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Sample records for alternative diagnostic strategies

  1. An alternative diagnostic strategy with lower radiatioin risk in young women with suspected pulmonary embolism

    NARCIS (Netherlands)

    Douma, R.A.; Kamphuisen, P.W.; Rijnders, A.J.M.; Hendrickx, B.; Ten Wolde, M.; Büller, H.R.

    2009-01-01

    Background: Since younger women have an increased risk of cancer following radiation exposure with CT scanning, they might benefit from an alternative diagnostic strategy for suspected pulmonary embolism (PE).Methods: We investigated the safety and efficiency of a diagnostic strategy consisting of

  2. An alternative strategy to western blot as a confirmatory diagnostic test for HIV infection.

    Science.gov (United States)

    Feng, Xia; Wang, Jibao; Gao, Zhiyun; Tian, Yu; Zhang, Ling; Chen, Huichao; Zhang, Tong; Xiao, Lin; Yao, Jun; Xing, Wenge; Qiu, Maofeng; Jiang, Yan

    2017-03-01

    In China, western blot (WB) is the recommended procedure for the diagnosis of HIV infection. However, this technique is time consuming and labor intensive, and its complexity restricts wide application in resource-limited regions. The aim of this study was to evaluate the efficacy of a dry blood spots (DBS)-urine paired enzyme-linked immunosorbent assay (ELISA) test, instead of WB, for HIV antibody detection. Plasma, DBS, and urine samples were collected from 1213 subjects from different populations. Two diagnostic testing strategies were conducted in parallel. The equivalence of the paired ELISA and WB strategies was assessed. A diagnosis of HIV was determined in 250 subjects according to the paired ELISA test, and in 249 according to the WB strategy. The discordant case was judged HIV-positive during follow-up. In total, 18 subjects were diagnosed with possible HIV using the paired ELISA test, among whom, 11 subjects tested negative with WB, and one was confirmed to be HIV-positive during follow-up. For the remaining 945 subjects, both strategies indicated a negative result. The kappa test indicated good conformity (kappa=0.954) between the two diagnostic strategies. The DBS-urine paired ELISA could be applied as an alternative to WB in HIV diagnosis, which would be valuable in resource-limited regions owing to the associated affordability and ease of use. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  3. Alternative diagnostic strategies for coronary artery disease in women: demonstration of the usefulness and efficiency of probability analysis

    International Nuclear Information System (INIS)

    Melin, J.A.; Wijns, W.; Vanbutsele, R.J.; Robert, A.; De Coster, P.; Brasseur, L.A.; Beckers, C.; Detry, J.M.

    1985-01-01

    Alternative strategies using conditional probability analysis for the diagnosis of coronary artery disease (CAD) were examined in 93 infarct-free women presenting with chest pain. Another group of 42 consecutive female patients was prospectively analyzed. For this latter group, the physician had access to the pretest and posttest probability of CAD before coronary angiography. These 135 women all underwent stress electrocardiographic, thallium scintigraphic, and coronary angiographic examination. The pretest and posttest probabilities of coronary disease were derived from a computerized Bayesian algorithm. Probability estimates were calculated by the four following hypothetical strategies: SO, in which history, including risk factors, was considered; S1, in which history and stress electrocardiographic results were considered; S2, in which history and stress electrocardiographic and stress thallium scintigraphic results were considered; and S3, in which history and stress electrocardiographic results were used, but in which stress scintigraphic results were considered only if the poststress probability of CAD was between 10% and 90%, i.e., if a sufficient level of diagnostic certainty could not be obtained with the electrocardiographic results alone. The strategies were compared with respect to accuracy with the coronary angiogram as the standard. For both groups of women, S2 and S3 were found to be the most accurate in predicting the presence or absence of coronary disease (p less than .05). However, it was found with use of S3 that more than one-third of the thallium scintigrams could have been avoided without loss of accuracy. It was also found that diagnostic catheterization performed to exclude CAD as a diagnosis could have been avoided in half of the patients without loss of accuracy.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Prostate carcinoma: current diagnostic strategy

    International Nuclear Information System (INIS)

    Schwarzschild, Monica Maria Agata Stiepcich; Ferraz, Maria Lucia Cardoso Gomes; Oliveira, Jose Marcelo Amatuzzi; Andriolo, Adagmar

    2001-01-01

    Prostate cancer is the second cause of cancer death in men in the Western world. Despite progress in the treatment of advanced disease, it is recognized that the only possibility of reduction in prostate cancer death is nearly diagnosis when the disease is localized. In the present study our aim was to review the current strategy for diagnosis of prostate carcinoma. Prostate-specific antigen (PSA) is a valuable tumor marker and has demonstrated effectiveness in detecting prostate carcinoma, monitoring therapeutic efficacy, and disclosing disease recurrence. However, alternative methods are been proposed just as the free to total PSA ratio, PSA density, PSA velocity, which could improve the diagnostic sensibility and the specificity. Image diagnostic methods include transrectal ultra sound, computerized tomography, magnetic resonance image, and bone cintigraphy. The ultra sound is the best approach to guide the prostate biopsy and, together with the magnetic resonance is still useful for loco regional graduation. Computerized tomography as magnetic resonance image can be used for identification of linfonodal involvement. Bone cintigraphy is the best method for the identification of metastatic disease. (author)

  5. Performance of alternative strategies for primary cervical cancer screening in sub-Saharan Africa: systematic review and meta-analysis of diagnostic test accuracy studies

    Science.gov (United States)

    Combescure, Christophe; Fokom-Defo, Victoire; Tebeu, Pierre Marie; Vassilakos, Pierre; Kengne, André Pascal; Petignat, Patrick

    2015-01-01

    Objective To assess and compare the accuracy of visual inspection with acetic acid (VIA), visual inspection with Lugol’s iodine (VILI), and human papillomavirus (HPV) testing as alternative standalone methods for primary cervical cancer screening in sub-Saharan Africa. Design Systematic review and meta-analysis of diagnostic test accuracy studies. Data sources Systematic searches of multiple databases including Medline, Embase, and Scopus for studies published between January 1994 and June 2014. Review methods Inclusion criteria for studies were: alternative methods to cytology used as a standalone test for primary screening; study population not at particular risk of cervical cancer (excluding studies focusing on HIV positive women or women with gynaecological symptoms); women screened by nurses; reference test (colposcopy and directed biopsies) performed at least in women with positive screening results. Two reviewers independently screened studies for eligibility and extracted data for inclusion, and evaluated study quality using the quality assessment of diagnostic accuracy studies 2 (QUADAS-2) checklist. Primary outcomes were absolute accuracy measures (sensitivity and specificity) of screening tests to detect cervical intraepithelial neoplasia grade 2 or worse (CIN2+). Results 15 studies of moderate quality were included (n=61 381 for VIA, n=46 435 for VILI, n=11 322 for HPV testing). Prevalence of CIN2+ did not vary by screening test and ranged from 2.3% (95% confidence interval 1.5% to 3.3%) in VILI studies to 4.9% (2.7% to 7.8%) in HPV testing studies. Positivity rates of VILI, VIA, and HPV testing were 16.5% (9.8% to 24.7%), 16.8% (11.0% to 23.6%), and 25.8% (17.4% to 35.3%), respectively. Pooled sensitivity was higher for VILI (95.1%; 90.1% to 97.7%) than VIA (82.4%; 76.3% to 87.3%) in studies where the reference test was performed in all women (Psub-Saharan Africa, VILI is a simple and affordable alternative to cytology that demonstrates higher

  6. Diagnostic Strategy in APR1400

    International Nuclear Information System (INIS)

    Kim, Dongyoung; Kim, Jonghyun

    2013-01-01

    These features may bring out changes in operator tasks, changing the characteristics of tasks, or creating new tasks. Diagnostic strategy for identifying anomaly may be different especially in APR1400 from that in the analog control room due to the change of human-system interface, i.e. alarm system and display system. Since the first plant of APR1400 is being built at this moment, it is not known what strategies the operators will adopt in diagnosis tasks in the new operating environment. In this light, this paper aims at investigating operator's diagnostic strategies which are appropriate for APR1400. In order to collect data, several different approaches which are complementary are used to identify diagnostic strategies in the digital control room: analysis on audio/video recording of operation, observation in the simulator, and interview with the operators. The result shows that the digital control room introduces new strategies in the diagnosis, compared with the analog control room, and also changed the characteristics of strategies, mostly, by getting more support from the computerized system. This paper investigated how the digitalized control room may influence operator's diagnostic strategies. Several different approaches, i. e., audio/video record, observation of training, and the interview with operators, were used to gather information about the operator's behaviors. As a conclusion, this paper figured out that the digital control room introduces new strategies in the diagnosis, compared with the analog control room, and also changed the characteristics of the strategies, mostly, by getting more support from the computerized system. The operators interviewed also commented that the diagnosis in the APR1400 is quicker, more correct, and easier, compared with the analog control room

  7. Diagnostic Strategy in APR1400

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dongyoung; Kim, Jonghyun [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

    2013-05-15

    These features may bring out changes in operator tasks, changing the characteristics of tasks, or creating new tasks. Diagnostic strategy for identifying anomaly may be different especially in APR1400 from that in the analog control room due to the change of human-system interface, i.e. alarm system and display system. Since the first plant of APR1400 is being built at this moment, it is not known what strategies the operators will adopt in diagnosis tasks in the new operating environment. In this light, this paper aims at investigating operator's diagnostic strategies which are appropriate for APR1400. In order to collect data, several different approaches which are complementary are used to identify diagnostic strategies in the digital control room: analysis on audio/video recording of operation, observation in the simulator, and interview with the operators. The result shows that the digital control room introduces new strategies in the diagnosis, compared with the analog control room, and also changed the characteristics of strategies, mostly, by getting more support from the computerized system. This paper investigated how the digitalized control room may influence operator's diagnostic strategies. Several different approaches, i. e., audio/video record, observation of training, and the interview with operators, were used to gather information about the operator's behaviors. As a conclusion, this paper figured out that the digital control room introduces new strategies in the diagnosis, compared with the analog control room, and also changed the characteristics of the strategies, mostly, by getting more support from the computerized system. The operators interviewed also commented that the diagnosis in the APR1400 is quicker, more correct, and easier, compared with the analog control room.

  8. Autocratic strategies for alternating games.

    Science.gov (United States)

    McAvoy, Alex; Hauert, Christoph

    2017-02-01

    Repeated games have a long tradition in the behavioral sciences and evolutionary biology. Recently, strategies were discovered that permit an unprecedented level of control over repeated interactions by enabling a player to unilaterally enforce linear constraints on payoffs. Here, we extend this theory of "zero-determinant" (or, more generally, "autocratic") strategies to alternating games, which are often biologically more relevant than traditional synchronous games. Alternating games naturally result in asymmetries between players because the first move matters or because players might not move with equal probabilities. In a strictly-alternating game with two players, X and Y, we give conditions for the existence of autocratic strategies for player X when (i) X moves first and (ii) Y moves first. Furthermore, we show that autocratic strategies exist even for (iii) games with randomly-alternating moves. Particularly important categories of autocratic strategies are extortionate and generous strategies, which enforce unfavorable and favorable outcomes for the opponent, respectively. We illustrate these strategies using the continuous Donation Game, in which a player pays a cost to provide a benefit to the opponent according to a continuous cooperative investment level. Asymmetries due to alternating moves could easily arise from dominance hierarchies, and we show that they can endow subordinate players with more autocratic strategies than dominant players. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Choosing wisely: a model-based analysis evaluating the trade-offs in cancer benefit and diagnostic referrals among alternative HPV testing strategies in Norway.

    Science.gov (United States)

    Burger, Emily A; Pedersen, Kine; Sy, Stephen; Kristiansen, Ivar Sønbø; Kim, Jane J

    2017-09-05

    Forthcoming cervical cancer screening strategies involving human papillomavirus (HPV) testing for women not vaccinated against HPV infections may increase colposcopy referral rates. We quantified health and resource trade-offs associated with alternative HPV-based algorithms to inform decision-makers when choosing between candidate algorithms. We used a mathematical simulation model of HPV-induced cervical carcinogenesis in Norway. We compared the current cytology-based strategy to alternative strategies that varied by the switching age to primary HPV testing (ages 25-34 years), the routine screening frequency (every 3-10 years), and management of HPV-positive, cytology-negative women. Model outcomes included reductions in lifetime cervical cancer risk, relative colposcopy rates, and colposcopy rates per cervical cancer prevented. The age of switching to primary HPV testing and the screening frequency had the largest impacts on cancer risk reductions, which ranged from 90.9% to 96.3% compared to no screening. In contrast, increasing the follow-up intensity of HPV-positive, cytology-negative women provided only minor improvements in cancer benefits, but generally required considerably higher rates of colposcopy referrals compared to current levels, resulting in less efficient cervical cancer prevention. We found that in order to maximise cancer benefits HPV-based screening among unvaccinated women should not be delayed: rather, policy makers should utilise the triage mechanism to control colposcopy referrals.

  10. Update on diagnostic strategies of pulmonary embolism

    International Nuclear Information System (INIS)

    Kauczor, H.U.; Heussel, C.P.; Thelen, M.

    1999-01-01

    Acute pulmonary embolism is a frequent disease with non-specific findings, high mortality, and multiple therapeutic options. A definitive diagnosis must be established by accurate, non-invasive, easily performed, cost-effective, and widely available imaging modalities. Conventional diagnostic strategies have relied on ventilation-perfusion scintigraphy complemented by venous imaging. If the results are inconclusive, pulmonary angiography, which is regarded as the gold standard, is to be performed. Recently, marked improvements in CT and MRI and shortcomings of scintigraphy led to an update of the diagnostic strategy. Spiral CT is successfully employed as a second-line procedure to clarify indeterminate scintigraphic results avoiding pulmonary angiography. It can also be used as a first-line screening tool if service and expertise is provided. Venous imaging is indicated if CT is inconclusive. The MRI technique can be applied as an alternative second-line test if spiral CT is not available or is contraindicated. It has the greatest potential for further developments and refinements. Echocardiography should be used as a first-line bedside examination in critical patients. If inconclusive stabilized patients undergo spiral CT, unstable patients should be referred for pulmonary angiography. Chronic thromboembolic pulmonary hypertension is a rare sequela of acute pulmonary embolism which can be cured surgically. Morphology, complications, and differential diagnoses are better illustrated by spiral CT and MRA, whereas invasive acquisition of hemodynamic data is the sole advantage of angiography. (orig.)

  11. Development of methodology for alternative testing strategies for the assessment of the toxicological profile of nanoparticles used in medical diagnostics. NanoTEST - EC FP7 project

    International Nuclear Information System (INIS)

    Dusinska, Maria; Fjellsbo, Lise Maria; Heimstad, Eldbjorg; Harju, Mikael; Bartonova, Alena; Tran, Lang; Juillerat-Jeanneret, Lucienne; Halamoda, Blanka; Marano, Francelyne; Boland, Sonja; Saunders, Margaret; Cartwright, Laura; Carreira, Sara; Thawley, Susan; Whelan, Maurice; Klein, Christoph; Housiadas, Christos; Volkovova, Katarina; Tulinska, Jana; Beno, Milan

    2009-01-01

    Nanoparticles (NPs) have unique, potentially beneficial properties, but their possible impact on human health is still not known. The area of nanomedicine brings humans into direct contact with NPs and it is essential for both public confidence and the nanotech companies that appropriate risk assessments are undertaken in relation to health and safety. There is a pressing need to understand how engineered NPs can interact with the human body following exposure. The FP7 project NanoTEST (www.nanotest-fp7.eu) addresses these requirements in relation to the toxicological profile of NPs used in medical diagnostics.

  12. [UroMRI, a diagnostic alternative].

    Science.gov (United States)

    Nemecek, Tanja Andrea; Militello, José Ignacio

    2008-10-01

    This paper aims to evaluate the clinical and diagnostic usefulness of uro MRI, to show the study technique and to establish correlations of some of its results with conventional intravenous urography (IVU). Frequency and prevalence by age and gender of pathologies were evaluated. We studied a total of 58 patients, 31 females and 27 males, with an age range between 22-92 years. All patients underwent uro MRI between April 2003 and January 2005. We perform a double-blind study with those patients undergoing conventional IVU before uro MRI. The total number of patients evaluated was 58, 35 of which present more than 1 concurrent pathology 17.2% (n=10) of the studies were normal, five males and five females, with an age range between 22 and 83 years, and a mean age of 46.1 years. IVU was diagnostic for 100% and 83.3% of A and B observers respectively; uro MRI was diagnostic for 50% and 0% respectively. Ureteral lithiasis showed a result of 50% and 100% for IVU; uro MRI had a 75% for both observers. In cases of double pyelocalyceal system both methods have a 100% accordance between both observers. In bladder cancer, uro MRI was diagnostic in 100% and IVU in 0% for both observers. The most frequent concurrent pathology was cystic renal disease, and the second was urolithiasis with urinary tract dilation. Uro MRI was superior to see bladder and pyeloureteral pathologies, but in cases of renal lithiasis and urinary tract calcifications IVU is the test of choice yet.

  13. randomised trial of alternative malaria chemoprophylaxis strategies ...

    African Journals Online (AJOL)

    hi-tech

    2000-02-02

    Feb 2, 2000 ... College of Health Sciences, Tanzania, K. Rukinisha, DMLT, Maweni Regional Hospital, Kigoma, Tanzania and W. Mpanju-Shumbusho, MD, MPH, ... Objective: The objective of the study was to assess the effectiveness of alternative strategies ... strategies for protecting pregnant women against malaria.

  14. Summary: analysis of alternative FBR development strategies

    International Nuclear Information System (INIS)

    Burnham, J.B.

    1981-12-01

    This report summarizes the comparative evaluation of alternative strategies for the development of the commercial fast breeder reactor (FBR) in the United States. For planning purposes, a range of possible FBR development paths called strategies were selected for evaluation. These strategies, designed to be technically and economically feasible, were expressed in terms of the timing and nature of facilities/research and development programs required to reach full power operation of the first commercial FBR. Four of the seven strategies resulted in a large (1457 MWe) FBR as an end point, the other three in a 1000-MWe plant. Probability distributions were calculated for total strategy costs and time to completion. For the seven strategies analyzed, the costs (discounted 1980 dollars) ranged from $1.8 billion to $4.9 billion; the completion times ranged from 24 to 55 years

  15. Alternative lithography strategies for flexible electronics

    NARCIS (Netherlands)

    Moonen, P.

    2012-01-01

    Main aim of the research has been the development of alternative lithography strategies for the fabrication of complex, flexible electronic devices. Flexible bottom-contact, bottom-gate thin-film transistors were solely patterned with UV nanoimprint lithography on poly(ethylene naphthalate) foil.

  16. Alternative entrepreneurial options: a policy mitigation strategy ...

    African Journals Online (AJOL)

    This study focused on alternative entrepreneurial options as a mitigation strategy against climate change among part-time farmers in Abia state Nigeria. Some farmers abandoned farming in the face of reoccurring adverse weather conditions to other livelihood sustaining activities. The objectives were to examine the ...

  17. Research requirements for alternative reactor development strategies

    International Nuclear Information System (INIS)

    1979-06-01

    The purpose of this paper is to estimate and compare resource requirements and other fuel cycle quantities for alternative reactor deployment strategies. The paper examines from global and national perspectives the interaction of various fuel cycle alternatives described in the previous U.S. submissions to Working Groups 4, 5, 8 and Subgroup 1A/2A. Nuclear energy forecasts of Subgroup 1A/2A are used in the calculation of uranium demand for each strategy. These uranium demands are then compared to U.S. estimates of annual uranium producibility. Annual rather than cumulative producibility was selected because it does not assume preplanned stockpiling, and is therefore more conservative. The strategies attempt to span a range of nuclear power mixes which could evolve if appropriate commercial and governmental climates develop

  18. Alternative evacuation strategies for nuclear power accidents

    International Nuclear Information System (INIS)

    Hammond, Gregory D.; Bier, Vicki M.

    2015-01-01

    In the U.S., current protective-action strategies to safeguard the public following a nuclear power accident have remained largely unchanged since their implementation in the early 1980s. In the past thirty years, new technologies have been introduced, allowing faster computations, better modeling of predicted radiological consequences, and improved accident mapping using geographic information systems (GIS). Utilizing these new technologies, we evaluate the efficacy of alternative strategies, called adaptive protective action zones (APAZs), that use site-specific and event-specific data to dynamically determine evacuation boundaries with simple heuristics in order to better inform protective action decisions (rather than relying on pre-event regulatory bright lines). Several candidate APAZs were developed and then compared to the Nuclear Regulatory Commission’s keyhole evacuation strategy (and full evacuation of the emergency planning zone). Two of the APAZs were better on average than existing NRC strategies at reducing either the radiological exposure, the population evacuated, or both. These APAZs are especially effective for larger radioactive plumes and at high population sites; one of them is better at reducing radiation exposure, while the other is better at reducing the size of the population evacuated. - Highlights: • Developed framework to compare nuclear power accident evacuation strategies. • Evacuation strategies were compared on basis of radiological and evacuation risk. • Current strategies are adequate for smaller scale nuclear power accidents. • New strategies reduced radiation exposure and evacuation size for larger accidents

  19. Biliary parasites: diagnostic and therapeutic strategies.

    Science.gov (United States)

    Khandelwal, Niraj; Shaw, Joanna; Jain, Mamta K

    2008-04-01

    Parasitic infections of the biliary tract are a common cause of biliary obstruction in endemic areas. This article focuses on primary biliary parasites: Ascaris lumbricoides, Clonorchis sinensis, Opisthorchis viverrini, Opisthorchis felineus, Dicrocoelium dendriticum, Fasciola hepatica, and Fasciola gigantica. Tropical and subtropical countries have the highest incidence and prevalence of these infections. Diagnosis is made primarily through direct microscopic examination of eggs in the stool, duodenal, or bile contents. Radiologic imaging may show intrahepatic ductal dilatation, whereas endoscopic retrograde cholangiopancreatography can be used diagnostically and therapeutically. However, oral treatment is inexpensive and effective for most of these parasites and can prevent untoward consequences. Primary and alternative treatments are available and are reviewed in this article.

  20. Antiphospholipid Syndrome Laboratory Testing and Diagnostic Strategies

    Science.gov (United States)

    Ortel, Thomas L.

    2016-01-01

    The Antiphospholipid Syndrome (APS) is diagnosed in patients with recurrent thromboembolic events and/or pregnancy loss in the presence of persistent laboratory evidence for antiphospholipid antibodies. Diagnostic tests for the detection of antiphospholipid antibodies include laboratory assays that detect anticardiolipin antibodies, lupus anticoagulants, and anti-β2-glycoprotein I antibodies. These assays have their origins beginning more than sixty years ago, with the identification of the biologic false positive test for syphilis, the observation of ‘circulating anticoagulants’ in certain patients with systemic lupus erythematosus, the identification of cardiolipin as a key component in the serologic test for syphilis, and the recognition and characterization of a ‘cofactor’ for antibody binding to phospholipids. Although these assays have been used clinically for many years, there are still problems with the accurate diagnosis of patients with this syndrome. For example, lupus anticoagulant testing can be difficult to interpret in patients receiving anticoagulant therapy, but most patients with a thromboembolic event will already be anticoagulated before the decision to perform the tests has been made. In addition to understanding limitations of the assays, clinicians also need to be aware of which patients should be tested and not obtain testing on patients unlikely to have APS. New tests and diagnostic strategies are in various stages of development and should help improve our ability to accurately diagnose this important clinical disorder. PMID:22473619

  1. Instructional Strategies Alternative for Reading Comprehension

    Directory of Open Access Journals (Sweden)

    Yajaira del Valle Cadenas Terán

    2017-05-01

    Full Text Available The purpose of this research is to expose significantly instruccionales strategic alternatives that help improve the process of reading in college students to be trained holistically, able to make critical decisions, thoughtful and successful in the academic field. The strategies implemented educational event isolated to produce no change is necessary, that are planned and executed in the proper context of the need to ensure a certain extent the instructional success. It is also essential that teachers be the first to appropriate it. This study was conducted with a literature review serves as instructional foundation - strategic. In conclusion the importance of instructional strategies in reading comprehension was determined, since they increase communication skills, provide specific or complex experiences and promote meaningful learning.

  2. Exploring alternative assessment strategies in science classrooms

    Directory of Open Access Journals (Sweden)

    Michèle Stears

    2010-01-01

    Full Text Available The knowledge children bring to the classroom or construct in the classroom may find expression in a variety of activities and is often not measurable with the traditional assessment instruments used in science classrooms. Different approaches to assessment are required to accommodate the various ways in which learners construct knowledge in social settings. In our research we attempted to determine the types of outcomes achieved in a Grade 6 classroom where alternative strategies such as interactive assessments were implemented. Analyses of these outcomes show that the learners learned much more than the tests indicate, although what they learnt was not necessarily science. The implications for assessment are clear: strategies that assess knowledge of science concepts, as well as assessment of outcomes other than science outcomes, are required if we wish to gain a holistic understanding of the learning that occurs in science classrooms.

  3. Alternative models of DSM-5 PTSD: Examining diagnostic implications.

    Science.gov (United States)

    Murphy, Siobhan; Hansen, Maj; Elklit, Ask; Yong Chen, Yoke; Raudzah Ghazali, Siti; Shevlin, Mark

    2018-04-01

    The factor structure of DSM-5 posttraumatic stress disorder (PTSD) has been extensively debated with evidence supporting the recently proposed seven-factor Hybrid model. However, despite myriad studies examining PTSD symptom structure few have assessed the diagnostic implications of these proposed models. This study aimed to generate PTSD prevalence estimates derived from the 7 alternative factor models and assess whether pre-established risk factors associated with PTSD (e.g., transportation accidents and sexual victimisation) produce consistent risk estimates. Seven alternative models were estimated within a confirmatory factor analytic framework using the PTSD Checklist for DSM-5 (PCL-5). Data were analysed from a Malaysian adolescent community sample (n = 481) of which 61.7% were female, with a mean age of 17.03 years. The results indicated that all models provided satisfactory model fit with statistical superiority for the Externalising Behaviours and seven-factor Hybrid models. The PTSD prevalence estimates varied substantially ranging from 21.8% for the DSM-5 model to 10.0% for the Hybrid model. Estimates of risk associated with PTSD were inconsistent across the alternative models, with substantial variation emerging for sexual victimisation. These findings have important implications for research and practice and highlight that more research attention is needed to examine the diagnostic implications emerging from the alternative models of PTSD. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Evaluation of alternative MGDS development strategies

    International Nuclear Information System (INIS)

    Roberds, W.; Miller, I.; Caldwell, D.

    1991-01-01

    A methodology has been developed to explicitly and quantitatively evaluate acceptable alternative repository development strategies, in terms of the degree to which they are likely to satisfy a specified set of system objectives (e.g., minimizing overall costs through closure, time to initial waste receipt and long-term health effects). An open-quotes acceptableclose quotes strategy is one which has a high likelihood of satisfying specified system functions and requirements. Simple but comprehensive system models have been developed to estimate the relevant consequences of any strategy, explicitly considering system uncertainties and contingencies, including the possibility of finding the site to be unsuitable and having to develop a repository elsewhere. Such open-quotes technical assessments,close quotes which are appropriately developed by technical experts, can then be combined with separate open-quotes value judgementsclose quotes regarding preferences and tradeoffs among the consequences, which are appropriately determined by the decision makers/stake holders (rather than by the technical experts) in order to explicitly determine preferences among the acceptable strategies. Implementation of the methodology has been demonstrated by example

  5. Colorectal cancer: diagnostic and therapeutic strategies

    International Nuclear Information System (INIS)

    Vaillant, J.C.

    1996-01-01

    Technical advances that has been achieved during the past two decades have not dramatically improved the 35 % five-year rate observed in patients with colorectal cancer. These tumours remain one of the most challenging problems in public health policies in western countries. Screening applies to some subgroups of high-risk individuals and the general population aged over 50. In order to improve their efficacy, such screening programs imply large-scale information campaigns and a strong cooperation with the general physicians. The diagnosis is strongly suggested by any recent modification of bowel habits ad by rectal bleeding. It has to be confirmed by rectal examination and by colonoscopy which allows sampling to the tumour. Loco-regional and distant metastatic tumour spread must be assessed precisely before any therapeutic strategy is decided. Surgery, which resects the tumour en bloc with the corresponding lymphatic territories, is the only treatment that can achieve long term cure. In localized tumours, surgery alone can provide patients with 5-years survival rates close to 95 %. On the other hand, surgery alone is not sufficient to cure patients with advances cancers. In recent years, several adjuvant therapeutic modalities have been shown to improve the results of surgery in these cases (rectal cancer: pre-operative radiotherapy or post-operative radio-chemotherapy, colon cancer with nodal metastases: post-operative chemotherapy). There is a hope that a better use of our diagnostic and therapeutic armementarium would be able to avoid or to cure up to 75 % of the colorectal cancers we are dealing with. (author)

  6. Bone Grafting: Sourcing, Timing, Strategies, and Alternatives.

    Science.gov (United States)

    Egol, Kenneth A; Nauth, Aaron; Lee, Mark; Pape, Hans-Christoph; Watson, J Tracy; Borrelli, Joseph

    2015-12-01

    Acute fractures, nonunions, and nonunions with bone defects or osteomyelitis often need bone graft to facilitate union. There are several factors to consider when it is determined that a bone graft is needed. These factors include the source of the bone graft (autograft vs. allograft), proper timing for placement of the bone graft, strategies to avoid further complications (particularly in the setting of osteomyelitis), and with the development of a variety of bone graft substitutes, whether alternatives to autograft are available and appropriate for the task at hand. Autograft bone has commonly been referred to as the "gold standard" of bone grafts, against which the efficacy of other grafts has been measured. The best timing for when to place a bone graft or substitute is also somewhat controversial, particularly after an open fracture or a potentially contaminated bed. The treatment of infected nonunions, particularly those that require a graft to facilitate healing, can be quite challenging. Typically, the infection is completely eradicated before placement of a bone graft, but achieving a sterile bed and the timing of a bone graft require strategic thinking and planning. This review outlines the benefits of autografts, the most suitable sites for harvesting bone grafts, the timing of bone graft procedures, the potential risks and benefits of grafting in the face of infection, and the currently available bone graft extenders.

  7. 24 CFR 248.223 - Alternative State strategy.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Alternative State strategy. 248.223... Preservation Act of 1987 § 248.223 Alternative State strategy. (a) The Commissioner may approve a State strategy providing for State approval of plans of action that involve termination of low income...

  8. Desquamative inflammatory vaginitis: differential diagnosis and alternate diagnostic criteria.

    Science.gov (United States)

    Bradford, Jennifer; Fischer, Gayle

    2010-10-01

    To describe alternate diagnostic protocols and describe the differential diagnosis for desquamative inflammatory vaginitis (DIV). One hundred one cases of DIV were audited retrospectively. All patients were seen exclusively by the authors in their private practices using diagnostic criteria applicable to local practice limitations. Other potential etiologies (infection, contact irritant vaginitis, fixed drug eruptions, immunobullous diseases, estrogen hypersensitivity vulvovaginitis, and graft-vs-host disease) were excluded by history, examination, and focused trials of treatment. Historical triggers in the study cohort and a control group of 75 women with lichen planus also drawn from the authors' private practice were compared. Patients were treated with 4 to 6 weeks of topical vaginal antibiotics, 94% with clindamycin, and response to treatment was recorded at subsequent follow-up. All patients were white. Of 101 patients, 57 (56%) had historical triggers, most frequently diarrhea or antibiotic treatment. Of the 75 women in the control group with vaginal lichen planus, 11 had historical triggers (15%, p treatment. Of this group, 10 patients who had triggers for their vaginitis, which were ongoing, were cured when their triggers were finally controlled or cured, leaving 35 patients who required long-term maintenance therapy. Desquamative inflammatory vaginitis seems to be a distinct entity of vaginitis that, in an office setting, can be distinguished from other diagnostic possibilities by careful clinical evaluation and focused trials of treatment. The majority of women responded promptly to intravaginal antibiotics, with approximately 35% of cases requiring maintenance therapy. More than half the cases have an historical trigger. We postulate that DIV occurs when a trigger causes shifts in vaginal homeostasis, resulting in an inflammatory response associated with increased epithelial cell turnover.

  9. Autoimmune diagnostics: the technology, the strategy and the clinical governance.

    Science.gov (United States)

    Bizzaro, Nicola; Tozzoli, Renato; Villalta, Danilo

    2015-02-01

    In recent years, there has been a profound change in autoimmune diagnostics. From long, tiring and inaccurate manual methods, the art of diagnostics has turned to modern, rapid and automated technology. New antibody tests have been developed, and almost all autoimmune diseases now have some specific diagnostic markers. The current need to make the most of available economic and human resources has led to the production of diagnostic algorithms and guidelines designated for optimal strategic use of the tests and to increase the diagnostic appropriateness. An important role in this scenario was assumed by the laboratory autoimmunologist, whose task is not only to govern the analytical phase, but also to help clinicians in correctly choosing the most suitable test for each clinical situation and provide consultancy support. In this review, we summarize recent advances in technology, describe the diagnostic strategies and highlight the current role of the laboratory autoimmunologist in the clinical governance of autoimmune diagnostics.

  10. Epidemiology of and Diagnostic Strategies for Toxoplasmosis

    Science.gov (United States)

    Dardé, Marie-Laure

    2012-01-01

    Summary: The apicomplexan parasite Toxoplasma gondii was discovered a little over 100 years ago, but knowledge of its biological life cycle and its medical importance has grown in the last 40 years. This obligate intracellular parasite was identified early as a pathogen responsible for congenital infection, but its clinical expression and the importance of reactivations of infections in immunocompromised patients were recognized later, in the era of organ transplantation and HIV infection. Recent knowledge of host cell-parasite interactions and of parasite virulence has brought new insights into the comprehension of the pathophysiology of infection. In this review, we focus on epidemiological and diagnostic aspects, putting them in perspective with current knowledge of parasite genotypes. In particular, we provide critical information on diagnostic methods according to the patient's background and discuss the implementation of screening tools for congenital toxoplasmosis according to health policies. PMID:22491772

  11. Characterization of alternative FBR development strategies

    International Nuclear Information System (INIS)

    Boegel, A.J.; Clausen, M.J.

    1981-08-01

    Near-term decisions regarding the nature and place of the FBR development program must be made. This study is part of a larger program designed to provide the Department of Energy (DOE) with imformation that can be used to make strategic programmatic decisions. The focus of this report is the description of alternative approaches for developing the FBR and the quantification of the duration and cost of each alternative. The time frames of the alternative approaches are investigated in companion reports (White 1981 and Fraley 1981). The results of these analyses will be described in a summary report

  12. Chromatin conformation capture strategies in molecular diagnostics

    NARCIS (Netherlands)

    de Vree, Pauline J.P.

    2015-01-01

    In this thesis I have explored the clinical potential of the 4C-technology and worked on development of a novel chromatin conformation capture based technology, called TLA. In chapter 2 I describe how the 4C-technology can be applied as a targeted strategy to identify putative fusion-genes or

  13. SYNTHESIS OF INFORMATION MODEL FOR ALTERNATIVE FUNCTIONAL DIAGNOSTICS PROCEDURE

    OpenAIRE

    P. F. Shchapov; R. P. Miguschenko

    2014-01-01

    Probabilistic approaches in information theory and information theory of measurement, allowing to calculate and analyze the amount expected to models measuring conversions and encoding tasks random measurement signals were considered. A probabilistic model of diagnostic information model transformation and diagnostic procedures was developed. Conditions for obtaining the maximum amount of diagnostic information were found out.

  14. Panniculitis: definition of terms and diagnostic strategy.

    Science.gov (United States)

    Diaz Cascajo, C; Borghi, S; Weyers, W

    2000-12-01

    Inflammation of the subcutaneous tissue represents a dynamic process that shows different histopathologic findings at different stages of development; therefore, the stage of evolution of a lesion at the time of biopsy influences the microscopic appearance significantly. Furthermore, location and type of inflammation may vary among different examples of the same panniculitis independent of the stage of evolution. For these reasons, the histopathologic diagnosis of panniculitides is often difficult. Currently, the most common approach to diagnosis is differentiation between predominantly septal and predominantly lobular panniculitis, followed by the distinction between lesions with and without vasculitis. Although these criteria are important for diagnosis, they are often insufficiently specific. To determine an alternative method of diagnosis, 329 cases of panniculitis were histopathologically analyzed using the following parameters: location and type of inflammatory infiltrate within and around the subcutaneous tissue, presence or absence of fat necrosis, type of necrosis, presence or absence of vascular changes, and presence or absence of associated findings (e.g., hemorrhage, sclerosis). On the basis of the results of this study and of an extensive review of the literature, tables of histopathologic findings for the diagnosis of panniculitides are presented.

  15. randomised trial of alternative malaria chemoprophylaxis strategies ...

    African Journals Online (AJOL)

    hi-tech

    2000-02-02

    Feb 2, 2000 ... consequences of malaria on the health status of pregnant women and their unborn children, regular ... strategies for protecting pregnant women against malaria. The present research project envisaged to test ..... from malaria vaccine trial conducted among Tanzanian children in Ifakara district appear to be ...

  16. Short Horizon Control Strategies for an Alternating Activated Sludge Process

    DEFF Research Database (Denmark)

    Isaacs, Steven Howard

    1996-01-01

    Three control strategies allowing improved operational flexibility of an alternating type activated sludge process are presented in a unified model based framework. The control handles employed are the addition rate of an external carbon source to denitrification, the cycle length...

  17. Endoscopy as a diagnostic and therapeutic alternative technique of taeniasis

    Directory of Open Access Journals (Sweden)

    Héctor Julian Canaval-Zuleta

    Full Text Available Despite a low incidence in developed countries, gastrointestinal taeniasis should be suspected in patients with abdominal pain, diarrhea, anemia, and/or malabsorption of unknown origin, even more so if they come from endemic regions or areas with poor hygienic and alimentary habits. Diagnosis is traditionally reached by identifying the parasite in stools, but more recently both serological and immunological approaches are also available. Based on a patient diagnosed by gastroscopy, a literature review was undertaken of patients diagnosed by endoscopy. We discuss endoscopy as diagnostic modality, and the effectiveness and safety that endoscopic treatment may provide in view of the potential risk for neurocysticercosis.

  18. Implications of caries diagnostic strategies for clinical management decisions

    DEFF Research Database (Denmark)

    Baelum, Vibeke; Hintze, Hanne; Wenzel, Ann

    2012-01-01

    OBJECTIVES: In clinical practice, a visual-tactile caries examination is frequently supplemented by bitewing radiography. This study evaluated strategies for combining visual-tactile and radiographic caries detection methods and determined their implications for clinical management decisions...... that the visual-tactile method alone was the superior strategy, resulting in most correct clinical management decisions and most correct decisions regarding the choice of treatment.......-specificity) were calculated for each diagnostic strategy. RESULTS: Visual-tactile examination provided a true-positive rate of 34.2% and a false-positive rate of 1.5% for the detection of a cavity. The combination of a visual-tactile and a radiographic examination using the lesion in dentin threshold...

  19. A diagnostic tree model for polytomous responses with multiple strategies.

    Science.gov (United States)

    Ma, Wenchao

    2018-04-23

    Constructed-response items have been shown to be appropriate for cognitively diagnostic assessments because students' problem-solving procedures can be observed, providing direct evidence for making inferences about their proficiency. However, multiple strategies used by students make item scoring and psychometric analyses challenging. This study introduces the so-called two-digit scoring scheme into diagnostic assessments to record both students' partial credits and their strategies. This study also proposes a diagnostic tree model (DTM) by integrating the cognitive diagnosis models with the tree model to analyse the items scored using the two-digit rubrics. Both convergent and divergent tree structures are considered to accommodate various scoring rules. The MMLE/EM algorithm is used for item parameter estimation of the DTM, and has been shown to provide good parameter recovery under varied conditions in a simulation study. A set of data from TIMSS 2007 mathematics assessment is analysed to illustrate the use of the two-digit scoring scheme and the DTM. © 2018 The British Psychological Society.

  20. Rational design of diagnostic and vaccination strategies for tuberculosis

    Directory of Open Access Journals (Sweden)

    Sibele Borsuk

    Full Text Available The development of diagnostic tests which can readily differentiate between vaccinated and tuberculosis-infected individuals is crucial for the wider utilization of bacillus Calmette-Guérin (BCG as vaccine in humans and animals. BCG_0092 is an antigen that elicits specific delayed type hypersensitivity reactions similar in size and morphological aspects to that elicited by purified protein derivative, in both animals and humans infected with the tubercle bacilli. We carried out bioinformatics analyses of the BCG_0092 and designed a diagnostic test by using the predicted MHC class I epitopes. In addition, we performed a knockout of this gene by homologous recombination in the BCG vaccine strain to allow differentiation of vaccinated from infected individuals. For that, the flanking sequences of the target gene (BCG_0092were cloned into a suicide vector. Spontaneous double crossovers, which result in wild type revertants or knockouts were selected using SacB. BCG_0092 is present only in members of the Mycobacterium tuberculosis complex. Eight predicted MHC class I epitopes with potential for immunological diagnosis were defined, allowing the design of a specific diagnostic test. The strategy used to delete the (BCG_0092 gene from BCG was successful. The knockout genotype was confirmed by PCR and by Southern blot. The mutant BCG strain has the potential of inducing protection against tuberculosis without interfering with the diagnostic test based on the use of selected epitopes from BCG_0092.

  1. Telemetry with an Optical Fiber Revisited: An Alternative Strategy

    Science.gov (United States)

    Kraftmakher, Yaakov

    2014-01-01

    With a new data-acquisition system developed by PASCO scientific, an experiment on telemetry with an optical fiber can be made easier and more accurate. For this aim, an alternative strategy of the remote temperature measurements is proposed: the frequency of light pulses transmitted via the light guide numerically equals the temperature using…

  2. Promoting Alternative Thinking Strategies (PATHS): Evaluation Report and Executive Summary

    Science.gov (United States)

    Humphrey, Neil; Barlow, Alexandra; Wigelsworth, Michael; Lendrum, Ann; Pert, Kirsty; Joyce, Craig; Stephens, Emma; Wo, Lawrence; Squires, Garry; Woods, Kevin; Calam, Rachel; Harrison, Mark; Turner, Alex; Humphrey, Neil

    2015-01-01

    Promoting Alternative Thinking Strategies (PATHS) is a school-based social and emotional learning (SEL) curriculum that aims to help children in primary school manage their behaviour, understand their emotions, and work well with others. PATHS consists of a series of lessons that cover topics such as identifying and labelling feelings, controlling…

  3. Nonequilibrium relaxation method – An alternative simulation strategy

    Indian Academy of Sciences (India)

    the results to infinite system. This equilibrium method traces over the standard theory of the thermal statistical mechanics, and over the idea of the thermodynamic limit. Recently, an alternative simulation strategy has been developed, which analyzes the nonequilibrium relaxation (NER) process. It is called the NER method.

  4. Alternative search strategies to explore ATLAS diboson excess

    Indian Academy of Sciences (India)

    Charanjit K Khosa

    Alternative search strategies to explore ATLAS diboson excess. CHARANJIT K KHOSA. Centre for High Energy Physics, Indian Institute of Science, Bengaluru 560 012, India. E-mail: khosacharanjit@chep.iisc.ernet.in. Published online 5 October 2017. Abstract. We consider the s-channel resonance to fit the 2 TeV ATLAS ...

  5. Reconstruction of the Anterior Cruciate Ligament : Alternative Strategies

    NARCIS (Netherlands)

    van Eijk, F.

    2009-01-01

    This thesis describes the long-term results of reconstruction of the anterior cruciate ligament with an allograft. Due to the poor results found, further studies were performed to investigate alternative strategies for reconstruction of the anterior cruciate ligament in the field of tissue

  6. Alternating-time temporal logic with finite-memory strategies

    DEFF Research Database (Denmark)

    Vester, Steen

    2013-01-01

    Model-checking the alternating-time temporal logics ATL and ATL* with incomplete information is undecidable for perfect recall semantics. However, when restricting to memoryless strategies the model-checking problem becomes decidable. In this paper we consider two other types of semantics based...

  7. Proteinuria: The diagnostic strategy based on urine proteins differentiation

    Directory of Open Access Journals (Sweden)

    Stojimirović Biljana B.

    2004-01-01

    Full Text Available Basal glomerular membrane represents mechanical and electrical barrier for passing of the plasma proteins. Mechanical barrier is composed of cylindrical pores and filtration fissure, and negative layer charge in exterior and interior side of basal glomerular membrane, made of heparan sulphate and sialoglicoproteine, provides certain electrical barrier. Diagnostic strategy based on different serum and urine proteins enables the differentiation of various types of proteinuria. Depending on etiology of proteinuria it can be prerenal, renal and postrenal. By analyzing albumin, armicroglobulin, immunoglobulin G and armacroglobulin, together with total protein in urine, it is possible to detect and differentiate causes of prerenal, renal (glomerular, tubular, glomerulo-tubular and postrenal proteinuria. The adequate and early differentiation of proteinuria type is of an immense diagnostic and therapeutic importance.

  8. [Food intolerance: reliability and characteristics of different diagnostic alternative tests].

    Science.gov (United States)

    Palmieri, B; Esposito, A; Capone, S; Fistetto, G; Iannitti, T

    2011-03-01

    The expression "food intolerance" dates back to the ancient Greece and can be generally defined as a sum of unpleasant symptoms of varying etiology that can onset in some patients after the ingestion of various food products. Adverse reactions to food can be divided into toxic and non-toxic. The last ones are classified as immunologically mediated, called "allergies", and non-immunologically mediated, commonly defined as "intolerances". The gut wall is directly involved in these adverse reactions to some foods, since it plays a key role in food absorption and in the regulation of the immunitary system. In this paper we discuss food intolerances and allergies, evaluating the available diagnostic methods and their scientific reliability and focusing on IgG analysis based immunoenzymatic test which is the most relevant test for intolerance diagnosis.

  9. Female impersonation as an alternative reproductive strategy in giant cuttlefish

    OpenAIRE

    Norman, M. D.; Finn, J.; Tregenza, T.

    1999-01-01

    Out of all the animals, cephalopods possess an unrivalled ability to change their shape and body patterns. Our observations of giant cuttlefish (Sepia apama) suggest this ability has allowed them to evolve alternative mating strategies in which males can switch between the appearance of a female and that of a male in order to foil the guarding attempts of larger males. At a mass breeding aggregation in South Australia, we repeatedly observed single small males accompanying mating pairs. While...

  10. Testing and assessment strategies, including alternative and new approaches

    DEFF Research Database (Denmark)

    Meyer, Otto A.

    2003-01-01

    ethical concern. However, irrespective of animal welfare it is an important aspect of the discipline of toxicology that the primary object is human health. The ideal testing and assessment strategy is simple to use all the available test methods and preferably more in laboratory animal species from which...... there are more than 100000 chemicals which are potential for human exposure, so the development of alternative testing and assessment strategies has taken place in the recent years. The toxicological evaluation should enable the society to cope with the simultaneous requirement of many chemicals for different...... uses and of the absence of health problems involved with their use. Thus, the regulatory toxicology is a cocktail of science and pragmatism added a crucial concern for animal welfare. Test methods are most often used in a testing sequence as bricks in a testing strategy. The main key driving forces...

  11. Improving the existing diagnostic strategy by accounting for characteristics of the women in the diagnostic work up for postmenopausal bleeding

    NARCIS (Netherlands)

    Opmeer, B. C.; van Doorn, H. C.; Heintz, A. P. M.; Burger, C. W.; Bossuyt, P. M. M.; Mol, B. W. J.

    2007-01-01

    OBJECTIVES: The aim of this study was to evaluate whether the efficiency of the current diagnostic work up following postmenopausal bleeding could be improved by diagnostic strategies that take into account characteristics of the women in addition to the currently recommended transvaginal

  12. Some Convergence Strategies for the Alternating Generalized Projection Method

    Directory of Open Access Journals (Sweden)

    Maricarmen Andrade

    2013-11-01

    Full Text Available In this paper we extend the application of the alternating projection algorithm to solve the problem of finding a point in the intersection of $n$ sets ($n\\geq2$, which are not all of them convex sets. Here we term such method as alternating generalized projection (AGP method. In particular, we are interested in addressing the problem of avoiding the so-called trap points, which may prevent an algorithm to obtain a feasible solution in two or more sets not all convex. Some strategies that allow us to reach the feasible solution are established and conjectured. Finally, we present simple numerical results that illustrate the efficiency of the iterative methods considered.

  13. Analysis of alternative strategies for energy conservation in new buildings

    Energy Technology Data Exchange (ETDEWEB)

    Fang, J.M.; Tawil, J.J.

    1980-12-01

    Building Energy Performance Standards (BEPS) were mandated by the Energy Conservation Standards for New Buildings Act of 1976 (Title III of Energy Conservation and Production Act) to promote energy efficiency and the use of renewable resources in new buildings. The report analyzes alternative Federal strategies and their component policy instruments and recommends a strategy for achieving the goals of the Act. The concern is limited to space conditioning (heating, cooling, and lighting) and water heating. The policy instruments considered include greater reliance on market forces; research and development; information, education and demonstration programs; tax incentives and sanctions; mortgage and finance programs; and regulations and standards. The analysis starts with an explanation of the barriers to energy conservation in the residential and commercial sectors. Individual policy instruments are then described and evaluated with respect to energy conservation, economic efficiency, equity, political impacts, and implementation and other transitional impacts. Five possible strategies are identified: (1) increased reliance on the market place; (2) energy consumption tax and supply subsidies; (3) BEPS with no sanctions and no incentives; (4) BEPS with sanctions and incentives (price control); and (5) BEPS with sanctions and incentives (no price controls). A comparative analysis is performed. Elements are proposed for inclusion in a comprehensive strategy for conservation in new buildings. (MCW)

  14. Convergence between DSM-IV-TR and DSM-5 diagnostic models for personality disorder: evaluation of strategies for establishing diagnostic thresholds.

    Science.gov (United States)

    Morey, Leslie C; Skodol, Andrew E

    2013-05-01

    The Personality and Personality Disorders Work Group for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) recommended substantial revisions to the personality disorders (PDs) section of DSM-IV-TR, proposing a hybrid categorical-dimensional model that represented PDs as combinations of core personality dysfunctions and various configurations of maladaptive personality traits. Although the DSM-5 Task Force endorsed the proposal, the Board of Trustees of the American Psychiatric Association (APA) did not, placing the Work Group's model in DSM-5 Section III ("Emerging Measures and Models") with other concepts thought to be in need of additional research. This paper documents the impact of using this alternative model in a national sample of 337 patients as described by clinicians familiar with their cases. In particular, the analyses focus on alternative strategies considered by the Work Group for deriving decision rules, or diagnostic thresholds, with which to assign categorical diagnoses. Results demonstrate that diagnostic rules could be derived that yielded appreciable correspondence between DSM-IV-TR and proposed DSM-5 PD diagnoses-correspondence greater than that observed in the transition between DSM-III and DSM-III-R PDs. The approach also represents the most comprehensive attempt to date to provide conceptual and empirical justification for diagnostic thresholds utilized within the DSM PDs.

  15. Long-term alternative energy R and D strategies

    International Nuclear Information System (INIS)

    1981-01-01

    Within the coming decades a transition must be initiated from oil and gas to 'unlimited' primary energy sources, i.e., nuclear and solar energy. Ever more expensive fossil energy forms will have to provide for an intermediary solution to the growing global energy demand. While a rather clear-cut picture of the energy problem has emerged on the global level, a straightforward translation to the national or even to the company level is not available. The current study contract between the European Economic Community and the International Institute for Applied Systems Analysis (IIASA) is a first exercice designed to transfer the global results to the intermediary level of the ''Subregion'' of the European Community. In operational terms the contract aims at identifying long-term (up to 2030) alternative energy R and D strategies for twelve European countries that would be consistent with the global scenarios, identified by IIASA

  16. Publications on diagnostic test evaluation in family medicine journals: an optimal search strategy.

    NARCIS (Netherlands)

    Devillé, W L; Bezemer, P D; Bouter, L M

    Search strategies for articles reporting on diagnostic test evaluations have been subjected to less research than those in the domain of clinical trials. We set out to develop an optimal search strategy for publications on diagnostic test evaluations in general, that could be added to keywords

  17. Protective behavioral strategy use and motivations for drinking: exploring Alternatives to Drinking strategies.

    Science.gov (United States)

    Linden, Ashley N; Kite, Benjamin A; Braitman, Abby L; Henson, James M

    2014-02-01

    Protective behavioral strategy (PBS) use is associated with less alcohol consumption and fewer alcohol-related problems. Further, greater endorsement of social or enhancement drinking motives (i.e., positive motives) is associated with less frequent PBS use. Limited research has, however, explored coping or conformity motives (i.e., negative motives) in relation to PBS. Consequently, the present study aimed to (1) identify the types of PBS most strongly associated with negative and positive motives and (2) examine different types of PBS as mediators of the relationship between each drinking motive and alcohol outcomes. Participants were college students (n=303; 70% women) who completed measures of drinking motives, PBS, alcohol use, and alcohol-related problems. Results indicated that greater endorsement of positive drinking motives were more strongly associated with less frequent use of PBS while drinking whereas negative motives were more strongly related to less frequent Alternatives to Drinking strategy use. Further, strategies used while drinking were more relevant in a model of positive drinking motives and Alternatives to Drinking strategies were more relevant in a model of negative motives. These findings may suggest that whereas individuals with stronger positive motives have difficulty using strategies while drinking, individuals who drink to cope or conform have greater difficulty utilizing Alternatives to Drinking strategies. Based on our results demonstrating that different types of PBS are more relevant for various types of drinkers, it may be important for future interventions to discuss not only the participant's PBS use but also their motivations for consuming alcohol. © 2013 Elsevier Ltd. All rights reserved.

  18. Electrical signature analysis applications for non-intrusive automotive alternator diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Ayers, C.W.

    1996-03-01

    Automotive alternators are designed to supply power for automobile engine ignition systems as well as charge the storage battery. This product is used in a large market where consumers are concerned with acoustic noise and vibration that comes from the unit. as well as overall quality and dependability. Alternators and generators in general are used in industries other than automotive, such as transportation and airline industries and in military applications. Their manufacturers are interested in pursuing state-of-the-art methods to achieve higher quality and reduced costs. Preliminary investigations of non-intrusive diagnostic techniques utilizing the inherent voltage signals of alternators have been performed with promising results. These techniques are based on time and frequency domain analyses of specially conditioned signals taken from several alternators under various test conditions. This paper discusses investigations that show correlations of the alternator output voltage to airborne noise production. In addition these signals provide insight into internal magnetic characteristics that relate to design and/or assembly problems.

  19. Female impersonation as an alternative reproductive strategy in giant cuttlefish

    Science.gov (United States)

    Norman, M. D.; Finn, J.; Tregenza, T.

    1999-01-01

    Out of all the animals, cephalopods possess an unrivalled ability to change their shape and body patterns. Our observations of giant cuttlefish (Sepia apama) suggest this ability has allowed them to evolve alternative mating strategies in which males can switch between the appearance of a female and that of a male in order to foil the guarding attempts of larger males. At a mass breeding aggregation in South Australia, we repeatedly observed single small males accompanying mating pairs. While doing so, the small male assumed the body shape and patterns of a female. Such males were never attacked by the larger mate-guarding male. On more than 20 occasions, when the larger male was distracted by another male intruder, these small males, previously indistinguishable from a female, were observed to change body pattern and behaviour to that of a male in mating display. These small males then attempted to mate with the female, often with success. This potential for dynamic sexual mimicry may have played a part in driving the evolution of the remarkable powers of colour and shape transformation which characterize the cephalopods.

  20. Outcome modelling strategies in epidemiology: traditional methods and basic alternatives.

    Science.gov (United States)

    Greenland, Sander; Daniel, Rhian; Pearce, Neil

    2016-04-01

    Controlling for too many potential confounders can lead to or aggravate problems of data sparsity or multicollinearity, particularly when the number of covariates is large in relation to the study size. As a result, methods to reduce the number of modelled covariates are often deployed. We review several traditional modelling strategies, including stepwise regression and the 'change-in-estimate' (CIE) approach to deciding which potential confounders to include in an outcome-regression model for estimating effects of a targeted exposure. We discuss their shortcomings, and then provide some basic alternatives and refinements that do not require special macros or programming. Throughout, we assume the main goal is to derive the most accurate effect estimates obtainable from the data and commercial software. Allowing that most users must stay within standard software packages, this goal can be roughly approximated using basic methods to assess, and thereby minimize, mean squared error (MSE). © The Author 2016. Published by Oxford University Press on behalf of the International Epidemiological Association.

  1. Alternative methods of fuel consumption metering based on the on-board diagnostics outputs

    Directory of Open Access Journals (Sweden)

    Jiří Čupera

    2005-01-01

    Full Text Available The article describes alternative methods of fuel consumption measurement based on model with using the diagnostic outputs of engine control unit. On-board diagnosis (the second level, known as OBD-2 has been mandated by government regulation because of advanced damage control systems in newer cars. However, its signals can be used for accurate analyses of power or torque measurement. On-board diagnostics offers many various parameters such a spark advance, intake air temperature, coolant temperature, throttle position, air flow mass and so on. Many of them have been unavailable without using sophisticated and expensive instrumentation. In the article are described two ways of fuel consumption measuring which are based on intake air consumption and knowledge about air-fuel ratio. First of them is founded on voltage output of oxygen sensor, the second on short (long term fuel trim. As is shown at the end the second way gives more accurately results.

  2. The effect of information types on diagnostic strategies in the information aid

    International Nuclear Information System (INIS)

    Kim, Jong Hyun; Seong, Poong Hyun

    2007-01-01

    Through experiments, this paper investigates the compatibility of information types with the diagnostic strategy in information aid. Compatibility with operator strategies is an important requirement for information aiding systems in nuclear power plants (NPPs). This paper used three typical types of information aids for MCR operators to investigate the effect of the aids on diagnostic strategies: 'alarm (A),' 'hypothesis on faults (H),' and 'hypothesis on faults and expected symptoms (HS).' The experimental results indicate that the effectiveness of information aid types can vary, dependent on the strategies subjects employ. The results also show that the HS aid improved the diagnosis performance in the hypothesis-and-test strategy

  3. Diagnostic task selection for strategy classification in judgment and decision making

    Directory of Open Access Journals (Sweden)

    Marc Jekel

    2011-12-01

    Full Text Available One major statistical and methodological challenge in Judgment and Decision Making research is the reliable identification of individual decision strategies by selection of diagnostic tasks, that is, tasks for which predictions of the strategies differ sufficiently. The more strategies are considered, and the larger the number of dependent measures simultaneously taken into account in strategy classification (e.g., choices, decision time, confidence ratings; Glockner, 2009, the more complex the selection of the most diagnostic tasks becomes. We suggest the Euclidian Diagnostic Task Selection (EDTS method as a standardized solution for the problem. According to EDTS, experimental tasks are selected that maximize the average difference between strategy predictions for any multidimensional prediction space. In a comprehensive model recovery simulation, we evaluate and quantify the influence of diagnostic task selection on identification rates in strategy classification. Strategy classification with EDTS shows superior performance in comparison to less diagnostic task selection algorithms such as representative sampling. The advantage of EDTS is particularly large if only few dependent measures are considered. We also provide an easy-to-use function in the free software package R that allows generating predictions for the most commonly considered strategies for a specified set of tasks and evaluating the diagnosticity of those tasks via EDTS; thus, to apply EDTS, no prior programming knowledge is necessary.

  4. Diagnostics Strategies with Electrochemical Affinity Biosensors Using Carbon Nanomaterials as Electrode Modifiers

    Science.gov (United States)

    Campuzano, Susana; Yáñez-Sedeño, Paloma; Pingarrón, José M.

    2016-01-01

    Early diagnosis is often the key to successful patient treatment and survival. The identification of various disease signaling biomarkers which reliably reflect normal and disease states in humans in biological fluids explain the burgeoning research field in developing new methodologies able to determine the target biomarkers in complex biological samples with the required sensitivity and selectivity and in a simple and rapid way. The unique advantages offered by electrochemical sensors together with the availability of high affinity and specific bioreceptors and their great capabilities in terms of sensitivity and stability imparted by nanostructuring the electrode surface with different carbon nanomaterials have led to the development of new electrochemical biosensing strategies that have flourished as interesting alternatives to conventional methodologies for clinical diagnostics. This paper briefly reviews the advantages of using carbon nanostructures and their hybrid nanocomposites as electrode modifiers to construct efficient electrochemical sensing platforms for diagnosis. The review provides an updated overview of some selected examples involving attractive amplification and biosensing approaches which have been applied to the determination of relevant genetic and protein diagnostics biomarkers. PMID:28035946

  5. Tobacco harm reduction: an alternative cessation strategy for inveterate smokers

    Directory of Open Access Journals (Sweden)

    Godshall William T

    2006-12-01

    Full Text Available Abstract According to the Centers for Disease Control and Prevention, about 45 million Americans continue to smoke, even after one of the most intense public health campaigns in history, now over 40 years old. Each year some 438,000 smokers die from smoking-related diseases, including lung and other cancers, cardiovascular disorders and pulmonary diseases. Many smokers are unable – or at least unwilling – to achieve cessation through complete nicotine and tobacco abstinence; they continue smoking despite the very real and obvious adverse health consequences. Conventional smoking cessation policies and programs generally present smokers with two unpleasant alternatives: quit, or die. A third approach to smoking cessation, tobacco harm reduction, involves the use of alternative sources of nicotine, including modern smokeless tobacco products. A substantial body of research, much of it produced over the past decade, establishes the scientific and medical foundation for tobacco harm reduction using smokeless tobacco products. This report provides a description of traditional and modern smokeless tobacco products, and of the prevalence of their use in the United States and Sweden. It reviews the epidemiologic evidence for low health risks associated with smokeless use, both in absolute terms and in comparison to the much higher risks of smoking. The report also describes evidence that smokeless tobacco has served as an effective substitute for cigarettes among Swedish men, who consequently have among the lowest smoking-related mortality rates in the developed world. The report documents the fact that extensive misinformation about ST products is widely available from ostensibly reputable sources, including governmental health agencies and major health organizations. The American Council on Science and Health believes that strong support of tobacco harm reduction is fully consistent with its mission to promote sound science in regulation and in

  6. Acquiring, Representing, and Evaluating a Competence Model of Diagnostic Strategy.

    Science.gov (United States)

    Clancey, William J.

    This paper describes NEOMYCIN, a computer program that models one physician's diagnostic reasoning within a limited area of medicine. NEOMYCIN's knowledge base and reasoning procedure constitute a model of how human knowledge is organized and how it is used in diagnosis. The hypothesis is tested that such a procedure can be used to simulate both…

  7. Diagnostic difficulties and treatment strategy of hepatic angiomyolipoma

    Directory of Open Access Journals (Sweden)

    Wei-Gao Hu

    2011-10-01

    Conclusion: Patients with typical diagnostic features suggestive of hepatic angiomyolipoma could be observed with regular surveillance. Definitive treatment should be performed when the tumor has symptoms/complications, when the tumor is enlarging, or when a malignant lesion cannot be ruled out.

  8. Comparing Alternative U.S. Counterterrorism Strategies: Can Assumption-Based Planning Help Elevate the Debate?

    National Research Council Canada - National Science Library

    Lempert, Robert J; Trujillo, Horacio R; Aaron, David; Dewar, James A; Berry, Sandra H; Popper, Steven W

    2008-01-01

    .... Frequently, both expert decisionmakers and lay citizens have trouble assessing alternative strategies to address such issues because of the emotions they engender and of the deep uncertainty involved...

  9. A Positive Diagnostic Strategy Is Noninferior to a Strategy of Exclusion for Patients With Irritable Bowel Syndrome

    DEFF Research Database (Denmark)

    Begtrup, Luise M; Engsbro, Anne Line; Kjeldsen, Jens

    2013-01-01

    BACKGROUND & AIMS: Guidelines recommend a positive strategy based on symptom criteria to diagnose patients with irritable bowel syndrome (IBS). We conducted a randomized noninferiority trial to determine whether a positive diagnostic strategy is noninferior to a strategy of exclusion, with regard...... by a strategy of exclusion (analyses of blood, stool samples for intestinal parasites, and sigmoidoscopies with biopsies) or a positive strategy (analyses of blood cell count and C-reactive protein). Patients were followed for 1 year. The primary end point was difference in change of HRQOL from baseline to 1...

  10. Effectiveness of alternative management strategies in meeting conservation objectives

    Science.gov (United States)

    Richards S. Holthausen; Carolyn Hull Sieg

    2007-01-01

    This chapter evaluates how well various management strategies meet a variety of conservation objectives, summarizes their effectiveness in meeting objectives for rare or little-known (RLK) species, and proposes ways to combine strategies to meet overall conservation objectives. We address two broad categories of management strategies. Species approaches result in...

  11. Simulation analysis of alternative strategies for public debt issuance ...

    African Journals Online (AJOL)

    The results show a trade-off between a debt strategy that largely depends on more external concessional borrowing and a debt strategy aimed at increasing the share of domestic debt in the public debt portfolio for market development purposes. While the strategy that maximises recourse to external concessional borrowing ...

  12. Molecular diagnostics clinical utility strategy: a six-part framework.

    Science.gov (United States)

    Frueh, Felix W; Quinn, Bruce

    2014-09-01

    The clinical utility of a molecular test rises proportional to a favorable regulatory risk/benefit assessment, and clinical utility is the driver of payer coverage decisions. Although a great deal has been written about clinical utility, debates still center on its 'definition.' We argue that the definition (an impact on clinical outcomes) is self-evident, and improved communications should focus on sequential steps in building and proving an adequate level of confidence for the diagnostic test's clinical value proposition. We propose a six-part framework to facilitate communications between test developers and health technology evaluators, relevant to both regulatory and payer decisions.

  13. Cost-effectiveness of different diagnostic strategies in patients with nonresectable upper gastrointestinal tract malignancies

    DEFF Research Database (Denmark)

    Mortensen, M B; Ainsworth, A P; Scheel-Hincke, J D

    2000-01-01

    cost. A change in diagnostic strategy from CT with US to CT with US and EUS resulted in a net saving regarding the cost of each additional nonresectable patient detected, but this strategy still required up to 20% futile explorative laparotomies. CONCLUSIONS: The combination of endoscopic...

  14. Integrative Strategy for Effective Teaching of Alternating Circuits in ...

    African Journals Online (AJOL)

    One of the reasons advanced for the low enrolment and achievement of students in Physics at both secondary and post-secondary schools is poor teaching strategies used by teachers of Physics particularly in teaching Physics concepts classified by students as being difficult. In this paper, integrative strategy for effective ...

  15. Simulation analysis of alternative strategies for public debt issuance ...

    African Journals Online (AJOL)

    the government to exchange rate, interest rate and commodity price shocks. The results show a trade-off between a debt strategy that largely depends on more external concessional borrowing and a debt strategy aimed at increasing the share of domestic debt in the public debt portfolio for market development purposes.

  16. Understanding Celiac Disease From Genetics to the Future Diagnostic Strategies

    Directory of Open Access Journals (Sweden)

    Carolina Salazar

    2017-07-01

    Full Text Available Celiac disease (CD is an autoimmune disorder characterized by the permanent inflammation of the small bowel, triggered by the ingestion of gluten. It is associated with a number of symptoms, the most common being gastrointestinal. The prevalence of this illness worldwide is 1%. One of the main problems of CD is its difficulty to be diagnosed due to the various presentations of the disease. Besides, in many cases, CD is asymptomatic. Celiac disease is a multifactorial disease, HLA-DQ2 and HLA-DQ8 haplotypes are predisposition factors. Nowadays, molecular markers are being studied as diagnostic tools. In this review, we explore CD from its basic concept, manifestations, types, current and future methods of diagnosis, and associated disorders. Before addressing the therapeutic approaches, we also provide a brief overview of CD genetics and treatment.

  17. Gestational Diabetes Mellitus: a review of current diagnostic strategies concepts

    Directory of Open Access Journals (Sweden)

    Juan Sebastián Frías-Ordoñez

    2016-10-01

    Full Text Available Gestational diabetes mellitus (GDM is a state of carbohydrate intolerance that is first recognized during pregnancy. The initial criteria for diagnosis were established more than 50 years ago by O’Sullivan & Mahan, and since then, some modifications have been made. Currently, diagnosis considers two methods: the onestep approach, consisting of an oral glucose tolerance test (OGTT for 2 hours with 75g of glucose, and the two-step approach, which involves an initial screening test with 50g of glucose and OGTT with 100g of glucose if screening is positive. Both diagnostic approaches have been justified by expert consensus; however, an absolute concept about the method to be applied has not been established yet. To select a method, the clinician must take into account various factors. This paper proposes a historical overview and the presentation of the current status of GDM diagnosis.

  18. Strategies for adding adaptive learning mechanisms to rule-based diagnostic expert systems

    Science.gov (United States)

    Stclair, D. C.; Sabharwal, C. L.; Bond, W. E.; Hacke, Keith

    1988-01-01

    Rule-based diagnostic expert systems can be used to perform many of the diagnostic chores necessary in today's complex space systems. These expert systems typically take a set of symptoms as input and produce diagnostic advice as output. The primary objective of such expert systems is to provide accurate and comprehensive advice which can be used to help return the space system in question to nominal operation. The development and maintenance of diagnostic expert systems is time and labor intensive since the services of both knowledge engineer(s) and domain expert(s) are required. The use of adaptive learning mechanisms to increment evaluate and refine rules promises to reduce both time and labor costs associated with such systems. This paper describes the basic adaptive learning mechanisms of strengthening, weakening, generalization, discrimination, and discovery. Next basic strategies are discussed for adding these learning mechanisms to rule-based diagnostic expert systems. These strategies support the incremental evaluation and refinement of rules in the knowledge base by comparing the set of advice given by the expert system (A) with the correct diagnosis (C). Techniques are described for selecting those rules in the in the knowledge base which should participate in adaptive learning. The strategies presented may be used with a wide variety of learning algorithms. Further, these strategies are applicable to a large number of rule-based diagnostic expert systems. They may be used to provide either immediate or deferred updating of the knowledge base.

  19. Coping Strategies: an alternative to face situations that produce burnout

    Directory of Open Access Journals (Sweden)

    Aparicio, Miriam Teresita

    2010-12-01

    Full Text Available The objective of this paper is to study Coping Strategies as explanatory variables of Job Burnout, in employees (University graduates vs. non-university graduates working at government offices in Mendoza Argentina. In order to develop a more comprehensive approach to this issue, the methodology used includes quantitative techniques and qualitative techniques. The research entailed a comparative study. The results obtained from the quantitative data, show significant differences between “university” graduates – who use strategies that seem to be closer to action and problem solving; and “non-university” graduates – who use strategies linked to emotion. From an applied point of view, it is expected that the results may generate Ongoing Training Programs focusing on burnout and stress related to the development of positive Coping Strategies.

  20. Optimal Sequential Diagnostic Strategy Generation Considering Test Placement Cost for Multimode Systems

    Directory of Open Access Journals (Sweden)

    Shigang Zhang

    2015-10-01

    Full Text Available Sequential fault diagnosis is an approach that realizes fault isolation by executing the optimal test step by step. The strategy used, i.e., the sequential diagnostic strategy, has great influence on diagnostic accuracy and cost. Optimal sequential diagnostic strategy generation is an important step in the process of diagnosis system construction, which has been studied extensively in the literature. However, previous algorithms either are designed for single mode systems or do not consider test placement cost. They are not suitable to solve the sequential diagnostic strategy generation problem considering test placement cost for multimode systems. Therefore, this problem is studied in this paper. A formulation is presented. Two algorithms are proposed, one of which is realized by system transformation and the other is newly designed. Extensive simulations are carried out to test the effectiveness of the algorithms. A real-world system is also presented. All the results show that both of them have the ability to solve the diagnostic strategy generation problem, and they have different characteristics.

