is known that high levels of radiation can cause significant damage by altering the properties of materials. A practical understanding of the effects of radiation - how radiation affects various types of materials and components - is required to design equipment to operate reliably in a gamma radiation environment. When designing equipment to operate in a high gamma radiation environment, such as will be present in a nuclear spent fuel handling facility, several important steps should be followed. In order to active test of the advanced spent fuel management process, the radiation-resistant analysis of the device and control component for active test which is concerned about the radiation environment is conducted. Also the system design process is analysis and reviewed. In the foreign literature, 'threshold' values are generally reported. the threshold values are normally the dose required to begin degradation in a particular material property. The radiation effect analysis for the device of vol-oxidation and metalization, which are main device for the advanced spent fuel management process, is performed by the SCALE 4.4 code. 5 refs., 4 figs., 13 tabs. (Author)

  4. Central polydactyly of the foot: surgical management with plantar and dorsal advancement flaps.

    Science.gov (United States)

    Osborn, Emily J; Davids, Jon R; Leffler, Lauren C; Gibson, Thomas W; Pugh, Linda I

    2014-01-01

    Central polydactyly is the least common form of foot polydactyly, and the intercalary location of the duplicated ray makes the surgical exposure, excision, and closure more complex. For these reasons there is little consensus concerning the optimal technique for surgical management. A retrospective case series of 22 patients with 27 feet with central polydactyly, treated surgically by the dorsal and plantar advancement flap technique, was performed. Change in width of the forefoot was measured from radiographs by the metatarsal gap ratio. Functional outcomes were assessed by the Foot and Ankle Ability Measure. Signficant narrowing of the forefoot, as measured radiographically by the metatarsal gap ratio, was achieved after surgery (Psports, and overall function categories. The few reports of less than normal foot function were related to shoe wear issues and incisional scarring that was painful or cosmetically unappealing. The radiographic and functional outcomes after surgical management of central polydactyly with the dorsal and plantar advancement flap technique are excellent. The technique successfully narrows the forefoot on radiographs, and this narrowing is maintained with growth over time. However, families should be advised that persistent perceived widening of the forefoot relative to normal is common, despite successful radiographic narrowing after surgery. IV.

  5. Potential Role of Metabolic Intervention in the Management of Advanced Differentiated Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    Sri Harsha Tella

    2017-07-01

    Full Text Available Well-differentiated thyroid carcinoma (DTC is the most common endocrine malignancy that has an excellent prognosis with a 5-year survival rate of about 98%. However, approximately 50% of the patients with DTC who present with distant metastases (advanced DTC die from the disease within 5 years of initial diagnosis even after getting the appropriate therapy. Apart from recent advancements in chemotherapy agents, the potential role of metabolic interventions, including the use of metformin, ketogenic diet, and high-dose vitamin C in the management of advanced cancers have been investigated as a less toxic co-adjuvant therapies. The role of vitamin C has been of interest again after a preclinical mice study showed that high-dose vitamin C is selectively lethal to KRAS and BRAF mutant colorectal cancer cells by targeting the glutathione pathway. This raises the possibility of utilizing high-doses of vitamin C in the treatment of aDTC where KRAS and BRAF mutations are common. Similarly, alteration of cellular metabolism by low-carbohydrate ketogenic diets can be an important therapeutic strategy to selectively kill cancer cells that mainly survive on glycolysis. Among the potential adjuvant therapies proposed in this paper, metformin is the only agent that has shown benefit in human model of aDTC, the others have shown benefit but in preclinical/animal studies only and need to be further evaluated in large clinical trials. In conclusion, in addition to concurrent chemotherapy options, these metabolic interventions may have a great potential as co-adjuvant therapy in the management of aDTC.

  6. Contemporary Management of Borderline Resectable and Locally Advanced Unresectable Pancreatic Cancer.

    Science.gov (United States)

    Shaib, Walid L; Ip, Andrew; Cardona, Kenneth; Alese, Olatunji B; Maithel, Shishir K; Kooby, David; Landry, Jerome; El-Rayes, Bassel F

    2016-02-01

    Adenocarcinoma of the pancreas remains a highly lethal disease, with less than 5% survival at 5 years. Borderline resectable pancreatic cancer (BRPC) and locally advanced unresectable pancreatic cancer (LAPC) account for approximately 30% of newly diagnosed cases of PC. The objective of BRPC therapy is to downstage the tumor to allow resection; the objective of LAPC therapy is to control disease and improve survival. There is no consensus on the definitions of BRPC and LAPC, which leads to major limitations in designing clinical trials and evaluating their results. A multimodality approach is always needed to ensure proper utilization and timing of chemotherapy, radiation, and surgery in the management of this disease. Combination chemotherapy regimens (5-fluorouracil, leucovorin, irinotecan, oxaliplatin, and gemcitabine [FOLFIRINOX] and gemcitabine/nab-paclitaxel) have improved overall survival in metastatic disease. The role of combination chemotherapy regimens in BRPC and LAPC is an area of active investigation. There is no consensus on the dose, modality, and role of radiation therapy in the treatment of BRPC and LAPC. This article reviews the literature and highlights the areas of controversy regarding management of BRPC and LAPC. Pancreatic cancer is one of the worst cancers with regard to survival, even at early stages of the disease. This review evaluates all the evidence for the stages in which the cancer is not primarily resectable with surgery, known as borderline resectable or locally advanced unresectable. Recently, advancements in radiation techniques and use of better combination chemotherapies have improved survival and tolerance. There is no consensus on description of stages or treatment sequences (chemotherapy, chemoradiation, radiation), nor on the best chemotherapy regimen. The evidence behind the treatment paradigm for these stages of pancreatic cancer is summarized. ©AlphaMed Press.

  7. Update on celiac disease – etiology, differential diagnosis, drug targets, and management advances

    Directory of Open Access Journals (Sweden)

    Scanlon SA

    2011-12-01

    Full Text Available Samantha A Scanlon1, Joseph A Murray1,21Department of Internal Medicine, 2Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USAAbstract: Celiac disease (CD is an immune-mediated enteropathy triggered by exposure to wheat gluten and similar proteins found in rye and barley that affects genetically susceptible persons. This immune-mediated enteropathy is characterized by villous atrophy, intraepithelial lymphocytosis, and crypt hyperplasia. Once thought a disease that largely presented with malnourished children, the wide spectrum of disease activity is now better recognized and this has resulted in a shift in the presenting symptoms of most patients with CD. New advances in testing, both serologic and endoscopic, have dramatically increased the detection and diagnosis of CD. While the gluten-free diet is still the only treatment for CD, recent investigations have explored alternative approaches, including the use of altered nonimmunogenic wheat variants, enzymatic degradation of gluten, tissue transglutaminase inhibitors, induction of tolerance, and peptides to restore integrity to intestinal tight junctions.Keywords: immune-mediated enteropathy, gliadin, gluten, epidemiology, CD diagnosis, therapy

  8. Advancing Nursing Practice: Management of Neuropathic Pain With Capsaicin 8% Without Physician Supervision.

    Science.gov (United States)

    O'Brien, Joanne; Keaveny, Joseph; Pollard, Valerie; Nugent, Linda Elizabeth

    The purpose of this study was to examine the management of patient's neuropathic pain with capsaicin 8% in a nurse-led clinic when administered by 1 registered advanced nurse practitioner without physician supervision. A longitudinal, single-group, descriptive research design was used to assess pain scores and quality of life 3 times over 3 months after treatment. Patients with a diagnosis of neuropathic pain were assessed and treated with capsaicin 8% by 1 advanced nurse practitioner with prescriptive authority in a nurse-led clinic. Pain scores were collected at baseline, and self-assessed pain, activity level, and quality of life were assessed at 1 week, 4 weeks, and 3 months after treatment. Twenty-four patients were recruited, and data were analyzed using Friedman's test. In post hoc analysis, Wilcoxon signed-rank test was used with Bonferroni correction. Pain scores differed from pretreatment to posttreatment at each of the 3 time points, at rest (χ3 = 20.54, P = .001) and on movement (χ3 = 23.644, P = .001), and remained significant after Bonferroni correction. Overall, 62.5% (n = 15) of patients achieved at least a 30% reduction in self-reported pain at rest from pretreatment to 3 months, and 54% (n = 13) achieved the same reduction in pain on movement. Most improvements in patient's quality of life occurred between 1 and 4 weeks. Patient satisfaction was high, with 83% stating that they would be happy to have the treatment repeated. Single-dose capsaicin 8% decreased neuropathic pain after being administered in an outpatient setting by an experienced registered advanced nurse practitioner. Further multicenter research led by advanced nurse practitioners is needed to support high-quality, safe treatment of neuropathic pain with high-concentration capsaicin in nurse-led chronic pain clinics.

  9. Ecological Effects of Sea Level Rise: Advancing coastal management through integrated research and engagement

    Science.gov (United States)

    Kidwell, D. M.

