WorldWideScience

Sample records for advanced spectrum management

  1. 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.

  2. 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.

  3. 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

  4. Joint Electromagnetic Spectrum Management Operations

    Science.gov (United States)

    2012-03-20

    will coordinate through the United States liaison office (USLO) or US office of military cooperation ( OMC ) to obtain spectrum support and...coordination process, the USLO or OMC may authorize direct coordination between the combatant command (CCMD) JFMO or JTF JSME and the HN FM authorities...J-5). HNC may involve the spectrum authority of the HN(s) involved, the US embassy defense attaché OMC , friendly forces coordination cell, etc

  5. 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.

  6. 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 collaborative organization, and present future technologies in KM including the management of knowledge using social media and intelligent techniques....

  7. 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.

  8. Advanced dementia pain management protocols.

    Science.gov (United States)

    Montoro-Lorite, Mercedes; Canalias-Reverter, Montserrat

    2017-08-04

    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.

  9. South Africa heading for dynamic spectrum management

    CSIR Research Space (South Africa)

    Lysko, Albert A

    2016-09-01

    Full Text Available  White Spaces (TVWS) technology development and trials is an initiative where unused TV spectrum is reused on a secondary basis. TVWS technology uses ultra­high frequency (UHF) spectrum and can penetrate the vegetation and long distances characteristic... Africa’s Council for Scientific and Industrial Research (CSIR) has developed and certified a geolocation spectrum database, with the country moving towards making its spectrum management more dynamic. The database is able to predict TV broadcasting strength distribution and, based on that, predict availability of the unused TV...

  10. 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...

  11. 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

  12. 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...

  13. 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.

  14. [Advances in infrared spectrum zoom imaging system research].

    Science.gov (United States)

    Bai, Yu; Xing, Ting-wen; Jiang, Ya-dong

    2014-12-01

    Compared with the infrared spectrum fixed focal length system and infrared spectrum dual-zoom system, infrared spectrum continuous zoom imaging system which has continuous variational field of view can track targets sequentially, so it is a research direction in infrared spectrum imaging technology. Some new technologies are presented overseas in order to improve the detection performance, reduce cost and have good athermalized performance in infrared spectrum continuous zoom imaging system. Infrared material, infrared detector and variable aperture, those new technologies are su mmarized and the idiographic application of those new technologies in infrared spectrum continuous zoom imaging system are presented in the paper, for example athermalization of an infrared spectrum zoom lens system with new infrared material for target detection, dual band infrared spectrum continuous zoom imaging system with mid-wave infrared and long-wave infrared, infrared spectrum continuous zoom imaging system with high ratio, nfrared spectrum continuous zoom imaging system with dual F/number. It is useful for the development of chinese infrared continuous zoom imaging system.

  15. 77 FR 5494 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2012-02-03

    ... 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...

  16. 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...

  17. 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...

  18. 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...

  19. 77 FR 48968 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2012-08-15

    ... 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...

  20. 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...

  1. 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...

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

    Science.gov (United States)

    2013-02-04

    ... 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. 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...

  4. 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...

  5. 77 FR 35941 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2012-06-15

    ... 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...

  6. 76 FR 23796 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2011-04-28

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

    Science.gov (United States)

    2013-06-12

    ... 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...

  8. 76 FR 61672 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2011-10-05

    ... 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...

  9. 77 FR 69597 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2012-11-20

    ... 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...

  10. 78 FR 23541 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2013-04-19

    ... 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...

  11. 76 FR 38638 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2011-07-01

    ... 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...

  12. 78 FR 49260 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2013-08-13

    ... 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...

  13. Cloud based spectrum manager for future wireless regulatory environment

    CSIR Research Space (South Africa)

    Masonta, MT

    2015-12-01

    Full Text Available optimal allocation lies with dynamic spectrum management as a policy and regulatory tool for addressing the dichotomy of technical, economic and socio-economic considerations. Different radio frequency bands have different technical characteristics...

  14. Auction based spectrum management of cognitive radio networks

    DEFF Research Database (Denmark)

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

    2009-01-01

    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...... (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....

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

    African Journals Online (AJOL)

    Journal of Fundamental and Applied Sciences. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 9, No 4S (2017) >. Log in or Register to get access to full text downloads.

  16. Educational and Behavioral Interventions in Management of Autism Spectrum Disorder.

    Science.gov (United States)

    Sengupta, Koyeli; Lobo, Leera; Krishnamurthy, Vibha

    2017-01-01

    The increasing prevalence of autism spectrum disorder (ASD) makes early recognition, evaluation and management an important task for pediatricians, physicians and other professionals caring for children. Educational interventions form the mainstay of management for children with autism spectrum disorder. Such interventions focus on improving social interaction, communication and challenging behaviors, thereby promoting learning and independence in children. This article provides an overview of educational and behavioral interventions in autism spectrum disorder, with special reference to challenges and feasible solutions in the Indian context. Articles were retrieved from various databases including Google Scholar, Medscape, Cochrane, PubMed using the search terms 'autism spectrum disorder OR autism AND educational interventions'; 'autism spectrum disorder OR autism, educational interventions AND India' and 'autism spectrum disorder OR autism AND India'. Reference lists from retrieved articles as well as websites of organizations working in this space in India were also searched. Extracted manuscripts were analysed for content related to various aspects of educational and behavioral interventions in autism spectrum disorder. Intervention models for autism spectrum disorder are based on various theoretical orientations and target specific deficits associated with the disorder. In addition, evidence-based principles for effective intervention are highlighted. In developing countries like India, access to interventions is a challenge and resources are limited. In such settings, the pediatrician's or physician's role is vital in supporting families choose programs that are evidence-based, target individual needs and result in improved outcomes.

  17. 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.

  18. 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.

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

    Science.gov (United States)

    2017-07-12

    Spectrum Center, the final approval must be given by US Strategic Command that includes a CONCURRENCE from the HQ FAA Spectrum and Policy Management ...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

  20. 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

    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...

  1. 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.

  2. 75 FR 52472 - Spectrum Requirements for Advanced Medical Technologies

    Science.gov (United States)

    2010-08-26

    .... 95.1209(d) (``Permissible Communications'') as adopted appears to contain unnecessary language that... data communications in other countries, but seeks to limit its application to only body-worn devices... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 95 [ET Docket No. 06-135; FCC 10-128] Spectrum...

  3. Wound management in patients with advanced illness.

    Science.gov (United States)

    Maida, Vincent

    2013-03-01

    To emphasize that the management of wounds represents a significant component within the overall supportive and palliative care of patients with advanced illness. It is also intended to clarify the linguistics that are commonly used around patients with wounds. New paradigms for wound management, wound outcomes, and goal setting have been defined and graphically depicted. Recent studies show that wounds may be used as prognostic factors for patients with advanced illness. Data from recent studies also demonstrate that marginal levels of wound healing are possible for all wound classes affecting patients with advanced illness. When indicated, time-limited trials of wound healing strategies should be facilitated by the Wound Bed Preparation Paradigm. Wound palliation may be guided through the use of the Toronto Symptom Assessment System for Wounds (TSAS-W). Wound management must continue to evolve as a tenet within the overall supportive and palliative care of patients with advanced illness.

  4. 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

  5. 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…

  6. Advanced Radio Resource Management for IMT

    DEFF Research Database (Denmark)

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

    generation mobile, 4G. This paper presents the first set of innovative concepts for advanced Radio Resource Management that has been identified by the Innovation Group of WINNER+ for potential inclusion in IMT-Advanced. These concepts consist of promising innovative techniques that are ready to be included...... in current OFDMAbased cellular systems to enhance system performance. A brief description of each technique together with the relevant state of the art is provided....

  7. Thermoelectric Devices Advance Thermal Management

    Science.gov (United States)

    2007-01-01

    Thermoelectric (TE) devices heat, cool, and generate electricity when a temperature differential is provided between the two module faces. In cooperation with NASA, Chico, California-based United States Thermoelectric Consortium Inc. (USTC) built a gas emissions analyzer (GEA) for combustion research. The GEA precipitated hydrocarbon particles, preventing contamination that would hinder precise rocket fuel analysis. The USTC research and design team uses patent-pending dimple, pin-fin, microchannel and microjet structures to develop and design heat dissipation devices on the mini-scale level, which not only guarantee high performance of products, but also scale device size from 1 centimeter to 10 centimeters. USTC continues to integrate the benefits of TE devices in its current line of thermal management solutions and has found the accessibility of NASA technical research to be a valuable, sustainable resource that has continued to positively influence its product design and manufacturing

  8. 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…

  9. 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...

  10. 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...

  11. porcine anaesthesia for advanced trauma operative management

    African Journals Online (AJOL)

    David Ofori-Adjei

    2008-09-01

    Sep 1, 2008 ... 120. PORCINE ANAESTHESIA FOR ADVANCED TRAUMA OPERATIVE. MANAGEMENT (ATOM). H. BADDOO, F. AHIAKU, E. FORDJUOR, I. WULFF, D. AKUOKU and D. KWAMI. Department of Anaesthesia, University of Ghana Medical School, Accra, Ghana. Author for correspondence: Dr Henry Baddoo.

  12. Dynamic spectrum management as an anti-interference method

    Science.gov (United States)

    Suchanski, M.; Matyszkiel, R.; Kaniewski, P.; Kustra, M.; Gajewski, P.; Łopatka, J.

    2017-04-01

    The rapid development of systems which use wireless technologies causes the escalation of the spectrum shortage problem. That is why the concept of coordinated dynamic spectrum management has appeared. It improves efficiency of the spectrum use and makes radio communication systems more resistant to interferences. The main element of the proposed solution is a frequency broker which provides frequency assignment plans for radio networks. Direct communication between the frequency broker and radio networks enables fast change of radio data. This paper presents an anti-interference method based on dynamic spectrum management, which is an implementation and extension of IST- 104/RTG-050 research task group "Cognitive Radio in NATO II" recommendations. The solution presented by the authors was tested in emulated and real environment. The designed algorithm of frequency assignment can effectively prevent interferences (including jamming) thanks to the implementation of monitoring mechanisms capable of obtaining information about the current state of radio channels from radio networks. Directions for further development of frequency planning algorithm based on belief distorted Nash equilibria for deterministic or stochastic beliefs were proposed.

  13. 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)

  14. Zellweger spectrum disorders: clinical overview and management approach.

    Science.gov (United States)

    Klouwer, Femke C C; Berendse, Kevin; Ferdinandusse, Sacha; Wanders, Ronald J A; Engelen, Marc; Poll-The, Bwee Tien

    2015-12-01

    Zellweger spectrum disorders (ZSDs) represent the major subgroup within the peroxisomal biogenesis disorders caused by defects in PEX genes. The Zellweger spectrum is a clinical and biochemical continuum which can roughly be divided into three clinical phenotypes. Patients can present in the neonatal period with severe symptoms or later in life during adolescence or adulthood with only minor features. A defect of functional peroxisomes results in several metabolic abnormalities, which in most cases can be detected in blood and urine. There is currently no curative therapy, but supportive care is available. This review focuses on the management of patients with a ZSD and provides recommendations for supportive therapeutic options for all those involved in the care for ZSD patients.

  15. Dental Management of Patients with Autism Spectrum Disorders

    Directory of Open Access Journals (Sweden)

    Al Mochamant Iosif-Grigorios

    2015-11-01

    Full Text Available Dental treatment of patients with Autism Spectrum Disorders (ASD can be complicated because of the presence of behavioural unpredictability. This article reviews the present literature on the issues dealt with children with autistic spectrum disorder from the dental perspective. The prevalence of autism is rising worldwide. Consequently, dentists will find an increasing number of such children in their routine practice, whose treatment will require special considerations in their dental management. Knowledge regarding the oral health status of autistic children is essential for the paediatric dentists. Negative behaviour toward dental treatment was very clear in autistic children. Self-inflicting trauma/habits were observed in autistic children. It was concluded that the autistic children do not have a higher dental caries score compared to that of normal children. Their oral hygiene was fair; however, they exhibited more debris deposits than normal children.

  16. 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....

  17. Managing the gap: balancing advances in technology with advances in management practice.

    Science.gov (United States)

    Ritchie, D

    1997-01-01

    Expenditure on information systems is widely anticipated to lead to improved management of health care resources. Despite large investments in hardware and software, these expectations are difficult to realise. Part of the difficulty lies in the manner in which information systems are applied to, rather than integrated within, organisations. This paper considers some of the the personal and organisational issues that need to be addressed to 'manage the gap' in balancing advances in information technology with advances in management practice. The issues identified are consistent with the concept of a learning organisation dealing with environmental change.

  18. 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.

  19. 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

  20. DoD Frequency Spectrum Issues Coping with Changes: Managing RF Spectrum to Meet DoD Needs

    National Research Council Canada - National Science Library

    Howard, William

    2000-01-01

    .... DoD's mastery at managing its spectrum, both within the Department and at national and international levels, is weakening due to changes in geopolitics, the perceived reduced primacy of defense needs...

  1. 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.

  2. 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.

  3. 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

  4. 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......-resistant prostate cancer; the role of imaging in APC; osteoclast-targeted therapy; molecular characterisation of blood and tissue; genetic counselling/testing; side effects of systemic treatment(s); global access to prostate cancer drugs. A panel of 60 international prostate cancer experts developed the program...... 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...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-05-01

    As early as 2014, mobile network operators’ spectral capacity will be overwhelmed by the demand brought on by new devices and applications. To augment capacity and meet this demand, operators may choose to deploy a Dynamic Spectrum Access (DSA) overlay. The signaling and functionality required by such an overlay have not yet been fully considered in the architecture of the planned Long Term Evolution Advanced (LTE+) networks. This paper presents a Spectrum Accountability framework to be integrated into LTE+ architectures, defining specific element functionality, protocol interfaces, and signaling flow diagrams required to enforce the rights and responsibilities of primary and secondary users. We also quantify, through integer programs, the benefits of using DSA channels to augment capacity under a scenario in which LTE+ network can opportunistically use TV and GSM spectrum. The framework proposed here may serve as a guide in the development of future LTE+ network standards that account for DSA.

  6. 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.

  7. 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

  8. Clinical spectrum, management and outcome of neonatal candidiasis.

    Science.gov (United States)

    Khan, Ejaz Ahmed; Choudhry, Shehla; Fatima, Masooma; Batool, Zahra

    2015-11-01

    To identify clinical spectrum, management and outcome of neonatal candidiasis. 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. Of the total 1550 neonatal admissions, 560 (36%) had positive cultures, and, of them, candida was isolated in 49(8.8%) neonates. Among them, 13(26%) had candida albicans and the rest had candida species. Majority were males 34(70%), and preterm with 30(61%) being <37 weeks. The mean birth weight was 2000±873 grams. Mean age at admission was 6±7.6 days. Overall, 39(80%) had ≥2 risk factors. The commonest site of isolation was blood in 41(84%). Besides, 32 (65%) received fluconazole alone for treatment. Mean duration of anti-fungal therapy was 10±5 days (range: 1-21 days). Twelve (24%) neonates expired and the cause of death was candida sepsis in 10(20%) 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). 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.

  9. 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)

  10. 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

  11. 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

  12. Hydrogel Dressings for Advanced Wound Management.

    Science.gov (United States)

    Francesko, Antonio; Petkova, Petya; Tzanov, Tzanko

    2017-09-20

    Composed in a large extent of water and due to their non-adhesiveness, hydrogels found their way to the wound dressing market as materials that provide a moisture environment for healing while being comfortable to the patient. Hydrogels' exploitation is constantly increasing after evidences of their even broader therapeutic potential due to resemblance to dermal tissue and ability to induce partial skin regeneration. The innovation in advanced wound care is further directed to the development of so-called active dressings, where hydrogels are combined with components that enhance the primary purpose of providing a beneficial environment for wound healing. The aim of this mini-review is to concisely describe the relevance of hydrogel dressings as platforms for delivery of active molecules for improved management of difficult-to-treat wounds. The emphasis is on the most recent advances in development of stimuli-responsive hydrogels, which allow for control over wound healing efficiency in response to different external modalities. Novel strategies for monitoring of the wound status and healing progress based on incorporation of sensor molecules into the hydrogel platforms are also discussed. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  13. 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

  14. 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

  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. 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.

  17. 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.

  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. 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.

  1. Management of Patients with Advanced Prostate Cancer

    DEFF Research Database (Denmark)

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

    2017-01-01

    BACKGROUND: In advanced prostate cancer (APC), successful drug development as well as advances in imaging and molecular characterisation have resulted in multiple areas where there is lack of evidence or low level of evidence. The Advanced Prostate Cancer Consensus Conference (APCCC) 2017 address...

  2. 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.

  3. Spontaneous reduction of intussusception: clinical spectrum, management and outcome

    Energy Technology Data Exchange (ETDEWEB)

    Kornecki, A.; Daneman, A.; Navarro, O.; Connolly, B.; Manson, D.; Alton, D.J. [Toronto Univ., ON (Canada); Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON (Canada)

    2000-01-01

    Background. To analyze the spectrum of clinical features, management and outcome of children with documented spontaneous reduction of intussusception (SROI). Materials and methods. Review of records of 50 children (33 boys, 17 girls; age range 11 days-15 years; mean age 4 years) with documented SROI, in whom intussusception was initially diagnosed by sonography (US) in 44, air enema in 2, and computed tomography in 4, in the 6-year period 1992-1998. Results. Symptoms suggestive of intussusception were present in 21 (3 of whom had Henoch-Schoenlein purpura and 4 had previous ileocolic intussusception reduced by air enema). Intussusception was an incidental finding in the other 29, in 28 of whom the finding was in the small bowel. Intussusception was limited to the small bowel in 43 and was ileocolic in 7. SROI was usually documented on US. Laparotomy performed in only 4 showed no evidence of intussusception or pathologic lead point. Outcome in all patients was favorable. Conclusions. SROI may present in symptomatic or asymptomatic children and occurs more commonly than previously reported. These intussusceptions are usually short-segment, small-bowel intussusceptions with no recognizable lead point. In asymptomatic patients, conservative observation is warranted. Intervention should be dictated by the clinical findings in symptomatic patients. (orig.)

  4. 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...

  5. Management and survival in advances prostate cancer in Nairobi ...

    African Journals Online (AJOL)

    Objective: To evaluate the management and survival of patients with advanced prostate cancer in this locality. Design: A prospective case study. Setting: Kenyatta National Referral Hospital and the Nairobi and Mater Hospitals. Patients: Fifty nine patients with advanced cancer of prostate (extra prostatic locally advanced ...

  6. Zellweger spectrum disorders: clinical overview and management approach

    NARCIS (Netherlands)

    Klouwer, Femke C. C.; Berendse, Kevin; Ferdinandusse, Sacha; Wanders, Ronald J. A.; Engelen, Marc; Poll-The, Bwee Tien

    2015-01-01

    Zellweger spectrum disorders (ZSDs) represent the major subgroup within the peroxisomal biogenesis disorders caused by defects in PEX genes. The Zellweger spectrum is a clinical and biochemical continuum which can roughly be divided into three clinical phenotypes. Patients can present in the

  7. Advancements in the management of pancreatic cancer.

    Science.gov (United States)

    Li, Jia; Saif, Muhammad Wasif

    2009-03-09

    Management of pancreatic cancer remains the most challenging work in oncology. Though pancreatic cancer represents only 2-3% of all cancers, it is the most fatal one accounting for the 6% of all cancer death. It remains the 4th cause of death by cancer since 1970s in the U.S.. Gemcitabine remains the only standard of care for this disease. More and more combination therapies containing gemcitabine have been tested or undergoing investigation. The interest in treating pancreatic cancer is apparently global. Over 75 abstracts were presented in the 2009 ASCO Gastrointestinal Cancers Symposium at San Francisco in the field of pancreatic cancer. In this highlights article, authors summarize the critical studies in the management of pancreatic cancer. A large retrospective study evaluated the role of post-operative adjuvant radiation (Abstract #181) and correlated the receipt of radiation with survival benefit. Borderline resectable pancreatic cancer remains an area that requires multi-disciplinary approach. Neo-adjuvant therapy very likely plays a role to downstage to a resectable state in these subgroup patients (Abstracts #197 and #248). In advanced or metastatic setting, studies aiming at the gemcitabine-based triplet or doublet combinations are still the mainstream. FFCD 0301 trial (Abstract #180), the only large phase III trial presented in the first-line setting, failed to demonstrate any survival advantage of either 5-FU and leucovorin plus cisplatin followed by gemcitabine or vice versa. Biologic agents containing regimens were also presented. Of note, gemcitabine and oxaliplatin plus bevacizumab achieved a high response rate of 39% (Abstract #182) while gemcitabine with dual monoclonal antibody regimen was disappointing (Abstract #183). The clear benefit of all other combinations over gemcitabine alone remains questionable given most studies are small. Newer agents, especially S-1 (Abstracts #213 and #251), are very promising, and further studies are warranted

  8. 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

  9. Proceedings of the topical meeting on advances in fuel management

    International Nuclear Information System (INIS)

    Anon.

    1986-01-01

    This book presents the papers given at a conference on fuel management strategies for nuclear power plants. Topics considered at the conference included a world perspective on the nuclear fuel cycle, reactor core and fuel management for advanced reactor systems, innovative core loading strategies, automated and interactive fuel management tools, cycle length and design flexibility, applications of micro and mini computers for fuel management, advanced fuel and burnable poison designs, the development and validation of fuel management tools, practical constraints on fuel management, fuel performance optimization with on-line monitoring systems, and utility experience in reload design and licensing

  10. 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 ...

  11. 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.

  12. Spectrum Utilisation and Management in Cognitive Radio Networks

    DEFF Research Database (Denmark)

    Patil, Kishor P.

    applicable to India since the geographical characteristics, and the social environment is different in India. The spectrum usage situation and therefore the Cognitive Radio in India are unclear. We address this in the thesis and present empirical work and modeling in the context of Cognitive Radio...... bands for Cognitive Radio. We present the model which has ability to reproduces the statistical characteristics of the spectrum usage. The cognitive access of unused TV band i.e. TV white spaces is the excellent opportunity to not only to counteract the spectrum scarcity problem but also for the new...

  13. 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.

  14. 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)

  15. 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.

  16. 75 FR 75967 - Commerce Spectrum Management Advisory Committee, Call for Applications

    Science.gov (United States)

    2010-12-07

    ... DEPARTMENT OF COMMERCE National Telecommunications and Information Administration Commerce... Information Administration, U.S. Department of Commerce. ACTION: Notice and Call for Applications to Serve on... seeking applications from persons interested in serving on the Department of Commerce Spectrum Management...

  17. Advanced Maternal Age and Maternal Education Disparity in Children with Autism Spectrum Disorder.

    Science.gov (United States)

    Lung, For-Wey; Chiang, Tung-Liang; Lin, Shio-Jean; Lee, Meng-Chih; Shu, Bih-Ching

    2018-02-06

    Objective Previous studies have shown inconsistent results with regard to the association between advanced parental age and autism spectrum disorder (ASD). The sociodemographic status of parents has been found to be associated with children with ASD, however. Therefore, a pathway analysis was undertaken of the roles of maternal age and education in ASD diagnosis and community screening, in a national birth cohort database, using a propensity score matching (PSM) method. Method The 6- and 66-month Taiwan Birth Cohort Study dataset was used (N = 20,095). The PSM exact matching method was used to select 1700 families (ratio of 1:4 between ASD diagnosis and control) from the Taiwan Birth Cohort Study dataset. Results (1) The results from the complete dataset and the PSM exact matching dataset both show that the risk of a child being diagnosed with ASD was increased by the mother being over 40 years old. (2) Although more children of mothers with lower-than-average education were positive on screening, more children of mothers with higher-than-average education were also diagnosed with ASD. Conclusions for Practice Advanced maternal age had a higher association with the diagnosis of ASD, and maternal educational disparity was found between ASD clinical diagnosis and community screening. Community and primary medical care services should pay more attention to children of parents with lower education during ASD screening to prevent delayed diagnosis.

  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. 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

  20. 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

  1. Managing a Live Advanced Abdominal Twin Pregnancy

    African Journals Online (AJOL)

    examination revealed a closed, uneffaced, firm and posterior ... Advanced abdominal pregnancies with live twin fetuses are extremely rare and are misdiagnosed ... operating room. Leaving the placenta in situ is the best way to deal with abdominal pregnancy, based on previous experience and review of the literature.

  2. Anesthetic Management for Prolonged Incidental Surgery in Advanced Liver Disease

    OpenAIRE

    Kundu, Riddhi; Subramaniam, Rajeshwari; Sardar, Arijit

    2017-01-01

    In spite of advances in perioperative management, operative procedures in patients with chronic liver disease pose a significant challenge for the anesthesiologist due to multisystem involvement, high risk of postoperative hepatic decompensation, and mortality. We describe the anesthetic management of an elderly patient with advanced liver disease (model for end-stage liver disease 16) for prolonged abdominal surgery. The use of invasive hemodynamic monitoring, point-of-care biochemical, and ...

  3. 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...

  4. 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…

  5. Spectrum management considerations of adaptive power control in satellite networks

    Science.gov (United States)

    Sawitz, P.; Sullivan, T.

    1983-01-01

    Adaptive power control concepts for the compensation of rain attenuation are considered for uplinks and downlinks. The performance of example power-controlled and fixed-EIRP uplinks is compared in terms of C/Ns and C/Is. Provisional conclusions are drawn with regard to the efficacy of uplink and downlink power control orbit/spectrum utilization efficiency.

  6. 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,…

  7. 78 FR 57370 - Commerce Spectrum Management Advisory Committee Meeting

    Science.gov (United States)

    2013-09-18

    ...: License radio frequencies in a way that maximizes their public benefits; keep wireless networks as open to... effectively to fundamental technological, operational, and other trends to continue advancement of delivering...

  8. Spectrum of aspergillosis: Pathogenesis, risk factors and management

    African Journals Online (AJOL)

    African Journal of Clinical and Experimental Microbiology. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 17, No 1 (2016) >. Log in or Register to get access to full text downloads.

  9. Optimal Design of Primary User Spectrum Management Using Stackelberg Games

    OpenAIRE

    Hosseini Kamal, Mahdad

    2008-01-01

    We consider a cognitive radio network in which a base station provides opportunistic unlicensed spectrum access for secondary base stations to transmit data to their subscribers. The primary user may decide to release some parts of its bandwidth for the use of secondary users. As a result, secondary users pay a fee to the primary user based on the interference they make. Considering cognitive radios, we propose and analyze a framework, whereby a primary user has the possibility to release its...

  10. The Impact of the Advancing Social-Communication and Play (ASAP) Intervention on Preschoolers with Autism Spectrum Disorder

    Science.gov (United States)

    Dykstra, Jessica R.; Boyd, Brian A.; Watson, Linda R.; Crais, Elizabeth R.; Baranek, Grace T.