  1. New techniques to collect live Sarcoptes scabiei and evaluation of methods as alternative diagnostics for infection.

    Science.gov (United States)

    Kido, Nobuhide; Akuta, Teruo; Tarui, Hiroshi; Imaizumi, Keitaro; Ueda, Takafumi; Ono, Yasuo; Kikuchi-Ueda, Takane; Tanaka, Sohei; Omiya, Tomoko

    2017-03-01

    Sarcoptes scabiei is a widespread, highly contagious skin disease that affects many mammals including humans. The biological characteristics of S. scabiei remain unclear. Therefore, the ability to collect adequate amount of mites for studies is required to advance our understanding of the parasite. The present study aimed to find a method to collect an adequate amount of live S. scabiei mites within a short time frame. The cornified layer and fur from an infected raccoon dog were inserted into a 50-ml catheter tip-type syringe. A 1.5-ml microtube was attached at the tip of the syringe to collect the mites, which crawled out from the cornified layer and fur. Four conditions were examined, and the following condition was determined to be the best: the syringe and microtube were shaded by aluminum foil, and the microtube was heated using a pet heater (36 °C). In addition, the effectiveness of this method as an alternative method to diagnose S. scabiei infections in animal was evaluated. S. scabiei live mites were not detected in the raccoon dog samples 24 h after the administration of medication (ivermectin or selamectin). The present study revealed that this technique was useful to collect adequate amounts of live mites, and the mites prefer a heated environment and actively move when using the shaded conditions. In addition, this technique was effective as an alternative diagnostic technique to detect live mites on an animal body.

  2. Towards an alternative testing strategy for nanomaterials used in nanomedicine

    DEFF Research Database (Denmark)

    Dusinska, M; Boland, S; Saunders, M

    2015-01-01

    TEST project ( www.nanotest-fp7.eu ) was a better understanding of mechanisms of interactions of NPs employed in nanomedicine with cells, tissues and organs and to address critical issues relating to toxicity testing especially with respect to alternatives to tests on animals. Here we describe an approach...

  3. Nontraumatic abdominal emergencies: acute abdominal pain: diagnostic strategies

    Energy Technology Data Exchange (ETDEWEB)

    Marincek, B. [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)

    2002-09-01

    Common causes of acute abdominal pain include appendicitis, cholecystitis, bowel obstruction, urinary colic, perforated peptic ulcer, pancreatitis, diverticulitis, and nonspecific, nonsurgical abdominal pain. The topographic classification of acute abdominal pain (pain in one of the four abdominal quadrants, diffuse abdominal pain, flank or epigastric pain) facilitates the choice of the imaging technique. The initial radiological evaluation often consists of plain abdominal radiography, despite significant diagnostic limitations. The traditional indications for plain films - bowel obstruction, pneumoperitoneum, and the search of ureteral calculi - are questioned by helical computed tomography (CT). Although ultrasonography (US) is in many centers the modality of choice for imaging the gallbladder and the pelvis in children and women of reproductive age, CT is considered to be one of the most valued tools for triaging patients with acute abdominal pain. CT is particularly beneficial in patients with marked obesity, unclear US findings, bowel obstruction, and multiple lesions. The introduction of multidetector row CT (MDCT) has further enhanced the utility of CT in imaging patients with acute abdominal pain. (orig.)

  4. Nontraumatic abdominal emergencies: acute abdominal pain: diagnostic strategies

    International Nuclear Information System (INIS)

    Marincek, B.

    2002-01-01

    Common causes of acute abdominal pain include appendicitis, cholecystitis, bowel obstruction, urinary colic, perforated peptic ulcer, pancreatitis, diverticulitis, and nonspecific, nonsurgical abdominal pain. The topographic classification of acute abdominal pain (pain in one of the four abdominal quadrants, diffuse abdominal pain, flank or epigastric pain) facilitates the choice of the imaging technique. The initial radiological evaluation often consists of plain abdominal radiography, despite significant diagnostic limitations. The traditional indications for plain films - bowel obstruction, pneumoperitoneum, and the search of ureteral calculi - are questioned by helical computed tomography (CT). Although ultrasonography (US) is in many centers the modality of choice for imaging the gallbladder and the pelvis in children and women of reproductive age, CT is considered to be one of the most valued tools for triaging patients with acute abdominal pain. CT is particularly beneficial in patients with marked obesity, unclear US findings, bowel obstruction, and multiple lesions. The introduction of multidetector row CT (MDCT) has further enhanced the utility of CT in imaging patients with acute abdominal pain. (orig.)

  5. Fitting N-mixture models to count data with unmodeled heterogeneity: Bias, diagnostics, and alternative approaches

    Science.gov (United States)

    Duarte, Adam; Adams, Michael J.; Peterson, James T.

    2018-01-01

    Monitoring animal populations is central to wildlife and fisheries management, and the use of N-mixture models toward these efforts has markedly increased in recent years. Nevertheless, relatively little work has evaluated estimator performance when basic assumptions are violated. Moreover, diagnostics to identify when bias in parameter estimates from N-mixture models is likely is largely unexplored. We simulated count data sets using 837 combinations of detection probability, number of sample units, number of survey occasions, and type and extent of heterogeneity in abundance or detectability. We fit Poisson N-mixture models to these data, quantified the bias associated with each combination, and evaluated if the parametric bootstrap goodness-of-fit (GOF) test can be used to indicate bias in parameter estimates. We also explored if assumption violations can be diagnosed prior to fitting N-mixture models. In doing so, we propose a new model diagnostic, which we term the quasi-coefficient of variation (QCV). N-mixture models performed well when assumptions were met and detection probabilities were moderate (i.e., ≥0.3), and the performance of the estimator improved with increasing survey occasions and sample units. However, the magnitude of bias in estimated mean abundance with even slight amounts of unmodeled heterogeneity was substantial. The parametric bootstrap GOF test did not perform well as a diagnostic for bias in parameter estimates when detectability and sample sizes were low. The results indicate the QCV is useful to diagnose potential bias and that potential bias associated with unidirectional trends in abundance or detectability can be diagnosed using Poisson regression. This study represents the most thorough assessment to date of assumption violations and diagnostics when fitting N-mixture models using the most commonly implemented error distribution. Unbiased estimates of population state variables are needed to properly inform management decision

  6. Economics of eradicating Foot-and-Mouth disease epidemics with alternative control strategies

    NARCIS (Netherlands)

    Bergevoet, R.H.M.; Asseldonk, van M.A.P.M.

    2014-01-01

    The paper presents an economic analysis of Foot-and-Mouth Disease (FMD) control strategies for livestock herds. Alternative vaccination-to-live control strategies were compared to the strategy that involves culling of all susceptible animals in an area of 1 km around infected herds in addition to

  7. [Diagnostic and therapeutic alternatives in perioperative acute myocardial ischemia in heart surgery].

    Science.gov (United States)

    Bueno-González, A M; Pérez-Vela, J L; Hernández, F; Renes, E; Arribas, P; Corres, M A; Gutiérrez, J; Perales, N

    2010-01-01

    Ischemia and infarct after surgical revascularization are a relatively frequent complication, with high morbidity and mortality. Early diagnosis is essential. However, this is less standardized and more complicated to diagnose than in patients who have not undergone surgery since there is no specific biomarker that allows the clinician to differentiate between myocardial ischemia due to the procedure itself and myocardial damage due to perioperative infarct. Once detected, perioperative ischemia should be treated immediately in order to limit myocardial damage. The objectives of this study have been 1. To show the diagnostic criteria for perioperative infarct and ischemia. 2. to show the different therapeutic options available. 3. to propose a treatment algorithm that includes the differential diagnosis, how to control vasospasm, implantation of balloon counterpulsation, and the possible revascularization strategies (percutaneous coronary intervention vs reoperation). Copyright 2008 Elsevier España, S.L. y SEMICYUC. All rights reserved.

  8. How does a change in the control room design affect diagnostic strategies in nuclear power plants?

    International Nuclear Information System (INIS)

    Kim, Dong Young; Kim, Jonghyun

    2014-01-01

    Recently, main control rooms have been considerably changed by modern computer techniques. Some of the features that distinguish digital control rooms from conventional, analog rooms in nuclear power plants include advanced alarm systems, graphic information display systems, computerized procedure systems, and soft control. These features can bring changes in operator tasks, changing the characteristics of tasks or creating new tasks for operators. It is especially expected that these features may bring out changes in the operator's diagnostic tasks and strategies in a digital control room as compared with an analog control room. This study investigates the differences in the operator's diagnostic tasks and strategies in analog and digital control rooms. This study also attempts to evaluate how new systems in a digital control room affect diagnostic strategies. Three different approaches, which are complementary, are used to identify diagnostic strategies in the digital control room and in the analog control room: (1) observation in the simulator, (2) interview with operators, and (3) a literature review. The results show that the digital control room introduces new diagnosis strategies compared with the analog control room while also changing the characteristics of the strategies, mostly by gaining more support from the computerized system. (author)

  9. Exploring alternative ovarian cancer biomarkers using innovative nanotechnology strategies.

    Science.gov (United States)

    Castro, Cesar M; Im, Hyungsoon; Le, Christine; Lee, Hakho; Weissleder, Ralph; Birrer, Michael J

    2015-03-01

    Our increased understanding of ovarian cancer's blueprints (mediated by DNA and RNA) and behavior (mediated by proteins) points to wide differences across patients that cannot be depicted by histology alone. Conventional diagnosis usually entails an adequate tissue biopsy, which limits serial testing. There is thus a motivation to shift towards easier to obtain clinical samples (e.g., ascites or blood). In response, investigators are increasingly leveraging alternative circulating biomarkers in blood or proximal fluids and harnessing novel profiling platforms to help explore treatment-related effects on such biomarkers in serial fashion. In this review, we discuss how new nanotechnologies we developed intersect with alternative ovarian cancer biomarkers for improved understanding of metastases and therapeutic response.

  10. Diagnostic approach and management strategy of childhood stroke

    International Nuclear Information System (INIS)

    Salih, Mustafa A.; Abdel-Gader, Abdel-Galil M.

    2006-01-01

    Prompt recognition and early intervention, with pertinent management and medication, may reduce subsequent neurologic deficits in stroke, which constitutes a devastating event in children. This is due to the tasking and demanding consequences including death or residual neurological deficits, which may last for many decades, in over 60% of survivors. Evidence based treatment for children with stroke is still lacking, reflecting scarcity in base line epidemiological data on pediatric stroke, the multitude of underlying risk factors, and ethical and practical challenges incurred in conducting clinical trials. Based on the experience we gained from a combined a combined prospective and retrospective study on childhood stroke (covering 10 years and 7 months and involving a cohort of 104 Saudi children), a diagnostic algorithm, which outlines the approach to a child with suspected stroke/cerebovascular lesion was designed. This algorithm might also be of use for managing other children with stroke from the Arabian Peninsula and Middle East Region with similar demographic, socioeconomic, and ethnic backgrounds. Underlying risk factors which need special attention, include thrombophilia and hypercoagulable states and sickle cell diseases (SCD), which contrary to previous studies from Saudi Arabia, were found to constitute a common risk factor with severe manifestations. Other risk factors include infections (especially neurobrucellosis), cardiac diseases, and hypernatremic dehydration. Recognition of an identifiable syndrome or inherited metabolic cause may unravel an underlying cerebovascular disease. This is particularly important in this region, given the large pool of autosomal recessive diseases and the high rate of consanguinity. In the evaluation of a suspected case of stroke, important imaging modalities include cranial CT, MRI (including diffusion-weighted images), magnetic resonance angiography (MRA), magnetic resonance venography (MRV) and conventional

  11. Nonequilibrium relaxation method – An alternative simulation strategy

    Indian Academy of Sciences (India)

    which is the theoretical virtual reality emulating the real physical phenomena. In these situations, a simple, reliable and computer-oriented analysis method is very important and the NER method will so far be the simplest simluation strategy to study the thermal property of macroscopic materials. Furthermore, the NER.

  12. Nonequilibrium relaxation method – An alternative simulation strategy

    Indian Academy of Sciences (India)

    One well-established simulation strategy to study the thermal phases and transitions of a given microscopic model system is the so-called equilibrium method, in which one first realizes the equilibrium ensemble of a finite system and then extrapolates the results to infinite system. This equilibrium method traces over the ...

  13. Nonequilibrium relaxation method–An alternative simulation strategy

    Indian Academy of Sciences (India)

    One well-established simulation strategy to study the thermal phases and transitions of a given microscopic model system is the so-called equilibrium method, in which one first realizes the equilibrium ensemble of a finite system and then extrapolates the results to infinite system. This equilibrium method traces over the ...

  14. Culture independent PCR: an alternative enzyme discovery strategy

    DEFF Research Database (Denmark)

    Jacobsen, Jonas; Lydolph, Magnus; Lange, Lene

    2005-01-01

    Degenerate primers were designed for use in a culture-independent PCR screening of DNA from composite fungal communities, inhabiting residues of corn stovers and leaves. According to similarity searches and alignments amplified clone sequences affiliated with glycosyl hydrolase family 7...... and glycosyl hydrolase family 45 though significant sequence divergence was observed. Glycosyl hydrolases from families 7 and 45 play a crucial role in biomass conversion to fuel ethanol. Research in this renewable energy source has two objectives: (i) To contribute to development of a renewable alternative...

  15. Analysis of alternative strategies for energy conservation in new buildings

    Science.gov (United States)

    Fang, J. M.; Tawil, J.

    1980-12-01

    The policy instruments considered include: greater reliance on market forces; research and development; information, education and demonstration programs; tax incentives and sanctions; mortgage and finance programs; and regulations and standards. The analysis starts with an explanation of the barriers to energy conservation in the residential and commercial sectors. Individual policy instruments are described and evaluated with respect to energy conservation, economic efficiency, equity, political impacts, and implementation and other transitional impacts. Five possible strategies are identified: (1) increased reliance on the market place; (2) energy consumption tax and supply subsidies; (3) Building Energy Performance Standards (BEPS) with no sanctions and no incentives; (4) BEPS with sanctions and incentives (price control); and (5) BEPS with sanctions and incentives (no price controls). A comparative analysis is performed. Elements are proposed for inclusion in a comprehensive strategy for conservation in new buildings.

  16. Teaching of interdisciplinary and core curriculum topics using alternative strategies.

    Science.gov (United States)

    Robertson, Janelle L; Yun, Heather C; Murray, Clinton K

    2009-11-01

    In the San Antonio Uniformed Services Health Education Consortium Infectious Diseases Fellowship program, didactic lecture formats were previously used to present training in interdisciplinary topics, journal discussions, and core curriculum topics, but herein is described the recent modification of the fellowship's teaching techniques along with a satisfaction survey. The initial modification to the curriculum included the institution of debates covering controversial core curriculum topics in parliamentary fashion. The second change was the teaching of interdisciplinary topics utilizing a conference moderator. To evaluate the impact of the new teaching strategies, an anonymous Likert-based survey was distributed to the staff and fellows. The staff and fellows were uniformly satisfied with the changes in the curriculum and new strategies are preferred over the traditional teaching methods. Creating innovative forums to enhance the education of trainees has improved fellow and staff satisfaction with the teaching of these topics.

  17. [DIAGNOSTIC AND TREATMENT STRATEGY IN FOLLICULAR TUMOR OF THYROID GLAND].

    Science.gov (United States)

    Mikhaĭlova, M V; Zubarovskiĭ, I N; Osipenko, S K

    2015-01-01

    The article is based on the treatment results of 44 patients with follicular tunor of thyroid gland. A staged morphological assessment of thyroid nodes was performed for all patients: in case of preoperative fine-needle biopsy, urgent intraoperative study and according to results of final histological research. The urgent histological study of surgical material was conducted for 44 patients with diagnosis "follicular tumor" according to fine-needle biopsy. The data of final histological study were matched with findings of intraoperative research. A micro-follicular adenoma was detected in 22 patients (50%) and 6 (13,6%) patients had this diagnosis combined with autoimmune thyroiditis. The general part of patients didn't changed in final study, but the rate of diagnosis "micro-follicular adenoma against the background of autoimmune thyroiditis" increased. Papillary carcinoma was revealed in 5 (11,4%) patients and follicular cancer had 4 (9,1%) patients detected in intraoperative study and 3 (6,8%) more patients according to data of final research. The histopathologic feature of colloid goiter was observed in 7 (15,9%) cases and a part of such patients reduced to 6,8% during final study. One of the patients (2,3%) had final diagnosis "oncocytoma". In case of thyroid nodules detection the needle biopsy should be carried out regardless to the size of nodule. The authors recommended performing the surgery with the urgent histological study in case of undetermined histological report. The following surgical strategy was specified by the results of the urgent histological report.

  18. Strategy for development modes competent performance in teachers qualified alternative

    Directory of Open Access Journals (Sweden)

    Sailí Rodríguez Fuentes

    2017-12-01

    Full Text Available Introduction: the process of professionalization of the teacher is a subject of contemporary conjuncture, which is debated and investigated by researchers from dissimilar edges. Objective: to contribute to the professionalization process of qualified teachers of Technical and Vocational Education through a pedagogical strategy. Materials and methods: The materialist dialectic is used as a general method, allowing the study of the object as a process, the determination of its components, as well as its contradictions. theoretical methods: the historical and logical to delve into the regularities and qualities of reality in the polytechnic centers. Essential empirical methods were used: the documentary analysis that included the professional model; study plans, to obtain authentic and reliable information for research, interviews with students with the purpose of analyzing the manifestations of the professionalization process of the students and the direction of the process by the teachers, the observation of teaching activities allowed to diagnose the object , the demonstration of the problem, as well as the results of the practice of the strategy to be implemented. Results: a pedagogical strategy is designed and implemented to perfect the competent professional performance modes in the qualified professors. Conclusions: it contributed to the improvement of the professionalization process in favor of the competent professional modes of action.

  19. Flipped Classroom as an Alternative Strategy for Teaching Stoichiometry

    Directory of Open Access Journals (Sweden)

    Norrie E. Gayeta

    2017-11-01

    Full Text Available This study aimed to compare the effectiveness of flipped classroom and traditional classroom instruction in measuring conceptual change and to determine if flipped classroom instruction would be an alternative method of teaching to traditional lecture method. This study covered the level of conceptual understanding of students on stoichiometry and the type of conceptual change before and after exposure to flipped and traditional classroom environment. Qualitative and quantitative research methods were used in the study. Respondents were two sections of third year Bachelor of Secondary Education, Biological Science. Frequency, percentage, ranking, mean, standard deviation, Hake factor test, and t-test were the statistical tools applied to answer specific questions. Results showed profound increase towards conceptual change representing a shift from intuitive understanding to correct incomplete understanding level. Thus, change for the better, in theoretical type was determined from pretest to posttest of students exposed to flipped and traditional classroom. Results also indicated that there is no significant difference on students’ conceptual change on stoichiometry exposed to flipped and traditional classroom environment thus, flipped classroom instruction can be used as an alternative teaching method to traditional lecture method in teaching stoichiometry

  20. Insecticide resistance in the horn fly: alternative control strategies.

    Science.gov (United States)

    Oyarzún, M P; Quiroz, A; Birkett, M A

    2008-09-01

    The horn fly, Haematobia irritans (Linnaeus 1758) (Diptera: Muscidae) is one of the most widespread and economically important pests of cattle. Although insecticides have been used for fly control, success has been limited because of the development of insecticide resistance in all countries where the horn fly is found. This problem, along with public pressure for insecticide-free food and the prohibitive cost of developing new classes of compounds, has driven the investigation of alternative control methods that minimize or avoid the use of insecticides. This review provides details of the economic impact of horn flies, existing insecticides used for horn fly control and resistance mechanisms. Current research on new methods of horn fly control based on resistant cattle selection, semiochemicals, biological control and vaccines is also discussed.

  1. Histone deacetylase inhibition as an alternative strategy against invasive aspergillosis

    Directory of Open Access Journals (Sweden)

    Frederic eLamoth

    2015-02-01

    Full Text Available Invasive aspergillosis (IA is a life-threatening infection due to Aspergillus fumigatus and other Aspergillus spp. Drugs targeting the fungal cell membrane (triazoles, amphotericin B or cell wall (echinocandins are currently the sole therapeutic options against IA. Their limited efficacy and the emergence of resistance warrant the identification of new antifungal targets. Histone deacetylases (HDACs are enzymes responsible of the deacetylation of lysine residues of core histones, thus controlling chromatin remodeling and transcriptional activation. HDACs also control the acetylation and activation status of multiple non-histone proteins, including the heat shock protein 90 (Hsp90, an essential molecular chaperone for fungal virulence and antifungal resistance. This review provides an overview of the different HDACs in Aspergillus spp. as well as their respective contribution to total HDAC activity, fungal growth, stress responses, and virulence. The potential of HDAC inhibitors, currently under development for cancer therapy, as novel alternative antifungal agents against IA is discussed.

  2. Main transition strategies and its logic: Actors, alternatives and prospects

    Directory of Open Access Journals (Sweden)

    Brdar Milan M.

    2004-01-01

    Full Text Available In the article author deals with ideological background of two transition strategies under the influence of three grand ideologies: liberalism conservativism, Marxism. Two prevailing strategies of shock therapy and gradualism are revisited with reference to the geopolitical context shaped after the fall of communism and vividly marked with conflict of liberalism and conservativism during the last 15 years in East Europe. Neoliberal strategy of shock therapy provides renewal of the conditions that this very strategy tries to avoid, namely condition of rise of socialism and conservativism. On the other hand, occurrences in East Europe in the same period, marked with failures in efforts to establish free market privatization and free flow of capital in economy, are unfolding in well known logic of confrontation of grand ideologies. In other words, after the fall of Berlin wall we could notice the rise of liberalism on the global scene akin to the form known from the XIX and beginning of the XX century. Ex socialist countries under the pressure of IMF and World Bank policies are disposed to the reiteration of neoliberal experiment that with its economic political and social effects paves the way to the renewal of left and right ideologies. Author maintains that enduring of ideological conflicts presents great obstacle to the rational politics. In addition to that, authors in the social sciences, due to their sharp divisions along ideological lines mostly failed in its historical opportunity to analyze and predict events. They were mostly pleading for democracy, regardless of concrete political and economic conditions, and were neglecting the care for institution building. But due to the lack in proper institutional frame transition amounts to one misfortune more in societies already ruined with outcomes of socialism. Without institutional background free market amounts to the black market, privatization turn into great robbery as a form of primary

  3. Using a Multi-Tier Diagnostic Test to Explore the Nature of Students' Alternative Conceptions on Reaction Kinetics

    Science.gov (United States)

    Yan, Yaw Kai; Subramaniam, R.

    2018-01-01

    This study focused on grade 12 students' understanding of reaction kinetics. A 4-tier diagnostic instrument was developed for this purpose and administered to 137 students in the main study. Findings showed that reaction kinetics is a difficult topic for these students, with a total of 25 alternative conceptions (ACs) being uncovered. Except for…

  4. Development and Assessment of a Diagnostic Tool to Identify Organic Chemistry Students' Alternative Conceptions Related to Acid Strength

    Science.gov (United States)

    McClary, LaKeisha M.; Bretz, Stacey Lowery

    2012-01-01

    The central goal of this study was to create a new diagnostic tool to identify organic chemistry students' alternative conceptions related to acid strength. Twenty years of research on secondary and college students' conceptions about acids and bases has shown that these important concepts are difficult for students to apply to qualitative problem…

  5. Coagulation factor XI vaccination: an alternative strategy to prevent thrombosis.

    Science.gov (United States)

    Zhong, C; Zhang, L; Chen, L; Deng, L; Li, R

    2017-01-01

    Essentials Coagulation Factor (F) XI is a safe target for the development of antithrombotics. We designed an antigen comprising the human FXI catalytic domain and diphtheria toxin T domain. Antigen immunization reduced plasma FXI activity by 54% and prevented thrombosis in mice. FXI vaccination can serve as an effective strategy for thrombosis prevention. Background Coagulation factor XI serves as a signal amplifier in the intrinsic coagulation pathway. Blockade of FXI by mAbs or small-molecule inhibitors inhibits thrombosis without causing severe bleeding, which is an inherent risk of currently available antithrombotic agents. Objectives To design an FXI vaccine and assess its efficacy in inhibiting FXI activity and preventing thrombosis. Methods An FXI antigen was generated by fusing the catalytic domain of human FXI to the C-terminus of the transmembrane domain of diphtheria toxin. The anti-FXI antibody response, plasma FXI activity and antithrombotic efficacy in mice immunized with the FXI antigen were examined. Results The antigen elicited a significant antibody response against mouse FXI, and reduced the plasma FXI activity by 54.0% in mice. FXI vaccination markedly reduced the levels of coagulation and inflammation in a mouse model of inferior vena cava stenosis. Significant protective effects were also observed in mouse models of venous thrombosis and pulmonary embolism. Conclusions Our data demonstrate that FXI vaccination can serve as an effective strategy for thrombosis prevention. © 2016 The Authors. Journal of Thrombosis and Haemostasis published by Wiley Periodicals, Inc. on behalf of International Society on Thrombosis and Haemostasis.

  6. Evaluating alternative offering strategies for wind producers in a pool

    International Nuclear Information System (INIS)

    Rahimiyan, Morteza; Morales, Juan M.; Conejo, Antonio J.

    2011-01-01

    Highlights: → Out-of-sample analysis allows comparing diverse offers using real-world data. → Offering the best production forecast is not optimal for a wind producer. → Stochastic programming offers lead to maximum expected profit. → Offering the best production forecast is not generally optimal for risk control. → Stochastic programming offers lead to the best tradeoff profit versus risk. -- Abstract: As wind power technology matures and reaches break-even cost, wind producers find it increasingly attractive to participate in pool markets instead of being paid feed-in tariffs. The key issue is then how a wind producer should offer in the pool markets to achieve maximum profit while controlling the variability of such profit. This paper compares two families of offering strategies based, respectively, on a naive use of wind production forecasts and on stochastic programming models. These strategies are compared through a comprehensive out-of-sample chronological analysis based on real-world data. A number of relevant conclusions are then duly drawn.

  7. Propulsion Diagnostic Method Evaluation Strategy (ProDiMES) User's Guide

    Science.gov (United States)

    Simon, Donald L.

    2010-01-01

    This report is a User's Guide for the Propulsion Diagnostic Method Evaluation Strategy (ProDiMES). ProDiMES is a standard benchmarking problem and a set of evaluation metrics to enable the comparison of candidate aircraft engine gas path diagnostic methods. This Matlab (The Mathworks, Inc.) based software tool enables users to independently develop and evaluate diagnostic methods. Additionally, a set of blind test case data is also distributed as part of the software. This will enable the side-by-side comparison of diagnostic approaches developed by multiple users. The Users Guide describes the various components of ProDiMES, and provides instructions for the installation and operation of the tool.

  8. Diagnostic strategies for excluding pulmonary embolism in clinical outcome studies - A systematic review

    NARCIS (Netherlands)

    Kruip, Marieke J. H. A.; Leclercq, Monique G. L.; van der Heul, Cees; Prins, Martin H.; Büller, Harry R.

    2003-01-01

    Background: Pulmonary embolism is a common clinical disorder that is associated with high morbidity and mortality if untreated. It is important to confirm or rule out the diagnosis in patients with clinical suspicion of the disease. Purpose: To evaluate various diagnostic strategies for excluding

  9. [Chest pain in the emergency department : Differential diagnosis and diagnostic strategy].

    Science.gov (United States)

    Köhnlein, T

    2017-01-01

    Chest pain as the leading symptom in emergency patients can have numerous causes and requires an immediate and targeted diagnostic and therapeutic strategy. Clinical scoring systems facilitate risk assessment for individual patients. In the emergency department, critical factors for success are defined professional qualification standards for physicians and nursing staff combined with a well-functioning organization of all technical procedures.

  10. Bioflocculation: An alternative strategy for harvesting of microalgae - An overview.

    Science.gov (United States)

    Ummalyma, Sabeela Beevi; Gnansounou, Edgard; Sukumaran, Rajeev K; Sindhu, Raveendran; Pandey, Ashok; Sahoo, Dinabandhu

    2017-10-01

    Microalgae based research has been extensively progressed for the production of value added products and biofuels. Potential application of microalgae for biofuel is recently gained more attention for possibilities of biodiesel and other high value metabolites. However, high cost of production of biomass associated with harvesting technologies is one of the major bottleneck for commercialization of algae based industrial product. Based on the operation economics, harvesting efficiency, technological possibilities, flocculation of algal biomass is a superior method for harvesting microalgae from the growth medium. In this article, latest trends of microalgal cell harvesting through flocculation are reviewed with emphasis on current progress and prospect in environmental friendly bio-based flocculation approach. Bio-flocculation based microalgae harvesting technologies is a promising strategy for low cost microalgal biomass production for various applications. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. An alternative strategy to teach biomechanics: The long jump

    Energy Technology Data Exchange (ETDEWEB)

    Vega, G J de la [School of Exactly, Physical and Naturals Science. I de la Roza 590 (Oeste). CP 5413. San Juan (Argentina); Aguilera, J A [School of Exactly, Physical and Naturals Science. I de la Roza 590 (Oeste). CP 5413. San Juan (Argentina); Puzzella, A E [School of Exactly, Physical and Naturals Science. I de la Roza 590 (Oeste). CP 5413. San Juan (Argentina); Mallamaci, C C [School of Exactly, Physical and Naturals Science. I de la Roza 590 (Oeste). CP 5413. San Juan (Argentina)

    2007-11-15

    The work develops an alternative methodology to teach the Physics principles of Parabolic Cannon Shot in the career of Bioengineering using instead the physic-biological relationship of the long jump performed in Athletics. This is a closer-to-reality example for this discipline, and it is a field- and computer laboratory-reproducible practice that is simple to do by using affordable technology, because the practice can be filmed by the students in a real setting for future analysis off classroom hours. The data extracted from the film can be analysed and used to learn the physics of motion of the participating athletes, and to draw conclusions from their hands-on experience. As a main factor of the proposal, this latter characteristic aims at motivating the students to work and participate within a collaborative framework, so as to motivate them to reason and respond the questionnaire issues that stems from a real experience. A significant improvement of knowledge transference is thus attained by promoting teaching (and self-teaching) through reality-based perception, analysis and learning). This work is undergoing its first stage, and its conclusions arise from the observations on team-work dynamics. Quantitative results are expected for the following stages which are under way of execution.

  12. Future site use and cleanup strategy alternatives: The Hanford approach

    International Nuclear Information System (INIS)

    Power, M.; Breckel, J.; Rasmussen, J.; Smith, R.; Bergman, T.

    1991-01-01

    Nuclear weapons materials production is no longer the mission of the Hanford Site, a 560-square-mile area in southeastern Washington's Columbia Basin. Environmental remediation, including removal of radioactive and hazardous contaminants, waste management and disposal decommissioning of old facilities, and restoration of land and groundwater, has become the site's major mission. The mission is conducted within the framework of the Tri-Party Agreement between USDOE, USEPA, and the State of Washington. There is broad public interest in cleanup and the future of the Hanford Site. A facilitated process to develop alternative future use and cleanup scenarios is about to begin. The process will introduce some traditional tools of land use planning alongside environmental regulations and cleanup technologies in order to develop an integrated vision. Many interests, including local governments, Indian Tribes, state and federal agencies, business, agriculture, labor, environmental, and recreational groups will be involved. It is hoped a widely shared vision of the site's future will both guide and sustain support for cleanup and restoration

  13. Bacteriophages as an alternative strategy for fighting biofilm development.

    Science.gov (United States)

    Parasion, Sylwia; Kwiatek, Magdalena; Gryko, Romuald; Mizak, Lidia; Malm, Anna

    2014-01-01

    The ability of microbes to form biofilms is an important element of their pathogenicity, and biofilm formation is a serious challenge for today's medicine. Fighting the clinical complications associated with biofilm formation is very difficult and linked to a high risk of failure, especially in a time of increasing bacterial resistance to antibiotics. Bacterial species most commonly isolated from biofilms include coagulase-negative staphylococci, Staphylococcus aureus, Enterococcus faecalis, Enterococcus faecium, Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter spp. The frequent failure of antibiotic therapy led researchers to look for alternative methods and experiment with the use of antibacterial factors with a mechanism of action different from that of antibiotics. Experimental studies with bacteriophages and mixtures thereof, expressing lytic properties against numerous biofilm-forming bacterial species showed that bacteriophages may both prevent biofilm formation and contribute to eradication of biofilm bacteria. A specific role is played here by phage depolymerases, which facilitate the degradation of extracellular polymeric substances (EPS) and thus the permeation of bacteriophages into deeper biofilm layers and lysis of the susceptible bacterial cells. Much hope is placed in genetic modifications of bacteriophages that would allow the equipping bacteriophages with the function of depolymerase synthesis. The use of phage cocktails prevents the development of phage-resistant bacteria.

  14. Alternative Strategy for Alzheimer’s Disease: Stress Response Triggers

    Directory of Open Access Journals (Sweden)

    Joan Smith Sonneborn

    2012-01-01

    Full Text Available Stress resistance capacity is a hallmark of longevity protection and survival throughout the plant and animal kingdoms. Latent pathway activation of protective cascades, triggered by environmental challenges to tolerate heat, oxygen deprivation, reactive oxygen species (ROS, diet restriction, and exercise provides tolerance to these stresses. Age-related changes and disease vulnerability mark an increase in damage, like damage induced by environmental challenges. An alternative approach to immunotherapy intervention in Alzheimer’s Disease is the use of mimetics of stress to upregulate endogenous protective cascades to repair age damage, shift the balance of apoptosis to regeneration to promote delay of onset, and even progression of Alzheimer’s disease memory dysfunction. Mimetics of environmental stress, hormetic agents, and triggers, endogenous or engineered, can “trick” activation of expression patterns of repair and rejuvenation. Examples of known candidate triggers of heat response, endogenous antioxidants, DNA repair, exercise, hibernation, and telomeres are available for AD intervention trials. Telomeres and telomerase emerge as major regulators in crossroads of senescence, cancer, and rejuvenation responsive to mimetics of telomeres. Lessons emerge from transgenic rodent models, the long-lived mole rat, clinical studies, and conserved innate pathways of stress resistance. Cross-reaction of benefits of different triggers promises intervention into seemingly otherwise unrelated diseases.

  15. An alternative strategy to teach biomechanics: The long jump

    International Nuclear Information System (INIS)

    Vega, G J de la; Aguilera, J A; Puzzella, A E; Mallamaci, C C

    2007-01-01

    The work develops an alternative methodology to teach the Physics principles of Parabolic Cannon Shot in the career of Bioengineering using instead the physic-biological relationship of the long jump performed in Athletics. This is a closer-to-reality example for this discipline, and it is a field- and computer laboratory-reproducible practice that is simple to do by using affordable technology, because the practice can be filmed by the students in a real setting for future analysis off classroom hours. The data extracted from the film can be analysed and used to learn the physics of motion of the participating athletes, and to draw conclusions from their hands-on experience. As a main factor of the proposal, this latter characteristic aims at motivating the students to work and participate within a collaborative framework, so as to motivate them to reason and respond the questionnaire issues that stems from a real experience. A significant improvement of knowledge transference is thus attained by promoting teaching (and self-teaching) through reality-based perception, analysis and learning). This work is undergoing its first stage, and its conclusions arise from the observations on team-work dynamics. Quantitative results are expected for the following stages which are under way of execution

  16. Multiple antigenic peptide (MAP): a synthetic peptide dendrimer for diagnostic, antiviral and vaccine strategies for emerging and re-emerging viral diseases.

    Science.gov (United States)

    Joshi, Vinay Ganeshrao; Dighe, Vikas D; Thakuria, Dimpal; Malik, Yashpal Singh; Kumar, Satish

    2013-12-01

    The peptide dendrimer provides novel strategies for various biological applications. Assembling of peptide in macromolecular structure is expected to give rational models as drugs, their delivery and diagnostic reagents. Improved understanding of virus structure and their molecular interactions with ligands have paved the way for treatment and control of emerging and re-emerging viral diseases. This review presents a brief account of a synthetic peptide dendrimer used for diagnostic, therapeutic and prophylactic applications. The designs comprise of multiple antigenic peptides which are being used as alternate synthetic antigens for different viruses.

  17. WRAP Module 1 sampling strategy and waste characterization alternatives study

    International Nuclear Information System (INIS)

    Bergeson, C.L.

    1994-01-01

    The Waste Receiving and Processing Module 1 Facility is designed to examine, process, certify, and ship drums and boxes of solid wastes that have a surface dose equivalent of less than 200 mrem/h. These wastes will include low-level and transuranic wastes that are retrievably stored in the 200 Area burial grounds and facilities in addition to newly generated wastes. Certification of retrievably stored wastes processing in WRAP 1 is required to meet the waste acceptance criteria for onsite treatment and disposal of low-level waste and mixed low-level waste and the Waste Isolation Pilot Plant Waste Acceptance Criteria for the disposal of TRU waste. In addition, these wastes will need to be certified for packaging in TRUPACT-II shipping containers. Characterization of the retrievably stored waste is needed to support the certification process. Characterization data will be obtained from historical records, process knowledge, nondestructive examination nondestructive assay, visual inspection of the waste, head-gas sampling, and analysis of samples taken from the waste containers. Sample characterization refers to the method or methods that are used to test waste samples for specific analytes. The focus of this study is the sample characterization needed to accurately identify the hazardous and radioactive constituents present in the retrieved wastes that will be processed in WRAP 1. In addition, some sampling and characterization will be required to support NDA calculations and to provide an over-check for the characterization of newly generated wastes. This study results in the baseline definition of WRAP 1 sampling and analysis requirements and identifies alternative methods to meet these requirements in an efficient and economical manner

  18. WRAP Module 1 sampling strategy and waste characterization alternatives study

    Energy Technology Data Exchange (ETDEWEB)

    Bergeson, C.L.

    1994-09-30

    The Waste Receiving and Processing Module 1 Facility is designed to examine, process, certify, and ship drums and boxes of solid wastes that have a surface dose equivalent of less than 200 mrem/h. These wastes will include low-level and transuranic wastes that are retrievably stored in the 200 Area burial grounds and facilities in addition to newly generated wastes. Certification of retrievably stored wastes processing in WRAP 1 is required to meet the waste acceptance criteria for onsite treatment and disposal of low-level waste and mixed low-level waste and the Waste Isolation Pilot Plant Waste Acceptance Criteria for the disposal of TRU waste. In addition, these wastes will need to be certified for packaging in TRUPACT-II shipping containers. Characterization of the retrievably stored waste is needed to support the certification process. Characterization data will be obtained from historical records, process knowledge, nondestructive examination nondestructive assay, visual inspection of the waste, head-gas sampling, and analysis of samples taken from the waste containers. Sample characterization refers to the method or methods that are used to test waste samples for specific analytes. The focus of this study is the sample characterization needed to accurately identify the hazardous and radioactive constituents present in the retrieved wastes that will be processed in WRAP 1. In addition, some sampling and characterization will be required to support NDA calculations and to provide an over-check for the characterization of newly generated wastes. This study results in the baseline definition of WRAP 1 sampling and analysis requirements and identifies alternative methods to meet these requirements in an efficient and economical manner.

  19. Ethnic enclaves and middleman minorities: alternative strategies of immigrant adaptation?

    Science.gov (United States)

    Cobas, J A

    1987-04-01

    This article examines 2 modes or strategies of immigrant adaptation: middleman minorities and ethnic enclaves. Although they have been discussed as if they were disjointed and mutually exclusive, the authors challenge this view. Middleman minorities 1) tend to be self-employed or to work for a coethnic, 2) are usually concentrated in small business, 3) tend to rely on the in-group for resources, and 4) fill a "status gap" in the receiving society. Ethnic enclaves depend on 3 features: 1) recent coethnic arrivals spend a tour of duty at the worst jobs, 2) coethnics provide ethnic entrepreneurs with consumer markets, 3) ethnic businesses rely on each other to supply their operating needs. Ethnic enclaves are concentrated and spatially identifiable. For this study, the authors collected data in a survey of the Cuban exile community of San Juan, Puerto Rico. The sample selection procedure yielded a total of 261 individuals, 220 of whom were interviewed. 10 predictions found in the middleman minority and ethnic enclave perspectives were checked against the researchers' data. 4 of these predictions are hld in common by both approaches: 1) eomployment in an ethnic enterprise increases subsequent chances of self-employment, 2) ethnic firms rely on the in-group for business resources, 3) coethnic workers represent an asset to the ethnic entrepreneur in that they occupy important positions requiring the employer's trust, and 4) there is business competition between locals and minority members. As predicted by the middleman strategy, Cuban businesses in Puerto Rico tend not to be immediately productive and there is no evidence of spatial concentration of these businesses. However, fitting the enclave approach, these firms do not dominate certain business lines, Cuban entrepreneurs do not appear to be sojourners, and they tend to have business backgrounds. The middleman perspective is supported in that some elements of the local elite favor Cuban exiles. Thus, there is no

  20. Alternative Testing Strategies for Nanomaterials: State of the Science and Considerations for Risk Analysis.

    Science.gov (United States)

    Shatkin, J A; Ong, K J

    2016-08-01

    The rapid growth of the nanotechnology industry has warranted equal progress in the nanotoxicology and risk assessment fields. In vivo models have traditionally been used to determine human and environmental risk for chemicals; however, the use of these tests has limitations, and there are global appeals to develop reliable alternatives to animal testing. Many have investigated the use of alternative (nonanimal) testing methods and strategies have quickly developed and resulted in the generation of large toxicological data sets for numerous nanomaterials (NMs). Due to the novel physicochemical properties of NMs that are related to surface characteristics, the approach toward toxicity test development has distinct considerations from traditional chemicals, bringing new requirements for adapting these approaches for NMs. The methodical development of strategies that combine multiple alternative tests can be useful for predictive NM risk assessment and help screening-level decision making. This article provides an overview of the main developments in alternative methods and strategies for reducing uncertainty in NM risk assessment, including advantages and disadvantages of in vitro, ex vivo, and in silico methods, and examples of existing comprehensive strategies. In addition, knowledge gaps are identified toward improvements for experimental and strategy design, specifically highlighting the need to represent realistic exposure scenarios and to consider NM-specific concerns such as characterization, assay interferences, and standardization. Overall, this article aims to improve the reliability and utility of alternative testing methods and strategies for risk assessment of manufactured NMs. © 2016 Society for Risk Analysis.

  1. Impulse oscillometry system as an alternative diagnostic method for chronic obstructive pulmonary disease.

    Science.gov (United States)

    Wei, Xia; Shi, Zhihong; Cui, Yajuan; Mi, Jiuyun; Ma, Zhengquan; Ren, Jingting; Li, Jie; Xu, Shudi; Guo, Youmin

    2017-11-01

    We aimed to compare impulse oscillation system (IOS) and traditional pulmonary function tests (PFTs) for the assessment of the severity of chronic obstructive pulmonary disease (COPD), and to assess the use of IOS parameters to identify patients who were forced expiratory volume in 1 second (FEV1)%pred IOS. Diagnostic performance of IOS parameters to determine indication for patients of FEV1%pred operating characteristics (ROC) curve analysis.Out of 215 patients, 18, 83, 78, and 36 patients were classified as grade 1, 2, 3, and 4, respectively, according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) severity grading. On Spearman correlation analysis, FEV1%pred, MMEF 75%-25%, and residual volume/total lung capacity (RV/TLC) correlated with total respiratory impedance (Z5)%pred, resistance at 5 Hz (R5)-resistance at 20 Hz (R20), R5-R20% R5, R5, R5%pred, frequency response (Fres), reactance area (Ax), and reactance at 5 Hz (X5). On ROC curve analysis, the area under the curve (AUC) of X5 absolute value, Fres, Ax, Z5%pred, R5-R20, and R5-R20% R5 were 0.748, 0.755, 0.760, 0.705, 0.715, and 0.735, respectively, for COPD patients who required inhalational glucocorticoid therapy.IOS parameters showed a good correlation with traditional pulmonary function parameters; reactance parameters showed a stronger correlation than that of the resistance parameters. IOS can be used as an alternative method for pulmonary function assessment in patients with COPD with FEV1%pred < 50% who need inhalational glucocorticoid therapy. ChiCTR-OCH-14004904.

  2. Rapid diagnostic tests duo as alternative to conventional serological assays for conclusive Chagas disease diagnosis.

    Directory of Open Access Journals (Sweden)

    Karina E Egüez

    2017-04-01

    Full Text Available Chagas disease is caused by the parasite Trypanosoma cruzi. It affects several million people, mainly in Latin America, and severe cardiac and/or digestive complications occur in ~30% of the chronically infected patients. Disease acute stage is mostly asymptomatic and infection goes undiagnosed. In the chronic phase direct parasite detection is hampered due to its concealed presence and diagnosis is achieved by serological methods, like ELISA or indirect hemagglutination assays. Agreement in at least two tests must be obtained due to parasite wide antigenic variability. These techniques require equipped labs and trained personnel and are not available in distant regions. As a result, many infected people often remain undiagnosed until it is too late, as the two available chemotherapies show diminished efficacy in the advanced chronic stage. Easy-to-use rapid diagnostic tests have been developed to be implemented in remote areas as an alternative to conventional tests. They do not need electricity, nor cold chain, they can return results within an hour and some even work with whole blood as sample, like Chagas Stat-Pak (ChemBio Inc. and Chagas Detect Plus (InBIOS Inc.. Nonetheless, in order to qualify a rapidly diagnosed positive patient for treatment, conventional serological confirmation is obligatory, which might risk its start. In this study two rapid tests based on distinct antigen sets were used in parallel as a way to obtain a fast and conclusive Chagas disease diagnosis using whole blood samples. Chagas Stat-Pak and Chagas Detect Plus were validated by comparison with three conventional tests yielding 100% sensitivity and 99.3% specificity over 342 patients seeking Chagas disease diagnosis in a reference centre in Sucre (Bolivia. Combined used of RDTs in distant regions could substitute laborious conventional serology, allowing immediate treatment and favouring better adhesion to it.

  3. Rapid diagnostic tests duo as alternative to conventional serological assays for conclusive Chagas disease diagnosis

    Science.gov (United States)

    Egüez, Karina E.; Terán, Carolina; Chipana, Zenobia; García, Wilson; Torrico, Faustino; Gascon, Joaquim; Lozano-Beltran, Daniel-Franz; Pinazo, María-Jesús

    2017-01-01

    Chagas disease is caused by the parasite Trypanosoma cruzi. It affects several million people, mainly in Latin America, and severe cardiac and/or digestive complications occur in ~30% of the chronically infected patients. Disease acute stage is mostly asymptomatic and infection goes undiagnosed. In the chronic phase direct parasite detection is hampered due to its concealed presence and diagnosis is achieved by serological methods, like ELISA or indirect hemagglutination assays. Agreement in at least two tests must be obtained due to parasite wide antigenic variability. These techniques require equipped labs and trained personnel and are not available in distant regions. As a result, many infected people often remain undiagnosed until it is too late, as the two available chemotherapies show diminished efficacy in the advanced chronic stage. Easy-to-use rapid diagnostic tests have been developed to be implemented in remote areas as an alternative to conventional tests. They do not need electricity, nor cold chain, they can return results within an hour and some even work with whole blood as sample, like Chagas Stat-Pak (ChemBio Inc.) and Chagas Detect Plus (InBIOS Inc.). Nonetheless, in order to qualify a rapidly diagnosed positive patient for treatment, conventional serological confirmation is obligatory, which might risk its start. In this study two rapid tests based on distinct antigen sets were used in parallel as a way to obtain a fast and conclusive Chagas disease diagnosis using whole blood samples. Chagas Stat-Pak and Chagas Detect Plus were validated by comparison with three conventional tests yielding 100% sensitivity and 99.3% specificity over 342 patients seeking Chagas disease diagnosis in a reference centre in Sucre (Bolivia). Combined used of RDTs in distant regions could substitute laborious conventional serology, allowing immediate treatment and favouring better adhesion to it. PMID:28369081

  4. Rapid diagnostic tests duo as alternative to conventional serological assays for conclusive Chagas disease diagnosis.

    Science.gov (United States)

    Egüez, Karina E; Alonso-Padilla, Julio; Terán, Carolina; Chipana, Zenobia; García, Wilson; Torrico, Faustino; Gascon, Joaquim; Lozano-Beltran, Daniel-Franz; Pinazo, María-Jesús

    2017-04-01

    Chagas disease is caused by the parasite Trypanosoma cruzi. It affects several million people, mainly in Latin America, and severe cardiac and/or digestive complications occur in ~30% of the chronically infected patients. Disease acute stage is mostly asymptomatic and infection goes undiagnosed. In the chronic phase direct parasite detection is hampered due to its concealed presence and diagnosis is achieved by serological methods, like ELISA or indirect hemagglutination assays. Agreement in at least two tests must be obtained due to parasite wide antigenic variability. These techniques require equipped labs and trained personnel and are not available in distant regions. As a result, many infected people often remain undiagnosed until it is too late, as the two available chemotherapies show diminished efficacy in the advanced chronic stage. Easy-to-use rapid diagnostic tests have been developed to be implemented in remote areas as an alternative to conventional tests. They do not need electricity, nor cold chain, they can return results within an hour and some even work with whole blood as sample, like Chagas Stat-Pak (ChemBio Inc.) and Chagas Detect Plus (InBIOS Inc.). Nonetheless, in order to qualify a rapidly diagnosed positive patient for treatment, conventional serological confirmation is obligatory, which might risk its start. In this study two rapid tests based on distinct antigen sets were used in parallel as a way to obtain a fast and conclusive Chagas disease diagnosis using whole blood samples. Chagas Stat-Pak and Chagas Detect Plus were validated by comparison with three conventional tests yielding 100% sensitivity and 99.3% specificity over 342 patients seeking Chagas disease diagnosis in a reference centre in Sucre (Bolivia). Combined used of RDTs in distant regions could substitute laborious conventional serology, allowing immediate treatment and favouring better adhesion to it.

  5. Identifying strategy use in category learning tasks: a case for more diagnostic data and models.

    Science.gov (United States)

    Donkin, Chris; Newell, Ben R; Kalish, Mike; Dunn, John C; Nosofsky, Robert M

    2015-07-01

    The strength of conclusions about the adoption of different categorization strategies-and their implications for theories about the cognitive and neural bases of category learning-depend heavily on the techniques for identifying strategy use. We examine performance in an often-used "information-integration" category structure and demonstrate that strategy identification is affected markedly by the range of models under consideration, the type of data collected, and model-selection techniques. We use a set of 27 potential models that represent alternative rule-based and information-integration categorization strategies. Our experimental paradigm includes the presentation of nonreinforced transfer stimuli that improve one's ability to discriminate among the predictions of alternative models. Our model-selection techniques incorporate uncertainty in the identification of individuals as either rule-based or information-integration strategy users. Based on this analysis we identify 48% of participants as unequivocally using an information-integration strategy. However, adopting the standard practice of using a restricted set of models, restricted data, and ignoring the degree of support for a particular strategy, we would typically conclude that 89% of participants used an information-integration strategy. We discuss the implications of potentially erroneous strategy identification for the security of conclusions about the categorization capabilities of various participant and patient groups. (c) 2015 APA, all rights reserved.

  6. A field trial of alternative targeted screening strategies for Chagas disease in Arequipa, Peru.

    Science.gov (United States)

    Hunter, Gabrielle C; Borrini-Mayorí, Katty; Ancca Juárez, Jenny; Castillo Neyra, Ricardo; Verastegui, Manuela R; Malaga Chavez, Fernando S; Cornejo del Carpio, Juan Geny; Córdova Benzaquen, Eleazar; Náquira, César; Gilman, Robert H; Bern, Caryn; Levy, Michael Z

    2012-01-01

    Chagas disease is endemic in the rural areas of southern Peru and a growing urban problem in the regional capital of Arequipa, population ∼860,000. It is unclear how to implement cost-effective screening programs across a large urban and periurban environment. We compared four alternative screening strategies in 18 periurban communities, testing individuals in houses with 1) infected vectors; 2) high vector densities; 3) low vector densities; and 4) no vectors. Vector data were obtained from routine Ministry of Health insecticide application campaigns. We performed ring case detection (radius of 15 m) around seropositive individuals, and collected data on costs of implementation for each strategy. Infection was detected in 21 of 923 (2.28%) participants. Cases had lived more time on average in rural places than non-cases (7.20 years versus 3.31 years, respectively). Significant risk factors on univariate logistic regression for infection were age (OR 1.02; p = 0.041), time lived in a rural location (OR 1.04; p = 0.022), and time lived in an infested area (OR 1.04; p = 0.008). No multivariate model with these variables fit the data better than a simple model including only the time lived in an area with triatomine bugs. There was no significant difference in prevalence across the screening strategies; however a self-assessment of disease risk may have biased participation, inflating prevalence among residents of houses where no infestation was detected. Testing houses with infected-vectors was least expensive. Ring case detection yielded four secondary cases in only one community, possibly due to vector-borne transmission in this community, apparently absent in the others. Targeted screening for urban Chagas disease is promising in areas with ongoing vector-borne transmission; however, these pockets of epidemic transmission remain difficult to detect a priori. The flexibility to adapt to the epidemiology that emerges during screening is key to an

  7. A field trial of alternative targeted screening strategies for Chagas disease in Arequipa, Peru.

    Directory of Open Access Journals (Sweden)

    Gabrielle C Hunter

    2012-01-01

    Full Text Available Chagas disease is endemic in the rural areas of southern Peru and a growing urban problem in the regional capital of Arequipa, population ∼860,000. It is unclear how to implement cost-effective screening programs across a large urban and periurban environment.We compared four alternative screening strategies in 18 periurban communities, testing individuals in houses with 1 infected vectors; 2 high vector densities; 3 low vector densities; and 4 no vectors. Vector data were obtained from routine Ministry of Health insecticide application campaigns. We performed ring case detection (radius of 15 m around seropositive individuals, and collected data on costs of implementation for each strategy.Infection was detected in 21 of 923 (2.28% participants. Cases had lived more time on average in rural places than non-cases (7.20 years versus 3.31 years, respectively. Significant risk factors on univariate logistic regression for infection were age (OR 1.02; p = 0.041, time lived in a rural location (OR 1.04; p = 0.022, and time lived in an infested area (OR 1.04; p = 0.008. No multivariate model with these variables fit the data better than a simple model including only the time lived in an area with triatomine bugs. There was no significant difference in prevalence across the screening strategies; however a self-assessment of disease risk may have biased participation, inflating prevalence among residents of houses where no infestation was detected. Testing houses with infected-vectors was least expensive. Ring case detection yielded four secondary cases in only one community, possibly due to vector-borne transmission in this community, apparently absent in the others.Targeted screening for urban Chagas disease is promising in areas with ongoing vector-borne transmission; however, these pockets of epidemic transmission remain difficult to detect a priori. The flexibility to adapt to the epidemiology that emerges during screening is key to

  8. Diagnostics

    DEFF Research Database (Denmark)

    Donné, A.J.H.; Costley, A.E.; Barnsley, R.

    2007-01-01

    In order to support the operation of ITER and the planned experimental programme an extensive set of plasma and first wall measurements will be required. The number and type of required measurements will be similar to those made on the present-day large tokamaks while the specification...... of the measurements—time and spatial resolutions, etc—will in some cases be more stringent. Many of the measurements will be used in the real time control of the plasma driving a requirement for very high reliability in the systems (diagnostics) that provide the measurements. The implementation of diagnostic systems......&D is needed to prepare the systems. In some cases the environmental difficulties are so severe that new diagnostic techniques are required. The starting point in the development of diagnostics for ITER is to define the measurement requirements and develop their justification. It is necessary to include all...

  9. Alternative Media and the Learning Culture of Civil Society: Outreach and Teach Strategies

    OpenAIRE

    Caton-Rosser, Mary; McGinley, Jennifer A.

    2006-01-01

    A media literate citizenry is at the core of vibrant democracy in civil society. However, local issues are frequently neglected in mass media, de-legitimizing the existence of real democracy. Alternative media mediate this discrepancy in providing access to communication venues through outreach and teach strategies. Many segments of civil society are searching for opportunities to voice their opinions through alternative media. Studies of citizen-produced media indicate that there are links...

  10. Optimizing Preventive Strategies and Malaria Diagnostics to Reduce the Impact of Malaria on US Military Forces

    Science.gov (United States)

    2012-05-01

    quinine (Q), intramuscular artemether, intravenous AS, and AS suppositories are used to treat severe malaria ; all are efficacious and should be...DOD Malaria Stakeholder Meeting May 30-31, 2012 Bethesda, MD Optimizing Preventive Strategies and Malaria Diagnostics to Reduce the Impact...of Malaria on US Military Forces The Armed Forces Health Surveillance Center, the U.S. Army Medical Research and Materiel Command and OSD/Health

  11. Muscle diseases with prominent joint contractures: Main entities and diagnostic strategy.

    Science.gov (United States)

    Eymard, B; Ferreiro, A; Ben Yaou, R; Stojkovic, T

    2013-01-01

    Muscle diseases may have various clinical manifestations including muscle weakness, atrophy or hypertrophy and joint contractures. A spectrum of non-muscular manifestations (cardiac, respiratory, cutaneous, central and peripheral nervous system) may be associated. Few of these features are specific. Limb joint contractures or spine rigidity, when prevailing over muscle weakness in ambulant patients, are of high diagnostic value for diagnosis orientation. Within this context, among several disorders, four groups of diseases should systematically come to mind including the collagen VI-related myopathies, the Emery-Dreifuss muscular dystrophies, the SEPN1 and FHL1 related myopathies. More rarely other genetic or acquired myopathies may present with marked contractures. Diagnostic work-up should include a comprehensive assessment including family history, neurological, cardiologic and respiratory evaluations. Paraclinical investigations should minimally include muscle imaging and electromyography. Muscle and skin biopsies as well as protein and molecular analyses usually help to reach a precise diagnosis. We will first describe the main muscle and neuromuscular junction diseases where contractures are typically a prominent symptom of high diagnostic value for diagnosis orientation. In the following chapters, we will present clues for the diagnostic strategy and the main measures to be taken when, at the end of the diagnostic work-up, no definite muscular disease has been identified. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  12. Strategy and optimization of diagnostic imaging in painful hip in adults.

    Science.gov (United States)

    Blum, A; Raymond, A; Teixeira, P

    2015-02-01

    Diagnostic imaging strategy in painful hip depends on many factors, but in all cases, plain X-ray is the first investigation. It may be sufficient to reach diagnosis and determine treatment options. More effective but more expensive exploration is indicated in two circumstances: when plain X-ray is non-contributive, and when diagnosis has been established but more accurate imaging assessment is needed to guide treatment. Following radiography, the choice of imaging techniques depends not only on the suspected pathology but also on the availability of equipment and its performance. MRI is probably the technique that provides the most comprehensive results; recent improved accessibility has significantly simplified the diagnostic algorithm. CT remains invaluable, and current techniques have reduced patient irradiation to a level similar to that of standard X-ray. Finally, cost is an important consideration in choosing the means of exploration, but the overall financial impact of the various strategies for diagnosis of painful hip is not well established. This article aims to provide a simple and effective diagnostic strategy for the assessment of painful hip, taking account of the clinical situation, and to detail the most typical semiologic patterns of each disease affecting this joint. Copyright © 2015. Published by Elsevier Masson SAS.

  13. Comparative Field Trial of Alternative Vector Control Strategies for Non-Domiciliated Triatoma dimidiata

    Science.gov (United States)

    Ferral, Jhibran; Chavez-Nuñez, Leysi; Euan-Garcia, Maria; Ramirez-Sierra, Maria Jesus; Najera-Vazquez, M. Rosario; Dumonteil, Eric

    2010-01-01

    Chagas disease is a major vector-borne disease, and regional initiatives based on insecticide spraying have successfully controlled domiciliated vectors in many regions. Non-domiciliated vectors remain responsible for a significant transmission risk, and their control is a challenge. We performed a proof-of-concept field trial to test alternative strategies in rural Yucatan, Mexico. Follow-up of house infestation for two seasons following the interventions confirmed that insecticide spraying should be performed annually for the effective control of Triatoma dimidiata; however, it also confirmed that insect screens or long-lasting impregnated curtains may represent good alternative strategies for the sustained control of these vectors. Ecosystemic peridomicile management would be an excellent complementary strategy to improve the cost-effectiveness of interventions. Because these strategies would also be effective against other vector-borne diseases, such as malaria or dengue, they could be integrated within a multi-disease control program. PMID:20064997

  14. Are value of information methods ready for prime time? An application to alternative treatment strategies for NSTEMI patients.

    Science.gov (United States)

    Kent, Seamus; Briggs, Andrew; Eckermann, Simon; Berry, Colin

    2013-10-01

    The use of value of information methods to inform trial design has been widely advocated but there have been few empirical applications of these methods and there is little evidence they are widely used in decision making. This study considers the usefulness of value of information models in the context of a real clinical decision problem relating to alternative diagnostic strategies for patients with a recent non-ST elevated myocardial infarction. A pretrial economic model is constructed to consider the cost-effectiveness of two competing strategies: coronary angiography alone or in conjunction with fractional flow reserve measurement. A closed-form solution to the expected benefits of information is used with optimal sample size estimated for a range of models reflecting increasingly realistic assumptions and alternative decision contexts. Fractional flow reserve measurement is expected to be cost-effective with an incremental cost-effectiveness ratio of GBP 1,621, however, there is considerable uncertainty in this estimate and consequently a large expected value to reducing this uncertainty via a trial. The recommended sample size is strongly affected by the reality of the assumptions of the expected value of information (EVI) model and the decision context. Value of information models can provide a simple and flexible approach to clinical trial design and are more consistent with the constraints and objectives of the healthcare system than traditional frequentist approaches. However, the variation in sample size estimates demonstrates that it is essential that appropriate model parameters and decision contexts are used in their application.

  15. Baseline energy forecasts and analysis of alternative strategies for airline fuel conservation

    Energy Technology Data Exchange (ETDEWEB)

    1976-01-01

    The objectives of this study were to identify measures to reduce airline fuel consumption and to evaluate the impact of these alternatives on fuel consumption through 1990. To evaluate the impact of fuel conservation strategies, baseline forecasts of airline activity and energy consumption to 1990 were developed. Alternative policy options to reduce fuel consumption were identified and analyzed for three baseline levels of aviation activity within the framework of an aviation activity/energy consumption model. By combining the identified policy options, a strategy was developed to provide incentives for airline fuel conservation. Strategies and policy options were evaluated in terms of their impact on airline fuel conservation and the functioning of the airline industry as well as the associated social, environmental, and economic costs. The need for strategies to conserve airline fuel is based on air transportation's dependence upon petroleum; the current lack of alternative energy sources; the potential for disruption of air service due to crises in fuel availability such as experienced during the OPEC oil embargo; and the overall national goal of energy independence through energy conservation in all consuming sectors. The transition from the current situation to that described by strategies and policy options may require difficult adjustments by the airline industry in the short term. In the long term, however, conservation strategies can enhance the health of the airline industry as well as its fuel efficiency.

  16. Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals

    Directory of Open Access Journals (Sweden)

    Asgar Aghaei Hashjin

    2015-10-01

    Full Text Available Background Iran has a widespread diagnostics and clinical support services (DCSS network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. Methods A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. Results The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS units. Most frequently reported were checking drugs expiration dates (94%, pharmacopoeia availability (92%, equipment calibration (87% and identifying responsibilities (86%. Least reported was external auditing of the DCSS (57%. The clinical chemistry and microbiology laboratories (84%, pharmacies, blood bank services (83% reported highest average application rates across all questioned QA strategies. Lowest application rates were reported in human tissue banks (50%. There was no significant difference between the reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research hospitals with the exception of pharmacies and radiology departments. They reported availability of a written QA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied significantly more often in the DCSS of Social Security Organization (SSO and private-for-profit hospitals than in governmental hospitals. Conclusion There is still room for strengthening the managerial cycle of QA systems and accountability in the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA strategies (eg, external/internal audits can be improved. Both the effectiveness of QA

  17. Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals.

    Science.gov (United States)

    Aghaei Hashjin, Asgar; Kringos, Dionne; Ravaghi, Hamid; Manoochehri, Jila; Gorji, Hassan Abolghasem; Klazinga, Niek S

    2015-05-20

    Iran has a widespread diagnostics and clinical support services (DCSS) network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA) policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS units. Most frequently reported were checking drugs expiration dates (94%), pharmacopoeia availability (92%), equipment calibration (87%) and identifying responsibilities (86%). Least reported was external auditing of the DCSS (57%). The clinical chemistry and microbiology laboratories (84%), pharmacies, blood bank services (83%) reported highest average application rates across all questioned QA strategies. Lowest application rates were reported in human tissue banks (50%). There was no significant difference between the reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research hospitals with the exception of pharmacies and radiology departments. They reported availability of a written QA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied significantly more often in the DCSS of Social Security Organization (SSO) and private-for-profit hospitals than in governmental hospitals. There is still room for strengthening the managerial cycle of QA systems and accountability in the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA strategies (eg, external/internal audits) can be improved. Both the effectiveness of QA strategies in practice, and the application of

  18. Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals

    Science.gov (United States)

    Aghaei Hashjin, Asgar; Kringos, Dionne; Ravaghi, Hamid; Manoochehri, Jila; Gorji, Hassan Abolghasem; Klazinga, Niek S.

    2015-01-01

    Background: Iran has a widespread diagnostics and clinical support services (DCSS) network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA) policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. Methods: A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. Results: The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS units. Most frequently reported were checking drugs expiration dates (94%), pharmacopoeia availability (92%), equipment calibration (87%) and identifying responsibilities (86%). Least reported was external auditing of the DCSS (57%). The clinical chemistry and microbiology laboratories (84%), pharmacies, blood bank services (83%) reported highest average application rates across all questioned QA strategies. Lowest application rates were reported in human tissue banks (50%). There was no significant difference between the reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research hospitals with the exception of pharmacies and radiology departments. They reported availability of a written QA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied significantly more often in the DCSS of Social Security Organization (SSO) and private-for-profit hospitals than in governmental hospitals. Conclusion: There is still room for strengthening the managerial cycle of QA systems and accountability in the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA strategies (eg, external/internal audits) can be improved. Both the effectiveness of QA

  19. Joint optimization of field development and water-alternating-gas recovery strategies

    NARCIS (Netherlands)

    Feng, T.; Leeuwenburgh, O.; Hewson, C.; Hanea, R.G.

    2017-01-01

    Alternating injection of water and gas (WAG) has been widely applied as an oil recovery strategy since the late 1950s. The expected benefits are improved macroscopic sweep, with the water and gas sweeping lower and upper zones of the reservoir respectively, and improved microscopic sweep due to

  20. The War on Drugs and Correctional Warehousing: Alternative Strategies for the Drug Crisis.

    Science.gov (United States)

    Welch, Michael

    1997-01-01

    Examines the current strategy to combat illegal drug use and its effect on corrections. Reviews three schools of thought on drug-control policy and explores the assumptions offered by the public-health generalists, the legalists, and the cost-benefit specialists. Concentrates on issues of race, class, and alternatives to correctional warehousing.…

  1. Evaluation of alternative management strategies of muskrat Ondatra zibethicus population control using a population model

    NARCIS (Netherlands)

    Bos, Daan; Ydenberg, Ron

    Muskrats Ondatra zibethicus are considered a pest species in the Netherlands, and a year-round control programme is in effect. Currently, the agency responsible for the management of muskrat populations in the Netherlands (the LCCM) is preparing for field studies to compare alternative strategies of

  2. Disciplinary Practices in Schools and Principles of Alternatives to Corporal Punishment Strategies

    Science.gov (United States)

    Moyo, George; Khewu, Noncedo P. D.; Bayaga, Anass

    2014-01-01

    The aim of the study was to determine the consistency prevailing between the disciplinary practices in the schools and the principles of the Alternatives-to-Corporal Punishment strategy. The three main research questions that guided the study were to determine (1) How much variance of offences can be explained by disciplinary measures of…

  3. Strategies Reported Used by Instructors to Address Student Alternate Conceptions in Chemical Equilibrium

    Science.gov (United States)

    Piquette, Jeff S.; Heikkinen, Henry W.

    2005-01-01

    This study explores general-chemistry instructors' awareness of and ability to identify and address common student learning obstacles in chemical equilibrium. Reported instructor strategies directed at remediating student alternate conceptions were investigated and compared with successful, literature-based conceptual change methods. Fifty-two…

  4. Alternative strategies to improve the beneficial effects of exercise throughout life : dietary and physiological aspects

    NARCIS (Netherlands)

    R.T. Mankowski (Robert Tomasz)

    2015-01-01

    markdownabstractAbstract It is certain that the aging process leads to death, but decreasing the levels of pathology throughout life improves the quality of life and extends life span. Therefore, this dissertation focuses on alternative strategies that may contribute to improving the aging

  5. Baseline energy forecasts and analysis of alternative strategies for airline fuel conservation

    Energy Technology Data Exchange (ETDEWEB)

    1976-07-01

    To evaluate the impact of fuel conservation strategies, baseline forecasts of airline activity and energy consumption to 1990 were developed. Alternative policy options to reduce fuel consumption were identified and analyzed for three baseline levels of aviation activity within the framework of an aviation activity/energy consumption model. By combining the identified policy options, a strategy was developed to provide incentives for airline fuel conservation. Strategies and policy options were evaluated in terms of their impact on airline fuel conservation and the functioning of the airline industry as well as the associated social, environmental, and economic costs. (GRA)

  6. Use of augmentative and alternative communication strategies by family members in the intensive care unit.

    Science.gov (United States)

    Broyles, Lauren M; Tate, Judith A; Happ, Mary Beth

    2012-03-01

    Little is known about communication between patients and their family members during critical illness and mechanical ventilation in the intensive care unit, including use of augmentative and alternative communication tools and strategies. To identify (1) which augmentative and alternative communication tools families use with nonspeaking intensive care patients and how they are used, and (2) what families and nurses say about communication of family members with nonspeaking intensive care patients. A qualitative secondary analysis was conducted of existing data from a clinical trial testing interventions to improve communication between nurses and intensive care patients. Narrative study data (field notes, intervention logs, nurses' interviews) from 127 critically ill adults were reviewed for evidence of family involvement with augmentative and alternative communication tools. Qualitative content analysis was applied for thematic description of family members' and nurses' accounts of patient-family communication. Family involvement with augmentative and alternative communication tools was evident in 44% of the 93 patients who completed the parent study protocol. Spouses or significant others communicated with patients most often. Main themes describing patient-family communication included (1) families being unprepared and unaware, (2) families' perceptions of communication effectiveness, (3) nurses deferring to or guiding patient-family communication, (4) patients' communication characteristics, and (5) families' experience with and interest in augmentative and alternative communication tools. Assessment by skilled bedside clinicians can reveal patients' communication potential and facilitate useful augmentative and alternative communication tools and strategies for patients and their families.

  7. Equipment availability and diagnostic strategies for suspected pulmonary embolism in Austria

    International Nuclear Information System (INIS)

    Schibany, N.; Fleischmann, D.; Thallinger, C.; Ba-Ssalamah, A.; Hahne, J.; Herold, C.J.