    2012-12-01

    Rising sea level represents a significant threat to coastal communities and ecosystems through land loss, altered habitats, and increased vulnerability to coastal storms and inundation. This threat is exemplified in the northern Gulf of Mexico where low topography, expansive marshes, and a prevalence of tropical storms have already resulted in extensive coastal impacts. The development of robust predictive capabilities that incorporate complex biological processes with physical dynamics are critical for informed planning and restoration efforts for coastal ecosystems. Looking to build upon existing predictive modeling capabilities and allow for use of multiple model (i.e., ensemble) approaches, NOAA initiated the Ecological Effects of Sea Level Rise program in 2010 to advance physical/biological integrative modeling capabilities in the region with a goal to provide user friendly predictive tools for coastal ecosystem management. Focused on the northern Gulf of Mexico, this multi-disciplinary project led by the University of Central Florida will use in situ field studies to parameterize physical and biological models. These field studies will also result in a predictive capability for overland sediment delivery and transport that will further enhance marsh, oyster, and submerged aquatic vegetation models. Results from this integrated modeling effort are envisioned to inform management strategies for reducing risk, restoration and breakwater guidelines, and resource sustainability for project planning, among other uses. In addition to the science components, this project incorporates significant engagement of the management community through a management applications principle investigator and an advisory management committee. Routine engagement between the science team and the management committee, including annual workshops, are focused on ensuring the development of applicable, relevant, and useable products and tools at the conclusion of this project. Particular

  10. Looking back on safety management in construction of advanced thermal nuclear power plant 'Fugen'

    International Nuclear Information System (INIS)

    Emori, Kengo

    1979-01-01

    The safety management of the advanced thermal nuclear power plant ''Fugen'' during the period from the preparation of plant construction in October, 1970, to the full power operation in March, 1979, is looked back and explained. Any large human and material accidents did not occur during the long construction time. The total numbers of persons and hours were 1.397 x 10 6 workers and 11.55 x 10 6 hours, respectively. The number of labor accidents was twenty with no dead person, the number of loss days was 645 days, the number of accident rate was 1.73, the intensity rate was 0.06, and the mean rate of labor accidents per year per 1000 workers was 6.4. The radiation exposure dose was 65.27 man-rem for the managed 1804 workers in total, during the testing and operating periods. These data show that the safety management for ''Fugen'' is very excellent, considering the following special features: 1) there were many works which were carried out for the first time, 2) the construction of the plant was conducted by five contractors taking partial charge, there were many kinds of construction works, the construction and testing periods were long, and the workers had to go to the site from Tsuruga city by car and bus. The organization of preventing disasters, the concrete implementation items for safety management, including the planning of activities, various meetings, patrol, education and training, the honoring system, the prevention of traffic accident and so on, and the results of actual safety management are explained with the reflection. (Nakai, Y.)

  11. Implementing Participatory Water Management: Recent Advances in Theory, Practice, and Evaluation

    Directory of Open Access Journals (Sweden)

    Yorck von Korff

    2012-03-01

    Full Text Available Many current water planning and management problems are riddled with high levels of complexity, uncertainty, and conflict, so-called "messes" or "wicked problems." The realization that there is a need to consider a wide variety of values, knowledge, and perspectives in a collaborative decision making process has led to a multitude of new methods and processes being proposed to aid water planning and management, which include participatory forms of modeling, planning, and decision aiding processes. However, despite extensive scientific discussions, scholars have largely been unable to provide satisfactory responses to two pivotal questions: (1 What are the benefits of using participatory approaches?; (2 How exactly should these approaches be implemented in complex social-ecological settings to realize these potential benefits? In the study of developing social-ecological system sustainability, the first two questions lead to a third one that extends beyond the one-time application of participatory approaches for water management: (3 How can participatory approaches be most appropriately used to encourage transition to more sustainable ecological, social, and political regimes in different cultural and spatial contexts? The answer to this question is equally open. This special feature on participatory water management attempts to propose responses to these three questions by outlining recent advances in theory, practice, and evaluation related to the implementation of participatory water management. The feature is largely based on an extensive range of case studies that have been implemented and analyzed by cross-disciplinary research teams in collaboration with practitioners, and in a number of cases in close cooperation with policy makers and other interested parties such as farmers, fishermen, environmentalists, and the wider public.

  12. Clinical Assessment and Management of Toddlers With Suspected Autism Spectrum Disorder: Insights From Studies of High-Risk Infants

    Science.gov (United States)

    Zwaigenbaum, Lonnie; Bryson, Susan; Lord, Catherine; Rogers, Sally; Carter, Alice; Carver, Leslie; Chawarska, Kasia; Constantino, John; Dawson, Geraldine; Dobkins, Karen; Fein, Deborah; Iverson, Jana; Klin, Ami; Landa, Rebecca; Messinger, Daniel; Ozonoff, Sally; Sigman, Marian; Stone, Wendy; Tager-Flusberg, Helen; Yirmiya, Nurit

    2010-01-01

    With increased public awareness of the early signs and recent American Academy of Pediatrics recommendations that all 18- and 24-month-olds be screened for autism spectrum disorders, there is an increasing need for diagnostic assessment of very young children. However, unique challenges exist in applying current diagnostic guidelines for autism spectrum disorders to children under the age of 2 years. In this article, we address challenges related to early detection, diagnosis, and treatment of autism spectrum disorders in this age group. We provide a comprehensive review of findings from recent studies on the early development of children with autism spectrum disorders, summarizing current knowledge on early signs of autism spectrum disorders, the screening properties of early detection tools, and current best practice for diagnostic assessment of autism spectrum disorders before 2 years of age. We also outline principles of effective intervention for children under the age of 2 with suspected/confirmed autism spectrum disorders. It is hoped that ongoing studies will provide an even stronger foundation for evidence-based diagnostic and intervention approaches for this critically important age group. PMID:19403506

  13. Mutation spectrum of RB1 mutations in retinoblastoma cases from Singapore with implications for genetic management and counselling.

    Directory of Open Access Journals (Sweden)

    Swati Tomar

    Full Text Available Retinoblastoma (RB is a rare childhood malignant disorder caused by the biallelic inactivation of RB1 gene. Early diagnosis and identification of carriers of heritable RB1 mutations can improve disease outcome and management. In this study, mutational analysis was conducted on fifty-nine matched tumor and peripheral blood samples from 18 bilateral and 41 unilateral unrelated RB cases by a combinatorial approach of Multiplex Ligation-dependent Probe Amplification (MLPA assay, deletion screening, direct sequencing, copy number gene dosage analysis and methylation assays. Screening of both blood and tumor samples yielded a mutation detection rate of 94.9% (56/59 while only 42.4% (25/59 of mutations were detected if blood samples alone were analyzed. Biallelic mutations were observed in 43/59 (72.9% of tumors screened. There were 3 cases (5.1% in which no mutations could be detected and germline mutations were detected in 19.5% (8/41 of unilateral cases. A total of 61 point mutations were identified, of which 10 were novel. There was a high incidence of previously reported recurrent mutations, occurring at 38.98% (23/59 of all cases. Of interest were three cases of mosaic RB1 mutations detected in the blood from patients with unilateral retinoblastoma. Additionally, two germline mutations previously reported to be associated with low-penetrance phenotypes: missense-c.1981C>T and splice variant-c.607+1G>T, were observed in a bilateral and a unilateral proband, respectively. These findings have implications for genetic counselling and risk prediction for the affected families. This is the first published report on the spectrum of mutations in RB patients from Singapore and shows that further improved mutation screening strategies are required in order to provide a definitive molecular diagnosis for every case of RB. Our findings also underscore the importance of genetic testing in supporting individualized disease management plans for patients and

  14. T-cell non-Hodgkin lymphomas: Spectrum of disease nd the role of imaging in the management of common subtypes

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hye Sun [Dept. of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Krajewski, Katherine M.; Braschi-Amirfarzan, Marta; Shinagare, Atul B. [Dept. of Imaging, Dana Farber Cancer Institute, Harvard Medical School, Boston (United States)

    2017-01-15

    T-cell non-Hodgkin lymphomas (NHLs) are biologically diverse, uncommon malignancies characterized by a spectrum of imaging findings according to subtype. The purpose of this review is to describe the common subtypes of T-cell NHL, highlight important differences between cutaneous, various peripheral and precursor subtypes, and summarize imaging features and the role of imaging in the management of this diverse set of diseases.

  15. The role of interventional radiology in the management of deep venous thrombosis: advanced therapy.

    LENUS (Irish Health Repository)

    O'Sullivan, Gerard J

    2011-06-01

    Deep vein thrombosis (DVT) is often managed with a health care pathway that funnels patients to anticoagulation therapy alone. This "usual treatment" is designed to stop propagation and embolisation of venous thrombus but not remove it. Surgical thrombectomy was once the only option in severe cases in which limbs were threatened, but thrombus removal is no longer restricted to emergency cases. Interventional radiologists are now using advanced endovascular techniques to achieve thrombus removal in a minimally invasive manner in a very short treatment time, thereby quickly restoring patency, relieving acute symptoms, and potentially limiting the subsequent development of postthrombotic syndrome when followed with anticoagulation and compression regimens. This article provides an overview of the interventions available for treating DVT. One of the newer "single-session" techniques is isolated pharmacomechanical thrombolysis, which is described here in detail with supporting cases.