    2012-01-01

    This study evaluates an intervention targeting social-communication and play skills (Advancing Social-communication and Play; ASAP) implemented by school staff in a public preschool setting. With increases in enrollment of children with autism spectrum disorder (ASD) in school systems, establishing the effectiveness and feasibility of…

  11. The diabetic foot management - recent advance.

    Science.gov (United States)

    Sinwar, Prabhu Dayal

    2015-03-01

    Diabetic ulceration of the foot represents a major global medical, social and economic problem. It is the commonest major end-point of diabetic complications. Diabetic neuropathy and peripheral vascular disease are the main etiological factors in foot ulceration and may act alone, together, or in combination with other factors such as microvascular disease, biomechanical abnormalities, limited joint mobility and increased susceptibility to infection. In the diabetic foot, distal sensory polyneuropathy is seen most commonly. The advent of insulin overcame the acute problems of ketoacidosis and infection, but could not prevent the vascular and neurological complications. Management of diabetic neuropathic ulcer by appropriate and timely removal of callus, control of infection and reduction of weight bearing forces. Management of diabetic ischaemic foot are medical management, surgical management and percutaneous transluminal angioplasty of stenosed and occluded lower extremity arteries. Foot ulceration in persons with diabetes is the most frequent precursor to amputation. Copyright © 2015 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  12. 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.

  13. Advances in the Endoscopic Management of Obesity

    Directory of Open Access Journals (Sweden)

    Jason Behary

    2015-01-01

    Full Text Available Obesity has become a worldwide epidemic with significant impact on quality of life, morbidity, and mortality rates. Over the past two decades, bariatric surgery has established itself as the most effective and durable treatment for patients with obesity and its associated comorbidities. However, despite the use of minimally invasive techniques, bariatric surgery is associated with complications in approximately 15% of patients, has a substantial cost, and is used by only 1% of patients who are eligible. Therefore, there is a need for effective minimally invasive therapies, which will be utilized by the large proportion of obese patients who are in desperate need of treatment but are not receiving any. Endoscopic approaches to the management of obesity have been developed, with the aim of delivering more effective, durable, and safer methods of weight reduction. In this paper, we review currently available and future endoscopic therapies that will likely join the armamentarium used in the management of obesity.

  14. 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.

  15. 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.

  16. Use of the recreation opportunity spectrum in natural protected area planning and management

    Science.gov (United States)

    Gustavo Perez-Verdin; Martha E. Lee; Deborah J. Chavez

    2008-01-01

    The use of the Recreation Opportunity Spectrum (ROS) framework, widely used in planning and managing wildland recreation in the United States, was tested for managing recreation opportunities in southern Durango, Mexico. Two natural protected areas were used as case studies to evaluate the ROS criteria and standards for land classification of outdoor recreation...

  17. 75 FR 843 - Call for Applications for the Commerce Spectrum Management Advisory Committee

    Science.gov (United States)

    2010-01-06

    ... Management Advisory Committee AGENCY: National Telecommunications and Information Administration, U.S... Commerce's Spectrum Management Advisory Committee (CSMAC) for new two-year terms. This Notice reopens the... should send their resumes or curriculum vitae and a statement summarizing the qualifications of the...

  18. Multi-criteria decision analysis of spectrum management frameworks for futuristic wireless networks: the context of developing countries

    CSIR Research Space (South Africa)

    Mfupe, Luzango P

    2017-03-01

    Full Text Available that are based on the Dynamic spectrum access (DSA) technique. The approach utilises Multicriteria decision analysis (MCDA) tools. The article uses a case study to evaluate dominant Dynamic spectrum management (DSM) frameworks. Finally, a sustainable DSM...

  19. 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.

  20. 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.

  1. 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.

  2. Advancing the science of forensic data management

    Science.gov (United States)

    Naughton, Timothy S.

    2002-07-01

    Many individual elements comprise a typical forensics process. Collecting evidence, analyzing it, and using results to draw conclusions are all mutually distinct endeavors. Different physical locations and personnel are involved, juxtaposed against an acute need for security and data integrity. Using digital technologies and the Internet's ubiquity, these diverse elements can be conjoined using digital data as the common element. This result is a new data management process that can be applied to serve all elements of the community. The first step is recognition of a forensics lifecycle. Evidence gathering, analysis, storage, and use in legal proceedings are actually just distinct parts of a single end-to-end process, and thus, it is hypothesized that a single data system that can also accommodate each constituent phase using common network and security protocols. This paper introduces the idea of web-based Central Data Repository. Its cornerstone is anywhere, anytime Internet upload, viewing, and report distribution. Archives exist indefinitely after being created, and high-strength security and encryption protect data and ensure subsequent case file additions do not violate chain-of-custody or other handling provisions. Several legal precedents have been established for using digital information in courts of law, and in fact, effective prosecution of cyber crimes absolutely relies on its use. An example is a US Department of Agriculture division's use of digital images to back up its inspection process, with pictures and information retained on secure servers to enforce the Perishable Agricultural Commodities Act. Forensics is a cumulative process. Secure, web-based data management solutions, such as the Central Data Repository postulated here, can support each process step. Logically marrying digital technologies with Internet accessibility should help nurture a thought process to explore alternatives that make forensics data accessible to authorized individuals

  3. Knowledge Management Platform in Advanced Product Quality Planning

    Science.gov (United States)

    Chiliban, Bogdan; Baral, Lal Mohan; Kifor, Claudiu

    2014-12-01

    Knowledge is an essential part of organizational competitiveness. This vital resource must be managed correctly within organizations in order to achieve desired performance levels within all undertakings. The process of managing knowledge is a very difficult one due to the illusive nature of the resource itself. Knowledge is stored within every aspect of an organization starting from people and ending with documents and processes. The Knowledge Management Platform is designed as a facilitator for managers and employees in all endeavours knowledge related within the Advanced Product Quality Planning Procedure

  4. 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)

  5. Current nutritional approaches in managing autism spectrum disorder: A review.

    Science.gov (United States)

    Cekici, Hande; Sanlier, Nevin

    2017-08-01

    The link between nutrition and autism spectrum disorder (ASD), which is a complex developmental disorder manifesting itself in significant delays or deviation in interaction and communication, has provided a fresh point of view and signals that nutrition may have a role in the aetiology of ASD, as well as play an active role in treatment by alleviating symptoms. In this review study aimed at evaluating, with scientific and concrete proof, the current medical nutrition implementations on ASD, existing medical nutrition therapies have been addressed and their effects on ASD symptoms have been discussed in light of current research. We reviewed articles regarding the medical nutritional therapy of autism on current nutritional approaches selected from PubMed, Science Direct, EBSCO, and databases about autism and nutrition. The research put forward that in individuals with ASD, while gluten-free/casein-free and ketogenic diets, camel milk, curcumin, probiotics, and fermentable foods can play a role in alleviating ASD symptoms, consumption of sugar, additives, pesticides, genetically modified organisms, inorganic processed foods, and hard-to-digest starches may aggravate symptoms. Further prospective controlled trials with large sample sizes are needed before recommendations can be made regarding the ideal ASD diet. This review emphasizes the value of identifying current nutritional approaches specific to individuals with ASD and integrating their effects on symptoms to the conversation and presents suggestions for future research designed to identify medical nutrition therapies targeting this population to better understand the link between ASD and nutrition.

  6. 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

    The article presents a practical approach to transform a wave energy spectrum from encounter domain to absolute domain. This problem has its specific relevance, when shipboard sea state estimation is conducted by the buoy analogy; notably for some particular implementation solving for the sea state...... 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......” the waves (beam to head sea) but in following sea conditions there exists no unique solution to the problem. Instead, a reasonable approach valid for practical engineering must be applied, and the article outlines one viable solution that can be used to transform a wave spectrum from encounter to absolute...

  7. THE CHALLENGES OF ADVANCED MANAGEMENT METHODS FOR THE ROMANIAN ORGANISATIONS

    OpenAIRE

    Eduard EDELHAUSER

    2012-01-01

    The aim of the paper is to study the use of the advanced management methods in Romania, through the evolution of the Enterprise Resource Planning (ERP) and Business Intelligence (BI) systems. The study set sights on Romanian organizations which implemented a SIVECO ERP and BI software and the methodology used is both quantitative and qualitative. In the past few years I have attempted to point out certain essential elements of integrated information systems, used as decision and management in...

  8. A Knowledge- Based Decision Support Architecture for Advanced Traffic Management

    OpenAIRE

    Ritchie, Stephen G.

    1990-01-01

    Fundamental to the operation of most currently envisioned Intelligent Vehicle-Roadway System (IVRS) projects are advanced systems for surveillance, control and management of integrated freeway and arterial networks. A major concern in the development of such Smart Roads, and the focus of this paper, is the provision of decision support for traffic management center personnel, particularly for addressing nonrecurring congestion in large or complex networks. Decision support for control room st...

  9. 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.

  10. 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.

  11. Advances in the diagnosis and management of allergic disease ...

    African Journals Online (AJOL)

    There have been a number of advances in the diagnosis and management of allergic diseases that are relevant to South African (SA) circumstances. These are all published or about to be published in new guidelines that provide practical advice to guide SA doctors who treat patients with these conditions. The guidelines ...

  12. Managing a Live Advanced Abdominal Twin Pregnancy | Mpogoro ...

    African Journals Online (AJOL)

    Advanced abdominal pregnancies with live twin fetuses are extremely rare and are misdiagnosed in up to 60% of the cases. Such a case is presented here, highlighting the diagnostic and management challenges encountered. A high index of suspicion in making the diagnosis of this rare variety of ectopic pregnancy, ...

  13. Management of locally advanced primary mediastinal synovial sarcoma.

    Science.gov (United States)

    Chatterjee, Ambarish S; Kumar, Rajiv; Purandare, Nilendu; Jiwnani, Sabita; Karimundackal, George; Pramesh, C S

    2017-01-01

    Primary mediastinal synovial sarcoma (PMSS) is a relatively rare disease, and patients are treated predominantly with surgery for resectable disease. Management of locally advanced borderline resectable and unresectable PMSS is not only challenging but also lacks standard guidelines. We present three patients with PMSS, who were unresectable or borderline resectable at presentation and were treated with neoadjuvant chemotherapy followed by surgery and postoperative radiotherapy.

  14. Management of locally advanced primary mediastinal synovial sarcoma

    OpenAIRE

    Ambarish S Chatterjee; Rajiv Kumar; Nilendu Purandare; Sabita Jiwnani; George Karimundackal; C S Pramesh

    2017-01-01

    Primary mediastinal synovial sarcoma (PMSS) is a relatively rare disease, and patients are treated predominantly with surgery for resectable disease. Management of locally advanced borderline resectable and unresectable PMSS is not only challenging but also lacks standard guidelines. We present three patients with PMSS, who were unresectable or borderline resectable at presentation and were treated with neoadjuvant chemotherapy followed by surgery and postoperative radiotherapy.

  15. 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...

  16. 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 =…

  17. 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

  18. 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

  19. 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.

  20. Conservative Management of an Advanced Abdominal Pregnancy at 22 Weeks

    Science.gov (United States)

    Marcellin, Louis; Ménard, Sophie; Lamau, Marie-Charlotte; Mignon, Alexandre; Aubelle, Marie Stephanie; Grangé, Gilles; Goffinet, François

    2014-01-01

    Objective We report an uneventful conservative approach of an advanced abdominal pregnancy discovered at 22 weeks of gestation. Study Design This study is a case report. Results Attempting to extend gestation of an advanced abdominal pregnancy is not a common strategy and is widely questioned. According to the couple's request, the management consisted in continuous hospitalization, regular ultrasound scan, and antenatal corticosteroids. While the woman remained asymptomatic, surgery was planned at 32 weeks, leading to the birth of a preterm child without any long-term complications. Placenta was left in situ with a prophylactic embolization, and its resorption was monitored. Conclusion Depending on multidisciplinary cares and agreement of the parents, when late discovered, prolonging advanced abdominal pregnancy appears to be a reasonable option. PMID:25032062

  1. Anesthetic Management for Prolonged Incidental Surgery in Advanced Liver Disease.

    Science.gov (United States)

    Kundu, Riddhi; Subramaniam, Rajeshwari; Sardar, Arijit

    2017-01-01

    In spite of advances in perioperative management, operative procedures in patients with chronic liver disease pose a significant challenge for the anesthesiologist due to multisystem involvement, high risk of postoperative hepatic decompensation, and mortality. We describe the anesthetic management of an elderly patient with advanced liver disease (model for end-stage liver disease 16) for prolonged abdominal surgery. The use of invasive hemodynamic monitoring, point-of-care biochemical, and hematological surveillance coupled with prompt correction of all abnormalities was responsible for good outcome. The patient's inguinal swellings turned out to be extensions of a large peritoneal mesothelioma, necessitating a large abdominal incision and blood loss. Analgesia was provided by bilateral transversus abdominis plane blocks, which helped to reduce opioid use and rapid extubation.

  2. 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)

  3. 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.

  4. 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

  5. Management of locally advanced primary mediastinal synovial sarcoma

    Directory of Open Access Journals (Sweden)

    Ambarish S Chatterjee

    2017-01-01

    Full Text Available Primary mediastinal synovial sarcoma (PMSS is a relatively rare disease, and patients are treated predominantly with surgery for resectable disease. Management of locally advanced borderline resectable and unresectable PMSS is not only challenging but also lacks standard guidelines. We present three patients with PMSS, who were unresectable or borderline resectable at presentation and were treated with neoadjuvant chemotherapy followed by surgery and postoperative radiotherapy.

  6. ADVANCES IN PLANT HEALTH MANAGEMENT IN THE TWENTIETH CENTURY.

    Science.gov (United States)

    Cook, R. James

    2000-01-01

    Plant health management is the science and practice of understanding and overcoming the succession of biotic and abiotic factors that limit plants from achieving their full genetic potential as crops, ornamentals, timber trees, or other uses. Although practiced as long as agriculture itself, as a science-based concept, plant heath management is even younger than integrated pest management (IPM), and includes and builds upon but is not a replacement for IPM. Probably the greatest collection of success stories for plant health management is the number of diseases managed by cleaning up the planting material. The record for root health management is more mixed, with the loss or phase-out of soil fumigants, and practices such as crop rotation and clean tillage being replaced with more intensive cropping and less or no tillage. Perhaps the greatest scientific and technical advances for plant health management have come from the work aimed at management of the pathogens, pests, and other hazards that arrive by air. Flor's work on flax rust, which produced the gene-for-gene model, is possibly the most significant contribution of plant pathology to the life sciences in the twentieth century. Research aimed at the management of foliar pathogens is also the basis for modern theory on epidemiology, population biology, aerobiology, and disease prediction and decision-support systems. Even IPM arose mainly in response to the need to protect crops from pests that arrive by air. If the definition of biological control includes the plant induced or genetically modified to defend itself, as it should, then biological control has been the most significant approach to plant health management during the twentieth century and promises through modern biotechnology to be even more significant in the twenty-first century. Rather than "reducing losses," the advances are discussed here within the simple framework of achieving the attainable yield by increasing the actual and/or affordable

  7. 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…

  8. 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...

  9. 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

  10. 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.

  11. 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.

  12. 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

  13. Recent advances in the management of brachial plexus injuries

    Directory of Open Access Journals (Sweden)

    Prem Singh Bhandari

    2014-01-01

    Full Text Available Management of brachial plexus injury is a demanding field of hand and upper extremity surgery. With currently available microsurgical techniques, functional gains are rewarding in upper plexus injuries. However, treatment options in the management of flail and anaesthetic limb are still evolving. Last three decades have witnessed significant developments in the management of these injuries, which include a better understanding of the anatomy, advances in the diagnostic modalities, incorporation of intra-operative nerve stimulation techniques, more liberal use of nerve grafts in bridging nerve gaps, and the addition of new nerve transfers, which selectively neurotise the target muscles close to the motor end plates. Newer research works on the use of nerve allografts and immune modulators (FK 506 are under evaluation in further improving the results in nerve reconstruction. Direct reimplantation of avulsed spinal nerve roots into the spinal cord is another area of research in brachial plexus reconstruction.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. Recent advances in wearable sensors for animal health management

    Directory of Open Access Journals (Sweden)

    Suresh Neethirajan

    2017-02-01

    Full Text Available Biosensors, as an application for animal health management, are an emerging market that is quickly gaining recognition in the global market. Globally, a number of sensors being produced for animal health management are at various stages of commercialization. Some technologies for producing an accurate health status and disease diagnosis are applicable only for humans, with few modifications or testing in animal models. Now, these innovative technologies are being considered for their future use in livestock development and welfare. Precision livestock farming techniques, which include a wide span of technologies, are being applied, along with advanced technologies like microfluidics, sound analyzers, image-detection techniques, sweat and salivary sensing, serodiagnosis, and others. However, there is a need to integrate all the available sensors and create an efficient online monitoring system so that animal health status can be monitored in real time, without delay. This review paper discusses the scope of different wearable technologies for animals, nano biosensors and advanced molecular biology diagnostic techniques for the detection of various infectious diseases of cattle, along with the efforts to enlist and compare these technologies with respect to their drawbacks and advantages in the domain of animal health management. The paper considers all recent developments in the field of biosensors and their applications for animal health to provide insight regarding the appropriate approach to be used in the future of enhanced animal welfare.

  19. 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

  20. Advanced Hemodynamic Management in Patients with Septic Shock.

    Science.gov (United States)

    Saugel, Bernd; Huber, Wolfgang; Nierhaus, Axel; Kluge, Stefan; Reuter, Daniel A; Wagner, Julia Y

    2016-01-01

    In patients with sepsis and septic shock, the hemodynamic management in both early and later phases of these "organ dysfunction syndromes" is a key therapeutic component. It needs, however, to be differentiated between "early goal-directed therapy" (EGDT) as proposed for the first 6 hours of emergency department treatment by Rivers et al. in 2001 and "hemodynamic management" using advanced hemodynamic monitoring in the intensive care unit (ICU). Recent large trials demonstrated that nowadays protocolized EGDT does not seem to be superior to "usual care" in terms of a reduction in mortality in emergency department patients with early identified septic shock who promptly receive antibiotic therapy and fluid resuscitation. "Hemodynamic management" comprises (a) making the diagnosis of septic shock as one differential diagnosis of circulatory shock, (b) assessing the hemodynamic status including the identification of therapeutic conflicts, and (c) guiding therapeutic interventions. We propose two algorithms for hemodynamic management using transpulmonary thermodilution-derived variables aiming to optimize the cardiocirculatory and pulmonary status in adult ICU patients with septic shock. The complexity and heterogeneity of patients with septic shock implies that individualized approaches for hemodynamic management are mandatory. Defining individual hemodynamic target values for patients with septic shock in different phases of the disease must be the focus of future studies.

  1. 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.

  2. 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

  3. 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...

  4. Broad spectrum moderators and advanced reflector filters using 208Pb

    DEFF Research Database (Denmark)

    Schönfeldt, Troels; Batkov, K.; Klinkby, Esben Bryndt

    2015-01-01

    thermalizing property of 208Pb to design a broad spectrum moderator, i.e. a moderator which emits thermal and cold neutrons from the same position. Using 208Pb as a reflector filter material is shown to be slightly less efficient than a conventional beryllium reflector filter. However, when surrounding...... the reflector filter by a cold moderator it is possible to regain the neutrons with wavelengths below the Bragg edge, which are suppressed in the beryllium reflector filter. In both the beryllium and lead case surrounding the reflector filter with a cold moderator increases the cold brightness significantly...

  5. 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.

  6. Managing dual color properties with the Z-parameter in the visual and NIR spectrum

    Science.gov (United States)

    Žiljak, Vilko; Pap, Klaudio; Žiljak Stanimirović, Ivana; Žiljak Vujić, Jana

    2012-07-01

    In this paper value Z is introduced into the physics of describing material light absorption in the sub-area of the near infrared (NIR) spectrum ranging from 1000 nm to 1100 nm. This value is added to the standard parameters for color description for managing dual color properties. The basic challenge is in grouping together the infrared technology of manipulation with inks and ink characteristics in the visible spectrum (VS) in order to design new inks, with the goal to create hidden, invisible and double information. The value Z is the numerical value of absorption in the NIR-Z spectrum from matter, ink and pigments, as well as from flora and fauna. It is introduced into standard colorimetric defined by three parameters (CIELab, RGB, HSB) as the fourth value with the assertion that there is no correlation between them and parameter Z. It has been proven experimentally that if there is a default fourth value Z, the desired ink color can be set in the visible spectrum in a single manner only. The significance of the four-parameter color LabZ (RGBZ, HSBZ) system is in the new approach to application of spot inks and pigments in visual arts (paintings), industrial and military application, as well as in security graphics designed with printing technologies.

  7. 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…

  8. Advances in Global Modelling of Methyl Mercaptan CH_{3}^{32}SH Torsion-Rotation Spectrum

    Science.gov (United States)

    Ilyushin, V.; Armieieva, Iuliia; Zakharenko, Olena; Müller, Holger S. P.; Lewen, Frank; Schlemmer, Stephan; Xu, Li-Hong; Lees, Ronald M.

    2017-06-01

    A progress in the analysis of the methyl mercaptan CH_{3}SH spectrum in its ground, first and second excited torsional states is reported. The available in the literature data were reanalyzed using RAM36 code with the main improvement achieved for the root mean square deviation of the microwave data. The updated Hamiltonian model was applied to the further assignments of the methyl mercaptan spectrum using the records obtained in the THz region in the previous study^{b} . Also a new measurement campaign in subTHz frequency range is planned for the nearest future using a set of spectrometers available in Köln. In the talk the details of this new study will be discussed. This work was done under support of the Volkswagen foundation. The assistance of Science and Technology Center in Ukraine is acknowledged (STCU partner project P686). L.-H. Xu, R. M. Lees, G. T. Crabbe, J. A. Myshrall, H. S. P. Müller, C. P. Endres, O. Baum, F. Lewen, S. Schlemmer, K. M. Menten, and B. E. Billinghurst J. Chem. Phys. 137, 104313 (2012). V. Ilyushin, Z. Kisiel, L. Pszczólkowski, H. Mäder, J. T. Hougen J. Mol. Spectrosc. Vol. 259, pp. 26-38 (2010).

  9. 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.

  10. Advanced vulvar carcinoma: is it worth operating? A perioperative management protocol for radical and reconstructive surgery.

    Science.gov (United States)

    Fanfani, Francesco; Garganese, Giorgia; Fagotti, Anna; Lorusso, Domenica; Gagliardi, Maria Lucia; Rossi, Marco; Salgarello, Marzia; Scambia, Giovanni

    2006-11-01

    The aim of this study was to characterize the means whereby the results could be improved and the morbidity and side-effects minimized, of radical and extensive surgery performed together with plastic reconstruction, in the treatment of locally advanced and relapsed vulvar carcinoma. Between May 2000 and November 2004, twenty-three patients with locally advanced or relapsed vulvar carcinoma underwent major radical or extended vulvectomy, requiring reconstructive surgery. A consistent protocol for the perioperative management of these patients, including precautionary measures to reduce the rate of early complications, was introduced in the second study period (from November 2003) to verify the benefit on surgical outcome. An analysis of the medical reports showed an improvement in the median time of the postoperative course and related morbidity as a consequence of a strict application of the management protocol, with consequent decrease of early complications. Reconstructive surgery, which broadens the spectrum of available operative therapy in primary and locally recurrent vulvar cancer, is characterized by a high complication rate. The application of a strict perioperative protocol could reduce the number and the clinical impact of such complications.

  11. The Worst-Case Interference in DSL Systems Employing Dynamic Spectrum Management

    Directory of Open Access Journals (Sweden)

    Brady Mark H

    2006-01-01

    Full Text Available Dynamic spectrum management (DSM has been proposed to achieve next-generation rates on digital subscriber lines (DSL. Because the copper twisted-pair plant is an interference-constrained environment, the multiuser performance and spectral compatibility of DSM schemes are of primary concern in such systems. While the analysis of multiuser interference has been standardized for current static spectrum-management (SSM techniques, at present no corresponding standard DSM analysis has been established. This paper examines a multiuser spectrum-allocation problem and formulates a lower bound to the achievable rate of a DSL modem that is tight in the presence of the worst-case interference. A game-theoretic analysis shows that the rate-maximizing strategy under the worst-case interference (WCI in the DSM setting corresponds to a Nash equilibrium in pure strategies of a certain strictly competitive game. A Nash equilibrium is shown to exist under very mild conditions, and the rate-adaptive waterfilling algorithm is demonstrated to give the optimal strategy in response to the WCI under a frequency-division (FDM condition. Numerical results are presented for two important scenarios: an upstream VDSL deployment exhibiting the near-far effect, and an ADSL RT deployment with long CO lines. The results show that the performance improvement of DSM over SSM techniques in these channels can be preserved by appropriate distributed power control, even in worst-case interference environments.

  12. Advanced Pulse Oximetry System for Remote Monitoring and Management

    Directory of Open Access Journals (Sweden)

    Ju Geon Pak

    2012-01-01

    Full Text Available 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.

  13. 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

  14. 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.

  15. Advances in photonics thermal management and packaging materials

    Science.gov (United States)

    Zweben, Carl

    2008-02-01

    Heat dissipation, thermal stresses, and cost are key packaging design issues for virtually all semiconductors, including photonic applications such as diode lasers, light-emitting diodes (LEDs), solid state lighting, photovoltaics, displays, projectors, detectors, sensors and laser weapons. Heat dissipation and thermal stresses affect performance and reliability. Copper, aluminum and conventional polymeric printed circuit boards (PCBs) have high coefficients of thermal expansion, which can cause high thermal stresses. Most traditional low-coefficient-of-thermal-expansion (CTE) materials like tungsten/copper, which date from the mid 20 th century, have thermal conductivities that are no better than those of aluminum alloys, about 200 W/m-K. There are an increasing number of low-CTE materials with thermal conductivities ranging between that of copper (400 W/m-K) and 1700 W/m-K, and many other new low-CTE materials with lower thermal conductivities. An important benefit of low-CTE materials is that they allow use of hard solders. Some advanced materials are low cost. Others have the potential to be low cost in high-volume production. High-thermal-conductivity materials enable higher power levels, potentially reducing the number of required devices. Advanced thermal materials can constrain PCB CTE and greatly increase thermal conductivity. This paper reviews traditional packaging materials and advanced thermal management materials. The latter provide the packaging engineer with a greater range of options than in the past. Topics include properties, status, applications, cost, using advanced materials to fix manufacturing problems, and future directions, including composites reinforced with carbon nanotubes and other thermally conductive materials.