    2001-01-01

    The aim of this study was to investigate equipment availability and current diagnostic strategies for suspected pulmonary embolism (PE) in Austrian hospitals. A questionnaire was sent to the medical directors of all Austrian hospitals with emergency and/or surgical, orthopedic, and medical departments. The questionnaire contained questions regarding the available equipment suitable for the imaging diagnosis of PE, the first-line and second-line imaging tests for patients with suspected PE, and additional lower extremity venous imaging and laboratory tests that complement the diagnostic armamentarium. The return rate for questionnaires was 81% (127 of 157 hospitals). There were 97% of hospitals that had the equipment to perform sonography, 59% could perform pulmonary angiography, 54% spiral CT, 19% ventilation/perfusion (V/P) scintigraphy, and 4% perfusion scintigraphy alone. Spiral-CT angiography (SCTA) was the first-line imaging study for suspected PE in 56% of hospitals, followed by echocardiography and V/P scintigraphy. Lower extremity venous imaging (47%) and, interestingly, V/P scintigraphy (43%), served as second-line imaging tests. D-dimer tests were included in the diagnostic strategy in 74% of hospitals. Spiral-CT angiography is the most commonly used primary method for suspected PE in Austrian hospitals. The V/P scintigraphy is available only in a minority of hospitals to investigate patients with suspected PE. When V/P scintigraphy is available, however, it is employed in a large number of patients per annum. (orig.)

  8. "Shotgun" versus sequential testing. Cost-effectiveness of diagnostic strategies for vaginitis.

    Science.gov (United States)

    Carr, Phyllis L; Rothberg, Michael B; Friedman, Robert H; Felsenstein, Donna; Pliskin, Joseph S

    2005-09-01

    Although vaginitis is a common outpatient problem, only 60% of patients can be diagnosed at the initial office visit of a primary care provider using the office procedures of pH testing, whiff tests, normal saline, and potassium hydroxide preps. To determine the most cost-effective diagnostic and treatment approach for the medical management of vaginitis. Decision and cost-effectiveness analyses. Healthy women with symptoms of vaginitis undiagnosed after an initial pelvic exam, wet mount preparations, pH, and the four criteria to diagnose bacterial vaginosis. General office practice. We evaluated 28 diagnostic strategies comprised of combinations of pH testing, vaginal cultures for yeast and Trichomonas vaginalis, Gram's stain for bacterial vaginosis, and DNA probes for Neisseria gonorrhoeae and Chlamydia. Data sources for the study were confined to English language literature. The outcome measures were symptom-days and costs. The least expensive strategy was to perform yeast culture, gonorrhoeae and Chlamydia probes at the initial visit, and Gram's stain and Trichomonas culture only when the vaginal pH exceeded 4.9 (330 dollars, 7.30 symptom days). Other strategies cost 8 dollars to 76 dollars more and increased duration of symptoms by up to 1.3 days. In probabilistic sensitivity analysis, this strategy was always the most effective strategy and was also least expensive 58% of the time. For patients with vaginitis symptoms undiagnosed by pelvic examination, wet mount preparations and related office tests, a comprehensive, pH-guided testing strategy at the initial office visit is less expensive and more effective than ordering tests sequentially.

  9. Disciplinary practices in schools and principles of alternatives to corporal punishment strategies

    Directory of Open Access Journals (Sweden)

    George Moyo

    2014-01-01

    Full Text Available The aim of the study was to determine the consistency prevailing between the disciplinary practices in the schools and the principles of the Alternatives-to-Corporal Punishment strategy. The three main research questions that guided the study were to determine (1 How much variance of offences can be explained by disciplinary measures of alternative corporal punishment? (2 How well do the different measures of alternative corporal punishment predict offences? (3 Which is the best predictor of offences given a set of alternative measures? Twenty-nine schools participated in the survey andfive schools participated in the case study, so the achieved sample was 34 schools. From the 29 survey schools, one principal and one Life Orientation (LO teacher participated. All in all 58 people participated. The results revealed that 66.60% of the variation in the offence of vandalism was explained by the predictors. When vandalism was predicted it was found that School identification (p = .693, p .05. The results reveal that there was no established consistency between the disciplinary practices in the schools and the principles of the alternatives-to-corporal punishment strategy.

  10. A systematic review and economic evaluation of diagnostic strategies for Lynch syndrome.

    Science.gov (United States)

    Snowsill, Tristan; Huxley, Nicola; Hoyle, Martin; Jones-Hughes, Tracey; Coelho, Helen; Cooper, Chris; Frayling, Ian; Hyde, Chris

    2014-09-01

    Lynch syndrome (LS) is an inherited autosomal dominant disorder characterised by an increased risk of colorectal cancer (CRC) and other cancers, and caused by mutations in the deoxyribonucleic acid (DNA) mismatch repair genes. To evaluate the accuracy and cost-effectiveness of strategies to identify LS in newly diagnosed early-onset CRC patients (aged strategies for individuals in whom LS is identified. Systematic reviews were conducted of the test accuracy of microsatellite instability (MSI) testing or immunohistochemistry (IHC) in individuals with CRC at risk of LS, and of economic evidence relating to diagnostic strategies for LS. Reviews were carried out in April 2012 (test accuracy); and in February 2012, repeated in February 2013 (economic evaluations). Databases searched included MEDLINE (1946 to April week 3, 2012), EMBASE (1980 to week 17, 2012) and Web of Science (inception to 30 April 2012), and risk of bias for test accuracy was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) quality appraisal tool. A de novo economic model of diagnostic strategies for LS was developed. Inconsistencies in study designs precluded pooling of diagnostic test accuracy results from a previous systematic review and nine subsequent primary studies. These were of mixed quality, with significant methodological concerns identified for most. IHC and MSI can both play a part in diagnosing LS but neither is gold standard. No UK studies evaluated the cost-effectiveness of diagnosing and managing LS, although studies from other countries generally found some strategies to be cost-effective compared with no testing. The de novo model demonstrated that all strategies were cost-effective compared with no testing at a threshold of £20,000 per quality-adjusted life-year (QALY), with the most cost-effective strategy utilising MSI and BRAF testing [incremental cost-effectiveness ratio (ICER) = £5491 per QALY]. The maximum health benefit to the

  11. Subgroup report on alternative technology strategies for the isolation of nuclear waste

    Energy Technology Data Exchange (ETDEWEB)

    None

    1978-10-01

    The purpose of this report is to provide information to support programmatic approaches to the disposal of high-level and transuranic-contaminated (TRU) wastes. For this purpose the report describes, in Appendices A through F, the state of knowledge relevant to selected nuclear waste disposal technologies. Within the main report a number of alternative technological strategies that could lead to a disposal facility are specified for illustrative and analytical purposes. These strategies span a wide range of variations of technological emphasis and programmatic diversity. Selected implications of these strategies are analyzed. In addition, subjects such as technical conservatism, retrievability, and intermediate scale facilities, that apply to any strategy, are examined and implications of each are discussed.

  12. Subgroup report on alternative technology strategies for the isolation of nuclear waste

    International Nuclear Information System (INIS)

    1978-10-01

    The purpose of this report is to provide information to support programmatic approaches to the disposal of high-level and transuranic-contaminated (TRU) wastes. For this purpose the report describes, in Appendices A through F, the state of knowledge relevant to selected nuclear waste disposal technologies. Within the main report a number of alternative technological strategies that could lead to a disposal facility are specified for illustrative and analytical purposes. These strategies span a wide range of variations of technological emphasis and programmatic diversity. Selected implications of these strategies are analyzed. In addition, subjects such as technical conservatism, retrievability, and intermediate scale facilities, that apply to any strategy, are examined and implications of each are discussed

  13. Is there an alternative strategy for reducing public debt by 2032?

    Directory of Open Access Journals (Sweden)

    Blot Christophe

    2014-01-01

    Full Text Available EMU countries have engaged in fiscal consolidation since 2011. This strategy has proven to be costly in terms of GDP. This cost has been amplified by the fact that fiscal multipliers are high in time of crisis, as recently stressed by the literature. Within this context, we wonder whether there is an alternative strategy aiming at bringing back the debt ratio to 60% of GDP in 2032, meanwhile lowering output losses. To this end, we report simulations realized from a simple model describing the Eurozone and the timing for consolidation. Based on a pragmatic view of the fiscal compact, we find an alternative path for consolidation which achieves a 60% threshold for public debt over the next 20 years in most euro area countries.

  14. Strategies to teach alternative and complementary therapies in nursing: an integrative review

    Directory of Open Access Journals (Sweden)

    Natália Chantal Magalhães da Silva

    2013-12-01

    Full Text Available The lack of discussions that clarify the teaching of alternative and complementary therapies in undergraduate nursing programs shows the need for developing research on this topic. The objective of this study was to identify, in scientific literature, the strategies for teaching alternative and complementary therapies in nursing undergraduate programs. The guiding methodology used was integrative review. The search was performed on SCIENCE DIRECT, LILACS and MEDLINE databases. According to the articles included in this study, the proposals for including these therapies in the program are by: lectures, theoretical courses and discussion groups. However, studies should be conducted to confirm the efficacy of these strategies so these therapeutic methods can be included in the Pedagogical Political Project of the nursing undergraduate program, thus allowing for the consolidation of those practices. Descriptors: Education, Nursing; Education, Higher; Complementary Therapies.

  15. Role of Genetics in the Etiology of Autistic Spectrum Disorder: Towards a Hierarchical Diagnostic Strategy

    Science.gov (United States)

    Robert, Cyrille; Pasquier, Laurent; Cohen, David; Fradin, Mélanie; Canitano, Roberto; Damaj, Léna; Odent, Sylvie; Tordjman, Sylvie

    2017-01-01

    Progress in epidemiological, molecular and clinical genetics with the development of new techniques has improved knowledge on genetic syndromes associated with autism spectrum disorder (ASD). The objective of this article is to show the diversity of genetic disorders associated with ASD (based on an extensive review of single-gene disorders, copy number variants, and other chromosomal disorders), and consequently to propose a hierarchical diagnostic strategy with a stepwise evaluation, helping general practitioners/pediatricians and child psychiatrists to collaborate with geneticists and neuropediatricians, in order to search for genetic disorders associated with ASD. The first step is a clinical investigation involving: (i) a child psychiatric and psychological evaluation confirming autism diagnosis from different observational sources and assessing autism severity; (ii) a neuropediatric evaluation examining neurological symptoms and developmental milestones; and (iii) a genetic evaluation searching for dysmorphic features and malformations. The second step involves laboratory and if necessary neuroimaging and EEG studies oriented by clinical results based on clinical genetic and neuropediatric examinations. The identification of genetic disorders associated with ASD has practical implications for diagnostic strategies, early detection or prevention of co-morbidity, specific treatment and follow up, and genetic counseling. PMID:28287497

  16. Female impersonation as an alternative reproductive strategy in giant cuttlefish\\ud

    OpenAIRE

    Norman, M.D.; Finn, J.; Tregenza, T.

    1999-01-01

    Out of all the animals, cephalopods possess an unrivalled ability to change their shape and body patterns. Our observations of giant cuttlefish (Sepia apama) suggest this ability has allowed them to evolve alternative mating strategies in which males can switch between the appearance of a female and that of a male in order to foil the guarding attempts of larger males. At a mass breeding aggregation in South Australia, we repeatedly observed single small males accompanying mating pairs. While...

  17. The Role of Alternative Testing Strategies in Environmental Risk Assessment of Engineered Nanomaterials

    OpenAIRE

    Hjorth, Rune; Holden, Patricia; Hansen, Steffen Foss; Colman, Ben; Grieger, Khara; Hendren, Christine

    2017-01-01

    Within toxicology there is a pressure to find new test systems and organisms to replace, reduce and refine animal testing. In nanoecotoxicology the need for alternative testing strategies (ATS) is further emphasized as the validity of tests and risk assessment practices developed for dissolved chemicals are challenged. Nonetheless, standardized whole organism animal testing is still considered the gold standard for environmental risk assessment. Advancing risk analysis of engineered nanomater...

  18. National Military Strategy in the Post Cold War Era: Nuclear Deterrence or an Alternative

    Science.gov (United States)

    1993-04-15

    service or government agency. N-ATIONAL MILITARY STRATEGY IN THE POST COLD WAR ERA: NULEAR DETERRENCE OR AK ALTERNATIVE AN JNDIVIDUAL STUDY PROJECT by , Ltc...Atomic Energy Agency have thus far demonstrated the North Koreans to be abiding by their agreement &t this facility.’ 0 However, there are no guarantees...subsequently began cooperation with the International Atomic Energy Agency (IAEA).21 It may have been the attitude of most whites regarding the future of

  19. Performance and suggested alternative strategies in developing Indonesian cocoa export business

    Directory of Open Access Journals (Sweden)

    Bambang Dradjat

    2009-08-01

    Full Text Available This research focussed on the export development of cocoa bean with respect to its export growth, values and competitiveness. Based on this deve-lopment, the aim of this research is to propose alternative development strategies of export business for cocoa bean in the future. The Analysis Hierarchie Process (AHP framework of export business of cocoa bean was arranged consecutively from formulation of focuss or goals, identification of affecting factors and actors, deter mination of actor objectives, and recognition of alternative strategies needed. Each component of goals, factors, actors, objectives, and alternative strategies were valued on the basis of their importance using Saaty scales. Results of interviews with experts were analyzed using AHP technique. The development of cocoa bean export from 2000 to 2006 showed the competitiveness position of Indonesia in the world market was fairly good. In order to increase the growth and values of cocoa bean export, the experts consider the role of government as regulators and facilitators is very important. The government became the main actor for the export development through de/regulation related to the cocoa bean commodity. The objectives of actors could be achieved by combining strategies (i provision of fund in national and regional budget, as well as other sources (ii implementation of recomended technologies of cocoa, (iii acceleration of replanting program, (iv improvement of research productivity in producing high yielding plant materials, (v development of transportation facilities from farms to harbours, (vi development of farmers’ organization and partnerships as well as strategic alliance, and (viii pests and diseases control. Key words: Cocoa bean, expor, role of government, objectives and strategies.

  20. Cost effectiveness of Alternative Helicobacter pylori Eradication Strategies in the Management of Duodenal Ulcer

    Directory of Open Access Journals (Sweden)

    Bernie O'Brien

    1997-01-01

    Full Text Available Published data and techniques for decision analysis were used to construct a model to estimate the cost effectiveness of nine alternative strategies for the management of patients diagnosed with uncomplicated duodenal ulcer. Two strategies of intermittent therapy with either ranitidine or omeprazole, one strategy of continuous maintenance treatment with ranitidine, and six strategies for ulcer healing and eradication of Helicobacter pylori infection were considered. Healing time curves were estimated by using published data, allowing for estimation of expected time for acute healing episodes. The expected number of weeks to heal per patient, in a one-year period, was estimated by combining healing time data with probability of ulcer recurrence. It was found that patients that underwent any of the six H pylori eradication regimens had fewer days with ulcer per year than those who underwent maintenance or intermittent ranitidine. Four eradication regimens had lower costs and better outcomes than ranitidine therapy. In comparing H pylori strategies, the two strategies of omeprazole plus one antibiotic (either amoxicillin or clarithromycin are more costly than omeprazole plus two antibiotics (specifically amoxicillin and metronidazole or clarithromycin and metronidazole and result in similar outcomes. Although omeprazole-based eradication regimens are more costly than ranitidine bismuth triple therapy, they are associated with fewer recurrences of ulcer and days of symptoms. A limitation of the analysis is that it did not incorporate issues of compliance and metronidazole resistance; however, the former concern may be less of an issue as H pylori regimens become simpler and shorter in duration.

  1. Cost effectiveness of alternative Helicobacter pylori eradication strategies in the management of duodenal ulcer.

    Science.gov (United States)

    O'Brien, B; Goeree, R; Hunt, R; Wilkinson, J; Levine, M; William, A

    1997-01-01

    Published data and techniques for decision analysis were used to construct a model to estimate the cost effectiveness of nine alternative strategies for the management of patients diagnosed with uncomplicated duodenal ulcer. Two strategies of intermittent therapy with either ranitidine or omeprazole, one strategy of continuous maintenance treatment with ranitidine, and six strategies for ulcer healing and eradication of Helicobacter pylori infection were considered. Healing time curves were estimated by using published data, allowing for estimation of expected time for acute healing episodes. The expected number of weeks to heal per patient, in a one-year period, was estimated by combining healing time data with probability of ulcer recurrence. It was found that patients that underwent any of the six H pylori eradication regimens had fewer days with ulcer per year than those who underwent maintenance or intermittent ranitidine. Four eradication regimens had lower costs and better outcomes than ranitidine therapy. In comparing H pylori strategies, the two strategies of omeprazole plus one antibiotic (either amoxicillin or clarithromycin) are most costly than omeprazole plus two antibiotics (specifically amoxicillin and metronidazole or clarithromycin and metronidazole) and result in similar outcomes. Although omeprazole-based eradication regimens are more costly than ranitidine bismuth triple therapy, they are associated with fewer recurrences of ulcer and days of symptoms. A limitation of the analysis is that it did not incorporate issues of compliance and metronidazole resistance; however, the former concern may be less of an issue as H pylori regimens become simpler and shorter in duration.

  2. Cost-effectiveness of alternative conservation strategies with application to the Pacific leatherback turtle.

    Science.gov (United States)

    Gjertsen, Heidi; Squires, Dale; Dutton, Peter H; Eguchi, Tomoharu

    2014-02-01

    Although holistic conservation addressing all sources of mortality for endangered species or stocks is the preferred conservation strategy, limited budgets require a criterion to prioritize conservation investments. We compared the cost-effectiveness of nesting site and at-sea conservation strategies for Pacific leatherback turtles (Dermochelys coriacea). We sought to determine which conservation strategy or mix of strategies would produce the largest increase in population growth rate per dollar. Alternative strategies included protection of nesters and their eggs at nesting beaches in Indonesia, gear changes, effort restrictions, and caps on turtle takes in the Hawaiian (U.S.A.) longline swordfish fishery, and temporal and area closures in the California (U.S.A.) drift gill net fishery. We used a population model with a biological metric to measure the effects of conservation alternatives. We normalized all effects by cost to prioritize those strategies with the greatest biological effect relative to its economic cost. We used Monte Carlo simulation to address uncertainty in the main variables and to calculate probability distributions for cost-effectiveness measures. Nesting beach protection was the most cost-effective means of achieving increases in leatherback populations. This result creates the possibility of noncompensatory bycatch mitigation, where high-bycatch fisheries invest in protecting nesting beaches. An example of this practice is U.S. processors of longline tuna and California drift gill net fishers that tax themselves to finance low-cost nesting site protection. Under certain conditions, fisheries interventions, such as technologies that reduce leatherback bycatch without substantially decreasing target species catch, can be cost-effective. Reducing bycatch in coastal areas where bycatch is high, particularly adjacent to nesting beaches, may be cost-effective, particularly, if fisheries in the area are small and of little commercial value.

  3. Interest of chest X-ray in tailoring the diagnostic strategy in patients with suspected pulmonary embolism.

    Science.gov (United States)

    Robin, Philippe; Le Roux, Pierre-Yves; Tissot, Valentin; Delluc, Aurélien; Le Duc-Pennec, Alexandra; Abgral, Ronan; Palard, Xavier; Couturaud, Francis; Le Gal, Grégoire; Salaun, Pierre-Yves

    2015-09-01

    Current diagnostic strategies for pulmonary embolism rely on the sequential use of noninvasive diagnostic tests including ventilation-perfusion (V/Q) scan and computed tomography pulmonary angiography (CTPA). V/Q scan remains criticized because of a high proportion of nondiagnostic test results, especially when the chest X-ray (CXR) is abnormal. The present study assesses whether CXR results have an impact on the conclusiveness of a noninvasive diagnostic strategy of pulmonary embolism based on the combination of pretest probability, compression ultrasonography, V/Q scan, and CTPA. Patients suspected of having pulmonary embolism were managed according to a validated diagnostic strategy. All patients underwent a CXR within 24 h of the suspicion of pulmonary embolism. CXR results were correlated to strategy conclusiveness, as assessed by the rate of required CTPA as per the diagnostic algorithm. Two hundred and twenty-three patients were retrospectively analyzed. CXRs were considered as normal in 108 (48%) patients and abnormal in 115 (52%) patients. According to the diagnostic algorithm, a CTPA was required to reach a diagnostic conclusion in 11 (10%) patients of the normal CXR group, and in 14 (12%) patients of the abnormal CXR group (P > 0.05). In this study, the presence of CXR abnormalities did not have an impact on the conclusiveness of a diagnostic strategy of pulmonary embolism based on V/Q scan. CXR abnormalities should likely not be regarded as a contraindication to the use of V/Q scan in patients with suspected pulmonary embolism.

  4. Development and Assessment of A Diagnostic Tool to Identify Organic Chemistry Students' Alternative Conceptions Related to Acid Strength

    Science.gov (United States)

    McClary, LaKeisha M.; Lowery Bretz, Stacey

    2012-10-01

    The central goal of this study was to create a new diagnostic tool to identify organic chemistry students' alternative conceptions related to acid strength. Twenty years of research on secondary and college students' conceptions about acids and bases has shown that these important concepts are difficult for students to apply to qualitative problem solving. Yet, few published studies document how students' prior knowledge of acids influences their understanding of acid strength in organic chemistry contexts. We developed a nine-item multiple-tier, multiple-choice concept inventory to identify alternative conceptions that organic chemistry students hold about acid strength, to determine the prevalence of these conceptions, and to determine how strongly these conceptions bias student reasoning. We identified two significant alternative conceptions that organic chemistry students hold about acid strength. Students who answered items incorrectly were more confident about their answers than peers who answered items correctly, suggesting that after one semester of organic chemistry, students do not know what they do not know. Implications for the teaching of acid strength are discussed.

  5. Dental Providers’ Perspectives on Diagnosis-Driven Dentistry: Strategies to Enhance Adoption of Dental Diagnostic Terminology

    Science.gov (United States)

    Obadan-Udoh, Enihomo; Etolue, Jini; Tokede, Oluwabunmi; White, Joel; Spallek, Heiko; Walji, Muhammad; Kalenderian, Elsbeth

    2017-01-01

    The routine use of standardized diagnostic terminologies (DxTMs) in dentistry has long been the subject of academic debate. This paper discusses the strategies suggested by a group of dental stakeholders to enhance the uptake of DxTMs. Through unstructured interviewing at the ‘Toward a Diagnosis-Driven Profession’ National Conference held on 19 March 2016 in Los Angeles, CA, USA participants were asked how enthusiastic they were about implementing and consistently using DxTMs at their work. They also brainstormed on strategies to improve the widespread use of DxTMs. Their responses are summarized by recursive abstraction and presented in themes. Conference participants were very enthusiastic about using a DxTM in their place of work. Participants enumerated several strategies to make DxTMs more appealing including: the use of mandates, a value proposition for providers, communication and education, and integration with EHRs and existing systems. All groups across the dental healthcare delivery spectrum will need to work together for the success of the widespread and consistent use of DxTMs. Understanding the provider perspective is however the most critical step in achieving this goal, as they are the group who will ultimately be saddled with the critical task of ensuring DxTM use at the point of care. PMID:28703751

  6. Dental Providers' Perspectives on Diagnosis-Driven Dentistry: Strategies to Enhance Adoption of Dental Diagnostic Terminology.

    Science.gov (United States)

    Obadan-Udoh, Enihomo; Simon, Lisa; Etolue, Jini; Tokede, Oluwabunmi; White, Joel; Spallek, Heiko; Walji, Muhammad; Kalenderian, Elsbeth

    2017-07-13

    The routine use of standardized diagnostic terminologies (DxTMs) in dentistry has long been the subject of academic debate. This paper discusses the strategies suggested by a group of dental stakeholders to enhance the uptake of DxTMs. Through unstructured interviewing at the 'Toward a Diagnosis-Driven Profession' National Conference held on 19 March 2016 in Los Angeles, CA, USA participants were asked how enthusiastic they were about implementing and consistently using DxTMs at their work. They also brainstormed on strategies to improve the widespread use of DxTMs. Their responses are summarized by recursive abstraction and presented in themes. Conference participants were very enthusiastic about using a DxTM in their place of work. Participants enumerated several strategies to make DxTMs more appealing including: the use of mandates, a value proposition for providers, communication and education, and integration with EHRs and existing systems. All groups across the dental healthcare delivery spectrum will need to work together for the success of the widespread and consistent use of DxTMs. Understanding the provider perspective is however the most critical step in achieving this goal, as they are the group who will ultimately be saddled with the critical task of ensuring DxTM use at the point of care.

  7. Diagnostic validity of alternative manual stress radiographic technique detecting subtalar instability with concomitant ankle instability.

    Science.gov (United States)

    Lee, Byung Hoon; Choi, Kyung-Hwa; Seo, Dong Yeon; Choi, Sang Min; Kim, Gab Lae

    2016-04-01

    To incorporate a diagnostic technique for measuring subtalar motion, namely "talar rotation", into the manual supination-anterior drawer stress radiographs for evaluation of the severity of rotational instability, and to determine its clinical relevance. Sixty-six patients with combined injuries of the anterior talofibular (ATFL) and calcaneofibular ligament (CFL) underwent three bilateral manual stress radiographs, and mean increments of anterior talar translation (mm), talar tilt (°), and talar rotation (%) in the injured ankle compared to the normal opposite side were measured with the technique. Intraobserver and interobserver reliability of each measure was assessed, and the difference in the degree of increments was compared according to the presence of additional cervical ligament insufficiency. Ankle stress radiographic intraobserver and interobserver agreement was ICC = 0.91 and 0.82 for talar rotation (%), ICC = 0.64 and 0.51 for anterior talar translation, and ICC = 0.78 and 0.71 for talar tilt angle, respectively. In group 2 including patients with combined injuries of the ATFL and CFL along with additional cervical ligament insufficiency, a significantly higher increment of talar rotation, mean 6.4% (SD 3.4%), was observed compared to that of talar rotation, mean 4.1% (SD 2.7 ), in the other group (group 1) with an intact cervical ligament (p technique for diagnosis of chronic lateral ankle instability presented in this study might be a reliable and representable measurement tool to assess additional injury or instability of the subtalar joint. Prospective cohort study, Level II.

  8. Diagnostic accuracy of a step-up imaging strategy in pediatric patients with blunt abdominal trauma

    International Nuclear Information System (INIS)

    Schuppen, J. van; Olthof, D.C.; Wilde, J.C.H.; Beenen, L.F.M.; Rijn, R.R. van; Goslings, J.C.

    2014-01-01

    Introduction: Blunt abdominal trauma (BAT) is an important but often unrecognized cause of death in children. Imaging plays a vital role in the early detection of abdominal trauma. The exact role of imaging in the management of BAT in children is still under research. The aim of this study was to assess diagnostic accuracy of a step-up imaging strategy, where the decision to observe or to perform an intervention depends on the vital parameters of the patient, in combination with the presence or absence of free fluid at Focused Assessment with Sonography for Trauma (FAST) and the findings on CT (performed selectively), for pediatric patients presenting to the ED with a blunt abdominal trauma. Methods: Consecutive patients aged ≤16 years admitted between January 2008 and December 2012 to a Dutch level 1 trauma centre were included in this retrospective study. Sensitivity, negative predictive value (NPV) and the negative likelihood ratio (LR−) of the imaging strategy were calculated. Results: The cohort consisted of 122 patients; 66 (54%) patients were discharged home after primary survey, 51 (41%) patients were admitted and observed, 3 (2%) patients underwent transarterial embolization and 2 (2%) patients underwent surgery. Treatment failed in 1 patient, initially selected for observation. The sensitivity of the imaging strategy was 0.833 (0.446–0.990). The NPV and LR− were 0.991 (0.963–1.000) and 0.167 (0.028–0.997), respectively. Conclusion: The step-up imaging strategy that is applied in our academic level 1 trauma centre has a high sensitivity and a high negative predictive value. No clinically relevant injuries were missed without doing unnecessary harm, e.g. radiation or an intervention

  9. Diagnostic accuracy of a step-up imaging strategy in pediatric patients with blunt abdominal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Schuppen, J. van [Department of Radiology, Academic Medical Centre, Amsterdam (Netherlands); Olthof, D.C. [Trauma Unit Department of Surgery, Academic Medical Centre, Amsterdam (Netherlands); Wilde, J.C.H. [Department of Paediatric Surgery, Emma' s Children Hospital/Academic Medical Centre, Amsterdam (Netherlands); Beenen, L.F.M.; Rijn, R.R. van [Department of Radiology, Academic Medical Centre, Amsterdam (Netherlands); Goslings, J.C., E-mail: j.c.goslings@amc.nl [Trauma Unit Department of Surgery, Academic Medical Centre, Amsterdam (Netherlands)

    2014-01-15

    Introduction: Blunt abdominal trauma (BAT) is an important but often unrecognized cause of death in children. Imaging plays a vital role in the early detection of abdominal trauma. The exact role of imaging in the management of BAT in children is still under research. The aim of this study was to assess diagnostic accuracy of a step-up imaging strategy, where the decision to observe or to perform an intervention depends on the vital parameters of the patient, in combination with the presence or absence of free fluid at Focused Assessment with Sonography for Trauma (FAST) and the findings on CT (performed selectively), for pediatric patients presenting to the ED with a blunt abdominal trauma. Methods: Consecutive patients aged ≤16 years admitted between January 2008 and December 2012 to a Dutch level 1 trauma centre were included in this retrospective study. Sensitivity, negative predictive value (NPV) and the negative likelihood ratio (LR−) of the imaging strategy were calculated. Results: The cohort consisted of 122 patients; 66 (54%) patients were discharged home after primary survey, 51 (41%) patients were admitted and observed, 3 (2%) patients underwent transarterial embolization and 2 (2%) patients underwent surgery. Treatment failed in 1 patient, initially selected for observation. The sensitivity of the imaging strategy was 0.833 (0.446–0.990). The NPV and LR− were 0.991 (0.963–1.000) and 0.167 (0.028–0.997), respectively. Conclusion: The step-up imaging strategy that is applied in our academic level 1 trauma centre has a high sensitivity and a high negative predictive value. No clinically relevant injuries were missed without doing unnecessary harm, e.g. radiation or an intervention.

  10. Early diagnostic value of survivin and its alternative splice variants in breast cancer

    International Nuclear Information System (INIS)

    Khan, Salma; Bennit, Heather Ferguson; Turay, David; Perez, Mia; Mirshahidi, Saied; Yuan, Yuan; Wall, Nathan R

    2014-01-01

    The inhibitor of apoptosis (IAP) protein Survivin and its splice variants are differentially expressed in breast cancer tissues. Our previous work showed Survivin is released from tumor cells via small membrane-bound vesicles called exosomes. We, therefore, hypothesize that analysis of serum exosomal Survivin and its splice variants may provide a novel biomarker for early diagnosis of breast cancer. We collected sera from forty breast cancer patients and ten control patients who were disease free for 5 years after treatment. In addition, twenty-three paired breast cancer tumor tissues from those same 40 patients were analyzed for splice variants. Serum levels of Survivin were analyzed using ELISA and exosomes were isolated from this serum using the commercially available ExoQuick kit, with subsequent Western blots and immunohistochemistry performed. Survivin levels were significantly higher in all the breast cancer samples compared to controls (p < 0.05) with exosome amounts significantly higher in cancer patient sera compared to controls (p < 0.01). While Survivin and Survivin-∆Ex3 splice variant expression and localization was identical in serum exosomes, differential expression of Survivin-2B protein existed in the exosomes. Similarly, Survivin and Survivin-∆Ex3 proteins were the predominant forms detected in all of the breast cancer tissues evaluated in this study, whereas a more variable expression of Survivin-2B level was found at different cancer stages. In this study we show for the first time that like Survivin, the Survivin splice variants are also exosomally packaged in the breast cancer patients’ sera, mimicking the survivin splice variant pattern that we also report in breast cancer tissues. Differential expression of exosomal-Survivin, particularly Survivin-2B, may serve as a diagnostic and/or prognostic marker, a “liquid biopsy” if you will, in early breast cancer patients. Furthermore, a more thorough understanding of the role of this

  11. Is propofol a safe alternative to pentobarbital for sedation during pediatric diagnostic CT?

    Science.gov (United States)

    Zgleszewski, Steven E; Zurakowski, David; Fontaine, Paulette J; D'Angelo, Margaret; Mason, Keira P

    2008-05-01

    To prospectively compare the incidence of adverse respiratory events, the need for airway interventions, and the recovery time after propofol sedation with similar data from a retrospective review of data obtained in patients who underwent pentobarbital sedation. This HIPAA-compliant study was conducted with institutional review board approval and parental informed consent. The hospital sedation committee approved a 2-month pilot program of propofol sedation as a potential alternative to pentobarbital sedation. Parents were given the choice of having their child sedated with intravenously administered propofol or pentobarbital. Fifty-two patients (18 female, 34 male; mean age, 2.9 years +/- 2.4 [standard deviation]) received propofol. An equal number of patients (21 female, 31 male; mean age, 2.5 years +/- 1.7) who previously received pentobarbital were included. The sample sizes provided 80% power to detect differences in airway manipulations, adverse respiratory events, and recovery time between the groups by using the Fisher exact test and the Student t test. A two-tailed P value of less than .05 indicated a significant difference. Patients sedated with propofol underwent significantly more airway manipulations to relieve obstruction than did patients sedated with pentobarbital (23% vs 0%, P pentobarbital group (12% vs 0%, P = .03). Patients in the propofol group had a faster recovery profile than did patients in the pentobarbital group (34 minutes +/- 17 vs 100 minutes +/- 30, P pentobarbital. (c) RSNA, 2008.

  12. Investigation of Alternative Return Strategies for Orion Trans-earth Injection Design Options

    Science.gov (United States)

    Marchand, Belinda G.; Scarritt, Sara K.; Howell, Kathleen C.; Weeks, Michael W.

    2010-01-01

    The purpose of this study is to investigate alternative return strategies for the Orion trans-Earth injection (TEI) phase. A dynamical systems analysis approach considers the structure of the stable and unstable Sun perturbed Earth-Moon manifolds near the Earth-Moon interface region. A hybrid approach, then, combines the results from this analysis with classical two-body methods in a targeting process that seeks to expand the window of return opportunities in a precision entry scenario. The resulting startup arcs can be used, for instance, to enhance the block set of solutions available onboard during an autonomous targeting process.

  13. Evaluating environmental and economic consequences of alternative pest management strategies: results of modeling workshops

    Science.gov (United States)

    Johnson, Richard L.; Andrews, Austin K.; Auble, Gregor T.L.; Ellison, Richard A.; Hamilton, David B.; Roelle, James E.; McNamee, Peter J.

    1983-01-01

    The U.S. Environmental Protection Agency (EPA) needs a comprehensive method to evaluate the human health and environmental effects of alternative agricultural pest management strategies. This project explored the utility of Adaptive Environmental Assessment (AEA) techniques for meeting this need. The project objectives were to produce models for environmental impact analysis, improve communications, identify research needs and data requirements, and demonstrate a process for resolving conflicts. The project was structured around the construction (in an initial 2 1/2-day workshop) and examination (in a second 2 1/2-day workshop) of a simulation model of a corn agroecosystem.

  14. The role of utilities in enabling technology innovation: The BC hydro alternative & emerging energy strategy

    Energy Technology Data Exchange (ETDEWEB)

    Tu, Alex; Leclair, Donna; Morrison, Allison

    2010-09-15

    In order for renewable energy to play a dominant role in the global electricity supply mix, emerging renewable energy technologies - such as wave, tidal, enhanced geothermal, and 3rd generation photovoltaic technologies - must prove their technical merits and achieve cost parity with conventional sources of supply. BC Hydro, a government-owned electric utility, launched an Alternative and Emerging Energy Strategy that describes its role as an enabler of technology innovation. This paper describes BC Hydro's goal, objectives and actions to accelerate the commercialization that will yield a diversity of supply options and a growing, local clean-tech cluster.

  15. Temporary implants for patients with low bone density of the upper maxilla: an alternative rehabilitation strategy.

    Science.gov (United States)

    de Aguiar, Rogério Coelho; Zabolotsky, Borys; de Souza, Dircilene Colares; Ferreira, Cimara Fortes; Cardoso, Antônio Carlos

    2012-03-01

    The use of removable provisional prosthesis after implant placement is undesirable for many patients. In addition, removable prostheses place unfavorable pressure over implants during the healing period. The use of temporary implants enable greater stability and functionality of the prostheses. This clinical report shows the use of temporary implants in a low density maxilla in conjunction with a fixed provisional prosthesis. The temporary implants contributed to the support of the provisional fixed upper arch prosthesis and to patient comfort with a fixed prosthesis during the healing period.   Fixed provisional prostheses are a potentially desirable alternative treatment strategy. © 2009 Wiley Periodicals, Inc.

  16. Treatment guided by rapid diagnostic tests for malaria in Tanzanian children: safety and alternative bacterial diagnoses

    Directory of Open Access Journals (Sweden)

    Sykes Alma

    2011-10-01

    Full Text Available Abstract Background WHO guidelines for the treatment of young children with suspected malaria have recently changed from presumptive treatment to anti-malarial treatment guided by a blood slide or malaria rapid diagnostic test (RDT. However, there is limited evidence of the safety of this policy in routine outpatient settings in Africa. Methods Children 3-59 months of age with a non-severe febrile illness and no obvious cause were enrolled over a period of one year in a malaria endemic area of Tanzania. Treatment was determined by the results of a clinical examination and RDT result, and blood culture and serum lactate were also collected. RDT-negative children were followed up over 14 days. Results Over the course of one year, 965 children were enrolled; 158 (16.4% were RDT-positive and treated with artemether-lumefantrine and 807 (83.4% were RDT-negative and treated with non-anti-malarial medicines. Compared with RDT-positives, RDT-negative children were on average younger with a lower axillary temperature and more likely to have a history of cough or difficulty in breathing. Six (0.6% children became RDT-positive after enrolment, all of whom were PCR-negative for Plasmodium falciparum DNA at enrolment. In addition, 12 (1.2% children were admitted to hospital, one with possible malaria, none of whom died. A bacterial pathogen was identified in 9/965 (0.9% children, eight of whom were RDT-negative and one was RDT-positive, but slide-negative. Excluding three children with Salmonella typhi, all of the children with bacteraemia were ≤12 months of age. Compared to double-read research slide results RDTs had a sensitivity of 97.8% (95%CI 96.9-98.7 and specificity of 96.3% (95%CI 96.3-98.4. Conclusions Use of RDTs to direct the use of anti-malarial drugs in young children did not result in any missed diagnoses of malaria although new infections soon after a consultation with a negative RDT result may undermine confidence in results. Invasive

  17. Longitudinal exchange: an alternative strategy towards quantification of dynamics parameters in ZZ exchange spectroscopy

    International Nuclear Information System (INIS)

    Kloiber, Karin; Spitzer, Romana; Grutsch, Sarina; Kreutz, Christoph; Tollinger, Martin

    2011-01-01

    Longitudinal exchange experiments facilitate the quantification of the rates of interconversion between the exchanging species, along with their longitudinal relaxation rates, by analyzing the time-dependence of direct correlation and exchange cross peaks. Here we present a simple and robust alternative to this strategy, which is based on the combination of two complementary experiments, one with and one without resolving exchange cross peaks. We show that by combining the two data sets systematic errors that are caused by differential line-broadening of the exchanging species are avoided and reliable quantification of kinetic and relaxation parameters in the presence of additional conformational exchange on the ms–μs time scale is possible. The strategy is applied to a bistable DNA oligomer that displays different line-broadening in the two exchanging species.

  18. Laboratory Evolution to Alternating Substrate Environments Yields Distinct Phenotypic and Genetic Adaptive Strategies.

    Science.gov (United States)

    Sandberg, Troy E; Lloyd, Colton J; Palsson, Bernhard O; Feist, Adam M

    2017-07-01

    Adaptive laboratory evolution (ALE) experiments are often designed to maintain a static culturing environment to minimize confounding variables that could influence the adaptive process, but dynamic nutrient conditions occur frequently in natural and bioprocessing settings. To study the nature of carbon substrate fitness tradeoffs, we evolved batch cultures of Escherichia coli via serial propagation into tubes alternating between glucose and either xylose, glycerol, or acetate. Genome sequencing of evolved cultures revealed several genetic changes preferentially selected for under dynamic conditions and different adaptation strategies depending on the substrates being switched between; in some environments, a persistent "generalist" strain developed, while in another, two "specialist" subpopulations arose that alternated dominance. Diauxic lag phenotype varied across the generalists and specialists, in one case being completely abolished, while gene expression data distinguished the transcriptional strategies implemented by strains in pursuit of growth optimality. Genome-scale metabolic modeling techniques were then used to help explain the inherent substrate differences giving rise to the observed distinct adaptive strategies. This study gives insight into the population dynamics of adaptation in an alternating environment and into the underlying metabolic and genetic mechanisms. Furthermore, ALE-generated optimized strains have phenotypes with potential industrial bioprocessing applications. IMPORTANCE Evolution and natural selection inexorably lead to an organism's improved fitness in a given environment, whether in a laboratory or natural setting. However, despite the frequent natural occurrence of complex and dynamic growth environments, laboratory evolution experiments typically maintain simple, static culturing environments so as to reduce selection pressure complexity. In this study, we investigated the adaptive strategies underlying evolution to

  19. Alternative futures: Fields, boundaries, and divergent professionalisation strategies within the Chiropractic profession.

    Science.gov (United States)

    Brosnan, Caragh

    2017-10-01

    Sociological studies of the complementary and alternative medicine (CAM) occupations have documented the professionalisation strategies these groups use to establish boundaries between themselves and their competitors, including seeking educational accreditation and statutory regulation/licensure. Chiropractic has been particularly successful at professionalising and in Australia and the UK it is taught within public universities. Recent events have threatened chiropractic's university foothold, however, showing that professionalisation needs to be understood as an ongoing process of negotiation. Based on interviews with chiropractors in Australia and the UK, this paper examines the professionalisation strategies deployed by chiropractors within and outside of the university. Highly divergent strategies are identified across different sectors of the profession, relating to defining the chiropractic paradigm, directing education and constructing professional identity. In each domain, chiropractic academics tended to prioritise building the evidence base and becoming more aligned with medicine and other allied health professions. Although some practitioners supported this agenda, others strove to preserve chiropractic's vitalistic philosophy and professional distinction. Following Bourdieu, these intra-professional struggles are interpreted as occurring within a field in which chiropractors compete for different forms of capital, pulled by two opposing poles. The differing orientations and strategies pursued at the two poles of the field point to a number of possible futures for this CAM profession, including a potential split within the profession itself. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Alternative Models of Self-regulation and Implications for L2 Strategy Research

    Directory of Open Access Journals (Sweden)

    Jim Ranalli

    2012-12-01

    Full Text Available In this paper I discuss the proposal of Dörnyei and colleagues (Dörnyei, 2005; Tseng, Dörnyei, & Schmitt, 2006 to replace the construct of learning strategy with that of self-regulation and thus shift the research focus from specific strategic behaviors to a trait that is seen to underlie them. I argue that before doing so, we need a fuller understanding of what self-regulation entails and how it might intersect with traditional concerns of second language strategy research. To contribute to this understanding, I highlight alternative conceptualizations of self-regulation and then use data from my doctoral research to illustrate one in particular, the COPES model of self-regulated learning (Winne & Hadwin, 1998. This model’s explanatory power is contrasted with that of Dörnyei and colleagues’ conceptualization to show that, depending on the model one adopts, self-regulation is not only compatible with the study of specific strategies but useful for shedding new light on strategy research and integrating it with research in other related areas, such as L2 motivation.

  1. Diagnostic performance of contrast-enhanced MR for acute appendicitis and alternative causes of abdominal pain in children

    Energy Technology Data Exchange (ETDEWEB)

    Koning, Jeffrey L. [University of California San Diego, Department of Radiology, San Diego, CA (United States); Naheedy, John H.; Kruk, Peter G. [University of California San Diego, Department of Radiology, San Diego, CA (United States); Rady Children' s Hospital, Department of Radiology, San Diego, CA (United States)

    2014-08-15

    Unenhanced MRI has emerged as a useful tool for diagnosing pediatric acute appendicitis. The use of contrast-enhanced MRI for diagnosing pediatric appendicitis has not been documented. The purpose of this study is to examine the diagnostic performance of contrast-enhanced MRI for acute appendicitis and alternative entities in the pediatric population presenting with acute abdominal pain. A retrospective review was conducted of 364 consecutive pediatric patients undergoing contrast-enhanced MRI for the evaluation of possible appendicitis at a single institution between November 2012 and September 2013. There were 132 cases of pathologically confirmed appendicitis out of 364 pediatric patients (36.3%) included in the study. Overall sensitivity and specificity were 96.2% (95% CI [91.4-98.4%]) and 95.7% (95% CI [92.3-97.6%]), respectively. Positive predictive value and negative predictive value were 92.7% (95% CI [86.6-96.3%]) and 97.8% (95% CI [94.7-99.1%]), respectively. The appendix was visualized in 243 cases (66.8%). Imaging confirmed alternative diagnoses in 75 patients, including most commonly colitis, enteritis or terminal ileitis (n = 25, 6.9%), adnexal cysts (n = 25, 6.9%) and mesenteric adenitis (n = 7, 1.9%). Contrast-enhanced MRI is capable of accurately diagnosing acute appendicitis while detecting many alternative entities of abdominal pain, and it allows good visualization of the appendix. Further evaluation is needed to determine whether contrast-enhanced MRI provides an advantage over non-enhanced MRI for imaging evaluation of acute abdominal pain in the pediatric population. (orig.)

  2. A test of alternative supervision strategies for family planning services in Guatemala.

    Science.gov (United States)

    Vernon, R; Staunton, A; García, M; Arroyo, J J; Rosenberg, R

    1994-01-01

    This report presents results of an operations research project that tested the impact and cost-effectiveness of alternative supervision schemes of reproductive health services in Guatemala. The strategies tested were (1) indirect supervision, in which one of the two annual supervised visits to each health unit was replaced by a one-day meeting at the district level with the supervisor; and (2) self-assessment, in which one supervised visit was replaced by a two-day workshop where participants filled out self-assessment checklists identifying quality of care problems and made a plan to solve identified problems during the following months. Health units in the two experimental groups showed greater increases in productivity than units receiving traditional supervision. In both alternative strategies, supervisors were able to reach a larger proportion of health units and service providers than through the traditional supervision system. The supervised cost per unit was also lower in the two experimental groups than in the control group. Few differences were observed between the experimental and control groups in terms of the satisfaction of service providers with their jobs and of clients with services received.

  3. Perspectives and strategies of alternative methods used in the risk assessment of personal care products.

    Science.gov (United States)

    Quantin, P; Thélu, A; Catoire, S; Ficheux, H

    2015-11-01

    Risk assessment for personal care products requires the use of alternative methods since animal testing is now totally banned. Some of these methods are effective and have been validated by the "European Union Reference Laboratory for alternatives to animal testing"; but there is still a need for development and implementation of methods for specific endpoints. In this review, we have focused on dermal risk assessment because it is the prime route of absorption and main target organ for personal care products. Within this field, various areas must be assessed: irritation, sensitisation and toxicokinetic. Personal care product behaviour after use by the consumer and potential effects on the environment are also discussed. The purpose of this review is to show evolution and the prospects of alternative methods for safety dermal assessment. Assessment strategies must be adapted to the different chemical classes of substances studied but also to the way in which they are used. Finally, experimental and theoretical technical parameters that may impact on measured effects have been identified and discussed. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  4. Pregnancy screening strategies for diagnostic nuclear medicine: survey results from Australia and New Zealand.

    Science.gov (United States)

    James, Daphne J; Cardew, Paul; Warren-Forward, Helen M

    2013-09-01

    radiation protection. The study demonstrated wide variety in pregnancy screening strategies used to determine the pregnancy status of patients before diagnostic nuclear medicine procedures, indicating that a standardized practice guideline is required for Australia and New Zealand.

  5. Gender-related differential item functioning in DSM-IV/DSM-5-III (alternative model) diagnostic criteria for borderline personality disorder.

    Science.gov (United States)

    Benson, Kathryn T; Donnellan, M Brent; Morey, Leslie C

    2017-01-01

    A number of studies have evaluated the possibility of bias in the diagnostic criteria in borderline personality disorder as an explanation of gender differences in prevalence. Previous studies have used both regression and latent trait approaches but the results have been inconsistent. The current study extended prior investigations in testing differential function of Borderline diagnostic criteria using both regression and latent-trait methods in the same sample, examining both Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV ) and DSM-5 alternative model criteria for borderline personality. Data were obtained from a national sample of 337 clinicians providing diagnostic information on 1 of their target patients. Chronic feelings of emptiness was the only criterion that demonstrated consistent evidence of potential differential functioning across methods and diagnostic models. Implications of these results for the conceptualization of borderline personality are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  6. Alternative foraging strategies enable a mountain ungulate to persist after migration loss

    Science.gov (United States)

    Courtemanch, Alyson B.; Kauffman, Matthew J.; Kilpatrick, Steve; Dewey, Sarah R.

    2017-01-01

    The persistence of many migratory ungulate populations worldwide is threatened due to anthropogenic impacts to seasonal ranges and migration routes. While many studies have linked migratory ungulate declines to migration disruption or loss, very few have explored the underlying factors that determine whether a population perishes or persists. In some cases, populations undergo severe declines and extirpation after migration loss; however, others appear able to persist as residents. We predict that to persist, populations must replace the traditional benefits of migration by altering the foraging strategies they employ as residents within one seasonal range. We propose the alternative foraging strategies (AFS) hypothesis as a framework for identifying various behavioral strategies that populations may use to cope with migration loss. We tested the hypothesis using the formerly migratory Teton bighorn sheep population in northwest Wyoming, which ceased migrating over 60 yr ago, but has persisted as a resident population. We used global positioning system data to evaluate winter and summer habitat selection and seasonal elevational movements for 28 adult female bighorn sheep (Ovis canadensis) from 2008 to 2010. Resource selection functions revealed that bighorn sheep employ winter foraging strategies to survive as residents by seeking out rugged, high-elevation, windswept ridgelines. Seasonal movement analyses indicated that bighorn sheep undergo a newly documented “abbreviated migration” strategy that is closely synchronized with vegetation green-up patterns within their one range. Bighorn sheep descend 500 m in elevation and travel up to 10 km in spring, gaining access to newly emergent forage approximately 30 d before it appears on their high-elevation winter and summer ranges. Our findings indicate that the Teton bighorn sheep population has persisted due to its habitat selection, AFS, and unique movement patterns, which allow migration loss to be mediated

  7. An Alternate Compliance Strategy for Title III of the 1990 Clean Air Act Amendments.

    Science.gov (United States)

    Brothers, Heidi S

    1997-04-01

    An alternate compliance strategy (ACS) is developed which incorporates pollution prevention and flexibility to replace traditional end-of-pipe (EOP) control strategy regulation. The ACS takes into consideration the intent of the 1990 Clean Air Act Amendments (CAAA) to incorporate pollution prevention into regulations and provides a viable mechanism for implementation. This proposed new compliance strategy was developed after studying the CAAA regulations, related compliance issues, and pollution prevention literature. The ACS is defined by amending language in the Hazardous Organic National Emission Standards for Hazardous Air Pollutants (HON) regulation into a performance-based standard permitting regulated facilities to design compliance programs to meet all requirements. A change in regulation is considered reasonable only if it forces the same emission reductions, reduces risk a comparable amount, and is acceptable to the public, the regulators, and the regulated industry. In order to demonstrate that the ACS can meet all these requirements, an example application is summarized from an ethylene oxide-ethylene glycol plant. The example demonstrates that the ACS reduces hazardous air pollution (HAP) emissions more than the HON rule requires. Three evaluation methods are developed and applied to further demonstrate the acceptability of the ACS. They include a qualitative evaluation matrix, a total cost assessment, and a risk reduction measurement model. Results indicate that the ACS provided a preferable compliance program. The ACS should be adopted as an alternative method of compliance. It provides a major step in the progression of regulations from the traditional EOP treatment philosophy to pollution prevention performance-based standards.

  8. Implications for local and global climate of alternative forest management strategies in Norway

    Science.gov (United States)

    Bright, Ryan M.; Antón-Fernández, Clara; Astrup, Rasmus; Cherubini, Francesco; Kvalevåg, Maria; Hammer Strømman, Anders

    2014-05-01

    We applied a mix of observation and empirical models to evaluate both local and global climate effects of three realistic alternative forest management scenarios in the boreal forests of Norway's largest logging region. The alternative management scenarios embraced strategies aimed at increasing harvest intensities and allowing harvested conifer sites to regenerate naturally with broadleaved species. Stand-level analysis was firstly executed to attribute differences in daily, seasonal, and annual mean surface temperatures to differences in surface intrinsic biophysical properties across coniferous, deciduous, and clear-cut sites. Relative to a coniferous site, we observed a slight local cooling of 0.13 °C at a deciduous site and 0.25 °C at a clear-cut site over a 6-year period which was mostly attributed to a higher albedo throughout the year. When monthly mean albedo trajectories over the entire managed forest landscape were taken into consideration, we found that strategies promoting natural regeneration of coniferous sites with native deciduous species led to substantial global direct climate cooling benefits relative to those maintaining current silviculture regimes - despite predicted long-term regional warming feedbacks and a reduced albedo in spring and autumn months. The magnitude and duration of the cooling benefit depended largely on whether management strategies simultaneously promoted an enhanced material supply over business-as-usual levels. While additional climate impact linked to changes in life-cycle emissions and to changes in the global supply and demand of timber products ought to be factored into any mitigation-oriented climate policy involving the forestry sector, our analysis demonstrates that - within the boundaries of the managed forest ecosystem - excluding important biogeophysical considerations like surface albedo change may lead to sub-optimal climate policy.

  9. Breeding Experience, Alternative Reproductive Strategies and Reproductive Success in a Captive Colony of Zebra Finches (Taeniopygia guttata)

    Science.gov (United States)

    Baran, Nicole M.; Adkins-Regan, Elizabeth

    2014-01-01

    Birds exhibit a remarkable diversity of different reproductive strategies both between and within species. Species such as the zebra finch (Taeniopygia guttata) may evolve the flexible use of alternative reproductive strategies, as well as benefit from prior breeding experience, which allows them to adaptively respond to unpredictable environments. In birds, the flexible use of alternative reproductive strategies, such as extra-pair mating, has been reported to be associated with fast reproduction, high mortality and environmental variability. However, little is known about the role of previous breeding experience in the adaptive use of alternative reproductive strategies. Here we performed an in-depth study of reproductive outcomes in a population of domesticated zebra finches, testing the impact of prior breeding experience on the use of alternative reproductive strategies and reproductive success. We provide evidence that older females with prior breeding experience are quicker to initiate a clutch with a new partner and have increased success in chick rearing, even in a captive colony of zebra finches with minimal foraging demands. We also find evidence that the breeding experience of other females in the same social group influences reproductive investment by female zebra finches. Furthermore, we demonstrate that the use of alternative reproductive strategies in female zebra finches is associated with previous failed breeding attempts with the same pair partner. The results provide evidence that age and breeding experience play important roles in the flexible use of both facultative and adaptive reproductive strategies in female zebra finches. PMID:24587051

  10. Age-adjusted D-dimer cut-off in the diagnostic strategy for deep vein thrombosis

    DEFF Research Database (Denmark)

    Nybo, Mads; Hvas, Anne-Mette

    2017-01-01

    Background. Studies have indicated that use of an age-adjusted D-dimer cut-off value for patients above 50 years increases utility of the diagnostic strategy for pulmonary embolism. Evidence for the same approach regarding diagnosis of deep vein thrombosis (DVT) is, however, unclear. Materials...

  11. Intrasexual competition facilitates the evolution of alternative mating strategies in a colour polymorphic fish.

    Science.gov (United States)

    Hurtado-Gonzales, Jorge L; Uy, J Albert C

    2010-12-23

    Intense competition for access to females can lead to males exploiting different components of sexual selection, and result in the evolution of alternative mating strategies (AMSs). Males of Poecilia parae, a colour polymorphic fish, exhibit five distinct phenotypes: drab-coloured (immaculata), striped (parae), structural-coloured (blue) and carotenoid-based red and yellow morphs. Previous work indicates that immaculata males employ a sneaker strategy, whereas the red and yellow morphs exploit female preferences for carotenoid-based colours. Mating strategies favouring the maintenance of the other morphs remain to be determined. Here, we report the role of agonistic male-male interactions in influencing female mating preferences and male mating success, and in facilitating the evolution of AMSs. Our study reveals variation in aggressiveness among P. parae morphs during indirect and direct interactions with sexually receptive females. Two morphs, parae and yellow, use aggression to enhance their mating success (i.e., number of copulations) by 1) directly monopolizing access to females, and 2) modifying female preferences after winning agonistic encounters. Conversely, we found that the success of the drab-coloured immaculata morph, which specializes in a sneak copulation strategy, relies in its ability to circumvent both male aggression and female choice when facing all but yellow males. Strong directional selection is expected to deplete genetic variation, yet many species show striking genetically-based polymorphisms. Most studies evoke frequency dependent selection to explain the persistence of such variation. Consistent with a growing body of evidence, our findings suggest that a complex form of balancing selection may alternatively explain the evolution and maintenance of AMSs in a colour polymorphic fish. In particular, this study demonstrates that intrasexual competition results in phenotypically distinct males exhibiting clear differences in their levels of

  12. Intrasexual competition facilitates the evolution of alternative mating strategies in a colour polymorphic fish

    Directory of Open Access Journals (Sweden)

    Uy J Albert C

    2010-12-01

    Full Text Available Abstract Background Intense competition for access to females can lead to males exploiting different components of sexual selection, and result in the evolution of alternative mating strategies (AMSs. Males of Poecilia parae, a colour polymorphic fish, exhibit five distinct phenotypes: drab-coloured (immaculata, striped (parae, structural-coloured (blue and carotenoid-based red and yellow morphs. Previous work indicates that immaculata males employ a sneaker strategy, whereas the red and yellow morphs exploit female preferences for carotenoid-based colours. Mating strategies favouring the maintenance of the other morphs remain to be determined. Here, we report the role of agonistic male-male interactions in influencing female mating preferences and male mating success, and in facilitating the evolution of AMSs. Results Our study reveals variation in aggressiveness among P. parae morphs during indirect and direct interactions with sexually receptive females. Two morphs, parae and yellow, use aggression to enhance their mating success (i.e., number of copulations by 1 directly monopolizing access to females, and 2 modifying female preferences after winning agonistic encounters. Conversely, we found that the success of the drab-coloured immaculata morph, which specializes in a sneak copulation strategy, relies in its ability to circumvent both male aggression and female choice when facing all but yellow males. Conclusions Strong directional selection is expected to deplete genetic variation, yet many species show striking genetically-based polymorphisms. Most studies evoke frequency dependent selection to explain the persistence of such variation. Consistent with a growing body of evidence, our findings suggest that a complex form of balancing selection may alternatively explain the evolution and maintenance of AMSs in a colour polymorphic fish. In particular, this study demonstrates that intrasexual competition results in phenotypically distinct

  13. Resource acquisition policy: Multiple account evaluation of electricity resource alternatives [and] resource acquisition strategy

    International Nuclear Information System (INIS)

    1994-06-01

    British Columbia Hydro has been directed by the provincial government to develop evaluation procedures to rank electricity resource alternatives in terms of their social benefits and costs, and to acquire resources on the basis of need. The current state of development of social costing at BC Hydro is detailed along with its application to the multiple account evaluation of resources. In this evaluation, BC Hydro's corporate costs, customer cost, transfer payments to the province, direct costs incurred by provincial or regional governments or other Crown agences, direct environmental impact costs from air emissions and land/water use, community and social impact costs, and economic development impacts are taken into account. The BC Hydro resource acquisition strategy is also described as it was developed in response to provincial policy on electricity supply from independent power producers. This strategy includes a determination of need, a decision to acquire need-determined resources either by itself or from a private sector developer, and decisions to acquire resources in advance of need for reasons such as economic opportunity, long-term strategies, or load displacement. Background information is included on calculation of air emissions costs. An illustrative example is provided of the multiple account evaluation of several types of resource projects. 1 fig., 5 tabs

  14. Development of alternative sulfur dioxide control strategies for a metropolitan area and its environs, utilizing a modified climatological dispersion model

    Science.gov (United States)

    K. J. Skipka; D. B. Smith

    1977-01-01

    Alternative control strategies were developed for achieving compliance with ambient air quality standards in Portland, Maine, and its environs, using a modified climatological dispersion model (CDM) and manipulating the sulfur content of the fuel oil consumed in four concentric zones. Strategies were evaluated for their impact on ambient air quality, economics, and...

  15. Guidelines and algorithms: strategies for standardization of referral criteria in diagnostic radiology

    International Nuclear Information System (INIS)

    Kainberger, Franz; Pokieser, Peter; Imhof, Herwig; Czembirek, Heinrich; Fruehwald, Franz

    2002-01-01

    Guidelines can be regarded as special forms of algorithms and have been shown to be useful tools for supporting medical decision making. With the Council Directive 97/43/Euratom recommendations concerning referral criteria for medical exposure have to be implemented into national law of all EU member states. The time- and cost-consuming efforts of developing, implementing, and updating such guidelines are balanced by the acceptance in clinical practice and eventual better health outcomes. Clearly defined objectives with special attention drawn on national and regional differences among potential users, support from organisations with expertise in evidence-based medicine, separated development of the evidence component and the recommendations component, and large-scale strategies for distribution and implementation are necessary. Editors as well as users of guidelines for referral criteria have to be aware which expectations can be met and which cannot be fulfilled with this instrument; thus, dealing with guidelines requires a new form of ''diagnostic reasoning'' based on medical ethics. (orig.)

  16. Segmental enhancement on breast MR images: differential diagnosis and diagnostic strategy

    International Nuclear Information System (INIS)

    Yuen, Sachiko; Uematsu, Takayoshi; Masako, Kasami; Uchida, Yoshihiro; Nishimura, Tsunehiko

    2008-01-01

    The histopathological variations of segmental enhancement on breast magnetic resonance imaging (MRI) were investigated, with the aim of identifying imaging characteristic clues to their differential diagnosis. We reviewed 70 breast MRI examinations demonstrating segmental enhancement, classified them based on their histopathology, and assessed their MRI findings as follows: (1) confluent or not confluent, (2) late enhancement pattern, and the absence or presence of (3) clustered ring enhancements and (4) surrounding high signal intensity (SI) on T2-weighted imaging. Thirteen lesions (18.5%) were benign, eight (11.5%) were high risk, 25 (36%) were ductal carcinoma in situ (DCIS) and 24 (34%) were infiltrating mammary carcinomas (IMC). Clustered ring enhancements were demonstrated in 74% of malignancies (high risk, DCIS and IMC) but no benign lesions (P = 0.0001). The surrounding high SI on T2-weighted imaging was seen in four of five IMC with marked lymphatic involvement. Clustered ring enhancement was not demonstrated in six of seven IMC of tubular and/or lobular types. Segmental enhancement was seen in not only DCIS but also IMC, high-risk and benign lesions. Clustered ring enhancement and surrounding high SI on T2-weighted imaging were clues to their differential diagnosis and helpful to decide their diagnostic strategy. (orig.)

  17. Central vestibular dysfunction in an otorhinolaryngological vestibular unit: incidence and diagnostic strategy.

    Science.gov (United States)

    Mostafa, Badr E; Kahky, Ayman O El; Kader, Hisham M Abdel; Rizk, Michael

    2014-07-01

    Introduction Vertigo can be due to a variety of central and peripheral causes. The relative incidence of central causes is underestimated. This may have an important impact of the patients' management and prognosis. Objective The objective of this work is to determine the incidence of central vestibular disorders in patients presenting to a vestibular unit in a tertiary referral academic center. It also aims at determining the best strategy to increase the diagnostic yield of the patients' visit. Methods This is a prospective observational study on 100 consecutive patients with symptoms suggestive of vestibular dysfunction. All patients completed a structured questionnaire and received bedside and vestibular examination and neuroimaging as required. Results There were 69 women and 31 men. Their ages ranged between 28 and 73 (mean 42.48 years). Provisional videonystagmography (VNG) results were: 40% benign paroxysmal positional vertigo (BPPV), 23% suspicious of central causes, 18% undiagnosed, 15% Meniere disease, and 4% vestibular neuronitis. Patients with an unclear diagnosis or central features (41) had magnetic resonance imaging (MRI) and Doppler studies. Combining data from history, VNG, and imaging studies, 23 patients (23%) were diagnosed as having a central vestibular lesion (10 with generalized ischemia/vertebra basilar insufficiency, 4 with multiple sclerosis, 4 with migraine vestibulopathy, 4 with phobic postural vertigo, and 1 with hyperventilation-induced nystagmus). Conclusions Combining a careful history with clinical examination, VNG, MRI, and Doppler studies decreases the number of undiagnosed cases and increases the detection of possible central lesions.

  18. Central Vestibular Dysfunction in an Otorhinolaryngological Vestibular Unit: Incidence and Diagnostic Strategy

    Directory of Open Access Journals (Sweden)

    Mostafa, Badr E.

    2014-03-01

    Full Text Available Introduction Vertigo can be due to a variety of central and peripheral causes. The relative incidence of central causes is underestimated. This may have an important impact of the patients' management and prognosis. Objective The objective of this work is to determine the incidence of central vestibular disorders in patients presenting to a vestibular unit in a tertiary referral academic center. It also aims at determining the best strategy to increase the diagnostic yield of the patients' visit. Methods This is a prospective observational study on 100 consecutive patients with symptoms suggestive of vestibular dysfunction. All patients completed a structured questionnaire and received bedside and vestibular examination and neuroimaging as required. Results There were 69 women and 31 men. Their ages ranged between 28 and 73 (mean 42.48 years. Provisional videonystagmography (VNG results were: 40% benign paroxysmal positional vertigo (BPPV, 23% suspicious of central causes, 18% undiagnosed, 15% Meniere disease, and 4% vestibular neuronitis. Patients with an unclear diagnosis or central features (41 had magnetic resonance imaging (MRI and Doppler studies. Combining data from history, VNG, and imaging studies, 23 patients (23% were diagnosed as having a central vestibular lesion (10 with generalized ischemia/vertebra basilar insufficiency, 4 with multiple sclerosis, 4 with migraine vestibulopathy, 4 with phobic postural vertigo, and 1 with hyperventilation-induced nystagmus. Conclusions Combining a careful history with clinical examination, VNG, MRI, and Doppler studies decreases the number of undiagnosed cases and increases the detection of possible central lesions.

  19. Gamma knife surgery for pineal region tumors: an alternative strategy for negative pathology

    Directory of Open Access Journals (Sweden)

    Peng Wang

    2014-02-01

    Full Text Available Objective : Pineal region tumors (PRTs are uncommon, and treatments vary among neoplasm types. The authors report their experience with gamma knife surgery (GKS as an initial treatment in a series of PRT patients with unclear pathological diagnoses. Method : Seventeen PRT patients with negative pathology who underwent GKS were retrospectively studied. Nine patients had further whole-brain and spinal cord radiotherapy and chemotherapy 6–9 months after GKS. Results : Sixteen of 17 cases were followed up over a mean of 33.3 months. The total response rate was 75%, and the control rate was 81.3%. No obvious neurological deficits or complications were attributable to GKS. Conclusion : The findings indicate that GKS may be an alternative strategy in selected PRT patients who have negative pathological diagnoses, and that good outcomes and quality of life can be obtained with few complications.

  20. Gamma knife surgery for pineal region tumors: an alternative strategy for negative pathology

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Peng [Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu (China); Department of Neurosurgery, The Fifth People' s Hospital of Chengdu, Chengdu (China); Mao, Qing; Wang, Wei; Zhou, Liang-Xue; Liu, Yan-Hui, E-mail: liuyanhui9@gmail.com [Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu (China)

    2014-03-01

    Objective: pineal region tumors (PRTs) are uncommon, and treatments vary among neoplasm types. The authors report their experience with gamma knife surgery (GKS) as an initial treatment in a series of PRT patients with unclear pathological diagnoses. Method: seventeen PRT patients with negative pathology who underwent GKS were retrospectively studied. Nine patients had further whole-brain and spinal cord radiotherapy and chemotherapy 6-9 months after GKS. Results: Sixteen of 17 cases were followed up over a mean of 33.3 months. The total response rate was 75%, and the control rate was 81.3%. No obvious neurological deficits or complications were attributable to GKS. Conclusion: the findings indicate that GKS may be an alternative strategy in selected PRT patients who have negative pathological diagnoses, and that good outcomes and quality of life can be obtained with few complications. (author)

  1. Antimicrobial Resistance: Its Surveillance, Impact, and Alternative Management Strategies in Dairy Animals

    Science.gov (United States)

    Sharma, Chetan; Rokana, Namita; Chandra, Mudit; Singh, Brij Pal; Gulhane, Rohini Devidas; Gill, Jatinder Paul Singh; Ray, Pallab; Puniya, Anil Kumar; Panwar, Harsh

    2018-01-01

    Antimicrobial resistance (AMR), one among the most common priority areas identified by both national and international agencies, is mushrooming as a silent pandemic. The advancement in public health care through introduction of antibiotics against infectious agents is now being threatened by global development of multidrug-resistant strains. These strains are product of both continuous evolution and un-checked antimicrobial usage (AMU). Though antibiotic application in livestock has largely contributed toward health and productivity, it has also played significant role in evolution of resistant strains. Although, a significant emphasis has been given to AMR in humans, trends in animals, on other hand, are not much emphasized. Dairy farming involves surplus use of antibiotics as prophylactic and growth promoting agents. This non-therapeutic application of antibiotics, their dosage, and withdrawal period needs to be re-evaluated and rationally defined. A dairy animal also poses a serious risk of transmission of resistant strains to humans and environment. Outlining the scope of the problem is necessary for formulating and monitoring an active response to AMR. Effective and commendably connected surveillance programs at multidisciplinary level can contribute to better understand and minimize the emergence of resistance. Besides, it requires a renewed emphasis on investments into research for finding alternate, safe, cost effective, and innovative strategies, parallel to discovery of new antibiotics. Nevertheless, numerous direct or indirect novel approaches based on host–microbial interaction and molecular mechanisms of pathogens are also being developed and corroborated by researchers to combat the threat of resistance. This review places a concerted effort to club the current outline of AMU and AMR in dairy animals; ongoing global surveillance and monitoring programs; its impact at animal human interface; and strategies for combating resistance with an extensive

  2. Antimicrobial Resistance: Its Surveillance, Impact, and Alternative Management Strategies in Dairy Animals

    Directory of Open Access Journals (Sweden)

    Chetan Sharma

    2018-01-01

    Full Text Available Antimicrobial resistance (AMR, one among the most common priority areas identified by both national and international agencies, is mushrooming as a silent pandemic. The advancement in public health care through introduction of antibiotics against infectious agents is now being threatened by global development of multidrug-resistant strains. These strains are product of both continuous evolution and un-checked antimicrobial usage (AMU. Though antibiotic application in livestock has largely contributed toward health and productivity, it has also played significant role in evolution of resistant strains. Although, a significant emphasis has been given to AMR in humans, trends in animals, on other hand, are not much emphasized. Dairy farming involves surplus use of antibiotics as prophylactic and growth promoting agents. This non-therapeutic application of antibiotics, their dosage, and withdrawal period needs to be re-evaluated and rationally defined. A dairy animal also poses a serious risk of transmission of resistant strains to humans and environment. Outlining the scope of the problem is necessary for formulating and monitoring an active response to AMR. Effective and commendably connected surveillance programs at multidisciplinary level can contribute to better understand and minimize the emergence of resistance. Besides, it requires a renewed emphasis on investments into research for finding alternate, safe, cost effective, and innovative strategies, parallel to discovery of new antibiotics. Nevertheless, numerous direct or indirect novel approaches based on host–microbial interaction and molecular mechanisms of pathogens are also being developed and corroborated by researchers to combat the threat of resistance. This review places a concerted effort to club the current outline of AMU and AMR in dairy animals; ongoing global surveillance and monitoring programs; its impact at animal human interface; and strategies for combating resistance

  3. Teaching evidence-based medicine at complementary and alternative medicine institutions: strategies, competencies, and evaluation.