  16. Development Potentials for LH2 Storage System with Advanced Boil-off Management

    International Nuclear Information System (INIS)

    Takashi Maemura; Takanobu Kamiya; Shuichi Kawasaki; Ryo Nakamura; Kenji Nakamichi

    2006-01-01

    This paper describes our R and D until 2004 for liquid hydrogen components and system, and current development status summary from 2005 for the LH2 storing, transporting, and refuelling system with the advanced boil-off management using 'slush hydrogen', sponsored by NEDO (domestic projects). The objectives of our study from 2005 are to prove the reduction of the evaporation loss (BOG loss) by utilizing the slush hydrogen, which is the mixture of solids and triple point liquid hydrogen. Use of slush hydrogen rather than atmospheric pressure liquid hydrogen provides the advantage in density and cooling capacity. Assuming a vehicle storage tank size such as 100 to 200 litter ones, the BOG rate can be reduced to 30 percent less than the atmospheric pressure liquid hydrogen is. Present execution plan is to develop, built, and test experimental equipments composed of a slush hydrogen generator, a transfer line, and a storage tank during three years from 2005 to 2007. (authors)

  17. Management of Gliomas: Overview of the Latest Technological Advancements and Related Behavioral Drawbacks

    Directory of Open Access Journals (Sweden)

    L. Ganau

    2015-01-01

    Full Text Available The advancements in basic sciences and the availability of sophisticated technological aids to surgical removal of gliomas have led over the last few years to the rise of innovative surgical strategies, the identification of better prognostic/predictive biomolecular factors, and the development of novel drugs and all are meant to profoundly impact the outcome of patients diagnosed with these aggressive tumours. Unfortunately, the treatment protocols available nowadays still confer only a small survival advantage at a potentially high cost in terms of overall well-being. In this review we identified the potential and limits of the most promising research trends in the management of glioma patients, also highlighting the related externalities. Finally, we focused our attention on the imbalance between the technical and behavioral aspects pertinent to this research area, which ultimately represent the two sides of the same coin.

  18. The development of technical database of advanced spent fuel management process

    Energy Technology Data Exchange (ETDEWEB)

    Ro, Seung Gy; Byeon, Kee Hoh; Song, Dae Yong; Park, Seong Won; Shin, Young Jun

    1999-03-01

    The purpose of this study is to develop the technical database system to provide useful information to researchers who study on the back end nuclear fuel cycle. Technical database of advanced spent fuel management process was developed for a prototype system in 1997. In 1998, this database system is improved into multi-user systems and appended special database which is composed of thermochemical formation data and reaction data. In this report, the detailed specification of our system design is described and the operating methods are illustrated as a user's manual. Also, expanding current system, or interfacing between this system and other system, this report is very useful as a reference. (Author). 10 refs., 18 tabs., 46 fig.

  19. Solid Waste Management Requirements Definition for Advanced Life Support Missions: Results

    Science.gov (United States)

    Alazraki, Michael P.; Hogan, John; Levri, Julie; Fisher, John; Drysdale, Alan

    2002-01-01

    Prior to determining what Solid Waste Management (SWM) technologies should be researched and developed by the Advanced Life Support (ALS) Project for future missions, there is a need to define SWM requirements. Because future waste streams will be highly mission-dependent, missions need to be defined prior to developing SWM requirements. The SWM Working Group has used the mission architecture outlined in the System Integration, Modeling and Analysis (SIMA) Element Reference Missions Document (RMD) as a starting point in the requirement development process. The missions examined include the International Space Station (ISS), a Mars Dual Lander mission, and a Mars Base. The SWM Element has also identified common SWM functionalities needed for future missions. These functionalities include: acceptance, transport, processing, storage, monitoring and control, and disposal. Requirements in each of these six areas are currently being developed for the selected missions. This paper reviews the results of this ongoing effort and identifies mission-dependent resource recovery requirements.

  20. Recent advances in the management of transient ischemic attacks [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Camilo R. Gomez

    2017-10-01

    Full Text Available Significant advances in our understanding of transient ischemic attack (TIA have taken place since it was first recognized as a major risk factor for stroke during the late 1950's. Recently, numerous studies have consistently shown that patients who have experienced a TIA constitute a heterogeneous population, with multiple causative factors as well as an average 5–10% risk of suffering a stroke during the 30 days that follow the index event. These two attributes have driven the most important changes in the management of TIA patients over the last decade, with particular attention paid to effective stroke risk stratification, efficient and comprehensive diagnostic assessment, and a sound therapeutic approach, destined to reduce the risk of subsequent ischemic stroke. This review is an outline of these changes, including a discussion of their advantages and disadvantages, and references to how new trends are likely to influence the future care of these patients.

  1. The Role of Interventional Radiology in the Management of Deep Venous Thrombosis: Advanced Therapy

    International Nuclear Information System (INIS)

    O’Sullivan, Gerard J.

    2011-01-01

    Deep vein thrombosis (DVT) is often managed with a health care pathway that funnels patients to anticoagulation therapy alone. This “usual treatment” is designed to stop propagation and embolisation of venous thrombus but not remove it. Surgical thrombectomy was once the only option in severe cases in which limbs were threatened, but thrombus removal is no longer restricted to emergency cases. Interventional radiologists are now using advanced endovascular techniques to achieve thrombus removal in a minimally invasive manner in a very short treatment time, thereby quickly restoring patency, relieving acute symptoms, and potentially limiting the subsequent development of postthrombotic syndrome when followed with anticoagulation and compression regimens. This article provides an overview of the interventions available for treating DVT. One of the newer “single-session” techniques is isolated pharmacomechanical thrombolysis, which is described here in detail with supporting cases.

  2. Risk-based management system development for the Advanced Test Reactor

    International Nuclear Information System (INIS)

    Davis, M.L.; Eide, S.A.

    1990-01-01

    A Risk-Based Management System (RBMS) is being developed to facilitate the use of the Advanced Test Reactor (ATR) probabilistic risk assessment to support ATR operation. Most ATR RBMS questions can best be answered using the System Analysis and Risk Assessment System (SARA) developed at the Idaho National Engineering Laboratory. However, some applications may require employment of the other four codes used to develop and report the PRA. These four codes include the Integrated Reliability and Risk Analysis System (IRRAS), SETS, ETA-II, and the Nuclear Computerized Library for Assessing Reactor Reliability (NUCLARR). The ATR RBMS will evolve over three years, and will include the results of the Level 3 and external events analysis

  3. Enterprise SRS: leveraging ongoing operations to advance radioactive waste management technologies

    International Nuclear Information System (INIS)

    Murray, Alice M.; Wilmarth, William; Marra, John E.

    2013-01-01

    The Savannah River Site (SRS) is re-purposing its vast array of assets to solve future national issues regarding environmental stewardship, national security, and clean energy. The vehicle for this transformation is Enterprise SRS which presents a new, strategic view of SRS as a united endeavor for 'all things nuclear' as opposed to a group of distinct and separate entities with individual missions and organizations. Key among the Enterprise SRS strategic initiatives is the integration of research into facilities in conjunction with ongoing missions to provide researchers from other national laboratories, academic institutions, and commercial entities the opportunity to demonstrate their technologies in a relevant environment and scale prior to deployment. To manage that integration of research demonstrations into site facilities, The DOE Savannah River Operations Office, Savannah River Nuclear Solutions, and the Savannah River National Laboratory (SRNL) have established a center for applied nuclear materials processing and engineering research (hereafter referred to as the Center). The key objective of this initiative is to bridge the gap between promising transformational nuclear materials management advancements and large-scale deployment of the technology by using SRS assets (e.g. facilities, staff, and property) for those critical engineering-scale demonstrations necessary to assure the successful deployment of new technologies. The Center will coordinate the demonstration of R and D technologies and serve as the interface between the engineering-scale demonstration and the R and D programs, essentially providing cradle-to-grave support to the R and D team during the demonstration. While the initial focus of the Center will be on the effective use of SRS assets for these demonstrations, the Center also will work with research teams to identify opportunities to perform R and D demonstrations at other facilities. Unique to this approach is the fact

  4. Advanced plutonium management in PWR - complementarity of thorium and uranium cycles

    International Nuclear Information System (INIS)

    Ernoult, Marc

    2014-01-01

    In order to study the possibility of advanced management of plutonium in existing reactors, 8 strategies for plutonium multi-recycling in PWRs are studied. Following equilibrium studies, it was shown that, by using homogeneous assemblies, the use of thorium cannot reduce the plutonium inventory of equilibrium cycle or production of americium. By distributing the different fuel types within the same assembly, some thoriated strategies allow however lower inventories and lower production americium best strategies using only the uranium cycle. However, in all cases, low fuel conversion theories in PWRs makes it impossible to lower resource consumption more than a few percent compared to strategies without thorium. To study the transition, active participation in development of the scenario code CLASS has been taken. It led to the two simulation scenarios among those studied in equilibrium with CLASS. These simulations have shown discrepancies with previously simulated scenarios. The major causes of these differences were identified and quantified. (author)

  5. Advancing Coordination Between DRM and CCA in Integrated Flood Risk Management

    DEFF Research Database (Denmark)

    Jebens, Martin; Sørensen, Carlo Sass

    Flood hazards in coastal regions induce risks toward lives, property, economy and the environment. In need of sustainable and holistic actions to reduce risks, these should include innovative Disaster Risk Management (DRM) and Climate Change Adaptation (CCA) measures. While differing on important...... flood events to exert pressure on the national government, and in a top-down approach the government could identify the needs among the civil society to include these in the decision-making process.......-structural measures is hampered by lack in coordination that should be improved to agree e.g. on an acceptable risk definition and to avoid duplicating efforts. To advance awareness and coordination between DRM and CCA and to improve measures, a bottom-up approach could by initiated by civil society using recent...