  16. AMCP Partnership Forum: Driving New Advances in Dyslipidemia Management.

    Science.gov (United States)

    2016-04-01

    Proprotein convertase subtilisin kexin 9 (PCSK9) inhibitors are specialty medications approved for the treatment of dyslipidemia. Because dyslipidemia is a prevalent and chronic condition, the costs associated with PCSK9 inhibitors must be carefully weighed against the benefits that they provide. However, the long-term clinical benefits of these agents are not yet fully defined, creating a complex situation for third-party payers who must determine how to allocate limited resources. To engage national stakeholders in a discussion of how to wisely use PCSK9 inhibitors in health care, the Academy of Managed Care Pharmacy organized a forum in Washington, DC, on September 16, 2015. The forum began with presentations reviewing the current environment for dyslipidemia treatment. Following these presentations, participants engaged in discussions regarding how to best select patients for treatment based on current treatment guidelines, how managed care pharmacy can best manage high-cost specialty products that may be indicated for large numbers of patients, and how managed care organizations can use real-world evidence to assess the impact of evolving treatment guidelines and options. Participants called for the development of a national database to gather more meaningful data regarding the impact of PCSK9 inhibitors on clinical outcomes. Such a database would be invaluable for determining the real-world impact of specialty medications and would support the development of sensible third-party payer benefit structures, coverage decisions, medical policies, and risk-sharing contracts. In the meantime, participants recommended enhanced collaboration among stakeholders for improved information sharing, increased collection and evaluation of real-world evidence, use of available cost-effectiveness analyses, and the implementation of strategies that optimize the use of evidence-based therapies. The AMCP Partnership Forum on Driving New Advances in Dyslipidemia Management and the

  17. 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

  18. 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

  19. 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.

  20. 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.

  1. 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)

  2. Advances in the Research of Melatonin in Autism Spectrum Disorders: Literature Review and New Perspectives

    Directory of Open Access Journals (Sweden)

    Guillaume Bronsard

    2013-10-01

    Full Text Available Abnormalities in melatonin physiology may be involved or closely linked to the pathophysiology and behavioral expression of autistic disorder, given its role in neurodevelopment and reports of sleep-wake rhythm disturbances, decreased nocturnal melatonin production, and beneficial therapeutic effects of melatonin in individuals with autism. In addition, melatonin, as a pineal gland hormone produced from serotonin, is of special interest in autistic disorder given reported alterations in central and peripheral serotonin neurobiology. More specifically, the role of melatonin in the ontogenetic establishment of circadian rhythms and the synchronization of peripheral oscillators opens interesting perspectives to ascertain better the mechanisms underlying the significant relationship found between lower nocturnal melatonin excretion and increased severity of autistic social communication impairments, especially for verbal communication and social imitative play. In this article, first we review the studies on melatonin levels and the treatment studies of melatonin in autistic disorder. Then, we discuss the relationships between melatonin and autistic behavioral impairments with regard to social communication (verbal and non-verbal communication, social interaction, and repetitive behaviors or interests with difficulties adapting to change. In conclusion, we emphasize that randomized clinical trials in autism spectrum disorders are warranted to establish potential therapeutic efficacy of melatonin for social communication impairments and stereotyped behaviors or interests.

  3. 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.

  4. 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...

  5. 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.).

  6. Advances in the management of basal cell carcinoma

    Science.gov (United States)

    Carucci, John A.

    2015-01-01

    Basal cell carcinoma (BCC), a malignant neoplasm derived from non-keratinizing cells that originate in the basal layer of the epidermis, is the most common cancer in humans. Several factors such as anatomic location, histologic features, primary or recurrent tumors, and patient characteristics influence the choice of treatment modality for BCC. Mohs micrographic surgery (MMS) facilitates optimal margin control and conservation of normal tissue for the management of BCC; however, other treatment modalities may also be implemented in the correct clinical scenario. Other treatment modalities that will be reviewed include simple excision, electrodesiccation and curettage, cryotherapy, topical immunotherapy and chemotherapy, photodynamic therapy, and radiation therapy. In addition, targeted molecular therapeutic options for the treatment of advanced or metastatic BCC will be discussed in this informal review based on recent literature obtained by using PubMed with relevant search terms. PMID:26097726

  7. 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.).

  8. Clinical Spectrum, Therapeutic Options, and Outcome of Advanced Heart Failure in Hypertrophic Cardiomyopathy.

    Science.gov (United States)

    Pasqualucci, Daniele; Fornaro, Alessandra; Castelli, Gabriele; Rossi, Alessandra; Arretini, Anna; Chiriatti, Chiara; Targetti, Mattia; Girolami, Francesca; Corda, Marco; Orrù, Pierpaolo; Matta, Gildo; Stefàno, Pierluigi; Cecchi, Franco; Porcu, Maurizio; Olivotto, Iacopo

    2015-11-01

    The clinical course of patients with hypertrophic cardiomyopathy and advanced heart failure (HF) subtended by progressive left ventricular dysfunction has received limited attention. Our aim was to assess the outcome of HF and impact of treatment options including the implantable cardioverter-defibrillator and heart transplantation (HT) in patients with hypertrophic cardiomyopathy evaluated at 2 Italian referral centers >3 decades. All-cause mortality and a combined end point including death, HT, or appropriate implantable cardioverter-defibrillator shock were assessed in 71 consecutive patients with HF not related to outflow obstruction (7% of the entire hypertrophic cardiomyopathy cohort) followed up for 6.1±6.9 years after development of New York Heart Association class III to IV symptoms. At enrollment, left ventricular ejection fraction was 50% in 16; all had restrictive left ventricular filling. During follow-up, 35 patients died (49%%; 5-year rate, 49%) and 53 met the combined end point (75%; 5-year rate, 62%). Most events occurred in the 3 years after HF onset (17% per year compared with only 3% per year subsequently). Appropriate implantable cardioverter-defibrillator shocks occurred in 11 of 34 implanted patients. Of 37 patients evaluated for HT, 14 were transplanted, 10 listed, and 13 excluded; 2 early post-HT deaths occurred in patients with elevated pulmonary vascular resistance. Eleven of the 14 HT patients were alive at 10±8 years. In hypertrophic cardiomyopathy, advanced HF not associated with outflow obstruction portends a severely unfavorable prognosis, particularly in the first 3 years after onset of symptoms, despite frequently preserved systolic function in about one quarter of the patients. Outcome of HT is favorable but requires early consideration, as the window of opportunity may be short. © 2015 American Heart Association, Inc.

  9. 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

  10. The Spectrum of Caregiving in Palliative Care for Serious, Advanced, Rare Diseases: Key Issues and Research Directions

    Science.gov (United States)

    Miller, Jeri L.; Grady, Patricia A.

    2016-01-01

    Abstract Rare diseases are often life-limiting conditions, the majority of which require constant caregiving needs. The realization of a spectrum of palliative care throughout the trajectory of rare diseases could ensure individualized and caregiver-focused approaches to the care of patients and families. In June 2015, the National Institute of Nursing Research (NINR), the lead institute at the National Institutes of Health for end-of-life research, in conjunction with the National Center for Advancing Translational Sciences, Office of Rare Diseases Research (ORDR) held an interdisciplinary workshop on the unique challenges of caregiving and palliative care in adult and pediatric rare diseases. The panel identified gaps in current knowledge, and afforded suggestions for research opportunities in palliative care science to improve the care of individuals with serious, advanced, rare diseases and their caregivers. This meeting provided an in-depth opportunity to incorporate new concepts into palliative and end-of-life care for individuals with a range of rare diseases and their caregivers. This report presents a summary of the workshop. PMID:27249541

  11. Behavioural aspects of patients with Autism Spectrum Disorders (ASD) that affect their dental management.

    Science.gov (United States)

    Limeres-Posse, Jacobo; Castaño-Novoa, Patricia; Abeleira-Pazos, Maite; Ramos-Barbosa, Isabel

    2014-09-01

    Dental treatment in patients with Autism Spectrum Disorders (ASD) can be complicated due to the presence of behavioral alterations. In this group, there are no specific behavioral profiles that allow dentist to anticipate the attitude that a patient will show during a visit. Thus, behavioral attitudes have been described that vary from total permissiveness and collaboration during even bloody procedures, to the absolute impossibility in conducting a simple oral examination. There is no effective behavioral management technique for all ASD patients. Prior information, such as the type of ASD or the presence of certain concurrent pathologies can help predict the patient's likely behavior. Therefore, gathering all the information in a preliminary interview with the parents/guardians of the patient is recommended. Knowing these factors will allow individualized behavioral management strategies to be designed and facilitates the planning of dental treatment.

  12. 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.

  13. Pharmacological management of persistent hostility and aggression in persons with schizophrenia spectrum disorders: a systematic review.

    Science.gov (United States)

    Victoroff, Jeff; Coburn, Kerry; Reeve, Alya; Sampson, Shirlene; Shillcutt, Samuel

    2014-01-01

    The incidence of aggressive behaviors is higher among persons with schizophrenia spectrum disorders (SSDs) than among persons without such disorders. This phenomenon represents a risk to the well-being of patients, their families, and society. The authors undertook a systematic review of the English language literature to determine the efficacy of neuropharmacological agents for the management of hostility and aggression among persons with SSDs. The search combined findings from the Medline, EMBASE, and PsycINFO databases. Ninety-two full text articles were identified that reported relevant findings. The American Academy of Neurology criteria were used to determine levels of evidence. Paliperidone-extended release is probably effective for the management of hostility among inpatients with SSDs who have not been preselected for aggression (Level B). Clozapine is possibly more effective than haloperidol for the management of overt aggression and possibly more effective than chlorpromazine for the management of hostility among inpatients with SSDs who have not been preselected for aggression (Level C). Clozapine is also possibly more effective than olanzapine or haloperidol for reducing aggression among selected physically assaultive inpatients (Level C). Adjunctive propranolol, valproic acid, and famotidine are possibly effective for reducing some aspects of hostility or aggression among inpatients with SSDs (Level C). Paliperidone-extended release currently appears to be the agent for the management of hostility among inpatients with SSDs for which there is the strongest evidence of efficacy.

  14. 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.

  15. The 1977 WARC on broadcasting satellites - Spectrum management aspects and implications

    Science.gov (United States)

    Gould, R. G.; Reinhart, E. E.

    1977-01-01

    Broadcasting satellites are allocated as a primary service in the band 11.7-12.2 GHz (11.7-12.5 GHz in Europe, Africa, and the USSR), but the band is also allocated on a primary basis (equal sharing) to other services - fixed, mobile, broadcasting, and fixed satellite. Presented with these difficult sharing situations, delegates from over 100 countries met at an ITU World Administrative Radio Conference in 1977 to develop a plan for broadcasting satellites. Many nations wanted a plan that would assign to them now, reserved orbital locations and channel asignments for their future use. Other countries wanted a plan adopted now for future broadcasting satellites which assigned specific channels to specific areas on the ground so that they could use the remaining frequencies to provide terrestrial service right away. This paper describes the 'Plan' developed at the conference and points out how the principles of spectrum management were employed. It also discusses the implications for future international management of the spectrum growing out of this meeting.

  16. 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

  17. 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.

  18. 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.

  19. 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.

  20. Studies, Summary Tables, and Data Related to the Advancing Sustainable Materials Management Report

    Science.gov (United States)

    This webpage provides further information about how EPA measures data for the annual Advancing Materials Management Report. Researchers can use the tables and studies to better understand how waste in managed in America

  1. Michigan Department of Transportation statewide advanced traffic management system (ATMS) procurement evaluation - phase I : software procurement.

    Science.gov (United States)

    2009-04-01

    This project evaluates the process that was followed by MDOT and other stakeholders for the acquisition : of new Advanced Traffic Management System (ATMS) software aiming to integrate and facilitate the : management of various Intelligent Transportat...

  2. 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.

  3. 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.

  4. 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

  5. Recent advances in diagnosis and management of Mycotic Keratitis.

    Science.gov (United States)

    Maharana, Prafulla K; Sharma, Namrata; Nagpal, Ritu; Jhanji, Vishal; Das, Sujata; Vajpayee, Rasik B

    2016-05-01

    Mycotic keratitis is a major cause of corneal blindness, especially in tropical and subtropical countries. The prognosis is markedly worse compared to bacterial keratitis. Delayed diagnosis and scarcity of effective antifungal agents are the major factors for poor outcome. Over the last decade, considerable progress has been made to rapidly diagnose cases with mycotic keratitis and increase the efficacy of treatment. This review article discusses the recent advances in diagnosis and management of mycotic keratitis with a brief discussion on rare and emerging organisms. A MEDLINE search was carried out for articles in English language, with the keywords, mycotic keratitis, fungal keratitis, emerging or atypical fungal pathogens in mycotic keratitis, investigations in mycotic keratitis, polymerase chain reaction in mycotic keratitis, confocal microscopy, treatment of mycotic keratitis, newer therapy for mycotic keratitis. All relevant articles were included in this review. Considering the limited studies available on newer diagnostic and therapeutic modalities in mycotic keratitis, case series as well as case reports were also included if felt important.

  6. Locally advanced prostate cancer: the role of surgical management.

    Science.gov (United States)

    Stratton, Kelly L; Chang, Sam S

    2009-08-01

    Among the heterogeneous population of patients with prostate cancer, a high-risk group with locally advanced prostate cancer (LAPC) present a diagnostic and therapeutic dilemma. Although the incidence of LAPC has decreased with screening since the introduction of prostate-specific antigen (PSA) testing, significantly many patients are still diagnosed with LAPC. These patients are by definition at higher risk of metastatic disease and worse outcomes. The role of radical prostatectomy (RP) in this population has been debated, as the combination of radiotherapy and hormonal therapy is becoming used more frequently for LAPC. Unfortunately, the clinical staging and evaluation of LAPC is a challenge that results in possibly understaging or overstaging these patients. This further complicates therapeutic decision-making, and as a result no established standard treatment has been proposed. Like other patients with prostate cancer, individualized therapeutic choices are essential and depend on a multitude of factors. Herein we examine the role of RP for managing LAPC and attempt to emphasize how the risk of distant disease and difficulty with clinical staging might favour incorporating a surgical approach as part of the therapy for patients with LAPC.

  7. 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.

  8. 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

  9. 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

  10. [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.

  11. 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)

  12. 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.

  13. 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.

  14. Management of constipation in children and adolescents with autism spectrum disorders.

    Science.gov (United States)

    Furuta, Glenn T; Williams, Kent; Kooros, Koorosh; Kaul, Ajay; Panzer, Rebecca; Coury, Daniel L; Fuchs, George

    2012-11-01

    To develop a practical, readily applied algorithm for primary health care providers to identify, evaluate, and manage constipation in children with autism spectrum disorders (ASDs). The Gastroenterology Committee of the Autism Speaks Autism Treatment Network (ATN), a multisite consortium of centers dedicated to improving standards of medical care for children with ASDs, guided the development of the constipation algorithm through expert opinion and literature review. The algorithm was finalized based on results of field testing by nongastrointestinal, ATN autism medical specialists at 4 ATN sites. A systematic review and grading of the literature pertaining to constipation and children with ASDs was also performed. Consensus among the ATN Gastroenterology Committee identified that in children with ASDs, (1) subtle or atypical symptoms might indicate the presence of constipation; (2) screening, identification, and treatment through a deliberate approach for underlying causes of constipation is appropriate; (3) diagnostic-therapeutic intervention can be provided when constipation is documented; and (4) careful follow-up after any intervention be performed to evaluate effectiveness and tolerance of the therapy. Literature review revealed limited evidence for the clinical evaluation or treatment strategies of children with ASD and constipation. Constipation and its underlying etiology have the potential to be effectively identified and managed using a systematic approach. Lack of evidence on this topic in the literature emphasizes the need for research.

  15. 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

  16. Mining the HST "Advanced Spectral Library (ASTRAL) - Hot Stars": The High Definition UV Spectrum of the Ap Star HR 465

    Science.gov (United States)

    Carpenter, Kenneth G.; Ayres, T. R.; Nielsen, K. E.; Kober, G. V.; Wahlgren, G. M.; Adelman, S. J.; Cowley, C. R.

    2014-01-01

    The "Advanced Spectral Library (ASTRAL) Project: Hot Stars" is a Hubble Space Telescope (HST) Cycle 21 Treasury Program (GO-13346: Ayres PI). It is designed to collect a definitive set of representative, high-resolution ( 30,000-100,000), high signal/noise (S/N>100), and full UV coverage 1200 - 3000 A) spectra of 21 early-type stars, utilizing the high-performance Space Telescope Imaging Spectrograph (STIS). The targets span the range of spectral types between early-O and early-A, including both main sequence and evolved stars, fast and slow rotators, as well as chemically peculiar (CP) and magnetic objects. These extremely high-quality STIS UV echelle spectra will be available from the HST archive and, in post-processed and merged form, at http://casa.colorado.edu ayres/ASTRAL/. The UV "atlases" produced by this program will enable investigations of a broad range of problems -- stellar, interstellar, and beyond -- for many years to come. We offer a first look at one of the earliest datasets to come out of this observing program, a "high definition" UV spectrum of the Ap star HR 465, which was chosen as a prototypical example of an A-type magnetic CP star. HR 465 has a global magnetic field of ~2200 Gauss. Earlier analyses of IUE spectra show strong iron-peak element lines, along with heavy elements such as Ga and Pt, while being deficient in the abundance of some ions of low atomic number, such as carbon. We demonstrate the high quality of the ASTRAL data and present the identification of spectral lines for a number of elements. By comparison of the observed spectra with calculated spectra, we also provide estimates of element abundances, emphasizing heavy elements, and place these measurements in the context of earlier results for this and other Ap stars.

  17. 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.

  18. 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.

  19. 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

  20. 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)

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

    Science.gov (United States)

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

    2015-01-01

    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 best established psychopharmacological option for the treatment of irritability and behavioral problems in ASD. This article gives an overview of the pharmacokinetic profile of risperidone and a comprehensive review of treatment studies regarding the use of risperidone in ASD. Ample evidence supports the short-term use of risperidone for treating irritability and behavioral problems in ASD. Risperidone also shows promise in treating symptoms often associated with ASD, such as stereotypical behavior, social difficulties, hyperactivity and cognitive problems. However, several adverse effects have been identified; most are mild or moderate and well manageable, but weight gain and metabolic changes are a considerable concern. Therefore, risperidone should in our view be seen as 'a last resort', only justified for the short-term treatment of serious behavioral problems, which have failed to respond sufficiently to behavioral interventions. Future studies should investigate long-term effects of risperidone and factors that facilitate individual risk-benefit analyses before treatment.

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

    Science.gov (United States)

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

    2013-11-01

    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 the existing body of evidence. The MEDLINE database was searched using the terms 'Autistic Disorder', 'Behaviour Control/methods', 'Child', 'Dental care for disabled', 'Education', 'Oral Health', and 'Pediatric Dentistry' to locate related articles published up to January 2013. Most of the relevant studies indicate poor oral hygiene whereas they are inconclusive regarding the caries incidence in autistic individuals. Undergraduate dental education appears to determine the competence of dental professionals to treat developmentally disabled children and account partly for compromised access to dental care. Dental management of an autistic child requires in-depth understanding of the background of the autism and available behavioural guidance theories. The dental professional should be flexible to modify the treatment approach according to the individual patient needs.

  3. Asthma management guidelines: updates, advances, and new options.

    Science.gov (United States)

    Navarro, Robert P; Schaecher, Kenneth L; Rice, Gary K

    2007-08-01

    Asthma still poses a substantial and unacceptable health and economic burden. The National Asthma Education and Prevention Program (NAEPP) guidelines for the management of asthma continue to evolve based on emerging clinical data, improving the understanding of asthma and approaches to its management. To examine the clinical implications of current NAEPP guidelines for the diagnosis and treatment of asthma and the potential impact of the proposed 2007 guidelines update on asthma management. To examine the role of managed care organizations in fostering evidence-based asthma management. Current NAEPP guidelines recognize symptom control as the chief therapeutic target in the management of asthma. The proposed update to NAEPP guidelines places greater emphasis on symptom control by expanding its definition to not only include measures of impairment but also the risk for deteriorating pulmonary function, asthma exacerbations, and controller medication side effects. Although inhaled corticosteroids remain central to achieving long-term asthma control in both current and proposed guidelines, the latter offers greater treatment flexibility and recognizes combination therapy as a preferred choice for achieving control in many patients with moderate persistent asthma. Managed care organizations, primarily using disease management programs, provide impetus for the widespread adoption of evidence-based asthma treatment guidelines. Widespread adoption of evidence-based asthma management programs offers the opportunity for achieving and maintaining asthma control.

  4. Automated Contingency Management for Advanced Propulsion Systems, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Impact Technologies LLC, in cooperation the Georgia Institute of Technology, proposes to develop and demonstrate an innovative Automated Contingency Management (ACM)...

  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

    Background: 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. Objective: To describe and explore how people with advanced cancer manage occupations when living at home. Material and methods: 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. Results: Managing occupations were manifested in two main categories; 1) Conditions influencing...

  6. 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...

  7. 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...

  8. Management of Moderate Obstructive Sleep Apnea with Mandibular Advancement Device

    Directory of Open Access Journals (Sweden)

    Reena R Kumar

    2014-01-01

    Results: AHI reduced from 77 to 27 with cessation of snoring and daytime sleepiness with improved quality of life with MAD. Conclusion: This case report highlights the role of oral appliances in the management of mild to moderate noncompliant OSA cases. CPAP continues to be the gold standard for conservative management of OSA though patient compliance still remains uncertain.

  9. Advances in Operational Flood Risk Management in the Netherlands

    NARCIS (Netherlands)

    Wojciechowska, K.A.

    2015-01-01

    Operational flood risk management refers to activities that aim to reduce the probability and/or negative consequences of flooding just prior to the expected flood event. An inherent feature of operational flood risk management is that outcomes of decisions taken are uncertain. The main goal of this

  10. Advances in the management of cerebral malaria in adults

    DEFF Research Database (Denmark)

    Mishra, Saroj K; Wiese, Lothar

    2009-01-01

    into large clinical trials. SUMMARY: Advances have been made in terms of antiparasitic treatment, but the identification of a well tolerated and effective adjuvant treatment to increase survival and reduce brain damage is still pending. The search for new approaches is a major challenge, not least of which...

  11. 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 ...

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

    African Journals Online (AJOL)

    Caring for a patient with locally advanced breast cancer requires a multidisciplinary approach, whether cure or palliation. Patient expectations need to be discussed, while alternative and holistic approaches help to reinforce the patient's belief that their decision regarding care is correct. It is important to recognise that a ...

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

    African Journals Online (AJOL)

    Locally advanced breast cancer (LABC) comprises a heterogenous group of diseases, which incorporates a subset of stage IIB (T3N0) disease, stage III disease and inflammatory breast cancer (IBC) (Fig. 1). In the developed world, based on data from the Surveillance,. Epidemiology, and End Results (SEER). Program of ...

  14. 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…

  15. 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.

  16. 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…

  17. 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.

  18. 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.

  19. Automated Contingency Management for Advanced Propulsion Systems Project

    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,...

  20. 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...

  1. 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,...

  2. 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.

  3. Recent advances in wearable sensors for animal health management

    OpenAIRE

    Suresh Neethirajan

    2017-01-01

    Biosensors, as an application for animal health management, are an emerging market that is quickly gaining recognition in the global market. Globally, a number of sensors being produced for animal health management are at various stages of commercialization. Some technologies for producing an accurate health status and disease diagnosis are applicable only for humans, with few modifications or testing in animal models. Now, these innovative technologies are being considered for their future u...

  4. 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

  5. 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.

  6. 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.

  7. 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

  8. 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.

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

    DEFF Research Database (Denmark)

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

    university hospital. Qualitative interviews were performed in the participant’s homes. Interviews were audio recorded and transcribed verbatim. Information on demographic and use of social service was included. Thematic and content analysis were performed. Results: The analysis resulted in a core category......Background: People with advanced cancer are increasingly able to live for extended periods of time. Advanced cancer influences the ability to manage occupations in the everyday life. Although studies have showed that people with advanced cancer experience occupational difficulties......, there are limited research that more specifically explore how these are managed. The objective was to describe and explore how people with advanced cancer manage occupations at home. Material and methods: A qualitative descriptive design was applied. 73 participants were consecutively recruited from a Danish...

  10. Advances in the endoscopic management of gastric outflow disorders.

    Science.gov (United States)

    Storm, Andrew C; Ryou, Marvin

    2017-11-01

    Disorders of gastric outflow and outlet obstruction include a variety of benign and malignant disorders such as peptic strictures, foreign bodies, gastroparesis, and cancers of the stomach, duodenum, and pancreas. Historically, a majority of patients presenting with gastric outlet obstruction (GOO) were to the result of peptic ulcers and surgical management of peptic ulcer complications was a mainstay of general surgical training. Invasive surgery is being performed less frequently today due to realization of the role of Helicobacter pylori in peptic ulcer disease and the introduction of novel endoscopic techniques for management of GOO. For malignant GOO, the introduction of lumen-apposing metal stents have opened the door for the development and performance of endoscopic ultrasound-guided gastric bypass procedures. For benign GOO, including gastroparesis and pyloric stenosis, endoscopic myotomy shows promise. Endoscopic ultrasound-guided gastric bypass, per-oral endoscopic myotomy, and other novel techniques in the endoscopic management of GOO, are discussed in this review.

  11. [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.

  12. Advances in the diagnosis and management of lymphoma

    Directory of Open Access Journals (Sweden)

    Matasar MJ

    2012-02-01

    Full Text Available Zachary H Word1, Matthew J Matasar1,21Lymphoma Service, Department of Medicine, Memorial Sloan–Kettering Cancer Center, 2Department of Medicine, New York Presbyterian Hospital, New York, NY, USAAbstract: The lymphomas are a heterogeneous group of cancers that have played a prominent role in the history of oncology, being among the first cancers to respond to radiotherapy or systemic chemotherapy. Progressive improvement in the understanding of the biology and natural history of these diseases has led to changes in both classification and management. Because of the heterogeneity present among the lymphomas, accurate diagnosis and staging are essential prerequisites to their effective management. Lymphoma stage frequently informs treatment decisions, but in contrast with solid tumor malignancies carries limited prognostic value. This has led to the development of prognostic models in lymphoma, which use patient and disease characteristics to stratify patients by risk. Modern approaches to Hodgkin's lymphoma include chemotherapy only, combined-modality therapy with both chemotherapy and radiotherapy, and risk-adapted approaches that modify treatment based on initial response. Management of non-Hodgkin's lymphoma (NHL varies widely depending upon histology. Use of rituximab, the anti-CD20 monoclonal antibody, is included in the management of most B cell lymphomas and has improved outcomes in these diseases. The T cell lymphomas are less common and generally less well understood than the B cell diseases, and their management has only recently become disease-specific. Though effective therapy is available for many types of lymphoma, relapse remains common in a number of subtypes, and management of relapsed and refractory disease remain research priorities.Keywords: lymphoma, diagnosis, treatment

  13. 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.