    Science.gov (United States)

    Zwickey, Heather; Schiffke, Heather; Fleishman, Susan; Haas, Mitch; Cruser, des Anges; LeFebvre, Ron; Sullivan, Barbara; Taylor, Barry; Gaster, Barak

    2014-12-01

    As evidence-based medicine (EBM) becomes a standard in health care, it is essential that practitioners of complementary and alternative medicine (CAM) become experts in searching and evaluating the research literature. In support of this goal, the National Institutes of Health (NIH) National Center for Complementary and Alternative Medicine (NCCAM) provided R25 funding to nine CAM colleges to develop individual programs focused on teaching EBM. An overarching goal of these research education grants has been to provide CAM faculty and students with the skills they need to apply a rigorous evidence-based perspective to their training and practice. This paper reviews the competencies and teaching strategies developed and implemented to enhance research literacy at all nine R25-funded institutions. While each institution designed approaches suitable for its research culture, the guiding principles were similar: to develop evidence-informed skills and knowledge, thereby helping students and faculty to critically appraise evidence and then use that evidence to guide their clinical practice. Curriculum development and assessment included faculty-driven learning activities and longitudinal curricular initiatives to encourage skill reinforcement and evaluate progress. As the field of integrative medicine matures, the NIH-NCCAM research education grants provide essential training for future clinicians and clinician-researchers. Building this workforce will facilitate multidisciplinary collaborations that address the unique needs for research that informs integrative clinical practice.

  4. Appealing to altruism: an alternative strategy to address the health workforce crisis in developing countries?

    Science.gov (United States)

    Smith, Richard; Lagarde, Mylene; Blaauw, Duane; Goodman, Catherine; English, Mike; Mullei, Kethi; Pagaiya, Nonglak; Tangcharoensathien, Viroj; Erasmus, Ermin; Hanson, Kara

    2013-03-01

    Recruitment and retention of health workers is a major concern. Policy initiatives emphasize financial incentives, despite mixed evidence of their effectiveness. Qualitative studies suggest that nurses especially may be more driven by altruistic motivations, but quantitative research has overlooked such values. This paper adds to the literature through characterizing the nature and determinants of nurses' altruism, based on a cross-country quantitative study. An experimental 'dictator game' was undertaken with 1064 final year nursing students in Kenya, South Africa and Thailand between April 2007 and July 2008. This presents participants with a real financial endowment to split between themselves and another student, a patient or a poor person. Giving a greater share of this financial endowment to the other person is interpreted as reflecting greater altruism. Nursing students gave over 30% of their initial endowment to others (compared with 10% in similar experiments undertaken in other samples). Respondents in all three countries showed greater generosity to patients and the poor than to fellow students. Consideration needs to be given to how to appeal to altruistic values as an alternative strategy to encourage nurses to enter the profession and remain, such as designing recruitment strategies to increase recruitment of altruistic individuals who are more likely to remain in the profession.

  5. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    International Nuclear Information System (INIS)

    Shah, Chirag; Vicini, Frank A.

    2011-01-01

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer–related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2–65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  6. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Chirag [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank A., E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

    2011-11-15

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer-related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2-65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  7. Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals

    NARCIS (Netherlands)

    Aghaei Hashjin, Asgar; Kringos, Dionne; Ravaghi, Hamid; Manoochehri, Jila; Gorji, Hassan Abolghasem; Klazinga, Niek S.

    2015-01-01

    Background: Iran has a widespread diagnostics and clinical support services (DCSS) network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA) policies in

  8. A cost-effectiveness analysis of the diagnostic strategies for differentiating focal nodular hyperplasia from hepatocellular adenoma

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Chong Hyun [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Liver Center, Asan Medical Center, Seoul (Korea, Republic of); Namwon Medical Center, Department of Radiology, Namwon-si (Korea, Republic of); Kim, Kyung Won [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Liver Center, Asan Medical Center, Seoul (Korea, Republic of); Harvard Medical School, Department of Imaging, Dana-Farber Cancer Institute, Brigham and Women' s Hospital, Boston, MA (United States); Park, Seong Ho [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Liver Center, Asan Medical Center, Seoul (Korea, Republic of); Shin, Sangjin; Ahn, Jeonghoon [National Evidence-based Healthcare Collaborating Agency, Division of Healthcare Technology Assessment Research, Department of Economic Evaluation, Seoul (Korea, Republic of); Pyo, Junhee [Utrecht University, Collaborating Center for Pharmaceutical Policy and Regulation, Department of Pharmaceutical Science, Utrecht (Netherlands); Shinagare, Atul B.; Krajewski, Katherine M.; Ramaiya, Nikhil H. [Harvard Medical School, Department of Imaging, Dana-Farber Cancer Institute, Brigham and Women' s Hospital, Boston, MA (United States)

    2018-01-15

    We evaluated the cost-effectiveness of a gadoxetic acid-enhanced MRI (EOB-MRI) strategy compared with conventional MRI strategy and biopsy to differentiate focal nodular hyperplasia (FNH) from hepatocellular adenoma (HCA). A decision tree model was constructed to compare the cost-effectiveness of EOB-MRI, conventional MRI with extracellular contrast agents, and biopsy as the initial diagnostic modality in patients with incidentally detected focal liver lesions suspected of being FNH or HCA. We analysed the cost and effectiveness, i.e. probability of successful diagnosis of each strategy. Costs were based on utilisation rates and Medicare reimbursements in the USA and South Korea. In the base case analysis of our decision tree model, the effectiveness of the three strategies was similar. The cost of the EOB-MRI strategy ($1283 in USA, $813 in South Korea) was lowest compared with the biopsy strategy ($1725 in USA, $847 in South Korea) and the conventional MRI strategy ($1750 in USA, $962 in South Korea). One-way, two-way and probabilistic sensitivity analysis showed unchanged results over an acceptable range. EOB-MRI strategy is the most cost-effective strategy for differentiating FNH from HCA in patients with incidentally detected focal liver lesions in a non-cirrhotic liver. (orig.)

  9. A cost-effectiveness analysis of the diagnostic strategies for differentiating focal nodular hyperplasia from hepatocellular adenoma

    International Nuclear Information System (INIS)

    Suh, Chong Hyun; Kim, Kyung Won; Park, Seong Ho; Shin, Sangjin; Ahn, Jeonghoon; Pyo, Junhee; Shinagare, Atul B.; Krajewski, Katherine M.; Ramaiya, Nikhil H.

    2018-01-01

    We evaluated the cost-effectiveness of a gadoxetic acid-enhanced MRI (EOB-MRI) strategy compared with conventional MRI strategy and biopsy to differentiate focal nodular hyperplasia (FNH) from hepatocellular adenoma (HCA). A decision tree model was constructed to compare the cost-effectiveness of EOB-MRI, conventional MRI with extracellular contrast agents, and biopsy as the initial diagnostic modality in patients with incidentally detected focal liver lesions suspected of being FNH or HCA. We analysed the cost and effectiveness, i.e. probability of successful diagnosis of each strategy. Costs were based on utilisation rates and Medicare reimbursements in the USA and South Korea. In the base case analysis of our decision tree model, the effectiveness of the three strategies was similar. The cost of the EOB-MRI strategy ($1283 in USA, $813 in South Korea) was lowest compared with the biopsy strategy ($1725 in USA, $847 in South Korea) and the conventional MRI strategy ($1750 in USA, $962 in South Korea). One-way, two-way and probabilistic sensitivity analysis showed unchanged results over an acceptable range. EOB-MRI strategy is the most cost-effective strategy for differentiating FNH from HCA in patients with incidentally detected focal liver lesions in a non-cirrhotic liver. (orig.)

  10. Evaluation of the impact of planning alternative strategies on urban metabolism with the ACASA model

    Science.gov (United States)

    Marras, S.; Casula, M.; Pyles, R. D.; Paw U, K. T.; Spano, D.

    2011-12-01

    A crucial point in urban sustainable development is to evaluate the impact that future planning alternatives has on the main factors affecting the citizens liveableness, as the development of the urban heat island or the carbon emissions level. Recent advances in bio-physical sciences have led to new methods and models to estimate energy, water, and carbon fluxes. Also, several studies have addressed urban metabolism issues, but few have integrated the development of numerical tools and methodologies for the analysis of fluxes between a city and its environment with its validation and application in terms of future development alternatives. Over the past several years and most recently within the European Project "BRIDGE", CMCC tested the ACASA (Advanced-Canopy-Atmosphere-Soil Algorithm) land-surface model over agricultural ecosystems (grapes), wild vegetation (forests and Mediterranean maquis), and urban (Florence) or mixed urban/vegetated land (Helsinki). Preliminary results show success in adapting the model to mixed urban systems in each of the main fluxes of interest. The model was improved to adapt it for urban environment, and key parameterizations of leaf-facet scale interactions permit separate accounting of both biogenic and anthropogenic flux sources and sinks, and allow for easy scenario building for simulations designed to test changes in land use or urban planning. In this way, sustainable planning strategies are proposed based on quantitative assessments of energy, water, and carbon fluxes. In this research, three planning alternatives accounting for an increase in urbanization intensity were tested by ACASA in Helsinki (Finland) for the year 2008. Helsinki is located at a high latitude and is characterized by a rapid urbanization that requires a substantial amount of energy for heating. The model behavior for the baseline and alternatives scenarios (i.e., urban classes with low, mid, and high residential intensity) during the entire year was

  11. Modeling the Impact of Alternative Immunization Strategies: Using Matrices as Memory Lanes.

    Directory of Open Access Journals (Sweden)

    Wladimir J Alonso

    Full Text Available Existing modeling approaches are divided between a focus on the constitutive (micro elements of systems or on higher (macro organization levels. Micro-level models enable consideration of individual histories and interactions, but can be unstable and subject to cumulative errors. Macro-level models focus on average population properties, but may hide relevant heterogeneity at the micro-scale. We present a framework that integrates both approaches through the use of temporally structured matrices that can take large numbers of variables into account. Matrices are composed of several bidimensional (time×age grids, each representing a state (e.g. physiological, immunological, socio-demographic. Time and age are primary indices linking grids. These matrices preserve the entire history of all population strata and enable the use of historical events, parameters and states dynamically in the modeling process. This framework is applicable across fields, but particularly suitable to simulate the impact of alternative immunization policies. We demonstrate the framework by examining alternative strategies to accelerate measles elimination in 15 developing countries. The model recaptured long-endorsed policies in measles control, showing that where a single routine measles-containing vaccine is employed with low coverage, any improvement in coverage is more effective than a second dose. It also identified an opportunity to save thousands of lives in India at attractively low costs through the implementation of supplementary immunization campaigns. The flexibility of the approach presented enables estimating the effectiveness of different immunization policies in highly complex contexts involving multiple and historical influences from different hierarchical levels.

  12. Cost-effectiveness analysis of alternative first-trimester pregnancy termination strategies in Mexico City.

    Science.gov (United States)

    Hu, D; Grossman, D; Levin, C; Blanchard, K; Goldie, S J

    2009-05-01

    To assess the comparative health and economic outcomes associated with three alternative first-trimester abortion techniques in Mexico City and to examine the policy implications of increasing access to safe abortion modalities within a restrictive setting. Cost-effectiveness analysis. Mexico City. Reproductive-aged women with unintended pregnancy seeking first-trimester abortion. Synthesising the best available data, a computer-based model simulates induced abortion and its potential complications and is used to assess the cost-effectiveness of alternative safe modalities for first-trimester pregnancy termination: (1) hospital-based dilatation and curettage (D&C), (2) hospital-based manual vacuum aspiration (MVA), (3) clinic-based MVA and (4) medical abortion using vaginal misoprostol. Number of complications, lifetime costs, life expectancy, quality-adjusted life expectancy. In comparison to the magnitude of health gains associated with all safe abortion modalities, the relative differences between strategies were more pronounced in terms of their economic costs. Assuming all options were equally available, clinic-based MVA was the least costly and most effective. Medical abortion with misoprostol provided comparable benefits to D&C, but cost substantially less. Enhanced access to safe abortion was always more influential than shifting between safe abortion modalities. This study demonstrates that the provision of safe abortion is cost-effective and will result in reduced complications, decreased mortality and substantial cost savings compared with unsafe abortion. In Mexico City, shifting from a practice of hospital-based D&C to clinic-based MVA and enhancing access to medical abortion will have the best chance to minimise abortion-related morbidity and mortality.

  13. Air Quality and Population Exposure in Urban Areas: Potential Co-Benefits of Alternative Strategies

    Science.gov (United States)

    Mikolajczyk, U.; Suppan, P.; Forkel, R.; Williams, M.

    2014-12-01

    Even though much progress has been achieved through dedicated approaches to improving air quality in many European cities, there are various threats which still remain unchanged. According to the World Health Organization, outdoor air pollution was linked to 3.7 million deaths in year 2012. As climate changes, the frequency of days with harmful levels of air pollutants may significantly increase causing exacerbation of cardiovascular and respiratory diseases. The aim of this study is to conduct health impact assessment by utilizing regionally and spatially specific data in order to assess the influence of alternative emission strategies on human health. In the first stage of this investigation, a modeling study was carried out using the Weather Research and Forecasting (WRF) model coupled with Chemistry (WRF/Chem; Grell et al., 2005) to estimate ambient concentrations of air pollutants. The model set-up included a nesting approach, where three domains with horizontal resolution of 18 km, 6 km and 2 km were defined. The investigation area included the city of Munich (1.5 million inhabitants). The model performance has been evaluated against available air quality observations from the monitoring database "AirBase". The chemical species including O3, NO, NO2 and PM10 simulated by WRF/Chem compare favorably with the observations. The model performs especially well in resolving the observed O3 concentrations. In the ongoing study, different emission reduction scenarios are compared to a baseline 2009 scenario based on Germany's National Emissions Inventory. To investigate health effects associated with air pollution concentrations a local-scale health impact assessment (HIA) will be conducted. Concentration-response functions (CRFs) link the change in mortality rates to the change in concentrations of air pollutants. CRFs are applied to population-weighted mean concentrations to estimate relative risks and hence estimate numbers of attributable deaths and associated

  14. An environmental cost-benefit analysis of alternative green roofing strategies

    Science.gov (United States)

    Richardson, M.; William, R. K.; Goodwell, A. E.; Le, P. V.; Kumar, P.; Stillwell, A. S.

    2016-12-01

    Green roofs and cool roofs are alternative roofing strategies that mitigate urban heat island effects and improve building energy performance. Green roofs consist of soil and vegetation layers that provide runoff reduction, thermal insulation, and potential natural habitat, but can require regular maintenance. Cool roofs involve a reflective layer that reflects more sunlight than traditional roofing materials, but require additional insulation during winter months. This study evaluates several roofing strategies in terms of energy performance, urban heat island mitigation, water consumption, and economic cost. We use MLCan, a multi-layer canopy model, to simulate irrigated and non-irrigated green roof cases with shallow and deep soil depths during the spring and early summer of 2012, a drought period in central Illinois. Due to the dry conditions studied, periodic irrigation is implemented in the model to evaluate its effect on evapotranspiration. We simulate traditional and cool roof scenarios by altering surface albedo and omitting vegetation and soil layers. We find that both green roofs and cool roofs significantly reduce surface temperature compared to the traditional roof simulation. Cool roof temperatures always remain below air temperature and, similar to traditional roofs, require low maintenance. Green roofs remain close to air temperature and also provide thermal insulation, runoff reduction, and carbon uptake, but might require irrigation during dry periods. Due to the longer lifetime of a green roof compared to cool and traditional roofs, we find that green roofs realize the highest long term cost savings under simulated conditions. However, using longer-life traditional roof materials (which have a higher upfront cost) can help decrease this price differential, making cool roofs the most affordable option due to the higher maintenance costs associated with green roofs

  15. Magnetopriming - an alternate strategy for crop stress management of field crops

    International Nuclear Information System (INIS)

    Anand, Anjali

    2014-01-01

    Abiotic stresses are major deterrent to sustainable crop production worldwide. Seed germination and early seedling growth are considered as the most critical stages of plant growth under stress conditions. Maximising stress tolerance of crop species by breeding is an integral part of development of strategies for improving sustainable food production under stressed environment but the unprecedented rate at which stress is increasing vis-a-vis the time taken for development of a tolerant variety, necessitates exploring alternate strategies of crop stress management. Seed priming has emerged as a promising crop stress management technique that increases the speed of germination thus ensuring synchronized field emergence of the crop. Magnetopriming (exposure of seeds to magnetic field) is a non invasive physical stimulant used for improving seedling vigour that helps in establishment of crop stand under stress. In our experiments on maize; chickpea and wheat under water deficit and salinity, respectively, improved seed water absorption characteristics resulted in faster hydration of enzymes (amylases, protease and dehydrogenase) leading to early germination and enhanced vigour of seedlings under stress. Increased levels of hydrogen peroxide in faster germinating - magnetoprimed seeds, under both the growing conditions, suggested its role in oxidative signaling during seed germination process. An 'oxidative window' for reactive oxygen species ensured that faster germination rate in magnetoprimed seeds led to vigourous seedlings. Improved root system integrated with higher photosynthetic efficiency and efficient partitioning of Na + increased yield from magnetoprimed seeds under salinity in controlled experiments. Magnetopriming can be effectively used as a pre-sowing treatment for mitigating adverse effects of water deficit and salinity at seed germination and early seedling growth. Unlike other conventional priming techniques it avoids seed hydration and

  16. Ornament size and colour as alternative strategies for effective communication in gliding lizards.

    Science.gov (United States)

    Klomp, D A; Ord, T J; Das, I; Diesmos, A; Ahmad, N; Stuart-Fox, D

    2016-09-01

    Sexual ornamentation needs to be conspicuous to be effective in attracting potential mates and defending territories and indeed, a multitude of ways exists to achieve this. Two principal mechanisms for increasing conspicuousness are to increase the ornament's colour or brightness contrast against the background and to increase the size of the ornament. We assessed the relationship between the colour and size of the dewlap, a large extendible throat-fan, across a range of species of gliding lizards (Agamidae; genus Draco) from Malaysia and the Philippines. We found a negative relationship across species between colour contrast against the background and dewlap size in males, but not in females, suggesting that males of different species use increasing colour contrast and dewlap size as alternative strategies for effective communication. Male dewlap size also increases with increasing sexual size dimorphism, and dewlap colour and brightness contrast increase with increasing sexual dichromatism in colour and brightness, respectively, suggesting that sexual selection may act on both dewlap size and colour. We further found evidence that relative predation intensity, as measured from predator attacks on models placed in the field, may play a role in the choice of strategy (high chromatic contrast or large dewlap area) a species employs. More broadly, these results highlight that each component in a signal (such as colour or size) may be influenced by different selection pressures and that by assessing components individually, we can gain a greater understanding of the evolution of signal diversity. © 2016 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2016 European Society For Evolutionary Biology.

  17. Endocrine differences among colour morphs in a lizard with alternative behavioural strategies.

    Science.gov (United States)

    Yewers, Madeleine St Clair; Jessop, Tim S; Stuart-Fox, Devi

    2017-07-01

    Alternative behavioural strategies of colour morphs are expected to associate with endocrine differences and to correspond to differences in physical performance (e.g. movement speed, bite force in lizards); yet the nature of correlated physiological and performance traits in colour polymorphic species varies widely. Colour morphs of male tawny dragon lizards Ctenophorus decresii have previously been found to differ in aggressive and anti-predator behaviours. We tested whether known behavioural differences correspond to differences in circulating baseline and post-capture stress levels of androgen and corticosterone, as well as bite force (an indicator of aggressive performance) and field body temperature. Immediately after capture, the aggressive orange morph had higher circulating androgen than the grey morph or the yellow morph. Furthermore, the orange morph maintained high androgen following acute stress (30min of capture); whereas androgen increased in the grey and yellow morphs. This may reflect the previously defined behavioural differences among morphs as the aggressive response of the yellow morph is conditional on the colour of the competitor and the grey morph shows consistently low aggression. In contrast, all morphs showed an increase in corticosterone concentration after capture stress and morphs did not differ in levels of corticosterone stress magnitude (CSM). Morphs did not differ in size- and temperature-corrected bite force but did in body temperature at capture. Differences in circulating androgen and body temperature are consistent with morph-specific behavioural strategies in C. decresii but our results indicate a complex relationship between hormones, behaviour, temperature and bite force within and between colour morphs. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Evidence for alternative trapping strategies in two forms of the pitcher plant, Nepenthes rafflesiana.

    Science.gov (United States)

    Bauer, Ulrike; Grafe, T Ulmar; Federle, Walter

    2011-06-01

    Nepenthes pitchers are specialized leaves that function as insect traps. Several pitcher components may contribute to trapping, including the pitcher fluid, slippery wax crystals and downward-pointing epidermal cells on the inner pitcher wall, and the wetness-dependent pitcher rim (peristome), but the relative importance of these traits is unclear. Mechanisms of prey capture and retention in the field were investigated by quantifying the effect of 'knock-out' manipulations of individual pitcher structures, and by testing the ability of pitcher fluids and water to retain insects. Two forms of Nepenthes rafflesiana Jack ('elongate' and 'typical') with contrasting combinations of pitcher traits were compared. Wax crystals on the inner pitcher wall were found to be the most important trapping structure in the elongate form, whereas the typical form relied primarily on the peristome. The pitcher fluids of both forms, differing markedly in the degree of viscoelasticity, retained significantly more ants than water. The present results show that pitcher plants utilize several mechanisms for prey capture and retention, varying in efficiency and relative importance between forms. It is proposed that these differences represent alternative prey capture strategies that may provide a mechanism to reduce competition and facilitate species co-existence in nutrient-limited habitats.

  19. Range expansion drives the evolution of alternate reproductive strategies in invasive fire ants

    Directory of Open Access Journals (Sweden)

    Jackson A. Helms IV

    2017-01-01

    Full Text Available Many species are expanding their ranges in response to climate changes or species introductions. Expansion-related selection likely drives the evolution of dispersal and reproductive traits, especially in invasive species introduced into novel habitats. We used an agent-based model to investigate these relationships in the red imported fire ant, Solenopsis invicta, by tracking simulated populations over 25 years. Most colonies of this invasive species produce two types of queens practicing alternate reproductive strategies. Claustral queens found new colonies in vacant habitats, while parasitic queens take over existing colonies whose queens have died. We investigated how relative investment in the two queen types affects population demography, habitat occupancy, and range expansion. We found that parasitic queens extend the ecological lifespan of colonies, thereby increasing a population’s overall habitat occupancy as well as average colony size (number of workers and territory size. At the same time, investment in parasitic queens slowed the rate of range expansion by diverting investment from claustral queens. Divergent selection regimes caused edge and interior populations to evolve different levels of reproductive investment, such that interior populations invested heavily in parasitic queens whereas those at the edge invested almost entirely in claustral queens. Our results highlight factors shaping ant life histories, including the evolution of social parasitism, and have implications for the response of species to range shifts.

  20. Alternative strategies: A means for saving money and time on the Yucca Mountain Project

    International Nuclear Information System (INIS)

    Wilder, D.G.

    1993-01-01

    The United States Department of Energy (DOE) is undertaking studies to determine the suitability of Yucca Mountain (YM) as a potential site for disposal of high level nuclear waste. Yucca Mountain is located in an arid environment. Many processes that could contribute to mobilization of radionuclides are either absent or minimized in a dry site. Therefore, Yucca Mountain should have the potential of being a veryfavorable site for disposal of waste. The determination of suitability has no precedence, and the characterization of an and site is complex, requiring intensive studies to determine suitability. The studies undertaken by the Yucca Mountain Site Characterization Project (YMP) are very costly. By a process called performance allocation, the YMP determined strategies to satisfy regulations or meet performance while minimizing costs and schedules. Those involved recognized that allocations should be reviewed as additional information became available. The allocation has not been reviewed nor revised since the initial allocation in the Site Characterization Plan (SCP). The purpose of this paper is to outline alternative allocations that the author feels should be considered based on the additional information that is available at this time

  1. Alternative Strategies in Response to Saline Stress in Two Varieties of Portulaca oleracea (Purslane.

    Directory of Open Access Journals (Sweden)

    Kristina R Mulry

    Full Text Available Purslane (Portulaca oleracea is a globally-distributed plant with a long history of use in folk medicine and cooking. We have developed purslane as a model system for exploring plant responses to stress. We exposed two varieties of purslane to saline stress with the objective of identifying differences between the varieties in the plasticity of morphological and physiological traits. The varieties responded to saline stress with significantly different changes in the measured traits, which included inter alia biomass, flower counts, proline concentrations and betalain pigment concentrations. The alternative responses of the two varieties consisted of complex, simultaneous changes in multiple traits. In particular, we observed that while both varieties increased production of betalain pigments and proline under saline stress, one variety invested more in betalain pigments while the other invested more in proline. Proline and betalain pigments undoubtedly play multiple roles in plant tissues, but in this case their role as antioxidants deployed to ameliorate saline stress appears to be important. Taken holistically, our results suggest that the two varieties employ different strategies in allocating resources to cope with saline stress. This conclusion establishes purslane as a suitable model system for the study of saline stress and the molecular basis for differential responses.

  2. Effect of Alternative Irrigation Strategies on Yield and Quality of Fiesta Raisin Grapes Grown in California

    Directory of Open Access Journals (Sweden)

    Isabel Abrisqueta

    2018-04-01

    Full Text Available Traditionally, grapes are fully irrigated, but alternative irrigation strategies to reduce applied irrigation water may be necessary in the future as occurrences of drought increase. This study was conducted in the San Joaquin Valley (SJV of California from 2012 to 2014. Three irrigation treatments were used to study the effects on the yield and quality of Fiesta grapes. The treatments included: grower irrigation (GI weekly irrigation lasting for approximately 65 h; sustained deficit (SD equal to 80% of the GI treatment; and regulated deficit (RD equal to 50% of the GI until fruit set when it was increased to 80% of the GI through harvest and reduced to 50% of the GI after harvest. Average water use across treatments was ≈489 mm. Average yield across all treatments was 7.9 t ha−1, 9.1 t ha−1 and 11.8 t ha−1 in 2012, 2013, and 2014, respectively. Yield was sustained in SD and RD, with up to a 20% reduction in applied water use compared to GI. There were no differences in raisin quality and grade among any of the treatments in any year. The percentage of substandard grapes decreased from an average of 12.6% in 2012 to 3.6% in 2013 and 2014. Growers may use a sustained deficit approach during periods of limited water availability to minimize the effect on yield.

  3. Alternative Strategies in Response to Saline Stress in Two Varieties of Portulaca oleracea (Purslane).

    Science.gov (United States)

    Mulry, Kristina R; Hanson, Bryan A; Dudle, Dana A

    2015-01-01

    Purslane (Portulaca oleracea) is a globally-distributed plant with a long history of use in folk medicine and cooking. We have developed purslane as a model system for exploring plant responses to stress. We exposed two varieties of purslane to saline stress with the objective of identifying differences between the varieties in the plasticity of morphological and physiological traits. The varieties responded to saline stress with significantly different changes in the measured traits, which included inter alia biomass, flower counts, proline concentrations and betalain pigment concentrations. The alternative responses of the two varieties consisted of complex, simultaneous changes in multiple traits. In particular, we observed that while both varieties increased production of betalain pigments and proline under saline stress, one variety invested more in betalain pigments while the other invested more in proline. Proline and betalain pigments undoubtedly play multiple roles in plant tissues, but in this case their role as antioxidants deployed to ameliorate saline stress appears to be important. Taken holistically, our results suggest that the two varieties employ different strategies in allocating resources to cope with saline stress. This conclusion establishes purslane as a suitable model system for the study of saline stress and the molecular basis for differential responses.

  4. The Future of Public Health Informatics: Alternative Scenarios and Recommended Strategies

    Science.gov (United States)

    Edmunds, Margo; Thorpe, Lorna; Sepulveda, Martin; Bezold, Clem; Ross, David A.

    2014-01-01

    Background: In October 2013, the Public Health Informatics Institute (PHII) and Institute for Alternative Futures (IAF) convened a multidisciplinary group of experts to evaluate forces shaping public health informatics (PHI) in the United States, with the aim of identifying upcoming challenges and opportunities. The PHI workshop was funded by the Robert Wood Johnson Foundation as part of its larger strategic planning process for public health and primary care. Workshop Context: During the two-day workshop, nine experts from the public and private sectors analyzed and discussed the implications of four scenarios regarding the United States economy, health care system, information technology (IT) sector, and their potential impacts on public health in the next 10 years, by 2023. Workshop participants considered the potential role of the public health sector in addressing population health challenges in each scenario, and then identified specific informatics goals and strategies needed for the sector to succeed in this role. Recommendations and Conclusion: Participants developed recommendations for the public health informatics field and for public health overall in the coming decade. These included the need to rely more heavily on intersectoral collaborations across public and private sectors, to improve data infrastructure and workforce capacity at all levels of the public health enterprise, to expand the evidence base regarding effectiveness of informatics-based public health initiatives, and to communicate strategically with elected officials and other key stakeholders regarding the potential for informatics-based solutions to have an impact on population health. PMID:25848630

  5. What Do You Know about Alternative Energy? Development and Use of a Diagnostic Instrument for Upper Secondary School Science

    Science.gov (United States)

    Poh-Ai Cheong, Irene; Johari, Marliza; Said, Hardimah; Treagust, David F.

    2015-01-01

    The need for renewable and non-fossil fuels is now recognised by nations throughout the world. Consequently, an understanding of alternative energy is needed both in schools and in everyday life-long learning situations. This study developed a two-tier instrument to diagnose students' understanding and alternative conceptions about alternative energy in terms of: sources of alternative energy, greenhouse gas emission, as well as advantages, and disadvantages. Results obtained with Years 10 and 11 students (n = 491) using the 12-item two-tier instrument (α = 0.61) showed that students' understanding of alternative energy was low (M = 7.03; SD = 3.90). The 23 alternative conceptions about alternative energy sources that could be identified from the instrument are reported. The implications for teaching and learning about alternative energy and suggestions for further development and improvement of the instrument are presented.

  6. Alternative strategies to reduce maternal mortality in India: a cost-effectiveness analysis.

    Directory of Open Access Journals (Sweden)

    Sue J Goldie

    2010-04-01

    Full Text Available BACKGROUND: Approximately one-quarter of all pregnancy- and delivery-related maternal deaths worldwide occur in India. Taking into account the costs, feasibility, and operational complexity of alternative interventions, we estimate the clinical and population-level benefits associated with strategies to improve the safety of pregnancy and childbirth in India. METHODS AND FINDINGS: Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy (both planned and unintended and pregnancy- and childbirth-associated complications in individual women; and considers delivery location, attendant, and facility level. Model outcomes included clinical events, population measures, costs, and cost-effectiveness ratios. Separate models were adapted to urban and rural India using survey-based data (e.g., unmet need for birth spacing/limiting, facility births, skilled birth attendants. Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged as integrated services, could reduce the incidence of a complication or its case fatality rate, and could include improved logistics such as reliable transport to an appropriate referral facility as well as recognition of referral need and quality of care. Increasing family planning was the most effective individual intervention to reduce pregnancy-related mortality. If over the next 5 y the unmet need for spacing and limiting births was met, more than 150,000 maternal deaths would be prevented; more than US$1 billion saved; and at least one of every two abortion-related deaths averted. Still, reductions in maternal mortality reached a threshold ( approximately 23%-35% without including strategies that ensured reliable access to intrapartum and emergency obstetrical care (EmOC. An integrated and stepwise approach was

  7. Alternative strategies to reduce maternal mortality in India: a cost-effectiveness analysis.

    Science.gov (United States)

    Goldie, Sue J; Sweet, Steve; Carvalho, Natalie; Natchu, Uma Chandra Mouli; Hu, Delphine

    2010-04-20

    Approximately one-quarter of all pregnancy- and delivery-related maternal deaths worldwide occur in India. Taking into account the costs, feasibility, and operational complexity of alternative interventions, we estimate the clinical and population-level benefits associated with strategies to improve the safety of pregnancy and childbirth in India. Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy (both planned and unintended) and pregnancy- and childbirth-associated complications in individual women; and considers delivery location, attendant, and facility level. Model outcomes included clinical events, population measures, costs, and cost-effectiveness ratios. Separate models were adapted to urban and rural India using survey-based data (e.g., unmet need for birth spacing/limiting, facility births, skilled birth attendants). Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged as integrated services, could reduce the incidence of a complication or its case fatality rate, and could include improved logistics such as reliable transport to an appropriate referral facility as well as recognition of referral need and quality of care. Increasing family planning was the most effective individual intervention to reduce pregnancy-related mortality. If over the next 5 y the unmet need for spacing and limiting births was met, more than 150,000 maternal deaths would be prevented; more than US$1 billion saved; and at least one of every two abortion-related deaths averted. Still, reductions in maternal mortality reached a threshold ( approximately 23%-35%) without including strategies that ensured reliable access to intrapartum and emergency obstetrical care (EmOC). An integrated and stepwise approach was identified that would ultimately prevent four of five

  8. Alternative Strategies to Reduce Maternal Mortality in India: A Cost-Effectiveness Analysis

    Science.gov (United States)

    Goldie, Sue J.; Sweet, Steve; Carvalho, Natalie; Natchu, Uma Chandra Mouli; Hu, Delphine

    2010-01-01

    Background Approximately one-quarter of all pregnancy- and delivery-related maternal deaths worldwide occur in India. Taking into account the costs, feasibility, and operational complexity of alternative interventions, we estimate the clinical and population-level benefits associated with strategies to improve the safety of pregnancy and childbirth in India. Methods and Findings Country- and region-specific data were synthesized using a computer-based model that simulates the natural history of pregnancy (both planned and unintended) and pregnancy- and childbirth-associated complications in individual women; and considers delivery location, attendant, and facility level. Model outcomes included clinical events, population measures, costs, and cost-effectiveness ratios. Separate models were adapted to urban and rural India using survey-based data (e.g., unmet need for birth spacing/limiting, facility births, skilled birth attendants). Model validation compared projected maternal indicators with empiric data. Strategies consisted of improving coverage of effective interventions that could be provided individually or packaged as integrated services, could reduce the incidence of a complication or its case fatality rate, and could include improved logistics such as reliable transport to an appropriate referral facility as well as recognition of referral need and quality of care. Increasing family planning was the most effective individual intervention to reduce pregnancy-related mortality. If over the next 5 y the unmet need for spacing and limiting births was met, more than 150,000 maternal deaths would be prevented; more than US$1 billion saved; and at least one of every two abortion-related deaths averted. Still, reductions in maternal mortality reached a threshold (∼23%–35%) without including strategies that ensured reliable access to intrapartum and emergency obstetrical care (EmOC). An integrated and stepwise approach was identified that would ultimately

  9. Sustainability indicators, alternative strategies and trade-offs in peasant agroecosystems : analysing 15 case studies from Latin America

    NARCIS (Netherlands)

    Astier, M.; Speelman, E.N.; López-Ridaura, S.; Masera, O.R.; Gonzalez-Esquivel, C.E.

    2011-01-01

    In view of the urgent need to improve agroecosystem sustainability, several efforts have been made to evaluate the effect of alternative strategies on key environmental and socioeconomic variables at the farm, community and regional levels. Most peasant farmers manage complex and diverse

  10. Use of time and materials and cost reimbursement subcontracts for remedial actions under the alternative remedial contracting strategy contracts. Directive

    International Nuclear Information System (INIS)

    1992-01-01

    The directive is intended to establish agency guidance on the use of time and materials and cost reimbursement contracts for remedial actions in general and to provide specific instruction regarding the use of these approaches in subcontracting under the Alternative Remedial Contracting Strategy (ARCS) contracts

  11. Economic Comparison of an Empirical Versus Diagnostic-Driven Strategy for Treating Invasive Fungal Disease in Immunocompromised Patients.

    Science.gov (United States)

    Barnes, Rosemary; Earnshaw, Stephanie; Herbrecht, Raoul; Morrissey, Orla; Slavin, Monica; Bow, Eric; McDade, Cheryl; Charbonneau, Claudie; Weinstein, David; Kantecki, Michal; Schlamm, Haran; Maertens, Johan

    2015-06-01

    Patients with persistent or recurrent neutropenic fevers at risk of invasive fungal disease (IFD) are treated empirically with antifungal therapy (AFT). Early treatment using a diagnostic-driven (DD) strategy may reduce clinical and economic burdens. We compared costs and outcomes of both strategies from a UK perspective. An empirical strategy with conventional amphotericin B deoxycholate (C-AmB), liposomal amphotericin B (L-AmB), or caspofungin was compared with a DD strategy (initiated based on positive ELISA results for galactomannan antigen) and/or positive results for Aspergillus species on polymerase chain reaction assay) using C-AmB, voriconazole, or L-AmB in a decision-analytic model. Rates of IFD incidence, overall mortality, and IFD-related mortality in adults expected to be neutropenic for ≥10 days were obtained. The empirical strategy was assumed to identify 30% of IFD and targeted AFT to improve survival by a hazard ratio of 0.589. AFT-specific adverse events were obtained from a summary of product characteristics. Resource use was obtained, and costs were estimated by using standard UK costing sources. All costs are presented in 2012 British pounds sterling. Total costs were 32% lower for the DD strategy (£1561.29) versus the empirical strategy (£2301.93) due to a reduced incidence of adverse events and decreased use of AFT. Administration of AFT was reduced by 41% (DD strategy, 74 of 1000; empirical strategy, 125 of 1000), with similar survival rates. This study suggests that a DD strategy is likely to be cost-saving versus empirical treatment for immunocompromised patients with persistent or recurrent neutropenic fevers. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  12. Workshop on acceleration of the validation and regulatory acceptance of alternative methods and implementation of testing strategies.

    Science.gov (United States)

    Piersma, A H; Burgdorf, T; Louekari, K; Desprez, B; Taalman, R; Landsiedel, R; Barroso, J; Rogiers, V; Eskes, C; Oelgeschläger, M; Whelan, M; Braeuning, A; Vinggaard, A M; Kienhuis, A; van Benthem, J; Ezendam, J

    2018-03-02

    This report describes the proceedings of the BfR-RIVM workshop on validation of alternative methods which was held 23 and 24 March 2017 in Berlin, Germany. Stakeholders from governmental agencies, regulatory authorities, universities, industry and the OECD were invited to discuss current problems concerning the regulatory acceptance and implementation of alternative test methods and testing strategies, with the aim to develop feasible solutions. Classical validation of alternative methods usually involves one to one comparison with the gold standard animal study. This approach suffers from the reductionist nature of an alternative test as compared to the animal study as well as from the animal study being considered as the gold standard. Modern approaches combine individual alternatives into testing strategies, for which integrated and defined approaches are emerging at OECD. Furthermore, progress in mechanistic toxicology, e.g. through the adverse outcome pathway approach, and in computational systems toxicology allows integration of alternative test battery results into toxicity predictions that are more fine-tuned to the human situation. The road towards transition to a mechanistically-based human-focused hazard and risk assessment of chemicals requires an open mind towards stepping away from the animal study as the gold standard and defining human biologically based regulatory requirements for human hazard and risk assessment. Copyright © 2018 Elsevier Ltd. All rights reserved.

  13. A diagnostic of the strategy employed for communicating nuclear related information to Brazilian communities around uranium mining areas

    International Nuclear Information System (INIS)

    Ferrari Dias, Fabiana; Tirollo Taddei, Maria H.

    2008-01-01

    This paper presents a diagnostic of the strategy used by the Brazilian uranium mining industry to communicate nuclear related information to communities around a mining area. The uranium mining industry in Brazil, which is run by the government, has been concerned with communication issues for quite some time. The need to communicate became more apparent after new mining operations started in the Northern region of Brazil. The fact that the government does not have a clear communication guideline made the operators of the uranium mining industry aware of the increasing demand for establishment of a good relationship with several types of Stake holders as well as employment of personnel with experience in dealing with them. A diagnostic of the current communication situation in Brazil and an analysis of the approaches over the past years was done through interviews with employees of the mining industry and review of institutional communication materials. The results were discussed during a Consultant's Meeting organized by the IAEA 's Seibersdorf Laboratory in October 2007. The output of the meeting included an overview of modern communication strategies used by different countries and a suggestion for new uranium mining operations in developing or under developed countries. The strategy for communicating nuclear related information to Brazilian communities varied according to the influence of different Stake holder groups. One initiative worth mentioning was the creation of a Mobile Nuclear Information Thematic Room, which was installed in several locations. This project was seen as one of the main tools to relate to community. Many Stake holders were identified during the diagnostic phase in preparation for the IAEA 's meeting on communication strategy: children, NGOs (Non Government Organizations), local churches, media and internal Stake holders, among others. An initial evaluation showed that the perception of a neighbouring community regarding an uranium

  14. Ecology of Fungus Gnats (Bradysia spp. in Greenhouse Production Systems Associated with Disease-Interactions and Alternative Management Strategies

    Directory of Open Access Journals (Sweden)

    Raymond A. Cloyd

    2015-04-01

    Full Text Available Fungus gnats (Bradysia spp. are major insect pests of greenhouse-grown horticultural crops mainly due to the direct feeding damage caused by the larvae, and the ability of larvae to transmit certain soil-borne plant pathogens. Currently, insecticides and biological control agents are being used successively to deal with fungus gnat populations in greenhouse production systems. However, these strategies may only be effective as long as greenhouse producers also implement alternative management strategies such as cultural, physical, and sanitation. This includes elimination of algae, and plant and growing medium debris; placing physical barriers onto the growing medium surface; and using materials that repel fungus gnat adults. This article describes the disease-interactions associated with fungus gnats and foliar and soil-borne diseases, and the alternative management strategies that should be considered by greenhouse producers in order to alleviate problems with fungus gnats in greenhouse production systems.

  15. Targeting HER2 signaling pathway for radiosensitization: alternative strategy for therapeutic resistance.

    Science.gov (United States)

    No, Mina; Choi, Eun Jung; Kim, In Ah

    2009-12-01

    Several studies have indicated the potential value of targeting HER-2 signaling to enhance the anti-tumor activity of ionizing radiation. However, therapeutic resistance resulting from several factors, including activation of the downstream pathway, represents a major obstacle to treatment. Here, we investigated whether inhibitors targeting downstream of HER-2 signaling would radiosensitize SKBR3 breast cancer cells that exhibit overamplification of HER2. Selective inhibition of MEK-ERK signaling using pharmacologic inhibitors (PD98059, UO126) did not increase the radiosensitivity of SKBR3 cells. Selective inhibition of the PI3K-AKT-mTOR pathway using pharmacologic inhibitors (LY294002, AKT inhibitor VIII, Rapamycin) significantly attenuated expression of p-AKT and p-70S6K, respectively and radiosensitized SKBR3 cells. MCF-7 cells those did not overexpress HER-2, showed less radiosensitization compared to SKBR3 cells by inhibition of this pathway. Pre-treatment with these inhibitors also caused significant abrogation of typical G(2) arrest following ionizing radiation and induced marked prolongation of gammaH2AX foci indicating impairment of DNA damage repair. A dual inhibitor of Class I PI3K and mTOR, PI103 effectively radiosensitized SKBR3 cells and showed significant prolongation of gammaH2AX foci. Inhibition of PI3K-AKT signaling was associated with downregulation of DNA-PKs, respectively. While apoptosis was the major mode of cell death when the cells were pretreated with LY294002 or AKT inhibitor VIII, the cells were pretreated by rapamycin or PI103 showed mixed mode of cell death including autophagy. Our results suggest possible mechanisms to counteract the HER-2 prosurvival signaling implicated in radioresistance, and offer an alternative strategy to overcome resistance to HER-2 inhibitors combined with radiation.

  16. Bouldering: an alternative strategy to long-vertical climbing in root-climbing hortensias.

    Science.gov (United States)

    Granados Mendoza, Carolina; Isnard, Sandrine; Charles-Dominique, Tristan; Van den Bulcke, Jan; Rowe, Nick P; Van Acker, Joris; Goetghebeur, Paul; Samain, Marie-Stéphanie

    2014-10-06

    In the Neotropics, the genus Hydrangea of the popular ornamental hortensia family is represented by climbing species that strongly cling to their support surface by means of adhesive roots closely positioned along specialized anchoring stems. These root-climbing hortensia species belong to the nearly exclusive American Hydrangea section Cornidia and generally are long lianescent climbers that mostly flower and fructify high in the host tree canopy. The Mexican species Hydrangea seemannii, however, encompasses not only long lianescent climbers of large vertical rock walls and coniferous trees, but also short 'shrub-like' climbers on small rounded boulders. To investigate growth form plasticity in root-climbing hortensia species, we tested the hypothesis that support variability (e.g. differences in size and shape) promotes plastic responses observable at the mechanical, structural and anatomical level. Stem bending properties, architectural axis categorization, tissue organization and wood density were compared between boulder and long-vertical tree-climbers of H. seemannii. For comparison, the mechanical patterns of a closely related, strictly long-vertical tree-climbing species were investigated. Hydrangea seemannii has fine-tuned morphological, mechanical and anatomical responses to support variability suggesting the presence of two alternative root-climbing strategies that are optimized for their particular environmental conditions. Our results suggest that variation of some stem anatomical traits provides a buffering effect that regulates the mechanical and hydraulic demands of two distinct plant architectures. The adaptive value of observed plastic responses and the importance of considering growth form plasticity in evolutionary and conservation studies are discussed. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

  17. Cost-effectiveness analysis of various strategies in the diagnostic management of pulmonary embolism

    NARCIS (Netherlands)

    Oudkerk, M.; van Beek, E. J.; van Putten, W. L.; Büller, H. R.

    1993-01-01

    Since the clinical diagnosis of pulmonary embolism is unreliable, various objective diagnostic methods (or combinations thereof) are advocated. Pulmonary angiography is the accepted reference method but is considered less suitable for initial screening due to its invasive nature. Therefore, at least

  18. Myocardial Bridging: Contemporary Understanding of Pathophysiology with Implications for Diagnostic and Therapeutic Strategies

    Science.gov (United States)

    Eshtehardi, Parham; Rasoul-Arzrumly, Emad; McDaniel, Michael; Mekonnen, Girum; Timmins, Lucas H.; Lutz, Jerre; Guyton, Robert A; Samady, Habib

    2014-01-01

    Patients with myocardial bridges are often asymptomatic but this anomaly may be associated with exertional angina, acute coronary syndromes, cardiac arrhythmias, syncope or even sudden cardiac death. This review presents our understanding of the pathophysiology of myocardial bridging and describes prevailing diagnostic modalities and therapeutic options for this challenging clinical entity. PMID:24583304

  19. Search strategies to identify diagnostic accuracy studies in MEDLINE and EMBASE

    NARCIS (Netherlands)

    Beynon, Rebecca; Leeflang, Mariska M. G.; McDonald, Steve; Eisinga, Anne; Mitchell, Ruth L.; Whiting, Penny; Glanville, Julie M.

    2013-01-01

    A systematic and extensive search for as many eligible studies as possible is essential in any systematic review. When searching for diagnostic test accuracy (DTA) studies in bibliographic databases, it is recommended that terms for disease (target condition) are combined with terms for the

  20. Human organ-on-a-chip BioMEMS devices for testing new diagnostic and therapeutic strategies

    Science.gov (United States)

    Leary, James F.; Key, Jaehong; Vidi, Pierre-Alexandre; Cooper, Christy L.; Kole, Ayeeshik; Reece, Lisa M.; Lelièvre, Sophie A.

    2013-03-01

    MEMS human "organs-on-a-chip" can be used to create model human organ systems for developing new diagnostic and therapeutic strategies. They represent a promising new strategy for rapid testing of new diagnostic and therapeutic approaches without the need for involving risks to human subjects. We are developing multicomponent, superparamagnetic and fluorescent nanoparticles as X-ray and MRI contrast agents for noninvasive multimodal imaging and for antibody- or peptide-targeted drug delivery to tumor and precancerous cells inside these artificial organ MEMS devices. Magnetic fields can be used to move the nanoparticles "upstream" to find their target cells in an organs-on-achip model of human ductal breast cancer. Theoretically, unbound nanoparticles can then be removed by reversing the magnetic field to give a greatly enhanced image of tumor cells within these artificial organ structures. Using branched PDMS microchannels and 3D tissue engineering of normal and malignant human breast cancer cells inside those MEMS channels, we can mimic the early stages of human ductal breast cancer with the goal to improve the sensitivity and resolution of mammography and MRI of very small tumors and test new strategies for treatments. Nanomedical systems can easily be imaged by multicolor confocal microscopy inside the artificial organs to test targeting and therapeutic responses including the differential viability of normal and tumor cells during treatments. Currently we are using 2-dimensional MEMS structures, but these studies can be extended to more complex 3D structures using new 3D printing technologies.

  1. Developing a science of clinical utility in diagnostic classification systems field study strategies for ICD-11 mental and behavioral disorders.

    Science.gov (United States)

    Keeley, Jared W; Reed, Geoffrey M; Roberts, Michael C; Evans, Spencer C; Medina-Mora, María Elena; Robles, Rebeca; Rebello, Tahilia; Sharan, Pratap; Gureje, Oye; First, Michael B; Andrews, Howard F; Ayuso-Mateos, José Luís; Gaebel, Wolfgang; Zielasek, Juergen; Saxena, Shekhar

    2016-01-01

    The World Health Organization (WHO) Department of Mental Health and Substance Abuse has developed a systematic program of field studies to evaluate and improve the clinical utility of the proposed diagnostic guidelines for mental and behavioral disorders in the Eleventh Revision of the International Classification of Diseases and Related Health Problems (ICD-11). The clinical utility of a diagnostic classification is critical to its function as the interface between health encounters and health information, and to making the ICD-11 be a more effective tool for helping the WHO's 194 member countries, including the United States, reduce the global disease burden of mental disorders. This article describes the WHO's efforts to develop a science of clinical utility in regard to one of the two major classification systems for mental disorders. We present the rationale and methodologies for an integrated and complementary set of field study strategies, including large international surveys, formative field studies of the structure of clinicians' conceptualization of mental disorders, case-controlled field studies using experimental methodologies to evaluate the impact of proposed changes to the diagnostic guidelines on clinicians' diagnostic decision making, and ecological implementation field studies of clinical utility in the global settings in which the guidelines will ultimately be implemented. The results of these studies have already been used in making decisions about the structure and content of ICD-11. If clinical utility is indeed among the highest aims of diagnostic systems for mental disorders, as their developers routinely claim, future revision efforts should continue to build on these efforts. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  2. International differences in health care costs in Europe and the United States: Do these affect the cost-effectiveness of diagnostic strategies for pulmonary embolism?

    International Nuclear Information System (INIS)

    Erkel, A.R. van; Pattynama, P.M.T.; Hout, W.B. van den

    1999-01-01

    The aim of this study was to assess whether potential differences in costs for diagnostic procedures and treatment of pulmonary embolism (PE) among European and U. S. hospitals alter the optimal cost-effective diagnostic strategy for PE. A standardized questionnaire was used to obtain cost data for the diagnosis and treatment of PE in participating European and U. S. hospitals. Costs for diagnostic tests and treatment of PE were then calculated in a standardized manner for all participating hospitals, from the hospital perspective. Costs were used in an existing cost-effectiveness analysis (CEA) model to determine the most cost-effective diagnostic strategy in participating hospitals. There were considerable differences in costs for diagnostic and therapeutic procedures for PE among the participating centers. These differences, however, did not affect the most cost-effective strategy based on incremental cost-effectiveness. In all hospitals the most cost-effective strategy appeared to be ultrasound followed by helical CT. International differences in cost of diagnostic and therapeutic procedures certainly exist and should be considered before applying a published CEA. Nevertheless, despite these cost differences, the diagnostic strategy for PE of ultrasound followed by helical CT appears most cost-effective. (orig.)

  3. Workgroup Report: Incorporating In Vitro Alternative Methods for Developmental Neurotoxicity into International Hazard and Risk Assessment Strategies

    Science.gov (United States)

    Coecke, Sandra; Goldberg, Alan M; Allen, Sandra; Buzanska, Leonora; Calamandrei, Gemma; Crofton, Kevin; Hareng, Lars; Hartung, Thomas; Knaut, Holger; Honegger, Paul; Jacobs, Miriam; Lein, Pamela; Li, Abby; Mundy, William; Owen, David; Schneider, Steffen; Silbergeld, Ellen; Reum, Torsten; Trnovec, Tomas; Monnet-Tschudi, Florianne; Bal-Price, Anna

    2007-01-01

    This is the report of the first workshop on Incorporating In Vitro Alternative Methods for Developmental Neurotoxicity (DNT) Testing into International Hazard and Risk Assessment Strategies, held in Ispra, Italy, on 19–21 April 2005. The workshop was hosted by the European Centre for the Validation of Alternative Methods (ECVAM) and jointly organized by ECVAM, the European Chemical Industry Council, and the Johns Hopkins University Center for Alternatives to Animal Testing. The primary aim of the workshop was to identify and catalog potential methods that could be used to assess how data from in vitro alternative methods could help to predict and identify DNT hazards. Working groups focused on two different aspects: a) details on the science available in the field of DNT, including discussions on the models available to capture the critical DNT mechanisms and processes, and b) policy and strategy aspects to assess the integration of alternative methods in a regulatory framework. This report summarizes these discussions and details the recommendations and priorities for future work. PMID:17589601

  4. The Lessons of East Asian Development and Alternative Development Strategies for Hainan

    Science.gov (United States)

    1991-01-01

    1989, pp. 1645-1690. Bhagwati, Jagdish N., "Rethinking Trade Strategy," in John P. Lewis and Valeriana Kallab (eds.), Development Strategies... Valeriana Kallab (eds.), Development Strategies Rcconsidered, Transaction Books, New Brunswick, NJ, 1986, pp. 115-128. Bradshaw, Thorton F., Daniel F...Lewis, John P., "Development Fromotion: A Time for Regrouping," in John P. Lewis and Valeriana Kallab (eds.), Development Strategies Reconsidered

  5. What Do You Know about Alternative Energy? Development and Use of a Diagnostic Instrument for Upper Secondary School Science

    Science.gov (United States)

    Cheong, Irene Poh-Ai; Johari, Marliza; Said, Hardimah; Treagust, David F.

    2015-01-01

    The need for renewable and non-fossil fuels is now recognised by nations throughout the world. Consequently, an understanding of alternative energy is needed both in schools and in everyday life-long learning situations. This study developed a two-tier instrument to diagnose students' understanding and alternative conceptions about alternative…

  6. Alternative Natural Resource Monitoring Strategies in the Mexican States of Jalisco and Colima

    Science.gov (United States)

    Cele Aguirre-Bravo; Hans Schreuder

    2005-01-01

    This paper presents a strategy for inventorying and monitoring the natural resources in the Mexican states of Jalisco and Colima. The strategy emphasizes a strong linkage between remote sensing with field sampling design to produce statistical summaries and spatial estimates at multiple scales and resolution levels. Outputs derived from this strategy are expected to...

  7. Planning diagnostic imaging work-up strategies using case-based reasoning.

    OpenAIRE

    Kahn, C. E.

    1994-01-01

    ISIS is a developmental decision support system that helps physicians select diagnostic imaging procedures. It uses case-based reasoning, an artificial-intelligence approach that emphasizes reasoning and planning from prior experience. The development, training, and evaluation of a prototype system were used to guide the development of ISIS. To realize a clinically useful system, particular emphasis has been placed on increasing the depth and breadth of case-based knowledge, enhancing the exp...

  8. Strategies in Ebola virus disease (EVD) diagnostics at the point of care.

    Science.gov (United States)

    Coarsey, Chad T; Esiobu, Nwadiuto; Narayanan, Ramswamy; Pavlovic, Mirjana; Shafiee, Hadi; Asghar, Waseem

    2017-11-01

    Ebola virus disease (EVD) is a devastating, highly infectious illness with a high mortality rate. The disease is endemic to regions of Central and West Africa, where there is limited laboratory infrastructure and trained staff. The recent 2014 West African EVD outbreak has been unprecedented in case numbers and fatalities, and has proven that such regional outbreaks can become a potential threat to global public health, as it became the source for the subsequent transmission events in Spain and the USA. The urgent need for rapid and affordable means of detecting Ebola is crucial to control the spread of EVD and prevent devastating fatalities. Current diagnostic techniques include molecular diagnostics and other serological and antigen detection assays; which can be time-consuming, laboratory-based, often require trained personnel and specialized equipment. In this review, we discuss the various Ebola detection techniques currently in use, and highlight the potential future directions pertinent to the development and adoption of novel point-of-care diagnostic tools. Finally, a case is made for the need to develop novel microfluidic technologies and versatile rapid detection platforms for early detection of EVD.

  9. Alternative powertrain strategies and fleet turnover in the 21st century.

    Science.gov (United States)

    2010-08-01

    The changes taking place in the global automotive industry related to alternative : powertrains and fuels are affecting each country or region differently. Each country or : region has its own policies in place to monitor and manage vehicle fuel cons...

  10. Augmentative and alternative communication in daily clinical practice: strategies and tools for management of severe communication disorders.

    Science.gov (United States)

    Frankoff, Denise J; Hatfield, Brooke

    2011-01-01

    Research indicates that augmentative and alternative communication (AAC) approaches can be used effectively by patients and their caregivers to improve communication skills. This article highlights strategies and tools for re-establishing communication competence by considering the complexity and diversity of communication interactions in an effort to maximize natural speech and language skills via a range of technologies that are implemented across the continuum of care rather than as a last resort.

  11. Developing alternative shoreline armoring strategies: the living shoreline approach in North Carolina

    OpenAIRE

    Currin, C.A.; Chappell, W.S.; Deaton, A.

    2010-01-01

    This paper reviews the scientific data on the ecosystem services provided by shoreline habitats, the evidence for adverse impacts from bulkheading on those habitats and services, and describes alternative approaches to shoreline stabilization, which minimize adverse impacts to the shoreline ecosystem. Alternative shoreline stabilization structures that incorporate natural habitats, also known as living shorelines, have been popularized by environmental groups and state regulatory agencies in ...

  12. Diagnostic evaluation and treatment strategy in patients with suspected prosthetic heart valve dysfunction: The incremental value of MDCT.

    Science.gov (United States)

    Suchá, Dominika; Symersky, Petr; van den Brink, Renee B A; Tanis, Wilco; Laufer, Eduard M; Meijs, Matthijs F L; Habets, Jesse; de Mol, Bas A J M; Mali, Willem P Th M; Chamuleau, Steven A J; van Herwerden, Lex A; Budde, Ricardo P J

    2016-01-01

    In patients with suspected prosthetic heart valve (PHV) dysfunction, routine evaluation echocardiography and fluoroscopy may provide unsatisfactory results for identifying the cause of dysfunction. This study assessed the value of MDCT as a routine, complementary imaging modality in suspected PHV-dysfunction for diagnosing the cause of PHV dysfunction and proposing a treatment strategy. Patients with suspected PHV dysfunction were prospectively recruited. All patients underwent routine diagnostic work-up (TTE, TEE ± fluoroscopy) and additional MDCT imaging. An expert panel reviewed all cases and assessed the diagnosis and treatment strategy, first based on routine evaluation only, second with additional MDCT information. Forty-two patients were included with suspected PHV obstruction (n = 30) and PHV regurgitation (n = 12). The addition of MDCT showed incremental value to routine evaluation in 26/30 (87%) cases for detecting the specific cause of PHV obstruction and in 7/12 (58%) regurgitation cases for assessment of complications and surgical planning. The addition of MDCT resulted in treatment strategy change in 8/30 (27%) patients with suspected obstruction and 3/12 (25%) patients with regurgitation. In addition to echocardiography and fluoroscopy, MDCT may identify the cause of PHV dysfunction and alter the treatment strategy. Copyright © 2016 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

  13. Smoldering multiple myeloma: pathophysiologic insights, novel diagnostics, clinical risk models, and treatment strategies.

    Science.gov (United States)

    Kazandjian, Dickran; Mailankody, Sham; Korde, Neha; Landgren, Ola

    2014-09-01

    Smoldering multiple myeloma (SMM) is a plasma cell disorder first described in 1980 when 6 patients were observed to meet the diagnostic criteria of multiple myeloma, defined as bone marrow plasmacytosis of 10% or greater or M protein level of 3 g/dL or greater, but did not have end-organ damage. Subsequent studies showed that the cumulative risk of SMM progression to symptomatic myeloma in 15 years was 73%. Since this time, advances have been made in understanding the biology of progression; namely, the contribution of branching evolution and microenvironment models to clonal heterogeneity. In parallel to this, clinical risk models using standard platforms of serum, bone marrow, and fluorescence in situ hybridization markers along with newer technologies of flow cytometry, gene expression profiling, and magnetic resonance imaging have been developed for prognostic stratification. Treatment has extended to the early myeloma category owing to more sensitive diagnostic approaches. The development of novel treatments will have to take into consideration our current knowledge of biological transformation. While it may be attractive to initiate early treatment in light of recent studies for high-risk SMM patients, clinical trial evidence of efficacy vs toxicity is still in its infancy. In our opinion, high-risk SMM patients should be strongly encouraged to enroll in treatment clinical trials, but treatment with unapproved agents or indications is not supported outside of trials.

  14. Cystic masses of the supraclavicular fossa: clinical features and diagnostic strategies.

    Science.gov (United States)

    Lin, Harrison W; Lister, Matthew T; Deschler, Daniel G

    2010-01-01

    Cystic masses of the supraclavicular fossa (SCF) are uncommon. The diverse anatomical structures within the SCF create an extended differential diagnosis for any mass arising in the SCF. This study describes the presenting symptoms, radiologic findings, medical and surgical management, and posttreatment outcomes of various cystic mass presenting in the SCF. A review of the literature and diagnostic and therapeutic algorithms are also provided. A retrospective study of an academic tertiary care head and neck cancer center was done. Seven cases of treated cystic masses of the SCF were identified. Diagnostic and therapeutic interventions are described. Cross-sectional imaging and needle aspiration or biopsy were obtained in all 7 cases. Aspirates accurately differentiated benign from malignant lesions in 6 cases, identified the offending pathology in 3 cases, and provided inoculum for culture-directed antibiotic therapy in 1 case. Surgical intervention was used for definitive therapy in 6 cases. All patients achieved complete resolution of signs and symptoms of the mass. Effective evaluation of a cystic lesion within the SCF mandates a thorough understanding of the anatomy and differential diagnosis. A well-defined algorithm allows successful management of benign and malignant lesions in the SCF. Copyright © 2010 Elsevier Inc. All rights reserved.

  15. Conservation in the residential sector: two alternatives as strategies for ordering the market

    International Nuclear Information System (INIS)

    Lins, M.E.

    1990-01-01

    This work purposes an economic flow analysis in order to be driven conservation strategies by the electric sector. Two strategies for three conservation measures are considered here in the residential sector. The results obtained increase the reliability of an action plan to be elaborated for the electric energy conservation in the residential sector. (author)

  16. The process evaluation of two alternative participatory ergonomics intervention strategies for construction companies.

    Science.gov (United States)

    Visser, Steven; van der Molen, Henk F; Sluiter, Judith K; Frings-Dresen, Monique H W

    2018-03-26

    To gain insight into the process of applying two guidance strategies - face-to-face (F2F) or e-guidance strategy (EC) - of a Participatory Ergonomics (PE) intervention and whether differences between these guidance strategies occur, 12 construction companies were randomly assigned to a strategy. The process evaluation contained reach, dose delivered, dose received, precision, competence, satisfaction and behavioural change of individual workers. Data were assessed by logbooks, and questionnaires and interviews at baseline and/or after six months. Reach was low (1%). Dose delivered (F2F: 63%; EC: 44%), received (F2F: 42%; EC: 16%) were not sufficient. The precision and competence were sufficient for both strategies and satisfaction was strongly affected by dose received. For behavioural change, knowledge (F2F) and culture (EC) changed positively within companies. Neither strategy was delivered as intended. Compliance to the intervention was low, especially for EC. Starting with a face-to-face meeting might lead to higher compliance, especially in the EC group. Practitioner Summary: This study showed that compliance to a face-to-face and an e-guidance strategy is low. To improve the compliance, it is advised to start with a face-to-face meeting to see which parts of the intervention are needed and which guidance strategy can be used for these parts. ISRCTN73075751.

  17. Statistical Significance of the Contribution of Variables to the PCA Solution: An Alternative Permutation Strategy

    Science.gov (United States)

    Linting, Marielle; van Os, Bart Jan; Meulman, Jacqueline J.

    2011-01-01

    In this paper, the statistical significance of the contribution of variables to the principal components in principal components analysis (PCA) is assessed nonparametrically by the use of permutation tests. We compare a new strategy to a strategy used in previous research consisting of permuting the columns (variables) of a data matrix…

  18. Teaching science for conceptual change: Toward a proposed taxonomy of diagnostic teaching strategies to gauge students' personal science conceptions

    Science.gov (United States)

    Shope, Richard Edwin, III

    Science instruction aims to ensure that students properly construct scientific knowledge so that each individual may play a role as a science literate citizen or as part of the science workforce (National Research Council, 1996, 2000). Students enter the classroom with a wide range of personal conceptions regarding science phenomena, often at variance with prevailing scientific views (Duschl, Hamilton, & Grandy, 1992; Hewson, 1992). The extensive misconceptions research literature emphasizes the importance of diagnosing students' initial understandings in order to gauge the accuracy and depth of what each student knows prior to instruction and then to use that information to adapt the teaching to address student needs. (Ausubel, 1968; Carey, 2000; Driver et al., 1985; Karplus & Thier, 1967; Mintzes, Wandersee, & Novak, 1998; Osborne & Freyberg, 1985; Project 2061, 1993; Strike & Posner, 1982, 1992; Vygotsky, 1934/1987). To gain such insight, teachers diagnose not only the content of the students' personal conceptions but also the thinking processes that produced them (Strike and Posner, 1992). Indeed, when teachers design opportunities for students to express their understanding, there is strong evidence that such diagnostic assessment also enhances science teaching and learning (Black & William, 1998). The functional knowledge of effective science teaching practice resides in the professional practitioners at the front lines---the science teachers in the classroom. Nevertheless, how teachers actually engage in the practice of diagnosis is not well documented. To help fill this gap, the researcher conducted a study of 16 sixth grade science classrooms in four Los Angeles area middle schools. Diagnostic teaching strategies were observed in action and then followed up by interviews with each teacher. Results showed that teachers use strategies that vary by the complexity of active student involvement, including pretests, strategic questions, interactive discussion

  19. Frequent change of procedure during coronary artery bypass surgery suggests insufficient preoperative diagnostic strategy

    DEFF Research Database (Denmark)

    Eckardt, Rozy; Kjeldsen, Bo Juel; Thayssen, Per

    2007-01-01

    We sought to evaluate how often and in what way surgeons change peroperatively their preoperative coronary artery bypass grafting strategy and to what degree these changes affect postoperative graft patency. A series of 109 patients with stable angina pectoris and at least one occluded coronary a...

  20. Sedation for pediatric diagnostic imaging: use of pediatric and nursing resources as an alternative to a radiology department sedation team

    International Nuclear Information System (INIS)

    Ruess, Lynne; O'Connor, Stephen C.; Mikita, Cecilia P.; Creamer, Kevin M.

    2002-01-01

    Objective. To develop a pathway to provide safe, effective, and efficient sedation for pediatric diagnostic imaging studies using non-radiology personnel. Materials and methods. A multidisciplinary team considered manpower and training requirements and national sedation standards before designing a sedation pathway, which included scheduling, pre-sedation history and physical, medication protocols, and monitoring. Oral and IV medication protocols were developed based on patient age and weight. Sedation delays were defined as >15 min (IV) or >30 min (PO) from start of sedation to start of imaging. A sedation failure resulted in an incomplete diagnostic imaging study. Failure rates of 124 sedations before and 388 sedations after the pathway were compared.Results. The sedation failure rate for 7 months prior to pathway initiation was 15% (19/124). In the first 25 months after pathway initiation, failures were significantly reduced to 1.5% (6/388) (P 55 min). Deviation from the recommended medication protocol accounted for most of the 115 delays. Only minor adverse events were seen (12/388, 3.1%).Conclusion. Implementing a pediatric sedation pathway significantly decreases the sedation failure rate. Pediatric residents and nurses can safely, effectively and efficiently sedate pediatric patients for routine diagnostic imaging procedures without the need for a radiology department sedation team in a department with a small-to-moderate volume of pediatric patients. (orig.)

  1. Evaluating alternative management strategies for bigeye tuna, Thunnus obesus, in the Indian Ocean

    Directory of Open Access Journals (Sweden)

    Yuhe Tong

    2013-09-01

    Full Text Available Bigeye tuna (Thunnus obesus support a large commercial fishery in the Indian Ocean. However, explicit management strategies and harvest control rules are yet to be developed for the management of this fishery. We used a stochastic age-structured production model as an operating model to evaluate several potential management strategies under different assumptions of stock productivity. Five management strategies—constant fishing mortality, constant catch, quasi-constant catch, constant escapement, and status-dependent strategies—were evaluated and compared using the performance indicators including average catch, average spawning stock biomass, variation in catch, average fishing mortality and lowest biomass during the time period considered in the simulation. This study shows that (1 for the constant catch strategy, an annual catch of 90000 t would result in a low risk of stock being overfished while obtaining a stable catch; (2 for the constant fishing mortality strategy fishing mortality of 0.3 per year could yield a higher catch, but might have a high probability (64% of stock dropping below the spawning stock biomass (SSB that could achieve maximum sustainable yield (SSBmsy; and (3 for the quasi-constant catch strategy an annual catch of 110000 t was sustainable if the current SSB was higher than SSBmsy. Constant escapement and status-dependent strategies were robust with respect to different levels of virgin recruitment and steepness. This study suggests that it is important to incorporate uncertainties associated with key life history, fisheries and management processes in evaluating management strategies.

  2. Evidence on anti-malarial and diagnostic markets in Cambodia to guide malaria elimination strategies and policies.

    Science.gov (United States)

    Phok, Sochea; Lek, Dysoley

    2017-04-25

    Understanding Cambodia's anti-malarial and diagnostic landscape in 2015 is critical for informing and monitoring strategies and policies as Cambodia moves forward with national efforts to eliminate malaria. The aim of this paper is to present timely and key findings on the public and private sector anti-malarial and diagnostic landscape in Cambodia. This evidence can serve as a baseline benchmark for guiding implementation of national strategies as well as other regional initiatives to address malaria elimination activities. From August 17th to October 1st, 2015, a cross sectional, nationally-representative malaria outlet survey was conducted in Cambodia. A census of all public and private outlets with potential to distribute malaria testing and/or treatment was conducted among 180 communes. An audit was completed for all anti-malarials, malaria rapid diagnostic tests (RDT) and microscopy. A total of 26,664 outlets were screened, and 1303 outlets were eligible and interviewed. Among all screened outlets in the public sector, 75.9% of public health facilities and 67.7% of community health workers stocked both malaria diagnostic testing and a first-line artemisinin-based combination therapy (ACT). Among anti-malarial-stocking private sector outlets, 64.7% had malaria blood testing available, and 70.9% were stocking a first-line ACT. Market share data illustrate that most of the anti-malarials were sold or distributed through the private sector (58.4%), including itinerant drug vendors (23.4%). First-line ACT accounted for the majority of the market share across the public and private sectors (90.3%). Among private sector outlets stocking any anti-malarial, the proportion of outlets with a first-line ACT or RDT was higher among outlets that had reportedly received one or more forms of 'support' (e.g. reportedly received training in the previous year on malaria diagnosis [RDT and/or microscopy] and/or the national treatment guidelines for malaria) compared to outlets

  3. Self-regulation from Educational Psychology to L2 Pedagogy: an Alternative to Language Learning Strategies

    Directory of Open Access Journals (Sweden)

    Maryam Banisaeid

    2014-01-01

    Full Text Available Language learning strategy was the focus of many studies during the last two decades. Because of definitional fuzziness and unreliable instrument, the concept of language learning strategy was replaced by self-regulation in educational psychology. Subsequently, this shift affected L2 research. The notion of self-regulation is used in some L2 studies today (Tseng, Dörnyei & Schmitt, 2006; Rose, 2011b, Banisaeid, 2013a, 2013b. Self-regulation is more process-oriented while language learning strategy is more product-oriented. Although it only encompasses the metacognitive strategy, the general domain of it is meaningfully wider than the strategic framework. It covers some aspects in the learning process as motivation, goals and self-efficacy.