  6. Recent advances in the management of migraine [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Mark Obermann

    2016-11-01

    Full Text Available Migraine remains one of the most disabling disorders worldwide. The high prevalence in the general population and the often-delicate treatment of patients account for that. Therapeutic management of migraine relies mainly on non-specific medical treatment and is affected by low patient adherence to the treatment regimens applied. The introduction of specific anti-migraine treatment occurred over 20 years ago when the first triptan was approved by regulatory authorities (sumatriptan, 28 December 1992. Triptan use is limited by side effects, time- and frequency-restricted application, and the risk of developing medication overuse headache. Within the past few years, new and promising drugs such as more specific 5-HT 1F receptor agonists (that is, lasmiditan and monoclonal calcitonin gene-related peptide (CGRP receptor antibodies entered advanced development phases while non-invasive neuromodulatory approaches were suggested to be potentially effective as non-pharmaceutical interventions for migraine.

  7. The development of technical database of advanced spent fuel management process

    International Nuclear Information System (INIS)

    Ro, Seung Gy; Byeon, Kee Hoh; Song, Dae Yong; Park, Seong Won; Shin, Young Jun

    1999-03-01

    The purpose of this study is to develop the technical database system to provide useful information to researchers who study on the back end nuclear fuel cycle. Technical database of advanced spent fuel management process was developed for a prototype system in 1997. In 1998, this database system is improved into multi-user systems and appended special database which is composed of thermochemical formation data and reaction data. In this report, the detailed specification of our system design is described and the operating methods are illustrated as a user's manual. Also, expanding current system, or interfacing between this system and other system, this report is very useful as a reference. (Author). 10 refs., 18 tabs., 46 fig

  8. Optimization of a Gas Switching Combustion process through advanced heat management strategies

    International Nuclear Information System (INIS)

    Cloete, Schalk; Zaabout, Abdelghafour; Romano, Matteo C.; Chiesa, Paolo; Lozza, Giovanni; Gallucci, Fausto; Sint Annaland, Martin van; Amini, Shahriar

    2017-01-01

    Highlights: • GSC is a promising new reactor concept for power production with cost effective CO 2 capture. • The standalone fluidized bed reactors employed will allow for easy process scale-up. • The GSC simple configuration achieves higher efficiencies than conventional solutions. • Further increases in efficiency can be achieved via advanced heat management. • The 41.9% maximum efficiency is in line with other CLC–IGCC configurations. - Abstract: Gas Switching Combustion (GSC) is a promising new process concept for energy efficient power production with integrated CO 2 capture. In comparison to conventional Chemical Looping Combustion (CLC) carried out in interconnected fluidized beds, the GSC concept will be substantially easier to design and scale up, especially for pressurized conditions. One potential drawback of the GSC concept is the gradual temperature variation over the transient process cycle, which leads to a drop in electric efficiency of the plant. This article investigates heat management strategies to mitigate this issue both through simulations and experiments. Simulation studies of the GSC concept integrated into an IGCC power plant show that heat management using a nitrogen recycle stream can increase plant efficiency by 3 percentage points to 41.6% while maintaining CO 2 capture ratios close to 90%. Reactive multiphase flow simulations of the GSC reactor also showed that heat management can eliminate fuel slip problems. In addition, the GSC concept offers the potential to remove the need for a nitrogen recycle stream by implementing a concentrated air injection that extracts heat while only a small percentage of oxygen reacts. Experiments have shown that, similar to nitrogen recycle, this strategy reduces transient temperature variations across the cycle and therefore merits further investigation.

  9. Pharmaceutical removal during managed aquifer recharge with pretreatment by advanced oxidation

    KAUST Repository

    Lekkerkerker-Teunissen, Karin; Chekol, E. T.; Maeng, Sungkyu; Ghebremichael, Kebreab A.; Houtman, Corine J.; Verliefde, Arne R. D.; Verberk, J. Q J C; Amy, Gary L.; Van Dijk, Johannis C.

    2012-01-01

    Organic micropollutants (OMPs) are detected in sources for drinking water and treatment possibilities are investigated. Innovative removal technologies are available such as membrane filtration and advanced oxidation, but also biological treatment should be considered. By combining an advanced oxidation process with managed aquifer recharge (MAR), two complementary processes are expected to provide a hybrid system for OMP removal, according to the multiple barrier approach. Laboratory scale batch reactor experiments were conducted to investigate the removal of dissolved organic carbon (DOC) and 14 different pharmaceutically active compounds (PhACs) from MAR influent water and water subjected to oxidation, under different process conditions. A DOC removal of 10% was found in water under oxic (aerobic) conditions for batch reactor experiments, a similar value for DOC removal was observed in the field. Batch reactor experiments for the removal of PhACs showed that the removal of pharmaceuticals ranged from negligible to more than 90%. Under oxic conditions, seven out of 14 pharmaceuticals were removed over 90% and 12 out of 14 pharmaceuticals were removed at more than 50% during 30 days of experiments. Under anoxic conditions, four out of 14 pharmaceuticals were removed over 90% and eight out of 14 pharmaceuticals were removed at more than 50% over 30 days' experiments. Carbamazepine and phenazone were persistent both under oxic and anoxic conditions. The PhACs removal efficiency with oxidized water was, for most compounds, comparable to the removal with MAR influent water. Copyright © IWA Publishing 2012.

  10. Pharmaceutical removal during managed aquifer recharge with pretreatment by advanced oxidation

    KAUST Repository

    Lekkerkerker-Teunissen, Karin

    2012-10-01

    Organic micropollutants (OMPs) are detected in sources for drinking water and treatment possibilities are investigated. Innovative removal technologies are available such as membrane filtration and advanced oxidation, but also biological treatment should be considered. By combining an advanced oxidation process with managed aquifer recharge (MAR), two complementary processes are expected to provide a hybrid system for OMP removal, according to the multiple barrier approach. Laboratory scale batch reactor experiments were conducted to investigate the removal of dissolved organic carbon (DOC) and 14 different pharmaceutically active compounds (PhACs) from MAR influent water and water subjected to oxidation, under different process conditions. A DOC removal of 10% was found in water under oxic (aerobic) conditions for batch reactor experiments, a similar value for DOC removal was observed in the field. Batch reactor experiments for the removal of PhACs showed that the removal of pharmaceuticals ranged from negligible to more than 90%. Under oxic conditions, seven out of 14 pharmaceuticals were removed over 90% and 12 out of 14 pharmaceuticals were removed at more than 50% during 30 days of experiments. Under anoxic conditions, four out of 14 pharmaceuticals were removed over 90% and eight out of 14 pharmaceuticals were removed at more than 50% over 30 days\\' experiments. Carbamazepine and phenazone were persistent both under oxic and anoxic conditions. The PhACs removal efficiency with oxidized water was, for most compounds, comparable to the removal with MAR influent water. Copyright © IWA Publishing 2012.

  11. Recent Insights and Advances in the Management of Merkel Cell Carcinoma.

    Science.gov (United States)

    Banks, Patricia D; Sandhu, Shahneen; Gyorki, David E; Johnston, Meredith L; Rischin, Danny

    2016-07-01

    Merkel cell carcinoma (MCC) is a rare and highly aggressive neuroendocrine malignancy with a propensity for recurrence and a poor prognosis. Incidence of MCC is on the rise and is known to increase with advanced age, immunosuppression, and UV exposure. Merkel cell polyomavirus is implicated in the pathogenesis of virus-positive MCC and accounts for 80% of MCCs in the northern hemisphere and 25% in southern latitudes. In contrast, tumorigenesis of virus-negative MCC is linked to UV-induced DNA damage. Interplay between ubiquitous Merkel cell polyomavirus skin infections that commonly occur in healthy skin and other established risk factors, such as immunosuppression and UV exposure, remains poorly understood. Surgery and radiotherapy achieves excellent locoregional control; however, invariably, a significant proportion of patients develop disseminated disease that is incurable. Chemotherapy offers a high response rate for metastatic disease, but responses are short-lived and the impact on survival is not established. Recent advances in our understanding of the genetic landscape and immunobiology of MCC has led to investigation of novel treatments, including immune checkpoint inhibitors, which are likely to rapidly transform the way we manage these patients. We review epidemiologic, clinical, and histopathologic features of MCC; describe recent insights in MCC biology; and discuss novel therapeutic approaches. Copyright © 2016 by American Society of Clinical Oncology.