  14. 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

  15. 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.

  16. 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

  17. 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.

  18. Recent advances in dengue pathogenesis and clinical management.

    Science.gov (United States)

    Simmons, Cameron P; McPherson, Kirsty; Van Vinh Chau, Nguyen; Hoai Tam, D T; Young, Paul; Mackenzie, Jason; Wills, Bridget

    2015-12-10

    This review describes and commentates on recent advances in the understanding of dengue pathogenesis and immunity, plus clinical research on vaccines and therapeutics. We expand specifically on the role of the dermis in dengue virus infection, the contribution of cellular and humoral immune responses to pathogenesis and immunity, NS1 and mechanisms of virus immune evasion. Additionally we review a series of therapeutic intervention trials for dengue, as well as recent clinical research aimed at improving clinical diagnosis, risk prediction and disease classification. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. 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.

  20. 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 ...

  1. Advancing in software product management: An incremental method engineering approach

    NARCIS (Netherlands)

    van de Weerd, I.

    2009-01-01

    Hardly any figures exist on the success of product software companies. What we do know is that a good Software Product Management (SPM) practice pays off. However, not many IT-professionals know how to implement SPM practices in their organization, which causes many companies to not have the proper

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

    African Journals Online (AJOL)

    This has led to the philosophy of “watch and intervene from ischaemie damage. Thrombolytic therapy given within 3 hours of ictus has been effective but this is not feasible in Africa because of time delay and lack of neuro-imaging facilities in most centers. Contemporary management of stroke is divided into 4 phases; acute, ...

  3. 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...

  4. Advances in Service and Operations for ATLAS Data Management

    CERN Document Server

    Stewart, GA; The ATLAS collaboration

    2011-01-01

    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, 55PB 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 to 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 service, which measures usage of data across ATLAS. - Space monitoring and accounting at sites. - Automated blacklisting service. - Cleaning agents, which trigger deletion of unused data at sites. - Deletion agents, to reliably delete unwanted data from sites. We describe the experience of data management operation in ATLAS computing, showing how these serv...

  5. Recent advances in the management of Crohn's disease.

    Science.gov (United States)

    Caprilli, R; Angelucci, E; Clemente, V

    2008-09-01

    In the last 10 years many advances have been achieved in the treatment of patients with Crohn's disease, particularly in the field of biological agents. Infliximab, a tumour necrosis factor alpha antagonist, has been recently added to the therapeutic armamentarium for Crohn's disease and has greatly improved our treatment options. Infliximab has demonstrated efficacy in the induction and maintenance of remission in luminal and fistulizing Crohn's disease both in adults and children. However, the potential development of autoantibodies and the risk of serious adverse events limit the possibility of a wider use of infliximab. Searching for less immunogenicity and higher effectiveness in the last years a number of biological agents have been developed. Adalimumab, a fully human monoclonal antibody anti tumour necrosis factor alpha, has resulted effective and safe in patients with Crohn's disease, both naive and refractory to infliximab, presenting also the advantage of subcutaneous way of administration. Natalizumab also showed promising results in terms of efficacy but its safety is still under investigation. To date no particular advances have been recently appeared in the literature concerning conventional immunosuppressive drugs. Surgery remains a valid resort for refractory patients. Autologous stem cell transplantation represents a new hope as rescue treatment for patients with severe refractory Crohn's disease.

  6. Advances in Understanding and Managing Rosacea: Part 1

    Science.gov (United States)

    2012-01-01

    Rosacea is a common inflammatory facial dermatoses affecting primarily adults with fair skin, although all skin types may be affected. The diagnostic term “rosacea” reflects a spectrum of clinical features with the more common presentations characterized by increased blood flow and vasodilation during disease flares, which accentuate central facial erythema. Inflammatory lesions, usually papules and/or pustules are present in some cases. Variations in magnitude of the associated features of rosacea are noted clinically. Over time, other clinical features emerge or may be further accentuated, such as diffuse facial erythema and telangiectasias, as fixed changes in cutaneous vasculature occur. These later findings account for persistent diffuse facial erythema usually accentuated centrally on the inner cheeks, chin, nose, and/or medial forehead. Some patients may also develop phymatous changes and/or have concurrent ocular rosacea. Augmented innate immune response to certain triggers (often exogenous) and neurovascular/neuroimmune dysregulation appear to be involved early in the pathophysiological sequence of cutaneous rosacea and appear to signal other downstream inflammatory or physiochemical cascades that contribute to the pathogenesis of the disorder. In this article, Part 1 of a two-part series, emphasis is placed upon the correlation of clinical features and underlying pathophysiological changes in the more common presentations of rosacea encountered by the clinician. The importance of this information is that some of these pathogenic mechanisms are modulated by available therapies, and others remain as targets for the development of new therapeutic agents or modalities. PMID:22468176

  7. Controversies and advances in the management of congenital ptosis

    Science.gov (United States)

    Mokhtarzadeh, Ali; Harrison, Andrew R

    2015-01-01

    The management issues associated with pediatric ptosis begin with determining the etiology of the ptosis, and considering how the eyelid position affects the child’s visual and psychosocial development. These ultimately determine if and when surgical management should be undertaken. Surgical challenges include the lack of intraoperative feedback regarding the dynamic eyelid height and contour under general anesthesia. When the eyelid elevators do not function or if there is little drive to lift the involved eyelid, obtaining good surgical outcomes can be extremely challenging. A plethora of surgical techniques and materials have been developed, each with their own benefits and drawbacks. Careful preoperative evaluation, planning and counseling can usually result in satisfactory surgical results with happy parents and patients. Families should always be aware that the child will need to be followed long term for visual development, ocular health, and they need to be counseled regarding the possibility of revision surgery. PMID:26925157

  8. 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.

  9. 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...

  10. 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...

  11. Building a multicenter telehealth network to advance chronic disease management.

    Science.gov (United States)

    Khairat, Saif; Wijesinghe, Namal; Wolfson, Julian; Scott, Rob; Simkus, Ray

    2014-01-01

    The use of telehealth solutions has proved to improve clinical management of chronic diseases, expand access to healthcare services and clinicians, and reduce healthcare-related costs. The project aims at improving Heart Failure (HF) management through the utilization of a Telemedicine and Personal Health Records systems that will assist HF specialist in Colombo, Sri Lanka to monitor and consult with remote HF patients. A telehealth network will be built at an international site that connects five remote telehealth clinics to a central clinic at a major University Hospital in Sri Lanka where HF specialists are located. In this study, 200 HF patients will be recruited for nine months, 100 patients will be randomly selected for the treatment group and the other 100 will be selected for the control group. Pre, mid, and post study surveys will be conducted to assess the efficacy and satisfaction levels of patients with both care models. Moreover, clinical outcomes will be collected to evaluate the impact of the intervention on the treatment patients compared to control patients. The research aims at enhancing Heart Failure management through eliminating current health challenges and healthcare-related financial burdens.

  12. 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.

  13. Advances in Service and Operations for ATLAS Data Management

    CERN Document Server

    Stewart, G A; The ATLAS collaboration; Lassnig, M; Molfetas, A; Baristis, M; Zhang, D; Calvet, I; Beermann, T; Barreiro Megino, F; Tykhonov, A; Campana, S; Serfon, C; Oleynik, O; Petrosyan, A

    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: egin{itemize} item hspace{2mm} Popularity service, which measures usage of data across ATLAS. item hspace{2mm} Space monitoring and accounting at sites. item hspace{2mm} Automated exclusion service. item hspace{2mm} Cleaning agents, which trigger deletion of unused data at sites. item hspace{2mm} Deletion agents, to reliably delete unwanted data from sites. end{itemize} We...

  14. Advanced age, constipation, depression: what are the ways of management?

    Directory of Open Access Journals (Sweden)

    N. P. Chernus

    2013-01-01

    Full Text Available Constipation is one of the key problems of modern therapy for elderly people. The research aim was to study the features of the psychological and microbiological status of the advanced and senile age patients with functional constipation and to see the effect of educational programmes on compliance of the patients with the therapy in the out!patient departments. The investigation showed that depression was more frequent in the patients of group 1 (68.4 % of the cases with compensated function of the large gut whereas in the 2nd group – 34.6 % (compensated and in the 3rd group – 41.5 % (subcompensatedcases. The 3rd degree dysbiosis was found in all patoents irrespective of the extern of disorder of the motor!kinetic function in the large gut.

  15. 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…

  16. Principled negotiation and distributed optimization for advanced air traffic management

    Science.gov (United States)

    Wangermann, John Paul

    Today's aircraft/airspace system faces complex challenges. Congestion and delays are widespread as air traffic continues to grow. Airlines want to better optimize their operations, and general aviation wants easier access to the system. Additionally, the accident rate must decline just to keep the number of accidents each year constant. New technology provides an opportunity to rethink the air traffic management process. Faster computers, new sensors, and high-bandwidth communications can be used to create new operating models. The choice is no longer between "inflexible" strategic separation assurance and "flexible" tactical conflict resolution. With suitable operating procedures, it is possible to have strategic, four-dimensional separation assurance that is flexible and allows system users maximum freedom to optimize operations. This thesis describes an operating model based on principled negotiation between agents. Many multi-agent systems have agents that have different, competing interests but have a shared interest in coordinating their actions. Principled negotiation is a method of finding agreement between agents with different interests. By focusing on fundamental interests and searching for options for mutual gain, agents with different interests reach agreements that provide benefits for both sides. Using principled negotiation, distributed optimization by each agent can be coordinated leading to iterative optimization of the system. Principled negotiation is well-suited to aircraft/airspace systems. It allows aircraft and operators to propose changes to air traffic control. Air traffic managers check the proposal maintains required aircraft separation. If it does, the proposal is either accepted or passed to agents whose trajectories change as part of the proposal for approval. Aircraft and operators can use all the data at hand to develop proposals that optimize their operations, while traffic managers can focus on their primary duty of ensuring

  17. 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

  18. Advanced water treatment as a tool in water scarcity management

    DEFF Research Database (Denmark)

    Harremoes, Poul

    2000-01-01

    until recently. This paper sets the stage with respect to perspective and management options related to implementation of water reuse. Water treatment has to be interpreted as the means by which to purify the water from any degree of impurity to any degree of purity that fits the desired use, including...... reuse. The historical distinction between processes used in water treatment for water supply versus processes used in water treatment of used water (wastewater) will fade, because it will all be unit processes and operations in combinations to fit the purpose of water use. Water can be purified to any...

  19. Advances of recurrent risk factors and management of choledocholithiasis.

    Science.gov (United States)

    Cai, Jian-Shan; Qiang, Sun; Bao-Bing, Yin

    2017-01-01

    Gallstone disease is a common and frequently occurring disease in human, and it is the main disease among the digestive system diseases. The incidence of gallstone disease in western countries is about 5%-22%, and common bile duct stones (CBDS) accounts for 8%-20%. CBDS easily lead to biliary obstruction, secondary cholangitis, pancreatitis, and obstructive jaundice, even endanger life. Therefore, it needs timely treatment once diagnosed. The recurrence of choledocholithiasis after bile duct stones clearance involves complicated factors and cannot be completely elaborated by a single factor. The risk factors for recurrence of choledocholithiasis include bacteria, biliary structure, endoscopic and surgical treatment, and inflammation. The modalities for management of choledocholithiasis are endoscopic retrograde cholangiopancreatography (ERCP), laparoscopic or open common bile duct exploration, dissolving solutions, extracorporeal shockwave lithotripsy (ESWL), percutaneous radiological interventions, electrohydraulic lithotripsy (EHL) and laser lithotripsy. We compare the different benefits between surgery and ERCP. And finally, we make a summary of the current strategy for reducing the recurrence of CBDS and future perspectives for CBDS management.

  20. Recent advances in omic technologies for meat quality management.

    Science.gov (United States)

    Picard, B; Lebret, B; Cassar-Malek, I; Liaubet, L; Berri, C; Le Bihan-Duval, E; Hocquette, J F; Renand, G

    2015-11-01

    The knowledge of the molecular organization of living organisms evolved considerably during the last years. The methodologies associated also progressed with the development of the high-throughput sequencing (SNP array, RNAseq, etc.) and of genomic tools allowing the simultaneous analysis of hundreds or thousands of genes, proteins or metabolites. In farm animals, some proteins, mRNAs or metabolites whose abundance has been associated with meat quality traits have been detected in pig, cattle, chicken. They constitute biomarkers for the assessment and prediction of qualities of interest in each species, with potential biomarkers across species. The ongoing development of rapid methods will allow their use for decision-making and management tools in slaughterhouses, to better allocate carcasses or cuts to the appropriate markets. Besides, their application on living animals will help to improve genetic selection and to adapt a breeding system to fulfill expected quality level. The ultimate goal is to propose effective molecular tools for the management of product quality in meat production chains. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. 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

  2. 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.

  3. SEMICONDUCTOR INTEGRATED CIRCUITS: An advanced monolithic digitalized random carrier frequency spread-spectrum clock generator for EMI suppression

    Science.gov (United States)

    Haiyan, Guo; Zao, Chen; Bo, Zhang; Zhaoji, Li

    2010-06-01

    A novel monolithic digitalized random carrier frequency modulation spread-spectrum clock generator (RCF-SSCG) is proposed. In this design, the output frequency of the proposed RCF-SSCG changes with the intensity of the capacitive charge and discharge current. Its analytical model is induced and the effect of the modulation parameters on the spread spectrum is numerically simulated and discussed. Compared with other works, this design has the advantages of small size, low power consumption and good robustness. The circuit has been fabricated in a 0.5 μm CMOS process and applied to a class D amplifier in which the proposed RCF-SSCG occupies an area of 0.112 mm2 and consumes 9 mW. The experimental results confirm the theoretical analyses.

  4. 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

  5. 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.

  6. Strategic Vision for Spectrum

    Science.gov (United States)

    2010-01-01

    that defines spectrum requirements consistent with emerging tech- proactive spectrum nologies, commercial trends , and increasing market demands...Integration, Capital Planning, Competency Management, Computing and Communications Infrastructure, Critical Infrastructure Protection, eBusiness

  7. 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.

  8. Advanced water treatment as a tool in water scarcity management

    DEFF Research Database (Denmark)

    Harremoes, Poul

    2000-01-01

    : water availability and water applicability. The availability is a question of quantitative demand relative to resource. The applicability is a question of quality suitability for the intended use of the water. There is a significant difference in this regard with respect to rural versus urban use...... of water. In the former case, the water is lost by evaporation and polluted. In the latter case, the water is not lost but heavily polluted. With increasing scarcity, the value of water and the need for controls increase. In this situation, water reuse becomes an option that has been considered exotic...... until recently. This paper sets the stage with respect to perspective and management options related to implementation of water reuse. Water treatment has to be interpreted as the means by which to purify the water from any degree of impurity to any degree of purity that fits the desired use, including...

  9. Advances in the Management of Meconium Aspiration Syndrome

    Directory of Open Access Journals (Sweden)

    Kamala Swarnam

    2012-01-01

    Full Text Available Meconium aspiration syndrome (MAS is a common cause of severe respiratory distress in term infants, with an associated highly variable morbidity and mortality. MAS results from aspiration of meconium during intrauterine gasping or during the first few breaths. The pathophysiology of MAS is multifactorial and includes acute airway obstruction, surfactant dysfunction or inactivation, chemical pneumonitis with release of vasoconstrictive and inflammatory mediators, and persistent pulmonary hypertension of newborn (PPHN. This disorder can be life threatening, often complicated by respiratory failure, pulmonary air leaks, and PPHN. Approaches to the prevention of MAS have changed over time with collaboration between obstetricians and pediatricians forming the foundations for care. The use of surfactant and inhaled nitric oxide (iNO has led to the decreased mortality and the need for extracorporeal membrane oxygenation (ECMO use. In this paper, we review the current understanding of the pathophysiology and management of MAS.

  10. Advances in the Management of Meconium Aspiration Syndrome

    Science.gov (United States)

    Swarnam, Kamala; Soraisham, Amuchou S.; Sivanandan, Sindhu

    2012-01-01

    Meconium aspiration syndrome (MAS) is a common cause of severe respiratory distress in term infants, with an associated highly variable morbidity and mortality. MAS results from aspiration of meconium during intrauterine gasping or during the first few breaths. The pathophysiology of MAS is multifactorial and includes acute airway obstruction, surfactant dysfunction or inactivation, chemical pneumonitis with release of vasoconstrictive and inflammatory mediators, and persistent pulmonary hypertension of newborn (PPHN). This disorder can be life threatening, often complicated by respiratory failure, pulmonary air leaks, and PPHN. Approaches to the prevention of MAS have changed over time with collaboration between obstetricians and pediatricians forming the foundations for care. The use of surfactant and inhaled nitric oxide (iNO) has led to the decreased mortality and the need for extracorporeal membrane oxygenation (ECMO) use. In this paper, we review the current understanding of the pathophysiology and management of MAS. PMID:22164183

  11. 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.

  12. Successful conservative management of Ludwig's angina in advanced pregnancy.

    Science.gov (United States)

    Soltero, Roxana; Mercado-Alvarado, Joanna

    2009-01-01

    A 20 year-old female in her 32nd week of gestation presented to the Emergency Department with dysphonia and dysphagia associated to a recent recurrence of a periapical abscess. Her oral examination showed trismus, elevated tongue and neck swelling. A clinical diagnosis of Ludwig's angina was reached, and empirical antibiotic coverage was started. The decompression and drainage placement was performed successfully under local anesthesia without airway compromise. At the moment, no clear guidelines exist for the acute treatment of Ludwig's angina. Establishment of a secure airway has long been considered the gold standard, yet new literature suggests a more conservative management. Ascertaining an early diagnosis at the Emergency Department, and involvement of Anesthesia, Obstetrics, and, Ear, Nose and Throat specialist services is vital for materno-fetal wellbeing. Careful evaluation of the airway status in addition to prompt antimicrobial therapy with surgical decompression may represent a plausible alternative in pregnant patients.

  13. Analysis of transportation and handling system for advanced spent fuel management process

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Dong Hee; Yoon, J. S.; Park, B. S.; Ahn, S. H.; Kim, Y. H.; Jung, J. H.; Jin, J. H.; Park, G. Y.; Song, T. G. [Korea Atomic Energy Research Institute, Taejeon (Korea)

    2002-04-01

    In this report, several devices which are used to safely transport and handle nuclear materials without scattering have been derived by analyzing the Advanced Management Process, object nuclear material and modules of process equipment and performing graphical simulation of transportation/handling by computers for the demonstration of the Advanced Spent Fuel Management Process. For verification, powder transportation vessel and handling device have been designed and manufactured. And several tests such as transporting, grappling, rotating the vessel have been performed. Also, the functional requirements of transportation/handling equipment have been analyzed based on test results and process studies. The developed functional requirements in this research will be used as the design data for the Advanced Management Process. 6 refs., 25 figs., 6 tabs. (Author)

  14. Recent advances in understanding and managing body dysmorphic disorder.

    Science.gov (United States)

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

    2017-07-20

    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. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly

  15. 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

  16. Radar Spectrum Engineering and Management (Ingenierie et gestion du spectre radar)

    Science.gov (United States)

    2017-04-01

    industry, and academic experts in various facets of radar technology is needed to address the spectrum problems facing current (legacy) and future radar...Radar Applications”, IEEE International RF and Microwave Conference 2013, pp. 258-262, Penang, Malaysia , 9-11 December 2013. [88] A.A. Salah, R.S.A

  17. 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

  18. 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

  19. 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...

  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. 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

  2. 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.

  3. 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.

  4. 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.

  5. Wireless Sensors and Networks for Advanced Energy Management

    Energy Technology Data Exchange (ETDEWEB)

    Hardy, J.E.

    2005-05-06

    Numerous national studies and working groups have identified low-cost, very low-power wireless sensors and networks as a critical enabling technology for increasing energy efficiency, reducing waste, and optimizing processes. Research areas for developing such sensor and network platforms include microsensor arrays, ultra-low power electronics and signal conditioning, data/control transceivers, and robust wireless networks. A review of some of the research in the following areas will be discussed: (1) Low-cost, flexible multi-sensor array platforms (CO{sub 2}, NO{sub x}, CO, humidity, NH{sub 3}, O{sub 2}, occupancy, etc.) that enable energy and emission reductions in applications such as buildings and manufacturing; (2) Modeling investments (energy usage and savings to drive capital investment decisions) and estimated uptime improvements through pervasive gathering of equipment and process health data and its effects on energy; (3) Robust, self-configuring wireless sensor networks for energy management; and (4) Quality-of-service for secure and reliable data transmission from widely distributed sensors. Wireless communications is poised to support technical innovations in the industrial community, with widespread use of wireless sensors forecasted to improve manufacturing production and energy efficiency and reduce emissions. Progress being made in wireless system components, as described in this paper, is helping bring these projected improvements to reality.

  6. Advances in hormone replacement therapy: making the menopause manageable

    Directory of Open Access Journals (Sweden)

    Palacios Santiago

    2008-11-01

    Full Text Available Abstract The importance of the results of some large, randomized controlled trials (RCTs on Hormone Replacement Therapy (HRT has modified the risk/benefit perception of HRT. Recent literature review supports a different management. The differences in age at initiation and the duration of HRT are key points. HRT appears to decrease coronary disease in younger women, near menopause; yet, in older women, HRT increases risk of a coronary event. Although HRT is a recognized method in the prevention and treatment of osteoporosis, it is not licensed for the prevention of osteoporosis as a first-line treatment. The effectiveness of low and ultra-low estrogen doses has been demonstrated for the treatment of vasomotor symptoms, genital atrophy and the prevention of bone loss, with fewer side-effects than the standard dose therapy. Further research, however, is needed to determine the effect both on fractures, as well as on cardiovascular and breast diseases. Newer progestins show effects that are remarkably different from those of other assays. The effectiveness of testosterone at improving both sexual desire and response in surgically and naturally postmenopausal women is shown by the testosterone patch. The intention, dose and regimen of HRT need to be individualized, based on the principle of choosing the lowest appropriate dose in relation to the severity of symptoms and the time and menopause age.

  7. 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.

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. 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.

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

    OpenAIRE

    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 the existing body of evidence. Material and Methods: The MEDLINE database was searched using the terms ?Autistic Disorder?, ?Behaviour Control/methods?, ?Child?, ?Dental care for disabled?, ?Educati...

  14. 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.

  15. 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.

  16. Advanced Light Management Approaches for Thin-Film Silicon Solar Cells

    NARCIS (Netherlands)

    Zeman, M.; Isabella, O.; Jäger, K.; Santbergen, R.; Solntsev, S.; Topic, M.; Krc, J.

    2012-01-01

    Light management is important for improving the performance of thin-film solar cells. Advanced concepts of efficient light scattering and trapping inside the cell structures need to be investigated. An important tool for design and optimisation of the concepts present optical modelling and

  17. 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...

  18. 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.

  19. Recent advances in the management of renal cell carcinoma-a ...

    African Journals Online (AJOL)

    This narrative review highlights the international best practices in the multidisciplinary approach to the management of RCC, its diagnosis and treatment, with emphasis on recent advances and radiation treatment. The National Comprehensive Cancer Network (NCCN) guideline (version 3.2015) served as a guide to select ...

  20. 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.

  1. 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.

  2. 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)

  3. Network management and signalling standards for CCSDS advanced orbiting system communication systems

    Science.gov (United States)

    Pietras, John

    The Consultative Committee for Space Data Systems (CCSDS) is an international organization chartered to develop and adopt communications protocols and data processing standards suitable for use in space-related communication and data processing systems. This paper briefly describes the CCSDS network management environment and reviews the current status of CCSDS recommendations for network management functional capability, use of internal standard for network management, and composition of signaling systems in support of the advanced orbiting systems services typified by the international Space Station Freedom Program. A timetable for future work in this area is presented.

  4. Recent advances in understanding and managing asthma [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Su-Ling Loo

    2016-08-01

    Full Text Available This review highlights the important articles published in the area of asthma research from January 2015 to July 2016. In basic science, significant advances have been made in understanding the link between the innate immune response and type II acquired immune responses in asthma and the role of the airway epithelium. Novel information continues to emerge with regard to the pathogenesis and heterogeneity of severe asthma. There have been important translational clinical trials in the areas of childhood asthma, treatment of allergy to improve asthma outcomes, and improving drug delivery to optimize the management of asthma. In addition, there are increasing data concerning the application of biological agents to the management of severe asthma. This body of work discusses the most notable advances in the understanding and management of asthma.

  5. The recreation opportunity spectrum: a framework for planning, management, and research.

    Science.gov (United States)

    Roger N. Clark; George H. Stankey

    1979-01-01

    The end product of recreation management is a diverse range of opportunities from which people can derive various experiences. This paper offers a framework for managing recreation opportunities based on six physical, biological, social, and managerial factors that, when combined, can be utilized by recreationists to obtain diverse experiences.

  6. Wideband spectrum analysis of ultra-high frequency radio-wave signals due to advanced one-phonon non-collinear anomalous light scattering.

    Science.gov (United States)

    Shcherbakov, Alexandre S; Arellanes, Adan Omar

    2017-04-20

    We present a principally new acousto-optical cell providing an advanced wideband spectrum analysis of ultra-high frequency radio-wave signals. For the first time, we apply a recently developed approach with the tilt angle to a one-phonon non-collinear anomalous light scattering. In contrast to earlier cases, now one can exploit a regime with the fixed optical wavelength for processing a great number of acoustic frequencies simultaneously in the linear regime. The chosen rutile-crystal combines a moderate acoustic velocity with low acoustic attenuation and allows us wide-band data processing within GHz-frequency acoustic waves. We have created and experimentally tested a 6-cm aperture rutile-made acousto-optical cell providing the central frequency 2.0 GHz, frequency bandwidth ∼0.52  GHz with the frequency resolution about 68.3 kHz, and ∼7620 resolvable spots. A similar cell permits designing an advanced ultra-high-frequency arm within a recently developed multi-band radio-wave acousto-optical spectrometer for astrophysical studies. This spectrometer is intended to operate with a few parallel optical arms for processing the multi-frequency data flows within astrophysical observations. Keeping all the instrument's advantages of the previous schematic arrangement, now one can create the highest-frequency arm using the developed rutile-based acousto-optical cell. It permits optimizing the performances inherent in that arm via regulation of both the central frequency and the frequency bandwidth for spectrum analysis.