  4. Organize First or Write First? A Comparison of Alternative Writing Strategies

    Science.gov (United States)

    1991-02-01

    Baddeley, A.D. (1976). The psychology of memory . New York: Basic Books. Becker, H.S. (1986). Writing for social scientists. Chicago: University of...Writing Without Teachers (1973), to anyone who would like to read more about the write-first strategy. Social scientists who describe similar...strategies are Howard Becker (1986), a sociologist, in a book called Writing for Social Scientists, and P. C. Wason (1980), a cognitive psychologist. Upon

  5. Situational Judgment Tests in High-Stakes Settings: Issues and Strategies with Generating Alternate Forms

    Science.gov (United States)

    Lievens, Filip; Sackett, Paul R.

    2007-01-01

    This study used principles underlying item generation theory to posit competing perspectives about which features of situational judgment tests might enhance or impede consistent measurement across repeat test administrations. This led to 3 alternate-form development approaches (random assignment, incident isomorphism, and item isomorphism). The…

  6. Long-term strategies for flood risk management: scenario definition and strategic alternative design

    NARCIS (Netherlands)

    Bruijn, de K.; Klijn, F.; McGahey, C.; Mens, M.; Wolfert, H.P.

    2008-01-01

    This report reviews some mainstream existing methods of scenario development and use, as well as experiences with the design and assessment of strategic alternatives for flood risk management. Next, a procedure and methods are proposed and discussed. Thirdly, the procedure and methods are tried on

  7. Assessing Tuition and Student Aid Strategies: Using Price-Response Measures to Simulate Pricing Alternatives.

    Science.gov (United States)

    St. John, Edward P.

    1994-01-01

    A study used price-response measures from recent national studies to assess college and university pricing (tuition and student aid) alternatives in diverse institutional settings. It is concluded that such analyses are feasible. Analysis indicated limits to "Robin Hood" pricing patterns are predominant in private colleges. Consideration…

  8. Single-Case Research Design: An Alternative Strategy for Evidence-Based Practice

    Science.gov (United States)

    Stapleton, Drue; Hawkins, Andrew

    2015-01-01

    Objective: The trend of utilizing evidence-based practice (EBP) in athletic training is now requiring clinicians, researchers, educators, and students to be equipped to both engage in and make judgments about research evidence. Single-case design (SCD) research may provide an alternative approach to develop such skills and inform clinical and…

  9. Alternative intrapopulation life-history strategies and their trade-offs in an African annual fish

    Czech Academy of Sciences Publication Activity Database

    Polačik, Matej; Blažek, Radim; Řežucha, Radomil; Vrtílek, Milan; Terzibasi Tozzini, E.; Reichard, Martin

    2014-01-01

    Roč. 27, č. 5 (2014), s. 854-865 ISSN 1010-061X R&D Projects: GA ČR GPP505/11/P646 Institutional support: RVO:68081766 Keywords : phenotypic plasticity * periodic habitat * senescence rate * polyphenism * lifespan * alternative embryonic pathway Subject RIV: EG - Zoology Impact factor: 3.232, year: 2014

  10. Beyond Behavioural Management Strategies: An Alternative Viewpoint from the Pupil Perspective

    Science.gov (United States)

    Fowler, Allan

    2007-01-01

    The article begins by discussing the literature as it relates to the perceived effectiveness of behavioural management approaches, as well as the author's experiences of implementing a behavioural approach. The second part highlights an alternative viewpoint, as derived from an empirical study, as it relates to the pupil perspective of effective…

  11. Clinical utility of the DSM-5 alternative model for borderline personality disorder: Differential diagnostic accuracy of the BFI, SCID-II-PQ, and PID-5.

    Science.gov (United States)

    Fowler, J Christopher; Madan, Alok; Allen, Jon G; Patriquin, Michelle; Sharp, Carla; Oldham, John M; Frueh, B Christopher

    2018-01-01

    With the publication of DSM 5 alternative model for personality disorders it is critical to assess the components of the model against evidence-based models such as the five factor model and the DSM-IV-TR categorical model. This study explored the relative clinical utility of these models in screening for borderline personality disorder (BPD). Receiver operator characteristics and diagnostic efficiency statistics were calculated for three personality measures to ascertain the relative diagnostic efficiency of each measure. A total of 1653 adult inpatients at a specialist psychiatric hospital completed SCID-II interviews. Sample 1 (n=653) completed the SCID-II interviews, SCID-II Questionnaire (SCID-II-PQ) and the Big Five Inventory (BFI), while Sample 2 (n=1,000) completed the SCID-II interviews, Personality Inventory for DSM5 (PID-5) and the BFI. BFI measure evidenced moderate accuracy for two composites: High Neuroticism+ low agreeableness composite (AUC=0.72, SE=0.01, pPID-5 BPD algorithm (consisting of elevated emotional lability, anxiousness, separation insecurity, hostility, depressivity, impulsivity, and risk taking) evidenced moderate-to-excellent accuracy (AUC=0.87, SE=0.01, pPID-5 BPD algorithm for screening purposes. Furthermore, findings support the accuracy of the DSM 5 alternative model Criteria B trait constellation for diagnosing BPD. Limitations of the study include the single inpatient setting and use of two discrete samples to assess PID-5 and SCID-II-PQ. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Screening for common mental disorders using the SRQ-20 in Brazil: what are the alternative strategies for analysis?

    Directory of Open Access Journals (Sweden)

    Maria B. Barreto do Carmo

    2017-09-01

    Full Text Available Objective: To analyze the prevalence of common mental disorders (CMD assessed with the Self Reporting Questionnaire (SRQ-20, using the established cutoff point, and comparing it with the results of a joint correspondence factor analysis (CFA and cluster analysis and of a latent class analysis (LCA. Methods: A cross-sectional study was carried out in an urban sample of 1,095 women aged 19 to 55 years. Joint CFA-cluster analysis and LCA were used. Results: We found a high prevalence of CMD, regardless of classification method (37.6% when using the cutoff point; 44.4% and 52% for LCA and joint CFA-cluster, respectively. The alternative analysis strategies describe the cases more efficiently when compared to the traditional cutoff method, especially regarding more severe symptoms. Both alternative strategies also provide a description of the SRQ-20 dimensions in their particularities, which may be useful for the planning and implementation of specific actions in a given population. Conclusion: The SRQ-20 cutoff point seems to underestimate the magnitude of CMD among women. The alternative methods of analysis presented herein highlight the different possibilities of using this important instrument of screening for mental health.

  13. The depressed patient in a biological world: on philosophical and diagnostic strategies.

    Science.gov (United States)

    Korf, Jakob; Bosker, Fokko

    2013-06-01

    We questioned: what kind of relationships between mental and neurobiological levels of complexity is or could become useful in the psychiatric practice? The concept of mind and associated mood states defended here is that they are physically emergent, subjective, qualitative, unified features of the brain. We compared our neurobiological assessment also to psychoanalytical practice (first person's perspective). Applied to recent work on major depressive disorder (MDD), our ideas are among other supported by clinical and experimental studies on sleep deprivation, deep brain stimulation and epidemiological assessments of time-to-recovery. We suggest that depression is a transient state of the brain, that is mutually exclusive to the state of pleasure (in the Freudian context), rather than a disorder or disease with a characteristic time course (like many reversible somatic diseases). MDD can best be described with stochastic transition models, which is discussed in the context of a presumed brain serotonin dysfunction in depression. Our ideas invite a reconsideration of some concepts underlying current diagnostic and therapeutic approaches in the clinical practice. © 2013 John Wiley & Sons Ltd.

  14. Search strategies to identify diagnostic accuracy studies in MEDLINE and EMBASE.

    Science.gov (United States)

    Beynon, Rebecca; Leeflang, Mariska M G; McDonald, Steve; Eisinga, Anne; Mitchell, Ruth L; Whiting, Penny; Glanville, Julie M

    2013-09-11

    A systematic and extensive search for as many eligible studies as possible is essential in any systematic review. When searching for diagnostic test accuracy (DTA) studies in bibliographic databases, it is recommended that terms for disease (target condition) are combined with terms for the diagnostic test (index test). Researchers have developed methodological filters to try to increase the precision of these searches. These consist of text words and database indexing terms and would be added to the target condition and index test searches.Efficiently identifying reports of DTA studies presents challenges because the methods are often not well reported in their titles and abstracts, suitable indexing terms may not be available and relevant indexing terms do not seem to be consistently assigned. A consequence of using search filters to identify records for diagnostic reviews is that relevant studies might be missed, while the number of irrelevant studies that need to be assessed may not be reduced. The current guidance for Cochrane DTA reviews recommends against the addition of a methodological search filter to target condition and index test search, as the only search approach. To systematically review empirical studies that report the development or evaluation, or both, of methodological search filters designed to retrieve DTA studies in MEDLINE and EMBASE. We searched MEDLINE (1950 to week 1 November 2012); EMBASE (1980 to 2012 Week 48); the Cochrane Methodology Register (Issue 3, 2012); ISI Web of Science (11 January 2013); PsycINFO (13 March 2013); Library and Information Science Abstracts (LISA) (31 May 2010); and Library, Information Science & Technology Abstracts (LISTA) (13 March 2013). We undertook citation searches on Web of Science, checked the reference lists of relevant studies, and searched the Search Filters Resource website of the InterTASC Information Specialists' Sub-Group (ISSG). Studies reporting the development or evaluation, or both, of a

  15. Neonatal cerebral sinovenous thrombosis: sifting the evidence for a diagnostic plan and treatment strategy.

    Science.gov (United States)

    Yang, Janet Y K; Chan, Anthony K C; Callen, David J A; Paes, Bosco A

    2010-09-01

    Although cerebral sinovenous thrombosis (CSVT) is an uncommon disorder in neonates, the incumbent morbidity, mortality, and adverse neurodevelopmental sequelae highlight the importance of establishing an early diagnosis with an appropriate therapeutic plan. The clinical signs and symptoms of the condition are subtle and invariably masquerade under the umbrella of a broad spectrum of neonatal illnesses. A high index of diagnostic suspicion is essential for investigating and initiating treatment in a timely fashion before major complications ensue. Recent advances in accessible radiographic techniques with reduced radiation exposure have facilitated rapid diagnosis of thrombosis in both the superficial and deep plexuses of the cerebral venous systems. The absence of large-scale randomized trials and solid prospective smaller-sample-sized studies of neonates with CSVT has compromised our ability to develop efficacious treatment decisions. In this review of the scientific literature we offer understanding of the complex etiology of CSVT and inherent problems involved in the diagnosis and treatment of the disorder and focus on the limitations in current follow-up. An approach to neonatal CSVT is proposed on the basis of the available evidence from guidelines, registries, prospective and retrospective infant studies, and case series.

  16. High impact of FDG-PET/CT in diagnostic strategies for ovarian cancer

    Energy Technology Data Exchange (ETDEWEB)

    Zytoon, Ashraf Anas [Radiology Dept., Faculty of Medicine, Menoufiya Univ. (Egypt); PET Center, Dokkyo Medical Univ. (Japan)], e-mail: ashradio@gmail.com; Murakami, Koji [PET Center, Dokkyo Medical Univ. (Japan); Eid, Hazem; El-Gammal, Mahmoud [Medical Imaging Sciences and Biostatistics Dept.s, Al-Ghad International Coll.s of Health Sciences (Saudi Arabia)

    2013-04-15

    Background: Ovarian cancer has the highest mortality of all gynecologic malignancies. FDG-PET/CT was proven to be accurate for identification of primary ovarian tumors, regional lymph nodes, and distant metastases. Purpose: To evaluate ovarian masses at FDG-PET/CT in correlation with histopathologic findings. Material and Methods: Ninety-eight patients underwent whole body FDG-PET/CT examination. Eighty-six patients with primary ovarian cancer and 12 patients with metastatic disease to the ovaries were included. Results: PET/CT imaging was true-positive in 87/94 patients with malignant tumors. In 4/4 patients with benign tumors, PET/CT results were true-negative, with sensitivity of 92.6%, specificity 100%, total test accuracy 92.9%. Fifty-seven patients were diagnosed as stage IV ovarian cancer with distant metastasis. Conclusion: The anatomical/functional examination by FDG-PET/CT was proven to be valuable in increasing the diagnostic accuracy that can help improve patient management.

  17. Intracranial aneurysms: optimized diagnostic tools call for thorough interdisciplinary treatment strategies.

    Science.gov (United States)

    Mueller, Oliver M; Schlamann, Marc; Mueller, Daniela; Sandalcioglu, I Erol; Forsting, Michael; Sure, Ulrich

    2011-09-01

    Intracranial aneurysms (IAs) require deliberately selected treatment strategies as they are incrementally found prior to rupture and deleterious subarachnoid haemorrhage (SAH). Multiple and recurrent aneurysms necessitate both neurointerventionalists and neurosurgeons to optimize aneurysmal occlusion in an interdisciplinary effort. The present study was conducted to condense essential strategies from a single neurovascular centre with regard to the lessons learned. Medical charts of 321 consecutive patients treated for IAs at our centre from September 2008 until December 2010 were retrospectively analysed for clinical presentation of the aneurysms, multiplicity and treatment pathways. In addition, a selective Medline search was performed. A total of 321 patients with 492 aneurysms underwent occlusion of their symptomatic aneurysm: 132 (41.1%) individuals were treated surgically, 189 (58.2%) interventionally; 138 patients presented with a SAH, of these 44.2% were clipped and 55.8% were coiled. Aneurysms of the middle cerebral artery were primarily occluded surgically (88), whereas most of the aneurysms of the internal carotid artery and anterior communicating artery (114) were treated endovascularly. Multiple aneurysms (range 2-5 aneurysms/individual) were diagnosed in 98 patients (30.2%). During the study period 12 patients with recurrent aneurysms were allocated to another treatment modality (previously clip to coil and vice versa). Our data show that successful interdisciplinary occlusion of IAs is based on both neurosurgical and neurointerventional therapy. In particular, multiple and recurrent aneurysms require tailored individual approaches to aneurysmal occlusion. This is achieved by a consequent interdisciplinary pondering of the optimal strategy to occlude IAs in order to prevent SAH.

  18. Workshop on acceleration of the validation and regulatory acceptance of alternative methods and implementation of testing strategies

    DEFF Research Database (Denmark)

    Piersma, A. H.; Burgdorf, T.; Louekari, K.

    2018-01-01

    This report describes the proceedings of the BfR-RIVM workshop on validation of alternative methods which was held 23 and 24 March 2017 in Berlin, Germany. Stakeholders from governmental agencies, regulatory authorities, universities, industry and the OECD were invited to discuss current problems......-focused hazard and risk assessment of chemicals requires an open mind towards stepping away from the animal study as the gold standard and defining human biologically based regulatory requirements for human hazard and risk assessment.......This report describes the proceedings of the BfR-RIVM workshop on validation of alternative methods which was held 23 and 24 March 2017 in Berlin, Germany. Stakeholders from governmental agencies, regulatory authorities, universities, industry and the OECD were invited to discuss current problems...... concerning the regulatory acceptance and implementation of alternative test methods and testing strategies, with the aim to develop feasible solutions. Classical validation of alternative methods usually involves one to one comparison with the gold standard animal study. This approach suffers from...

  19. A diagnostic strategy for pulmonary embolism based on standardised pretest probability and perfusion lung scanning: a management study

    International Nuclear Information System (INIS)

    Miniati, Massimo; Monti, Simonetta; Bauleo, Carolina; Scoscia, Elvio; Tonelli, Lucia; Dainelli, Alba; Catapano, Giosue; Formichi, Bruno; Di Ricco, Giorgio; Prediletto, Renato; Carrozzi, Laura; Marini, Carlo

    2003-01-01

    Pulmonary embolism remains a challenging diagnostic problem. We developed a simple diagnostic strategy based on combination of assessment of the pretest probability with perfusion lung scan results to reduce the need for pulmonary angiography. We studied 390 consecutive patients (78% in-patients) with suspected pulmonary embolism. The pretest probability was rated low ( 10%, ≤50%), moderately high (>50%, ≤90%) or high (>90%) according to a structured clinical model. Perfusion lung scans were independently assigned to one of four categories: normal; near-normal; abnormal, suggestive of pulmonary embolism (wedge-shaped perfusion defects); abnormal, not suggestive of pulmonary embolism (perfusion defects other than wedge shaped). Pulmonary embolism was diagnosed in patients with abnormal scans suggestive of pulmonary embolism and moderately high or high pretest probability. Patients with normal or near-normal scans and those with abnormal scans not suggestive of pulmonary embolism and low pretest probability were deemed not to have pulmonary embolism. All other patients were allocated to pulmonary angiography. Patients in whom pulmonary embolism was excluded were left untreated. All patients were followed up for 1 year. Pulmonary embolism was diagnosed non-invasively in 132 patients (34%), and excluded in 191 (49%). Pulmonary angiography was required in 67 patients (17%). The prevalence of pulmonary embolism was 41% (n=160). Patients in whom pulmonary embolism was excluded had a thrombo-embolic risk of 0.4% (95% confidence interval: 0.0%-2.8%). Our strategy permitted a non-invasive diagnosis or exclusion of pulmonary embolism in 83% of the cases (95% confidence interval: 79%-86%), and appeared to be safe. (orig.)

  20. Mixed strategies for energy conservation and alternative energy utilization (solar) in buildings. Final report. Volume III. Appendixes. [10 appendices

    Energy Technology Data Exchange (ETDEWEB)

    None

    1977-06-01

    This appendix summarizes building characteristics used to determine heating and cooling loads for each of the five building types in each of the four regions. For the selected five buildings, the following data are attached: new and existing construction characteristics; new and existing construction thermal resistance; floor plan and elevation; people load schedule; lighting load schedule; appliance load schedule; ventilation schedule; and hot water use schedule. For the five building types (single family, apartment buildings, commercial buildings, office buildings, and schools), data are compiled in 10 appendices. These are Building Characteristics; Alternate Energy Sources and Energy Conservation Techniques Description, Costs, Fuel Price Scenarios; Life Cycle Cost Model; Simulation Models; Solar Heating/Cooling System; Condensed Weather; Single and Multi-Family Dwelling Characteristics and Energy Conservation Techniques; Mixed Strategies for Energy Conservation and Alternative Energy Utilization in Buildings. An extensive bibliography is given in the final appendix. (MCW)

  1. Note-Taking with Computers: Exploring Alternative Strategies for Improved Recall

    Science.gov (United States)

    Bui, Dung C.; Myerson, Joel; Hale, Sandra

    2013-01-01

    Three experiments examined note-taking strategies and their relation to recall. In Experiment 1, participants were instructed either to take organized lecture notes or to try and transcribe the lecture, and they either took their notes by hand or typed them into a computer. Those instructed to transcribe the lecture using a computer showed the…

  2. A Comparison of Alternative Strategies for Cost-Effective Water Quality Management in Lakes

    Science.gov (United States)

    Daniel Boyd Kramer; Stephen Polasky; Anthony Starfield; Brian Palik; Lynn Westphal; Stephanie Snyder; Pamela Jakes; Rachel Hudson; Eric Gustafson

    2006-01-01

    Roughly 45% of the assessed lakes in the United States are impaired for one or more reasons. Eutrophication due to excess phosphorus loading is common in many impaired lakes. Various strategies are available to lake residents for addressing declining lake water quality, including septic system upgrades and establishing riparian buffers. This study examines 25 lakes to...

  3. Mindfulness-Based Exposure Strategies as a Transdiagnostic Mechanism of Change: An Exploratory Alternating Treatment Design.

    Science.gov (United States)

    Brake, C Alex; Sauer-Zavala, Shannon; Boswell, James F; Gallagher, Matthew W; Farchione, Todd J; Barlow, David H

    2016-03-01

    The present study explored whether distress reduction in response to strong negative emotions, a putative transdiagnostic mechanism of action, is facilitated by mindfulness strategies. Seven patients (mean age=31.14years, SD=12.28, range 19-48 years, 43% female, 86% Caucasian) with heterogeneous anxiety disorders (i.e., panic disorder with or without agoraphobia, social anxiety, generalized anxiety) were assigned a randomized order of weeklong blocks utilizing either mindfulness- or avoidance-based strategies while ascending a 6-week emotion exposure hierarchy. Participants completed three exposures per block and provided distress and avoidance use ratings following each exposure. Anxiety severity, distress aversion, and distraction/suppression tendencies were also assessed at baseline and the conclusion of each block. Visual, descriptive, and effect size results showing exposures utilizing mindfulness were associated with higher overall distress levels, compared with those utilizing avoidance. Within blocks, the majority of participants exhibited declining distress levels when employing mindfulness strategies, as opposed to more static distress levels in the avoidance condition. Systematic changes in anxiety severity, distress aversion, and distraction/suppression were not observed. These results suggest mindfulness strategies may be effective in facilitating emotion exposure; however, a minimum dosage may be necessary to overcome initial distress elevation. Potential transdiagnostic change mechanisms and clinical implications are discussed. Copyright © 2015. Published by Elsevier Ltd.

  4. Efficiency of alternative MCMC strategies illustrated using the reaction norm model.

    Science.gov (United States)

    Shariati, M; Sorensen, D

    2008-06-01

    The Markov chain Monte Carlo (MCMC) strategy provides remarkable flexibility for fitting complex hierarchical models. However, when parameters are highly correlated in their posterior distributions and their number is large, a particular MCMC algorithm may perform poorly and the resulting inferences may be affected. The objective of this study was to compare the efficiency (in terms of the asymptotic variance of features of posterior distributions of chosen parameters, and in terms of computing cost) of six MCMC strategies to sample parameters using simulated data generated with a reaction norm model with unknown covariates as an example. The six strategies are single-site Gibbs updates (SG), single-site Gibbs sampler for updating transformed (a priori independent) additive genetic values (TSG), pairwise Gibbs updates (PG), blocked (all location parameters are updated jointly) Gibbs updates (BG), Langevin-Hastings (LH) proposals, and finally Langevin-Hastings proposals for updating transformed additive genetic values (TLH). The ranking of the methods in terms of asymptotic variance is affected by the degree of the correlation structure of the data and by the true values of the parameters, and no method comes out as an overall winner across all parameters. TSG and BG show very good performance in terms of asymptotic variance especially when the posterior correlation between genetic effects is high. In terms of computing cost, TSG performs best except for dispersion parameters in the low correlation scenario where SG was the best strategy. The two LH proposals could not compete with any of the Gibbs sampling algorithms. In this study it was not possible to find an MCMC strategy that performs optimally across the range of target distributions and across all possible values of parameters. However, when the posterior correlation between parameters is high, TSG, BG and even PG show better mixing than SG.

  5. Biosensor-based diagnostics of contaminated groundwater: assessment and remediation strategy

    International Nuclear Information System (INIS)

    Bhattacharyya, Jessica; Read, David; Amos, Sean; Dooley, Stephen; Killham, Kenneth; Paton, Graeme I.

    2005-01-01

    Shallow groundwater beneath a former airfield site in southern England has been heavily contaminated with a wide range of chlorinated solvents. The feasibility of using bacterial biosensors to complement chemical analysis and enable cost-effective, and focussed sampling has been assessed as part of a site evaluation programme. Five different biosensors, three metabolic (Vibrio fischeri, Pseudomonas fluorescens 10568 and Escherichia coli HB101) and two catabolic (Pseudomonas putida TVA8 and E. coli DH5α), were employed to identify areas where the availability and toxicity of pollutants is of most immediate environmental concern. The biosensors used showed different sensitivities to each other and to the groundwater samples tested. There was generally a good agreement with chemical analyses. The potential efficacy of remediation strategies was explored by coupling sample manipulation to biosensor tests. Manipulation involved sparging and charcoal treatment procedures to simulate remediative engineering solutions. Sparging was sufficient at most locations. - Luminescent bacteria complement chemical analysis and support remediation technology

  6. Evaluation of alternating pressure air mattresses: one laboratory-based strategy.

    Science.gov (United States)

    Rithalia, Shyam V

    2004-04-01

    Although many different type of alternating pressure air mattresses (APAMs) are used for the prevention and treatment of pressure ulcers, few high quality randomised controlled trials are available on which to base purchasing decisions. Faced with this situation, physiological measurements are increasingly being used as a surrogate. Laboratory evaluation techniques have centred largely on interface pressure (IP) measurement, typically analysing discrete maximum and minimum levels, or average pressure. However, since pressure relief is time varying, a time-based analysis technique may be more suitable for performance assessment. Measurements of IP, mattress air cell pressure (AP), skin tissue perfusion using laser Doppler fluxmetry (LDF), transcutaneous oxygen (tcPO2) and carbon dioxide (tcPCO2) were taken simultaneously on the sacrum, heels, trochanters and buttock over at least two alternating cycles. Duration of IP below three thresholds (30, 20, and 10 mmHg) as well as the area under the tcPO2, tcPCO2 and LDF curves were calculated automatically. Ten healthy volunteers were recruited to evaluate the pressure-relieving characteristics of two different designs of APAMs. Results indicated significant differences between the products. During the deflation phase of the cycle contact pressures on the heel were significantly lower (p pressure was significantly higher, although there was no significant difference in deflation pressure. Therefore, it is important to note that low APs do not necessarily produce lower IPs under the heel, contrary to the intuitive classical notion. These techniques could assist in the selection of alternating or dynamic surfaces of any description confirmed by further clinical validation.

  7. Alternative spawning strategy and temperature for larval emergence of longfin dace (Agosia chrysogaster) in stream mesocosms

    Energy Technology Data Exchange (ETDEWEB)

    Troia, Matthew J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Whitney, James E. [Kansas State Univ., Manhattan, KS (United States); Gido, Keith B. [Kansas State Univ., Manhattan, KS (United States)

    2014-06-01

    To determine if the strategy of spawning in saucer-like depressions is obligate or facultative for longfin dace (Agosia chrysogaster), we collected adults from four sites in the upper Gila River (southwestern New Mexico), stocked them in separate outdoor stream-mesocosms lined with cobble substrate, and made daily observations for the presence of saucer-nests and hatched larvae. Larvae were observed from three of the four mesocosms and emerged at temperatures ranging from 19.2 24.0 °C. Here, the absence of saucer-nests in all mesocosms throughout the study indicates that longfin dace can spawn over cobble substrate and have larvae hatch successfully, suggesting that longfin dace can use an alternate spawning strategy when sand substrate is not available for construction of saucer-nests.

  8. Efficiency of alternative MCMC strategies illustrated using the reaction norm model

    DEFF Research Database (Denmark)

    Shariati, Mohammad Mahdi; Sørensen, D.

    2008-01-01

    The Markov chain Monte Carlo (MCMC) strategy provides remarkable flexibility for fitting complex hierarchical models. However, when parameters are highly correlated in their posterior distributions and their number is large, a particular MCMC algorithm may perform poorly and the resulting...... norm model with unknown covariates as an example. The six strategies are single-site Gibbs updates (SG), single-site Gibbs sampler for updating transformed (a priori independent) additive genetic values (TSG), pairwise Gibbs updates (PG), blocked (all location parameters are updated jointly) Gibbs...... updates (BG), Langevin-Hastings (LH) proposals, and finally Langevin-Hastings proposals for updating transformed additive genetic values (TLH). The ranking of the methods in terms of asymptotic variance is affected by the degree of the correlation structure of the data and by the true values...

  9. Regenerative medicine provides alternative strategies for the treatment of anal incontinence

    DEFF Research Database (Denmark)

    Gräs, Søren; Tolstrup, Cæcilie Krogsgaard; Lose, Gunnar

    2017-01-01

    INTRODUCTION AND HYPOTHESIS: Anal incontinence is a common disorder but current treatment modalities are not ideal and the development of new treatments is needed. The aim of this review was to identify the existing knowledge of regenerative medicine strategies in the form of cellular therapies...... or bioengineering as a treatment for anal incontinence caused by anal sphincter defects. METHODS: PubMed was searched for preclinical and clinical studies in English published from January 2005 to January 2016. RESULTS: Animal studies have demonstrated that cellular therapy in the form of local injections...... cells stimulate repair of sphincter injuries, and a complex bioengineering strategy for creation and implantation of an intrinsically innervated internal anal sphincter construct has been successfully developed in a series of animal studies. CONCLUSION: Cellular therapies with myogenic cells...

  10. The Henry-Saltwater Intrusion Benchmark – Alternatives in Multiphysics Formulations and Solution Strategies

    Directory of Open Access Journals (Sweden)

    E Holzbecher

    2016-03-01

    Full Text Available In a classical paper Henry set up a conceptual model for simulating saltwater intrusion into coastal aquifers. Up to now the problem has been taken up by software developers and modellers as a benchmark for codes simulating coupled flow and transport in porous media. The Henry test case has been treated using different numerical methods based on various formulations of differential equations. We compare several of these approaches using multiphysics software. We model the problem using Finite Elements, utilizing the primitive variables and the streamfunction approach, both with and without using the Oberbeck-Boussinesq assumption. We compare directly coupled solvers with segregated solver strategies. Changing finite element orders and mesh refinement, we find that models based on the streamfunction converge 2-4 times faster than runs based on primitive variables. Concerning the solution strategy, we find an advantage of Picard iterations compared to monolithic Newton iterations.

  11. Cloak and Dagger: Alternative Immune Evasion and Modulation Strategies of Poxviruses.

    Science.gov (United States)

    Bidgood, Susanna R; Mercer, Jason

    2015-08-21

    As all viruses rely on cellular factors throughout their replication cycle, to be successful they must evolve strategies to evade and/or manipulate the defence mechanisms employed by the host cell. In addition to their expression of a wide array of host modulatory factors, several recent studies have suggested that poxviruses may have evolved unique mechanisms to shunt or evade host detection. These potential mechanisms include mimicry of apoptotic bodies by mature virions (MVs), the use of viral sub-structures termed lateral bodies for the packaging and delivery of host modulators, and the formation of a second, "cloaked" form of infectious extracellular virus (EVs). Here we discuss these various strategies and how they may facilitate poxvirus immune evasion. Finally we propose a model for the exploitation of the cellular exosome pathway for the formation of EVs.

  12. Cloak and Dagger: Alternative Immune Evasion and Modulation Strategies of Poxviruses

    Directory of Open Access Journals (Sweden)

    Susanna R. Bidgood

    2015-08-01

    Full Text Available As all viruses rely on cellular factors throughout their replication cycle, to be successful they must evolve strategies to evade and/or manipulate the defence mechanisms employed by the host cell. In addition to their expression of a wide array of host modulatory factors, several recent studies have suggested that poxviruses may have evolved unique mechanisms to shunt or evade host detection. These potential mechanisms include mimicry of apoptotic bodies by mature virions (MVs, the use of viral sub-structures termed lateral bodies for the packaging and delivery of host modulators, and the formation of a second, “cloaked” form of infectious extracellular virus (EVs. Here we discuss these various strategies and how they may facilitate poxvirus immune evasion. Finally we propose a model for the exploitation of the cellular exosome pathway for the formation of EVs.

  13. Decision-Making about Healthcare Related Tests and Diagnostic Strategies: User Testing of GRADE Evidence Tables.

    Directory of Open Access Journals (Sweden)

    Reem A Mustafa

    Full Text Available To develop guidance on what information to include and how to present it in tables summarizing the evidence from systematic reviews of test accuracy following the Grading of Recommendations Assessment, Development and Evaluation (GRADE approach.To design and refine the evidence tables, we used an iterative process based on the analysis of data from four rounds of discussions, feedback and user testing. During the final round, we conducted one-on-one user testing with target end users. We presented a number of alternative formats of evidence tables to participants and obtained information about users' understanding and preferences.More than 150 users participated in initial discussions and provided their formal and informal feedback. 20 users completed one-on-one user testing interviews. Almost all participants preferred summarizing the results of systematic reviews of test accuracy in tabular format rather than plain text. Users generally preferred less complex tables but found presenting sensitivity and specificity estimates only as too simplistic. Users found the presentation of test accuracy for several values of prevalence initially confusing but modifying table layout and adding sample clinical scenarios for each prevalence reduced this confusion. Providing information about clinical consequences of testing result was viewed as not feasible for authors of systematic reviews.We present the current formats for tables presenting test accuracy following the GRADE approach. These tables can be developed using GRADEpro guidelines development tool (www.guidelinedevelopment.org or www.gradepro.org and are being further developed into electronic interactive tables that will suit the needs of different end users. The formatting of these tables, and how they influence result interpretation and decision-making will be further evaluated in a randomized trial.

  14. Greening the Mixture: An Evaluation of the Department of Defense’s Alternative Aviation Fuel Strategy

    Science.gov (United States)

    2012-06-08

    from coal sources produces twice the amount of greenhouse gasses than petroleum production, of which half is carbon dioxide.26 There are two processes...55 APPENDIX B Assessment of National Mandates and Defense Fuel Strategy .................56 APPENDIX C Normalized Lifecycle Greenhouse Gas...GHG Greenhouse Gas HRJ Hydrotreated Renewable Jet JP Jet Propellant LUC Land-use-change MIT Massachusetts Institute of Technology NDAA National

  15. Towards an appropriate malaria control strategy: issues of concern and alternatives for action.

    Science.gov (United States)

    Seghal, P N

    1997-01-01

    A resurgence of malaria in India prompted formation of a Malaria Expert Group, which met in 1996 to formulate an appropriate malaria control strategy. An estimated 20-30 million episodes of malaria occur in India each year. Since malaria is an exclusively focal phenomenon, strategies should be responsive to the epidemiologic characteristics of the five ecotypes: tribal, rural, urban, industrial, and border. Also needed are flexible, individualized strategies for development project areas and Triple Insecticide Resistance Areas. Most malaria deaths are attributable to delayed diagnosis and treatment. Recommended are streamlined logistics for laboratory supplies, monitoring of anti-malarial drugs for possible resistance, training of nongovernmental organizations to open peripheral laboratories, rigorous training for laboratory technicians in malaria diagnosis, training of supervisors for laboratory work and cross-checking of findings, and establishment of graded laboratory facilities for different levels of the health care delivery system. Integration of malaria control into India's primary health care system will require community participation, appropriate technology, intersectoral coordination, and social equity.

  16. Management strategies to curb rhino poaching: Alternative options using a cost benefit approach

    Directory of Open Access Journals (Sweden)

    Sam M. Ferreira

    2014-05-01

    Full Text Available The combination of increasing demand and high black market prices for rhino horn in Asian markets has fueled an escalation in rhino poaching since 2007, particularly in South Africa. This situation has in turn resulted in greatly increased rhino protection costs, loss in confidence by the private sector in rhinos, loss of revenue to conservation authorities and reduced rhino population growth rates. Within current CITES processes, management responses to threats posed by poaching to rhino persistence fall within a mixture of reactive responses of increased protection and law enforcement and some pro-active responses such as demand reduction tactics, along with a parallel call for opening a legal trade in horn. These rhino management strategies carry different risks and benefits in meeting several conservation objectives. An expert-based risk-benefit analysis of five different rhino management strategies was undertaken to assess their potential for delivering upon agreed rhino conservation objectives. The outcomes indicated that benefits may exceed risks for those strategies that in some or other format legally provided horn for meeting demand. Expert risk-benefit approaches are suggested to offer a rational, inclusive and consensus generating means of addressing complex issues such as rhino poaching and augmenting the information used within the CITES decision-making processes.

  17. Prospects for a nicotine-reduction strategy in the cigarette endgame: Alternative tobacco harm reduction scenarios.

    Science.gov (United States)

    Kozlowski, Lynn T

    2015-06-01

    Some major national and international tobacco control organisations favour mandating a reduction in nicotine content of cigarettes to non-addictive levels as a tobacco control tool. Reducing nicotine content, it is argued, will make tobacco smoking less attractive. The 2009 U.S. Food and Drug Administration's regulation of cigarettes appears to have the power to reduce nicotine to non-addictive levels provided it is not taken to zero. A consideration of the U.S. context, however, raises doubts about (a) whether this will ever be practicable and (b), if practicable, how long it will take to implement. Current versions of the nicotine-reducing strategy propose the systematic, incentivised use of less harmful nicotine/tobacco products as elements of the mandatory cigarette nicotine-reduction strategy. Time will tell if and when mandatory nicotine reduction in tobacco cigarettes will occur and what impact it might have on smoking prevalence. The question posed here is "Why wait?" Resources used in implementing reduction in nicotine content have an opportunity cost. In the meantime, nicotine-maintaining harm reduction strategies can have nearer term effects on tobacco use as an individual and a public health issue. Copyright © 2015 The Author. Published by Elsevier B.V. All rights reserved.

  18. An Alternative Evacuation Framework to Improve Protective-action Strategies Following a Nuclear Power Accident: The Adaptive Protective Action Zone

    Science.gov (United States)

    Hammond, Gregory D.

    Within the U.S. current protective-action strategies to safeguard the public following a nuclear power accident have remained largely unchanged since their implementation in the early 1980s. In the past thirty years, new technologies have been introduced allowing faster computations, better modeling of predicted radiological consequences, and improved accident mapping with geographic information systems (GIS). Utilizing these new technologies, we evaluate the efficacy of alternative strategies, called adaptive protective action zones (APAZs), that use site-specific and event-specific data to dynamically determine evacuation boundaries with simple heuristics in order to better inform protective action decisions (rather than relying on pre-event regulatory bright lines). Several candidate APAZs were developed and then compared to the Nuclear Regulatory Commission's keyhole evacuation strategy (and full evacuation of the emergency planning zone). Two of the APAZs were better on average than existing NRC strategies at reducing either the radiological exposure, the population evacuated, or both. These APAZs are especially effective for larger radioactive plumes and at high population sites; one of them is better at reducing radiation exposure, while the other is better at reducing the population evacuated. However, should policy makers decide that the benefits of APAZs outweigh the costs of implementation, APAZ adoption by U.S. regulatory agencies should be accompanied by a revision to the nuclear-power plant emergency planning basis, and revisions to local nuclear power emergency response planning areas.

  19. A strategy for molecular diagnostics of Fanconi anemia in Brazilian patients.

    Science.gov (United States)

    Pilonetto, Daniela V; Pereira, Noemi F; Bonfim, Carmem M S; Ribeiro, Lisandro L; Bitencourt, Marco A; Kerkhoven, Lianne; Floor, Karijn; Ameziane, Najim; Joenje, Hans; Gille, Johan J P; Pasquini, Ricardo

    2017-07-01

    Fanconi anemia (FA) is a predominantly autosomal recessive disease with wide genetic heterogeneity resulting from mutations in several DNA repair pathway genes. To date, 21 genetic subtypes have been identified. We aimed to identify the FA genetic subtypes in the Brazilian population and to develop a strategy for molecular diagnosis applicable to routine clinical use. We screened 255 patients from Hospital de Clínicas, Universidade Federal do Paraná for 11 common FA gene mutations. Further analysis by multiplex ligation-dependent probe amplification (MLPA) for FANCA and Sanger sequencing of all coding exons of FANCA , -C , and - G was performed in cases who harbored a single gene mutation. We identified biallelic mutations in 128/255 patients (50.2%): 89, 11, and 28 carried FANCA , FANCC , and FANCG mutations, respectively. Of these, 71 harbored homozygous mutations, whereas 57 had compound heterozygous mutations. In 4/57 heterozygous patients, both mutations were identified by the initial screening, in 51/57 additional analyses was required for classification, and in 2/57 the second mutation remained unidentified. We found 52 different mutations of which 22 were novel. The proposed method allowed genetic subtyping of 126/255 (49.4%) patients at a significantly reduced time and cost, which makes molecular diagnosis of FA Brazilian patients feasible.

  20. Invasive Candidiasis in Various Patient Populations: Incorporating Non-Culture Diagnostic Tests into Rational Management Strategies

    Science.gov (United States)

    Clancy, Cornelius J.; Shields, Ryan K.; Nguyen, M. Hong

    2016-01-01

    Mortality rates due to invasive candidiasis remain unacceptably high, in part because the poor sensitivity and slow turn-around time of cultures delay the initiation of antifungal treatment. β-d-glucan (Fungitell) and polymerase chain reaction (PCR)-based (T2Candida) assays are FDA-approved adjuncts to cultures for diagnosing invasive candidiasis, but their clinical roles are unclear. We propose a Bayesian framework for interpreting non-culture test results and developing rational patient management strategies, which considers test performance and types of invasive candidiasis that are most common in various patient populations. β-d-glucan sensitivity/specificity for candidemia and intra-abdominal candidiasis is ~80%/80% and ~60%/75%, respectively. In settings with 1%–10% likelihood of candidemia, anticipated β-d-glucan positive and negative predictive values are ~4%–31% and ≥97%, respectively. Corresponding values in settings with 3%–30% likelihood of intra-abdominal candidiasis are ~7%–51% and ~78%–98%. β-d-glucan is predicted to be useful in guiding antifungal treatment for wide ranges of populations at-risk for candidemia (incidence ~5%–40%) or intra-abdominal candidiasis (~7%–20%). Validated PCR-based assays should broaden windows to include populations at lower-risk for candidemia (incidence ≥~2%) and higher-risk for intra-abdominal candidiasis (up to ~40%). In the management of individual patients, non-culture tests may also have value outside of these windows. The proposals we put forth are not definitive treatment guidelines, but rather represent starting points for clinical trial design and debate by the infectious diseases community. The principles presented here will be applicable to other assays as they enter the clinic, and to existing assays as more data become available from different populations. PMID:29376927

  1. Invasive Candidiasis in Various Patient Populations: Incorporating Non-Culture Diagnostic Tests into Rational Management Strategies

    Directory of Open Access Journals (Sweden)

    Cornelius J. Clancy

    2016-02-01

    Full Text Available Mortality rates due to invasive candidiasis remain unacceptably high, in part because the poor sensitivity and slow turn-around time of cultures delay the initiation of antifungal treatment. β-d-glucan (Fungitell and polymerase chain reaction (PCR-based (T2Candida assays are FDA-approved adjuncts to cultures for diagnosing invasive candidiasis, but their clinical roles are unclear. We propose a Bayesian framework for interpreting non-culture test results and developing rational patient management strategies, which considers test performance and types of invasive candidiasis that are most common in various patient populations. β-d-glucan sensitivity/specificity for candidemia and intra-abdominal candidiasis is ~80%/80% and ~60%/75%, respectively. In settings with 1%–10% likelihood of candidemia, anticipated β-d-glucan positive and negative predictive values are ~4%–31% and ≥97%, respectively. Corresponding values in settings with 3%–30% likelihood of intra-abdominal candidiasis are ~7%–51% and ~78%–98%. β-d-glucan is predicted to be useful in guiding antifungal treatment for wide ranges of populations at-risk for candidemia (incidence ~5%–40% or intra-abdominal candidiasis (~7%–20%. Validated PCR-based assays should broaden windows to include populations at lower-risk for candidemia (incidence ≥~2% and higher-risk for intra-abdominal candidiasis (up to ~40%. In the management of individual patients, non-culture tests may also have value outside of these windows. The proposals we put forth are not definitive treatment guidelines, but rather represent starting points for clinical trial design and debate by the infectious diseases community. The principles presented here will be applicable to other assays as they enter the clinic, and to existing assays as more data become available from different populations.

  2. First meeting "Cystic echinococcosis in Chile, update in alternatives for control and diagnostics in animals and humans".

    Science.gov (United States)

    Alvarez Rojas, Cristian A; Fredes, Fernando; Torres, Marisa; Acosta-Jamett, Gerardo; Alvarez, Juan Francisco; Pavletic, Carlos; Paredes, Rodolfo; Cortés, Sandra

    2016-09-13

    This report summarizes the outcomes of a meeting on cystic echinococcosis (CE) in animals and humans in Chile held in Santiago, Chile, between the 21st and 22nd of January 2016. The meeting participants included representatives of the Departamento de Zoonosis, Ministerio de Salud (Zoonotic Diseases Department, Ministry of Health), representatives of the Secretarias Regionales del Ministerio de Salud (Regional Department of Health, Ministry of Health), Instituto Nacional de Desarrollo Agropecuario (National Institute for the Development of Agriculture and Livestock, INDAP), Instituto de Salud Pública (National Institute for Public Health, ISP) and the Servicio Agrícola y Ganadero (Animal Health Department, SAG), academics from various universities, veterinarians and physicians. Current and future CE control activities were discussed. It was noted that the EG95 vaccine was being implemented for the first time in pilot control programmes, with the vaccine scheduled during 2016 in two different regions in the South of Chile. In relation to use of the vaccine, the need was highlighted for acquiring good quality data, based on CE findings at slaughterhouse, previous to initiation of vaccination so as to enable correct assessment of the efficacy of the vaccine in the following years. The current world's-best-practice concerning the use of ultrasound as a diagnostic tool for the screening population in highly endemic remote and poor areas was also discussed.

  3. Environmental assessment of alternative municipal solid waste management strategies. A Spanish case study.

    Science.gov (United States)

    Bovea, M D; Ibáñez-Forés, V; Gallardo, A; Colomer-Mendoza, F J

    2010-11-01

    The aim of this study is to compare, from an environmental point of view, different alternatives for the management of municipal solid waste generated in the town of Castellón de la Plana (Spain). This town currently produces 207 ton of waste per day and the waste management system employed today involves the collection of paper/cardboard, glass and light packaging from materials banks and of rest waste at street-side containers. The proposed alternative scenarios were based on a combination of the following elements: selective collection targets to be accomplished by the year 2015 as specified in the Spanish National Waste Plan (assuming they are reached to an extent of 50% and 100%), different collection models implemented nationally, and diverse treatments of both the separated biodegradable fraction and the rest waste to be disposed of on landfills. This resulted in 24 scenarios, whose environmental behaviour was studied by applying the life cycle assessment methodology. In accordance with the ISO 14040-44 (2006) standard, an inventory model was developed for the following stages of the waste management life cycle: pre-collection (bags and containers), collection, transport, pre-treatment (waste separation) and treatment/disposal (recycling, composting, biogasification+composting, landfill with/without energy recovery). Environmental indicators were obtained for different impact categories, which made it possible to identify the key variables in the waste management system and the scenario that offers the best environmental behaviour. Finally, a sensitivity analysis was used to test some of the assumptions made in the initial life cycle inventory model. Copyright © 2010 Elsevier Ltd. All rights reserved.

  4. Biosolids management strategies: an evaluation of energy production as an alternative to land application.

    Science.gov (United States)

    Egan, Maureen

    2013-07-01

    Currently, more than half of the biosolids produced within the USA are land applied. Land application of biosolids introduces organic contaminants into the environment. There are potential ecological and human health risks associated with land application of biosolids. Biosolids may be used as a renewable energy source. Nutrients may be recovered from biosolids used for energy generation for use as fertilizer. The by-products of biosolids energy generation may be used beneficially in construction materials. It is recommended that energy generation replace land application as the leading biosolids management strategy.

  5. Lesbian Continuum As An Alternative Strategy In Negotiating Heteronormativity In Sarah Water’s Fingersmith

    Directory of Open Access Journals (Sweden)

    Mega Hayuningtyas Erwanti

    2015-12-01

    Full Text Available This study is conducted to examine the portrayal of a lesbian continuum in Sarah Waters’ Fingersmith. To conduct the analysis, there are two research questions: first, how is the construction of lesbian continuum portrayed in the relationship between Susan Trinder and Maud Lilly and how does lesbian continuum become a strategy to negotiate compulsory heterosexuality. In doing the analysis, the theory of lesbian continuum which is proposed by Adrienne Rich will be used to elaborate the novel. This study is a qualitative research where the data are taken from the novel Fingersmith, library research, journals, and other relevant sources. To gain the comprehensive analysis, this study uses some methods which are: close reading, postulation the statements of the problems, data classification, and analysis using the lesbian continuum theory, supporting analysis through library research, books, and academic journals. This study finds that the characters of Susan Trinder and Maud Lilly can be identified as having a double life which constructs the lesbian continuum. Moreover, the lesbian continuum becomes a strategy to negotiate compulsory heterosexuality with denial and negotiation of women’s oppression. Abstrak: Artikel ini mengkaji representasi lesbian continuum dalam novel Sarah Waters yang berjudul Fingersmith. Dua pertanyaan utama penelitian ini adalah (1 bagaimana konstruksi lesbian continuum direpresentasikan dalam hubungan antara tokoh Susan Trinder dan Maud Lily dalam novel Fingersmith dan (2 bagaimana lesbian continuum menjadi strategi untuk menghadapi compulsory heterosexuality dalam novel Fingersmith. Teori lesbian continuum oleh Adrienne Rich akan menjadi teori utama untuk menjawab pertanyaan penelitian. Menggunakan teknik pembacaan novel dan analisis pustaka yang bersumber dari jurnal dan sumber lain yang mendukung. Untuk mendapatkan data yang komprehensip, metode yang dipakai adalah close reading, menjabarkan pertanyaan, klasifikasi

  6. [Impact of prostate volume on the diagnostic value of prostate cancer with different biopsy strategies].

    Science.gov (United States)

    Yu, Wei; Pattar, Abudurahman; He, Qun; Shan, Gang-zhi; Jin, Jie

    2010-08-18

    To assess impact of different prostate biopsy strategies according to prostate volume on tumor detection. A total of 323 consecutive men with suspected prostate cancer were included in the study. Indications for transrectal ultrasound guided prostate biopsy were: abnormal digital rectal examination (DRE, 52 cases) and/or a total prostate specific antigen (PSA) over 4.0 microg/L (305 cases). In the subjects, their ages were between 49 years and 90 years, the mean: 69 years; PSAs were between 0.6 microg/L and 142.5 microg/L, the mean: 20.8 microg/L; and the prostate volumes were between 12.3 mL and 255.5 mL, the mean: 60.4 mL. Transrectal ultrasound guided prostate biopsy of 13 core scheme was conducted in each patient. The cancer detection rate for each biopsy core was calculated. The sensitivities of different combinations of biopsy cores were compared with a 13 core biopsy protocol and the prostate volumes were divided into two groups (or=50 mL). The optimum number of biopsy cores was determined in patients with different prostate volumes. Of the 323 patients 120 (37.2%) were positive for prostate cancer. Compared to the patients with a prostate volumeor=50 mL decreased significantly (51.0% vs 26.1%). In patients with a prostate volume smaller than 50 mL, the 8 core biopsy protocol consisting of the apex, mid gland, base, lateral mid gland or of the apex, mid gland, lateral mid gland, lateral base of the prostate revealed the results similar to those of the 13 core biopsy protocol (sensitivities: 98.6% and 97.3%, both P>0.05). In the larger prostate volume group, 10 core biopsy protocol that included cores at the apex, mid gland, base, lateral mid gland and lateral base detected 97.6% of cancers (P>0.05). Patients with larger prostates have lower cancer detection rates. For patients with prostate volume smaller than 50 mL, 8 core biopsy protocol consisting of the apex, mid gland, base, lateral mid gland or of the apex, mid gland, lateral mid gland, lateral base of

  7. Wings versus legs in the avian bauplan: development and evolution of alternative locomotor strategies.

    Science.gov (United States)

    Heers, Ashley M; Dial, Kenneth P

    2015-02-01

    Wings have long been regarded as a hallmark of evolutionary innovation, allowing insects, birds, and bats to radiate into aerial environments. For many groups, our intuitive and colloquial perspective is that wings function for aerial activities, and legs for terrestrial, in a relatively independent manner. However, insects and birds often engage their wings and legs cooperatively. In addition, the degree of autonomy between wings and legs may be constrained by tradeoffs, between allocating resources to wings versus legs during development, or between wing versus leg investment and performance (because legs must be carried as baggage by wings during flight and vice versa). Such tradeoffs would profoundly affect the development and evolution of locomotor strategies, and many related aspects of animal ecology. Here, we provide the first evaluation of wing versus leg investment, performance and relative use, in birds-both across species, and during ontogeny in three precocial species with different ecologies. Our results suggest that tradeoffs between wing and leg modules help shape ontogenetic and evolutionary trajectories, but can be offset by recruiting modules cooperatively. These findings offer a new paradigm for exploring locomotor strategies of flying organisms and their extinct precursors, and thereby elucidating some of the most spectacular diversity in animal history. © 2014 The Author(s). Evolution © 2014 The Society for the Study of Evolution.

  8. Alternative Assessment Strategy and Its Impact on Student Comprehension in an Undergraduate Microbiology Course

    Directory of Open Access Journals (Sweden)

    Barry J. Margulies

    2009-12-01

    Full Text Available Medical Microbiology is a content-intensive course that requires a large time commitment from the students. Students are typically biology or prenursing majors, including students headed for professional schools, such as medical school and pharmacy school. This group is somewhat diverse in terms of background science coursework, so it can be difficult to teach in a way that benefits all the students. Numerous changes have been implemented in our microbiology curriculum to address the different abilities of our students by altering assessment and teaching strategies. It was hypothesized that changing the assessment strategy from the traditional scheme of two or three exams and one final to a new model of seven or eight shorter exams would have a positive impact on student comprehension and retention. The quantity of material taught or expected of the students to learn did not change, but there was definitely an impact on them. Although 30.0% of students routinely did not pass microbiology in previous semesters, the new method of assessment resulted in only 9.63% not completing the semester successfully, as determined by earning a grade of C or better. There is some evidence from conversations and interviews with students that indicates a positive impact of this methodology on student attitude. Implementation of these changes in other courses and their current effectiveness will be examined in the future, with an eye towards more broadly applicable successful teaching techniques in the sciences, especially for nonmajors.

  9. Analysis of climatic conditions and preliminary assessment of alternative cooling strategies for houses in California transition climate zones

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Y.J.; Zhang, H.

    1995-07-01

    This is a preliminary scoping study done as part of the {open_quotes}Alternatives to Compressive Cooling in California Transition Climates{close_quotes} project, which has the goal of demonstrating that houses in the transitional areas between the coast and the Central Valley of California do not require air-conditioning if they are properly designed and operated. The first part of this report analyzes the climate conditions within the transitional areas, with emphasis on design rather than seasonal conditions. Transitional climates are found to be milder but more variable than those further inland. The design temperatures under the most stringent design criteria, e.g. 0.1 % annual, are similar to those in the Valley, but significantly lower under more relaxed design criteria, e.g., 2% annual frequency. Transition climates also have large day-night temperature swings, indicating significant potential for night cooling, and wet-bulb depressions in excess of 25 F, indicating good potential for evaporative cooling. The second part of the report is a preliminary assessment using DOE-2 computer simulations of the effectiveness of alternative cooling and control strategies in improving indoor comfort conditions in two conventional Title-24 houses modeled in various transition climate locations. The cooling measures studied include increased insulation, light colors, low-emissivity glazing, window overhangs, and exposed floor slab. The control strategies studied include natural and mechanical ventilation, and direct and two-stage evaporative cooling. The results indicate the cooling strategies all have limited effectiveness, and need to be combined to produce significant improvements in indoor comfort. Natural and forced ventilation provide similar improvements in indoor conditions, but during peak cooling periods, these will still be above the comfort zone. Two-stage evaporative coolers can maintain indoor comfort at all hours, but not so direct evaporative coolers.

  10. Alternating current electrical stimulation enhanced chemotherapy: a novel strategy to bypass multidrug resistance in tumor cells

    International Nuclear Information System (INIS)

    Janigro, Damir; Perju, Catalin; Fazio, Vincent; Hallene, Kerri; Dini, Gabriele; Agarwal, Mukesh K; Cucullo, Luca

    2006-01-01

    Tumor burden can be pharmacologically controlled by inhibiting cell division and by direct, specific toxicity to the cancerous tissue. Unfortunately, tumors often develop intrinsic pharmacoresistance mediated by specialized drug extrusion mechanisms such as P-glycoprotein. As a consequence, malignant cells may become insensitive to various anti-cancer drugs. Recent studies have shown that low intensity very low frequency electrical stimulation by alternating current (AC) reduces the proliferation of different tumor cell lines by a mechanism affecting potassium channels while at intermediate frequencies interfere with cytoskeletal mechanisms of cell division. The aim of the present study is to test the hypothesis that permeability of several MDR1 over-expressing tumor cell lines to the chemotherapic agent doxorubicin is enhanced by low frequency, low intensity AC stimulation. We grew human and rodent cells (C6, HT-1080, H-1299, SKOV-3 and PC-3) which over-expressed MDR1 in 24-well Petri dishes equipped with an array of stainless steel electrodes connected to a computer via a programmable I/O board. We used a dedicated program to generate and monitor the electrical stimulation protocol. Parallel cultures were exposed for 3 hours to increasing concentrations (1, 2, 4, and 8 μM) of doxorubicin following stimulation to 50 Hz AC (7.5 μA) or MDR1 inhibitor XR9576. Cell viability was assessed by determination of adenylate kinase (AK) release. The relationship between MDR1 expression and the intracellular accumulation of doxorubicin as well as the cellular distribution of MDR1 was investigated by computerized image analysis immunohistochemistry and Western blot techniques. By the use of a variety of tumor cell lines, we show that low frequency, low intensity AC stimulation enhances chemotherapeutic efficacy. This effect was due to an altered expression of intrinsic cellular drug resistance mechanisms. Immunohistochemical, Western blot and fluorescence analysis revealed

  11. Laboratory Evolution to Alternating Substrate Environments Yields Distinct Phenotypic and Genetic Adaptive Strategies

    DEFF Research Database (Denmark)

    Sandberg, Troy E.; Lloyd, Colton J.; Palsson, Bernhard O.

    2017-01-01

    and specialists, in one case being completely abolished, while gene expression data distinguished the transcriptional strategies implemented by strains in pursuit of growth optimality. Genome-scale metabolic modeling techniques were then used to help explain the inherent substrate differences giving rise...... applications.IMPORTANCE Evolution and natural selection inexorably lead to an organism's improved fitness in a given environment, whether in a laboratory or natural setting. However, despite the frequent natural occurrence of complex and dynamic growth environments, laboratory evolution experiments typically...... of evolved strains via a number of different data types revealed the various genetic and phenotypic changes implemented in pursuit of growth optimality and how these differed across the different growth substrates and switching protocols. This work not only helps to establish general principles of adaptation...

  12. The effect of alternative permutation testing strategies on the performance of multifactor dimensionality reduction

    Directory of Open Access Journals (Sweden)

    Motsinger-Reif Alison A

    2008-12-01

    Full Text Available Abstract Background Multifactor Dimensionality Reduction (MDR is a novel method developed to detect gene-gene interactions in case-control association analysis by exhaustively searching multi-locus combinations. While the end-goal of analysis is hypothesis generation, significance testing is employed to indicate statistical interest in a resulting model. Because the underlying distribution for the null hypothesis of no association is unknown, non-parametric permutation testing is used. Lately, there has been more emphasis on selecting all statistically significant models at the end of MDR analysis in order to avoid missing a true signal. This approach opens up questions about the permutation testing procedure. Traditionally omnibus permutation testing is used, where one permutation distribution is generated for all models. An alternative is n-locus permutation testing, where a separate distribution is created for each n-level of interaction tested. Findings In this study, we show that the false positive rate for the MDR method is at or below a selected alpha level, and demonstrate the conservative nature of omnibus testing. We compare the power and false positive rates of both permutation approaches and find omnibus permutation testing optimal for preserving power while protecting against false positives. Conclusion Omnibus permutation testing should be used with the MDR method.

  13. The effect of alternative permutation testing strategies on the performance of multifactor dimensionality reduction

    Science.gov (United States)

    Motsinger-Reif, Alison A

    2008-01-01

    Background Multifactor Dimensionality Reduction (MDR) is a novel method developed to detect gene-gene interactions in case-control association analysis by exhaustively searching multi-locus combinations. While the end-goal of analysis is hypothesis generation, significance testing is employed to indicate statistical interest in a resulting model. Because the underlying distribution for the null hypothesis of no association is unknown, non-parametric permutation testing is used. Lately, there has been more emphasis on selecting all statistically significant models at the end of MDR analysis in order to avoid missing a true signal. This approach opens up questions about the permutation testing procedure. Traditionally omnibus permutation testing is used, where one permutation distribution is generated for all models. An alternative is n-locus permutation testing, where a separate distribution is created for each n-level of interaction tested. Findings In this study, we show that the false positive rate for the MDR method is at or below a selected alpha level, and demonstrate the conservative nature of omnibus testing. We compare the power and false positive rates of both permutation approaches and find omnibus permutation testing optimal for preserving power while protecting against false positives. Conclusion Omnibus permutation testing should be used with the MDR method. PMID:19116021

  14. The effect of alternative permutation testing strategies on the performance of multifactor dimensionality reduction.

    Science.gov (United States)

    Motsinger-Reif, Alison A

    2008-12-30

    Multifactor Dimensionality Reduction (MDR) is a novel method developed to detect gene-gene interactions in case-control association analysis by exhaustively searching multi-locus combinations. While the end-goal of analysis is hypothesis generation, significance testing is employed to indicate statistical interest in a resulting model. Because the underlying distribution for the null hypothesis of no association is unknown, non-parametric permutation testing is used. Lately, there has been more emphasis on selecting all statistically significant models at the end of MDR analysis in order to avoid missing a true signal. This approach opens up questions about the permutation testing procedure. Traditionally omnibus permutation testing is used, where one permutation distribution is generated for all models. An alternative is n-locus permutation testing, where a separate distribution is created for each n-level of interaction tested. In this study, we show that the false positive rate for the MDR method is at or below a selected alpha level, and demonstrate the conservative nature of omnibus testing. We compare the power and false positive rates of both permutation approaches and find omnibus permutation testing optimal for preserving power while protecting against false positives. Omnibus permutation testing should be used with the MDR method.

  15. Influence of Nanotoxicity on Human Health and Environment: The Alternative Strategies.

    Science.gov (United States)

    Viswanath, Buddolla; Kim, Sanghyo

    Currently, nanotechnology revolutionizing both scientific and industrial community due to their applications in the fields of medicine, environmental protection, energy, and space exploration. Despite of the evident benefits of nanoparticles, there are still open questions about the influence of these nanoparticles on human health and environment. This is one of the critical issues that have to be addressed in the near future, before massive production of nanomaterials. Manufactured nanoparticles, which are finding ever-increasing applications in industry and consumer products fall into the category of emerging contaminants with ecological and toxicological effects on populations, communities and ecosystems. The existing experimental knowledge gave evidence that inhaled nanoparticles are less efficiently separated than larger particles by the macrophage clearance mechanisms and these nanoparticles are known to translocate through the lymphatic, circulatory and nervous systems to many tissues and organs, including the brain. In this review we highlight adverse impacts of nanoparticles on human and the environment with special emphasis on green nanoscience as a sustainable alternative.

  16. Inducing the Alternative Oxidase Forms Part of the Molecular Strategy of Anoxic Survival in Freshwater Bivalves

    Directory of Open Access Journals (Sweden)

    Maria S. Yusseppone

    2018-02-01

    Full Text Available Hypoxia in freshwater ecosystems is spreading as a consequence of global change, including pollution and eutrophication. In the Patagonian Andes, a decline in precipitation causes reduced lake water volumes and stagnant conditions that limit oxygen transport and exacerbate hypoxia below the upper mixed layer. We analyzed the molecular and biochemical response of the North Patagonian bivalve Diplodon chilensis after 10 days of experimental anoxia (<0.2 mg O2/L, hypoxia (2 mg O2/L, and normoxia (9 mg O2/L. Specifically, we investigated the expression of an alternative oxidase (AOX pathway assumed to shortcut the regular mitochondrial electron transport system (ETS during metabolic rate depression (MRD in hypoxia-tolerant invertebrates. Whereas, the AOX system was strongly upregulated during anoxia in gills, ETS activities and energy mobilization decreased [less transcription of glycogen phosphorylase (GlyP and succinate dehydrogenase (SDH in gills and mantle]. Accumulation of succinate and induction of malate dehydrogenase (MDH activity could indicate activation of anaerobic mitochondrial pathways to support anoxic survival in D. chilensis. Oxidative stress [protein carbonylation, glutathione peroxidase (GPx expression] and apoptotic intensity (caspase 3/7 activity decreased, whereas an unfolded protein response (HSP90 was induced under anoxia. This is the first clear evidence of the concerted regulation of the AOX and ETS genes in a hypoxia-tolerant freshwater bivalve and yet another example that exposure to hypoxia and anoxia is not necessarily accompanied by oxidative stress in hypoxia-tolerant mollusks.

  17. 'Doctor Google' ending the diagnostic odyssey in lysosomal storage disorders: parents using internet search engines as an efficient diagnostic strategy in rare diseases.

    Science.gov (United States)

    Bouwman, Machtelt G; Teunissen, Quirine G A; Wijburg, Frits A; Linthorst, Gabor E

    2010-08-01

    The expansion of the internet has resulted in widespread availability of medical information for both patients and physicians. People increasingly spend time on the internet searching for an explanation, diagnosis or treatment for their symptoms. Regarding rare diseases, the use of the internet may be an important tool in the diagnostic process. The authors present two cases in which concerned parents made a correct diagnosis of a lysosomal storage disorder in their child by searching the internet after a long doctor's delay. These cases illustrate the utility of publicly available internet search engines in diagnosing rare disorders and in addition illustrate the lengthy diagnostic odyssey which is common in these disorders.

  18. Revisiting the two-layer hypothesis: coexistence of alternative functional rooting strategies in savannas.

    Directory of Open Access Journals (Sweden)

    Ricardo M Holdo

    Full Text Available The two-layer hypothesis of tree-grass coexistence posits that trees and grasses differ in rooting depth, with grasses exploiting soil moisture in shallow layers while trees have exclusive access to deep water. The lack of clear differences in maximum rooting depth between these two functional groups, however, has caused this model to fall out of favor. The alternative model, the demographic bottleneck hypothesis, suggests that trees and grasses occupy overlapping rooting niches, and that stochastic events such as fires and droughts result in episodic tree mortality at various life stages, thus preventing trees from otherwise displacing grasses, at least in mesic savannas. Two potential problems with this view are: 1 we lack data on functional rooting profiles in trees and grasses, and these profiles are not necessarily reflected by differences in maximum or physical rooting depth, and 2 subtle, difficult-to-detect differences in rooting profiles between the two functional groups may be sufficient to result in coexistence in many situations. To tackle this question, I coupled a plant uptake model with a soil moisture dynamics model to explore the environmental conditions under which functional rooting profiles with equal rooting depth but different depth distributions (i.e., shapes can coexist when competing for water. I show that, as long as rainfall inputs are stochastic, coexistence based on rooting differences is viable under a wide range of conditions, even when these differences are subtle. The results also indicate that coexistence mechanisms based on rooting niche differentiation are more viable under some climatic and edaphic conditions than others. This suggests that the two-layer model is both viable and stochastic in nature, and that a full understanding of tree-grass coexistence and dynamics may require incorporating fine-scale rooting differences between these functional groups and realistic stochastic climate drivers into future

  19. Predicting thermally stressful events in rivers with a strategy to evaluate management alternatives

    Science.gov (United States)

    Maloney, K.O.; Cole, J.C.; Schmid, M.

    2016-01-01

    Water temperature is an important factor in river ecology. Numerous models have been developed to predict river temperature. However, many were not designed to predict thermally stressful periods. Because such events are rare, traditionally applied analyses are inappropriate. Here, we developed two logistic regression models to predict thermally stressful events in the Delaware River at the US Geological Survey gage near Lordville, New York. One model predicted the probability of an event >20.0 °C, and a second predicted an event >22.2 °C. Both models were strong (independent test data sensitivity 0.94 and 1.00, specificity 0.96 and 0.96) predicting 63 of 67 events in the >20.0 °C model and all 15 events in the >22.2 °C model. Both showed negative relationships with released volume from the upstream Cannonsville Reservoir and positive relationships with difference between air temperature and previous day's water temperature at Lordville. We further predicted how increasing release volumes from Cannonsville Reservoir affected the probabilities of correctly predicted events. For the >20.0 °C model, an increase of 0.5 to a proportionally adjusted release (that accounts for other sources) resulted in 35.9% of events in the training data falling below cutoffs; increasing this adjustment by 1.0 resulted in 81.7% falling below cutoffs. For the >22.2 °C these adjustments resulted in 71.1% and 100.0% of events falling below cutoffs. Results from these analyses can help managers make informed decisions on alternative release scenarios.

  20. Greek Civil Society’s Online Alternative Networks as Emergent Resilience Strategies in Time of Crisis

    Directory of Open Access Journals (Sweden)

    Maria Zafiropoulou

    2016-12-01

    Full Text Available The use of new communications technologies and social media, in Greece, during the time of crisis, has led to the development of numerous online informal Civil Society Networks (CSNs (i.e. networking-building platforms, self - organized groups in Facebook, forums, exchange platforms proposing a rethinking of the status quo of formal civil organizations. This research, utilizing the methodology of discourse analysis, aims at summarizing the rise of these networks in Greece that incorporates both solidarity initiatives and autonomous political/economic spaces and identify the indicative predictive factors of their survival and growth. Some basic conclusions that have been drawn through this research is that alternative online networks can be proven as indicative sign of the social dynamism of a given period but in order to be resilient and sustainable they should develop focal points of physical reference, pursue national representation, focus mainly on monothematic goods/services and cultivate, in several cases, links with relevant social movements and local or national NGOs. A general induction through this research is that a CSN, during this current crisis, stands between two classical models of reference in a society seeking modernity and flexibility and can be considered as a proposed type of effective experimentation and mobilization that can pursue common social goals and serve needs of deprived people. Some issues that still remain underexplored and need further elaboration are social and political identity of participants, the potential links with local, national and international communities, the functional balance between structure and flexibility as well as the efficient distribution of energy between solidarity and protest.

  1. Comparative life cycle assessment of alternative strategies for energy recovery from used cooking oil.

    Science.gov (United States)

    Lombardi, Lidia; Mendecka, Barbara; Carnevale, Ennio

    2017-05-15

    The separate collection of Used Cooking Oil (UCO) is gaining popularity through several countries in Europe. An appropriate management of UCO waste stream leads to substantial benefits. In this study, we analyse two different possibilities of UCO energy reuse: the direct feed to a reciprocating internal combustion engine (ICE) for cogeneration purpose, and the processing to generate biodiesel. Concerning biodiesel production, we analyse four among conventional and innovative technologies, characterised by different type and amount of used chemicals, heat and electricity consumptions and yields. We perform a systematic evaluation of environmental benefits and drawbacks by applying life cycle assessment (LCA) analysis to compare the alternatives. For the impact assessment, two methods are selected: the Global Warming Potential (GWP) and Cumulative Exergy Consumption (CExC). Results related only to the processing phases (i.e. not including yet the avoided effects) show that the recovery of UCO in cogeneration plant has in general lower values in terms of environmental impacts than its employment in biodiesel production. When products and co-products substitution are included, the savings obtained by the substitution of conventional diesel production, in the biodiesel cases, are significantly higher than the avoided effects for electricity and heat in the cogeneration case. In particular, by using the UCO in the biodiesel production processes, the savings vary from 41.6 to 54.6 GJ ex per tUCO, and from 2270 to 2860 kg CO 2eq per tUCO for CExC and GWP, respectively. A particular focus is put on sensitivity and uncertainty analyses. Overall, high uncertainty of final results for process impacts is observed, especially for the supercritical methanol process. Low uncertainty values are evaluated for the avoided effects. Including the uncertain character of the impacts, cogeneration scenario and NaOH catalysed process of biodiesel production result to be the most suitable

  2. Revisiting the Two-Layer Hypothesis: Coexistence of Alternative Functional Rooting Strategies in Savannas

    Science.gov (United States)

    Holdo, Ricardo M.