  12. Ten-year Survivors After Contemporary Management of Advanced 'Horseshoe' Anterior Commissure Laryngeal Cancer.

    Science.gov (United States)

    Ampil, Federico; Caldito, Gloria; Vora, Moiz; Richards, Troy

    2016-06-01

    Combinations of treatment modalities for locally extensive carcinomas of the larynx constitute the standard of care. Advanced 'horseshoe' anterior commissure laryngeal cancer (HACLC) is a disease entity that has not received much attention in the literature. The aims of this study were to evaluate prolonged survival in patients after standard combined therapy for HACLC and to identify clinicopathological factors influential towards an extended outcome. Fourteen patients (10-year survivors) with stage III or IV laryngeal cancer involving the anterior commissure and both true vocal cords were treated with total laryngectomy (and postoperative radiotherapy in 11 individuals). During follow-up, ranging from 123 to 256 months, locoregional recurrent disease and distant metastasis were not observed. Complications after therapy were manageable and few. The long-term survivors were particularly difficult to characterize. The optimal treatment for advanced HACLC has not been clarified; however, in this study, total laryngectomy and the indicated use of postoperative radiotherapy, were successful in achieving long-term disease-free survival. Predictive factors for longevity were not detected in this limited experience. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  13. Management of treatment-related toxicities in advanced medullary thyroid cancer.

    Science.gov (United States)

    Brose, Marcia S; Bible, Keith C; Chow, Laura Q M; Gilbert, Jill; Grande, Carolyn; Worden, Francis; Haddad, Robert

    2018-04-22

    Progress in the treatment of advanced medullary thyroid cancer (MTC) has resulted from the approval of 2 drugs within the past 5 years, vandetanib and cabozantinib. These multikinase inhibitors (MKIs) possess overlapping specificities for multiple kinase targets implicated in the progression of MTC. Both drugs are associated with toxicities, including hypertension, hemorrhage/perforation, diarrhea and other gastrointestinal events, several dermatologic events, and hypothyroidism. In addition, vandetanib is uniquely associated with QTc prolongation through interaction with myocardial potassium channels, and cabozantinib is uniquely associated with hand-foot skin reaction. Treatment-related toxicities occur frequently and can be severe or life-threatening, and patients undergoing long-term treatment will likely experience adverse events (AEs). Here we offer specific practical recommendations for managing AEs commonly occurring with vandetanib and cabozantinib. The recommended approach relies on early recognition and palliation of symptoms, dose interruption, and dose reduction as necessary in order for the patient to maintain the highest tolerable dose for as long as possible and optimal quality of life. Treatment guidelines do not specify a recommended sequence for treating with vandetanib and cabozantinib; however, most patients will receive both drugs during their lifetime. The choice for first-line therapy is individualized after a risk-benefit assessment and depends on physician preference and patient-related factors, such as comorbid conditions. Because most generalist practices may not be familiar with the intricacies of agents such as vandetanib and cabozantinib, we commend that patients with advanced MTC be managed and treated by a thyroid cancer specialist with coordination of care within a multidisciplinary team. Copyright © 2018. Published by Elsevier Ltd.

  14. Advanced in-vessel retention design for next generation risk management

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Kune Y.; Hwang, Il Soon [Seoul National University, Seoul (Korea, Republic of)

    1997-12-31

    In the TMI-2 accident, approximately twenty (20) tons of molten core material drained into the lower plenum. Early advanced light water reactor (LWR) designs assumed a lower head failure and incorporated various measures for ex-vessel accident mitigation. However,one of the major findings from the TMI-2 Vessel Investigation Project was that one part of the reactor lower head wall estimated to have attained a temperature of 1100 deg C for about 30 minutes has seemingly experienced a comparatively rapid cooldown with no major threat to the vessel integrity. In this regard, recent empirical and analytical studies have shifted interests to such in-vessel retention designs or strategies as reactor cavity flooding, in-vessel flooding and engineered gap cooling of the vessel. Accurate thermohydrodynamic and creep deformation modeling and rupture prediction are the key to the success in developing practically useful in-vessel accident/risk management strategies. As an advanced in-vessel design concept, this work presents the COrium Attack Syndrome Immunization Structures (COASIS) that are being developed as prospective in-vessel retention devices for a next-generation LWR in concert with existing ex-vessel management measures. Both the engineered gap structures in-vessel (COASISI) and ex-vessel (COASISO) are demonstrated to maintain effective heat transfer geometry during molten core debris attack when applied to the Korean Standard Nuclear Power Plant (KSNPP) reactor. The likelihood of lower head creep rupture during a severe accident is found to be significantly suppressed by the COASIS options. 15 refs., 5 figs., 1 tab. (Author)

  15. Advanced in-vessel retention design for next generation risk management

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Kune Y; Hwang, Il Soon [Seoul National University, Seoul (Korea, Republic of)

    1998-12-31

    In the TMI-2 accident, approximately twenty (20) tons of molten core material drained into the lower plenum. Early advanced light water reactor (LWR) designs assumed a lower head failure and incorporated various measures for ex-vessel accident mitigation. However,one of the major findings from the TMI-2 Vessel Investigation Project was that one part of the reactor lower head wall estimated to have attained a temperature of 1100 deg C for about 30 minutes has seemingly experienced a comparatively rapid cooldown with no major threat to the vessel integrity. In this regard, recent empirical and analytical studies have shifted interests to such in-vessel retention designs or strategies as reactor cavity flooding, in-vessel flooding and engineered gap cooling of the vessel. Accurate thermohydrodynamic and creep deformation modeling and rupture prediction are the key to the success in developing practically useful in-vessel accident/risk management strategies. As an advanced in-vessel design concept, this work presents the COrium Attack Syndrome Immunization Structures (COASIS) that are being developed as prospective in-vessel retention devices for a next-generation LWR in concert with existing ex-vessel management measures. Both the engineered gap structures in-vessel (COASISI) and ex-vessel (COASISO) are demonstrated to maintain effective heat transfer geometry during molten core debris attack when applied to the Korean Standard Nuclear Power Plant (KSNPP) reactor. The likelihood of lower head creep rupture during a severe accident is found to be significantly suppressed by the COASIS options. 15 refs., 5 figs., 1 tab. (Author)

  16. Plasma under control: Advanced solutions and perspectives for plasma flux management in material treatment and nanosynthesis

    Science.gov (United States)

    Baranov, O.; Bazaka, K.; Kersten, H.; Keidar, M.; Cvelbar, U.; Xu, S.; Levchenko, I.

    2017-12-01

    Given the vast number of strategies used to control the behavior of laboratory and industrially relevant plasmas for material processing and other state-of-the-art applications, a potential user may find themselves overwhelmed with the diversity of physical configurations used to generate and control plasmas. Apparently, a need for clearly defined, physics-based classification of the presently available spectrum of plasma technologies is pressing, and the critically summary of the individual advantages, unique benefits, and challenges against key application criteria is a vital prerequisite for the further progress. To facilitate selection of the technological solutions that provide the best match to the needs of the end user, this work systematically explores plasma setups, focusing on the most significant family of the processes—control of plasma fluxes—which determine the distribution and delivery of mass and energy to the surfaces of materials being processed and synthesized. A novel classification based on the incorporation of substrates into plasma-generating circuitry is also proposed and illustrated by its application to a wide variety of plasma reactors, where the effect of substrate incorporation on the plasma fluxes is emphasized. With the key process and material parameters, such as growth and modification rates, phase transitions, crystallinity, density of lattice defects, and others being linked to plasma and energy fluxes, this review offers direction to physicists, engineers, and materials scientists engaged in the design and development of instrumentation for plasma processing and diagnostics, where the selection of the correct tools is critical for the advancement of emerging and high-performance applications.

  17. Self-management support and eHealth for patients and informal caregivers confronted with advanced cancer : An online focus group study among nurses

    NARCIS (Netherlands)

    Slev, Vina N.; Pasman, H. Roeline W.; Eeltink, Corien M.; Van Uden-Kraan, Cornelia F.; Verdonck-De Leeuw, Irma M.; Francke, Anneke L.

    2017-01-01

    Background: Self-management by patients and informal caregivers confronted with advanced cancer is not self-evident. Therefore they might need self-management support from nurses. This article reports on nurses' perspectives on self-management support for people confronted with advanced cancer, and

  18. Cost-utility analysis of an advanced pressure ulcer management protocol followed by trained wound, ostomy, and continence nurses.