  7. Pre-hospital advanced airway management by experienced anaesthesiologists: a prospective descriptive study

    Science.gov (United States)

    2013-01-01

    Introduction We report data from the first Utstein-style study of physician-provided pre-hospital advanced airway management. Materials and methods Anaesthesiologists from eight pre-hospital critical care teams in the Central Denmark Region (a mixed rural and urban region with 1.27 million inhabitants) prospectively registered data according to the template for reporting data from pre-hospital advanced airway management. Data collection took place from February 1st 2011 to October 31st 2012. Included were patients of all ages on whom pre-hospital advanced airway management was performed. The objective was to estimate the incidences of failed and difficult pre-hospital endotracheal intubation, and complications related to pre-hospital advanced airway management. Results The overall incidence of successful pre-hospital endotracheal intubation among 636 intubation attempts was 99.7%, even though 22.4% of pre-hospital endotracheal intubations required more than one intubation attempt. The overall incidence of complications related to pre-hospital advanced airway management was 7.9%. Following rapid sequence intubation, the incidence of first pass success was 85.8%, the overall incidence of complications was 22.0%, the incidence of hypotension 7.3% and that of hypoxia 5.3%. Multiple endotracheal intubation attempts were associated with an increased overall incidence of complications. No airway management related deaths occurred. Discussion The overall incidence of successful pre-hospital endotracheal intubations compares to those found in other physician-staffed pre-hospital systems. The incidence of pre-hospital endotracheal intubations requiring more than one attempt is higher than suspected. The incidence of hypotension or hypoxia after pre-hospital rapid sequence intubation compares to those found in UK emergency departments. Conclusion Pre-hospital advanced airway management including pre-hospital endotracheal intubation performed by experienced anaesthesiologists

  8. 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.

  9. Precise parallel optical spectrum analysis using the advanced two-phonon light scattering combined with the cross-disperser technique.

    Science.gov (United States)

    Shcherbakov, A S; Arellanes, A O; Chavushyan, V

    2016-12-01

    We develop an advanced approach to the optical spectrometer with acousto-optical dynamic grating for the Guillermo Haro astrophysical observatory (Mexico). The progress consists of two principle novelties. First is the use of the acousto-optical nonlinearity of two-phonon light scattering in crystals with linear acoustic losses. This advanced regime of light scattering exhibits a recently revealed additional degree of freedom, which allows tuning of the frequency of elastic waves and admits the nonlinear apodization improving the dynamic range. The second novelty is the combination of the cross-disperser with acousto-optical processing. A similar pioneering step provides an opportunity to operate over all the visible range in a parallel regime with maximal achievable resolution. The observation window of the optical spectrometer in that observatory is ∼9  cm, so that the theoretical estimations of maximal performances for a low-loss LiNbO3 crystal for this optical aperture at λ=405  nm give spectral resolution of 0.0523 Å, resolving power of 77,400, and 57,500 spots. The illustrative proof-of-principle experiments with a 6 cm LiNbO3 crystal have been performed.

  10. 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.

  11. Advanced data management for optimising the operation of a full-scale WWTP.

    Science.gov (United States)

    Beltrán, Sergio; Maiza, Mikel; de la Sota, Alejandro; Villanueva, José María; Ayesa, Eduardo

    2012-01-01

    The lack of appropriate data management tools is presently a limiting factor for a broader implementation and a more efficient use of sensors and analysers, monitoring systems and process controllers in wastewater treatment plants (WWTPs). This paper presents a technical solution for advanced data management of a full-scale WWTP. The solution is based on an efficient and intelligent use of the plant data by a standard centralisation of the heterogeneous data acquired from different sources, effective data processing to extract adequate information, and a straightforward connection to other emerging tools focused on the operational optimisation of the plant such as advanced monitoring and control or dynamic simulators. A pilot study of the advanced data manager tool was designed and implemented in the Galindo-Bilbao WWTP. The results of the pilot study showed its potential for agile and intelligent plant data management by generating new enriched information combining data from different plant sources, facilitating the connection of operational support systems, and developing automatic plots and trends of simulated results and actual data for plant performance and diagnosis.

  12. Improving student knowledge in medication management through an advanced pharmacy practice experience.

    Science.gov (United States)

    Childress, Bc; Bosler, Julie N; Beck, Morgan

    2013-06-01

    To assess the impact of an advanced pharmacy practice rotation on student therapeutic knowledge, confidence in performing medication therapy management (MTM), and ability to use MTM documentation platforms. Pretest/post-test quasi-experiment. This study was conducted at the InterNational Center for Advanced Pharmacy Services (INCAPS), a licensed pharmacy that provides MTM services to geriatric patients in Louisville, Kentucky. This research evaluated 37 advanced pharmacy practice students who participated in the five-week learning rotation at INCAPS between October 1, 2011, and June 30, 2012. Thirty-seven students were tested before (pretest) beginning the rotation. During the rotation, students performed daily MTM consultations and participated in weekly topic discussions pertaining to relevant areas of chronic disease management and geriatric pharmacotherapy. Following the five-week rotation, a post-test was administered to these 37 students to analyze the changes in their knowledge. The primary outcome measure was the test score for the assessment of chronic disease management and geriatric pharmacotherapy. Compared with baseline, post-test scores showed a statistically significant improvement in the areas that were assessed-osteoporosis, hypertension, diabetes, asthma/chronic obstructive pulmonary disease, and inappropriate medication use in the elderly. A post-rotation survey also reflected positive improvements in student confidence when performing MTM consults for geriatric patients. The five-week MTM-focused rotation at INCAPS with weekly topic discussions and daily MTM consults showed a positive impact on students' ability to manage medication therapy for chronically ill and geriatric patients.

  13. 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....

  14. 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.

  15. 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.

  16. 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

    their practice and unify the treatment approaches in different communities. In order to develop a national consensus and recommendations for the diagnosis and management of NMOSD in Iran, a group of neurologists with long term experience in management of NMOSD were gathered to develop this consensus based...... on available national and international data. The primary draft was prepared and discussed to suggest the most appropriate treatment for these patients. We propose strategies for early diagnosis and treatment for prevention of relapses and minimizing consequences of attacks as a primary therapeutic goal...... in order to reduce attack frequency. The current consensus reviews the previous data and provides the clinicians with practical recommendations and advices for the diagnosis and management of NMOSD based on scientific data and clinical experience....

  17. 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)

  18. 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.

  19. 252Cf fission-neutron spectrum using a simplified time-of-flight setup: An advanced teaching laboratory experiment

    Science.gov (United States)

    Becchetti, F. D.; Febbraro, M.; Torres-Isea, R.; Ojaruega, M.; Baum, L.

    2013-02-01

    The removal of PuBe and AmBe neutron sources from many university teaching laboratories (due to heightened security issues) has often left a void in teaching various aspects of neutron physics. We have recently replaced such sources with sealed 252Cf oil-well logging sources (nominal 10-100 μCi), and developed several experiments using them as neutron sources. This includes a fission-neutron time-of-flight experiment using plastic scintillators, which utilizes the prompt γ rays emitted in 252Cf spontaneous fission as a fast timing start signal. The experiment can be performed with conventional nuclear instrumentation and a 1-D multi-channel pulse-height analyzer, available in most advanced teaching laboratories. Alternatively, a more sophisticated experiment using liquid scintillators and n/γ pulse-shape discrimination can be performed. Several other experiments using these neutron sources are also feasible. The experiments can introduce students to the problem of detecting the dark matter thought to dominate the universe and to the techniques used to detect contraband fissionable nuclear materials.

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

    International Nuclear Information System (INIS)

    Apsimon, R.J.; Batchelor, L.E.; Beck, G.A.; Canard, P.; Carter, A.A.; Carter, J.R.; Davis, V.R.; Oliveira, R. de; Gibson, M.D.; Hominal, L.; Ilie, D.M.; Ilie, S.D.; Leboube, C.G.; Mistry, J.; Morin, J.; Morris, J.; Nagai, K.; Sexton, I.; Thery, X.; Tyndel, M.

    2006-01-01

    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

  1. 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.

  2. 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)

  3. 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.

  4. 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.

  5. Survey of behavior management teaching in pediatric dentistry advanced education programs.

    Science.gov (United States)

    Adair, Steven M; Rockman, Roy A; Schafer, Tara E; Waller, Jennifer L

    2004-01-01

    The purpose of this study was to survey pediatric dentistry advanced education program directors regarding the teaching of behavior management techniques. Surveys were mailed to all (65) advanced education programs in the United States. Follow-up mailings were sent to nonrespondents. The survey contained items on program demographics and the program's teaching of communicative and pharmacologic techniques. Information was also obtained on informed consent and parental presence in the operatory. Surveys were returned by 54 programs. Two programs declined to respond because they had not yet accepted or certified residents. The final response rate was 86%. The mean percentage (+/- SD) of total didactic time devoted to behavior management was 13% (+/-9.5). Communicative techniques were taught as "acceptable" by 98% of programs, with the exception of the hand-over-mouth exercise (HOME), which was taught as "unacceptable" by 54% of programs. Active and passive immobilization of sedated and nonsedated children was taught as "acceptable" by 76% to 98% of programs. All programs taught that pharmacologic techniques (nitrous oxide, conscious sedation, general anesthesia) are "acceptable." There was little evidence that the teaching of behavior management techniques had changed over the previous 5 years, nor that it is likely to change in the near future. Parental presence in the operatory was common for some procedures, particularly among younger children. Most programs do not teach HOME as an acceptable behavior management technique. The amount of curricular time devoted to behavior management is not likely to change appreciably in the near future.

  6. 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)

  7. Human-System Safety Methods for Development of Advanced Air Traffic Management Systems

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, W.R.

    1999-05-24

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, William R. [Idaho National Engineering and Environmental Laboratory, Idaho Falls (United States)

    1999-05-15

    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)

  9. 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.

  10. Surgical Management of a Locally Advanced Symptomatic Recurrence of Penile Sarcoma Secondary to Prostate Brachytherapy

    Directory of Open Access Journals (Sweden)

    Tariq S. Hakky

    2013-04-01

    Full Text Available Background The surgical management of patients with symptomatic metastatic or locally advanced recurrences involving the penis remains poorly characterized. The aim of the present abstract and video is to detail our experience in the surgical management of a specific patient with a locally advanced symptomatic recurrence of penile sarcoma secondary to prostate cancer treated with primary brachytherapy. Materials and Methods A 70 year old male patient initially treated for localized prostate cancer with interstitial brachytherapy at an outside facility developed an unfortunate secondary malignancy consisting of a locally advanced penile sarcoma involving as well the prostate and base of the bladder. Despite our best efforts to control his pain, he developed a very symptomatic local recurrence with a secondary penile abscess and purulent periurethral drainage. At this time, it was felt a surgical resection consisting of a total penectomy, urethrectomy, cystoprostatectomy, and ileal conduit urinary diversion would be the best option for local cancer control in this particular patient. Results The patient underwent the surgical resection without any complications as illustrated in this surgical video, with a jejunal intestinal mass identified at the time of surgery which was resected with a primary bowel anastomosis performed. The patient was discharged from hospital uneventfully with his symptomatic local recurrence being successfully managed and the patient no longer requiring oral narcotics for pain control. The pathological report confirmed a locally advanced sarcoma involving the penile, prostate, and bladder which was resected with negative surgical margins and the jejunal mass was confirmed to represent a small bowel sarcoma metastatic site. Conclusion As highlighted in the present video, the treatment of a symptomatic sarcoma local recurrence contiguously involving the penis can be successfully managed provided the patient is informed of the

  11. Advances in the management of squamous cell carcinoma of the head and neck

    OpenAIRE

    Machiels, Jean-Pascal; Lambrecht, Maarten; Hanin, François-Xavier; Duprez, Thierry; Gregoire, Vincent; Schmitz, Sandra; Hamoir, Marc

    2014-01-01

    Squamous cell carcinoma of the head and neck (SCCHN) is the sixth most common cancer worldwide. The main risk factors for cancers of the oral cavity, larynx, oropharynx, and hypopharynx are alcohol and tobacco use. In addition, the human papillomavirus (HPV) is an established cause of oropharyngeal cancer. An experienced multidisciplinary team is necessary for adequate management and optimal outcome. The treatment of locally advanced disease generally requires various combinations of radiothe...

  12. Recent advances in the management of acromegaly [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Georgia Ntali

    2015-12-01

    Full Text Available Acromegaly is a rare condition of GH excess associated with significant morbidities (e.g. hypertension, glucose intolerance or diabetes mellitus, cardiac, cerebrovascular, respiratory disease and arthritis and, when uncontrolled, high mortality. Surgery, medical treatment and radiotherapy remain our therapeutic tools. Advances in these options during the last years have offered further perspectives in the management of patients and particularly those with challenging tumours; the impact of these on the long-term morbidity and mortality remains to be assessed.

  13. Screening of Soybean (Glycine max L.) Advanced Lines under Organic Management in Turkey

    OpenAIRE

    Kir, Alev; Karagul, Eylem Tugay; Buyukkileci, Ceylan; Kalin, Ahmet

    2015-01-01

    The breeding research of soybean (Glycine max L.) began with advanced lines of “Soybean Breeding Project” supported by MFAL-GDAR in 2013 under organic management for comparing grain legume crops of organic breeding programme of COBRA (Coordinating Organic Plant Breeding Activities for Diversity) project because of priority for this species to be produced organically in Turkey for organic sector at Organic Open Field Experimental Area of AARI located in the Mediterranean Region. Main objective...

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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

  20. 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

  1. 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.

  2. A review of pre-admission advanced airway management in combat casualties, Helmand Province 2013.

    Science.gov (United States)

    Pugh, Harry E J; LeClerc, S; Mclennan, J

    2015-06-01

    Airway compromise is the third leading cause of potentially preventable combat death. Pre-hospital airway management has lower success rates than in hospital. This study reviewed advanced airway management focusing on cricothyroidotomies and supraglottic airway devices in combat casualties prior to admission to a Role 3 Hospital in Afghanistan. This was a retrospective review of all casualties who required advanced airway management prior to arrival at the Role 3 Hospital, Bastion, Helmand Province over a 30-week period identified by the US Joint Theatre Trauma Registry. The notes and relevant X-rays were analysed. The opinions of US and UK clinical Subject Matter Experts (SME) were then sought. Fifty-seven advanced airway interventions were identified. 45 casualties had attempted intubations, 37 (82%) were successful and of those who had failed intubations, one had a King LT Airway (supraglottic device) and seven had a rescue cricothyroidotomy. The other initial advanced airway interventions were five attempted King LT airways and seven attempted cricothyroidotomies. In total, 14 cricothyroidotomies were performed; in this group, there were nine complications/significant events. The SMEs suggested that dedicated surgical airway kits should be used and students in training should be taught to secure the cricothyroidotomy tube as well as how to insert it. This review re-emphasises the need to 'ensure the right person, with the right equipment and the right training, is present at the right time if we are to improve the survival of patients with airway compromise on the battlefield'. The audit reference number is RCDM/Res/Audit/1036/12/0368. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  3. 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.

  4. 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 work...... 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....

  5. Spectrum of intradialytic complications during hemodialysis and its management: A single-center experience

    Directory of Open Access Journals (Sweden)

    Prabhakar

    2015-01-01

    Full Text Available Hemodialysis (HD is one of the important modalities of renal replacement therapy in acute renal failure (ARF as well as chronic renal failure (CRF. This study was performed to evaluate the various intradialytic complications that occur during HD and their management. This is a retrospective study performed in patients who underwent conventional HD during the period of 1 January 2000 to 31 December 2011 at our center. Clinical details, various complications faced and their management were retrieved from dialysis case sheets. A total of 2325 patients of renal failure (790 ARF and 1535 CRF patients were assessed for the intradialytic complications of HD. During the study period, there were 12,785 bicarbonate dialyses performed on these patients. In the ARF patients, the common intradialytic complications were: Hypotension, seen in 1296 sessions (30.4%, nausea and vomiting seen in 1125 sessions (26.4%, fever and chills seen in 818 sessions (19.2%, headache seen in 665 sessions (15.6%, cramps seen in 85 sessions (2.0%, chest pain and back pain seen in 82 sessions (1.92%, hypoglycemia seen in 77 sessions (1.8%, first-use syndrome seen in 72 sessions (1.7% and femoral hematoma seen in 31 sessions (0.73%. In the CRF group, common complications were hypotension in 2230 sessions (26.1%, nausea and vomiting in 1211 sessions (14.2%, fever and chills in 1228 sessions (14.4%, chest pain and back pain in 1108 cases (13.0%, hypertension in 886 sessions (10.4%, headache in 886 sessions (10.4%, cramps in 256 sessions (3.0%, hematoma in 55 sessions (0.64%, intracerebral hemorrhage in three sessions (0.03% and catheter tip migration in three sessions (0.03%. There is a need for special attention for the diagnosis and management of intradialytic complications of HD because such complications could be managed successfully without the need for termination of the dialysis procedure.

  6. 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

  7. Nursing and Focal Dyscognitive Seizures: A Clinical Update When Managing Risk Using Advanced Nursing Skills.

    Science.gov (United States)

    Holland, Christine; Edward, Karen-Leigh; Giandinoto, Jo-Ann

    2017-06-01

    Focal seizures are divided into simple and dyscognitive, with the latter resulting in the alteration of consciousness. In the ictal and postictal stages, patients may present with confusion, delirium, and psychosis, presenting a risk of safety to themselves and others. This article presents 3 case studies where patients have been admitted for visual and electroencephalographic monitoring. Seizure activity is provoked for the diagnosis and development of a management plan. These cases illustrate the unique nursing implications when caring for patients experiencing focal dyscognitive seizures, highlighting the unique circumstances for the neuroscience nurse regarding risk management, safe administration of radioactive isotopes, detection of subtle seizure manifestation, and use of family as experts in patient-centered care. Through a deliberate onset of seizures, neuroscience nurses are placed in nontypical nursing situations, thus managing risk in unpredictable conditions and displaying advanced and distinctive nursing skills.

  8. Managing diabetes mellitus in patients with advanced cancer: a case note audit and guidelines.

    Science.gov (United States)

    McCoubrie, R; Jeffrey, D; Paton, C; Dawes, L

    2005-07-01

    Patients with advanced cancer and diabetes mellitus present a challenge to healthcare professionals. To establish how diabetes is currently being managed in these patients, we audited the care of patients who died in Cheltenham General Hospital over the previous 12 months with diagnoses of both diabetes mellitus and cancer. Management and monitoring of the diabetes was variable and there was little record of discussion between healthcare professionals and the patient or family regarding the diabetes. Thirty-two out of 42 patients continued to have blood sugar monitoring up to and including the day they died. We review the literature on this topic and suggest guidelines to help professionals to appropriately manage diabetes in the palliative setting at the end of life.

  9. 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

  10. 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.

  11. 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.

  12. 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.

  13. Quo Vadis Radiotherapy? Technological Advances and the Rising Problems in Cancer Management

    Directory of Open Access Journals (Sweden)

    Barry J. Allen

    2013-01-01

    Full Text Available Purpose. 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. Methods. The currently available advanced radiotherapy treatment techniques have been analysed and their cost-effectiveness discussed. The problem of systemic disease management was specifically targeted. Results. 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. Conclusion. 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.

  14. 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…

  15. 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)…

  16. Recent Advances in the Management of Mucormycosis: From Bench to Bedside

    Science.gov (United States)

    Spellberg, Brad; Walsh, Thomas J.; Kontoyiannis, Dimitrios P.; Edwards, John; Ibrahim, Ashraf S.

    2009-01-01

    Recent therapeutic advances have the potential to improve outcomes of mucormycosis. Lipid formulations of amphotericin B (LFAB) have evolved as the cornerstone of primary therapy for mucormycosis. Posaconazole may be useful as salvage therapy, but it cannot be recommended as primary therapy for mucormycosis on the basis of available data. Preclinical and limited retrospective clinical data suggest that combination LFAB-echinocandin therapy may improve survival during mucormycosis. A definitive trial is needed to confirm these results. Combination therapy with LFAB and the iron chelator, deferasirox, also improved outcomes in animal models of mucormycosis. In contrast, combination polyene-posaconazole therapy was of no benefit in preclinical studies. Adjunctive therapy with recombinant cytokines, hyperbaric oxygen, and/or granulocyte transfusions can be considered for selected patients. Early initiation of therapy is critical to maximizing outcomes; recent developments in polymerase chain reaction technology are advancing early diagnostic strategies. Prospective, randomized clinical trials are needed to define optimal management strategies for mucormycosis. PMID:19435437

  17. 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.

  18. 10 CFR 830 Major Modification Determination for the Advanced Test Reactor Remote Monitoring and Management Capability

    Energy Technology Data Exchange (ETDEWEB)

    Bohachek, Randolph Charles [Idaho National Laboratory (INL), Idaho Falls, ID (United States)

    2015-09-01

    The Advanced Test Reactor (ATR; TRA-670), which is located in the ATR Complex at Idaho National Laboratory, was constructed in the 1960s for the purpose of irradiating reactor fuels and materials. Other irradiation services, such as radioisotope production, are also performed at ATR. While ATR is safely fulfilling current mission requirements, assessments are continuing. These assessments intend to identify areas to provide defense–in-depth and improve safety for ATR. One of the assessments performed by an independent group of nuclear industry experts recommended that a remote accident management capability be provided. The report stated that: “contemporary practice in commercial power reactors is to provide a remote shutdown station or stations to allow shutdown of the reactor and management of long-term cooling of the reactor (i.e., management of reactivity, inventory, and cooling) should the main control room be disabled (e.g., due to a fire in the control room or affecting the control room).” This project will install remote reactor monitoring and management capabilities for ATR. Remote capabilities will allow for post scram reactor management and monitoring in the event the main Reactor Control Room (RCR) must be evacuated.

  19. 10 CFR 830 Major Modification Determination for the Advanced Test Reactor Remote Monitoring and Management Capability

    International Nuclear Information System (INIS)

    Bohachek, Randolph Charles

    2015-01-01

    The Advanced Test Reactor (ATR; TRA-670), which is located in the ATR Complex at Idaho National Laboratory, was constructed in the 1960s for the purpose of irradiating reactor fuels and materials. Other irradiation services, such as radioisotope production, are also performed at ATR. While ATR is safely fulfilling current mission requirements, assessments are continuing. These assessments intend to identify areas to provide defense–in-depth and improve safety for ATR. One of the assessments performed by an independent group of nuclear industry experts recommended that a remote accident management capability be provided. The report stated that: 'contemporary practice in commercial power reactors is to provide a remote shutdown station or stations to allow shutdown of the reactor and management of long-term cooling of the reactor (i.e., management of reactivity, inventory, and cooling) should the main control room be disabled (e.g., due to a fire in the control room or affecting the control room).' This project will install remote reactor monitoring and management capabilities for ATR. Remote capabilities will allow for post scram reactor management and monitoring in the event the main Reactor Control Room (RCR) must be evacuated.

  20. 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.

  1. 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.

  2. 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

  3. 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

    2018-03-20

    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 an MRI 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. Seventy-eight 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 between 1997 and 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=0.84). Magnetic resonance imaging resulted in over-diagnosis in 23% and in under

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. An advanced energy management system for controlling the ultracapacitor discharge and improving the electric vehicle range

    Science.gov (United States)

    Armenta, Jesús; Núñez, Ciro; Visairo, Nancy; Lázaro, Isabel

    2015-06-01

    Over the last years issues regarding both the use and the improvement of energy management in electric vehicles have been highlighted by industry and academic fields. Some of the research has been focused on exploiting the ultracapacitor characteristics and on protecting the battery life. From this standpoint, this paper proposes an advanced energy management system based on the adequate discharge of the ultracapacitor bank in order to utilize all the energy available from the regenerative breaking. In this way, the energy consumption is reduced and the electric vehicle range is increased. This strategy, based on simple rules, takes advantage of the high power density of the ultracapacitor and prevents an overstress of the battery. The benefits are featured using three standard drive cycles for a 1550 kg electric vehicle via simulations.

  9. NUCare: Advancing research on technological integration for self-management in the aging population.

    Science.gov (United States)

    Lees, Kristin E; Guthrie, Barbara J; Henderson, Elizabeth L; Jimison, Holly B; Sceppa, Carmen; Pavel, Misha; Gordon, Christine; Fulmer, Terry

    2017-11-15

    The Center for Technology in Support of Self-Management and Health (NUCare) is an exploratory research center funded by the National Institute of Nursing Research's P20 mechanism positioned to conduct rigorous research on the integration of technology in the self-management of the older adult population. The purpose of this paper is to describe the development and application of an evaluation plan and preliminary evaluation results from the first year of implementation. This evaluation plan is derived from and is consistent with Dorsey et al.'s (2014) logic model. Dorsey's model provided guidelines for evaluating sustainability, leveraging of resources, and interdisciplinary collaboration within the center. Preliminary results and strategies for addressing findings from the first year of evaluation are discussed. A secondary aim of this paper is to showcase the relevance of this center to the advancement and maintenance of health in the aging population. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Online fault adaptive control for efficient resource management in Advanced Life Support Systems

    Science.gov (United States)

    Abdelwahed, Sherif; Wu, Jian; Biswas, Gautam; Ramirez, John; Manders, Eric-J

    2005-01-01

    This article presents the design and implementation of a controller scheme for efficient resource management in Advanced Life Support Systems. In the proposed approach, a switching hybrid system model is used to represent the dynamics of the system components and their interactions. The operational specifications for the controller are represented by utility functions, and the corresponding resource management problem is formulated as a safety control problem. The controller is designed as a limited-horizon online supervisory controller that performs a limited forward search on the state-space of the system at each time step, and uses the utility functions to decide on the best action. The feasibility and accuracy of the online algorithm can be assessed at design time. We demonstrate the effectiveness of the scheme by running a set of experiments on the Reverse Osmosis (RO) subsystem of the Water Recovery System (WRS).

  11. 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...

  12. 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

  13. Radiation therapy and concurrent cisplatin in management of locoregionally advanced nasopharyngeal carcinomas

    International Nuclear Information System (INIS)

    Serin, M.; Erkal, H.S.; Cakmak, A.