    2013-01-01

    The two-layer hypothesis of tree-grass coexistence posits that trees and grasses differ in rooting depth, with grasses exploiting soil moisture in shallow layers while trees have exclusive access to deep water. The lack of clear differences in maximum rooting depth between these two functional groups, however, has caused this model to fall out of favor. The alternative model, the demographic bottleneck hypothesis, suggests that trees and grasses occupy overlapping rooting niches, and that stochastic events such as fires and droughts result in episodic tree mortality at various life stages, thus preventing trees from otherwise displacing grasses, at least in mesic savannas. Two potential problems with this view are: 1) we lack data on functional rooting profiles in trees and grasses, and these profiles are not necessarily reflected by differences in maximum or physical rooting depth, and 2) subtle, difficult-to-detect differences in rooting profiles between the two functional groups may be sufficient to result in coexistence in many situations. To tackle this question, I coupled a plant uptake model with a soil moisture dynamics model to explore the environmental conditions under which functional rooting profiles with equal rooting depth but different depth distributions (i.e., shapes) can coexist when competing for water. I show that, as long as rainfall inputs are stochastic, coexistence based on rooting differences is viable under a wide range of conditions, even when these differences are subtle. The results also indicate that coexistence mechanisms based on rooting niche differentiation are more viable under some climatic and edaphic conditions than others. This suggests that the two-layer model is both viable and stochastic in nature, and that a full understanding of tree-grass coexistence and dynamics may require incorporating fine-scale rooting differences between these functional groups and realistic stochastic climate drivers into future models. PMID

  3. Evaluation of research activities and research needs to increase the impact and applicability of alternative testing strategies in risk assessment practice

    NARCIS (Netherlands)

    Punt, Ans; Schiffelers, Marie-Jeanne W. A.; Horbach, G. Jean; van de Sandt, Johannes J. M.; Groothuis, Geny M. M.; Rietjens, Ivonne M. C. M.; Blaauboer, Bas J.

    2011-01-01

    The present paper aims at identifying strategies to increase the impact and applicability of alternative testing strategies in risk assessment. To this end, a quantitative and qualitative literature evaluation was performed on (a) current research efforts in the development of in vitro methods

  4. A data-based assessment of alternative strategies for identification of potential human cancer hazards.

    Science.gov (United States)

    Boobis, Alan R; Cohen, Samuel M; Doerrer, Nancy G; Galloway, Sheila M; Haley, Patrick J; Hard, Gordon C; Hess, Frederick G; Macdonald, James S; Thibault, Stéphane; Wolf, Douglas C; Wright, Jayne

    2009-10-01

    The two-year cancer bioassay in rodents remains the primary testing strategy for in-life screening of compounds that might pose a potential cancer hazard. Yet experimental evidence shows that cancer is often secondary to a biological precursor effect, the mode of action is sometimes not relevant to humans, and key events leading to cancer in rodents from nongenotoxic agents usually occur well before tumorigenesis and at the same or lower doses than those producing tumors. The International Life Sciences Institute (ILSI) Health and Environmental Sciences Institute (HESI) hypothesized that the signals of importance for human cancer hazard identification can be detected in shorter-term studies. Using the National Toxicology Program (NTP) database, a retrospective analysis was conducted on sixteen chemicals with liver, lung, or kidney tumors in two-year rodent cancer bioassays, and for which short-term data were also available. For nongenotoxic compounds, results showed that cellular changes indicative of a tumorigenic endpoint can be identified for many, but not all, of the chemicals producing tumors in two-year studies after thirteen weeks utilizing conventional endpoints. Additional endpoints are needed to identify some signals not detected with routine evaluation. This effort defined critical questions that should be explored to improve the predictivity of human carcinogenic risk.

  5. Alternative feeding strategies and potential disease transmission in Wisconsin white-tailed deer

    Science.gov (United States)

    Thompson, A.K.; Samuel, M.D.; VanDeelen, T.R.

    2008-01-01

    We conducted experimental feeding using 3 feeding methods (pile, spread, trough) and 2 quantities (rationed, ad libitum) of shelled corn to compare deer activity and behavior with control sites and evaluate potential direct and indirect transmission of infectious disease in white-tailed deer (Odocoileus virginianus) in central Wisconsin, USA. Deer use was higher at 2 of the feeding sites than at natural feeding areas (P ??? 0.02). Deer spent a higher proportion of time (P feeding at pile (49%) and spread (61%) treatments than at natural feeding areas (36%). We found higher deer use for rationed than ad libitum feeding quantities and feeding intensity was greatest at rationed piles and lowest at ad libitum spreads. We also observed closer pairwise distances (???0.3 m) among deer when corn was provided in a trough relative to spread (P=0.03). Supplemental feeding poses risks for both direct and indirect disease transmission due to higher deer concentration and more intensive use relative to control areas. Concentrated feeding and contact among deer at feeding sites can also increase risk for disease transmission. Our results indicated that restrictions on feeding quantity would not mitigate the potential for disease transmission None of the feeding strategies we evaluated substantially reduced the potential risk for disease transmission and banning supplemental feeding to reduce transmission is warranted.

  6. The evolution of alternative adaptive strategies for effective communication in noisy environments.

    Science.gov (United States)

    Ord, Terry J; Charles, Grace K; Hofer, Rebecca K

    2011-01-01

    Animals communicating socially are expected to produce signals that are conspicuous within the habitats in which they live. The particular way in which a species adapts to its environment will depend on its ancestral condition and evolutionary history. At this point, it is unclear how properties of the environment and historical factors interact to shape communication. Tropical Anolis lizards advertise territorial ownership using visual displays in habitats where visual motion or "noise" from windblown vegetation poses an acute problem for the detection of display movements. We studied eight Anolis species that live in similar noise environments but belong to separate island radiations with divergent evolutionary histories. We found that species on Puerto Rico displayed at times when their signals were more likely to be detected by neighboring males and females (during periods of low noise). In contrast, species on Jamaica displayed irrespective of the level of environmental motion, apparently because these species have a display that is effective in a range of viewing conditions. Our findings appear to reflect a case of species originating from different evolutionary starting points evolving different signal strategies for effective communication in noisy environments.

  7. An analysis of alternative New Technical Strategy flowsheets for tank waste remediation system

    International Nuclear Information System (INIS)

    Booker, C.P.

    1994-01-01

    The Hanford Tank remediation plans have gone through a few revisions for the best waste processing system. Some designs have been complex while others have been fairly simple. One of the key means in understanding and selecting among the various proposed systems is a discrete events modeling of the system. This modeling provides insight into (1) The total required size of the system; (2) The amount of material, such as reagents and other added materials that must be supplied; (3) The final mass of waste that must be stored; and (4) Areas within the system where a small change can greatly effect the total system. Discrete events modeling also provides the means by which various proposed systems may be compared. It is the framework in which variations within a particular system may be explored and compared to other instantiations. This study examines the current New Technical Strategy flowsheet system with discrete event modeling. Some of the possible variations within that system are examined and compared. Further, an previously proposed, more complex system is examined

  8. Drag reduction in wave-swept macroalgae: alternative strategies and new predictions.

    Science.gov (United States)

    Martone, Patrick T; Kost, Laurie; Boller, Michael

    2012-05-01

    Intertidal macroalgae must resist extreme hydrodynamic forces imposed by crashing waves. How does frond flexibility mitigate drag, and how does flexibility affect predictions of drag and dislodgement in the field? We characterized flexible reconfiguration of six seaweed species in a recirculating water flume, documenting both shape change and area reduction as fronds reorient. We then used a high-speed gravity-accelerated water flume to test our ability to predict drag under waves based on extrapolations of drag recorded at slower speeds. We compared dislodgement forces to drag forces predicted from slow- and high-speed data to generate new predictions of survivorship and maximum sustainable frond size along wave-swept shores. Bladed algae were generally "shape changers", limiting drag by reducing drag coefficients, whereas the branched alga Calliarthron was an "area reducer", limiting drag by reducing projected area in flow. Drag predictions often underestimated actual drag measurements at high speeds, suggesting that slow-speed data may not reflect the performance of flexible seaweeds under breaking waves. Several seaweeds were predicted to dislodge at similar combinations of velocity and frond size, suggesting common scaling factors of dislodgement strength and drag. Changing shape and reducing projected area in flow are two distinct strategies employed by flexible seaweeds to resist drag. Flexible reconfiguration contributes to the uncertainty of drag extrapolation, and researchers should use caution when predicting drag and dislodgement of seaweeds in the field.

  9. Multiple intelligences and alternative teaching strategies: The effects on student academic achievement, conceptual understanding, and attitude

    Science.gov (United States)

    Baragona, Michelle

    The purpose of this study was to investigate the interactions between multiple intelligence strengths and alternative teaching methods on student academic achievement, conceptual understanding and attitudes. The design was a quasi-experimental study, in which students enrolled in Principles of Anatomy and Physiology, a developmental biology course, received lecture only, problem-based learning with lecture, or peer teaching with lecture. These students completed the Multiple Intelligence Inventory to determine their intelligence strengths, the Students' Motivation Toward Science Learning questionnaire to determine student attitudes towards learning in science, multiple choice tests to determine academic achievement, and open-ended questions to determine conceptual understanding. Effects of intelligence types and teaching methods on academic achievement and conceptual understanding were determined statistically by repeated measures ANOVAs. No significance occurred in academic achievement scores due to lab group or due to teaching method used; however, significant interactions between group and teaching method did occur in students with strengths in logical-mathematical, interpersonal, kinesthetic, and intrapersonal intelligences. Post-hoc analysis using Tukey HSD tests revealed students with strengths in logical-mathematical intelligence and enrolled in Group Three scored significantly higher when taught by problem-based learning (PBL) as compared to peer teaching (PT). No significance occurred in conceptual understanding scores due to lab group or due to teaching method used; however, significant interactions between group and teaching method did occur in students with strengths in musical, kinesthetic, intrapersonal, and spatial intelligences. Post-hoc analysis using Tukey HSD tests revealed students with strengths in logical-mathematical intelligence and enrolled in Group Three scored significantly higher when taught by lecture as compared to PBL. Students with

  10. Control strategy minimizing the converter-alternating current motor losses: application to electric traction; Strategies de commande minimisant les pertes d'un ensemble convertisseur - machine alternative: application a la traction electrique

    Energy Technology Data Exchange (ETDEWEB)

    Bastiani, Ph.

    2001-02-01

    Improving the efficiency of the converter-alternating current motor system is a major task in electric traction. Global energy optimisation implies a specific approach at system scale. To reach this goal, we have chosen an algebraic method using sub-system models. To start with, a synchronous machine Park model is developed to take account magnetic saturation and iron losses. Then, an averaged model of the voltage inverter is used in order to obtain a simplified model of the losses to be implemented in our optimisation method. This is how the global model is built including losses in the synchronous machine along with the losses of the power converter. Experimental results are there to validate our approach. This study proposes a method based on algebraic formulation of the general laws to control torque. Algorithms take into account magnetic circuits saturation and power losses in both the machine and its converter. Here again, experimental results validate the algorithm on several test benches. Achieved efficiency improvement is important compared to existing usual control strategies. The proposed method can be generalised to other machine-converter systems. As a matter of fact we have extended our study to the induction machine. As a complement ti this study we have looked at the effects natural limitations of voltages and currents in the torque-speed plane. Therefore algebraic formulation of the torque-speed plane and optimisation strategies are proposed including those constraints. (author)

  11. Draft Programmatic Environmental Impact Statement for alternative strategies for the long-term management and use of depleted uranium hexafluoride. Volume 2: Appendices

    International Nuclear Information System (INIS)

    1997-12-01

    This PEIS assesses the potential impacts of alternative management of alternative management strategies for depleted uranium hexafluoride (UF 6 ) currently stored at three DOE sites: Paducah site near Paducah, Kentucky; Portsmouth site near Portsmouth, Ohio; and K-25 site on the Oak Ridge Reservation, Oak Ridge, Tennessee. The alternatives analyzed in the PEIS include no action, long-term storage as UF 6 , long-term storage as uranium oxide, use as uranium oxide, use as uranium metal, and disposal. The preferred alternative for the long-term management of depleted UF 6 is to use the entire inventory of material. This volume contains the appendices to volume I

  12. Draft Programmatic Environmental Impact Statement for alternative strategies for the long-term management and use of depleted uranium hexafluoride. Volume 1: Main text

    International Nuclear Information System (INIS)

    1997-12-01

    This PEIS assesses the potential impacts of alternative management of alternative management strategies for depleted uranium hexafluoride (UF 6 ) currently stored at three DOE sites: Paducah site near Paducah, Kentucky; Portsmouth site near Portsmouth, Ohio; and K-25 site on the Oak Ridge Reservation, Oak Ridge, Tennessee. The alternatives analyzed in the PEIS include no action, long-term storage as UF 6 , long-term storage as uranium oxide, use as uranium oxide, use as uranium metal, and disposal. The preferred alternative for the long-term management of depleted UF 6 is to use the entire inventory of material

  13. THE STRATEGY OF INCREASING THE COMPETITIVENESS OF ROMANIAN AUTOMOBILE INDUSTRY BY TRANSITION TO ALTERNATIVE ENERGY IN INTERNATIONALIZATION CONDITIONS

    Directory of Open Access Journals (Sweden)

    ALINA HAGIU,

    2014-10-01

    Full Text Available The increasing complexity and the increase of the variability grade of the business environment in general, and of the international business environment especially, represented determinant elements of the awareness of strategic issues of international competitiveness of firms and of the intensifying efforts to resolve the many different aspects of it. This paper is addressed to all those interested in the interesting and important issue of competitiveness in general and of the automotive industry competitiveness in particular. We stopped to the car industry as the automotive industry in Romania is one of the industries that have a high added value and a significant share of GDP. A role no less important had the fact that in the case of the automotive industry there are clear opportunities to improve competitiveness in the international market by focusing not only on low cost segments but also pointing to other market segments. The economic crisis has made Dacia sales to exports increase considerably, but the data show that with alleviate of the economic crisis the success of Dacia will begin to decrease. So it turns out that Dacia is a crisis car, and as the crisis will end, the manufacturer must rethink its strategy if it wants to maintain or increase sales. In the present paper we stoped to the transition to alternative energy sources strategy in the functioning of automobiles as a possible way to increase the competitiveness of Romanian automotive industry because all indicates are that alternative sources are the future and we should adapt trends better sooner rather than later.

  14. THE STRATEGY OF INCREASING THE COMPETITIVENESS OF ROMANIAN AUTOMOBILE INDUSTRY BY TRANSITION TO ALTERNATIVE ENERGY IN INTERNATIONALIZATION CONDITIONS

    Directory of Open Access Journals (Sweden)

    ALINA HAGIU

    2014-10-01

    Full Text Available The increasing complexity and the increase of the variability grade of the business environment in general, and of the international business environment especially, represented determinant elements of the awareness of strategic issues of international competitiveness of firms and of the intensifying efforts to resolve the many different aspects of it. This paper is addressed to all those interested in the interesting and important issue of competitiveness in general and of the automotive industry competitiveness in particular. We stopped to the car industry as the automotive industry in Romania is one of the industries that have a high added value and a significant share of GDP. A role no less important had the fact that in the case of the automotive industry there are clear opportunities to improve competitiveness in the international market by focusing not only on low cost segments but also pointing to other market segments. The economic crisis has made Dacia sales to exports increase considerably, but the data show that with alleviate of the economic crisis the success of Dacia will begin to decrease. So it turns out that Dacia is a crisis car, and as the crisis will end, the manufacturer must rethink its strategy if it wants to maintain or increase sales. In the present paper we stoped to the transition to alternative energy sources strategy in the functioning of automobiles as a possible way to increase the competitiveness of Romanian automotive industry because all indicates are that alternative sources are the future and we should adapt trends better sooner rather than later

  15. Costs and Effectiveness of Treating Homeless Persons with Cocaine Addiction with Alternative Contingency Management Strategies.

    Science.gov (United States)

    Mennemeyer, Stephen T; Schumacher, Joseph E; Milby, Jesse B; Wallace, Dennis

    2017-03-01

    "Housing First", achieved better abstinence (12.1 v. 10 weeks) at higher average cost (USD 22,512 v. USD 17,541) yielding an ICER for this comparison of (USD 2,367, 95% CI=USD -10,587 to USD 12,467). Similar results are found at 12 months (6 months after active treatment). More intensive methods of counseling improved abstinence but 4 of the 7 treatments were inefficient ("dominated"). Bootstrapping shows that results are sensitive to which individuals were randomly assigned to each arm. A limitation of the analysis is that it does not consider the full societal cost of lost wages, crime costs beyond jail expenses and deterioration of neighborhood quality of life. Additionally, populations treated by Housing First programs may differ from the Birmingham Homeless studies in the severity of addiction or co-occuring psychological problems. The Homeless studies show that abstinent contingent safe housing with counseling can substantially improve abstinence for homeless cocaine abusers. Incremental costs rise sharply with more intensive counseling; modest programs of counseling may be more cost effective in a stepped treatment strategy.

  16. Mentoring for text editors: Fit for purpose in the era of freelancing, more so than alternative development strategies

    Directory of Open Access Journals (Sweden)

    John Linnegar

    2015-12-01

    Full Text Available In this article, the supportive role that mentoring relationships currently do and should play in the development and careers of text editors is described against the background of the particular circumstances of these service providers in a sector experiencing great organisational and technological changes. This is a group that is much neglected in the literature on mentoring. Since the mentoring of text editors is distinct from other forms of mentoring in a number of key respects, this article draws together what the literature has to say about both conventional and online or distance mentoring as performed in a range of contexts. I consider the application of Knowles’ (1970, 1984 adult learning theory and Bandura’s (1977 self-efficacy mechanisms to be important potential contributors to the success of mentorships, in particular those involving adult text editors. The article also critically analyses how mentoring for text editors can be distinguished from alternative development strategies such as coaching, training, teaching and counselling. It shows that mentoring is fundamentally different from these strategies according to ten criteria, and is better suited to text editors’ need for professional development as a form of lifelong adult e-learning. The lack of any form of assessment of mentees, in particular, is regarded as a weakness of the currently available mentorship programmes aiming to professionalise adult text editors through a process of lifelong learning.

  17. Coupling of radiofrequency with magnetic nanoparticles treatment as an alternative physical antibacterial strategy against multiple drug resistant bacteria

    Science.gov (United States)

    Chaurasia, Akhilesh K.; Thorat, Nanasaheb D.; Tandon, Anshula; Kim, Jin-Hahn; Park, Sung Ha; Kim, Kyeong Kyu

    2016-09-01

    Antibiotic resistant bacteria not only affect human health and but also threatens the safety in hospitals and among communities. However, the emergence of drug resistant bacteria is inevitable due to evolutionary selection as a consequence of indiscriminate antibiotic usage. Therefore, it is necessary to develop a novel strategy by which pathogenic bacteria can be eliminated without triggering resistance. We propose a novel magnetic nanoparticle-based physical treatment against pathogenic bacteria, which blocks biofilm formation and kills bacteria. In this approach, multiple drug resistant Staphylococcus aureus USA300 and uropathogenic Escherichia coli CFT073 are trapped to the positively charged magnetic core-shell nanoparticles (MCSNPs) by electrostatic interaction. All the trapped bacteria can be completely killed within 30 min owing to the loss of membrane potential and dysfunction of membrane-associated complexes when exposed to the radiofrequency current. These results indicate that MCSNP-based physical treatment can be an alternative antibacterial strategy without leading to antibiotic resistance, and can be used for many purposes including environmental and therapeutic applications.

  18. Does Gadoxetic acid-enhanced 3.0T MRI in addition to 64-detector-row contrast-enhanced CT provide better diagnostic performance and change the therapeutic strategy for the preoperative evaluation of colorectal liver metastases?

    Science.gov (United States)

    Sofue, Keitaro; Tsurusaki, Masakatsu; Murakami, Takamichi; Onoe, Shunsuke; Tokue, Hiroyuki; Shibamoto, Kentaro; Arai, Yasuaki; Sugimura, Kazuro

    2014-10-01

    To compare diagnostic performance in the detection of colorectal liver metastases between 64-detector-row contrast-enhanced CT (CE-CT) alone and the combination of CE-CT and gadoxetic acid-enhanced MRI (EOB-MRI) at 3.0T, and to assess whether EOB-MRI in addition to CE-CT results in a change to initially planned operative strategy. A total of 39 patients (27 men, mean age 65 years) with 85 histopathologically confirmed liver metastases were included. At EOB-MRI, unenhanced (T1- and T2-weighted), dynamic, and hepatocyte-phase images were obtained. At CE-CT, four-phase dynamic contrast-enhanced images were obtained. One on-site reader and three off-site readers independently reviewed both CE-CT alone and the combination of CE-CT and EOB-MRI. Sensitivity, positive predictive value, and alternative free-response receiver operating characteristic (AFROC) method were calculated. Differences in therapeutic strategy before and after the EOB-MRI examination were also evaluated. Sensitivity and area under the AFROC curve with the combination of CE-CT and EOB-MRI were significantly superior to those with CE-CT alone. Changes in surgical therapy were documented in 13 of 39 patients. The combination of CE-CT and EOB-MRI may provide better diagnostic performance than CE-CT alone for the detection of colorectal liver metastases, and EOB-MRI in addition to CE-CT resulted in changes to the planned operative strategy in one-third of the patients. • Accurate preoperative imaging is essential for surgical planning and successful hepatic resection. • Combination of CE-CT and EOB-MRI is useful to detect colorectal liver metastases. • EOB-MRI combined with CE-CT contributes to determine the correct therapeutic strategy.

  19. The perspective of USDA APHIS Veterinary Services Emergency Management and Diagnostics in preparing and responding to Foreign Animal Diseases - plans, strategies, and countermeasures.

    Science.gov (United States)

    Díez, J R; Styles, D K

    2013-01-01

    The United States Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS) Veterinary Services (VS) is charged with monitoring, controlling, and responding to select reportable diseases and all foreign animal diseases. Emergency Management and Diagnostics (EM&D) oversees Foreign Animal Disease (FAD) preparedness and response. In order to effectively prepare for and respond to FADs, such as highly pathogenic avian influenza and foot-and-mouth disease, VS develops plans, strategies, and policies to effectively combat an intrusion. USDA APHIS VS has made significant gains in preparedness and response planning. However, much remains to be done especially in surveillance, diagnostic tools, and vaccines. There are significant needs for novel medical technologies to improve diagnostic capabilities and offer additional approaches for FAD response.

  20. Can PSA Reflex Algorithm be a valid alternative to other PSA-based prostate cancer screening strategies?

    Science.gov (United States)

    Caldarelli, G; Troiano, G; Rosadini, D; Nante, N

    2017-01-01

    The available laboratory tests for the differential diagnosis of prostate cancer, are represented by the total PSA, the free PSA, and the free/total PSA ratio. In Italy most of doctors tend to request both total and free PSA for their patients even in cases where the total PSA doesn't justify the further request of free PSA, with a consequent growth of the costs for the National Health System. The aim of our study was to predict the saving in Euro (due to reagents) and reduction in free PSA tests, applying the "PSA Reflex" algorithm. We calculated the number of total PSA and free PSA exams performed in 2014 in the Hospital of Grosseto and, simulating the application of the "PSA Reflex" algorithm in the same year, we calculated the decrease in the number of free PSA requests and we tried to predict the Euro savings in reagents, obtained from this reduction. In 2014 in the Hospital of Grosseto 25,955 total PSA tests have been performed: 3,631 (14%) resulted greater than 10 ng / ml; 7,686 (29.6%) between 2 and 10 ng / ml; 14,638 (56.4%) lower than 2 ng / ml. The performed free PSA tests were 16904. Simulating the use of "PSA Reflex" algorithm, the free PSA tests would be performed only in cases with total PSA values between 2 and 10 ng / mL with a saving of 54.5% of free PSA exams and of 8,971 euros, only for reagents. Our study showed that the "PSA Reflex" algorithm is a valid alternative leading to a reduction of the costs. The estimated intralaboratory savings, due to the reagents, seem to be modest, however, they are followed by the additional savings due to the other diagnostic processes for prostate cancers.

  1. Advancing Risk Analysis for Nanoscale Materials: Report from an International Workshop on the Role of Alternative Testing Strategies for Advancement.

    Science.gov (United States)

    Shatkin, J A; Ong, Kimberly J; Beaudrie, Christian; Clippinger, Amy J; Hendren, Christine Ogilvie; Haber, Lynne T; Hill, Myriam; Holden, Patricia; Kennedy, Alan J; Kim, Baram; MacDonell, Margaret; Powers, Christina M; Sharma, Monita; Sheremeta, Lorraine; Stone, Vicki; Sultan, Yasir; Turley, Audrey; White, Ronald H

    2016-08-01

    The Society for Risk Analysis (SRA) has a history of bringing thought leadership to topics of emerging risk. In September 2014, the SRA Emerging Nanoscale Materials Specialty Group convened an international workshop to examine the use of alternative testing strategies (ATS) for manufactured nanomaterials (NM) from a risk analysis perspective. Experts in NM environmental health and safety, human health, ecotoxicology, regulatory compliance, risk analysis, and ATS evaluated and discussed the state of the science for in vitro and other alternatives to traditional toxicology testing for NM. Based on this review, experts recommended immediate and near-term actions that would advance ATS use in NM risk assessment. Three focal areas-human health, ecological health, and exposure considerations-shaped deliberations about information needs, priorities, and the next steps required to increase confidence in and use of ATS in NM risk assessment. The deliberations revealed that ATS are now being used for screening, and that, in the near term, ATS could be developed for use in read-across or categorization decision making within certain regulatory frameworks. Participants recognized that leadership is required from within the scientific community to address basic challenges, including standardizing materials, protocols, techniques and reporting, and designing experiments relevant to real-world conditions, as well as coordination and sharing of large-scale collaborations and data. Experts agreed that it will be critical to include experimental parameters that can support the development of adverse outcome pathways. Numerous other insightful ideas for investment in ATS emerged throughout the discussions and are further highlighted in this article. © 2016 Society for Risk Analysis.

  2. Strategies in protein sequencing and characterization: Multi-enzyme digestion coupled with alternate CID/ETD tandem mass spectrometry

    Energy Technology Data Exchange (ETDEWEB)

    Nardiello, Donatella; Palermo, Carmen, E-mail: carmen.palermo@unifg.it; Natale, Anna; Quinto, Maurizio; Centonze, Diego

    2015-01-07

    Highlights: • Multi-enzyme digestion for protein sequencing and characterization by CID/ETD. • Simultaneous use of trypsin/chymotrypsin for the maximization of sequence. • Identification of PTMs, sequence variants and species-specific residues. • Increase of accuracy in sequence assignments by orthogonal fragmentation techniques. - Abstract: A strategy based on a simultaneous multi-enzyme digestion coupled with electron transfer dissociation (ETD) and collision-induced dissociation (CID) was developed for protein sequencing and characterization, as a valid alternative platform in ion-trap based proteomics. The effect of different proteolytic procedures using chymotrypsin, trypsin, a combination of both, and Lys-C, was carefully evaluated in terms of number of identified peptides, protein coverage, and score distribution. A systematic comparison between CID and ETD is shown for the analysis of peptides originating from the in-solution digestion of standard caseins. The best results were achieved with a trypsin/chymotrypsin mix combined with CID and ETD operating in alternating mode. A post-database search validation of MS/MS dataset was performed, then, the matched peptides were cross checked by the evaluation of ion scores, rank, number of experimental product ions, and their relative abundances in the MS/MS spectrum. By integrated CID/ETD experiments, high quality-spectra have been obtained, thus allowing a confirmation of spectral information and an increase of accuracy in peptide sequence assignments. Overlapping peptides, produced throughout the proteins, reduce the ambiguity in mapping modifications between natural variants and animal species, and allow the characterization of post translational modifications. The advantages of using the enzymatic mix trypsin/chymotrypsin were confirmed by the nanoLC and CID/ETD tandem mass spectrometry of goat milk proteins, previously separated by two-dimensional gel electrophoresis.

  3. The use of body weight support on ground level: an alternative strategy for gait training of individuals with stroke

    Directory of Open Access Journals (Sweden)

    Barela Ana MF

    2009-12-01

    Full Text Available Abstract Background Body weight support (BWS systems on treadmill have been proposed as a strategy for gait training of subjects with stroke. Considering that ground level is the most common locomotion surface and that there is little information about individuals with stroke walking with BWS on ground level, it is important to investigate the use of BWS on ground level in these individuals as a possible alternative strategy for gait training. Methods Thirteen individuals with chronic stroke (four women and nine men; mean age 54.46 years were videotaped walking on ground level in three experimental conditions: with no harness, with harness bearing full body weight, and with harness bearing 30% of full body weight. Measurements were recorded for mean walking speed, cadence, stride length, stride speed, durations of initial and terminal double stance, single limb support, swing period, and range of motion of ankle, knee, and hip joints; and foot, shank, thigh, and trunk segments. Results The use of BWS system leads to changes in stride length and speed, but not in stance and swing period duration. Only the hip joint was influenced by the BWS system in the 30% BWS condition. Shank and thigh segments presented less range of motion in the 30% BWS condition than in the other conditions, and the trunk was held straighter in the 30% BWS condition than in the other conditions. Conclusion Individuals with stroke using BWS system on ground level walked slower and with shorter stride length than with no harness. BWS also led to reduction of hip, shank, and thigh range of motion. However, this system did not change walking temporal organization and body side asymmetry of individuals with stroke. On the other hand, the BWS system enabled individuals with chronic stroke to walk safely and without physical assistance. In interventions, the physical therapist can watch and correct gait pattern in patients' performance without the need to provide physical

  4. The use of body weight support on ground level: an alternative strategy for gait training of individuals with stroke.

    Science.gov (United States)

    Sousa, Catarina O; Barela, José A; Prado-Medeiros, Christiane L; Salvini, Tania F; Barela, Ana M F

    2009-12-01

    Body weight support (BWS) systems on treadmill have been proposed as a strategy for gait training of subjects with stroke. Considering that ground level is the most common locomotion surface and that there is little information about individuals with stroke walking with BWS on ground level, it is important to investigate the use of BWS on ground level in these individuals as a possible alternative strategy for gait training. Thirteen individuals with chronic stroke (four women and nine men; mean age 54.46 years) were videotaped walking on ground level in three experimental conditions: with no harness, with harness bearing full body weight, and with harness bearing 30% of full body weight. Measurements were recorded for mean walking speed, cadence, stride length, stride speed, durations of initial and terminal double stance, single limb support, swing period, and range of motion of ankle, knee, and hip joints; and foot, shank, thigh, and trunk segments. The use of BWS system leads to changes in stride length and speed, but not in stance and swing period duration. Only the hip joint was influenced by the BWS system in the 30% BWS condition. Shank and thigh segments presented less range of motion in the 30% BWS condition than in the other conditions, and the trunk was held straighter in the 30% BWS condition than in the other conditions. Individuals with stroke using BWS system on ground level walked slower and with shorter stride length than with no harness. BWS also led to reduction of hip, shank, and thigh range of motion. However, this system did not change walking temporal organization and body side asymmetry of individuals with stroke. On the other hand, the BWS system enabled individuals with chronic stroke to walk safely and without physical assistance. In interventions, the physical therapist can watch and correct gait pattern in patients' performance without the need to provide physical assistance.

  5. New strategy to identify radicals in a time evolving EPR data set by multivariate curve resolution-alternating least squares

    Energy Technology Data Exchange (ETDEWEB)

    Fadel, Maya Abou [LASIR CNRS UMR 8516, Université Lille 1, Sciences et Technologies, 59655 Villeneuve d' Ascq Cedex (France); Juan, Anna de [Chemometrics Group, Section of Analytical Chemistry, Universitat de Barcelona, Diagonal 645, 08028 Barcelona (Spain); Vezin, Hervé [LASIR CNRS UMR 8516, Université Lille 1, Sciences et Technologies, 59655 Villeneuve d' Ascq Cedex (France); Duponchel, Ludovic, E-mail: ludovic.duponchel@univ-lille1.fr [LASIR CNRS UMR 8516, Université Lille 1, Sciences et Technologies, 59655 Villeneuve d' Ascq Cedex (France)

    2016-12-01

    Electron paramagnetic resonance (EPR) spectroscopy is a powerful technique that is able to characterize radicals formed in kinetic reactions. However, spectral characterization of individual chemical species is often limited or even unmanageable due to the severe kinetic and spectral overlap among species in kinetic processes. Therefore, we applied, for the first time, multivariate curve resolution-alternating least squares (MCR-ALS) method to EPR time evolving data sets to model and characterize the different constituents in a kinetic reaction. Here we demonstrate the advantage of multivariate analysis in the investigation of radicals formed along the kinetic process of hydroxycoumarin in alkaline medium. Multiset analysis of several EPR-monitored kinetic experiments performed in different conditions revealed the individual paramagnetic centres as well as their kinetic profiles. The results obtained by MCR-ALS method demonstrate its prominent potential in analysis of EPR time evolved spectra. - Highlights: • A new strategy to identify radicals in a time evolving EPR data set. • Extraction of pure EPR spectral signatures and corresponding kinetic profiles. • The proposed method does not require any prior knowledge of the chemical system. • A multiset analysis in order to decrease rotational ambiguity.

  6. The effects of Promoting Alternative Thinking Strategies Preschool Program on teacher-children relationships and children's social competence in Turkey.

    Science.gov (United States)

    Bilir Seyhan, Gamze; Ocak Karabay, Sakire; Arda Tuncdemir, Tugce B; Greenberg, Mark T; Domitrovich, Celene

    2017-05-02

    This quasi-experimental study examined the effects of the Promoting Alternative Thinking Strategies (PATHS) Preschool Program on the outcomes of children's social-emotional competence, perceived relationships between teacher and children and teachers' ability to create a positive classroom atmosphere. Two hundred and eighty five children (48-72 months) and teachers in Izmir participated in the intervention, and 280 children (48-72 months) and teachers participated as comparison group. Intervention teachers implemented PATHS in their classrooms. For data triangulation, multiple sources of data were collected in the study. Classrooms were observed using two different scales. Teacher rated students using another two different scales. Children were assessed with an interview to evaluate their perceptions of relationships. Intervention group teachers reported greater improvement of children's social-emotional skills, interpersonal relationship skills and emotion regulation. Furthermore, when observed intervention group children showed higher levels of pro-social behaviour, increased levels of compliance, better problem solving skills and more positive feelings. Intervention group children also described their relationships with their teachers as significantly more positively. Finally, intervention group teachers perceived more dependency in their relationships with children. © 2017 International Union of Psychological Science.

  7. Evaluation Outcomes Associated with Alternative Dosing Strategies for Piperacillin/Tazobactam: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Yang, Hui; Cui, Xiangli; Ma, Zhuo; Liu, Lihong

    2016-01-01

    A better dosing strategy can improve clinical outcomes for patients. We systematically reviewed the literatures to determine whether any clinical benefits exist for piperacillin/tazobactam by extended or continuous infusion. Methods - A search of PubMed, Web of Science, ProQuest, ScienceDirect, Cochrane, Embase and related ICAAC and ACCP conferences were conducted up to September 5, 2015. Randomized controlled and observational studies that compared extended or continuous infusion with conventional intermittent infusion of piperacillin/tazobactam were identified from the databases above and analyzed. Two reviewers independently evaluated the methodology and extracted data from primary studies. A meta-analysis was performed using Revman 5.2 software. The quality of each study was assessed. Sensitivity analysis and publication bias were evaluated. Results - Three randomized controlled trials and twelve observational studies were included in this study. All included studies had high quality and no publication bias was found. Compared to the conventional intermittent infusion approach, the extended or continuous infusion group had a significant cost effectiveness (OR -0.89.02, CI (-114.69,-63.35), P<0.00001). No statistical difference was observed for clinical cure rate (OR 1.64, 95% CI (0.88, 3.30), P=0.12) between the two dosing regimens. The sensitivity analysis showed the results were stable. Conclusions - Our systematic review and meta-analysis found that the outcomes associated with alternative dosing strategies of piperacillin/tazobactam have changed compared with conclusions before for several literatures with large samples published. Further data on the outcomes should be generated for a better understanding of the extended or continuous infusion strategy. On the whole, our meta-analysis suggested that the extended or continuous infusion should be recommended for clinical use only considering its economic advantage, but there was no significantly higher

  8. Exploring the Histogenesis and Diagnostic Strategy Using Immunoassay and RT-PCR in Alveolar Soft Part Sarcoma.

    Science.gov (United States)

    Ju, Xinxin; Sun, Kunming; Liu, Ruixue; Li, Shugang; Abulajiang, Gulinaer; Zou, Hong; Lan, Jiaojiao; Ren, Yan; Jiang, Jinfang; Liang, Weihua; Pang, Lijuan; Li, Feng

    2017-08-01

    Alveolar soft part sarcoma (ASPS) is a rare soft tissue sarcoma, but it's easily misdiagnosed in rare locations. The derivation of ASPS is still uncertain, therefore we conducted this study to explore the histogenesis of ASPS by analyzing stem cell markers (ALDH1, CD29, CD133 and Nestin). Protein TFE3 and fusion gene ASPS-TFE3 were tested in paraffin to explore diagnostic strategy and molecular pathological features. In this study, nine cases of ASPS were immunostained with stem cell surface markers (ALDH1, CD29, CD133 and Nestin) and protein TFE3. Seven cases of ASPS mRNA were successfully extracted from nine paraffin-embedded tissues. The expression of fusion gene ASPL-TFE3 was examined by reverse transcriptase-polymerase chain reaction. The immunohistochemical staining of nine patients showed that CD29 and Nestin were negative in all nine cases (0/9). CD133 was weakly positive in one cases (1/9) and ALDH1 was weakly positive in one cases (1/9). TFE3 was positive in nine cases (9/9). Seven paraffin tissues could be successfully extracted with mRNA in nine cases. The results of Reverse Transcription Polymerase Chain Reaction (RT-PCR) showed that ASPL-TFE3 fusion transcripts could be tested in the seven cases (four cases being type 2 and three cases being type 1). The positive rate of CD133 and ALDH1 were less than 1% and the expression of CD29 and Nestin were negative in ASPS. Immunohistochemistry results indicated that the histogenesis of ASPS maybe not derive from mesenchymal stem cells. Immunohistochemistry staining showed that TFE3 protein expression was highly sensitive in ASPS. Furthermore, RT-PCR results showed that fusion gene ASPL-TFE3 (ASPL-TFE3 type 1 and ASPL-TFE3 type 2) was expressed in ASPS, which could provide information for clinical molecular pathological diagnosis and improve the diagnosis rate of rare atypical ASPS.

  9. The cost-effectiveness of alternative vaccination strategies for polyvalent meningococcal vaccines in Burkina Faso: A transmission dynamic modeling study.

    Science.gov (United States)

    Yaesoubi, Reza; Trotter, Caroline; Colijn, Caroline; Yaesoubi, Maziar; Colombini, Anaïs; Resch, Stephen; Kristiansen, Paul A; LaForce, F Marc; Cohen, Ted

    2018-01-01

    The introduction of a conjugate vaccine for serogroup A Neisseria meningitidis has dramatically reduced disease in the African meningitis belt. In this context, important questions remain about the performance of different vaccine policies that target remaining serogroups. Here, we estimate the health impact and cost associated with several alternative vaccination policies in Burkina Faso. We developed and calibrated a mathematical model of meningococcal transmission to project the disability-adjusted life years (DALYs) averted and costs associated with the current Base policy (serogroup A conjugate vaccination at 9 months, as part of the Expanded Program on Immunization [EPI], plus district-specific reactive vaccination campaigns using polyvalent meningococcal polysaccharide [PMP] vaccine in response to outbreaks) and three alternative policies: (1) Base Prime: novel polyvalent meningococcal conjugate (PMC) vaccine replaces the serogroup A conjugate in EPI and is also used in reactive campaigns; (2) Prevention 1: PMC used in EPI and in a nationwide catch-up campaign for 1-18-year-olds; and (3) Prevention 2: Prevention 1, except the nationwide campaign includes individuals up to 29 years old. Over a 30-year simulation period, Prevention 2 would avert 78% of the meningococcal cases (95% prediction interval: 63%-90%) expected under the Base policy if serogroup A is not replaced by remaining serogroups after elimination, and would avert 87% (77%-93%) of meningococcal cases if complete strain replacement occurs. Compared to the Base policy and at the PMC vaccine price of US$4 per dose, strategies that use PMC vaccine (i.e., Base Prime and Preventions 1 and 2) are expected to be cost saving if strain replacement occurs, and would cost US$51 (-US$236, US$490), US$188 (-US$97, US$626), and US$246 (-US$53, US$703) per DALY averted, respectively, if strain replacement does not occur. An important potential limitation of our study is the simplifying assumption that all

  10. The cost-effectiveness of alternative vaccination strategies for polyvalent meningococcal vaccines in Burkina Faso: A transmission dynamic modeling study.

    Directory of Open Access Journals (Sweden)

    Reza Yaesoubi

    2018-01-01

    Full Text Available The introduction of a conjugate vaccine for serogroup A Neisseria meningitidis has dramatically reduced disease in the African meningitis belt. In this context, important questions remain about the performance of different vaccine policies that target remaining serogroups. Here, we estimate the health impact and cost associated with several alternative vaccination policies in Burkina Faso.We developed and calibrated a mathematical model of meningococcal transmission to project the disability-adjusted life years (DALYs averted and costs associated with the current Base policy (serogroup A conjugate vaccination at 9 months, as part of the Expanded Program on Immunization [EPI], plus district-specific reactive vaccination campaigns using polyvalent meningococcal polysaccharide [PMP] vaccine in response to outbreaks and three alternative policies: (1 Base Prime: novel polyvalent meningococcal conjugate (PMC vaccine replaces the serogroup A conjugate in EPI and is also used in reactive campaigns; (2 Prevention 1: PMC used in EPI and in a nationwide catch-up campaign for 1-18-year-olds; and (3 Prevention 2: Prevention 1, except the nationwide campaign includes individuals up to 29 years old. Over a 30-year simulation period, Prevention 2 would avert 78% of the meningococcal cases (95% prediction interval: 63%-90% expected under the Base policy if serogroup A is not replaced by remaining serogroups after elimination, and would avert 87% (77%-93% of meningococcal cases if complete strain replacement occurs. Compared to the Base policy and at the PMC vaccine price of US$4 per dose, strategies that use PMC vaccine (i.e., Base Prime and Preventions 1 and 2 are expected to be cost saving if strain replacement occurs, and would cost US$51 (-US$236, US$490, US$188 (-US$97, US$626, and US$246 (-US$53, US$703 per DALY averted, respectively, if strain replacement does not occur. An important potential limitation of our study is the simplifying assumption that

  11. Comments on B. Kumaravadivelu's "The Postmethod Condition: (E)merging Strategies for Second/Foreign Language Teaching.""Alternative to" or "Addition to" Method?

    Science.gov (United States)

    Liu, Dilin

    1995-01-01

    This critique of an article by B. Kumaravadivelu argues that principles/strategies should not and cannot replace methods; it also takes issue with Kumaravadivelu's claim that his strategic framework is an alternative to, not simply an addition to, method. A reply by Kumaravadivelu is included. (Contains nine references.) (LR)

  12. Designing alternative strategies for the European industry according to its strength and weaknesses and taking into consideration the opportunities and threats of the PV market

    International Nuclear Information System (INIS)

    Viaud, M.; Despotou, E.; Latour, M.; Cameron, M.; Weiss, I.; Baumann, J.; Stierstorfer, J.; Gisler, R.

    2004-01-01

    The objectives were to generate a variety of strategies to identify alternative ways that the PV Sector can use its specific strengths to capitalize on opportunities or to avoid threats and to overcome its weaknesses. The so-called SWOT analysis provides a matrix illustrating how businesses can match the external opportunities and threats facing the sector with its internal strengths and weaknesses to yield in possible strategic alternatives. This method lends itself to brainstorming to create alternative strategies and actions, which might not otherwise be considered. In two working group meetings with participants from the PV industry, research and other stakeholders the SWOT were performed to result into implications for the PV sector. Through workshops the results will be discussed within an expert group and priorities for the future activities will be defined. The project is co-financed through the 6. Framework Programme of the EC. (authors)

  13. The Northeastern United States Energy-Water Nexus: Climate Change Impacts and Alternative Water Management Strategies for the Power Sector

    Science.gov (United States)

    Miara, A.; Macknick, J.; Vorosmarty, C. J.; Cohen, S. M.; Rosenzweig, B.

    2014-12-01

    The Northeastern United States (NE) relies heavily on thermoelectric power plants (90% of total capacity) to provide electricity to more than 70 million people. This region's power plants require consistent, large volumes of water at sufficiently cold temperatures to generate electricity efficiently, and withdraw approximately 10.5 trillion gallons of water annually. Previous findings indicate that assessments of future electricity pathways must account for water availability, water temperature and the changing climate, as changes in these conditions may limit operational efficiency in the future. To account for such electric system vulnerabilities, we have created a link between an electricity system capacity expansion model (ReEDS) and a hydrologic model that is coupled to a power plant simulation model (FrAMES-TP2M) that allows for a new approach to analyze electricity system development, performance, and environmental impacts. Together, these coupled tools allow us to estimate electricity development and operations in the context of a changing climate and impacts on the seasonal spatial and temporal variability of water resources, downstream thermal effluents that cause plant-to-plant interferences and harm aquatic habitat, economic costs of water conservation methods and associated carbon emissions. In this study, we test and compare a business-as-usual strategy with three alternative water management scenarios that include changes in cooling technologies and water sources utilized for the years 2014-2050. Results of these experiments can provide useful insight into the feasibility of the electricity expansion scenarios in terms of associated water use and thermal impacts, carbon emissions, the cost of generating electricity, and also highlight the importance of accounting for water resources in future power sector planning and performance assessments.

  14. Balance sheet method assessment for nitrogen fertilization in winter wheat: II. alternative strategies using the CropSyst simulation model

    Directory of Open Access Journals (Sweden)

    Maria Corbellini

    2006-09-01

    Full Text Available It is important, both for farmer profit and for the environment, to correctly dose fertilizer nitrogen (N for winter wheat growth. Balance-sheet methods are often used to calculate the recommended dose of N fertilizer. Other methods are based on the dynamic simulation of cropping systems. Aim of the work was to evaluate the balance-sheet method set up by the Region Emilia-Romagna (DPI, by comparing it with the cropping systems simulation model CropSyst (CS, and with an approach based on fixed supplies of N (T. A 3-year trial was structured as a series of N fertility regimes at 3 sites (Papiano di Marsciano, Ravenna, San Pancrazio. The N-regimes were generated at each site-year as separate trials in which 3 N rates were applied: N1 (DPI, N2 (DPI+50 kg ha-1 N at spike initiation, N3 (DPI + 50 kg ha-1 N at early booting. Above ground biomass and soil data (NO3-N and water were sampled and used to calibrate CS. Doses of fertilizer N were calculated by both DPI and CS for winter wheat included in three typical rotations for Central and Northern Italy. Both these methods and method T were simulated at each site over 50 years, by using daily generated weather data. The long-term simulation allowed evaluating such alternative fertilization strategies. DPI and CS estimated comparable crop yields and N leached amounts, and both resulted better than T. Minor risk of leaching emerged for all N doses. The N2 and N3 rates allowed slightly higher crop yields than N1.

  15. Optimising the diagnostic strategy for onychomycosis from sample collection to FUNGAL identification evaluation of a diagnostic kit for real-time PCR.

    Science.gov (United States)

    Petinataud, Dimitri; Berger, Sibel; Ferdynus, Cyril; Debourgogne, Anne; Contet-Audonneau, Nelly; Machouart, Marie

    2016-05-01

    Onychomycosis is a common nail disorder mainly due to dermatophytes for which the conventional diagnosis requires direct microscopic observation and culture of a biological sample. Nevertheless, antifungal treatments are commonly prescribed without a mycological examination having been performed, partly because of the slow growth of dermatophytes. Therefore, molecular biology has been applied to this pathology, to support a quick and accurate distinction between onychomycosis and other nail damage. Commercial kits are now available from several companies for improving traditional microbiological diagnosis. In this paper, we present the first evaluation of the real-time PCR kit marketed by Bio Evolution for the diagnosis of dermatophytosis. Secondly, we compare the efficacy of the kit on optimal and non-optimal samples. This study was conducted on 180 nails samples, processed by conventional methods and retrospectively analysed using this kit. According to our results, this molecular kit has shown high specificity and sensitivity in detecting dermatophytes, regardless of sample quality. On the other hand, and as expected, optimal samples allowed the identification of a higher number of dermatophytes by conventional mycological diagnosis, compared to non-optimal samples. Finally, we have suggested several strategies for the practical use of such a kit in a medical laboratory for quick pathogen detection. © 2016 Blackwell Verlag GmbH.

  16. Assessment of off-design performance of a small-scale combined cooling and power system using an alternative operating strategy for gas turbine

    International Nuclear Information System (INIS)

    Han, Wei; Chen, Qiang; Lin, Ru-mou; Jin, Hong-guang

    2015-01-01

    Highlights: • We develop an off-design model for a CCP system driven by gas turbine. • An alternative operating strategy is proposed to improve the system performance. • Off-design performance of the combined cooling and power system (CCP) is enhanced. • Effects of both the different operating strategy are analyzed and compared. • Performance enhancement mechanism of the proposed operating strategy is presented. - Abstract: A small-scale combined cooling and power (CCP) system usually serves district air conditioning apart from power generation purposes. The typical system consists of a gas turbine and an exhaust gas-fired absorption refrigerator. The surplus heat of the gas turbine is recovered to generate cooling energy. In this way, the CCP system has a high overall efficiency at the design point. However, the CCP system usually runs under off-design conditions because the users’ demand varies frequently. The operating strategy of the gas turbine will affect the thermodynamic performance of itself and the entire CCP system. The operating strategies for gas turbines include the reducing turbine inlet temperature (TIT) and the compressor inlet air throttling (IAT). A CCP system, consisting of an OPRA gas turbine and a double effects absorption refrigerator, is investigated to identify the effects of different operating strategies. The CCP system is simulated based on the partial-load model of gas turbine and absorption refrigerator. The off-design performance of the CCP system is compared under different operating strategies. The results show that the IAT strategy is the better one. At 50% rated power output of the gas turbine, the IAT operating strategy can increase overall system efficiency by 10% compared with the TIT strategy. In general, the IAT operating strategy is suited for other gas turbines. However, the benefits of IAT should be investigated in the future, when different gas turbine is adopted. This study may provide a new operating

  17. A strategy for establishing diagnostic and related services to dairy farmers in developing countries based on radioimmunoassay of progesterone in milk

    International Nuclear Information System (INIS)

    Galloway, D.B.; Perera, B.M.A.O.; Manar, S.

    2001-01-01

    The radioimmunoassay (RIA) for progesterone in milk samples collected from cattle has been used for monitoring ovarian activity, diagnosis of pregnancy and non-pregnancy, assessment of the accuracy of oestrus detection and for surveying efficiency of artificial insemination services. The establishment of a service to dairy farmers in developing countries based on this technique has not been previously reported but there are clear potential benefits in such a service. A strategy was therefore developed for the establishment of diagnostic and related services to dairy farmers in Morocco on a pilot basis, using RIA of progesterone in milk for possible adoption as a model for other developing countries. (author)

  18. COMPAS: a European project on the ''comparison of alternative waste management strategies for long-lived radioactive wastes''. Scope, working methods and conclusions

    International Nuclear Information System (INIS)

    Dutton, L.M.C.; Hillis, Z.K.; Roehlig, K.J.

    2004-01-01

    The paper presents the content and major findings of a project on the ''COMParison of Alternative waste management Strategies for long-lived radioactive wastes'' (COMPAS) carried out within the 5 th framework programme of the European commission. Under the leadership of NNC (UK), the project was carried out by individuals representing waste management organisations from 15 European countries. After having compiled information on the nature and amount of long-lived radioactive waste to be managed, issues influencing the selection of waste management strategies and options, presently adopted national strategies as well as options for the future were addressed. Conclusions concerning key issues for the success or otherwise of strategies and management solutions were drawn. (orig.)

  19. Retrofitting a spent fuel pool spray system for alternative cooling as a strategy for beyond design basis events

    Energy Technology Data Exchange (ETDEWEB)

    Hartmann, Christoph; Vujic, Zoran [Westinghouse Electric Germany GmbH, Mannheim (Germany)

    2017-06-15

    Due to requirements for nuclear power plants to withstand beyond design basis accidents, including events such as happened in 2011 in the Fukushima Daiichi Nuclear Power Plant in Japan, alternative cooling of spent fuel is needed. Alternative spent fuel cooling can be provided by a retrofitted spent fuel pool spray system based on the AP1000 plant design. As part of Krsko Nuclear Power Plant's Safety Upgrade Program, Krsko Nuclear Power Plant decided on, and Westinghouse successfully designed a retrofit of the AP1000 {sup registered} plant spent fuel pool spray system to provide alternative spent fuel cooling.

  20. Final programmatic environmental impact statement for alternative strategies for the long-term management and use of depleted uranium hexafluoride. Volume 2: Appendices

    International Nuclear Information System (INIS)

    1999-04-01

    This PEIS assesses the potential impacts of alternative management strategies for depleted uranium hexafluoride (UF 6 ) currently stored at three DOE sites: Paducah site near Paducah, Kentucky, Portsmouth site near Portsmouth, Ohio; and K-25 site on the Oak Ridge Reservation, Oak Ridge, Tennessee. The alternatives analyzed in the PEIS include no action, long-term storage as UF 6 , long-term storage as uranium oxide, use as uranium oxide, use as uranium metal, and disposal. DOE's preferred alternative is to begin conversion of the depleted UF 6 inventory as soon as possible, either to uranium oxide, uranium metal, or a combination of both, while allowing for use of as much of this inventory as possible. This volume contains Appendices A--O

  1. Final programmatic environmental impact statement for alternative strategies for the long-term management and use of depleted uranium hexafluoride. Volume 1: Main text

    International Nuclear Information System (INIS)

    1999-04-01

    This PEIS assesses the potential impacts of alternative management strategies for depleted uranium hexafluoride (UF 6 ) currently stored at three DOE sites: Paducah site near Paducah, Kentucky, Portsmouth site near Portsmouth, Ohio; and K-25 site on the Oak Ridge Reservation, Oak Ridge, Tennessee. The alternatives analyzed in the PEIS include no action, long-term storage as UF 6 , long-term storage as uranium oxide, use as uranium oxide, use as uranium metal, and disposal. DOE's preferred alternative is to begin conversion of the depleted UF 6 inventory as soon as possible, either to uranium oxide, uranium metal, or a combination of both, while allowing for use of as much of this inventory as possible

  2. Final programmatic environmental impact statement for alternative strategies for the long-term management and use of depleted uranium hexafluoride. Summary

    International Nuclear Information System (INIS)

    1999-04-01

    This PEIS assesses the potential impacts of alternative management strategies for depleted uranium hexafluoride (UF 6 ) currently stored at three DOE sites: Paducah site near Paducah, Kentucky, Portsmouth site near Portsmouth, Ohio; and K-25 site on the Oak Ridge Reservation, Oak Ridge, Tennessee. The alternatives analyzed in the PEIS include no action, long-term storage as UF 6 , long-term storage as uranium oxide, use as uranium oxide, use as uranium metal, and disposal. DOE's preferred alternative is to begin conversion of the depleted UF 6 inventory as soon as possible, either to uranium oxide, uranium metal, or a combination of both, while allowing for use of as much of this inventory as possible

  3. Evaluation of research activities and research needs to increase the impact and applicability of alternative testing strategies in risk assessment practice.

    Science.gov (United States)

    Punt, Ans; Schiffelers, Marie-Jeanne W A; Jean Horbach, G; van de Sandt, Johannes J M; Groothuis, Geny M M; Rietjens, Ivonne M C M; Blaauboer, Bas J

    2011-10-01

    The present paper aims at identifying strategies to increase the impact and applicability of alternative testing strategies in risk assessment. To this end, a quantitative and qualitative literature evaluation was performed on (a) current research efforts in the development of in vitro methods aiming for alternatives to animal testing, (b) the possibilities and limitations of in vitro methods for regulatory purposes and (c) the potential of physiologically-based kinetic (PBK) modeling to improve the impact and applicability of in vitro methods in risk assessment practice. Overall, the evaluation showed that the focus of state-of-the-art research activities does not seem to be optimally directed at developing in vitro alternatives for those endpoints that are most animal-demanding, such as reproductive and developmental toxicity, and carcinogenicity. A key limitation in the application of in vitro alternatives to such systemic endpoints is that in vitro methods do not provide so-called points of departure, necessary for regulators to set safe exposure limits. PBK-modeling could contribute to overcoming this limitation by providing a method that allows extrapolation of in vitro concentration-response curves to in vivo dose-response curves. However, more proofs of principle are required. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. Alternatives to imprisonment in Scotland: policy, strategy and practice / Mesures alternatives à l’incarcération en Écosse : politique, stratégie et pratique

    Directory of Open Access Journals (Sweden)

    Freeman Ruth

    2016-12-01

    Full Text Available La gamma delle iniziative introdotta dal governo scozzese e dalle agenzie partner, nazionali e locali, ha lo scopo di ridurre il ricorso alla detenzione di breve durata, di promuovere una risposta più efficace nei confronti delle cause del crimine e di ridurre la recidiva. Queste iniziative indicano che il governo ed i suoi partner riconoscono che, anche se di cruciale importanza, le misure in comunità da sole saranno inefficaci. Sono state previste anche altre risposte che focalizzano chiaramente l’attenzione sulla prevenzione, sulla riduzione delle disuguaglianze e sulle problematiche connesse all'infanzia e associate alla recidiva in età adulta. Viene prestata particolare attenzione all'importanza della tipologie di condanne disponibili e alle agenzie che lavorano in modo collaborativo e responsabile nella comunità, al fine di concentrarsi su obiettivi condivisi. Resta da verificare se, dopo anni di continuo aumento della popolazione carceraria, queste diverse misure possono dimostrare di avere un impatto sia sul ricorso alla custodia in carcere sia sui tassi di recidiva. Tuttavia, in conformità con la ricerca, in merito a ciò che funziona per ridurre il crimine e a quello che potrebbe ridurre il ricorso alla carcerazione, sembra che l'approccio si mostri complessivamente promettente. Les différentes initiatives mises en ɶuvre par le gouvernement écossais et par les agences partenaires nationales et locales ont pour but de réduire le recours à l'emprisonnement de courte durée, de promouvoir une réponse plus efficace aux causes de la criminalité et de réduire la récidive. Elles indiquent que le gouvernement et les partenaires reconnaissent que, bien qu’elles soient extrêmement importantes, les solutions communautaires alternatives à l’incarcération seules s’avéreront inefficaces. D’autres réponses, clairement axées sur la prévention, sur la réduction des inégalités et sur des questions liées à l

  5. Is case-based learning an effective teaching strategy to challenge students' alternative conceptions regarding chemical kinetics?

    Science.gov (United States)

    Yalçınkaya, Eylem; Taştan-Kırık, Özgecan; Boz, Yezdan; Yıldıran, Demet

    2012-07-01

    Background: Case-based learning (CBL) is simply teaching the concept to the students based on the cases. CBL involves a case, which is a scenario based on daily life, and study questions related to the case, which allows students to discuss their ideas. Chemical kinetics is one of the most difficult concepts for students in chemistry. Students have generally low levels of conceptual understanding and many alternative conceptions regarding it. Purpose: This study aimed to explore the effect of CBL on dealing with students' alternative conceptions about chemical kinetics. Sample: The sample consists of 53 high school students from one public high school in Turkey. Design and methods : Nonequivalent pre-test and post-test control group design was used. Reaction Rate Concept Test and semi-structured interviews were used for data collection. Convenience sampling technique was followed. For data analysis, the independent samples t-test and ANOVA was performed. Results : Both concept test and interview results showed that students instructed with cases had better understanding of core concepts of chemical kinetics and had less alternative conceptions related to the subject matter compared to the control group students, despite the fact that it was impossible to challenge all the alternative conceptions in the experimental group. Conclusions: CBL is an effective teaching method for challenging students' alternative conceptions in the context of chemical kinetics. Since using cases in small groups and whole class discussions has been found to be an effective way to cope with the alternative conceptions, it can be applied to other subjects and grade levels in high schools with a higher sample size. Furthermore, the effect of this method on academic achievement, motivation and critical thinking skills are other variables that can be investigated for future studies in the subject area of chemistry.

  6. Accelerating access to quality TB care for pediatric TB cases through better diagnostic strategy in four major cities of India.

    Science.gov (United States)

    Raizada, Neeraj; Khaparde, Sunil D; Salhotra, Virender Singh; Rao, Raghuram; Kalra, Aakshi; Swaminathan, Soumya; Khanna, Ashwani; Chopra, Kamal Kishore; Hanif, M; Singh, Varinder; Umadevi, K R; Nair, Sreenivas Achuthan; Huddart, Sophie; Prakash, C H Surya; Mall, Shalini; Singh, Pooja; Saha, B K; Denkinger, Claudia M; Boehme, Catharina; Sarin, Sanjay

    2018-01-01

    Diagnosis of TB in children is challenging, and is largely based on positive history of contact with a TB case, clinical and radiological findings, often without microbiological confirmation. Diagnostic efforts are also undermined by challenges in specimen collection and the limited availability of high sensitivity, rapid diagnostic tests that can be applied with a quick turnaround time. The current project was undertaken in four major cities of India to address TB diagnostic challenges in pediatric population, by offering free of cost Xpert testing to pediatric presumptive TB cases, thereby paving the way for better TB care. A high throughput lab was established in each of the four project cities, and linked to various health care providers across the city through rapid specimen transportation and electronic reporting linkages. Free Xpert testing was offered to all pediatric (0-14 years) presumptive TB cases (both pulmonary and extra-pulmonary) seeking care at public and private health facilities. The current project enrolled 42,238 pediatric presumptive TB cases from April, 2014 to June, 2016. A total of 3,340 (7.91%, CI 7.65-8.17) bacteriologically confirmed TB cases were detected, of which 295 (8.83%, CI 7.9-9.86) were rifampicin-resistant. The level of rifampicin resistance in the project cohort was high. Overall Xpert yielded a high proportion of valid results and TB detection rates were more than three-fold higher than smear microscopy. The project provided same-day testing and early availability of results led to rapid treatment initiation and success rates and very low rates of treatment failure and loss to follow-up. The current project demonstrated the feasibility of rolling out rapid and upfront Xpert testing for pediatric presumptive TB cases through a single Xpert lab per city in an efficient manner. Rapid turnaround testing time facilitated prompt and appropriate treatment initiation. These results suggest that the upfront Xpert assay is a promising

  7. Alternative end points to evaluate a therapeutic strategy in advanced colorectal cancer: evaluation of progression-free survival, duration of disease control, and time to failure of strategy--an Aide et Recherche en Cancerologie Digestive Group Study.

    Science.gov (United States)

    Chibaudel, Benoist; Bonnetain, Franck; Shi, Qian; Buyse, Marc; Tournigand, Christophe; Sargent, Daniel J; Allegra, Carmen J; Goldberg, Richard M; de Gramont, Aimery

    2011-11-01

    Progression-free survival (PFS) is not an optimal end point to evaluate therapeutic strategies in advanced colorectal cancer (ACRC). Therefore, composite end points have been proposed to evaluate a chemotherapy strategy when sequential treatments are available: duration of disease control (DDC) and time to failure of strategy (TFS). The goal of this study was to evaluate these alternative end points and their potential surrogacy for overall survival (OS). We pooled individual patient data from three randomized trials evaluating chemotherapy strategy, which accrued 1,042 patients with previously untreated ACRC. In these trials, first-line treatment was either oxaliplatin- or irinotecan-based chemotherapy. Compared with TFS, DDC included neither time interval between progression and next sequence of treatment nor time to progression if the best result of the next sequence of treatment was progression. There was good correlation between DDC and OS (correlation of median: r, 0.62; correlation of hazard ratio [HR]: adjusted copula R(2), 0.72) and between TFS and OS (correlation of median: r, 0.59; correlation of HR: adjusted copula R(2), 0.67). There was no correlation between PFS and OS (correlation of median: r, 0.45; correlation of HR: adjusted copula R(2), 0.47). DDC and TFS roughly achieved the same results. Both are acceptable new end points to evaluate a therapeutic strategy in ACRC. Although TFS achieved a pragmatic evaluation of a multiline strategy, DDC captured the effect of a specific sequence in a therapeutic strategy.

  8. The Quality of Quantity: Mini-UAVS As An Alternative UAV Acquisition Strategy at the Army Brigade Level

    National Research Council Canada - National Science Library

    Weed, Shawn

    2002-01-01

    This monograph asks should the U.S. Army alter its current UAV acquisition strategy for maneuver brigades from one in which limited numbers of high capability systems are acquired, in favor of another that fields a large quantity...

  9. How to diagnose a child? Atention Deficit-Hiperactivity Disorder diagnostic strategies from a critical discursive perspective

    Directory of Open Access Journals (Sweden)

    Mónica Peña Ochoa

    2015-03-01

    Full Text Available This work examines from the perspective of critical discourse analysis, the Attention Deficit with Hyperactivity Disorder diagnosis as stated by the DSM–IV and ICD-10. It considers as basis the difficulties posed by medical taxonomy of childhood as a distinct social category from adulthood, the using the sign of hyperkinesia as an evidence of the disorder, and the utilization of auxiliary instruments, external to the clinical “setting”, as the “Test of Conners”. The context of analysis refers to conditions present in Chile. Specifically, taking into consideration the diagnostic applications in the institutional space of the school. Finally, the diagnosis is analyzed from the uses and effects in regulating and self-government of individuals and bodies.

  10. Workshop on acceleration of the validation and regulatory acceptance of alternative methods and implementation of testing strategies.

    NARCIS (Netherlands)

    Piersma, A H; Burgdorf, T; Louekari, K; Desprez, B; Taalman, R; Landsiedel, R; Barroso, J; Rogiers, V; Eskes, C; Oelgeschläger, M; Whelan, M; Braeuning, A; Vinggaard, A M; Kienhuis, A; van Benthem, J; Ezendam, J

    2018-01-01

    This report describes the proceedings of the BfR-RIVM workshop on validation of alternative methods which was held 23 and 24 March 2017 in Berlin, Germany. Stakeholders from governmental agencies, regulatory authorities, universities, industry and the OECD were invited to discuss current problems

  11. Contribution of diagnostic tests for the etiological assessment of uveitis, data from the ULISSE study (Uveitis: Clinical and medicoeconomic evaluation of a standardized strategy of the etiological diagnosis).

    Science.gov (United States)

    Grumet, Pierre; Kodjikian, Laurent; de Parisot, Audrey; Errera, Marie-Hélène; Sedira, Neila; Heron, Emmanuel; Pérard, Laurent; Cornut, Pierre-Loïc; Schneider, Christelle; Rivière, Sophie; Ollé, Priscille; Pugnet, Grégory; Cathébras, Pascal; Manoli, Pierre; Bodaghi, Bahram; Saadoun, David; Baillif, Stéphanie; Tieulie, Nathalie; Andre, Marc; Chiambaretta, Frédéric; Bonin, Nicolas; Bielefeld, Philip; Bron, Alain; Mouriaux, Frédéric; Bienvenu, Boris; Vicente, Stéphanie; Bin, Sylvie; Labetoulle, Marc; Broussolle, Christiane; Jamilloux, Yvan; Decullier, Evelyne; Sève, Pascal

    2018-04-01

    ULISSE is the only study that prospectively assessed the efficiency of a standardized strategy, compared to an open strategy for the etiologic diagnosis of uveitis. Our aim was to evaluate the diagnostic yield of the tests prescribed in the ULISSE study to clarify their relevance. ULISSE is a non-inferiority, prospective, multicenter and cluster randomized study. The standardized strategy is a two-steps strategy: in the first step, common standard tests were performed, and in the second step, tests were guided by the clinical and anatomic type of uveitis. We reported the relevance of the diagnostic tests used in the standardized strategy, as well as the profitability of the tests that were prescribed to more than twenty patients in each group. Based on diagnostic criteria, either an ophthalmologist, or an internist, established the profitability of a test by considering whether the test lead to a diagnosis or not. Among the 676 patients included (standardized 303; open 373), a diagnosis was made for 152 (50.4%) in the standardized group and 203 (54.4%) in the open group. The most common entities were HLA-B27 associated uveitis (22%), spondyloarthritis (11%), sarcoidosis (18%), tuberculosis (10.7%) and herpes virus infections (8.5%). Among the first step's systematic tests, tuberculin skin test was the most contributive investigation (17.1%), followed by chest X-ray (8.4%), C reactive protein and ESR (6.6% and 5.1%), complete blood count (2.2%) and VDRL (2.0%). The second step's most often contributive tests were: HLA B27 (56.3%), chest-CT (30.3%) and angiotensin converting enzyme (ACE) (16.5%). HLA B27 and ACE were significantly more contributive in the standardized group than in the open group. Immunological tests were never contributive. Among the free investigations, or among the investigations guided by clinical or paraclinical findings, the most often contributive tests were: Quantiferon® (24%), electrophoresis of serum protein (7.8%) and sacroiliac imagery

  12. Evaluation of alternative groundwater-management strategies for the Bureau of Reclamation Klamath Project, Oregon and California

    Science.gov (United States)

    Wagner, Brian J.; Gannett, Marshall W.

    2014-01-01

    The water resources of the upper Klamath Basin, in southern Oregon and northern California, are managed to achieve various complex and interconnected purposes. Since 2001, irrigators in the Bureau of Reclamation Klamath Irrigation Project (Project) have been required to limit surface-water diversions to protect habitat for endangered freshwater and anadromous fishes. The reductions in irrigation diversions have led to an increased demand for groundwater by Project irrigators, particularly in drought years. The potential effects of sustained pumping on groundwater and surface-water resources have caused concern among Federal and state agencies, Indian tribes, wildlife groups, and groundwater users. To aid in the development of a viable groundwater-management strategy for the Project, the U.S. Geological Survey, in collaboration with the Klamath Water and Power Agency and the Oregon Water Resources Department, developed a groundwater-management model that links groundwater simulation with techniques of constrained optimization. The overall goal of the groundwater-management model is to determine the patterns of groundwater pumping that, to the extent possible, meet the supplemental groundwater demands of the Project. To ensure that groundwater development does not adversely affect groundwater and surface-water resources, the groundwater-management model includes constraints to (1) limit the effects of groundwater withdrawal on groundwater discharge to streams and lakes that support critical habitat for fish listed under the Endangered Species Act, (2) ensure that drawdowns do not exceed limits allowed by Oregon water law, and (3) ensure that groundwater withdrawal does not adversely affect agricultural drain flows that supply a substantial portion of water for irrigators and wildlife refuges in downslope areas of the Project. Groundwater-management alternatives were tested and designed within the framework of the Klamath Basin Restoration Agreement (currently [2013

  13. Terrorism and Counter-Terrorism Strategies in a Globalised World : alternative perceptiveness of terrorist emergence theory and policing strategies confrontation with human rights

    OpenAIRE

    Kikkas, Margit

    2015-01-01

    Globalisation and development in technology have advanced terrorism to reach a broader target audience. Especially focussing at the international co-operation strategies and combined social networks, terrorist activities have an direct- and indirect effect on private households, international commerce and local governments. Security institutions and state organisations use various combinations of counter- terrorism measures, that are mostly social-, political-, or financial in nature. Neverth...