    Science.gov (United States)

    Kaitani, Toshiko; Nakagami, Gojiro; Iizaka, Shinji; Fukuda, Takashi; Oe, Makoto; Igarashi, Ataru; Mori, Taketoshi; Takemura, Yukie; Mizokami, Yuko; Sugama, Junko; Sanada, Hiromi

    2015-01-01

    The high prevalence of severe pressure ulcers (PUs) is an important issue that requires to be highlighted in Japan. In a previous study, we devised an advanced PU management protocol to enable early detection of and intervention for deep tissue injury and critical colonization. This protocol was effective for preventing more severe PUs. The present study aimed to compare the cost-effectiveness of the care provided using an advanced PU management protocol, from a medical provider's perspective, implemented by trained wound, ostomy, and continence nurses (WOCNs), with that of conventional care provided by a control group of WOCNs. A Markov model was constructed for a 1-year time horizon to determine the incremental cost-effectiveness ratio of advanced PU management compared with conventional care. The number of quality-adjusted life-years gained, and the cost in Japanese yen (¥) ($US1 = ¥120; 2015) was used as the outcome. Model inputs for clinical probabilities and related costs were based on our previous clinical trial results. Univariate sensitivity analyses were performed. Furthermore, a Bayesian multivariate probability sensitivity analysis was performed using Monte Carlo simulations with advanced PU management. Two different models were created for initial cohort distribution. For both models, the expected effectiveness for the intervention group using advanced PU management techniques was high, with a low expected cost value. The sensitivity analyses suggested that the results were robust. Intervention by WOCNs using advanced PU management techniques was more effective and cost-effective than conventional care. © 2015 by the Wound Healing Society.

  19. Design and application of a theory-based case/care management model for home care: advanced practice for nurses as care managers.

    Science.gov (United States)

    Sears, Nancy A

    2002-01-01

    Case management has developed in a variety of health care, social service, and insurance industries. Its historical pattern of development has resulted in practices that are generally administrative and technical in nature as well as being relatively generic and often undifferentiated between being a role and process. Research over the last decade has resulted in the opportunity to move case management practice for home care into a structured theory-based model and practice. Design and implementation of a specialized advanced practice care management model reflective of care management research and theory design by British researchers is beginning to show clinical and systemic results that should be replicable in other regions.

  20. Managing uncertainty in advanced liver disease: a qualitative, multiperspective, serial interview study.

    Science.gov (United States)

    Kimbell, Barbara; Boyd, Kirsty; Kendall, Marilyn; Iredale, John; Murray, Scott A

    2015-11-19

    To understand the experiences and support needs of people with advanced liver disease and those of their lay and professional carers to inform improvements in the supportive and palliative care of this rapidly growing but currently neglected patient group. Multiperspective, serial interviews. We conducted up to three qualitative in-depth interviews with each patient and lay carer over 12 months and single interviews with case-linked healthcare professionals. Data were analysed using grounded theory techniques. Patients with advanced liver disease of diverse aetiologies recruited from an inpatient hepatology ward, and their lay carers and case-linked healthcare professionals nominated by the patients. Primary and secondary care in South-East Scotland. 37 participants (15 patients, 11 lay and 11 professional carers) completed 51 individual and 13 joint patient-carer interviews. Nine patients died during the study. Uncertainty dominated experiences throughout the course of the illness, across patients' considerable physical, psychological, social and existential needs and affected patients, lay carers and professionals. This related to the nature of the condition, the unpredictability of physical deterioration and prognosis, poor communication and information-sharing, and complexities of care. The pervasive uncertainty also shaped patients' and lay carers' strategies for coping and impeded care planning. While patients' acute medical care was usually well coordinated, their ongoing care lacked structure and focus. Living, dying and caring in advanced liver disease is dominated by pervasive, enduring and universally shared uncertainty. In the face of high levels of multidimensional patient distress, professionals must acknowledge this uncertainty in constructive ways that value its contribution to the person's coping approach. Pervasive uncertainty makes anticipatory care planning in advanced liver disease challenging, but planning 'just in case' is vital to ensure

  1. Advances in the diagnosis and management of asthma in older adults.

    LENUS (Irish Health Repository)

    Al-Alawi, Mazen

    2013-12-28

    Global estimates on ageing predict an increased burden of asthma in the older population. Consequently, its recognition, diagnosis and management in clinical practice require optimization. This review aims to provide an update for clinicians highlighting advances in the understanding of the ageing process and immunosenescence together with their applicability to asthma from a diagnostic and therapeutic perspective. Ageing impacts airway responses, immune function and influences efficacy of emerging phenotype-specific therapies when applied to the elderly patient. Differentiating eosinophilic and neutrophilic disease accounts for atopic illness and distinguishes long-standing from late-onset asthma. Therapeutic challenges in drug delivery, treatment adherence and side effect profiles persist in the older patient while novel recording devices developed to aid detection of an adequate inhalation evaluates treatment effectiveness and compliance more accurately than previously attainable. Anti-cytokine therapies improve control of brittle asthma while bronchial thermoplasty is an option in refractory cases. Multi-dimensional intervention strategies prove best in the management of asthma in the older adult which remains a condition that is not rare but rarely diagnosed in this patient population.

  2. Requirements Development Issues for Advanced Life Support Systems: Solid Waste Management

    Science.gov (United States)

    Levri, Julie A.; Fisher, John W.; Alazraki, Michael P.; Hogan, John A.

    2002-01-01

    Long duration missions pose substantial new challenges for solid waste management in Advanced Life Support (ALS) systems. These possibly include storing large volumes of waste material in a safe manner, rendering wastes stable or sterilized for extended periods of time, and/or processing wastes for recovery of vital resources. This is further complicated because future missions remain ill-defined with respect to waste stream quantity, composition and generation schedule. Without definitive knowledge of this information, development of requirements is hampered. Additionally, even if waste streams were well characterized, other operational and processing needs require clarification (e.g. resource recovery requirements, planetary protection constraints). Therefore, the development of solid waste management (SWM) subsystem requirements for long duration space missions is an inherently uncertain, complex and iterative process. The intent of this paper is to address some of the difficulties in writing requirements for missions that are not completely defined. This paper discusses an approach and motivation for ALS SWM requirements development, the characteristics of effective requirements, and the presence of those characteristics in requirements that are developed for uncertain missions. Associated drivers for life support system technological capability are also presented. A general means of requirements forecasting is discussed, including successive modification of requirements and the need to consider requirements integration among subsystems.

  3. Advanced neutron source project information management. A model for the future

    International Nuclear Information System (INIS)

    King-Jones, K.; Cleaves, J.

    1995-01-01

    The Advanced Neutron Source (ANS) is a proposed new research facility that will provide steady-state beams of neutrons for experiments by more than 1000 researchers per year in the fields of materials science and engineering, biology, chemistry, materials analysis, and nuclear science. The facility will also include irradiation capabilities to produce radioisotopes for medical applications, research, industry, and materials testing. This paper discusses the architecture and data flow used by the project, some quantitative examinations of potential cost savings and return on investment and software applications used to generate and manage data across IBM-compatible personal computers, Macintosh, and Unix-based workstations. Personnel management aspects addressed include providing paper copy to users only when needed for adequate technical review, using graded approaches to providing support for numerous user-needed software applications, and implementing a phased approach to compliance with computer-aided acquisition and logistic support (CALS) standards that allows sufficient user flexibility for performing technical tasks while providing needed data sharing and integration

  4. Advanced Neutron Source project information management: A model for the future

    International Nuclear Information System (INIS)

    King-Jones, K.; Cleaves, J.

    1995-01-01

    The Advanced Neutron Source (ANS) is a proposed new research facility that will provide steady-state beams of neutrons for experiments by more than 1,000 researchers per year in the fields of materials science and engineering, biology, chemistry, materials analysis, and nuclear science. The facility will also include irradiation capabilities to produce radioisotopes for medical applications, research, industry, and materials testing. This paper discusses the architecture and data flow used by the project, some quantitative examinations of potential cost savings and return on investment, and software applications used to generate and manage data across IBM-compatible personal computers, Macintosh, and Unix-based workstations. Personnel management aspects addressed include providing paper copy to users only when needed for adequate technical review, using graded approaches to providing support for numerous user-needed software applications, and implementing a phased approach to compliance with computer-aided acquisition and logistic support (CALS) standards that allows sufficient user flexibility for performing technical tasks while providing needed data sharing and integration

  5. Current Advances in Thyroid Cancer Management. Are We Ready for the Epidemic Rise of Diagnoses?

    Directory of Open Access Journals (Sweden)

    Dagmara Rusinek

    2017-08-01

    Full Text Available A rising incidence of thyroid cancers (TCs mainly small tumors, observed during recent years, lead to many controversies regarding treatment strategies. TCs represent a distinct molecular background and clinical outcome. Although in most cases TCs are characterized by a good prognosis, there are some aggressive forms, which do not respond to standard treatment. There are still some questions, which have to be resolved to avoid dangerous simplifications in the clinical management. In this article, we focused on the current advantages in preoperative molecular diagnostic tests and histopathological examination including noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP. We discussed the controversies regarding the extent of thyroid surgery and adjuvant radioiodine therapy, as well as new treatment modalities for radioiodine-refractory differentiated thyroid cancer (RR-DTC. Considering medullary thyroid cancer (MTC, we analyzed a clinical management based on histopathology and RET (ret proto-oncogene mutation genotype, disease follow-up with a special attention to serum calcitonin doubling time as an important prognostic marker, and targeted therapy applied in advanced MTC. In addition, we provided some data regarding anaplastic thyroid cancer (ATC, a highly lethal neoplasm, which lead to death in nearly 100% of patients due to the lack of effective treatment options.