    1999-01-01

    Radiation therapy in combination with chemotherapy in the management of locoregionally advanced nasopharyngeal carcinomas is evaluated in an attempt to improve locoregional response, reduce locoregional failure and reduce systemic failure. The current study was designed to investigate radiation therapy and concurrent cisplatin in this context. From 1992 through 1997, 70 patients with locoregionally advanced nasopharyngeal carcinomas were treated with radiation therapy and concurrent cisplatin. External beam radiation dose was 60 Gy for T1, T2 and T3 tumors, 70 Gy for T4 tumors and 70 Gy for metastatic cervical lymph nodes. An intracavitary brachytherapy boost (10 Gy) was applied for T1, T2 and T3 tumors. Cisplatin (30 mg/m 2 ) was administered weekly during external beam radiation therapy. Locoregional complete response was achieved in 63 patients, locoregional failure was observed in 4 patients and systemic failure was observed in 15. N-stage predicted systemic failure. Overall survival, locoregional failure-free survival and systemic failure-free survival were 63%, 79% and 75%, respectively, at three years. Grade 3 acute skin toxicity was observed in 2 patients, Grade 3 acute mucous membrane toxicity was observed in 6 and Grad 3 acute hematological toxicity was observed in 2 patients. Despite improved locoregional response, reduced locoregional failure and improved survival with radiation therapy and concurrent cisplatin, systemic failure remains prevalent for locoregionally advanced nasopharyngeal carcinomas. (orig.)

  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. 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

  16. Tele-Dysphagia Management: An Opportunity for Prevention, Cost-Savings and Advanced Training

    Directory of Open Access Journals (Sweden)

    James Coyle

    2012-06-01

    Full Text Available Many patients survive severe stroke because of aggressive management in intensive care units.  However, acquiring pneumonia during the post-onset phase significantly reduces both the quality and likelihood of survival. Aspiration pneumonia (AP, a relatively recent addition to the list of the pneumonias, is associated with dysphagia, a swallowing disorder that may cause aspiration of swallowed food or liquids mixed with bacterial pathogens common to saliva, or by aspiration of gastric contents due to emesis or gastroesophageal reflux. While it is within the purview of speech-language pathologists to provide evaluation, treatment, and management of dysphagia, the number of patients with dysphagia is growing faster than the number of qualified dysphagia clinicians.  Because dysphagia consultations via telepractice are feasible and relatively accessible from a technological standpoint, they offer a promising strategy to bring the expertise of distant dysphagia experts to patients in underserved areas.  Tele-dysphagia management has the potential to increase patients’ survival, enhance the expertise of primary, local clinicians, and reduce healthcare costs. Even a modest reduction in either hospital admissions for aspiration pneumonia, or in the length of stay for AP, could save the US health care system hundreds of millions of dollars each year.  Wide spread tele-dysphagia management offers significant opportunities for prevention, cost-savings and advanced training, and is therefore worthy of consideration by stakeholders in the health care system and university training programs.

  17. 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.

  18. Strategic management of therapeutic advances: experience with colony-stimulating factors.

    Science.gov (United States)

    Shane, R; Nishimura, L

    1994-09-01

    Recent therapeutic advances offer significant opportunities for improved patient outcomes while challenging our ability to deliver these outcomes in a cost-effective manner. This report describes the strategies for managing such advanced therapies--specifically, the recently introduced colony stimulating factors (CSFs)--that have been adopted at Cedars-Sinai Medical Center. Based on the principles of Continuous Quality Improvement (CQI), our approach begins with a multidisciplinary task force that develops and continuously refines guidelines for use of these agents. To provide immediate feedback when physician orders do not conform to the guidelines, the pharmacist notifies a physician expert, who promptly contacts the prescriber for a discussion of the case and how the guidelines do or do not apply. Since the introduction of CSFs, cost per admission has declined from $983 to $729 (26%) for oncology patients and from $737 to $281 (62%) for HIV patients. Although it is impossible to rigorously establish how much of this decrease has resulted from our proactive management strategy, costs have consistently decreased following each task force intervention.

  19. 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

  20. 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.

  1. 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.

  2. 'I Can Breathe Again!' Patients' Self-Management Strategies for Episodic Breathlessness in Advanced Disease, Derived from Qualitative Interviews

    NARCIS (Netherlands)

    Simon, S.T.; Weingärtner, V.; Higginson, I.J.; Benalia, H.; Gysels, M.; Murtagh, F.E.M.; Spicer, J.; Linde, P.; Voltz, R.; Bausewein, C.

    Context. Episodic breathlessness causes additional distress to breathless patients with advanced disease, but management is still insufficient and there is a lack of knowledge on effective coping strategies. Objectives. The aim was to explore patients’ self-management strategies for episodic

  3. 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.

  4. 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

  5. Review article: next-generation transformative advances in the pathogenesis and management of autoimmune hepatitis.

    Science.gov (United States)

    Czaja, A J

    2017-11-01

    Advances in autoimmune hepatitis that transform current concepts of pathogenesis and management can be anticipated as products of ongoing investigations driven by unmet clinical needs and an evolving biotechnology. To describe the advances that are likely to become transformative in autoimmune hepatitis, based on the direction of current investigations. Pertinent abstracts were identified in PubMed by multiple search terms. Full-length articles were selected for review, and a secondary bibliography was developed. The discovery process was repeated, and a tertiary bibliography was identified. The number of abstracts reviewed was 2830, and the number of full-length articles reviewed exceeded 150. Risk-laden allelic variants outside the major histocompatibility complex (rs3184504, r36000782) are being identified by genome-wide association studies, and their gene products are potential therapeutic targets. Epigenetic changes associated with environmental cues can enhance the transcriptional activity of genes, and chromatin re-structuring and antagonists of noncoding molecules of ribonucleic acid are feasible interventions. The intestinal microbiome is a discovery field for microbial products and activated immune cells that may translocate to the periphery and respond to manipulation. Epidemiological studies and controlled interview-based surveys may implicate environmental and xenobiotic factors that warrant evidence-based changes in lifestyle, and site-directed molecular and cellular interventions promise to change the paradigm of treatment from one of blanket immunosuppression. Advances in genetics, epigenetics, pathophysiology, epidemiology, and site-directed molecular and cellular interventions constitute the next generation of transformative advances in autoimmune hepatitis. © 2017 John Wiley & Sons Ltd.

  6. 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.

  7. 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

  8. Mutation spectrum of RB1 mutations in retinoblastoma cases from Singapore with implications for genetic management and counselling.

    Science.gov (United States)

    Tomar, Swati; Sethi, Raman; Sundar, Gangadhara; Quah, Thuan Chong; Quah, Boon Long; Lai, Poh San

    2017-01-01

    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 asymptomatic

  9. Advanced Test Reactor Complex Facilities Radioactive Waste Management Basis and DOE Manual 435.1-1 Compliance Tables

    Energy Technology Data Exchange (ETDEWEB)

    Lisa Harvego; Brion Bennett

    2011-11-01

    U.S. Department of Energy Order 435.1, 'Radioactive Waste Management,' along with its associated manual and guidance, requires development and maintenance of a radioactive waste management basis for each radioactive waste management facility, operation, and activity. This document presents a radioactive waste management basis for Idaho National Laboratory's Advanced Test Reactor Complex facilities that manage radioactive waste. The radioactive waste management basis for a facility comprises existing laboratory-wide and facility-specific documents. U.S. Department of Energy Manual 435.1-1, 'Radioactive Waste Management Manual,' facility compliance tables also are presented for the facilities. The tables serve as a tool to develop the radioactive waste management basis.

  10. 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)

  11. 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.

  12. 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

  13. 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.

  14. Uterine leiomyosarcoma: a review of recent advances in molecular biology, clinical management and outcome.

    Science.gov (United States)

    Cui, R R; Wright, J D; Hou, J Y

    2017-06-01

    Uterine leiomyosarcoma (LMS) are rare but aggressive tumours with poor clinical outcomes regardless of stage. Most tumours are identified by histopathology at time of surgery, and pre-operative diagnosis remains a clinical challenge. Management of early-stage LMS relies on surgical resection. Cytotoxic chemotherapy remains the mainstay of therapy for advanced-stage, recurrent or metastatic LMS, and includes single or combination doxorubicin-, ifosfamide- or gemcitabine-based regimens. Recent interest in genetic biomarkers led to developments of targeted therapies for LMS, although more research is needed to understand the molecular complexities underlying LMS to guide the development of novel treatment strategies. The diagnosis and treatment of uterine LMS is challenging. Novel biomarkers offer hope for future therapies. © 2017 Royal College of Obstetricians and Gynaecologists.

  15. 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.

  16. Recent advances in ChIP-seq analysis: from quality management to whole-genome annotation.

    Science.gov (United States)

    Nakato, Ryuichiro; Shirahige, Katsuhiko

    2017-03-01

    Chromatin immunoprecipitation followed by sequencing (ChIP-seq) analysis can detect protein/DNA-binding and histone-modification sites across an entire genome. Recent advances in sequencing technologies and analyses enable us to compare hundreds of samples simultaneously; such large-scale analysis has potential to reveal the high-dimensional interrelationship level for regulatory elements and annotate novel functional genomic regions de novo. Because many experimental considerations are relevant to the choice of a method in a ChIP-seq analysis, the overall design and quality management of the experiment are of critical importance. This review offers guiding principles of computation and sample preparation for ChIP-seq analyses, highlighting the validity and limitations of the state-of-the-art procedures at each step. We also discuss the latest challenges of single-cell analysis that will encourage a new era in this field. © The Author 2016. Published by Oxford University Press.

  17. T-cell non-Hodgkin lymphomas: Spectrum of disease nd the role of imaging in the management of common subtypes

    International Nuclear Information System (INIS)

    Park, Hye Sun; Krajewski, Katherine M.; Braschi-Amirfarzan, Marta; Shinagare, Atul B.

    2017-01-01

    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

  18. 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.

  19. 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.

  20. 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.

  1. 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)

  2. Malignant bowel obstruction in advanced cancer patients: epidemiology, management, and factors influencing spontaneous resolution

    Directory of Open Access Journals (Sweden)

    Tuca A

    2012-06-01

    Full Text Available Albert Tuca1, Ernest Guell2, Emilio Martinez-Losada3, Nuria Codorniu41Cancer and Hematological Diseases Institute, Hospital Clínic de Barcelona, Barcelona, Spain; 2Palliative Care Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; 3Palliative Care Unit, Institut Català Oncologia Badalona, Barcelona, Spain; 4Medical Oncology Department, Institut Català Oncologia L'Hospitalet, Barcelona, SpainAbstract: Malignant bowel obstruction (MBO is a frequent complication in advanced cancer patients, especially in those with abdominal tumors. Clinical management of MBO requires a specific and individualized approach that is based on disease prognosis and the objectives of care. The global prevalence of MBO is estimated to be 3% to 15% of cancer patients. Surgery should always be considered for patients in the initial stages of the disease with a preserved general status and a single level of occlusion. Less invasive approaches such as duodenal or colonic stenting should be considered when surgery is contraindicated in obstructions at the single level. The priority of care for inoperable and consolidated MBO is to control symptoms and promote the maximum level of comfort possible. The spontaneous resolution of an inoperable obstructive process is observed in more than one third of patients. The mean survival is of no longer than 4–5 weeks in patients with consolidated MBO. Polymodal medical treatment based on a combination of glucocorticoids, strong opioids, antiemetics, and antisecretory drugs achieves very high symptomatic control. This review focuses on the epidemiological aspects, diagnosis, surgical criteria, medical management, and factors influencing the spontaneous resolution of MBO in advanced cancer patients.Keywords: malignant bowel obstruction, cancer, intestinal obstruction, bowel occlusion

  3. 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.

  4. Training mid-level providers on palliative care: bringing advanced directives and symptom assessment and management to community oncology practices.

    Science.gov (United States)

    Lesperance, Mary; Shannon, Robert; Pumphrey, Phyllis K; Dunbar, Erin; Genther, Renee; Coleman, C Lynn; Tabano, Margaret; Maurer, Jennifer; Vazquez, Adrienne; Capp, Elizabeth; McMillan, Jessica; Wilkerson, Katie; Robbins, Gerald; Phillips, Dorothy Green; Howick, Priscilla; Solaun, Catherine; Sloan, Jeff; Colón-Otero, Gerardo

    2014-05-01

    Palliative care services are not available in most outpatient oncology practices. A program training 11 mid-level providers from oncology practices on advanced directive discussions and supportive symptom assessment and management performed by palliative care specialists was completed. A follow-up session 9 months later identified barriers to implementation. Of the 11 mid-level providers, 8 participated in the follow-up session, and 9 of the 11 providers implemented advanced directive's discussions and symptom assessment and management for patients with metastatic cancer. Main barriers included uncertainties about reimbursement, patients' lack of knowledge about palliative care, and lack of access to supportive services. This program successfully promoted advanced directive discussions and supportive/palliative care symptom assessment and management to community oncology practices, which will hopefully translate into improved quality of life for patients with metastatic cancer.

  5. Latest developments in advanced network management and cross-sharing of next-generation flux stations

    Science.gov (United States)

    Burba, George; Johnson, Dave; Velgersdyk, Michael; Begashaw, Israel; Allyn, Douglas

    2016-04-01

    In recent years, spatial and temporal flux data coverage improved significantly and on multiple scales, from a single station to continental networks, due to standardization, automation, and management of the data collection, and better handling of the extensive amounts of generated data. However, operating budgets for flux research items, such as labor, travel, and hardware, are becoming more difficult to acquire and sustain. With more stations and networks, larger data flows from each station, and smaller operating budgets, modern tools are required to effectively and efficiently handle the entire process, including sharing data among collaborative groups. On one hand, such tools can maximize time dedicated to publications answering research questions, and minimize time and expenses spent on data acquisition, processing, quality control and overall station management. On the other hand, cross-sharing the stations with external collaborators may help leverage available funding, and promote data analyses and publications. A new low-cost, advanced system, FluxSuite, utilizes a combination of hardware, software and web-services to address these specific demands. It automates key stages of flux workflow, minimizes day-to-day site management, and modernizes the handling of data flows: (i) The system can be easily incorporated into a new flux station, or as un upgrade to many presently operating flux stations, via weatherized remotely-accessible microcomputer, SmartFlux 2, with fully digital inputs (ii) Each next-generation station will measure all parameters needed for flux computations in a digital and PTP time-synchronized mode, accepting digital signals from a number of anemometers and data loggers (iii) The field microcomputer will calculate final fully-processed flux rates in real time, including computation-intensive Fourier transforms, spectra, co-spectra, multiple rotations, stationarity, footprint, etc. (iv) Final fluxes, radiation, weather and soil data will

  6. Routine management of locally advanced cervical cancer with concurrent radiation and cisplatin. Five-year results

    Directory of Open Access Journals (Sweden)

    Candelaria Myrna

    2006-02-01

    Full Text Available Abstract Background Globally, cervical cancer primarily affects socially disadvantaged women. Five randomized trials were the foundation for adopting cisplatin-based chemotherapy during radiation as the standard of care for high-risk patients after primary radical hysterectomy who require adjuvant radiation and for locally advanced patients treated with definitive radiation. These results were obtained in clinical trials performed in carefully prepared academic centers; hence, we sought to determine whether these results could be reproduced when patients were treated on an out-of-protocol basis. Methods We reviewed the files of 294 patients with locally advanced cervical cancer who received radiation plus weekly cisplatin as routine management between 1999 to 2003, and analyzed treatment compliance, response rate, toxicity, and survival. Results A total of 294 patients who received radiation and cisplatin were analyzed. Mean age was 43.8 years (range, 26–68 years. The majority of cases were squamous cell carcinoma (87.8%, and distribution according to International Federation of Gynecology and Obstetrics (FIGO stage was as follows: IB2-IIA, 23%; IIB, 53.3%, and IIIB, 23%; there were only two IVA cases. Overall, 96% of patients completed external beam, and intracavitary therapy. The majority of patients (67% received the planned six courses of weekly cisplatin. Complete responses were achieved in 243 (83% patients, whereas 51 (17% had either persistent (32 patients, 10.8% or progressive (19 patients, 6.4% disease. At median follow-up (28 months; range, 2–68 months, 36 patients (12.2% have relapsed (locally 30.5, and systemically, 69.5%. The most common toxicities were hematologic and gastrointestinal, in the majority of cases considered mild-moderate. At median follow-up (28 months; range, 2–68 months, overall and progression-free survival are 76.5 and 67%, respectively. Conclusion Our results support use of chemoradiation with six weekly

  7. 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.

  8. 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.

  9. 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

  10. 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

  11. 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.

  12. Advanced neutron source project information management. A model for the future

    Energy Technology Data Exchange (ETDEWEB)

    King-Jones, K.; Cleaves, J.

    1995-12-31

    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.

  13. Advanced Neutron Source project information management: A model for the future

    Energy Technology Data Exchange (ETDEWEB)

    King-Jones, K.; Cleaves, J.

    1995-12-31

    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.

  14. 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

  15. ADVANCED SIMULATION CAPABILITY FOR ENVIRONMENTAL MANAGEMENT – CURRENT STATUS AND PHASE II DEMONSTRATION RESULTS

    Energy Technology Data Exchange (ETDEWEB)

    Seitz, Roger; Freshley, Mark D.; Dixon, Paul; Hubbard, Susan S.; Freedman, Vicky L.; Flach, Gregory P.; Faybishenko, Boris; Gorton, Ian; Finsterle, Stefan A.; Moulton, John D.; Steefel, Carl I.; Marble, Justin

    2013-06-27

    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

  16. 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.

  17. 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

  18. Exploiting the potential of intranet for managing drug spectrum a web base publication in a Tertiary Care Hospital in Mumbai.

    Science.gov (United States)

    Shetty, Yashashri Chandrakant; Patel, Tejal Chetan; Parmar, Urwashi Indrakumar

    2015-01-01

    The study surveyed the availability of the intranet in campus and also the knowledge related to drug spectrum an intranet publication. 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. 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. 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 the participants had a lot of suggestions. Thus, intranet has

  19. Managing talent across advanced and emerging economies: HR issues and challenges in a Sino-German strategic collaboration

    OpenAIRE

    Stokes, Peter; Liu, Yipeng; Smith, Simon; Leidner, Sarah; Moore, Neil; Rowland, Caroline

    2015-01-01

    The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link. Abstract The human resource (HR) practices involved in global talent management continue to advance and evolve. A majority of talent management commentary is from multinational corporation (MNC) perspectives. However, the less commented small-to-medium-sized enterprise (SME) also confronts challenges grounded in economic (i.e. resources, fin...

  20. 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

  1. Overcoming Barriers To IVHS -- Lessons From Other Technologies, Final Task F Report, Model Advanced Traffic Management System Franchise Agreement

    Science.gov (United States)

    1995-08-25

    VIABLE ADVANCED TRAFFIC MANAGEMENT SYSTEMS WILL BE CENTRAL TO THE : DEVELOPMENT OF ITS TECHNOLOGIES, AND CRITICAL TO THE DELIVERY OF MANY PRIVATE SECTOR ITS SERVICES TO THE PUBLIC. BY ITS VERY NATURE, HOWEVER, ATMS RELIES HEAVILY ON ACCESS TO THE PUB...

  2. Managing dyspnea in patients with advanced chronic obstructive pulmonary disease: A Canadian Thoracic Society clinical practice guideline

    Science.gov (United States)

    Marciniuk, Darcy D; Goodridge, Donna; Hernandez, Paul; Rocker, Graeme; Balter, Meyer; Bailey, Pat; Ford, Gordon; Bourbeau, Jean; O’Donnell, Denis E; Maltais, Francois; Mularski, Richard A; Cave, Andrew J; Mayers, Irvin; Kennedy, Vicki; Oliver, Thomas K; Brown, Candice

    2011-01-01

    Dyspnea is a cardinal symptom of chronic obstructive pulmonary disease (COPD), and its severity and magnitude increases as the disease progresses, leading to significant disability and a negative effect on quality of life. Refractory dyspnea is a common and difficult symptom to treat in patients with advanced COPD. There are many questions concerning optimal management and, specifically, whether various therapies are effective in this setting. The present document was compiled to address these important clinical issues using an evidence-based systematic review process led by a representative interprofessional panel of experts. The evidence supports the benefits of oral opioids, neuromuscular electrical stimulation, chest wall vibration, walking aids and pursed-lip breathing in the management of dyspnea in the individual patient with advanced COPD. Oxygen is recommended for COPD patients with resting hypoxemia, but its use for the targeted management of dyspnea in this setting should be reserved for patients who receive symptomatic benefit. There is insufficient evidence to support the routine use of anxiolytic medications, nebulized opioids, acupuncture, acupressure, distractive auditory stimuli (music), relaxation, hand-held fans, counselling programs or psychotherapy. There is also no evidence to support the use of supplemental oxygen to reduce dyspnea in nonhypoxemic patients with advanced COPD. Recognizing the current unfamiliarity with prescribing and dosing of opioid therapy in this setting, a potential approach for their use is illustrated. The role of opioid and other effective therapies in the comprehensive management of refractory dyspnea in patients with advanced COPD is discussed. PMID:21499589

  3. Advancing the Science of Behavioral Self-Management of Chronic Disease: The Arc of a Research Trajectory

    Science.gov (United States)

    Allegrante, John P.

    2018-01-01

    This article describes advances in the behavioral self-management of chronic disease from the perspective of a 25-year trajectory of National Institute of Health-funded research in arthritis and cardiopulmonary diseases that has sought to develop a transdisciplinary understanding of how applied behavioral science can be used to improve health…

  4. 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 ...

  5. Headwaters to estuaries: advances in watershed science and management - Proceedings of the Fifth Interagency Conference on Research in the Watersheds

    Science.gov (United States)

    Christina E. Stringer; Ken W. Krauss; James S. Latimer

    2016-01-01

    These proceedings contain the abstracts, manuscripts, and posters of presentations given at the Fifth Interagency Conference on Research in the Watersheds—Headwaters to estuaries: advances in watershed science and management, held at the Trident Technical College Conference Center in North Charleston, South Carolina, March 3-5, 2015. The conference was hosted...

  6. Efficacy of a self-management plan in exacerbations for patients with advanced COPD

    Directory of Open Access Journals (Sweden)

    Sánchez-Nieto JM

    2016-08-01

    Full Text Available Juan Miguel Sánchez-Nieto,1,2 Rubén Andújar-Espinosa,3 Roberto Bernabeu-Mora,1,2 Chunshao Hu,1 Beatriz Gálvez-Martínez,1 Andrés Carrillo-Alcaraz,1 Carlos Federico Álvarez-Miranda,3 Olga Meca-Birlanga,1 Eva Abad-Corpa4 1Division of Pneumology, Hospital Morales Meseguer, 2University of Murcia, 3Division of Pneumology, Hospital Arrixaca, Murcia, 4Department of Professional Development Unit, Murcia, Spain Background: Self-management interventions improve different outcome variables in various chronic diseases. Their role in COPD has not been clearly established. We assessed the efficacy of an intervention called the self-management program on the need for hospital care due to disease exacerbation in patients with advanced COPD.Methods: Multicenter, randomized study in two hospitals with follow-up of 1 year. All the patients had severe or very severe COPD, and had gone to either an accident and emergency (A&E department or had been admitted to a hospital at least once in the previous year due to exacerbation of COPD. The intervention consisted of a group education session on the main characteristics of the disease, an individual training session on inhalation techniques, at the start and during the 3rd month, and a written action plan containing instructions for physical activity and treatment for stable phases and exacerbations. We determined the combined number of COPD-related hospitalizations and emergency visits per patient per year. Secondary endpoints were number of patients with visits to A&E and the number of patients hospitalized because of exacerbations, use of antibiotics and corticosteroids, length of hospital stay, and all-cause mortality.Results: After 1 year, the rate of COPD exacerbations with visits to A&E or hospitalization had decreased from 1.37 to 0.89 (P=0.04 and the number of exacerbations dropped from 52 to 42 in the group of patients who received the intervention. The numbers of patients hospitalized, at 19 (40

  7. Fundamental concepts and research priorities for advancing the science of urban stormwater hydrology and flood management

    Science.gov (United States)

    Nytch, C. J.; Meléndez-Ackerman, E. J.; Vivoni, E. R.; Grove, J. M.; Ortiz, J.

    2016-12-01

    In cities, hydrologic processes are drastically altered by human interventions. Modification of land cover and the enhancement of hydraulic efficiency have been documented as root causes of augmented stormwater runoff in urban watersheds, contributing to higher magnitude discharge events that pose flood risks for human communities. Climate change is expected to accelerate the hydrologic cycle, leading to more extreme events and increased flood risk. We present a synthesis of the physical and conceptual components and processes that govern urban stormwater runoff, and highlight key areas for future research. There is limited understanding about the fine-scale spatio-temporal relationships between gray, green, brown, and blue land cover features, the underlying social-ecological mechanisms responsible for their distribution, and the resulting effects on runoff dynamics. Horizontal and vertical complexity of urban morphological features and connectivity with the network of stormwater management infrastructure leads to heterogeneous and non-linear runoff responses that confound efforts for accurately predicting flood hazards. Quantitative analysis is needed to understand how urban drainage network structure varies across stream orders, and illuminate the landscape-scale patterns that potentially serve as organizing principles for generating hydrologic processes across diverse socio-bio-climatic domains and scales. Field-based and modeling studies are also needed to quantify the individual hydrologic capacities of urban structural elements and their cumulative effects at the watershed scale, particularly in developing regions. Integrated, transdisciplinary, multi-scalar approaches to framing and investigating complex socio-eco-techno-hydrologic systems are essential for advancing the science of urban stormwater hydrology, and developing resilient, multifunctional management solutions appropriate to the challenges of urban flooding in the twenty-first century.

  8. Advanced Monitoring and Management Systems for Improving Sustainability in Precision Irrigation

    Directory of Open Access Journals (Sweden)

    Olutobi Adeyemi

    2017-02-01

    Full Text Available Globally, the irrigation of crops is the largest consumptive user of fresh water. Water scarcity is increasing worldwide, resulting in tighter regulation of its use for agriculture. This necessitates the development of irrigation practices that are more efficient in the use of water but do not compromise crop quality and yield. Precision irrigation already achieves this goal, in part. The goal of precision irrigation is to accurately supply the crop water need in a timely manner and as spatially uniformly as possible. However, to maximize the benefits of precision irrigation, additional technologies need to be enabled and incorporated into agriculture. This paper discusses how incorporating adaptive decision support systems into precision irrigation management will enable significant advances in increasing the efficiency of current irrigation approaches. From the literature review, it is found that precision irrigation can be applied in achieving the environmental goals related to sustainability. The demonstrated economic benefits of precision irrigation in field-scale crop production is however minimal. It is argued that a proper combination of soil, plant and weather sensors providing real-time data to an adaptive decision support system provides an innovative platform for improving sustainability in irrigated agriculture. The review also shows that adaptive decision support systems based on model predictive control are able to adequately account for the time-varying nature of the soil–plant–atmosphere system while considering operational limitations and agronomic objectives in arriving at optimal irrigation decisions. It is concluded that significant improvements in crop yield and water savings can be achieved by incorporating model predictive control into precision irrigation decision support tools. Further improvements in water savings can also be realized by including deficit irrigation as part of the overall irrigation management

  9. DREAM: Distributed Resources for the Earth System Grid Federation (ESGF) Advanced Management

    Science.gov (United States)

    Williams, D. N.