  14. Diagnostic accuracy and cost-effectiveness of alternative methods for detection of soil-transmitted helminths in a post-treatment setting in western Kenya.

    Directory of Open Access Journals (Sweden)

    Liya M Assefa

    2014-05-01

    Full Text Available This study evaluates the diagnostic accuracy and cost-effectiveness of the Kato-Katz and Mini-FLOTAC methods for detection of soil-transmitted helminths (STH in a post-treatment setting in western Kenya. A cost analysis also explores the cost implications of collecting samples during school surveys when compared to household surveys.Stool samples were collected from children (n = 652 attending 18 schools in Bungoma County and diagnosed by the Kato-Katz and Mini-FLOTAC coprological methods. Sensitivity and additional diagnostic performance measures were analyzed using Bayesian latent class modeling. Financial and economic costs were calculated for all survey and diagnostic activities, and cost per child tested, cost per case detected and cost per STH infection correctly classified were estimated. A sensitivity analysis was conducted to assess the impact of various survey parameters on cost estimates.Both diagnostic methods exhibited comparable sensitivity for detection of any STH species over single and consecutive day sampling: 52.0% for single day Kato-Katz; 49.1% for single-day Mini-FLOTAC; 76.9% for consecutive day Kato-Katz; and 74.1% for consecutive day Mini-FLOTAC. Diagnostic performance did not differ significantly between methods for the different STH species. Use of Kato-Katz with school-based sampling was the lowest cost scenario for cost per child tested ($10.14 and cost per case correctly classified ($12.84. Cost per case detected was lowest for Kato-Katz used in community-based sampling ($128.24. Sensitivity analysis revealed the cost of case detection for any STH decreased non-linearly as prevalence rates increased and was influenced by the number of samples collected.The Kato-Katz method was comparable in diagnostic sensitivity to the Mini-FLOTAC method, but afforded greater cost-effectiveness. Future work is required to evaluate the cost-effectiveness of STH surveillance in different settings.

  15. A comparison of the suitability of patient dosimetry methods for establishing diagnostic dose reference levels and optimisation strategies

    International Nuclear Information System (INIS)

    Gfirtner, Hans; Moores, B. Michael; Stieve, Friedrich E.

    2008-01-01

    For 50 adult patients referred for chest radiography, air kerma at the diaphragm KD, dose area product and entrance skin dose were measured. The air kerma at the diaphragm and the dose area product were determined using Diamentor M4KDK(PTW) which allows measuring air kerma and dose area product simultaneously. For the measurement of entrance skin dose TLDs are used. A 50% variation in dose, incident dose as well as entrance skin dose, was registered for the same patient thickness. The recommendation of ICRP to perform the measurements for DRLs at 'representative patients' and that of the CEC to use 'standard-sized patients' seem to make little sense in the case of chest radiography. It could be demonstrated, that the dose area product is the least appropriate dose quantity for patient measurements and to define dose reference levels. For some radiological examinations like chest, pelvis and lumbar spine the dose area product is even sex dependent. Incident dose and entrance surface dose are of equal quality for patient dose measurements in diagnostic radiography. (author)

  16. Laboratory diagnostics in dog-mediated rabies: an overview of performance and a proposed strategy for various settings.

    Science.gov (United States)

    Duong, Veasna; Tarantola, Arnaud; Ong, Sivuth; Mey, Channa; Choeung, Rithy; Ly, Sowath; Bourhy, Hervé; Dussart, Philippe; Buchy, Philippe

    2016-05-01

    The diagnosis of dog-mediated rabies in humans and animals has greatly benefited from technical advances in the laboratory setting. Approaches to diagnosis now include the detection of rabies virus (RABV), RABV RNA, or RABV antigens. These assays are important tools in the current efforts aimed at the global elimination of dog-mediated rabies. The assays available for use in laboratories are reviewed herein, as well as their strengths and weaknesses, which vary with the types of sample analyzed. Depending on the setting, however, the public health objectives and use of RABV diagnosis in the field will also vary. In non-endemic settings, the detection of all introduced or emergent animal or human cases justifies exhaustive testing. In dog RABV-endemic settings, such as rural areas of developing countries where most cases occur, the availability of or access to testing may be severely constrained. Thus, these issues are also discussed along with a proposed strategy to prioritize testing while access to rabies testing in the resource-poor, highly endemic setting is improved. As the epidemiological situation of rabies in a country evolves, the strategy should shift from that of an endemic setting to one more suitable for a decreased rabies incidence following the implementation of efficient control measures and when nearing the target of dog-mediated rabies elimination. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Social supports and prevention strategies as adjuncts and alternatives to sedation and anesthesia for people with special needs.

    Science.gov (United States)

    Glassman, Paul; Miller, Christine

    2009-01-01

    People with special needs are assuming a more prominent place in our society. The number of people living in communities with medical, physical, and psychological conditions is increasing dramatically. In spite of the advances that people with special needs have made in recognition of their right to live in society and access services open to other people, their oral health is still significantly poorer than that of other groups. There are a number of modalities that can complement or replace pharmacological interventions and allow individuals to have dental treatment in a dental office or clinic. These include behavioral or psychological interventions and social support and prevention strategies. Social supports include care management and integration of oral health services with general health and social service systems. Preventive programs using modern "medical model" oral health prevention strategies also have the potential to reduce the burden of disease among people with special needs and therefore reduce the need for dental procedures. A social support system using community-based Dental Hygienists acting as Dental Coordinators, is described along with outcomes demonstrating improved oral health for people with special needs living in community residential care facilities. Combined social support systems and community prevention strategies have the potential to reduce the need for pharmacological interventions in order to maintain oral health in populations of people with special needs. Social supports and modern preventive strategies must be included in the range of options available in communities in order to improve and maintain oral health for people with special needs.

  18. Physical and biological responses to an alternative removal strategy of a moderate-sized dam in Washington, USA.

    Science.gov (United States)

    Shannon Claeson; B. Coffin

    2015-01-01

    Dam removal is an increasingly practised river restoration technique, and ecological responses vary with watershed, dam and reservoir properties, and removal strategies. Moderate-sized dams, like Hemlock Dam (7.9m tall and 56m wide), are large enough that removal effects could be significant, but small enough that mitigation may be possible through a modified dam...

  19. Evaluation of ICA-AROMA and alternative strategies for motion artifact removal in resting state fMRI

    NARCIS (Netherlands)

    Pruim, R.H.; Mennes, M.; Buitelaar, J.K.; Beckmann, C.F.

    2015-01-01

    We proposed ICA-AROMA as a strategy for the removal of motion-related artifacts from fMRI data (Pruim et al., submitted for publication). ICA-AROMA automatically identifies and subsequently removes data-driven derived components that represent motion-related artifacts. Here we present an extensive

  20. Playing the Metadata Game: Technologies and Strategies Used by Climate Diagnostics Center for Cataloging and Distributing Climate Data.

    Science.gov (United States)

    Schweitzer, R. H.

    2001-05-01

    The Climate Diagnostics Center maintains a collection of gridded climate data primarily for use by local researchers. Because this data is available on fast digital storage and because it has been converted to netCDF using a standard metadata convention (called COARDS), we recognize that this data collection is also useful to the community at large. At CDC we try to use technology and metadata standards to reduce our costs associated with making these data available to the public. The World Wide Web has been an excellent technology platform for meeting that goal. Specifically we have developed Web-based user interfaces that allow users to search, plot and download subsets from the data collection. We have also been exploring use of the Pacific Marine Environment Laboratory's Live Access Server (LAS) as an engine for this task. This would result in further savings by allowing us to concentrate on customizing the LAS where needed, rather that developing and maintaining our own system. One such customization currently under development is the use of Java Servlets and JavaServer pages in conjunction with a metadata database to produce a hierarchical user interface to LAS. In addition to these Web-based user interfaces all of our data are available via the Distributed Oceanographic Data System (DODS). This allows other sites using LAS and individuals using DODS-enabled clients to use our data as if it were a local file. All of these technology systems are driven by metadata. When we began to create netCDF files, we collaborated with several other agencies to develop a netCDF convention (COARDS) for metadata. At CDC we have extended that convention to incorporate additional metadata elements to make the netCDF files as self-describing as possible. Part of the local metadata is a set of controlled names for the variable, level in the atmosphere and ocean, statistic and data set for each netCDF file. To allow searching and easy reorganization of these metadata, we loaded

  1. Massively Parallel Sequencing of Genes Implicated in Heritable Cardiac Disorders: A Strategy for a Small Diagnostic Laboratory

    Directory of Open Access Journals (Sweden)

    Ivone U. S. Leong

    2017-10-01

    Full Text Available Sudden cardiac death (SCD in people before the age of 35 years is a devastating event for any family. The causes of SCD in the young can be broadly divided into two groups: heritable cardiac disorders that affect the heart structure (cardiomyopathies and primary electrical disorders (cardiac ion channelopathies. Genetic testing is vital as those suffering from cardiac ion channelopathies have structurally normal hearts, and those with cardiomyopathies may only show subtle abnormalities in the heart and these signs may not be detected during an autopsy. Post-mortem genetic testing of SCD victims is important to identify the underlying genetic cause. This is important as family cascade screening may be undertaken to identify those who may be at risk and provide vital information about risk stratification and clinical management. The development of massively parallel sequencing (MPS has made it possible for the simultaneous screening of multiple patients for hundreds of genes. In light of this, we opted to develop an MPS approach for SCD analysis that would allow us to screen for mutations in genes implicated in cardiomyopathies and cardiac ion channelopathies. The rationale behind this panel was to limit it to genes carrying the greatest mutation load. If no likely pathogenic gene variant were found then testing could cascade to whole exome/genome sequencing as a gene-discovery exercise. The overarching aim was to design and validate a custom-cardiac panel that satisfies the diagnostic requirements of LabPLUS (Auckland City Hospital, Auckland, NZ and the guidelines provided by the Royal College of Pathologists of Australasia and the Association for Clinical Genetic Science.

  2. Massively Parallel Sequencing of Genes Implicated in Heritable Cardiac Disorders: A Strategy for a Small Diagnostic Laboratory.

    Science.gov (United States)

    Leong, Ivone U S; Stuckey, Alexander; Belluoccio, Daniele; Fan, Vicky; Skinner, Jonathan R; Prosser, Debra O; Love, Donald R

    2017-10-10

    Sudden cardiac death (SCD) in people before the age of 35 years is a devastating event for any family. The causes of SCD in the young can be broadly divided into two groups: heritable cardiac disorders that affect the heart structure (cardiomyopathies) and primary electrical disorders (cardiac ion channelopathies). Genetic testing is vital as those suffering from cardiac ion channelopathies have structurally normal hearts, and those with cardiomyopathies may only show subtle abnormalities in the heart and these signs may not be detected during an autopsy. Post-mortem genetic testing of SCD victims is important to identify the underlying genetic cause. This is important as family cascade screening may be undertaken to identify those who may be at risk and provide vital information about risk stratification and clinical management. The development of massively parallel sequencing (MPS) has made it possible for the simultaneous screening of multiple patients for hundreds of genes. In light of this, we opted to develop an MPS approach for SCD analysis that would allow us to screen for mutations in genes implicated in cardiomyopathies and cardiac ion channelopathies. The rationale behind this panel was to limit it to genes carrying the greatest mutation load. If no likely pathogenic gene variant were found then testing could cascade to whole exome/genome sequencing as a gene-discovery exercise. The overarching aim was to design and validate a custom-cardiac panel that satisfies the diagnostic requirements of LabPLUS (Auckland City Hospital, Auckland, NZ) and the guidelines provided by the Royal College of Pathologists of Australasia and the Association for Clinical Genetic Science.

  3. A strategy to optimize radiation exposure for non-contrast head CT: comparison with the Japanese diagnostic reference levels.

    Science.gov (United States)

    Kumamaru, Kanako K; Kogure, Yosuke; Suzuki, Michimasa; Hori, Masaaki; Nakanishi, Atsushi; Kamagata, Koji; Hagiwara, Akifumi; Andica, Christina; Ri, Keiken; Houshido, Naoyoshi; Aoki, Shigeki

    2016-06-01

    To describe how we performed a protocol review, analyzed data, identified opportunities to reduce radiation exposure, and then implemented a new imaging protocol for non-contrast adult head CT at our institution with reduced radiation exposure, using the Japanese diagnostic reference levels (DRLs) as the reference. After analyzing the CT dose index (CTDIvol) and dose length product (DLP) in all non-contrast adult head CT examinations performed during a 3-month period (September to November 2015) in order to identify a specific protocol that contributed to the above-DRL-level radiation exposure observed for non-contrast adult head CT at our institution, phantom studies with objective and subjective image quality analyses were performed to develop a new imaging protocol. After implementing the new protocol, its feasibility was evaluated in terms of radiation exposure, prevalence of significant disease detection, and subjective image quality. The review of 2040 examinations revealed that a helical protocol (CTDIvol = 93.4 mGy) with one of four CT scanners mainly contributed to the above-DRL-level radiation exposure (mean DLP at this scanner = 1401.2 mGy cm) in non-contrast adult head CT at our institution. To replace this protocol, the phantom study identified a wide-volume scan using 120 kVp, 350 mAs, a 4-cm detector, a slice thickness of 5 mm, and a CTDIvol of 69.8 mGy as a new protocol that yielded comparable image quality to the existing protocol. After the implementation of the new protocol, the overall mean DLP reduced to 1365 mGy cm without any apparent degradation of image quality. No significant decrease in the prevalence of significant findings after protocol revision was noted. We report the successful implementation of a new protocol with reduced radiation exposure for non-contrast head CT examinations.

  4. An Overview on Coronary Heart Disease (A Comparative Evaluation of Turkey and Europe and Cost-effectiveness of Diagnostic Strategies

    Directory of Open Access Journals (Sweden)

    Cengiz Taşçı

    2011-12-01

    Full Text Available Objective: Coronary heart disease (CHD is the leading cause of death for men and women in Turkey as it is in Europe and US. The prevalence of the disease is 3.8% in Turkey and 200,000 patients are added to the pool of CHD annually Because of genetic predis¬position and high proportions of physical inactivity, smoking habit, and obesity, CHD is encountered in earlier ages in our country So, the economic burden of the disease is expected to be relatively high, but the amount of health expenditure is not always parallel to the prevalence of a disease in the community. This article was written to overview CHD statistics to make a comparison between Turkey and some European countries and to investigate the value of myocardial perfusion scan (MPS as a gatekeeper in diagnosing CHD before invasive coronary angiography (ICA. The consequences were evaluated for Turkey In diagnosis; noninvasive testing gains impor¬tance in connection with the new approaches in treatment strategies, because a direct ICA strategy results in higher rates of revascu¬larization without improvement in clinical outcomes. A "gatekeeper" is needed to select the patients who are not required to under¬go angiography. MPS with its proved power in diagnosis and predicting prognosis, provides a cost-effective solution, and is accepted in some extensive analyses as a "gatekeeper" particularly in intermediate and high risk patients and in patients with known CHD. In conclusion, MPS may provide an optimal solution better than the ongoing situation in Turkey as well, when it is approved as a "gatekeeper in an algorithm before ICA. (MIRT 2011;20:75-93

  5. Cost-effectiveness and public health impact of alternative influenza vaccination strategies in high-risk adults.

    Science.gov (United States)

    Raviotta, Jonathan M; Smith, Kenneth J; DePasse, Jay; Brown, Shawn T; Shim, Eunha; Nowalk, Mary Patricia; Wateska, Angela; France, Glenson S; Zimmerman, Richard K

    2017-10-09

    High-dose trivalent inactivated influenza vaccine (HD-IIV3) or recombinant trivalent influenza vaccine (RIV) may increase influenza vaccine effectiveness (VE) in adults with conditions that place them at high risk for influenza complications. This analysis models the public health impact and cost-effectiveness (CE) of these vaccines for 50-64year-olds. Markov model CE analysis compared 5 strategies in 50-64year-olds: no vaccination; only standard-dose IIV3 offered (SD-IIV3 only), only quadrivalent influenza vaccine offered (SD-IIV4 only); high-risk patients receiving HD-IIV3, others receiving SD-IIV3 (HD-IIV3 & SD-IIV3); and high-risk patients receiving HD-IIV3, others receiving SD-IIV4 (HD-IIV3 & SD-IIV4). In a secondary analysis, RIV replaced HD-IIV3. Parameters were obtained from U.S. databases, the medical literature and extrapolations from VE estimates. Effectiveness was measured as 3%/year discounted quality adjusted life year (QALY) losses avoided. The least expensive strategy was SD-IIV3 only, with total costs of $99.84/person. The SD-IIV4 only strategy cost an additional $0.91/person, or $37,700/QALY gained. The HD-IIV3 & SD-IIV4 strategy cost $1.06 more than SD-IIV4 only, or $71,500/QALY gained. No vaccination and HD-IIV3 & SD-IIV3 strategies were dominated. Results were sensitive to influenza incidence, vaccine cost, standard-dose VE in the entire population and high-dose VE in high-risk patients. The CE of RIV for high-risk patients was dependent on as yet unknown parameter values. Based on available data, using high-dose influenza vaccine or RIV in middle-aged, high-risk patients may be an economically favorable vaccination strategy with public health benefits. Clinical trials of these vaccines in this population may be warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Clinical outcomes with alternative dosing strategies for piperacillin/tazobactam: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Hui Yang

    Full Text Available A better dosing strategy can improve clinical outcomes for patients. We sought to compare the extended or continuous infusion with conventional intermittent infusion of piperacillin/tazobactam, investigating which approach is better and worthy of recommendation for clinical use.Articles were gathered from PubMed, Web of Science, ProQuest, Science Direct, Cochrane, two Chinese literature databases (CNKI, Wan Fang Data and related ICAAC and ACCP conferences. Randomized controlled and observational studies that compared extended or continuous infusion with conventional intermittent infusion of piperacillin/tazobactam were identified from the databases above and analyzed. Two reviewers independently extracted and investigated the data. A meta-analysis was performed using Revman 5.2 software. The quality of each study was assessed. Sensitivity analysis and publication bias were evaluated.Five randomized controlled trials and nine observational studies were included in this study. All included studies had high quality and no publication bias was found. Compared to the conventional intermittent infusion approach, the extended or continuous infusion group had a significantly higher clinical cure rate (OR 1.88, 95% CI 1.29-2.73, P = 0.0009 and a lower mortality rate (OR 0.67, 95% CI 0.50-0.89, P = 0.005. No statistical difference was observed for bacteriologic cure (OR 1.40, 95% CI 0.82-2.37, P = 0.22 between the two dosing regimens. The sensitivity analysis showed the results were stable.Our systematic review and meta-analysis suggested that the extended or continuous infusion strategy of piperacillin/tazobactam should be recommended for clinical use considering its higher clinical cure rate and lower mortality rate in comparison with conventional intermittent strategy. Data from this study could be extrapolated for other β-lactam antimicrobials. Therefore, this dosing strategy could be considered in clinical practice.

  7. Do Small Format Supermarkets Improve the Shopping Experience?: Field Study Assessment of Two Alternative U.S. Strategies

    OpenAIRE

    Mark Lang; Primidya K. M. Soesilo; Richard Lancioni

    2012-01-01

    Industry reports have highlighted the trend for smaller format supermarkets in the food industry. Retailers such as Wal-Mart, Tesco, and Safeway see smaller format supermarkets as an opportunity to respond to the changing preferences of customers who are seeking a more convenient shoppability experience. This study investigates differences in small format retail strategies among retailers. A combination of direct observation in a naturalistic setting and Delphi methodologies were employed. A ...

  8. ss-siRNAs allele selectively inhibit ataxin-3 expression: multiple mechanisms for an alternative gene silencing strategy.

    Science.gov (United States)

    Liu, Jing; Yu, Dongbo; Aiba, Yuichiro; Pendergraff, Hannah; Swayze, Eric E; Lima, Walt F; Hu, Jiaxin; Prakash, Thazha P; Corey, David R

    2013-11-01

    Single-stranded silencing RNAs (ss-siRNAs) provide an alternative approach to gene silencing. ss-siRNAs combine the simplicity and favorable biodistribution of antisense oligonucleotides with robust silencing through RNA interference (RNAi). Previous studies reported potent and allele-selective inhibition of human huntingtin expression by ss-siRNAs that target the expanded CAG repeats within the mutant allele. Mutant ataxin-3, the genetic cause of Machado-Joseph Disease, also contains an expanded CAG repeat. We demonstrate here that ss-siRNAs are allele-selective inhibitors of ataxin-3 expression and then redesign ss-siRNAs to optimize their selectivity. We find that both RNAi-related and non-RNAi-related mechanisms affect gene expression by either blocking translation or affecting alternative splicing. These results have four broad implications: (i) ss-siRNAs will not always behave similarly to analogous RNA duplexes; (ii) the sequences surrounding CAG repeats affect allele-selectivity of anti-CAG oligonucleotides; (iii) ss-siRNAs can function through multiple mechanisms and; and (iv) it is possible to use chemical modification to optimize ss-siRNA properties and improve their potential for drug discovery.

  9. New alternatives for reference evapotranspiration estimation in West Africa using limited weather data and ancillary data supply strategies.

    Science.gov (United States)

    Landeras, Gorka; Bekoe, Emmanuel; Ampofo, Joseph; Logah, Frederick; Diop, Mbaye; Cisse, Madiama; Shiri, Jalal

    2018-05-01

    Accurate estimation of reference evapotranspiration ( ET 0 ) is essential for the computation of crop water requirements, irrigation scheduling, and water resources management. In this context, having a battery of alternative local calibrated ET 0 estimation methods is of great interest for any irrigation advisory service. The development of irrigation advisory services will be a major breakthrough for West African agriculture. In the case of many West African countries, the high number of meteorological inputs required by the Penman-Monteith equation has been indicated as constraining. The present paper investigates for the first time in Ghana, the estimation ability of artificial intelligence-based models (Artificial Neural Networks (ANNs) and Gene Expression Programing (GEPs)), and ancillary/external approaches for modeling reference evapotranspiration ( ET 0 ) using limited weather data. According to the results of this study, GEPs have emerged as a very interesting alternative for ET 0 estimation at all the locations of Ghana which have been evaluated in this study under different scenarios of meteorological data availability. The adoption of ancillary/external approaches has been also successful, moreover in the southern locations. The interesting results obtained in this study using GEPs and some ancillary approaches could be a reference for future studies about ET 0 estimation in West Africa.

  10. To mate or fight? Male-male competition and alternative mating strategies in Argyrodes antipodiana (Theridiidae, Araneae).

    Science.gov (United States)

    Whitehouse, M E

    1991-05-01

    Argyrodes antipodiana is a kleptoparasitic spider that builds its own web around the webs of other, larger host species. Males are more prone to have contests on webs of conspecific females than on webs of conspecific males. Males are also more likely to escalate interactions when on the females' webs than on males' webs, consistent with predictions from game theory models. Yet, in nearly half the tests, males on females' webs did not escalate. Instead of just being "sampling error", these failures to escalate may reflect the contest losers' abilities to gain copulations by "sneaking", an alternative mating tactic which enables males to obtain access to a female, not by fighting, but by exploiting the dominant male's dilemma of whether to mate or fight. Copyright © 1991. Published by Elsevier B.V.

  11. New strategy to identify radicals in a time evolving EPR data set by multivariate curve resolution-alternating least squares.

    Science.gov (United States)

    Fadel, Maya Abou; de Juan, Anna; Vezin, Hervé; Duponchel, Ludovic

    2016-12-01

    Electron paramagnetic resonance (EPR) spectroscopy is a powerful technique that is able to characterize radicals formed in kinetic reactions. However, spectral characterization of individual chemical species is often limited or even unmanageable due to the severe kinetic and spectral overlap among species in kinetic processes. Therefore, we applied, for the first time, multivariate curve resolution-alternating least squares (MCR-ALS) method to EPR time evolving data sets to model and characterize the different constituents in a kinetic reaction. Here we demonstrate the advantage of multivariate analysis in the investigation of radicals formed along the kinetic process of hydroxycoumarin in alkaline medium. Multiset analysis of several EPR-monitored kinetic experiments performed in different conditions revealed the individual paramagnetic centres as well as their kinetic profiles. The results obtained by MCR-ALS method demonstrate its prominent potential in analysis of EPR time evolved spectra. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Sustainable alternatives for land-based biofuels in the European Union. Assessment of options and development of a policy strategy

    Energy Technology Data Exchange (ETDEWEB)

    Kampman, B.; Van Grinsven, A.; Croezen, H.

    2012-12-15

    It is feasible for EU member states to meet their commitments regarding transport fuels under the Renewable Energy Directive (RED) and the Fuel Quality Directive (FQD) without resorting to biofuels from food crops. The RED target (10% renewable transport energy in 2020) can be met by a mix of measures aimed at improving energy efficiency, combined with a strong focus on growth of renewable electricity use and biofuels and biomethane from waste and residues. These measures also contribute to the FQD target (6% reduction in carbon intensity of fuels by 2020), but will need to be complemented by other measures such as reduced flaring and venting during oil production. The report shows how EU transport energy policy could reduce its reliance on biofuels from food crops that are likely to cause land use change. This alternative vision for the transport sector in 2020 would cut CO2 emissions by 205 million tonnes.

  13. Feasibility of reaching world health organization targets for hepatitis C and the cost-effectiveness of alternative strategies.

    Science.gov (United States)

    Wisløff, Torbjørn; White, Richard; Dalgard, Olav; Amundsen, Ellen J; Meijerink, Hinta; Kløvstad, Hilde

    2018-04-06

    New drugs for treating hepatitis C have considerably increased the probability of being cured. Treatment uptake, however, is still low. The objectives of this study were to analyse the impact of initiatives that may increase the proportion of infected people on treatment and interventions aimed at reducing the incidence of new infection among people who inject drugs. A compartmental model for Norway was used to simulate hepatitis C and related complications. We analysed two different screening initiatives aimed to increase the proportion of infected people on treatment. Interventions aiming at reducing the hepatitis C incidence analysed were opioid substitution therapy, a clean needle and syringe programme and a combination of both.The most cost-effective strategy for increasing hepatitis C treatment uptake was screening by general practitioners while simultaneously allowing for all infected people to be treated. We estimated that this intervention reduce the incidence of hepatitis C by 2030 by 63% compared to the current incidence. The two harm-reduction strategies both reduced the incidence of hepatitis C by about 70%. Combining an increase of the current clean needles and syringe programme with opioid substitution therapy was clearly the most cost-effective option. This strategy would reduce the incidence of hepatitis C by 80% compared to the current incidence by 2030. Thus, interventions to reduce the burden and spread of hepatitis C are cost-effective. Reaching the WHO target of a 90% reduction in hepatitis C incidence by 2030 may be difficult without combining different initiatives. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  14. Depression screening in stroke: a comparison of alternative measures with the structured diagnostic interview for the diagnostic and statistical manual of mental disorders, fourth edition (major depressive episode) as criterion standard.

    Science.gov (United States)

    Turner, Alyna; Hambridge, John; White, Jennifer; Carter, Gregory; Clover, Kerrie; Nelson, Louise; Hackett, Maree

    2012-04-01

    Screening tools for depression and psychological distress commonly used in medical settings have not been well validated in stroke populations. We aimed to determine the accuracy of common screening tools for depression or distress in detecting caseness for a major depressive episode compared with a clinician-administered structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders Fourth Edition as the gold standard. Seventy-two participants ≥3 weeks poststroke underwent a diagnostic interview for major depressive episode and completed the Patient Health Questionnaire-2 and -9, Hospital Anxiety and Depression Scale, Beck Depression Inventory-II, Distress Thermometer, and Kessler-10. Internal consistency, sensitivity, specificity, likelihood ratios, and posttest probabilities were calculated. Each measure was validated against the gold standard using receiver operating characteristic curves with comparison of the area under the curve for all measures. Internal consistency ranged from acceptable to excellent for all measures (Cronbach α=0.78-0.94). Areas under the curve (95% CI) for the Patient Health Questionnaire-2, Patient Health Questionnaire-9, Hospital Anxiety and Depression Scale depression and total score, Beck Depression Inventory-II, and Kessler-10 ranged from 0.80 (0.69-0.89) for the Kessler-10 to 0.89 (0.79-0.95) for the Beck Depression Inventory-II with no significant differences between measures. The Distress Thermometer had an area under the curve (95% CI) of 0.73 (0.61-0.83), significantly smaller than the Beck Depression Inventory-II (P<0.05). Apart from the Distress Thermometer, selected scales performed adequately in a stroke population with no significant difference between measures. The Patient Health Questionnaire-2 would be the most useful single screen given free availability and the shortest number of items.

  15. Final programmatic environmental impact statement for alternative strategies for the long-term management and use of depleted uranium hexafluoride. Volume 3: Responses to public comments

    International Nuclear Information System (INIS)

    1999-04-01

    This PEIS assesses the potential impacts of alternative management strategies for depleted uranium hexafluoride (UF 6 ) currently stored at three DOE sites: Paducah site near Paducah, Kentucky, Portsmouth site near Portsmouth, Ohio; and K-25 site on the Oak Ridge Reservation, Oak Ridge, Tennessee. The alternatives analyzed in the PEIS include no action, long-term storage as UF 6 , long-term storage as uranium oxide, use as uranium oxide, use as uranium metal, and disposal. DOE's preferred alternative is to begin conversion of the depleted UF 6 inventory as soon as possible, either to uranium oxide, uranium metal, or a combination of both, while allowing for use of as much of this inventory as possible. This volume of the Final PEIS contains the comments and DOE's responses to comments received during the comment period. Chapter 2 contains photocopies of written submissions received by DOE on the Draft PEIS; DOE's responses to those comments are listed in Chapter 3. Chapter 4 provides the oral comments received at the public hearings and DOE's responses. Chapter 5 provides indices to comments and responses arranged by commentor name and by comment number

  16. An Alternative Strategy of Preventive Control of Tick-borne Relapsing Fever in Rural Areas of Sine-Saloum, Senegal

    Science.gov (United States)

    Diatta, Georges; Mediannikov, Oleg; Boyer, Sylvie; Sokhna, Cheikh; Bassène, Hubert; Fenollar, Florence; Chauvancy, Gilles; Ndiaye, Abdoul Aziz; Diene, Fatoumata; Parola, Philippe; Raoult, Didier

    2016-01-01

    In Senegal, tick-borne relapsing fever (TBRF) is a major cause of morbidity and a neglected public health problem. Borreliosis cases commonly detected in two villages led us to implement a borreliosis preventive control including cementing of floors in bedrooms and outbuildings attended by inhabitants to avoid human contacts with tick vectors. Epidemiological and medical monitoring of the TBRF incidence was carried out at Dielmo and Ndiop by testing the blood of febrile patients since 1990 and 1993, respectively. Intra-domiciliary habitat conditions were improved by cementing, coupled with accompanying measures, from March 2013 to September 2015. Application of this strategy was associated with a significant reduction of borreliosis incidence. This was more evident in Dielmo, dropping from 10.55 to 2.63 cases per 100 person-years (P < 0.001), than in Ndiop where it changed from 3.79 to 1.39 cases per 100 person-years (P < 0.001). Thirty-six cases of TBRF were estimated to be prevented at a cost of €526 per infection. The preventive control strategy was successful in Dielmo and Ndiop, being associated with decreased incidence by 89.8% and 81.5%, respectively, suggesting that TBRF may be widely decreased when the population is involved. Public health authorities or any development stakeholders should adopt this effective tool for promoting rural health through national prevention programs. PMID:27430543

  17. Alternative strategies for carcinogenicity assessment: an efficient and simplified approach based on in vitro mutagenicity and cell transformation assays.

    Science.gov (United States)

    Benigni, Romualdo; Bossa, Cecilia

    2011-05-01

    The need for tools able to predict chemical carcinogens in less time and at a lower cost in terms of animal lives and money is still a research priority, even after several decades of effort in that direction. Now, new regulatory requirements (e.g. the Registration, Evaluation, Authorisation and Restriction of Chemical substances recently implemented in Europe) have even increased the pressure to develop new tools in this field. Drawbacks of the present testing strategies have come to light again recently especially in view of new requirements in worldwide regulations. Among these are (i) the lack of assays able to identify non-genotoxic carcinogens, (ii) the exaggerated rate of misleading (false) positive results of the in vitro mammalian cell-based short-term mutagenicity tests and (iii) the extremely low sensitivity of in vivo short-term mutagenicity tests. Within this perspective, we analyse the contribution of cell transformation assays (CTAs), and we show that they are a valid complement to tools able to detect DNA-reactive carcinogens. We also show that a tiered strategy, with inexpensive and fast tests in Tier 1 (e.g. the Ames test or structural alerts) and the Syrian hamster embryo CTA in Tier 2, is able to identify up to 90% of carcinogens.

  18. Comparison of dobutamine-stress magnetic resonance imaging and dipyridamole-Tl-201-SPECT as alternative strategies for the detection of coronary artery disease in patients not suitable for stress-echocardiography

    International Nuclear Information System (INIS)

    Schmidt, M.; Theissen, P.; Voth, E.; Schicha, H.; Jochims, M.; Baer, F.M.; Crnac, J.; Schneider, C.A.; Erdmann, E.

    2001-01-01

    Aim: During the past decade stress-echocardiography has gained increasing popularity for detection of myocardial ischemia in patients with coronary artery disease. However, about 10% to 15% of the patients submitted for stress-echocardiography do not have an adequate acoustic window. The purpose of this study was to compare high-dose dobutamine-stress magnetic resonance imaging (dobutamine-MRI) with dipyridamole-Tl-201-SPECT (dipyridamole-SPECT) as alternative strategies for detection of myocardial ischemia in patients with inadequate image quality by stress-echocardiography. Patients and Methods: Of 296 patients which were consecutively submitted to stress-echo-cardiography 45 patients (15%) had two or more segments that could not be evaluated according to the 16-segment-model of the American Society of Echocardiography. They underwent dobutamine-MRI and dipyridamole-SPECT studies, which were evaluated using a 28-segment modell. Myocardial segments were attributed to perfusion territories of the coronary arteries. The results of ischemia detection were compared to the results of coronary angiography (stenosis ≥50%). Results: In comparison to coronary angiography dobutamine-MRI yielded a sensitivity of 87%, a specificity of 86%, a positive predictive value of 93%, a negative predictive value of 75% and a diagnostic accuracy of 86%. For dipyridamole-SPECT results were 90%, 86%, 93%, 80% and 89%, respectively. These values were not significantly different. Conclusions: In patients not suitable for stress-echocardiography, both dobutamine-MRI and dipyridamole-SPECT are reliable strategies for detection of myocardial ischemia. Selection is dependent on the patient criteria, technical considerations, local logistics and experience of the observer. (orig.) [de

  19. The Unsuccessful Poverty Reduction Strategies in Indonesia and the Alternatives Solutions (The Study on BLT and Jamkesmas

    Directory of Open Access Journals (Sweden)

    Dewi Iriani

    2014-08-01

    Full Text Available Indonesia as the 16th largest economy in the world, the 4th in Asia-after China, Japan and India as well as Southeast Asia’s largest-has the potential to be the seventh biggest by 2030, due to the increasing economic. Indonesia also has many potential natural resources that can be utilized to support development in order to increase the nation welfare. However, the number of poor people still has not been significantly reduced, reaching 28.07 million or 11.37% of the total population in 2013. The Government has tried to reduce poverty with some programs such as BLT (Bantuan Langsung Tunai/Direct Cash Assistance and Jamkesmas (Jaminan Kesehatan Masyarakat/ Community Health Protection Scheme. However, the programs are considered not effective and do not make poor people become financially independent. Ironically, in inadequate evaluation, the Government continues to runs the programs. By using a qualitative approach, researchers will provide policy alternatives that can be implemented by Government.

  20. Cost-effectiveness of alternative strategies for annual influenza vaccination among children aged 6 months to 14 years in four provinces in China.

    Directory of Open Access Journals (Sweden)

    Lei Zhou

    Full Text Available BACKGROUND: To support policy making, we developed an initial model to assess the cost-effectiveness of potential strategies to increase influenza vaccination rates among children in China. METHODS: We studied on children aged 6 months to 14 years in four provinces (Shandong, Henan, Hunan, and Sichuan, with a health care system perspective. We used data from 2005/6 to 2010/11, excluding 2009/10. Costs are reported in 2010 U.S. dollars. RESULTS: In comparison with no vaccination, the mean (range of Medically Attended Cases averted by the current self-payment policy for the two age groups (6 to 59 months and 60 months to 14 years was 1,465 (23 ∼ 11,132 and 792 (36 ∼ 4,247, and the cost effectiveness ratios were $ 0 (-11-51 and $ 37 (6-125 per case adverted, respectively. In comparison with the current policy, the incremental cost effectiveness ratio (ICER of alternative strategies, OPTION One-reminder and OPTION Two-comprehensive package, decreased as vaccination rate increased. The ICER for children aged 6 to 59 months was lower than that for children aged 60 months to 14 years. CONCLUSIONS: The model is a useful tool in identifying elements for evaluating vaccination strategies. However, more data are needed to produce more accurate cost-effectiveness estimates of potential vaccination policies.

  1. Cost-Effectiveness of Alternative Strategies for Annual Influenza Vaccination among Children Aged 6 Months to 14 Years in Four Provinces in China

    Science.gov (United States)

    Zhou, Lei; Situ, Sujian; Feng, Zijian; Atkins, Charisma Y.; Fung, Isaac Chun-Hai; Xu, Zhen; Huang, Ting; Hu, Shixiong; Wang, Xianjun; Meltzer, Martin I.

    2014-01-01

    Background To support policy making, we developed an initial model to assess the cost-effectiveness of potential strategies to increase influenza vaccination rates among children in China. Methods We studied on children aged 6 months to 14 years in four provinces (Shandong, Henan, Hunan, and Sichuan), with a health care system perspective. We used data from 2005/6 to 2010/11, excluding 2009/10. Costs are reported in 2010 U.S. dollars. Results In comparison with no vaccination, the mean (range) of Medically Attended Cases averted by the current self-payment policy for the two age groups (6 to 59 months and 60 months to 14 years) was 1,465 (23∼11,132) and 792 (36∼4,247), and the cost effectiveness ratios were $ 0 (-11-51) and $ 37 (6-125) per case adverted, respectively. In comparison with the current policy, the incremental cost effectiveness ratio (ICER) of alternative strategies, OPTION One-reminder and OPTION Two-comprehensive package, decreased as vaccination rate increased. The ICER for children aged 6 to 59 months was lower than that for children aged 60 months to 14 years. Conclusions The model is a useful tool in identifying elements for evaluating vaccination strategies. However, more data are needed to produce more accurate cost-effectiveness estimates of potential vaccination policies. PMID:24498145

  2. Distributed and dynamic modelling of hydrology, phosphorus and ecology in the Hampshire Avon and Blashford Lakes: evaluating alternative strategies to meet WFD standards.

    Science.gov (United States)

    Whitehead, P G; Jin, L; Crossman, J; Comber, S; Johnes, P J; Daldorph, P; Flynn, N; Collins, A L; Butterfield, D; Mistry, R; Bardon, R; Pope, L; Willows, R

    2014-05-15

    The issues of diffuse and point source phosphorus (P) pollution in the Hampshire Avon and Blashford Lakes are explored using a catchment model of the river system. A multibranch, process based, dynamic water quality model (INCA-P) has been applied to the whole river system to simulate water fluxes, total phosphorus (TP) and soluble reactive phosphorus (SRP) concentrations and ecology. The model has been used to assess impacts of both agricultural runoff and point sources from waste water treatment plants (WWTPs) on water quality. The results show that agriculture contributes approximately 40% of the phosphorus load and point sources the other 60% of the load in this catchment. A set of scenarios have been investigated to assess the impacts of alternative phosphorus reduction strategies and it is shown that a combined strategy of agricultural phosphorus reduction through either fertiliser reductions or better phosphorus management together with improved treatment at WWTPs would reduce the SRP concentrations in the river to acceptable levels to meet the EU Water Framework Directive (WFD) requirements. A seasonal strategy for WWTP phosphorus reductions would achieve significant benefits at reduced cost. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. Cost-effectiveness of alternate strategies for childhood immunization against meningococcal disease with monovalent and quadrivalent conjugate vaccines in Canada.

    Directory of Open Access Journals (Sweden)

    Thomas E Delea

    Full Text Available Public health programs to prevent invasive meningococcal disease (IMD with monovalent serogroup C meningococcal conjugate vaccine (MCV-C and quadrivalent meningococcal conjugate vaccines (MCV-4 in infancy and adolescence vary across Canadian provinces. This study evaluated the cost-effectiveness of various vaccination strategies against IMD using current and anticipated future pricing and recent epidemiology.A cohort model was developed to estimate the clinical burden and costs (CAN$2014 of IMD in the Canadian population over a 100-year time horizon for three strategies: (1 MCV-C in infants and adolescents (MCV-C/C; (2 MCV-C in infants and MCV-4 in adolescents (MCV-C/4; and (3 MCV-4 in infants (2 doses and adolescents (MCV-4/4. The source for IMD incidence was Canadian surveillance data. The effectiveness of MCV-C was based on published literature. The effectiveness of MCV-4 against all vaccination regimens was assumed to be the same as for MCV-C regimens against serogroup C. Herd effects were estimated by calibration to estimates reported in prior analyses. Costs were from published sources. Vaccines prices were projected to decline over time reflecting historical procurement trends.Over the modeling horizon there are a projected 11,438 IMD cases and 1,195 IMD deaths with MCV-C/C; expected total costs are $597.5 million. MCV-C/4 is projected to reduce cases of IMD by 1,826 (16% and IMD deaths by 161 (13%. Vaccination costs are increased by $32 million but direct and indirect IMD costs are projected to be reduced by $46 million. MCV-C/4 is therefore dominant vs. MCV-C/C in the base case. Cost-effectiveness of MCV-4/4 was $111,286 per QALY gained versus MCV-C/4 (2575/206 IMD cases/deaths prevented; incremental costs $68 million.If historical trends in Canadian vaccines prices continue, use of MCV-4 instead of MCV-C in adolescents may be cost-effective. From an economic perspective, switching to MCV-4 as the adolescent booster should be considered.

  4. Cost-effectiveness of alternate strategies for childhood immunization against meningococcal disease with monovalent and quadrivalent conjugate vaccines in Canada.

    Science.gov (United States)

    Delea, Thomas E; Weycker, Derek; Atwood, Mark; Neame, Dion; Alvarez, Fabián P; Forget, Evelyn; Langley, Joanne M; Chit, Ayman

    2017-01-01

    Public health programs to prevent invasive meningococcal disease (IMD) with monovalent serogroup C meningococcal conjugate vaccine (MCV-C) and quadrivalent meningococcal conjugate vaccines (MCV-4) in infancy and adolescence vary across Canadian provinces. This study evaluated the cost-effectiveness of various vaccination strategies against IMD using current and anticipated future pricing and recent epidemiology. A cohort model was developed to estimate the clinical burden and costs (CAN$2014) of IMD in the Canadian population over a 100-year time horizon for three strategies: (1) MCV-C in infants and adolescents (MCV-C/C); (2) MCV-C in infants and MCV-4 in adolescents (MCV-C/4); and (3) MCV-4 in infants (2 doses) and adolescents (MCV-4/4). The source for IMD incidence was Canadian surveillance data. The effectiveness of MCV-C was based on published literature. The effectiveness of MCV-4 against all vaccination regimens was assumed to be the same as for MCV-C regimens against serogroup C. Herd effects were estimated by calibration to estimates reported in prior analyses. Costs were from published sources. Vaccines prices were projected to decline over time reflecting historical procurement trends. Over the modeling horizon there are a projected 11,438 IMD cases and 1,195 IMD deaths with MCV-C/C; expected total costs are $597.5 million. MCV-C/4 is projected to reduce cases of IMD by 1,826 (16%) and IMD deaths by 161 (13%). Vaccination costs are increased by $32 million but direct and indirect IMD costs are projected to be reduced by $46 million. MCV-C/4 is therefore dominant vs. MCV-C/C in the base case. Cost-effectiveness of MCV-4/4 was $111,286 per QALY gained versus MCV-C/4 (2575/206 IMD cases/deaths prevented; incremental costs $68 million). If historical trends in Canadian vaccines prices continue, use of MCV-4 instead of MCV-C in adolescents may be cost-effective. From an economic perspective, switching to MCV-4 as the adolescent booster should be considered.

  5. Assessing the water quality response to an alternative sewage disposal strategy at bathing sites on the east coast of Ireland.

    Science.gov (United States)

    Bedri, Zeinab; O'Sullivan, John J; Deering, Louise A; Demeter, Katalin; Masterson, Bartholomew; Meijer, Wim G; O'Hare, Gregory

    2015-02-15

    A three-dimensional model is used to assess the bathing water quality of Bray and Killiney bathing sites in Ireland following changes to the sewage management system. The model, firstly calibrated to hydrodynamic and water quality data from the period prior to the upgrade of the Wastewater Treatment Works (WwTW), was then used to simulate Escherichia coli (E. coli) distributions for discharge scenarios of the periods prior to and following the upgrade of the WwTW under dry and wet weather conditions. E. coli distributions under dry weather conditions demonstrate that the upgrade in the WwTW has remarkably improved the bathing water quality to a Blue Flag status. The new discharge strategy is expected to drastically reduce the rainfall-related incidents in which environmental limits of the Bathing Water Directive are breached. However, exceedances to these limits may still occur under wet weather conditions at Bray bathing site due to storm overflows that may still be discharged through two sea outfalls offshore of Bray bathing site. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. IDegLira Versus Alternative Intensification Strategies in Patients with Type 2 Diabetes Inadequately Controlled on Basal Insulin Therapy

    DEFF Research Database (Denmark)

    Freemantle, Nick; Mamdani, Muhammad; Vilsbøll, Tina

    2015-01-01

    glycated hemoglobin (HbA1c) and other outcomes. METHODS: A pooled analysis of five completed Novo Nordisk randomized clinical trials in patients with type 2 diabetes inadequately controlled on basal insulin was used to compare indirectly IDegLira (N = 199) with: addition of liraglutide to basal insulin (N...... = 225) [glucagon-like peptide-1 receptor agonist (GLP-1RA) add-on strategy]; basal-bolus (BB) insulin [insulin glargine (IGlar) + insulin aspart] (N = 56); or up-titration of IGlar (N = 329). A supplementary analysis was performed with the BB arm including patients who received IGlar or IDeg as basal...... of study, differences between IDegLira and BB or up-titrated IGlar, respectively, were as follows: reduction in HbA1c -0.30%, 95% confidence interval (-0.58; -0.01) and -0.65% (-0.83; -0.47); change in body weight -6.89 kg (-7.92; -5.86) and -4.04 kg (-4.69; -3.40) all in favor of IDegLira. Confirmed...

  7. Lifetime attributable risk as an alternative to effective dose to describe the risk of cancer for patients in diagnostic and therapeutic nuclear medicine

    Science.gov (United States)

    Andersson, Martin; Eckerman, Keith; Mattsson, Sören

    2017-12-01

    The aim of this study is to implement lifetime attributable risk (LAR) predictions of cancer for patients of various age and gender, undergoing diagnostic investigations or treatments in nuclear medicine and to compare the outcome with a population risk estimate using effective dose and the International Commission on Radiological Protection risk coefficients. The radiation induced risk of cancer occurrence (incidence) or death from four nuclear medicine procedures are estimated for both male and female between 0 and 120 years. Estimations of cancer risk are performed using recommended administered activities for two diagnostic (18F-FDG and 99mTc-phosphonate complex) and two therapeutic (131I-iodide and 223Ra-dichloride) radiopharmaceuticals to illustrate the use of cancer risk estimations in nuclear medicine. For 18F-FDG, the cancer incidence for a male of 5, 25, 50 and 75 years at exposure is 0.0021, 0.0010, 0.0008 and 0.0003, respectively. For 99mTc phosphonates complex the corresponding values are 0.000 59, 0.000 34, 0.000 27 and 0.000 13, respectively. For an 131I-iodide treatment with 3.7 GBq and 1% uptake 24 h after administration, the cancer incidence for a male of 25, 50 and 75 years at exposure is 0.041, 0.029 and 0.012, respectively. For 223Ra-dichloride with an administration of 21.9 MBq the cancer incidence for a male of 25, 50 and 75 years is 0.31, 0.21 and 0.09, respectively. The LAR estimations are more suitable in health care situations involving individual patients or specific groups of patients than the health detriment based on effective dose, which represents a population average. The detriment consideration in effective dose adjusts the cancer incidence for suffering of non-lethal cancers while LAR predicts morbidity (incidence) or mortality (cancer). The advantages of these LARs are that they are gender and age specific, allowing risk estimations for specific patients or subgroups thus better representing individuals in health care

  8. A strategy for cell-based multiplex diagnostics of Myasthenia gravis and autoimmune encephalitis by modifying the subcellular localization of cell membrane autoantigens.

    Science.gov (United States)

    George, S; Georgi, M; Roggenbuck, D; Conrad, K; Küpper, J-H

    2014-01-01

    Many autoimmune diseases are characterized by autoantibodies directed against cell membrane proteins. We were intrigued to develop a strategy for targeting individual cell membrane proteins to various subcellular compartments as a prerequisite for their simultaneous immunofluorescence detection. We first employed GFP and RFP reporters that were equipped with defined intracellular localization signals. Expressing these protein reporters in HEp-2 cells we found by using fluorescence microscopy that protein localization in cytoplasm or at mitochondria can be clearly discriminated from localization at Golgi, ER or lysosomes. We then tested for muscle-specific kinase, a relevant cell membrane autoantigen in Myasthenia gravis, and NMDA receptor which is relevant for autoimmune encephalitis, whether these autoantigens can be localized to the same intracellular compartments. To this end, we successfully targeted muscle-specific kinase to Golgi apparatus, mitochondria and cytoplasm. We found that its Golgi localization can be clearly distinguished from its natural cell membrane localization. The same we found for Golgi-localized NMDA receptor 1. Interestingly, cell membrane proteins kept at the Golgi system accumulated in higher amounts than their wild-type counterparts. The obtained results are the basis for the further development of multiplex assays for the immunofluorescence diagnostics of Myasthenia gravis and autoimmune encephalitis.

  9. Diagnostic strategies in spinal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Heinemann, Uwe [Institut fuer Radiologie und Neuroradiologie, Klinikum Aschaffenburg, Am Hasenkopf 1, 63739 Aschaffenburg (Germany); Freund, Michael [Institut fuer Radiologie und Neuroradiologie, Klinikum Aschaffenburg, Am Hasenkopf 1, 63739 Aschaffenburg (Germany)]. E-mail: michael.freund@klinikum-aschaffenburg.de

    2006-04-15

    Spinal injuries may result in severe neurological deficits, especially if nerve roots or even the spinal cord are affected. Besides presenting the important anatomical and technical basis underlying the imaging findings of spinal injuries, the trauma mechanisms and the resulting injuries are discussed. Based on the current literature and recommendations of scientific organizations, an approach is provided to the radiologic work up of spinal trauma. The different imaging modalities are presented. Advantages and disadvantages of the methods are discussed.

  10. Diagnostic strategies in spinal trauma

    International Nuclear Information System (INIS)

    Heinemann, Uwe; Freund, Michael

    2006-01-01

    Spinal injuries may result in severe neurological deficits, especially if nerve roots or even the spinal cord are affected. Besides presenting the important anatomical and technical basis underlying the imaging findings of spinal injuries, the trauma mechanisms and the resulting injuries are discussed. Based on the current literature and recommendations of scientific organizations, an approach is provided to the radiologic work up of spinal trauma. The different imaging modalities are presented. Advantages and disadvantages of the methods are discussed

  11. Relationship Between Alternative Resuscitation Strategies, Host Response and Injury Biomarkers, and Outcome in Septic Shock: Analysis of the Protocol-Based Care for Early Septic Shock Study.

    Science.gov (United States)

    Kellum, John A; Pike, Francis; Yealy, Donald M; Huang, David T; Shapiro, Nathan I; Angus, Derek C

    2017-03-01

    The Protocol-based Care for Early Septic Shock trial found no differences across alternative resuscitation strategies in all-cause mortality. A separate aim was to determine whether differences in resuscitation strategies affected trajectories of biomarkers of key pathways associated with downstream clinical outcomes of sepsis and whether there were differences in survival across treatment arms for patients with different baseline biomarker profiles. Secondary analysis of a large randomized clinical trial. Thirty-one U.S. hospitals. Six hundred twenty-eight patients with septic shock. Two resuscitation protocols versus usual care. We measured a panel of biomarkers representing four pathophysiologic domains: "inflammation" (tumor necrosis factor, interleukin-6, and -10); "coagulation" (D-dimers, thrombin-antithrombin complex); "oxidative stress" (urine isoprostane); and "tissue hypoxia" (lactate) at 0, 6, 24, and 72 hours after treatment. We analyzed whether alternative resuscitation strategies affected biomarker trajectories over 72 hours and whether effects on 90-day hospital mortality varied by baseline (time 0) biomarker profiles-both using regression models with interaction terms for treatment arms. For all baseline biomarkers, higher concentrations were associated with increased risk of death by 90 days. However, there was no significant effect of treatment assignment on subsequent biomarker trajectories. We did find evidence for heterogeneity of treatment effect of protocol-based care on mortality for patients with different baseline [interleukin-6] and [interleukin-6] × [interleukin-10] profiles, whereas patients with the lowest quartiles fared better with protocol-based care (odds ratios, 0.32 [0.13-075]; p = 0.01 and 0.32 [0.14-0.73]; p = 0.01, respectively). In patients with septic shock, alterations in inflammation, coagulation, oxidative stress, and tissue hypoxia are common and associated with adverse outcomes but are not influenced by protocol

  12. A simple quantitative diagnostic alternative for MGMT DNA-methylation testing on RCL2 fixed paraffin embedded tumors using restriction coupled qPCR.

    Science.gov (United States)

    Pulverer, Walter; Hofner, Manuela; Preusser, Matthias; Dirnberger, Elisabeth; Hainfellner, Johannes A; Weinhaeusel, Andreas

    2014-01-01

    MGMT promoter methylation is associated with favorable prognosis and chemosensitivity in glioblastoma multiforme (GBM), especially in elderly patients. We aimed to develop a simple methylation-sensitive restriction enzyme (MSRE)-based quantitative PCR (qPCR) assay, allowing the quantification of MGMT promoter methylation. DNA was extracted from non-neoplastic brain (n = 24) and GBM samples (n = 20) upon 3 different sample conservation conditions (-80 °C, formalin-fixed and paraffin-embedded (FFPE); RCL2-fixed). We evaluated the suitability of each fixation method with respect to the MSRE-coupled qPCR methylation analyses. Methylation data were validated by MALDITOF. qPCR was used for evaluation of alternative tissue conservation procedures. DNA from FFPE tissue failed reliable testing; DNA from both RCL2-fixed and fresh frozen tissues performed equally well and was further used for validation of the quantitative MGMT methylation assay (limit of detection (LOD): 19.58 pg), using individual's undigested sample DNA for calibration. MGMT methylation analysis in non-neoplastic brain identified a background methylation of 0.10 ± 11% which we used for defining a cut-off of 0.32% for patient stratification. Of GBM patients 9 were MGMT methylationpositive (range: 0.56 - 91.95%), and 11 tested negative. MALDI-TOF measurements resulted in a concordant classification of 94% of GBM samples in comparison to qPCR. The presented methodology allows quantitative MGMT promoter methylation analyses. An amount of 200 ng DNA is sufficient for triplicate analyses including control reactions and individual calibration curves, thus excluding any DNA qualityderived bias. The combination of RCL2-fixation and quantitative methylation analyses improves pathological routine examination when histological and molecular analyses on limited amounts of tumor samples are necessary for patient stratification.

  13. Mechanism of alternative splicing and its regulation.

    Science.gov (United States)

    Wang, Yan; Liu, Jing; Huang, B O; Xu, Yan-Mei; Li, Jing; Huang, Lin-Feng; Lin, Jin; Zhang, Jing; Min, Qing-Hua; Yang, Wei-Ming; Wang, Xiao-Zhong

    2015-03-01

    Alternative splicing of precursor mRNA is an essential mechanism to increase the complexity of gene expression, and it plays an important role in cellular differentiation and organism development. Regulation of alternative splicing is a complicated process in which numerous interacting components are at work, including cis-acting elements and trans-acting factors, and is further guided by the functional coupling between transcription and splicing. Additional molecular features, such as chromatin structure, RNA structure and alternative transcription initiation or alternative transcription termination, collaborate with these basic components to generate the protein diversity due to alternative splicing. All these factors contributing to this one fundamental biological process add up to a mechanism that is critical to the proper functioning of cells. Any corruption of the process may lead to disruption of normal cellular function and the eventuality of disease. Cancer is one of those diseases, where alternative splicing may be the basis for the identification of novel diagnostic and prognostic biomarkers, as well as new strategies for therapy. Thus, an in-depth understanding of alternative splicing regulation has the potential not only to elucidate fundamental biological principles, but to provide solutions for various diseases.

  14. Advancing Risk Analysis for Nanoscale Materials: Report from an International Workshop on the Role of Alternative Testing Strategies for Advancement: Advancing Risk Analysis for Nanoscale Materials

    Energy Technology Data Exchange (ETDEWEB)

    Shatkin, J. A. [Vireo Advisors, Boston MA USA; Ong, Kimberly J. [Vireo Advisors, Boston MA USA; Beaudrie, Christian [Compass RM, Vancouver CA USA; Clippinger, Amy J. [PETA International Science Consortium Ltd, London UK; Hendren, Christine Ogilvie [Center for the Environmental Implications of NanoTechnology, Duke University, Durham NC USA; Haber, Lynne T. [TERA, Cincinnati OH USA; Hill, Myriam [Health Canada, Ottawa Canada; Holden, Patricia [UC Santa Barbara, Bren School of Environmental Science & Management, ERI, and UC CEIN, University of California, Santa Barbara CA USA; Kennedy, Alan J. [U.S. Army Engineer Research and Development Center, Environmental Laboratory, Vicksburg MS USA; Kim, Baram [Independent, Somerville MA USA; MacDonell, Margaret [Argonne National Laboratory, Environmental Science Division, Argonne IL USA; Powers, Christina M. [U.S. Environmental Protection Agency, Office of Air and Radiation, Office of Transportation and Air Quality, Ann Arbor MI USA; Sharma, Monita [PETA International Science Consortium Ltd, London UK; Sheremeta, Lorraine [Alberta Ingenuity Labs, Edmonton Alberta Canada; Stone, Vicki [John Muir Building Gait 1 Heriot-Watt University, Edinburgh Scotland UK; Sultan, Yasir [Environment Canada, Gatineau QC Canada; Turley, Audrey [ICF International, Durham NC USA; White, Ronald H. [RH White Consultants, Silver Spring MD USA

    2016-08-01

    The Society for Risk Analysis (SRA) has a history of bringing thought leadership to topics of emerging risk. In September 2014, the SRA Emerging Nanoscale Materials Specialty Group convened an international workshop to examine the use of alternative testing strategies (ATS) for manufactured nanomaterials (NM) from a risk analysis perspective. Experts in NM environmental health and safety, human health, ecotoxicology, regulatory compliance, risk analysis, and ATS evaluated and discussed the state of the science for in vitro and other alternatives to traditional toxicology testing for NM. Based on this review, experts recommended immediate and near-term actions that would advance ATS use in NM risk assessment. Three focal areas-human health, ecological health, and exposure considerations-shaped deliberations about information needs, priorities, and the next steps required to increase confidence in and use of ATS in NM risk assessment. The deliberations revealed that ATS are now being used for screening, and that, in the near term, ATS could be developed for use in read-across or categorization decision making within certain regulatory frameworks. Participants recognized that leadership is required from within the scientific community to address basic challenges, including standardizing materials, protocols, techniques and reporting, and designing experiments relevant to real-world conditions, as well as coordination and sharing of large-scale collaborations and data. Experts agreed that it will be critical to include experimental parameters that can support the development of adverse outcome pathways. Numerous other insightful ideas for investment in ATS emerged throughout the discussions and are further highlighted in this article.

  15. Korean Unification. Alternative Economics Strategies.

    Science.gov (United States)

    1995-09-01

    lower-middle-income countries, above such low-income countries as India , China, and Indonesia. In recent years, however, the north’s progress has been...required to renovate the electricity, gas, and district heating sectors.104 The pollution problems stemmed from relying on lignite , a dirty brown coal...The lignite -based power plants were technologically obsolete and much less efficient than those of the west. To avert dependence on public investment

  16. Investigating alternatives to the fish early-life stage test: a strategy for discovering and annotating adverse outcome pathways for early fish development.

    Science.gov (United States)

    Villeneuve, Daniel; Volz, David C; Embry, Michelle R; Ankley, Gerald T; Belanger, Scott E; Léonard, Marc; Schirmer, Kristin; Tanguay, Robert; Truong, Lisa; Wehmas, Leah

    2014-01-01

    The fish early-life stage (FELS) test (Organisation for Economic Co-operation and Development [OECD] test guideline 210) is the primary test used internationally to estimate chronic fish toxicity in support of ecological risk assessments and chemical management programs. As part of an ongoing effort to develop efficient and cost-effective alternatives to the FELS test, there is a need to identify and describe potential adverse outcome pathways (AOPs) relevant to FELS toxicity. To support this endeavor, the authors outline and illustrate an overall strategy for the discovery and annotation of FELS AOPs. Key events represented by major developmental landmarks were organized into a preliminary conceptual model of fish development. Using swim bladder inflation as an example, a weight-of-evidence-based approach was used to support linkage of key molecular initiating events to adverse phenotypic outcomes and reduced young-of-year survival. Based on an iterative approach, the feasibility of using key events as the foundation for expanding a network of plausible linkages and AOP knowledge was explored and, in the process, important knowledge gaps were identified. Given the scope and scale of the task, prioritization of AOP development was recommended and key research objectives were defined relative to factors such as current animal-use restrictions in the European Union and increased demands for fish toxicity data in chemical management programs globally. The example and strategy described are intended to guide collective efforts to define FELS-related AOPs and develop resource-efficient predictive assays that address the toxicological domain of the OECD 210 test. © 2013 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

  17. 1968 Prototype Diagnostic Test.

    Science.gov (United States)

    Veterans Administration Hospital, Bedford, MA.

    This true-false diagnostic test was used for pretesting of employees at a Veterans Administration Hospital. The test is comprised of 20 items. An alternate test--Classification Questionnaire--was used for testing after remedial training. (For related document, see TM 002 334.) (DB)

  18. Exploring Alternative Radiolabeling Strategies for Sialic Acid-Binding Immunoglobulin-Like Lectin 9 Peptide: [68Ga]Ga- and [18F]AlF-NOTA-Siglec-9

    Directory of Open Access Journals (Sweden)

    Olli Moisio

    2018-01-01

    Full Text Available Amino acid residues 283–297 from sialic acid-binding immunoglobulin-like lectin 9 (Siglec-9 form a cyclic peptide ligand targeting vascular adhesion protein-1 (VAP-1. VAP-1 is associated with the transfer of leukocytes from blood to tissues upon inflammation. Therefore, analogs of Siglec-9 peptide are good candidates for visualizing inflammation non-invasively using positron emission tomography (PET. Gallium-68-labeled 1,4,7,10-tetraazacyclododecane-N,N′,N″,N‴-tetraacetic acid (DOTA-conjugated Siglec-9 has been evaluated extensively for this purpose. Here, we explored two alternative strategies for radiolabeling Siglec-9 peptide using a 1,4,7-triazacyclononane-triacetic acid (NOTA-chelator to bind [68Ga]Ga or [18F]AlF. The radioligands were evaluated by in vivo PET imaging and ex vivo γ-counting of turpentine-induced sterile skin/muscle inflammation in Sprague-Dawley rats. Both tracers showed clear accumulation in the inflamed tissues. The whole-body biodistribution patterns of the tracers were similar.

  19. Effect of Different Alternate Irrigation Strategies using Saline and Non-Saline Water on Corn Yield, Salinity and Moisture Distribution in Soil Profile

    Directory of Open Access Journals (Sweden)

    Ali Reza Kiani

    2017-01-01

    Full Text Available Introduction: Lack of water and deterioration in the quality of soil and water resources are considered to be the prime cause of reduced crop yield in arid and semi-arid regions ‘More crop per drop’ by trickle irrigation, deficit irrigation, and uncommon water are the best strategies for mitigating water crises. Different irrigation management strategies are needed to increase production in different areas. In areas where sufficient water is available, a full irrigation strategy could be a suitable option, while in areas where water is limited, deficit irrigation would be an appropriate method, and finally in areas where water resources are saline, management strategies for achieving sustainable production as well as economic yields would be suitable. Maize is the third most important grain crop in the world following wheat and rice and it is the main source of nutrition for humans and animals. Because of the importance of maize in the world, increasing maize production under environmental stresses is a big challenge for agricultural scientists. Different methods of irrigation and the use of saline water that had satisfactory results for increasing agricultural production have been studied by several investigators . The main objective of this study was to establish an efficient use of limited water resources as well as to explore the possibility of replacing saline water with fresh water using different management techniques. Materials and Methods: A field experiment was conducted over two maize cropping seasons (2012–2013 in northern Iran (Gorgan Agricultural Research Station to compare different alternate irrigation scenarios using saline water on corn yield, salinity and soil moisture distribution in a randomized complete block design with three replications. Treatments were: T1 and T2 = 100 and 50 % of crop water requirement with non-saline water, respectively; T3 and T4 = variable and fixed full irrigation with saline and non

  20. Alternative security

    International Nuclear Information System (INIS)

    Weston, B.H.

    1990-01-01

    This book contains the following chapters: The Military and Alternative Security: New Missions for Stable Conventional Security; Technology and Alternative Security: A Cherished Myth Expires; Law and Alternative Security: Toward a Just World Peace; Politics and Alternative Security: Toward a More Democratic, Therefore More Peaceful, World; Economics and Alternative Security: Toward a Peacekeeping International Economy; Psychology and Alternative Security: Needs, Perceptions, and Misperceptions; Religion and Alternative Security: A Prophetic Vision; and Toward Post-Nuclear Global Security: An Overview

  1. The effectiveness of (IgG-ELISA) serology as an alternative diagnostic method for detecting Helicobacter pylori infection in patients with gastro-intestinal bleeding due to gastro-duodenal ulcer.

    Science.gov (United States)

    García-Díaz, E; Castro-Fernández, M; Romero-Gómez, M; Vargas-Romero, J

    2002-12-01

    To establish the sensitivity, specificity, positive predictive value and negative predictive value of serology (IgG ELISA) as an alternative diagnostic method for Helicobacter pylori infection in patients with gastro-duodenal peptic ulcer and digestive hemorrhage. The diagnosis of Helicobacter pylori infection in these patients is difficult due to the low sensitivity of invasive tests and the need to discontinue treatment with proton pump inhibitors to perform a breath test with urea 13C or the detection of Helicobacter pylori antigens in feces. We included 214 patients (164 men and 50 women) with an average age of 58 +/- 15 years, who were admitted to hospital due to upper gastro-intestinal bleeding caused by a gastro-duodenal peptic ulcer. The presence of Helicobacter pylori was established by means of gastric biopsy (fast urease test histology and/or culture) and a breath test with 13C-labeled urea. Serology was performed with the ELISA method (Pyloriset EIA-G by Orion Diagnostica). Positive Helicobacter pylori infection was accepted with any positive invasive method or breath test, and no infection was established if all invasive tests performed and the breath test with 13C-labeled urea were negative. We calculated the sensitivity, specificity, positive predictive value and negative predictive value of serology in the global series and in different subgroups of patients according to age (> 60 and peptic ulcer. 192 patients (89.7%) showed infection due to Helicobacter pylori. In the global series (n = 214) we obtained a sensitivity, specificity, positive predictive value and negative predictive value of 87.5, 54.5, 94.3 and 33.3%, respectively. Specificity was greater in the group not exposed to non-steroidal anti-inflammatory drugs (n = 110) as compared to the exposed group (n = 104), in the 60 years group (n = 105), in the duodenal ulcer group (n = 141) with respect to the gastric ulcer group (n = 59), and in the group with a history of gastro-duodenal peptic

  2. A combination of representative compounds, metabolism platform and diagnostic extraction strategy for characterization of metabolites of Shuang-Huang-Lian oral liquid in vivo by ultra-performance liquid chromatography coupled with time-of-flight mass spectrometry.

    Science.gov (United States)

    Zhang, Feng-Xiang; Xie, Zhi-Neng; Tang, Xi-Yang; Li, Chang; Li, Min; Yao, Zhi-Hong; Dai, Yi; Yao, Xin-Sheng

    2018-04-04

    Traditional Chinese medicines (TCMs) usually contained a large number of chemical components, which could be transformed into more complex metabolites in vivo. In this work, a "Representative compounds-Metabolism platform-Diagnostic extraction" strategy (RMD strategy) was proposed for comprehensively identification or characterization of xenobiotics in rat after oral administration of TCMs. Shuang-Huang-Lian oral liquid (SHL), a well-known traditional Chinese medicine preparation, was used as an example. The metabolic pathways of six representative compounds, bearing five different core structures in SHL, were elucidated and their metabolic reactions were employed for exploring metabolites of homologous components in metabolism platform. Meanwhile, diagnostic ions extraction were also used for screening more structural analogues in biofluids. All this work was completed by ultra-performance liquid chromatography coupled electrospray ionization quadruple time-of-flight mass spectrometry (UPLC/Qtof MS) and UNIFI metabolism platform. As a result, a total of 254 xenobiotics were identified or tentatively characterized in rat plasma and urine after oral administration of SHL and six representative compounds. The metabolism reaction included phase I reaction (hydroxylation, hydrolysis reaction, deglycosylation, hydrogenation, demethylation, dehydroxylation and ring opening reaction) and phase II reaction (glucuronidation, sulfation and methylation). This research provided useful information for further study of the pharmacology and mechanism of SHL in vivo. It also demonstrated that RMD strategy was an efficient approach for facilitate screening-out and rapid identification of xenobiotics in biological samples after oral administration of TCMs. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Costruzione di un modello decisionale per valutare la costo/efficacia delle strategie alternative nella terapia della polmonite acquisita in comunità

    Directory of Open Access Journals (Sweden)

    Mario Eandi

    2001-03-01

    Full Text Available Aim of this paper was to analyse the cost effectiveness of the main alternative (and complementary strategies in the disease menagement of the Community-Acquired Pneumonia (CAP: hospital admission vs home-care, antibiotic parental vs oral therapy, switch vs no-switch therapy, and early discarge vs conventional hospitalization. The cost effectivenessanalysis (CEA has been performed by implementing a general decision tree model wich describes all the main decisional and change nodes encountered in the clinical course from the firm sign and symptoms of CAP (root to the final aoutcomes: full recovery or death (terminal nodes. We assumed the perspectives of three main institutional decision-makers: the society, the italian national healthcare system (NACS, and the hospital. In the perspective of society both the direct (health and non-health costs and the indirect costs have been included, while in the perspective of the NACS only the health-direct costs were considered. In the perspective of the hospital we considered the overall mean expences sustained for each day of staying in the general and in the intensive care unit. Separately, the antibiotic treatement costs to hospital have been accounted. As effectiveness we considered the percentage of recovery for each class of mortality aqccording to fine. Most of the probability data used in the model were obtained or derived from the published literature. The cost were valued according to the Italian NACS charges and prices in use during the year 2000. According to the model structure, the main expenditure factor for the SSN is the hospitalization cost, while the home care is less expensive. The antibiotic parentenal therapy, during hospedalization or home care, is more expensive than the antibiotic oral therapy; but the cost difference between one therapy and the other is clearly lower than the cost difference between the hospitalization and the home care. The optimum expenditure situation for the

  4. Alternate strategies to obtain mass balance without the use of radiolabeled compounds: application of quantitative fluorine (19F) nuclear magnetic resonance (NMR) spectroscopy in metabolism studies.