  6. Considerations on monitoring needs of advanced, passive safety light water reactors for severe accident management

    International Nuclear Information System (INIS)

    Bava, G.; Zambardi, F.

    1992-01-01

    This paper deals with problems concerning information and related instrumentation needs for Accident Management (AM), with special emphasis on Severe Accidents (SA) in the new advanced, passive safety Light Water Reactors (PLWR), presently in a development stage. The passive safety conception adopted in the plants concerned goes parallel with a deeper consideration of SA, that reflects the need of increasing the plant resistance against conditions going beyond traditional ''design basis accidents''. Further, the role of Accident Management (AM) is still emphasized as last step of the defence in depth concept, in spite of the design efforts aimed to reduce human factor importance; as a consequence, the availability of pertinent information on actual plant conditions remains a necessary premise for performing preplanned actions. This information is essential to assess the evolution of the accident scenarios, to monitor the performances of the safety systems, to evaluate the ultimate challenge to the plant safety, and to implement the emergency operating procedures and the emergency plans. Based on these general purposes, the impact of the new conception on the monitoring structure is discussed, furthermore reference is made to the accident monitoring criteria applied in current plants to evaluate the requirements for possible solutions. (orig.)

  7. THE PROJECTED RATE OF COMPETENCE FORMATION AS A TOOL OF EDUCATIONAL MANAGEMENT OF ADVANCED LEVEL OF EDUCATION

    Directory of Open Access Journals (Sweden)

    L. V. Lvov

    2017-01-01

    Full Text Available Introduction. Specially organized complex of the scientific research directed to obtaining the reliable advancing information about development of pedagogical members is necessary for the development of educational policy, the strategy of development for educational systems, and methods of management of quality of pedagogical activity at different stages of education. The result of the educational management of professional and educational process is caused by the quality of pedagogical design. In turn, the quality of pedagogical forecasting is a factor determining the overall effectiveness of management through the pedagogical design.The aim of this article is to describe the model that allows applying the rate of competence formation as a tool of educational management and providing the advanced level of education. Methodology and research methods are based on pre-competence and context approach, which supposes the content selection as a set of competencies and designing the educational and professional process with the use of the rate of formation of ability and readiness (competency as a tool of teaching management.Results. The author states socio-pedagogical contradiction, which is in acute shortage of predictive tools in the management of the educational process. The article describes terminology and empirical mathematical models that underpin pedagogical management of the educational and professional training of students that provides the advanced level of formation of organizational and managerial competence.Scientific novelty. The author clarifies the concept of the advanced level of education; introduces the term of the rate of formation of competency; proposes a new model to solve the problem of predicting learning outcomes and timely management influence by managers of education at all stages of the design and functioning of the educational system in the conditions of implementation of competence-based approach in the higher school

  8. Exploiting the potential of intranet for managing drug spectrum a web base publication in a Tertiary Care Hospital in Mumbai

    Directory of Open Access Journals (Sweden)

    Yashashri Chandrakant Shetty

    2015-01-01

    Full Text Available Objective: The study surveyed the availability of the intranet in campus and also the knowledge related to drug spectrum an intranet publication. Materials and Methods: Institutional ethics committee permission was obtained. Verbal consent was taken from the faculty and resident doctors of departments where all the facilities were available. Universal sampling method was used for recruitment. Pre-validated questionnaires were given to approximately 100 faculty and 500 resident doctors in the year 2012-2013. The questionnaire contained 15 items. Content analysis was done. The study questionnaire focused on a survey to obtain participants feedback on the use of the intranet and to evaluate the use of intranet as a source of knowledge. It also dealt on the relevance of the drug spectrum in the context of their subject. The responses were taken after giving the participants sufficient time. Data was entered into an Excel 2003 spread sheet and analyzed by using descriptive statistics. Results: The total number of respondents who participated in our study was 134 including faculty and residents from various departments. A total of 117 (89.66% respondents stated that their departments have access to the internet. Departments having access to intranet was 103 (76.29%. 67 (49.62% respondents have accessed. 67 (49.62% did not have the time to visit intranet site whereas 67 (49.62% have not accessed intranet. 89 (65.92% respondents were not aware of the drug spectrum. 101 (74.81% respondents felt that drug spectrum is a useful activity on intranet. 45 (33.33% knew about the intranet periodical drug spectrum, but most of the respondents (33.33% explained the meaning of the word drug spectrum according to their understanding, but never knew about the online intranet journal drug spectrum. Conclusion: The study found that the intranet is available in the campus, but it is not being utilized. The awareness and knowledge regarding drug spectrum is lacking, but

  9. Patient Preferences for Pain Management in Advanced Cancer: Results from a Discrete Choice Experiment.

    Science.gov (United States)

    Meads, David M; O'Dwyer, John L; Hulme, Claire T; Chintakayala, Phani; Vinall-Collier, Karen; Bennett, Michael I

    2017-10-01

    Pain from advanced cancer remains prevalent, severe and often under-treated. The aim of this study was to conduct a discrete choice experiment with patients to understand their preferences for pain management services and inform service development. Focus groups were used to develop the attributes and levels of the discrete choice experiment. The attributes were: waiting time, type of healthcare professional, out-of-pocket costs, side-effect control, quality of communication, quality of information and pain control. Patients completed the discrete choice experiment along with clinical and health-related quality of life questions. Conditional and mixed logit models were used to analyse the data. Patients with cancer pain (n = 221) and within palliative care services completed the survey (45% were female, mean age 64.6 years; age range 21-92 years). The most important aspects of pain management were: good pain control, zero out-of-pocket costs and good side-effect control. Poor or moderate pain control and £30 costs drew the highest negative preferences. Respondents preferred control of side effects and provision of better information and communication, over access to certain healthcare professionals. Those with lower health-related quality of life were less willing to wait for treatment and willing to incur higher costs. The presence of a carer influenced preferences. Outcome attributes were more important than process attributes but the latter were still valued. Thus, supporting self-management, for example by providing better information on pain may be a worthwhile endeavour. However, service provision may need to account for individual characteristics given the heterogeneity in preferences.

  10. Advances in the understanding of nutrient dynamics and management in UK agriculture

    International Nuclear Information System (INIS)

    Dungait, Jennifer A.J.; Cardenas, Laura M.; Blackwell, Martin S.A.; Wu, Lianhai; Withers, Paul J.A.; Chadwick, David R.; Bol, Roland; Murray, Philip J.; Macdonald, Andrew J.; Whitmore, Andrew P.; Goulding, Keith W.T.

    2012-01-01

    Current research on macronutrient cycling in UK agricultural systems aims to optimise soil and nutrient management for improved agricultural production and minimise effects on the environment and provision of ecosystem services. Nutrient use inefficiencies can cause environmental pollution through the release of greenhouse gases into the atmosphere and of soluble and particulate forms of N, P and carbon (C) in leachate and run-off into watercourses. Improving nutrient use efficiencies in agriculture calls for the development of sustainable nutrient management strategies: more efficient use of mineral fertilisers, increased recovery and recycling of waste nutrients, and, better exploitation of the substantial inorganic and organic reserves of nutrients in the soil. Long-term field experimentation in the UK has provided key knowledge of the main nutrient transformations in agricultural soils. Emerging analytical technologies, especially stable isotope labelling, that better characterise macronutrient forms and bioavailability and improve the quantification of the complex relationships between the macronutrients in soils at the molecular scale, are augmenting this knowledge by revealing the underlying processes. The challenge for the future is to determine the relationships between the dynamics of N, P and C across scales, which will require both new modelling approaches and integrated approaches to macronutrient cycling. -- Highlights: ► Major advances in the knowledge of macronutrient cycling in agricultural soils are reviewed in the context of management. ► Novel analytical techniques and innovative modelling approaches that enhance understanding of nutrient cycling are explored. ► Knowledge gaps are identified, and the potential to improve comprehension of the integrated nutrient cycles is considered.