    2015-12-01

    The data associated with climate research is often generated, accessed, stored, and analyzed on a mix of unique platforms. The volume, variety, velocity, and veracity of this data creates unique challenges as climate research attempts to move beyond stand-alone platforms to a system that truly integrates dispersed resources. Today, sharing data across multiple facilities is often a challenge due to the large variance in supporting infrastructures. This results in data being accessed and downloaded many times, which requires significant amounts of resources, places a heavy analytic development burden on the end users, and mismanaged resources. Working across U.S. federal agencies, international agencies, and multiple worldwide data centers, and spanning seven international network organizations, the Earth System Grid Federation (ESGF) has begun to solve this problem. Its architecture employs a system of geographically distributed peer nodes that are independently administered yet united by common federation protocols and application programming interfaces. However, significant challenges remain, including workflow provenance, modular and flexible deployment, scalability of a diverse set of computational resources, and more. Expanding on the existing ESGF, the Distributed Resources for the Earth System Grid Federation Advanced Management (DREAM) will ensure that the access, storage, movement, and analysis of the large quantities of data that are processed and produced by diverse science projects can be dynamically distributed with proper resource management. This system will enable data from an infinite number of diverse sources to be organized and accessed from anywhere on any device (including mobile platforms). The approach offers a powerful roadmap for the creation and integration of a unified knowledge base of an entire ecosystem, including its many geophysical, geographical, social, political, agricultural, energy, transportation, and cyber aspects. The

  10. Advanced monitoring technologies for the evaluation of demand-side management programs

    Energy Technology Data Exchange (ETDEWEB)

    De Almeida, A.T. [Coimbra Univ. (Portugal). Dept. of Electrical Engineering; Vine, E.L.

    1993-06-01

    This report was commissioned by the California Institute for Energy Efficiency as part of its research mission to advance the energy efficiency and productivity of all end-use sectors in California. The aim of this study is to provide an assessment of the state-of-the-art technologies that can be used for monitoring and evaluating demand-side management (DSM) programs. Additionally, the study points out research, development, and demonstration projects whose implementation can contribute to a more accurate and cost-effective evaluation of the performance of end-use technologies. During the past two decades, technology developments in the fields of microelectronics, computers and communications had a large impact on monitoring equipment. The improvements achieved led to the appearance of increasingly powerful, convenient to use, and flexible equipment, enabling a wider application of end-use metering at a lower cost. Equipment specifications are getting closer and closer to an ``ideal`` monitoring system: Good accuracy, high reliability, moderate cost, large number of monitored end uses, large data storage capacity, flexible communications, non-intrusiveness, powerful preprocessing of data. This report briefly examines the following techniques that can be used for end-use monitoring: field test equipment, general purpose data loggers, run-time data loggers, utility-oriented data loggers, energy management systems, two-way communication, power line carrier techniques, direct and distributed load control, and non-intrusive load monitoring. The report concludes with recommendations for developing new measurement technologies, as well as additional research and development activities to support these efforts.

  11. Advance Noise Control Fan II: Test Rig Fan Risk Management Study

    Science.gov (United States)

    Lucero, John

    2013-01-01

    Since 1995 the Advanced Noise Control Fan (ANCF) has significantly contributed to the advancement of the understanding of the physics of fan tonal noise generation. The 9'x15' WT has successfully tested multiple high speed fan designs over the last several decades. This advanced several tone noise reduction concepts to higher TRL and the validation of fan tone noise prediction codes.

  12. [Pulmonary hypertension of the newborn--recent advances in the management and treatment].

    Science.gov (United States)

    Vakrilova, L; Radulova, P; Hitrova, St; Slancheva, B

    2014-01-01

    Pulmonary hypertension of the newborn is a clinical syndrome with diverse etiology in which the transition from fetal circulation with high pulmonary vascular resistance to postnatal circulation with low pulmonary vascular resistance failed. The persistence of high pulmonary vascular pressure leads to right-left shunts and marked cyanosis. Despite of the advances in neonatology, the treatment of some forms of PPHN is often difficult and mortality rate remains high. In infants with PPHN appropriate interventions are critical to reverse hypoxemia, improve pulmonary and systemic perfusion and preserve end-organ function. Our understanding for management of PPHN has evaluated over decades. This review summarizes the current strategies for treatment of pulmonary hypertension of the newborn: general care, cardiovascular support, the advantages and limitations of different ventilatory strategies, oxygen therapy, extracorporal membrane oxygenation, and the evidence-based inhaled nitric oxide therapy. The balance between pulmonary vasoconstrictor and vasodilator mediators plays an important role for pulmonary vascular resistance. Recent studies are designed to develop evidence-based therapies for regulation of pulmonary vascular tone, safe medications for selective pulmonary vasodilatation effective for treatment of PPHN and other forms of pulmonary hypertension in the neonatal intensive care unit.

  13. MATLAB/Simulink Framework for Modeling Complex Coolant Flow Configurations of Advanced Automotive Thermal Management Systems

    Energy Technology Data Exchange (ETDEWEB)

    Titov, Gene; Lustbader, Jason; Leighton, Daniel; Kiss, Tibor

    2016-04-05

    The National Renewable Energy Laboratory's (NREL's) CoolSim MATLAB/Simulink modeling framework was extended by including a newly developed coolant loop solution method aimed at reducing the simulation effort for arbitrarily complex thermal management systems. The new approach does not require the user to identify specific coolant loops and their flow. The user only needs to connect the fluid network elements in a manner consistent with the desired schematic. Using the new solution method, a model of NREL's advanced combined coolant loop system for electric vehicles was created that reflected the test system architecture. This system was built using components provided by the MAHLE Group and included both air conditioning and heat pump modes. Validation with test bench data and verification with the previous solution method were performed for 10 operating points spanning a range of ambient temperatures between -2 degrees C and 43 degrees C. The largest root mean square difference between pressure, temperature, energy and mass flow rate data and simulation results was less than 7%.

  14. GRAPEVINE VIRUS DISEASES:ECONOMIC IMPACT AND CURRENT ADVANCES IN VIRAL PROSPECTION AND MANAGEMENT

    Directory of Open Access Journals (Sweden)

    MARCOS FERNANDO BASSO

    Full Text Available ABSTRACT Grapevine (Vitis spp. is a major vegetative propagated fruit crop with high socioeconomic importance worldwide. It is susceptible to several graft-transmitted agents that cause several diseases and substantial crop losses, reducing fruit quality and plant vigor, and shorten the longevity of vines. The vegetative propagation and frequent exchanges of propagative material among countries contribute to spread these pathogens, favoring the emergence of complex diseases. Its perennial life cycle further accelerates the mixing and introduction of several viral agents into a single plant. Currently, approximately 65 viruses belonging to different families have been reported infecting grapevines, but not all cause economically relevant diseases. The grapevine leafroll, rugose wood complex, leaf degeneration and fleck diseases are the four main disorders having worldwide economic importance. In addition, new viral species and strains have been identified and associated with economically important constraints to grape production. In Brazilian vineyards, eighteen viruses, three viroids and two virus-like diseases had already their occurrence reported and were molecularly characterized. Here, we review the current knowledge of these viruses, report advances in their diagnosis and prospection of new species, and give indications about the management of the associated grapevine diseases.

  15. An overview on age related macular degeneration and recent advances in its management

    Directory of Open Access Journals (Sweden)

    SOBIA N.

    2014-03-01

    Full Text Available Age-related macular degeneration (AMD is a condition characterized, in the early stages, by slow development and progression, absence of symptoms over a number of years, and extensive retinal deposits called drusen, often associated with pigmentary abnormalities (early AMD.There is strong and consistent evidence that increasing age, family history, obesity/high body mass index, and cataract surgery are associated with late AMD. Smoking is the strongest and most consistently found modifiable risk factor for late AMD.Age-related macular degeneration remains one of the most severe and profound disabilities encountered in medicine, particularly due to the loss of the central vision and the high economic burden it places on patients and societies.Recent advances in management of AMD is anti-angiogenic drugs. The identification of the crucial role played by vascular endothelial growth factor (VEGF in the pathogenesis of wet AMD hasallowed the development of VEGF-blocking agents such as bevacizumab, pegaptanib and ranibizumab.

  16. The impact of IAIMS on the work of information experts. Integrated Advanced Information Management Systems.

    Science.gov (United States)

    Ash, J

    1995-10-01

    Integrated Advanced Information Management Systems (IAIMS) programs differ but have certain characteristics in common. Technological and organizational integration are universal goals. As integration takes place, what happens to those implementing the vision? A survey of 125 staff members, or information experts, involved in information or informatics at an IAIMS-funded institution was conducted during the last year of the implementation phase. The purpose was to measure the impact of IAIMS on the jobs of those in the library and related service units, and the computing, telecommunications, and health informatics divisions. The researchers used newly developed scales measuring levels of integration (knowledge of and involvement with other departments), customer orientation (focus on the user), and informatedness (changes in the nature of work beyond automation of former routines). Ninety-four percent of respondents indicated that their jobs had changed a great deal; the changes were similar regardless of division. To further investigate the impact of IAIMS on librarians in particular, a separate skills survey was conducted. The IAIMS librarians indicated that technology and training skills are especially needed in the new, integrated environment.

  17. Advances in the management of infertility in men with spinal cord injury

    Directory of Open Access Journals (Sweden)

    Emad Ibrahim

    2016-01-01

    Full Text Available Couples with a spinal cord injured male partner require assisted ejaculation techniques to collect semen that can then be further used in various assisted reproductive technology methods to achieve a pregnancy. The majority of men sustaining a spinal cord injury regardless of the cause or the level of injury cannot ejaculate during sexual intercourse. Only a small minority can ejaculate by masturbation. Penile vibratory stimulation and electroejaculation are the two most common methods used to retrieve sperm. Other techniques such as prostatic massage and the adjunct application of other medications can be used, but the results are inconsistent. Surgical sperm retrieval should be considered as a last resort if all other methods fail. Special attention must be paid to patients with T6 and rostral levels of injury due to the risk of autonomic dysreflexia resulting from stimulation below the level of injury. Bladder preparation should be performed before stimulation if retrograde ejaculation is anticipated. Erectile dysfunction is ubiquitous in the spinal cord injured population but is usually easily managed and does not pose a barrier to semen retrieval in these men. Semen analysis parameters of men with spinal cord injury are unique for this population regardless of the method of retrieval, generally presenting as normal sperm concentration but abnormally low sperm motility and viability. When sperm retrieval is desired in this population, emphasis should be placed on initially trying the simple methods of penile vibratory stimulation or electroejaculation before resorting to more advanced and invasive surgical procedures.

  18. Cost estimates for near-term depolyment of advanced traffic management systems. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Stevens, S.S.; Chin, S.M.

    1993-02-15

    The objective of this study is to provide cost est engineering, design, installation, operation and maintenance of Advanced Traffic Management Systems (ATMS) in the largest 75 metropolitan areas in the United States. This report gives estimates for deployment costs for ATMS in the next five years, subject to the qualifications and caveats set out in following paragraphs. The report considers infrastructure components required to realize fully a functional ATMS over each of two highway networks (as discussed in the Section describing our general assumptions) under each of the four architectures identified in the MITRE Intelligent Vehicle Highway Systems (IVHS) Architecture studies. The architectures are summarized in this report in Table 2. Estimates are given for eight combinations of highway networks and architectures. We estimate that it will cost between $8.5 Billion (minimal network) and $26 Billion (augmented network) to proceed immediately with deployment of ATMS in the largest 75 metropolitan areas. Costs are given in 1992 dollars, and are not adjusted for future inflation. Our estimates are based partially on completed project costs, which have been adjusted to 1992 dollars. We assume that a particular architecture will be chosen; projected costs are broken by architecture.

  19. Advancements in the Management of HPV-Associated Head and Neck Squamous Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Ross Zeitlin

    2015-04-01

    Full Text Available Head and neck carcinomas have long been linked to alcohol and tobacco abuse; however, within the last two decades, the human papillomavirus (HPV has emerged as a third etiology and is specifically associated with head and neck squamous cell carcinomas (HNSCC. In this anatomical region, the oncogenic HPV-16 mediates transformation and immortalization of epithelium, most commonly in the oropharynx. Nevertheless, the recent identification of novel HPV mechanisms thought to be specific to oropharyngeal carcinogenesis has coincided with observations that HPV-associated HNSCC has differing clinical behavior—in terms of natural history, therapeutic response, and prognosis—than HPV-negative head and neck tumors. Taken together with the growing incidence of HPV transmission in younger populations, these discoveries have sparked a rapid expansion in both laboratory and clinical studies on the infection and disease. Herein, we review the clinical characteristics of HPV-associated HNSCC, with particular emphasis on recent advancements in our understanding of the management of this infectious malignancy.

  20. Advanced Simulation Capability for Environmental Management - Current Status and Phase II Demonstration Results - 13161

    Energy Technology Data Exchange (ETDEWEB)

    Seitz, Roger R.; Flach, Greg [Savannah River National Laboratory, Savannah River Site, Bldg 773-43A, Aiken, SC 29808 (United States); Freshley, Mark D.; Freedman, Vicky; Gorton, Ian [Pacific Northwest National Laboratory, MSIN K9-33, P.O. Box 999, Richland, WA 99352 (United States); Dixon, Paul; Moulton, J. David [Los Alamos National Laboratory, MS B284, P.O. Box 1663, Los Alamos, NM 87544 (United States); Hubbard, Susan S.; Faybishenko, Boris; Steefel, Carl I.; Finsterle, Stefan [Lawrence Berkeley National Laboratory, 1 Cyclotron Road, MS 50B-4230, Berkeley, CA 94720 (United States); Marble, Justin [Department of Energy, 19901 Germantown Road, Germantown, MD 20874-1290 (United States)

    2013-07-01

    The U.S. Department of Energy (US DOE) 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 Tool-sets and High-Performance Computing (HPC) Multi-process 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, tool-sets 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 tool-sets 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

  1. Advanced Simulation Capability for Environmental Management - Current Status and Phase II Demonstration Results - 13161

    International Nuclear Information System (INIS)

    Seitz, Roger R.; Flach, Greg; Freshley, Mark D.; Freedman, Vicky; Gorton, Ian; Dixon, Paul; Moulton, J. David; Hubbard, Susan S.; Faybishenko, Boris; Steefel, Carl I.; Finsterle, Stefan; Marble, Justin

    2013-01-01

    The U.S. Department of Energy (US DOE) 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 Tool-sets and High-Performance Computing (HPC) Multi-process 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, tool-sets 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 tool-sets 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

  2. Advanced simulation capability for environmental management - current status and future applications

    International Nuclear Information System (INIS)

    Freshley, Mark; Scheibe, Timothy; Robinson, Bruce; Moulton, J. David; Dixon, Paul; Marble, Justin; Gerdes, Kurt; Stockton, Tom; Seitz, Roger; Black, Paul

    2013-01-01

    The U.S. Department of Energy (US DOE) Office of Environmental Management (EM), Office of Soil and Groundwater (EM-12), is supporting development of the Advanced Simulation Capability for Environmental Management (ASCEM). ASCEM is a state-of-the-art scientific tool and approach that is currently aimed at understanding and predicting contaminant fate and transport in natural and engineered systems. ASCEM is a modular and open source high-performance computing tool. It will be used to facilitate integrated approaches to modeling and site characterization, and provide 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, with current emphasis on integration of capabilities in FY12. Capability development is occurring for both the Platform and Integrated Tool-sets and High-Performance Computing (HPC) multi-process 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, tool-sets for interaction with Platform, and verification and model confidence testing. The integration of the Platform and HPC capabilities were tested and evaluated for EM applications in a set of demonstrations as part of Site Applications Thrust Area activities in 2012. The current maturity of the ASCEM computational and analysis capabilities has afforded the opportunity for collaborative efforts to develop decision analysis tools to support and optimize radioactive waste disposal. Recent advances in computerized decision analysis frameworks provide the perfect opportunity to bring this capability into ASCEM. This will allow radioactive waste

  3. How can we help family carers manage pain medicines for patients with advanced cancer? A systematic review of intervention studies.

    Science.gov (United States)

    Latter, Sue; Hopkinson, Jane B; Richardson, Alison; Hughes, Jane A; Lowson, Elizabeth; Edwards, Deborah

    2016-09-01

    Family carers play a significant role in managing pain and associated medicines for people with advanced cancer. Research indicates that carers often feel inadequately prepared for the tasks involved, which may impact on carers' and patients' emotional state as well as the achievement of optimal pain control. However, little is known about effective methods of supporting family carers with cancer pain medicines. To systematically identify and review studies of interventions to help carers manage medicines for pain in advanced cancer. To identify implications for practice and research. A systematic literature search of databases (MEDLINE, CINAHL, PsycINFO and AMED) was carried out to identify studies of pain medication management interventions that involved family carers of patients with advanced cancer, and reported specific outcomes for family carers. Patient pain outcomes were also sought. Studies were quality appraised; key aspects of study design, interventions and outcomes were compared and a narrative synthesis of findings developed. 8 studies were included; all had significant methodological limitations. The majority reported improvements in family carer knowledge and/or self-efficacy for managing pain medicines; no effect on patient pain outcomes; and no adverse effects. It was not possible to discern any association between particular intervention characteristics and family carer outcomes. Current evidence is limited, but overall suggests face-to-face educational interventions supported by written and/or other resources have potential to improve carers' knowledge and self-efficacy for pain management. Further research is needed to identify how best to help family carers manage pain medicines for patients with advanced cancer. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. Compressive Multispectral Spectrum Sensing for Spectrum Cartography

    Directory of Open Access Journals (Sweden)

    Jeison Marín Alfonso

    2018-01-01

    Full Text Available In the process of spectrum sensing applied to wireless communications, it is possible to build interference maps based on acquired power spectral values. This allows the characterization of spectral occupation, which is crucial to take management spectrum decisions. However, the amount of information both in the space and frequency domains that needs to be processed generates an enormous amount of data with high transmission delays and high memory requirements. Meanwhile, compressive sensing is a technique that allows the reconstruction of sparse or compressible signals using fewer samples than those required by the Nyquist criterion. This paper presents a new model that uses compressed multispectral sampling for spectrum sensing. The aim is to reduce the number of data required for the storage and the subsequent construction of power spectral maps with geo-referenced information in different frequency bands. This model is based on architectures that use compressive sensing to analyze multispectral images. The operation of a centralized manager is presented in order to select the power data of different sensors by binary patterns. These sensors are located in different geographical positions. The centralized manager reconstructs a data cube with the transmitted power and frequency of operation of all the sensors based on the samples taken and applying multispectral sensing techniques. The results show that this multispectral data cube can be built with 50% of the samples generated by the devices, and the spectrum cartography information can be stored using only 6.25% of the original data.

  5. Compressive Multispectral Spectrum Sensing for Spectrum Cartography.

    Science.gov (United States)

    Marín Alfonso, Jeison; Martínez Torre, Jose Ignacio; Arguello Fuentes, Henry; Agudelo, Leonardo Betancur

    2018-01-29

    In the process of spectrum sensing applied to wireless communications, it is possible to build interference maps based on acquired power spectral values. This allows the characterization of spectral occupation, which is crucial to take management spectrum decisions. However, the amount of information both in the space and frequency domains that needs to be processed generates an enormous amount of data with high transmission delays and high memory requirements. Meanwhile, compressive sensing is a technique that allows the reconstruction of sparse or compressible signals using fewer samples than those required by the Nyquist criterion. This paper presents a new model that uses compressed multispectral sampling for spectrum sensing. The aim is to reduce the number of data required for the storage and the subsequent construction of power spectral maps with geo-referenced information in different frequency bands. This model is based on architectures that use compressive sensing to analyze multispectral images. The operation of a centralized manager is presented in order to select the power data of different sensors by binary patterns. These sensors are located in different geographical positions. The centralized manager reconstructs a data cube with the transmitted power and frequency of operation of all the sensors based on the samples taken and applying multispectral sensing techniques. The results show that this multispectral data cube can be built with 50% of the samples generated by the devices, and the spectrum cartography information can be stored using only 6.25% of the original data.

  6. Recent advances in fish hatchery management Avanços recentes em larvicultura

    Directory of Open Access Journals (Sweden)

    Ronald P. Phelps

    2010-07-01

    Full Text Available The advancement of aquaculture has often been bottlenecked because of the lack of seed, but once that bottleneck was overcome there was rapid growth. Recent examples of advances in hatchery technology leading to increased production are sea bream and Pangasius. Three areas contributing to the advancement of hatchery management are: brood stock management, induced spawning and larval feeding. Formulated diets have been developed for marine brood fish that are equal or better than the traditional raw fish diets. The importance of lipids and their composition in brood fish diets, particularly n-3 HUFAs has received much attention. The lipid composition of the brood diet is reflected in egg composition and egg quality. Protein quantity and quality in brood diets also impacts reproductive success and egg quality. The use of Gonadotropin-releasing hormone agonists (GnRHa given as an injection or a slow release implant for induced spawning is becoming more widely used. The addition of dopamine antagonists with GnRHa may not be necessary to successfully induce spawn some species of fish. The use of GnRHa can advance the maturation of oocytes allowing such fish to be successfully induced spawned. Significant advances have been made in the development of formulated microdiets for larval fish. Such microdiets have been used successfully with young larvae reducing the need for live foods such as artemia. The quality of both live foods and formulated diets has been enriched with the use of fatty acids. Not only the quantity of n-3 HUFAs added to a diet impacts larval growth and survival but the ratios of specific n-3 HUFAs has an impact. Enrichment of live foods with amino acids can also improve larval fish growth and survival.A escassez de alevinos tem sido um dos principais pontos de estrangulamento para o avanço da aquicultura. No entanto, quando a produção de alevinos em quantidade e qualidade deixa de ser limitante, o setor produtivo normalmente

  7. The role of neoadjuvant chemotherapy in the management of locally advanced cervix cancer: a systematic review

    Directory of Open Access Journals (Sweden)

    Mohammed Osman

    2014-09-01

    Full Text Available Cervical cancer is the second most common cancer in women. Neoadjuvant chemotherapy for patients with locally advanced cervix cancer has comparable benefits to concurrent chemoradiotherapy (CCRT, but with fewer side effects. This systematic review aims to provide a comprehensive summary of the benefits of neoadjuvant chemotherapy for the management of locally advanced cervix cancer from stage IB2 (tumor >4.0 cm to IIIB (tumor extending to the pelvic wall and/or hydronephrosis. Our primary objective was to assess benefits in terms of survival. The data source included the USA national library of medicine, Medline search, and the National Cancer Institute PDQ Clinical Protocols. Inclusion criteria for consideration in the current systematic review included studies published between January 1997 and December 2012. In terms of histology, they had to be focused on squamous cell carcinoma, adenosquamous carcinoma, and/or adenocarcinoma. Patients should be either chemotherapy naïve or cervix cancer chemotherapy naïve, and have a performance status ≤2. The search in the above-mentioned scientific websites led to identify 49 publications, 19 of which were excluded, as they did not meet the inclusion criteria of this systematic review. Therefore only 30 studies were deemed eligible. Data was collected from 1760 patients enrolled in the current systematic review study. The mean age was 45.2 years. The mean tumor size was 4.7 cm. The most commonly used chemotherapies were cisplatin doublets. Paclitaxel was the most commonly used chemotherapeutic agent in the doublets. The mean chemotherapy cycles were 2.7. After chemotherapy, patients underwent surgery after a mean time of 2.5 weeks. The standard operation was radical hysterectomy with pelvic lymphadenectomy. Chemotherapy achieved an objective response rate of 84%. The 5-year progression-free survival and overall survival were 61.9% and 72.8% respectively. The treatment protocol was associated

  8. Slaughterhouse wastewater characteristics, treatment, and management in the meat processing industry: A review on trends and advances.

    Science.gov (United States)

    Bustillo-Lecompte, Ciro Fernando; Mehrvar, Mehrab

    2015-09-15

    A thorough review of advancement in slaughterhouse wastewater (SWW) characteristics, treatment, and management in the meat processing industry is presented. This study also provides a general review of the environmental impacts, health effects, and regulatory frameworks relevant to the SWW management. A significant progress in high-rate anaerobic treatment, nutrient removal, advanced oxidation processes (AOPs), and the combination of biological treatment and AOPs for SWW treatment is highlighted. The treatment processes are described and few examples of their applications are given. Conversely, few advances are accounted in terms of waste minimization and water use reduction, reuse, and recycle in slaughterhouses, which may offer new alternatives for cost-effective waste management. An overview of the most frequently applied technologies and combined processes for organic and nutrient removal during the last decade is also summarized. Several types of individual and combined processes have been used for the SWW treatment. Nevertheless, the selection of a particular technology depends on the characteristics of the wastewater, the available technology, and the compliance with regulations. This review facilitates a better understanding of current difficulties that can be found during production and management of the SWW, including treatment and characteristics of the final effluent. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. The Biology and Ecology of Cat Fleas and Advancements in Their Pest Management: A Review

    Directory of Open Access Journals (Sweden)

    Michael K. Rust

    2017-10-01

    Full Text Available The cat flea Ctenocephalides felis felis (Bouché is the most important ectoparasite of domestic cats and dogs worldwide. It has been two decades since the last comprehensive review concerning the biology and ecology of C. f. felis and its management. Since then there have been major advances in our understanding of the diseases associated with C. f. felis and their implications for humans and their pets. Two rickettsial diseases, flea-borne spotted fever and murine typhus, have been identified in domestic animal populations and cat fleas. Cat fleas are the primary vector of Bartonella henselae (cat scratch fever with the spread of the bacteria when flea feces are scratched in to bites or wounds. Flea allergic dermatitis (FAD common in dogs and cats has been successfully treated and tapeworm infestations prevented with a number of new products being used to control fleas. There has been a continuous development of new products with novel chemistries that have focused on increased convenience and the control of fleas and other arthropod ectoparasites. The possibility of feral animals serving as potential reservoirs for flea infestations has taken on additional importance because of the lack of effective environmental controls in recent years. Physiological insecticide resistance in C. f. felis continues to be of concern, especially because pyrethroid resistance now appears to be more widespread. In spite of their broad use since 1994, there is little evidence that resistance has developed to many of the on-animal or oral treatments such as fipronil, imidacloprid or lufenuron. Reports of the perceived lack of performance of some of the new on-animal therapies have been attributed to compliance issues and their misuse. Consequentially, there is a continuing need for consumer awareness of products registered for cats and dogs and their safety.