  11. Advances in the understanding of nutrient dynamics and management in UK agriculture

    Energy Technology Data Exchange (ETDEWEB)

    Dungait, Jennifer A.J., E-mail: jennifer.dungait@rothamsted.ac.uk [Department of Sustainable Soils and Grassland Systems, Rothamsted Research, North Wyke, Okehampton, Devon, EX20 2SB (United Kingdom); Cardenas, Laura M.; Blackwell, Martin S.A.; Wu, Lianhai [Department of Sustainable Soils and Grassland Systems, Rothamsted Research, North Wyke, Okehampton, Devon, EX20 2SB (United Kingdom); Withers, Paul J.A. [School of Environment, Natural Resources and Geography, Bangor University, Bangor, Gwynedd, LL57 2UW (United Kingdom); Chadwick, David R.; Bol, Roland; Murray, Philip J. [Department of Sustainable Soils and Grassland Systems, Rothamsted Research, North Wyke, Okehampton, Devon, EX20 2SB (United Kingdom); Macdonald, Andrew J.; Whitmore, Andrew P. [Department of Sustainable Soils and Grassland Systems, Rothamsted Research, Harpenden, Hertfordshire, AL5 2LQ (United Kingdom); Goulding, Keith W.T. [Department of Sustainable Soils and Grassland Systems, Rothamsted Research, North Wyke, Okehampton, Devon, EX20 2SB (United Kingdom); Department of Sustainable Soils and Grassland Systems, Rothamsted Research, Harpenden, Hertfordshire, AL5 2LQ (United Kingdom)

    2012-09-15

    Current research on macronutrient cycling in UK agricultural systems aims to optimise soil and nutrient management for improved agricultural production and minimise effects on the environment and provision of ecosystem services. Nutrient use inefficiencies can cause environmental pollution through the release of greenhouse gases into the atmosphere and of soluble and particulate forms of N, P and carbon (C) in leachate and run-off into watercourses. Improving nutrient use efficiencies in agriculture calls for the development of sustainable nutrient management strategies: more efficient use of mineral fertilisers, increased recovery and recycling of waste nutrients, and, better exploitation of the substantial inorganic and organic reserves of nutrients in the soil. Long-term field experimentation in the UK has provided key knowledge of the main nutrient transformations in agricultural soils. Emerging analytical technologies, especially stable isotope labelling, that better characterise macronutrient forms and bioavailability and improve the quantification of the complex relationships between the macronutrients in soils at the molecular scale, are augmenting this knowledge by revealing the underlying processes. The challenge for the future is to determine the relationships between the dynamics of N, P and C across scales, which will require both new modelling approaches and integrated approaches to macronutrient cycling. -- Highlights: Black-Right-Pointing-Pointer Major advances in the knowledge of macronutrient cycling in agricultural soils are reviewed in the context of management. Black-Right-Pointing-Pointer Novel analytical techniques and innovative modelling approaches that enhance understanding of nutrient cycling are explored. Black-Right-Pointing-Pointer Knowledge gaps are identified, and the potential to improve comprehension of the integrated nutrient cycles is considered.

  12. ADVANCED SIMULATION CAPABILITY FOR ENVIRONMENTAL MANAGEMENT- CURRENT STATUS AND PHASE II DEMONSTRATION RESULTS

    Energy Technology Data Exchange (ETDEWEB)

    Seitz, R.

    2013-02-26

    The U.S. Department of Energy (USDOE) Office of Environmental Management (EM), Office of Soil and Groundwater, is supporting development of the Advanced Simulation Capability for Environmental Management (ASCEM). ASCEM is a state-of-the-art scientific tool and approach for understanding and predicting contaminant fate and transport in natural and engineered systems. The modular and open source high-performance computing tool facilitates integrated approaches to modeling and site characterization that enable robust and standardized assessments of performance and risk for EM cleanup and closure activities. The ASCEM project continues to make significant progress in development of computer software capabilities with an emphasis on integration of capabilities in FY12. Capability development is occurring for both the Platform and Integrated Toolsets and High-Performance Computing (HPC) Multiprocess Simulator. The Platform capabilities provide the user interface and tools for end-to-end model development, starting with definition of the conceptual model, management of data for model input, model calibration and uncertainty analysis, and processing of model output, including visualization. The HPC capabilities target increased functionality of process model representations, toolsets for interaction with Platform, and verification and model confidence testing. The Platform and HPC capabilities are being tested and evaluated for EM applications in a set of demonstrations as part of Site Applications Thrust Area activities. The Phase I demonstration focusing on individual capabilities of the initial toolsets was completed in 2010. The Phase II demonstration completed in 2012 focused on showcasing integrated ASCEM capabilities. For Phase II, the Hanford Site deep vadose zone (BC Cribs) served as an application site for an end-to-end demonstration of capabilities, with emphasis on integration and linkages between the Platform and HPC components. Other demonstrations

  13. Is ISO 14001 a Gateway to More Advanced Voluntary Action? A Case for Green Supply Chain Management

    OpenAIRE

    Arimura, Toshi H.; Darnall, Nicole; Katayama, Hajime

    2009-01-01

    Using Japanese facility-level data, we estimate the effects of ISO 14001 certification on the promotion of more advanced practices, namely green supply chain management (GSCM). Our results show that ISO 14001 promotes GSCM practices, in that facilities with environmental management systems (EMS) certified to ISO 14001 are 40 percent more likely to assess their suppliers’ environmental performance and 50 percent more likely to require that their suppliers undertake specific environmental pract...

  14. Quality assurance and risk management: Perspectives on Human Factors Certification of Advanced Aviation Systems

    Science.gov (United States)

    Taylor, Robert M.; Macleod, Iain S.

    1994-01-01

    This paper is based on the experience of engineering psychologists advising the U.K. Ministry of Defense (MoD) on the procurement of advanced aviation systems that conform to good human engineering (HE) practice. Traditional approaches to HE in systems procurement focus on the physical nature of the human-machine interface. Advanced aviation systems present increasingly complex design requirements for human functional integration, information processing, and cognitive task performance effectiveness. These developing requirements present new challenges for HE quality assurance (QA) and risk management, requiring focus on design processes as well as on design content or product. A new approach to the application of HE, recently adopted by NATO, provides more systematic ordering and control of HE processes and activities to meet the challenges of advanced aircrew systems design. This systematic approach to HE has been applied by MoD to the procurement of mission systems for the Royal Navy Merlin helicopter. In MoD procurement, certification is a judicial function, essentially independent of the service customer and industry contractor. Certification decisions are based on advice from MoD's appointed Acceptance Agency. Test and evaluation (T&E) conducted by the contractor and by the Acceptance Agency provide evidence for certification. Certification identifies limitations of systems upon release to the service. Evidence of compliance with HE standards traditionally forms the main basis of HE certification and significant non-compliance could restrict release. The systems HE approach shows concern for the quality of processes as well as for the content of the product. Human factors certification should be concerned with the quality of HE processes as well as products. Certification should require proof of process as well as proof of content and performance. QA criteria such as completeness, consistency, timeliness, and compatibility provide generic guidelines for

  15. State of the art and setting priorities for fetal alcohol spectrum disorder(s) prevention and management

    NARCIS (Netherlands)

    Roozen, Sylvia; Peters, Gjalt-Jorn; Kok, Gerjo; Townend, David; Koek, Ger; Nijhuis, Jan; Curfs, Leopold

    2017-01-01

    Background: Fetal Alcohol Spectrum Disorders (FASD) is an umbrella term for one of the leading preventable forms of mental retardation affecting individuals and societies worldwide. Alcohol and its interference with the development of the fetus and child are complex and highly variable. The aim of

  16. Self-Management and Parents as Interventionists to Improve Homework Independence in Students with Autism Spectrum Disorders

    Science.gov (United States)

    Hampshire, Patricia Korzekwa; Butera, Gretchen D.; Bellini, Scott

    2016-01-01

    Homework challenges are particularly relevant for students with autism spectrum disorders who demonstrate difficulty maintaining attention, motivation, and developing effective study skills. These challenges are often exacerbated for adolescents with disabilities who face a number of challenges during the middle school years. A multiple baseline…

  17. Development of a model forecasting Dermanyssus gallinae's population dynamics for advancing Integrated Pest Management in laying hen facilities

    NARCIS (Netherlands)

    Mul, Monique F.; Riel, van Johannes; Roy, Lise; Zoons, Johan; Andre, Geert; George, David R.; Meerburg, Bastiaan G.; Dicke, Marcel; Mourik, van Simon; Groot Koerkamp, Peter W.G.

    2017-01-01

    The poultry red mite, Dermanyssus gallinae, is the most significant pest of egg laying hens in many parts of the world. Control of D. gallinae could be greatly improved with advanced Integrated Pest Management (IPM) for D. gallinae in laying hen facilities. The development of a model forecasting

  18. Fy00 Treasure Valley ITS Deployment Project : advanced traffic management system (ATMS) software procurement and implementation process

    Science.gov (United States)

    2006-08-02

    In 2000, the Treasure Valley area of the State of Idaho received a federal earmark of $390,000 to develop an Advanced Transportation Management System (ATMS) for the Treasure Valley region of Idaho. The Ada County Highway District (ACHD), located in ...

  19. Development of advanced spent fuel management process. The fabrication and oxidation behavior of simulated metallized spent fuel

    Energy Technology Data Exchange (ETDEWEB)

    Ro, Seung Gy; Shin, Y.J.; You, G.S.; Joo, J.S.; Min, D.K.; Chun, Y.B.; Lee, E.P.; Seo, H.S.; Ahn, S.B

    1999-03-01

    The simulated metallized spent fuel ingots were fabricated and evaluated the oxidation rates and the activation energies under several temperature conditions to develop an advanced spent fuel management process. It was also checked the alloying characteristics of the some elements with metal uranium. (Author). 3 refs., 1 tab., 36 figs.

  20. How Project Management Tools Aid in Association to Advance Collegiate Schools of Business (AACSB) International Maintenance of Accreditation

    Science.gov (United States)

    Cann, Cynthia W.; Brumagim, Alan L.

    2008-01-01

    The authors present the case of one business college's use of project management techniques as tools for accomplishing Association to Advance Collegiate Schools of Business (AACSB) International maintenance of accreditation. Using these techniques provides an efficient and effective method of organizing maintenance efforts. In addition, using…