  10. Recent advancement in biosensors technology for animal and livestock health management.

    Science.gov (United States)

    Neethirajan, Suresh; Tuteja, Satish K; Huang, Sheng-Tung; Kelton, David

    2017-12-15

    The term biosensors encompasses devices that have the potential to quantify physiological, immunological and behavioural responses of livestock and multiple animal species. Novel biosensing methodologies offer highly specialised monitoring devices for the specific measurement of individual and multiple parameters covering an animal's physiology as well as monitoring of an animal's environment. These devices are not only highly specific and sensitive for the parameters being analysed, but they are also reliable and easy to use, and can accelerate the monitoring process. Novel biosensors in livestock management provide significant benefits and applications in disease detection and isolation, health monitoring and detection of reproductive cycles, as well as monitoring physiological wellbeing of the animal via analysis of the animal's environment. With the development of integrated systems and the Internet of Things, the continuously monitoring devices are expected to become affordable. The data generated from integrated livestock monitoring is anticipated to assist farmers and the agricultural industry to improve animal productivity in the future. The data is expected to reduce the impact of the livestock industry on the environment, while at the same time driving the new wave towards the improvements of viable farming techniques. This review focusses on the emerging technological advancements in monitoring of livestock health for detailed, precise information on productivity, as well as physiology and well-being. Biosensors will contribute to the 4th revolution in agriculture by incorporating innovative technologies into cost-effective diagnostic methods that can mitigate the potentially catastrophic effects of infectious outbreaks in farmed animals. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Recent advances in the management of osteoporosis [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Seiji Fukumoto

    2017-05-01

    Full Text Available There has been substantial progress in the management of patients with osteoporosis and the prevention of osteoporotic fractures. Currently available strong anti-resorptive agents are bisphosphonates and an anti-receptor activator of nuclear factor-kappa B ligand (RANKL antibody, denosumab. Although bisphosphonates and denosumab both inhibit bone resorption and prevent vertebral and non-vertebral fractures, their mechanisms of action are different. Whereas bisphosphonates’ effects on bone mineral density and fracture peak around 3 to 5 years and become plateaued, those of denosumab are maintained for up to 10 years. There are differences in the modes of action of these two drugs. Bisphosphonates accumulate on the mineralized bone surface and are released by the acid environment under osteoclastic bone resorption, whereas denosumab is not accumulated on bone but directly binds RANKL and inhibits its binding to the receptor RANK. Thus, the reduction in denosumab concentration 4 to 6 months after injection may enable RANK to bind to RANKL, where it is highly expressed, such as in damaged bone regions. As anabolic agents, only teriparatide has been available for a long time, but abaloparatide, a synthetic analog of PTHrP(1–34, is currently under development. Because of the difference in the preferential binding conformations of PTH1 receptor between teriparatide and abaloparatide, the latter shows anabolic effects with fewer bone resorptive effects. Romosozumab, an anti-sclerostin antibody, inhibits the action of sclerostin, a canonical Wnt signal inhibitor secreted from osteocytes, and enhances canonical Wnt signaling. Romosozumab robustly increases vertebral and proximal femoral bone mineral density within 12 months and inhibits vertebral and clinical fractures in patients with osteoporosis by enhancing bone formation and inhibiting bone resorption. In this review, we summarize the recent advances in therapeutic agents for the treatment of

  12. Autonomous micro-platform for multisensors with an advanced power management unit (PMU

    Directory of Open Access Journals (Sweden)

    P. Bellier

    2018-04-01

    Full Text Available In this work, we developed and characterised an autonomous micro-platform including several types of sensors, an advanced power management unit (PMU and radio frequency (RF transmission capabilities. Autonomy requires integration of an energy harvester, an energy storage device, a PMU, ultra-low-power components (including sensors and optimized software. Our choice was to use commercial off-the-shelf components with low-power consumption, low cost and compactness as selection criteria. For the multi-purpose micro-platform, we choose to include the most common sensors (such as temperature, humidity, luminosity, acceleration, etc. and to integrate them in one miniaturised autonomous device.A processing unit is embedded in the system. It allows for data acquisition from each sensor individually, simple data processing, and storing and/or wireless data transmission. Such a system can be used as stand-alone, with an internal storage in a non-volatile memory, or as a node in a wireless network, with bi-directional communication with a hub device where data can be analysed further. According to specific application requirements, system settings can be adjusted, such as the sampling rate, the resolution and the processing of the sensor data.Parallel to full autonomous functionality, the low-power design enables us to power the system by a small battery leading to a high degree of autonomy at a high sampling rate. Therefore, we also developed an alternative battery-powered version of the micro-platform that increases the range of applications. As such, the system is highly versatile and due to its reduced dimensions, it can be used nearly everywhere. Typical applications include the Internet of Things, Industry 4.0, home automation and building structural health monitoring.

  13. A consensus-based template for uniform reporting of data from pre-hospital advanced airway management

    DEFF Research Database (Denmark)

    Sollid, Stephen J M; Lockey, David; Lossius, Hans Morten

    2009-01-01

    with international experts to establish a set of core data points to be documented and reported in cases of advanced pre-hospital airway management. METHODS: A four-step modified nominal group technique process was employed. RESULTS: The inclusion criterion for the template was defined as any patient for whom...... with airway management have recently propagated the need for guidelines and standards in pre-hospital airway management. Following the path of other initiatives to establish templates for uniform data reporting, like the many Utstein-style templates, we initiated and carried out a structured consensus process......, the group defined 19 optional variables for which a consensus could not be achieved or the data were considered as valuable but not essential. CONCLUSION: We successfully developed an Utstein-style template for documenting and reporting pre-hospital airway management. The core dataset for this template...

  14. The Promise and Potential Perils of Big Data for Advancing Symptom Management Research in Populations at Risk for Health Disparities.

    Science.gov (United States)

    Bakken, Suzanne; Reame, Nancy

    2016-01-01

    Symptom management research is a core area of nursing science and one of the priorities for the National Institute of Nursing Research, which specifically focuses on understanding the biological and behavioral aspects of symptoms such as pain and fatigue, with the goal of developing new knowledge and new strategies for improving patient health and quality of life. The types and volume of data related to the symptom experience, symptom management strategies, and outcomes are increasingly accessible for research. Traditional data streams are now complemented by consumer-generated (i.e., quantified self) and "omic" data streams. Thus, the data available for symptom science can be considered big data. The purposes of this chapter are to (a) briefly summarize the current drivers for the use of big data in research; (b) describe the promise of big data and associated data science methods for advancing symptom management research; (c) explicate the potential perils of big data and data science from the perspective of the ethical principles of autonomy, beneficence, and justice; and (d) illustrate strategies for balancing the promise and the perils of big data through a case study of a community at high risk for health disparities. Big data and associated data science methods offer the promise of multidimensional data sources and new methods to address significant research gaps in symptom management. If nurse scientists wish to apply big data and data science methods to advance symptom management research and promote health equity, they must carefully consider both the promise and perils.

  15. Systematic review, including meta-analyses, on the management of locally advanced pancreatic cancer using radiation/combined modality therapy

    OpenAIRE

    Sultana, A; Tudur Smith, C; Cunningham, D; Starling, N; Tait, D; Neoptolemos, J P; Ghaneh, P

    2007-01-01

    There is no consensus on the management of locally advanced pancreatic cancer, with either chemotherapy or combined modality approaches being employed (Maheshwari and Moser, 2005). No published meta-analysis (Fung et al, 2003; Banu et al, 2005; Liang, 2005; Bria et al, 2006; Milella et al, 2006) has included randomised controlled trials employing radiation therapy. The aim of this systematic review was to compare the following: (i) chemoradiation followed by chemotherapy (combined modality th...

  16. Integrating Prognostics in Automated Contingency Management Strategies for Advanced Aircraft Controls, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — Automated Contingency Management (ACM) is an emerging and game-changing area of engineering and scientific research that integrates prognostics and health management...

  17. Managing 'shades of grey': a focus group study exploring community-dwellers' views on advance care planning in older people.

    Science.gov (United States)

    Michael, Natasha; O'Callaghan, Clare; Sayers, Emma

    2017-01-13

    to their decisions. Advance care planning programs traditionally assume participants are 'planning ready' to legally appoint a substitute decision maker (power of attorney) and record end-of-life treatment preferences in short time frames. This contrasts with how community dwelling older people and offspring/caregivers conceive future care decisions over time. Advance care planning programs need to include provision of information, which supports older people's advance care planning understanding and management, and also supports offspring/caregivers' development of strategies for broaching advance care planning with older people, and preparing for potential substitute decision maker roles. Development and integration of strategies to support older people's decision-making when in the 'grey zone', with fluctuating cognitive capacities, needs further consideration. Findings support an advance care planning model with conversations occurring at key points across a person's lifespan.

  18. Framework for multi-resolution analyses of advanced traffic management strategies.

    Science.gov (United States)

    2016-11-01

    Demand forecasting models and simulation models have been developed, calibrated, and used in isolation of each other. However, the advancement of transportation system technologies and strategies, the increase in the availability of data, and the unc...

  19. Advanced Product Water Removal and Management (APWR) Fuel Cell System, Phase II

    Data.gov (United States)

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

  20. Testing for Gluten-Related Disorders in Clinical Practice: The Role of Serology in Managing the Spectrum of Gluten Sensitivity

    Directory of Open Access Journals (Sweden)

    David Armstrong

    2011-01-01

    Full Text Available Immunoglobulin A tissue transglutaminase is the single most efficient serological test for the diagnosis of celiac disease. It is well known that immunoglobulin A tissue transglutaminase levels correlate with the degree of intestinal damage, and that values can fluctuate in patients over time. Serological testing can be used to identify symptomatic individuals that need a confirmatory biopsy, to screen at-risk populations or to monitor diet compliance in patients previously diagnosed with celiac disease. Thus, interpretation of serological testing requires consideration of the full clinical scenario. Antigliadin tests are no longer recommended for the diagnosis of classical celiac disease. However, our understanding of the pathogenesis and spectrum of gluten sensitivity has improved, and gluten-sensitive irritable bowel syndrome patients are increasingly being recognized. Studies are needed to determine the clinical utility of antigliadin serology in the diagnosis of gluten sensitivity.

  1. Advanced Health Management of a Brushless Direct Current Motor/Controller

    Science.gov (United States)

    Pickett, R. D.

    2003-01-01

    This effort demonstrates that health management can be taken to the component level for electromechanical systems. The same techniques can be applied to take any health management system to the component level, based on the practicality of the implementation for that particular system. This effort allows various logic schemes to be implemented for the identification and management of failures. By taking health management to the component level, integrated vehicle health management systems can be enhanced by protecting box-level avionics from being shut down in order to isolate a failed computer.

  2. 20070607 NATO Advanced Study Institute on the Electromagnetic Spectrum of Neutron Stars Marmaris, Turkey 07 - 18 Jun 2004 2004 marmaris20040607 TR 20040618

    CERN Document Server

    Baykal, Altan; Inam, Sitki C; Grebenev, Sergei

    2005-01-01

    Neutron stars hold a central place in astrophysics, not only because they are made up of the most extreme states of the condensed matter, but also because they are, along with white dwarfs and black holes, one of the stable configurations that stars reach at the end of stellar evolution. Neutron stars posses the highest rotation rates and strongest magnetic fields among all stars. They radiate prolifically, in high energy electromagnetic radiation and in the radio band. This book is devoted to the selected lectures presented in the 6th NATO-ASI series entitled "The Electromagnetic Spectrum of Neutron Stars" in Marmaris, Turkey, on 7-18 June 2004. This ASI is devoted to the spectral properties of neutron stars. Spectral observations of neutron stars help us to understand the magnetospheric emission processes of isolated radio pulsars and the emission processes of accreting neutron stars. This volume includes spectral information from the neutron stars in broadest sense, namely neutrino and gravitational radiat...

  3. Applied Behavior Analysis and the Autism Diagnostic Observation Schedule (ADOS): a Symbiotic Relationship for Advancements in Services for Individuals with Autism Spectrum Disorders (ASDs).

    Science.gov (United States)

    Guercio, John M; Hahs, Adam D

    2015-05-01

    The Autism Diagnostic Observation Schedule (ADOS) is a widely used diagnostic tool for the assessment of autism spectrum disorders. We compared interobserver reliability scores for observers using the existing guidelines for administration of the ADOS with those of the same observers using modified guidelines that included operational definitions for each area of observation. The results indicated increased mean interobserver reliability scores from 55.83 % using the existing guidelines to 84 % when using the modified guidelines and enhanced reliability scores for 3 of 3 clients with whom the ADOS was used. The guidelines are the following: integration of a highly effective diagnostic tool with ABA, the inclusion of a diagnostic tool may promote more comprehensive ABA services, more clearly define and identify areas of concern in autism, and impact implementation efficacy and reliability of assessments for individuals with autism.

  4. Left ventricular assist device management in patients chronically supported for advanced heart failure.

    Science.gov (United States)

    Cowger, Jennifer; Romano, Matthew A; Stulak, John; Pagani, Francis D; Aaronson, Keith D

    2011-03-01

    This review summarizes management strategies to reduce morbidity and mortality in heart failure patients supported chronically with implantable left ventricular assist devices (LVADs). As the population of patients supported with long-term LVADs has grown, patient selection, operative technique, and patient management strategies have been refined, leading to improved outcomes. This review summarizes recent findings on LVAD candidate selection, and discusses outpatient strategies to optimize device performance and heart failure management. It also reviews important device complications that warrant close outpatient monitoring. Managing patients on chronic LVAD support requires regular patient follow-up, multidisciplinary care teams, and frequent laboratory and echocardiographic surveillance to ensure optimal outcomes.

  5. Radio Resource Management for Uplink Carrier Aggregation in LTE-Advanced

    DEFF Research Database (Denmark)

    Wang, Hua; Rosa, Claudio; Pedersen, Klaus I.

    2015-01-01

    transmission for LTE-Advanced UEs has to be careful. A pathloss-threshold based component carrier (CC) and cluster configuration algorithm is proposed to determine whether an LTE-Advanced UE should be configured with multiple CCs and/or dual cluster scheduling. An extended bandwidth-expansion based packet......This paper investigates the uplink resource allocation problem in the context of LTE-Advanced systems with carrier aggregation (CA) and dual-cluster scheduling. On one hand these Rel’10 functionalities can increase the available transmission bandwidth and scheduling flexibility in uplink....... On the other hand they will introduce additional power back-off for the power amplifier in the user equipment (UE) with non-contiguous resource allocation. Taking into account that the uplink is inherently limited by the maximum transmission power of the UE, the assignment of uplink CA and/or dual cluster...

  6. Model for Team Training Using the Advanced Trauma Operative Management Course: Pilot Study Analysis.

    Science.gov (United States)

    Perkins, R Serene; Lehner, Kathryn A; Armstrong, Randy; Gardiner, Stuart K; Karmy-Jones, Riyad C; Izenberg, Seth D; Long, William B; Wackym, P Ashley

    2015-01-01

    Education and training of surgeons has traditionally focused on the development of individual knowledge, technical skills, and decision making. Team training with the surgeon's operating room staff has not been prioritized in existing educational paradigms, particularly in trauma surgery. We aimed to determine whether a pilot curriculum for surgical technicians and nurses, based on the American College of Surgeons' Advanced Trauma Operative Management (ATOM) course, would improve staff knowledge if conducted in a team-training environment. Between December 2012 and December 2014, 22 surgical technicians and nurses participated in a curriculum complementary to the ATOM course, consisting of 8 individual 8-hour training sessions designed by and conducted at our institution. Didactic and practical sessions included educational content, hands-on instruction, and alternating role play during 5 system-specific injury scenarios in a simulated operating room environment. A pre- and postcourse examination was administered to participants to assess for improvements in team members' didactic knowledge. Course participants displayed a significant improvement in didactic knowledge after working in a team setting with trauma surgeons during the ATOM course, with a 9-point improvement on the postcourse examination (83%-92%, p = 0.0008). Most participants (90.5%) completing postcourse surveys reported being "highly satisfied" with course content and quality after working in our simulated team-training setting. Team training is critical to improving the knowledge base of surgical technicians and nurses in the trauma operative setting. Improved communication, efficiency, appropriate equipment use, and staff awareness are the desired outcomes when shifting the paradigm from individual to surgical team training so that improved patient outcomes, decreased risk, and cost savings can be achieved. Determine whether a pilot curriculum for surgical technicians and nurses, based on the

  7. Foundational Report Series: Advanced Distribution Management Systems for Grid Modernization, Implementation Strategy for a Distribution Management System

    Energy Technology Data Exchange (ETDEWEB)

    Singh, Ravindra [Argonne National Lab. (ANL), Argonne, IL (United States); Reilly, James T. [Reilly Associates, Pittston, PA (United States); Wang, Jianhui [Argonne National Lab. (ANL), Argonne, IL (United States)

    2017-03-01

    Electric distribution utilities encounter many challenges to successful deployment of Distribution Management Systems (DMSs). The key challenges are documented in this report, along with suggestions for overcoming them. This report offers a recommended list of activities for implementing a DMS. It takes a strategic approach to implementing DMS from a project management perspective. The project management strategy covers DMS planning, procurement, design, building, testing, Installation, commissioning, and system integration issues and solutions. It identifies the risks that are associated with implementation and suggests strategies for utilities to use to mitigate them or avoid them altogether. Attention is given to common barriers to successful DMS implementation. This report begins with an overview of the implementation strategy for a DMS and proceeds to put forward a basic approach for procuring hardware and software for a DMS; designing the interfaces with external corporate computing systems such as EMS, GIS, OMS, and AMI; and implementing a complete solution.

  8. Potential mechanisms of disease progression and management of advanced-phase chronic myeloid leukemia

    Science.gov (United States)

    Jabbour, Elias J.; Hughes, Timothy P.; Cortés, Jorge E.; Kantarjian, Hagop M.; Hochhaus, Andreas

    2014-01-01

    Despite vast improvements in treatment of Philadelphia chromosome–positive chronic myeloid leukemia (CML) in chronic phase (CP), advanced stages of CML, accelerated phase or blast crisis, remain notoriously difficult to treat. Treatments that are highly effective against CML-CP produce disappointing results against advanced disease. Therefore, a primary goal of therapy should be to maintain patients in CP for as long as possible, by (1) striving for deep, early molecular response to treatment; (2) using tyrosine kinase inhibitors that lower risk of disease progression; and (3) more closely observing patients who demonstrate cytogenetic risk factors at diagnosis or during treatment. PMID:24050507

  9. Advanced containment research for the Canadian Nuclear Fuel Waste Management Program

    International Nuclear Information System (INIS)

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

    1986-09-01

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

  10. Advance Liquid Metal Reactor Discrete Dynamic Event Tree/Bayesian Network Analysis and Incident Management Guidelines (Risk Management for Sodium Fast Reactors)

    Energy Technology Data Exchange (ETDEWEB)

    Denman, Matthew R. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Groth, Katrina M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Cardoni, Jeffrey N. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Wheeler, Timothy A. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-04-01

    Accident management is an important component to maintaining risk at acceptable levels for all complex systems, such as nuclear power plants. With the introduction of self-correcting, or inherently safe, reactor designs the focus has shifted from management by operators to allowing the system's design to manage the accident. Inherently and passively safe designs are laudable, but nonetheless extreme boundary conditions can interfere with the design attributes which facilitate inherent safety, thus resulting in unanticipated and undesirable end states. This report examines an inherently safe and small sodium fast reactor experiencing a beyond design basis seismic event with the intend of exploring two issues : (1) can human intervention either improve or worsen the potential end states and (2) can a Bayesian Network be constructed to infer the state of the reactor to inform (1). ACKNOWLEDGEMENTS The authors would like to acknowledge the U.S. Department of Energy's Office of Nuclear Energy for funding this research through Work Package SR-14SN100303 under the Advanced Reactor Concepts program. The authors also acknowledge the PRA teams at Argonne National Laboratory, Oak Ridge National Laboratory, and Idaho National Laboratory for their continue d contributions to the advanced reactor PRA mission area.

  11. Advances and Challenges for Nutrient Management in China in the 21st Century

    NARCIS (Netherlands)

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

    2013-01-01

    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

  12. Advances in multi-agency disaster management : Key elements in disaster research

    NARCIS (Netherlands)

    Janssen, M.; Lee, J.; Bharosa, N.; Cresswell, A.

    2009-01-01

    Multi-agency disaster management requires collaboration among geographically distributed public and private organizations to enable a rapid and effective response to an unexpected event. Many disaster management systems often lack the capability to cope with the complexity and uncertainty. In this

  13. Technology of integral transformational yoga for leadership : Manuscript for advances in management

    NARCIS (Netherlands)

    Nandram, S.S.

    2011-01-01

    In management there is a need for holistic concepts to offer new perspective to leaders. Many management journals pay attention to this need by publishing articles on spirituality but most of them concentrate on defining spirituality. Yoga and meditation as spiritual tools become more and more

  14. Refraining from pre-hospital advanced airway management: a prospective observational study of critical decision making in an anaesthesiologist-staffed pre-hospital critical care service

    Science.gov (United States)

    2013-01-01

    Introduction We report prospectively recorded observational data from consecutive cases in which the attending pre-hospital critical care anaesthesiologist considered performing pre-hospital advanced airway management but decided to withhold such interventions. Materials and methods Anaesthesiologists from eight pre-hospital critical care teams in the Central Denmark Region (a mixed rural and urban region with 1.27 million inhabitants) registered data from February 1st 2011 to October 31st 2012. Included were patients of all ages for whom pre-hospital advanced airway management were considered but not performed. The main objectives were to investigate (1) the pre-hospital critical care anaesthesiologists’ reasons for considering performing pre-hospital advanced airway management in this group of patients (2) the pre-hospital critical care anaesthesiologists’ reasons for not performing pre-hospital advanced airway management (3) the methods used to treat these patients (4) the incidence of complications related to pre-hospital advanced airway management not being performed. Results We registered data from 1081 cases in which the pre-hospital critical care anaesthesiologists’ considered performing pre-hospital advanced airway management. The anaesthesiologists decided to withhold pre-hospital advanced airway management in 32.1% of these cases (n = 347). In 75.1% of these cases (n = 257) pre-hospital advanced airway management were withheld because of the patient’s condition and in 30.8% (n = 107) because of patient co-morbidity. The most frequently used alternative treatment was bag-mask ventilation, used in 82.7% of the cases (n = 287). Immediate complications related to the decision of not performing pre-hospital advanced airway management occurred in 0.6% of the cases (n = 2). Conclusion We have illustrated the complexity of the critical decision-making associated with pre-hospital advanced airway management. This study is the first to identify

  15. Recognizing and Managing Complexity: Teaching Advanced Programming Concepts and Techniques Using the Zebra Puzzle

    Science.gov (United States)

    Crabtree, John; Zhang, Xihui

    2015-01-01

    Teaching advanced programming can be a challenge, especially when the students are pursuing different majors with diverse analytical and problem-solving capabilities. The purpose of this paper is to explore the efficacy of using a particular problem as a vehicle for imparting a broad set of programming concepts and problem-solving techniques. We…

  16. Management of radiation necrosis and advanced cancer of the chest wall in patients with breast malignancy

    International Nuclear Information System (INIS)

    Woods, J.E.; Arnold, P.G.; Masson, J.K.; Irons, G.B.; Payne, W.S.

    1979-01-01

    Aggressive resection, with individualized reconstruction by several methods, is of value in many patients with radiation necrosis and/or advanced breast cancer of the chest wall. Although this does not always significantly lengthen survival, it can improve the quality of life markedly in many instances. Remarkably large defects can be reconstructed with single-stage procedures

  17. Advancing Environmental Education and Training for Sustainable Management of Environmental Resources in Palestine

    Science.gov (United States)

    Al-Sa'ed, Rashed; Abu-Madi, Maher; Heun, Jetze

    2009-01-01

    This article describes the various capacity-building activities at the Institute of Environmental and Water Studies of Birzeit University during the past 10 years. It highlights the gained experience in advancing environmental science and engineering education and training programs as components of sustainable water and environmental management…

  18. Vandetanib in advanced medullary thyroid cancer: review of adverse event management strategies

    DEFF Research Database (Denmark)

    Grande, Enrique; Kreissl, Michael C; Filetti, Sebastiano

    2013-01-01

    Vandetanib has recently demonstrated clinically meaningful benefits in patients with unresectable, locally advanced or metastatic medullary thyroid cancer (MTC). Given the potential for long-term vandetanib therapy in this setting, in addition to treatment for disease-related symptoms, effective ...

  19. Imaging of the pancreas: Recent advances

    Directory of Open Access Journals (Sweden)

    Vikas Chaudhary

    2011-01-01

    Full Text Available A wide spectrum of anomalies of pancreas and the pancreatic duct system are commonly encountered at radiological evaluation. Diagnosing pancreatic lesions generally requires a multimodality approach. This review highlights the new advances in pancreatic imaging and their applications in the diagnosis and management of pancreatic pathologies. The mainstay techniques include computed tomography (CT, magnetic resonance imaging (MRI, endoscopic ultrasound (EUS, radionuclide imaging (RNI and optical coherence tomography (OCT.

  20. Non-pharmacological nurse-led interventions to manage anxiety in patients with advanced cancer: A systematic literature review.

    Science.gov (United States)

    Zweers, Danielle; de Graaf, Everlien; Teunissen, Saskia C C M

    2016-04-01

    Anxiety is a common symptom in patients with advanced cancer. Although pharmacological and psychosocial interventions are recommended, it remains unclear which role nurses can play in supporting patients with anxiety. The objective was to provide an inventory of non-pharmacological nurse-led interventions and evaluate the effectiveness in managing anxiety in advanced cancer patients. A systematic literature review was performed from xx-xx-xxxx until March 2013. Four databases (MEDLINE, CINAHL, PsycINFO and Cochrane) were searched using predefined search terms without date limits. Randomized controlled trials, focusing on non-pharmacological nurse-led interventions in the management of anxiety in patients with advanced cancer were identified. Due to the heterogeneity of the included studies, results are presented in a descriptive way. A total of seven studies were included. The interventions were categorized into patient education, telemonitoring, psychotherapy, complementary care or a combination of these. Two studies showed significant improvements in anxiety levels in patients who received a psychoeducational intervention and in those who participated in a telemonitoring program. However, both studies were judged with a high risk of bias due to attrition, the randomization process and the lack of blinding which was not described. A complementary care intervention, a focused narrative interview and a telemonitoring program identified improvement in anxiety after each time the intervention was provided. However, no significant differences between intervention and control group were found. Although there is no firm evidence due to the high risk of bias, two studies showed that nurses could play a meaningful role in the management of anxiety with regard to early recognition and even in a specific set of psychotherapeutic interventions. Obviously, interventions should be adapted to the underlying cause of anxiety. However, the results of this systematic literature