    Science.gov (United States)

    Mutlib, Abdul; Espina, Robert; Atherton, James; Wang, Jianyao; Talaat, Rasmy; Scatina, JoAnn; Chandrasekaran, Appavu

    2012-03-19

    Nuclear magnetic resonance (NMR) spectroscopy is playing an increasingly important role in the quantitation of small and large molecules. Recently, we demonstrated that (1)H NMR could be used to quantitate drug metabolites isolated in submilligram quantities from biological sources. It was shown that these metabolites, once quantitated by NMR, were suitable to be used as reference standards in quantitative LC/MS-based assays, hence circumventing the need for radiolabeled material or synthetic standards to obtain plasma exposure estimates in humans and preclinical species. The quantitative capabilities of high-field NMR is further demonstrated in the current study by obtaining the mass balance of fluorinated compounds using (19)F-NMR. Two fluorinated compounds which were radio-labeled with carbon-14 on metabolically stable positions were dosed in rats and urine and feces collected. The mass balance of the compounds was obtained initially by counting the radioactivity present in each sample. Subsequently, the same sets of samples were analyzed by (19)F-NMR, and the concentrations determined by this method were compared with data obtained using radioactivity counting. It was shown that the two methods produced comparable values. To demonstrate the value of this analytical technique in drug discovery, a fluorinated compound was dosed intravenously in dogs and feces and urine collected. Initial profiling of samples showed that this compound was excreted mainly unchanged in feces, and hence, an estimate of mass balance was obtained using (19)F-NMR. The data obtained by this method was confirmed by additional quantitative studies using mass spectrometry. Hence cross-validations of the quantitative (19)F-NMR method by radioactivity counting and mass spectrometric analysis were demonstrated in this study. A strategy outlining the use of fluorinated compounds in conjunction with (19)F-NMR to understand their routes of excretion or mass balance in animals is proposed. These

  5. Economic evaluation of diagnostic localization following biochemical prostate cancer recurrence.

    Science.gov (United States)

    Barocas, Daniel A; Bensink, Mark E; Berry, Kristin; Musa, Zahra; Bodnar, Carolyn; Dann, Robert; Ramsey, Scott D

    2014-10-01

    The aim of this study was to assess potential cost-effectiveness of using a prostate cancer specific functional imaging technology capable of identifying residual localized disease versus small volume metastatic disease for asymptomatic men with low but detectable prostate specific antigen (PSA) elevation following radical prostatectomy. Markov modeling was used to estimate the incremental impact on healthcare system costs (2012 USD) and quality-adjusted life-years (QALYs) of two alternative strategies: (i) using the new diagnostic to guide therapy versus (ii) current usual care-using a combination of computed tomography, magnetic resonance imaging, and bone scan to guide therapy. Costs were based on estimates from literature and Medicare reimbursement. Prostate cancer progression, survival, utilities, and background risk of all-cause mortality were obtained from literature. Base-case diagnostic sensitivity (75 percent), specificity (90 percent), and cost (USD 2,500) were provided by our industry partner GE Healthcare. The new diagnostic strategy provided an average gain of 1.83 (95 percent uncertainty interval [UI]: 1.24-2.64) QALYs with added costs of USD 15,595 (95 percent UI: USD -6,330-44,402) over 35 years. The resulting incremental cost-effectiveness ratio was USD 8,516/QALY (95 percent UI: USD -2,947-22,372). RESULTS were most influenced by the utility discounting rate and test performance characteristics; however, the new diagnostic provided clinical benefits over a wide range of sensitivity and specificity. This analysis suggests a diagnostic technology capable of identifying whether men with biochemical recurrence after radical prostatectomy have localized versus metastatic disease would be a cost-effective alternative to current standard work-up. The results support additional investment in development and validation of such a diagnostic.

  6. Alternative additives; Alternative additiver

    Energy Technology Data Exchange (ETDEWEB)

    2007-08-15

    In this project a number of industrial and agricultural waste products have been characterised and evaluated in terms of alkali-getter performance. The intended use is for biomass-fired power stations aiming at reducing corrosion or slagging related problems. The following products have been obtained, characterised and evaluated: 1) Brewery draff 2) Danish de-gassed manure 3) Paper sludge 4) Moulding sand 5) Spent bleaching earth 6) Anorthosite 7) Sand 8) Clay-sludge. Most of the above alternative additive candidates are deemed unsuitable due to insufficient chemical effect and/or expensive requirements for pre-treatment (such as drying and transportation). 3 products were selected for full-scale testing: de-gassed manure, spent bleaching earth and clay slugde. The full scale tests were undertaken at the biomass-fired power stations in Koege, Slagelse and Ensted. Spent bleaching earth (SBE) and clay sludge were the only tested additive candidates that had a proven ability to react with KCl, to thereby reduce Cl-concentrations in deposits, and reduce the deposit flux to superheater tubes. Their performance was shown to nearly as good as commercial additives. De-gassed manure, however, did not evaluate positively due to inhibiting effects of Ca in the manure. Furthermore, de-gassed manure has a high concentration of heavy metals, which imposes a financial burden with regard to proper disposal of the ash by-products. Clay-sludge is a wet clay slurring, and drying and transportation of this product entails substantial costs. Spent bleaching does not require much pre-treatment and is therefore the most promising alternative additive. On the other hand, bleaching earth contains residual plant oil which means that a range of legislation relating to waste combustion comes into play. Not least a waste combustion fee of 330 DKK/tonne. For all alternative (and commercial) additives disposal costs of the increase ash by-products represents a significant cost. This is

  7. Gelişen Piyasa Ekonomilerinde Alternatif Para Politikası Stratejileri, Türkiye Ekonomisi Açısından Bir Değerlendirme(Alternative Monetary Policy Strategies in Emerging Countries, An Assessing For Turkish Economy

    Directory of Open Access Journals (Sweden)

    Şehnaz Bakır YİĞİTBAŞ

    2009-01-01

    Full Text Available This paper assesses the advantages and disadvantages of alternative monetary policy strategies involves for emerging market countries. Then it discusses two emerging market countries which illustrate what it takes to make inflation targeting work well, Chile and Brazil. The next topic that assessing inflation targeting as a monetary policy strategy for Turkey. The conclusion from this analysis is that inflation targeting is more complicated in Turkey. In order to improve inflation targeting’s performance in Turkey, the role of communication and transparency which is crutial for the process of building credibility, should be increased.

  8. A multi-species modelling approach to examine the impact of alternative climate change adaptation strategies on range shifting ability in a fragmented landscape

    OpenAIRE

    Synes, Nicholas W.; Watts, Kevin; Palmer, Stephen C.F.; Bocedi, Greta; Bartoń, Kamil A.; Osborne, Patrick E.; Travis, Justin M.J.

    2015-01-01

    An individual-based model of animal dispersal and population dynamics was used to test the effects of different climate change adaptation strategies on species range shifting ability, namely the improvement of existing habitat, restoration of low quality habitat and creation of new habitat. These strategies were implemented on a landscape typical of fragmentation in the United Kingdom using spatial rules to differentiate between the allocation of strategies adjacent to or away from existing h...

  9. Diagnostic laparoscopy

    Science.gov (United States)

    ... cavity. These complications could lead to immediate open surgery ( laparotomy ). Diagnostic laparoscopy may not be possible if you have a swollen bowel, fluid in the abdomen (ascites), or you have had a past surgery.

  10. Companion diagnostics

    DEFF Research Database (Denmark)

    Jørgensen, Jan Trøst; Hersom, Maria

    2016-01-01

    . Despite having discussed personalized medicine for more than a decade, we still see that most drug prescriptions for severe chronic diseases are largely based on 'trial and error' and not on solid biomarker data. However, with the advance of molecular diagnostics and a subsequent increased understanding...... of disease mechanisms, things are slowly changing. Within the last few years, we have seen an increasing number of predictive biomarker assays being developed to guide the use of targeted cancer drugs. This type of assay is called companion diagnostics and is developed in parallel to the drug using the drug-diagnostic...... co-development model. The development of companion diagnostics is a relatively new discipline and in this review, different aspects will be discussed including clinical and regulatory issues. Furthermore, examples of drugs, such as the ALK and PD-1/PD-L1 inhibitors, that have been approved recently...

  11. Strategy; Strategies

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    2005-07-15

    Francois Loos, Minister of Industry, explains the French energy policy in the frame of Europe. ONERC is a French public body in charge of defining a national strategy against climate changes. It submits its first strategic elements to the Government. (authors)

  12. Representing strategies

    NARCIS (Netherlands)

    Duijf, Hein; Broersen, Jan

    2016-01-01

    Quite some work in the ATL-tradition uses the differences between various types of strategies (positional, uniform, perfect recall) to give alternative semantics to the same logical language. This paper contributes to another perspective on strategy types, one where we characterise the differences

  13. Chasing down the triple-negative myeloproliferative neoplasms: Implications for molecular diagnostics.

    Science.gov (United States)

    Langabeer, Stephen E

    2016-01-01

    The majority of patients with classical myeloproliferative neoplasms (MPN) of polycythemia vera, essential thrombocythemia, and primary myelofibrosis harbor distinct disease-driving mutations within the JAK2 , CALR , or MPL genes. The term triple-negative has been recently applied to those MPN without evidence of these consistent mutations, prompting whole or targeted exome sequencing approaches to determine the driver mutational status of this subgroup. These strategies have identified numerous novel mutations that occur in alternative exons of both JAK2 and MPL , the majority of which result in functional activation. Current molecular diagnostic approaches may possess insufficient coverage to detect these alternative mutations, prompting further consideration of targeted exon sequencing into routine diagnostic practice. How to incorporate these illuminating findings into the expanding molecular diagnostic algorithm for MPN requires continual attention.

  14. Alternative Strategies to Achieve Cardiovascular Mortality Goals in China and India: A Microsimulation of Target- Versus Risk-Based Blood Pressure Treatment.

    Science.gov (United States)

    Basu, Sanjay; Yudkin, John S; Sussman, Jeremy B; Millett, Christopher; Hayward, Rodney A

    2016-03-01

    The World Health Organization aims to reduce mortality from chronic diseases including cardiovascular disease (CVD) by 25% by 2025. High blood pressure is a leading CVD risk factor. We sought to compare 3 strategies for treating blood pressure in China and India: a treat-to-target (TTT) strategy emphasizing lowering blood pressure to a target, a benefit-based tailored treatment (BTT) strategy emphasizing lowering CVD risk, or a hybrid strategy currently recommended by the World Health Organization. We developed a microsimulation model of adults aged 30 to 70 years in China and in India to compare the 2 treatment approaches across a 10-year policy-planning horizon. In the model, a BTT strategy treating adults with a 10-year CVD event risk of ≥ 10% used similar financial resources but averted ≈ 5 million more disability-adjusted life-years in both China and India than a TTT approach based on current US guidelines. The hybrid strategy in the current World Health Organization guidelines produced no substantial benefits over TTT. BTT was more cost-effective at $205 to $272/disability-adjusted life-year averted, which was $142 to $182 less per disability-adjusted life-year than TTT or hybrid strategies. The comparative effectiveness of BTT was robust to uncertainties in CVD risk estimation and to variations in the age range analyzed, the BTT treatment threshold, or rates of treatment access, adherence, or concurrent statin therapy. In model-based analyses, a simple BTT strategy was more effective and cost-effective than TTT or hybrid strategies in reducing mortality. © 2016 American Heart Association, Inc.

  15. Attitudes and perceptions of three groups of family farmers in Brazil on problems they perceive in raising broilers and alternative feeding strategies

    DEFF Research Database (Denmark)

    de Almeida, Gustavo Fonseca; Horsted, Klaus; Figueiredo, E. A.

    2015-01-01

    With the purpose to identify alternatives to the use of oil seed crops and cereals in broiler feeding, we interviewed 21 family farmers raising broilers in alternative systems located in three relevant sites for the poultry industry in Brazil. Two groups in the south (Parana and Rio Grande do Sul......) were organized in cooperatives raising slow-growing broilers in free-range systems. The third group was linked to a broiler company in the state of Sao Paulo producing antibiotic-free (AF) broilers in intensive systems. Individual assessments were performed through surveys with semi...

  16. Alternative Fuels

    Science.gov (United States)

    Alternative fuels include gaseous fuels such as hydrogen, natural gas, and propane; alcohols such as ethanol, methanol, and butanol; vegetable and waste-derived oils; and electricity. Overview of alternative fuels is here.

  17. A quantitative comparison of data evaluation methods to derive diagnostic reference levels for CT from a dosimetric survey: correlation analysis compared to simple evaluation strategies.

    Science.gov (United States)

    Leithner, Robert; Homolka, Peter

    2013-09-01

    To compare simple and sophisticated evaluation strategies for CT dosimetry surveys with focus on DRLs. Based on data from a nationwide Austrian CT dose survey, different evaluation strategies are compared. These were pooled data analysis, weight banding excluding data from patients with weights outside ±20 kg of the standard weights (70 and 75.6 kg representing the actual average weight), and a regression method estimating DLP probability distributions for the standard patient for each scanner before calculating quartiles. In the abdomen and chest region, weight restriction (-9% and -4% around 70 and 75.6 kg, respectively, compared to pooled data analysis) and statistically weighting each scanner equally (-9%) have the largest effect on DRLs derived. However, the difference in 3rd quartiles calculated using weight restriction alone compared to regression analysis is relatively small (CT examinations (different to a paediatric survey), quite simple evaluation strategies yield results very comparable to those from sophisticated strategies. Copyright © 2013 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  18. Travel demand management : a toolbox of strategies to reduce single\\0x2010occupant vehicle trips and increase alternate mode usage in Arizona.

    Science.gov (United States)

    2012-02-01

    The report provides a suite of recommended strategies to reduce single-occupant vehicle traffic in the urban : areas of Phoenix and Tucson, Arizona, which are presented as a travel demand management toolbox. The : toolbox includes supporting research...

  19. Alternatives to the Fish Early Life-Stage Test: A Research Strategy for Discovering and Annotating Adverse Outcome Pathways During Fish Development

    Science.gov (United States)

    The OECD 210 fish early life]stage (FELS) test is the primary guideline test used to estimate chronic fish toxicity, as well as support ecological risk assessments and chemical management programs around the world. As a step toward developing alternatives to the FELS test, a HES...

  20. Certified Organic Agriculture as an Alternative Livelihood Strategy for Small-scale Farmers in China: A Case Study in Wanzai County, Jiangxi Province

    DEFF Research Database (Denmark)

    Qiao, Yuhui; Martin, Friederike; Cook, Seth

    2018-01-01

    Organic agriculture can sustain rural development and ease poverty. However, whether it could be a viable pathway to improve the livelihoods of small-scale farmers in the context of urbanisation and demographic change has been less studied. To understand this, household surveys were conducted...... and sustainable alternative livelihoods, especially in a situation where available land offers opportunities for scaling up....

  1. Applications of a Rapid and Sensitive Dengue DUO Rapid Immunochromatographic Test Kit as a Diagnostic Strategy during a Dengue Type 2 Epidemic in an Urban City.

    Science.gov (United States)

    Shih, Hsin-I; Hsu, Hsiang-Chin; Wu, Chi-Jung; Lin, Chih-Hao; Chang, Chia-Ming; Tu, Yi-Fang; Hsieh, Chih-Chia; Chi, Chih-Hsien; Sung, Tzu-Ching

    2016-01-01

    Dengue infection is a major health problem in tropical and subtropical countries. A prospective observational study in a university-affiliated hospital was conducted between August 2015 and September 2015. Patients who visited the emergency department (ED) with a presentation of any symptoms of dengue were eligible for the dengue non-structural protein 1 (NS1), IgM/IgG rapid immunochromatographic tests and real-time polymerase chain reaction (RT-PCR) to evaluate the performance of the rapid tests. Considering the RT-PCR as the gold standard for the dengue diagnosis, the ideal primary results of sensitivity (80-100%), specificity (60-84%), positive predicted value(75%-95%), and negative predicted value (70-100%) suggested that the NS1-based test with or without a combination of IgM and IgG tests have good diagnostic performances in detecting dengue infections, even in the afebrile or elderly populations.

  2. Diagnostic development

    International Nuclear Information System (INIS)

    Barnett, C.F.; Brisson, D.A.; Greco, S.E.

    1978-01-01

    During the past year the far-infrared or submillimeter diagnostic research program resulted in three major developments: (1) an optically pumped 0.385-μm D 2 O-laser oscillator-amplifier system was operated at a power level of 1 MW with a line width of less than 50 MHz; (2) a conical Pyrex submillimeter laser beam dump with a retention efficiency greater than 10 4 was developed for the ion temperature Thompson scattering experiment; and (3) a new diagnostic technique was developed that makes use of the Faraday rotation of a modulated submillimeter laser beam to determine plasma current profile. Measurements of the asymmetric distortion of the H/sub α/ (6563 A) spectral line profile show that the effective toroidal drift velocity, dv/sub two vertical bars i/dT/sub i/, may be used as an indicator of plasma quality and as a complement to other ion temperature diagnostics

  3. Fungal diagnostics.

    Science.gov (United States)

    Kozel, Thomas R; Wickes, Brian

    2014-04-01

    Early diagnosis of fungal infection is critical to effective treatment. There are many impediments to diagnosis such as a diminishing number of clinical mycologists, cost, time to result, and requirements for sensitivity and specificity. In addition, fungal diagnostics must meet the contrasting needs presented by the increasing diversity of fungi found in association with the use of immunosuppressive agents in countries with high levels of medical care and the need for diagnostics in resource-limited countries where large numbers of opportunistic infections occur in patients with AIDS. Traditional approaches to diagnosis include direct microscopic examination of clinical samples, histopathology, culture, and serology. Emerging technologies include molecular diagnostics and antigen detection in clinical samples. Innovative new technologies that use molecular and immunoassay platforms have the potential to meet the needs of both resource-rich and resource-limited clinical environments.

  4. Alternative routes to the leader male role in a multi-level society: follower vs. solitary male strategies and outcomes in hamadryas baboons.

    Science.gov (United States)

    Pines, Mathew; Saunders, Julian; Swedell, Larissa

    2011-07-01

    The nested one-male units (OMUs) of the hamadryas baboon are part of a complex social system in which "leader" males achieve near exclusive mating access by forcibly herding females into permanent consortships. Within this multi-level social system (troops, bands, clans and OMUs) are two types of prereproductive males--the follower and solitary male--whose different trajectories converge on the leader role. Here we compare OMU formation strategies of followers, who associate with a particular OMU and may have social access to females, with those of solitary males, who move freely within the band and do not associate regularly with OMUs. Data were derived from 42 OMU formations (16 by followers and 26 by solitary males) occurring over 8 years in a hamadryas baboon band at the Filoha site in Ethiopia. "Initial units" (IUs) with sexually immature females (IU strategy) were formed by 44% of followers and 46% of solitary males. The remaining followers took over mature females when their leader was deposed (challenge strategy) or disappeared (opportunistic strategy), or via a seemingly peaceful transfer (inheritance strategy). Solitary males took over mature females from other clans and bands, but mainly from old, injured or vanished leaders within their clan (via both the challenge and opportunistic strategies). Former followers of an OMU were more successful at taking over females from those OMUs than any other category of male. Despite this advantage enjoyed by ex-follower leaders, ex-solitary leaders were equally capable of increasing their OMU size at a comparable rate in their first 2 years as a leader. These results demonstrate the potential for males to employ both multiple roles (follower vs. solitary male) and multiple routes (IU, inheritance, challenge, opportunistic) to acquire females and become a leader male in a mating system characterized by female defense polygyny in a competitive arena. © 2011 Wiley-Liss, Inc.

  5. Diagnostic formulation

    OpenAIRE

    Kuruvilla, K.; Kuruvilla, Anju

    2010-01-01

    Writing a ?Diagnostic Formulation? is a skill expected of candidates in the post-graduate examinations in psychiatry in most universities in India. However there is ambiguity regarding what the term means and how it should be written. This article is an attempt to provide some guidelines on this topic.

  6. Methodology for integrated evaluation of alternative siting and treatment, storage, and disposal strategies for U.S. Department of Energy waste management

    International Nuclear Information System (INIS)

    Avci, H.; Habegger, L.; Kotek, T.

    1994-01-01

    A computational model named WASTE-MGMT has been developed by Argonne National Laboratory in support of the U.S. Department of Energy (DOE) Environmental Restoration and Waste Management (EM) Programmatic Environmental Impact Statement (PEIS) to assist in the analysis of alternative approaches to the management of existing and future radioactive wastes at DOE facilities. Input to the model includes waste inventory and characterization data at each DOE site; unit operations data for the facilities used for treatment, storage and disposal (TSD) of the wastes; and information about the alternative approaches for the TSD of the wastes and for the siting of such TSD facilities. The quantities calculated by the model include the air emissions of radionuclides and hazardous chemicals during operation of the TSD facilities, the quantities and characteristics of the wastes processes annually at these facilities, and the quantities and characteristics of the waste shipped among sites. These quantities are then used as input to calculate the cost and the environmental and socioeconomic impacts resulting from the TSD of the DOE wastes under various alternative management approaches considered in the EM PEIS

  7. A specifically designed nanoconstruct associates, internalizes, traffics in cardiovascular cells, and accumulates in failing myocardium: a new strategy for heart failure diagnostics and therapeutics.

    Science.gov (United States)

    Ruiz-Esparza, Guillermo U; Segura-Ibarra, Victor; Cordero-Reyes, Andrea M; Youker, Keith A; Serda, Rita E; Cruz-Solbes, Ana S; Amione-Guerra, Javier; Yokoi, Kenji; Kirui, Dickson K; Cara, Francisca E; Paez-Mayorga, Jesus; Flores-Arredondo, Jose H; Guerrero-Beltrán, Carlos E; Garcia-Rivas, Gerardo; Ferrari, Mauro; Blanco, Elvin; Torre-Amione, Guillermo

    2016-02-01

    Ongoing inflammation and endothelial dysfunction occurs within the local microenvironment of heart failure, creating an appropriate scenario for successful use and delivery of nanovectors. This study sought to investigate whether cardiovascular cells associate, internalize, and traffic a nanoplatform called mesoporous silicon vector (MSV), and determine its intravenous accumulation in cardiac tissue in a murine model of heart failure. In vitro cellular uptake and intracellular trafficking of MSVs was examined by scanning electron microscopy, confocal microscopy, time-lapse microscopy, and flow cytometry in cardiac myocytes, fibroblasts, smooth muscle cells, and endothelial cells. The MSVs were internalized within the first hours, and trafficked to perinuclear regions in all the cell lines. Cytotoxicity was investigated by annexin V and cell cycle assays. No significant evidence of toxicity was found. In vivo intravenous cardiac accumulation of MSVs was examined by high content fluorescence and confocal microscopy, with results showing increased accumulation of particles in failing hearts compared with normal hearts. Similar to observations in vitro, MSVs were able to associate, internalize, and traffic to the perinuclear region of cardiomyocytes in vivo. Results show that MSVs associate, internalize, and traffic in cardiovascular cells without any significant toxicity. Furthermore, MSVs accumulate in failing myocardium after intravenous administration, reaching intracellular regions of the cardiomyocytes. These findings represent a novel avenue to develop nanotechnology-based therapeutics and diagnostics in heart failure. © 2016 The Authors European Journal of Heart Failure © 2016 European Society of Cardiology.

  8. Statement of the Problem: Health Reform, Value-Based Purchasing, Alternative Payment Strategies, and Children and Youth With Special Health Care Needs.

    Science.gov (United States)

    Bachman, Sara S; Comeau, Meg; Long, Thomas F

    2017-05-01

    There is increasing interest in maximizing health care purchasing value by emphasizing strategies that promote cost-effectiveness while achieving optimal health outcomes. These value-based purchasing (VBP) strategies have largely focused on adult health, and little is known about the impact of VBP program development and implementation on children, especially children and youth with special health care needs (CYSHCN). With the increasing emphasis on VBP, policymakers must critically analyze the potential impact of VBP for CYSCHN, because this group of children, by definition, uses more health care services than other children and inevitably incurs higher per person costs. We provide a history and definition of VBP and insurance design, noting its origin in employer-sponsored health insurance, and discuss various financing and payment strategies that may be pursued under a VBP framework. The relevance of these approaches for CYSHCN is discussed, and recommendations for next steps are provided. There is considerable work to be done if VBP strategies are to be applied to CYSHCN. Issues include the low prevalence of specific special health care need conditions, how to factor in a life course perspective, in which investments in children's health pay off over a long period of time, the marginal savings that may or may not accrue, the increased risk of family financial hardship, and the potential to exacerbate existing inequities across race, class, ethnicity, functional status, and other social determinants of health. Copyright © 2017 by the American Academy of Pediatrics.

  9. Does Digital Game-Based Learning Improve Student Time-on-Task Behavior and Engagement in Comparison to Alternative Instructional Strategies?

    Science.gov (United States)

    Schaaf, Ryan

    2012-01-01

    Digital Game-Based Learning (DGBL) activities were examined in comparison with effective, research-based learning strategies to observe any difference in student engagement and time-on task behavior. Experimental and control groups were randomly selected amongst the intermediate elementary school students ages 8 to 10 years old. Student…

  10. Diagnostic efficacy of gadoxetic acid (Primovist)-enhanced MRI and spiral CT for a therapeutic strategy: comparison with intraoperative and histopathologic findings in focal liver lesions

    International Nuclear Information System (INIS)

    Hammerstingl, Renate; Vogl, Thomas J.; Huppertz, Alexander; Breuer, Josy; Balzer, Thomas; Blakeborough, Anthony; Carter, Rick; Castells Fuste, Lluis; Heinz-Peer, Gertraud; Judmaier, Werner; Laniado, Michael; Manfredi, Riccardo M.; Mathieu, Didier G.; Mueller, Dieter; Mortele, Koenraad; Reimer, Peter; Reiser, Maximilian F.; Robinson, Philip J.; Shamsi, Kohkan; Strotzer, Michael; Taupitz, Matthias; Tombach, Bernd; Valeri, Gianluca; Beers, Bernhard E. van

    2008-01-01

    A multicenter study has been employed to evaluate the diagnostic efficacy of magnetic resonance imaging (MRI) using the new liver-specific contrast agent gadoxetic acid (Gd-EOB-DTPA, Primovist), as opposed to contrast-enhanced biphasic spiral computed tomography (CT), in the diagnosis of focal liver lesions, compared with a standard of reference (SOR). One hundred and sixty-nine patients with hepatic lesions eligible for surgery underwent Gd-EOB-DTPA-enhanced MRI as well as CT within 6 weeks. Pathologic evaluation of the liver specimen combined with intraoperative ultrasound established the SOR. Data sets were evaluated on-site (14 investigators) and off-site (three independent blinded readers). Gd-EOB-DTPA was well tolerated. Three hundred and two lesions were detected in 131 patients valid for analysis by SOR. The frequency of correctly detected lesions was significantly higher on Gd-EOB-DTPA-enhanced MRI compared with CT in the clinical evaluation [10.44%; 95% confidence interval (CI): 4.88, 16.0]. In the blinded reading there was a trend towards Gd-EOB-DTPA-enhanced MRI, not reaching statistical significance (2.14%; 95% CI: -4.32, 8.6). However, the highest rate of correctly detected lesions with a diameter below 1 cm was achieved by Gd-EOB-DTPA-enhanced MRI. Differential diagnosis was superior for Gd-EOB-DTPA-enhanced MRI (82.1%) versus CT (71.0%). A change in surgical therapy was documented in 19 of 131 patients (14.5%) post Gd-EOB-DTPA-enhanced MRI. Gd-EOB-DTPA-enhanced MRI was superior in the diagnosis and therapeutic management of focal liver lesions compared with CT. (orig.)

  11. Diagnostic efficacy of gadoxetic acid (Primovist)-enhanced MRI and spiral CT for a therapeutic strategy: comparison with intraoperative and histopathologic findings in focal liver lesions

    Energy Technology Data Exchange (ETDEWEB)

    Hammerstingl, Renate; Vogl, Thomas J. [Johann Wolfgang Goethe-Univ., Inst. of Diagnostic and Interventional Radiology, Frankfurt am Main (Germany); Huppertz, Alexander [Imaging Science Inst., Charite - Siemens, Berlin (Germany); Breuer, Josy; Balzer, Thomas [Gobal Clinical Development Diagnostics, Bayer Schering Pharma AG, Berlin (Germany); Blakeborough, Anthony [Royal Hallamshire Hospital, Dept. of Radiology, Sheffield (United Kingdom); Carter, Rick [Bayer Health Care Ltd., Burgess Hill, West Sussex (United Kingdom); Castells Fuste, Lluis [Hospital Vall d' Hebron, Liver Unit, Dept. of Internal Medicine, Barcelona (Spain); Heinz-Peer, Gertraud [Universitaetsklinik fuer Radiodiagnostik, Allg. Krankenhaus der Stadt Wien, Wien (Germany); Judmaier, Werner [Univ. Hospital Innsbruck, Dept. of Magnetic Resonance Imaging and Spectroscopy, Innsbruck (Austria); Laniado, Michael [Universitaetsklinikum Carl Gustav Carus, Technische Univ. Dresden, Inst. for Diagnostic Radiology, Dresden (Germany); Manfredi, Riccardo M. [Univ. of Verona, Dept. of Radiology, Verona (Italy); Mathieu, Didier G. [Centre d' Imagerie, Aix en Provence (France); Mueller, Dieter [Georg-August Univ., Dept. of Radiology, Goettingen (Germany); Mortele, Koenraad [Brigham and Women' s Hospital, Dept. of Radiology (L1), Boston, MA (United States); Reimer, Peter [Klinikum Karlsruhe, Dept. of Radiology, Karlsruhe (Germany); Reiser, Maximilian F. [Ludwig-Maximilians-Univ. Munich - Klinikum Grosshadern, Inst. of Clinical Radiology, Munich (Germany); Robinson, Philip J. [St James' s Univ. Hospital, Dept. of Clinical Radiology, Leeds (United Kingdom); Shamsi, Kohkan [Berlex Labs. Inc., Montville, NJ (United States); Strotzer, Michael [Univ. Hospital, Dept. of Diagnostic Radiology, Regensburg (Germany); Taupitz, Matthias [Universitaetsklinikum Charite, Med. Fakultaet der Humboldt-Univ., Dept. of Radiology, Berlin (Germany); Tombach, Bernd; Valeri, Gianluca; Beers, Bernhard E. van [and others

    2008-03-15

    A multicenter study has been employed to evaluate the diagnostic efficacy of magnetic resonance imaging (MRI) using the new liver-specific contrast agent gadoxetic acid (Gd-EOB-DTPA, Primovist), as opposed to contrast-enhanced biphasic spiral computed tomography (CT), in the diagnosis of focal liver lesions, compared with a standard of reference (SOR). One hundred and sixty-nine patients with hepatic lesions eligible for surgery underwent Gd-EOB-DTPA-enhanced MRI as well as CT within 6 weeks. Pathologic evaluation of the liver specimen combined with intraoperative ultrasound established the SOR. Data sets were evaluated on-site (14 investigators) and off-site (three independent blinded readers). Gd-EOB-DTPA was well tolerated. Three hundred and two lesions were detected in 131 patients valid for analysis by SOR. The frequency of correctly detected lesions was significantly higher on Gd-EOB-DTPA-enhanced MRI compared with CT in the clinical evaluation [10.44%; 95% confidence interval (CI): 4.88, 16.0]. In the blinded reading there was a trend towards Gd-EOB-DTPA-enhanced MRI, not reaching statistical significance (2.14%; 95% CI: -4.32, 8.6). However, the highest rate of correctly detected lesions with a diameter below 1 cm was achieved by Gd-EOB-DTPA-enhanced MRI. Differential diagnosis was superior for Gd-EOB-DTPA-enhanced MRI (82.1%) versus CT (71.0%). A change in surgical therapy was documented in 19 of 131 patients (14.5%) post Gd-EOB-DTPA-enhanced MRI. Gd-EOB-DTPA-enhanced MRI was superior in the diagnosis and therapeutic management of focal liver lesions compared with CT. (orig.)

  12. The marketing strategies of electricity and natural gas providers in France. Which perspectives for alternate operators in front of EDF and GDF Suez?

    International Nuclear Information System (INIS)

    2012-10-01

    This article presents the content of a market study which aimed at gathering and analysing figures regarding electricity and natural gas (production, consumption, tariffs, gross prices, etc.), at assessing the market shares of the main providers and their commercial position, at understanding the impact of the Nome law and of the gas price problematic on providers and consumers, and at assessing the capacity of alternate operators to challenge the positions held by EDF and GDF Suez. Besides EDF and GDF Suez, the following providers are analysed: Alpiq, Electricite de Strasbourg, Enel France, ENI, E.ON France, Gas Natural Fenosa, Poweo Direct Energie, Soregies, Tegaz

  13. Alternative methods and strategies to reduce, refine, and replace animal use for veterinary vaccine post-licensing safety testing: state of the science and future directions

    OpenAIRE

    KULPA-EDDY Jodie; SRINIVAS Geetha; HALDER Maria; BROWN Karen; DRAAYER Hans; GALVIN Jeffrey; CLAASEN Ivo; WOODLAND Ralph; DOELLING Vivian; JONES Brett; STOKES William

    2011-01-01

    NICEATM and ICCVAM convened an international workshop to review the state of the science of human and veterinary vaccine potency and safety testing methods and to identify opportunities to advance new and improved methods that can further reduce, refine, and replace animal use. Six topics were addressed in detail by speakers and workshop participants and are reported in a series of six reports. This workshop report, the last in the series, addresses methods and strategies for veterinary vacci...

  14. SNP Variation in MicroRNA Biogenesis Pathway Genes as a New Innovation Strategy for Alzheimer Disease Diagnostics: A Study of 10 Candidate Genes in an Understudied Population From the Eastern Mediterranean.

    Science.gov (United States)

    Görücü Yilmaz, Şenay; Erdal, Mehmet E; Avci Özge, Aynur; Sungur, Mehmet A

    2016-01-01

    Alzheimer disease (AD) is a common complex neurodegenerative disorder accounting for nearly 50% to 70% of dementias worldwide. Yet the current diagnostic options for AD are limited. New diagnostic innovation strategies focusing on novel molecules and pathways are sorely needed. In this connection, microRNAs (miRNAs) are conserved small noncoding RNAs that regulate posttranscriptional gene expression and are vital for neuronal development and its functional sustainability. Conceivably, biological pathways responsible for the biogenesis of miRNAs represent a veritable set of upstream candidate genes that can be potentially associated with the AD pathophysiology. Notably, whereas functional single-nucleotide polymorphisms (SNPs) in miRNA biogenesis pathway genes have been studied in other complex diseases, surprisingly, virtually no such study has been conducted on their relevance in AD. Moreover, novel diagnostics identified in easily accessible peripheral tissues such as the whole blood samples represent the initial entry or gateway points on the biomarker discovery critical path for AD. To the best of our knowledge, we report here the first association study of functional SNPs, as measured by real-time PCR in 10 "upstream" candidate genes critically situated on the miRNA biogenesis pathway, in a large sample of AD patients (N=172) and healthy controls (N=109) in a hitherto understudied world population from the Mersin region of the Eastern Mediterranean. We observed a significant association between 2 candidate genes and AD, TARBP2 rs784567 genotype and AD (χ=6.292, P=0.043), and a trend for RNASEN rs10719 genotype (χ=4.528, P=0.104) and allele (P=0.035). Functional SNP variations in the other 8 candidate genes (DGCR8, XPO5, RAN, DICER1, AGO1, AGO2, GEMIN3, and GEMIN4) did not associate with AD in our sample. Given the putative biological importance of miRNA biogenesis pathways, these emerging data can provide a new foundation to stimulate future debate and

  15. Creutzfeldt-Jakob Disease as a Cause of Cognitive Decline and Seizures in the Elderly: Diagnostic Pointers and Strategy for Investigation

    Directory of Open Access Journals (Sweden)

    R. Williams

    2011-01-01

    Full Text Available Cognitive decline affects one in twenty people over the age of 65. There is often a paucity of clues as to the underlying pathology, and while the diagnosis will usually prove to be either Alzheimer’s disease or vascular dementia, there may be clinical features suggesting rarer alternatives. This case of a 71-year-old lady with a 3-month history of progressive cognitive decline illustrates clinical features suggestive of Creutzfeltd-Jakob disease such as rapid decline in conscious level and myoclonic jerking. Diagnosis was confirmed by 3 means: (1 Electroencephalogram demonstrating periodic sharp wave complexes, (2 MRI brain showing cortical ribboning and high signal in the caudate nucleus, and (3 presence of protein S100 and protein14-3-3 in the cerebrospinal fluid. Postmortem brain histology confirmed a typical spongiform encephalopathy. Establishing an underlying aetiology is dementia is important not only for prognostic reasons but in order to detect potentially reversible causes. In cases of an atypical dementing illness our proposed investigations may assist in confirming or excluding underlying Creutzfeltd-Jakob disease.

  16. [Diagnostic laparoscopy in acute abdomen].

    Science.gov (United States)

    Keller, R; Kleemann, M; Hildebrand, P; Roblick, U J; Bruch, H-P

    2006-11-01

    Acute abdomen is not a disease in itself but a description of a complex of symptoms combined with severe abdominal pain developed within a time frame of less than 24 h. All strategies for the management of acute abdomen underline the need for an interdisciplinary approach to diagnosis and therapy. This requires focused and intelligent use of efficient diagnostic procedures. Diagnostic laparoscopy may be a key to solving the diagnostic dilemma of unspecific acute abdomen. Furthermore, it allows not only direct inspection of the abdominal cavity but also surgical intervention, if needed. In particular the rate of negative laparotomies can be reduced.

  17. Periodontal diagnostics.

    Science.gov (United States)

    Kinane, D F

    2000-10-01

    Periodontitis affects a subset of the population and our current thinking is that progression of periodontal disease may be either continuous or cyclical (burst hypothesis). These features make screening and diagnostic tools desirable in the management of this disease. Although many potential markers exist, several difficulties hamper our ability to declare them diagnostic tests with proven utility. The 'gold standard' for active periodontal disease is not available and inflammation due to gingivally confined lesions (gingivitis) and periodontal inflammation which results in attachment loss is a potential confounder of any test based on assessing the host response elements of the disease. The current absence of proof for the progression of periodontal disease i.e., whether or not the burst hypothesis is correct, is a further problem. Although much is written about the need for markers of current or future disease which will prevent us from overtreating pockets, the time, effort and cost involved in testing these sites has to be balanced against the relative ease and speed of routine therapy such as root planing. In addition, we are still some way from the development and validation of reliable host or microbial testing methods. In terms of screening tests for diseases such as the early-onset forms of periodontitis, the research and development on diagnostic tools involving genetic polymorphisms, specific genes, systemic antibodies or leucocyte cell surface markers of the patients, may become a clinical reality in time. One could envisage chairside tests using blood from thumb pricks being capable of determining a young individual's risk of developing disease at a later age, and thus the need for a timely prevention programme. Before applying any test we should reconsider what treatment planning effects a positive or negative result will have, and any test which does not influence the treatment plan is redundant. Whether periodontal diagnostic tests will be

  18. Fragment ion diagnostic strategies for the comprehensive identification of chemical profile of Gui-Zhi-Tang by integrating high-resolution MS, multiple-stage MS and UV information.

    Science.gov (United States)

    Wang, Shufang; Chen, Lulin; Leng, Jing; Chen, Pinghong; Fan, Xiaohui; Cheng, Yiyu

    2014-09-01

    Gui-Zhi-Tang was considered to be the most famous formula in Shang-Han-Lun, treating 32 symptoms of disease after adding up or cutting down crude drugs. The chemical constituents in Gui-Zhi-Tang were comprehensively studied by rapid resolution liquid chromatography quadrupole time-of-flight mass spectrometry (RRLC-Q-TOF-MS) combined with rapid resolution liquid chromatography - diode array detector - ion trap mass spectrometry (RRLC-DAD-IT-MS) in this work, and a total number of 187 compounds were detected. Systematic diagnostic ion filtering strategies were recommended for flavonoids and oleanane-type triterpenoids, respectively. On the basis of the summarized strategies, compounds in Glycyrrhizae could be easily classified into flavones, isoflavones, flavanones or chalcones with special structures, and triterpene saponins with different sugar moieties. Consequently, among 187 compounds, 144 ones were confirmed or assumed tentatively. In addition, nine potential novel compounds were reported for the first time. This approach provided a rapid method for characterizing the constituents in Gui-Zhi-Tang, and would be also helpful in other TCM formulae analysis. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. [Reproductive behavior of the green birdmouth wrasse Gomphosus caeruleus on a Reunion Island reef: Mode of reproduction, environmental factors and reproductive strategy alternation].

    Science.gov (United States)

    Desvignes, Thomas; Bourjon, Philippe; Chanet, Bruno

    2018-01-01

    The green birdmouth wrasse Gomphosus caeruleus is present all year round on the coral reefs of Reunion Island (Indian Ocean). A group of individuals was followed on one of these reefs with the objective of studying the reproduction mode of the species, the influence of environmental factors, and social behaviors on the control of reproduction. Our observations revealed that G. caeruleus is, like many Labridae, a protogynous hermaphrodite species, probably diandric, that the reproduction of G. caeruleus is, like in other reef fish species, influenced by the lunar cycle with a peak of reproductive activity during waxing gibbous phase, and that G. caeruleus displays social behavior leading to alternating haremic mating system on a single territory and lek-like mating systems without aggressions between males. These observations enhanced our knowledge of the reproduction of Labridae and reef species. Copyright © 2017 Académie des sciences. Published by Elsevier Masson SAS. All rights reserved.

  20. Microfluidic technology for molecular diagnostics.

    Science.gov (United States)

    Robinson, Tom; Dittrich, Petra S

    2013-01-01

    Molecular diagnostics have helped to improve the lives of millions of patients worldwide by allowing clinicians to diagnose patients earlier as well as providing better ongoing therapies. Point-of-care (POC) testing can bring these laboratory-based techniques to the patient in a home setting or to remote settings in the developing world. However, despite substantial progress in the field, there still remain many challenges. Progress in molecular diagnostics has benefitted greatly from microfluidic technology. This chapter aims to summarise the more recent advances in microfluidic-based molecular diagnostics. Sections include an introduction to microfluidic technology, the challenges of molecular diagnostics, how microfluidic advances are working to solve these issues, some alternative design approaches, and detection within these systems.

  1. FEL components and diagnostics

    International Nuclear Information System (INIS)

    Carr, R.

    1997-01-01

    FEL hardware includes undulators, alignment systems, electron beam diagnostics, and mechanical and vacuum systems. While most FEL close-quote s employ conventional undulators, there is some interest in novel types, particularly where conventional designs cannot be used, as at very short periods and high fields. For these areas, superconducting technology is indicated. The most serious issue facing long FEL undulators is that of alignment; mechanical techniques may not be accurate enough, and beam-based strategies must be considered. To maintain alignment and control the electron trajectory, beam position monitors with micron precision are required. Beam size monitors are also required to assure control of emittance. The talks given in the working group sessions touch on undulators, alignment, and electron beam diagnostics, and they are summarized here. copyright 1997 American Institute of Physics

  2. How alternative are alternative fuels?

    OpenAIRE

    Soffritti, Tiziana; Danielis, Romeo

    1998-01-01

    Could alternative fuel vehicles contribute to a substantial reduction of air pollution? Is there a market for alternative fuel vehicles? Could a market be created via a pollution tax? The article answers these questions on the basis of the available estimates.

  3. New religious movements and alternative religions in France: the use of digital media as a counter-strategy against social and legal exclusion

    Directory of Open Access Journals (Sweden)

    Christiane Königstedt

    2016-08-01

    Full Text Available The internet is widely used internationally by individuals and groups who otherwise perceive and experience a lack of influence and even repression by authorities and whose opinions remain invisible in or are ignored by the mass media. The new media are a frequently-used means of expression in the political struggles of social and religious movements, especially as part of attempts to increase the number of supporters and to mobilise public opinion. The extent, of the usage as well as its degree of success, does vary and because of this variety, a comparative analysis can illuminate parts of the whole conflictuous configuration as well as the chances and limits of resistance and opposition via these media channels. Organisations which were chosen to be investigated here were the so-called ‘new religious movements’, or more precisely, the many forms of alternative religion in France who face significant levels of social and legal exclusion, while most of their members are themselves usually strongly committed to democracy and their identities as equal French citizens. Therefore, they choose to perform counter-actions which are within the law and act strategically, which makes them a special case compared to revolutionary political movements which may question the social order of the state as a whole. France, with its ‘anti-cult’ policy, has come to a unique standing within the Western world in this respect. Though religious freedom and state neutrality in relation to religious issues are constitutionally granted, a differentiation is made – and partially even legally enforced – between good religions and harmful ones which attempt to manipulate their adepts mentally. The debates are held in a constant dynamic between the struggling parties of ‘anti-cult’ movements and alternative religions. The exclusion of the latter from the mass media is revealed be one central means of hindering them from gaining approval within society

  4. Prevalence, socio-demographic and clinical predictors of post-diagnostic utilisation of different types of complementary and alternative medicine (CAM) in a nationwide cohort of Danish women treated for primary breast cancer

    DEFF Research Database (Denmark)

    Pedersen, Christina Gundgaard; Christensen, Søren; Jensen, Anders Bonde

    2009-01-01

    This study investigated the prevalence and predictors of use of complementary and alternative medicine (CAM) in a nationwide inception cohort of Danish women treated for early-stage breast cancer as well as differences in user patterns for individual types of CAM.......This study investigated the prevalence and predictors of use of complementary and alternative medicine (CAM) in a nationwide inception cohort of Danish women treated for early-stage breast cancer as well as differences in user patterns for individual types of CAM....

  5. Ambient diagnostics

    CERN Document Server

    Cai, Yang

    2014-01-01

    Part I. FundamentalsIntroductionWhat is Ambient Diagnostics?Diagnostic ModelsMultimedia IntelligenceCrowd SourcingSoft SensorsScience of SimplicityPersonal DiagnosesBasic AlgorithmsBasic ToolsSummaryProblemsTransformationEarly Discoveries of Heartbeat PatternsTransforms, Features, and AttributesSequential FeaturesSpatiotemporal FeaturesShape FeaturesImagery FeaturesFrequency Domain FeaturesMulti-Resolution FeaturesSummaryProblemsPattern RecognitionSimilarities and DistancesClustering MethodsClassification MethodsClassifier Accuracy MeasuresSummaryProblemsPart II. Multimedia IntelligenceSound RecognitionMicrophone AppsModern Acoustic Transducers (Microphones)Frequency Response CharacteristicsDigital Audio File FormatsHeart Sound SensingLung Sound SensingSnore MeterSpectrogram (STFT)Ambient Sound AnalysisSound RecognitionRecognizing Asthma SoundPeak ShiftFeature CompressionRegroupingNoise IssuesFuture ApplicationsSummaryProblemsColor SensorsColor SensingHuman Color VisionColor SensorsColor Matching ExperimentsC...

  6. Brain inflammation induced by severe asphyxia in newborn pigs and the impact of alternative resuscitation strategies on the newborn central nervous system.

    Science.gov (United States)

    Dannevig, Ingrid; Solevåg, Anne Lee; Sonerud, Tonje; Saugstad, Ola Didrik; Nakstad, Britt

    2013-02-01

    We compared the current guidelines for neonatal resuscitation with alternative measures and aimed to find out whether this modulated brain inflammation. Progressive asphyxia was induced in 94 newborn pigs until asystole. With the reference being resuscitation guidelines, 30 s of initial positive-pressure ventilation before compression (C) and ventilation (V) (C:V; 3:1) in 21% oxygen, pigs were randomized to (i) ventilation for 30, 60, or 90 s before chest compressions; (ii) C:V ratios of 3:1, 9:3, or 15:2; or (iii) 21% or 100% oxygen. Concentrations of inflammatory markers in the cerebrospinal fluid (CSF) and gene expression in the hippocampus and frontal cortex were measured for different interventions. In CSF, S100 was higher with 90 s than with 30 or 60 s of initial positive-pressure ventilation, whereas concentrations of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were higher with 30 than with 60 s. Matrix metalloproteinase-2 (MMP-2) and intracellular adhesion molecule 1 (ICAM-1) were higher with 30 than with 60 s. No other comparison between ratios and oxygen concentrations used yielded significant results. With respect to signs of brain inflammation, newly born pigs at asystole should be ventilated for longer than 30 s before chest compressions start. C:V ratios of 9:3 and 15:2 as compared with 3:1, or air instead of pure oxygen, did not modulate inflammatory markers.

  7. Newer diagnostic approaches to intestinal protozoa.

    Science.gov (United States)

    van Lieshout, Lisette; Verweij, Jaco J

    2010-10-01

    To update the reader on the latest developments in the laboratory diagnosis of intestinal protozoa. Correct identification of a diarrhoea causing pathogens is essential for the choice of treatment in an individual patient as well as to map the aetiology of diarrhoea in a variety of patient populations. Classical diagnosis of diarrhoea causing protozoa by microscopic examination of a stool sample lacks both sensitivity and specificity. Alternative diagnostic platforms are discussed. Recent literature on the diagnosis of intestinal protozoa has focused mainly on nucleic acid-based assays, in particular the specific detection of parasite DNA in stool samples using real-time PCR. In addition, the trend has been moving from single pathogen detection to a multiplex approach, allowing simultaneous identification of multiple parasites. Different combinations of targets can be used within a routine diagnostic setting, depending on the patient population, such as children, immunocompromised individuals and those who have been travelling to tropical regions. Large-scale monitoring and evaluation of control strategies become feasible due to automation and high-throughput facilities. Improved technology also has become available for differentiating protozoa subspecies, which facilitates outbreak investigations and extensive research in molecular epidemiology.

  8. Invitational rhetoric: Alternative rhetorical strategy for transformation of perception and use of energy in the residential built environment from the Keweenaw to Kerala

    Science.gov (United States)

    Kindred, Merle Niemi

    This dissertation explores the viability of invitational rhetoric as a mode of advocacy for sustainable energy use in the residential built environment. The theoretical foundations for this study join ecofeminist concepts and commitments with the conditions and resources of invitational rhetoric, developing in particular the rhetorical potency of the concepts of re-sourcement and enfoldment. The methodological approach is autoethnography using narrative reflection and journaling, both adapted to and developed within the autoethnographic project. Through narrative reflection, the author explores her lived experiences in advocating for energy-responsible residential construction in the Keweenaw Peninsula of Michigan. The analysis reveals the opportunities for cooperative, collaborative advocacy and the struggle against traditional conventions of persuasive advocacy, particularly the centrality of the rhetor. The author also conducted two field trips to India, primarily the state of Kerala. Drawing on autoethnographic journaling, the analysis highlights the importance of sensory relations in lived advocacy and the resonance of everyday Indian culture to invitational principles. Based on field research, the dissertation proposes autoethnography as a critical development in encouraging invitational rhetoric as an alternative mode of effecting change. The invitational force of autoethnography is evidenced in portraying the material advocacy of the built environment itself, specifically the sensual experience of material arrangements and ambience, as well as revealing the corporeality of advocacy, that is, the body as the site of invitational engagement, emotional encounter, and sensory experience. This study concludes that vulnerability of self in autoethnographic work and the vulnerability of rhetoric as invitational constitute the basis for transformation. The dissertation confirms the potential of an ecofeminist invitational advocacy conveyed autoethnographically for

  9. Impact of alternative reimbursement strategies in the new cooperative medical scheme on caesarean delivery rates: a mixed-method study in rural China

    Directory of Open Access Journals (Sweden)

    Huang Kun

    2012-07-01

    Full Text Available Abstract Background The rate of caesarean delivery (CD in rural China has been rapidly increasing in recent decades. Due to the exorbitant costs associated with CD, paying for this expensive procedure is often a great challenge for the majority of rural families. Since 2003, the Chinese government has re-established the New Cooperative Medical Scheme (NCMS, aimed to improve the access of essential healthcare to rural residents and reduce financial burden owing to high out of pocket payments. This paper seeks to test the hypothesis that NCMS may provide service users and providers with financial incentives to select CD. It also assesses the effect of different health insurance reimbursement strategies of NCMS on CD rates in rural China. Methods Mixed quantitative and qualitative methods were adopted for data collection. Two cross-sectional household surveys were conducted with women having babies delivered in 2006 and 2009; 2326 and 1515 women, respectively, from the study sites were interviewed using structured questionnaires, to collect demographic and socio-economic data, maternal and child care characteristics and health-related expenditures. Focus group discussions (FGDs and in-depth key informant interviews (KIIs were undertaken with policy makers, health managers, providers and mothers to understand their perceptions of the influence of NCMS on the choices of delivery mode. Results The CD rates in the two study counties were 46.0 percent and 64.7 percent in 2006, increasing to 63.6 percent and 82.1 percent, respectively, in 2009. The study found that decisions on the selection of CD largely came from the pregnant women. Logistic regression analysis, after adjusting for socio-economic, maternal and fetal characteristics, did not indicate a significant effect of either proportional reimbursement or fixed amount reimbursement on the choice of CD for both study years. Interviews with stakeholders reflected that different reimbursable rates for

  10. Economic feasibility of hydrogen enrichment for reducing NOx emissions from landfill gas power generation alternatives: A comparison of the levelized cost of electricity with present strategies

    International Nuclear Information System (INIS)

    Kornbluth, Kurt; Greenwood, Jason; Jordan, Eddie; McCaffrey, Zach; Erickson, Paul A.

    2012-01-01

    Based on recent research showing that hydrogen enrichment can lower NO x emissions from landfill gas combustion below future NO x emission control standards imposed by both federal and California state regulations, an investigation was performed to compare the levelized cost of electricity of this technology with other options. In this cost study, a lean-burn reciprocating engine with no after-treatment was the baseline case to compare six other landfill gas-to-energy projects. These cases include a lean burn engine with selective catalytic reduction after treatment, a lean-burn microturbine, and four variations on an ultra-lean-burn engine utilizing hydrogen enrichment with each case using a different method of hydrogen production. Only hydrogen enrichment with an in-stream autothermal fuel reformer was shown to be potentially cost-competitive with current strategies for reaching the NO x reduction target in IC engines. - Highlights: ► Levelized cost of electricity for hydrogen enriched combustion was compared. ► Various ultra-lean-burn engines and microturbines with hydrogen were analyzed. ► Combustion with an autothermal fuel reformer was potentially cost-competitive.

  11. Diagnostic accuracy of organ electrodermal diagnostics | Szopinski ...

    African Journals Online (AJOL)

    Objective. To estimate the diagnostic accuracy as well as the scope of utilisation of a new bio-electronic method of organ diagnostics. Design. Double-blind comparative study of the diagnostic results obtained by means of organ electrodermal diagnostics (OED) and clinical diagnoses, as a criterion standard. Setting.

  12. Strategy Development in Organisations

    DEFF Research Database (Denmark)

    Sørensen, Lene

    1999-01-01

    There exist certain ambiguities with the converging fields of information technology and organisational strategy development. The term "IT strategy" has evolved and reflects in some respects this confusion. This paper discusses some of the ambiguities and difficulties of the term "IT strategy......" as used in practice and literature. Emphasis is put on how the term is related to the problem, the organisation, the strategy process and the practical way of methodologically developing the strategy. Finally, alternative strategy developing perspectives are presented....

  13. An edge over diagnostic setup

    Directory of Open Access Journals (Sweden)

    Sridhar Kannan

    2017-01-01

    Full Text Available Diagnostic setup proposed by H.D. Kingsley serves as a practical aid in treatment planning and diagnosis. These setups have some inherent shortcomings. A simple technique of duplication of the setups in dental stone can solve problems encountered before as well as provide many other advantages over the conventional procedure. The diagnostic setup is prepared by the conventional method [Figure 1]. An alginate impression is then taken of the setups and poured in dental stone to obtain the derived treatment model [Figure 2]. The same setup can now be further modified for alternate lines of treatment. Subsequently models could then be obtained as required [Figure 3].

  14. Longitudinal changes in ultrasonic measurements of body composition during growth in Suffolk ram lambs and evaluation of alternative adjustment strategies for ultrasonic scan data.

    Science.gov (United States)

    Emenheiser, J C; Greiner, S P; Lewis, R M; Notter, D R

    2010-04-01

    Four equations were used to compare alternative procedures to adjust ultrasonic estimates (y) of backfat thickness (BF) and LM area (LMA) for BW using data from a series of 7 scans on 24 Suffolk ram lambs born in 2007. Equations were linear, linear + quadratic, allometric (y = alphaBW(beta)), and allometric + BW (ABW; y = alphaBW(beta)e(gammaW)). Goodness of fit was very similar between equations over the range of the data. Resulting adjustment equations were tested using 3 serial scans on winter-born Suffolk (n = 150), Hampshire (n = 36), and Dorset (n = 43) rams and 52 fall-born Dorset rams tested at the Virginia Ram Test in 1999 through 2002. Partial correlations (accounting for the effect of year) between predicted and actual measures ranged from 0.78 to 0.87 for BF and 0.66 to 0.93 for LMA in winter-born rams and from 0.70 to 0.71 for BF and 0.72 to 0.78 for LMA in fall-born rams. No significant differences in predictive ability existed between equations for BF or LMA (P > 0.05), and there was no indication that the allometric equation was a better predictor than linear within the range of the data. Adjustment equations were also tested using serial scan data from 37 Suffolk ewe lambs born in the same contemporary group as the rams used to derive the prediction equations but fed for a substantially slower rate of BW gain. Correlations between predicted and actual values of BF and LMA indicated lambs were too young and small at the first scan (77 d, 32.4 kg) to reliably predict carcass measures at typical slaughter weights. For prediction using data from the 2 subsequent scans, at mean ages >96 d and mean BW >39 kg, correlations between predicted and actual values were 0.72 to 0.74 for BF and 0.54 to 0.76 for LMA. Little difference existed between equations for predicting BF. For LMA, the ABW form was a weaker predictor than the others, and the linear equation was slightly superior to allometric. Therefore, it appears the linear and allometric forms are both

  15. AtPDS overexpression in tomato: exposing unique patterns of carotenoid self-regulation and an alternative strategy for the enhancement of fruit carotenoid content.

    Science.gov (United States)

    McQuinn, Ryan P; Wong, Breanna; Giovannoni, James J

    2018-02-01

    The regulation of plant carotenogenesis is an active research area for both biological discovery and practical implementation. In tomato (Solanum lycopersicum), we demonstrate additional bottlenecks exist in the poly-cis-transformation of phytoene to lycopene in the context of ripening-induced PSY1 expression and activity and reveal phytoene desaturase (PDS), as a target for manipulation towards elevated lycopene content in maturing tomato fruit. Overexpression of Arabidopsis PDS, AtPDS, elevated PDS transcript abundance in all aerial tissues resulting in both altered carotenoid accumulation and associated pathway gene expression in a tissue-specific manner. Significant increases in downstream carotenoids (all-trans-lycopene and β-carotene) and minimal changes in carotenogenic gene expression (carotenoid isomerase-like 1, CRTIL1) suggest overexpression of heterologous AtPDS in tomato circumvents endogenous regulatory mechanism observed with previous strategies. In transgenic leaves, depletion of the PDS substrate, phytoene, was accompanied by minor, but significant increases in xanthophyll production. Alterations in the leaf carotenogenic transcript profile, including the upstream MEP pathway, were observed revealing unique feedback and feedforward regulatory mechanisms in response to AtPDS overexpression. AtPDS overexpression in the background of the tangerine (carotenoid isomerase, CRTISO) mutant exposes its potential in elevating downstream cis-lycopene accumulation in ripe tomato fruit, as cis-lycopene is more bioavailable yet less abundant than all-trans-lycopene in the wild-type control. In summary, we demonstrate the limitation of PDS in ripening fruit, its utility in modifying carotenoid profiles towards improved quality, and reveal novel carotenoid pathway feedback regulation. © 2017 The Authors. Plant Biotechnology Journal published by Society for Experimental Biology and The Association of Applied Biologists and John Wiley & Sons Ltd.

  16. Alternative fluorescent labeling strategies for characterizing gram-positive pathogenic bacteria: Flow cytometry supported counting, sorting, and proteome analysis of Staphylococcus aureus retrieved from infected host cells.

    Science.gov (United States)

    Hildebrandt, Petra; Surmann, Kristin; Salazar, Manuela Gesell; Normann, Nicole; Völker, Uwe; Schmidt, Frank

    2016-10-01

    Staphylococcus aureus is a Gram-positive opportunistic pathogen that is able to cause a broad range of infectious diseases in humans. Furthermore, S. aureus is able to survive inside nonprofessional phagocytic host cell which serve as a niche for the pathogen to hide from the immune system and antibiotics therapies. Modern OMICs technologies provide valuable tools to investigate host-pathogen interactions upon internalization. However, these experiments are often hampered by limited capabilities to retrieve bacteria from such an experimental setting. Thus, the aim of this study was to develop a labeling strategy allowing fast detection and quantitation of S. aureus in cell lysates or infected cell lines by flow cytometry for subsequent proteome analyses. Therefore, S. aureus cells were labeled with the DNA stain SYTO ® 9, or Vancomycin BODIPY ® FL (VMB), a glycopeptide antibiotic binding to most Gram-positive bacteria which was conjugated to a fluorescent dye. Staining of S. aureus HG001 with SYTO 9 allowed counting of bacteria from pure cultures but not in cell lysates from infection experiments. In contrast, with VMB it was feasible to stain bacteria from pure cultures as well as from samples of infection experiments. VMB can also be applied for histocytochemistry analysis of formaldehyde fixed cell layers grown on coverslips. Proteome analyses of S. aureus labeled with VMB revealed that the labeling procedure provoked only minor changes on proteome level and allowed cell sorting and analysis of S. aureus from infection settings with sensitivity similar to continuous gfp expression. Furthermore, VMB labeling allowed precise counting of internalized bacteria and can be employed for downstream analyses, e.g., proteomics, of strains not easily amendable to genetic manipulation such as clinical isolates. © 2016 International Society for Advancement of Cytometry. © 2016 International Society for Advancement of Cytometry.

  17. The urban solid wastes in La Habana (Cuba): management diagnostics and alternatives for their improvement; Los residuos solidos urbanos en la ciudad de La Habana: Diagnostico de la gestion y alternativas para su aprovechamiento

    Energy Technology Data Exchange (ETDEWEB)

    Ponjuan Reyes, G. T. [Univsersidad de Las Palmas de Gran Canaria (Spain)

    1999-11-01

    In this study, it is carried out a diagnosis of all the looks of the Systems of Administration of the R. S. U. in the country of Ciudad de la Habana and they propose alternating for the economical development of the R. S. U. in the county, starting from classifying and study the actions according to the politics of the country concerning the protection of the 2environment and the saving of natural resources. (Author) 22 refs.

  18. Cost-Effectiveness Analysis of Alternative Antiviral Strategies for the Treatment of HBeAg-Positive and HBeAg-Negative Chronic Hepatitis B in the United Kingdom.

    Science.gov (United States)

    Bermingham, Sarah L; Hughes, Ralph; Fenu, Elisabetta; Sawyer, Laura M; Boxall, Elizabeth; T Kennedy, Patrick; Dusheiko, Geoff; Hill-Cawthorne, Grant; Thomas, Howard

    2015-09-01

    Seven drugs are licensed for the treatment of chronic hepatitis B (CHB) in the United Kingdom. Which initial treatment, secondary therapy, and whether antivirals should be given alone or in combination are questions of considerable uncertainty. The aim of this model was to undertake a comprehensive economic evaluation of all antiviral treatments for CHB to recommend the most cost-effective therapeutic sequence. We developed a probabilistic Markov model to compare the cost-effectiveness of all clinically relevant antiviral treatment sequences for nucleos(t)ide-naive adults with hepatitis B e-antigen (HBeAg)-positive or HBeAg-negative CHB. Relative rates of HBeAg seroconversion and viral suppression were obtained from a network meta-analysis. Data on mortality, antiviral drug resistance, durability of response, adverse events, and costs were obtained from published literature. Results are reported in terms of lifetime costs, quality-adjusted life-years (QALYs), and expected net benefit. In the base-case analysis, pegylated interferon alpha-2a (peg-IFN α-2a) followed by tenofovir disoproxil fumarate was most effective and cost-effective in HBeAg-positive patients, with a cost of £7488 per QALY gained compared with no treatment. In HBeAg-negative patients, peg-IFN α-2a followed by entecavir was most effective and cost-effective, with a cost of £6981 per QALY gained. The model was robust to a wide range of sensitivity analyses. Peg-IFN α-2a followed by tenofovir disoproxil fumarate or entecavir is the most effective antiviral treatment strategy for people with both variants of CHB. At a cost of less than £10,000 per QALY gained, these sequences are considered cost-effective in England and Wales. The results of this analysis were used to inform 2013 National Institute for Health and Care Excellence guideline recommendations. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  19. Decision making about healthcare-related tests and diagnostic test strategies. Paper 5: a qualitative study with experts suggests that test accuracy data alone is rarely sufficient for decision making.

    Science.gov (United States)

    Mustafa, Reem A; Wiercioch, Wojtek; Ventresca, Matthew; Brozek, Jan; Schünemann, Holger J

    2017-12-01

    The objective of the study was to identify the critical factors that determine recommendations and other decisions about healthcare-related tests and diagnostic strategies (HCTDS). We used a qualitative descriptive approach and conducted semi-structured in-depth interviews with 24 international experts (informants) in evidence and decisions about HCTDS. Although test accuracy (TA) was the factor most commonly considered by organizations when developing recommendations about HCTDS, informants agreed that TA is necessary but rarely, if ever, sufficient and may be misleading when solely considered. The informants identified factors that are important for developing recommendations about HCTDS. Informants largely agreed that laying out the potential care pathways based on the test result is an essential early step but is rarely done in developing recommendations about HCTDS. Most informants also agreed that decision analysis could be useful for organizing the clinical, cost, and preference data relevant to the use of tests in the absence of direct evidence. However, they noted that using models is limited by the lack of resources and expertise required. Developing guidelines about HCTDS requires consideration of factors beyond TA, but implementing this may be challenging. Further development and testing of "frameworks" that can guide this process is a priority for decision makers. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Sensitive Diagnostics for Chemically Reacting Flows

    KAUST Repository

    Farooq, Aamir

    2015-11-02

    This talk will feature latest diagnostic developments for sensitive detection of gas temperature and important combustion species. Advanced optical strategies, such as intrapulse chirping, wavelength modulation, and cavity ringdown are employed.

  1. Alternative Therapies

    Science.gov (United States)

    ... the widespread and erroneous belief that they are natural and do no harm, and because their use offers the opportunity for more control over treatment options and procedures. Alternative therapies can reduce stress, pain, and/or fatigue. Some therapies are covered ...

  2. Growing Alternatives

    DEFF Research Database (Denmark)

    Bagger-Petersen, Mai Corlin

    2014-01-01

    From 2014, Anhui Province will pilot a reform of the residential land market in China, thus integrating rural Anhui in the national housing market. In contrast, artist and activist Ou Ning has proposed the Bishan time money currency, intending to establish an alternative economic circuit in Bishan...

  3. Magnetostrictive Alternator

    Science.gov (United States)

    Dyson, Rodger; Bruder, Geoffrey

    2013-01-01

    This innovation replaces the linear alternator presently used in Stirling engines with a continuous-gradient, impedance-matched, oscillating magnetostrictive transducer that eliminates all moving parts via compression, maintains high efficiency, costs less to manufacture, reduces mass, and eliminates the need for a bearing system. The key components of this new technology are the use of stacked magnetostrictive materials, such as Terfenol-D, under a biased magnetic and stress-induced compression, continuous-gradient impedance-matching material, coils, force-focusing metallic structure, and supports. The acoustic energy from the engine travels through an impedancematching layer that is physically connected to the magnetostrictive mass. Compression bolts keep the structure under compressive strain, allowing for the micron-scale compression of the magnetostrictive material and eliminating the need for bearings. The relatively large millimeter displacement of the pressure side of the impedance-matching material is reduced to micron motion, and undergoes stress amplification at the magnetostrictive interface. The alternating compression and expansion of the magnetostrictive material creates an alternating magnetic field that then induces an electric current in a coil that is wound around the stack. This produces electrical power from the acoustic pressure wave and, if the resonant frequency is tuned to match the engine, can replace the linear alternator that is commonly used.

  4. Mitigation diagnostics

    International Nuclear Information System (INIS)

    Hall, S.T.

    1990-01-01

    This paper reports that experience in the remediation of schools and other large buildings has shown the importance of the effects of both the location of geologic sources and HVAC-induced distribution of indoor radon. In general, elevated radon in areas of schools with evenly distributed HVAC pressures are correlated with maximum soil radon emanations. However, strong or unequal HVAC effects can redistribute indoor radon to areas away from the direct source. Effective remediation required a complete understanding of both contributions. In some schools, highest indoor radon levels were located near large return ducts and were attributed to proximity to negative HVAC pressure. Successful sub-slab depressurization systems were installed, however, in rooms with lower indoor but greatest sub-slab radon levels, closest to the source. This shows the inadequacy of using indoor radon levels alone as a basis for remediation. Wings of two other schools with radon problems have equivalent window fan coil units in rooms of equal size and no central HVAC system. Highest indoor radon levels correlated well with highest sub-slab radon levels due to the equivalent effects of the window units. Diagnostic tests in other schools have revealed: blockwall radon transport to upper floors; high blockwall radon adjacent to sub-slab sources; and elevated indoor radon over crawlspace being drawn upward by HVAC-induced negative pressure, determined from indoor to outdoor micromanometer measurements

  5. A microcosting study of diagnostic tests for the detection of coronary artery disease in the Netherlands

    Energy Technology Data Exchange (ETDEWEB)

    Tan, S.S. [Erasmus MC University Medical Center, Institute for Medical Technology Assessment, P.O. Box 1738, 3000 DR Rotterdam (Netherlands)], E-mail: s.s.tan@erasmusmc.nl; Oppe, M. [Erasmus MC University Medical Center, Institute for Medical Technology Assessment, P.O. Box 1738, 3000 DR Rotterdam (Netherlands)], E-mail: m.oppe@erasmusmc.nl; Zoet-Nugteren, S.K. [Ikazia Hospital Rotterdam, Department of Cardiology, P.O. Box 5009, 3008 AA Rotterdam (Netherlands)], E-mail: sk.zoet@ikazia.nl; Niezen, R.A. [Medical Center Rijnmond-Zuid, Department of Radiology, P.O. Box 9100, 3007 AC Rotterdam (Netherlands)], E-mail: niezenr@mcrz.nl; Kofflard, M.J.M. [Albert Schweitzer Hospital, Department of Cardiology, P.O. Box 444, 3300 AK Dordrecht (Netherlands)], E-mail: m.j.m.kofflard@asz.nl; Ten Cate, F.J. [Erasmus MC University Medical Center, Department of Cardiology, P.O. Box 2040, 3000 CA Rotterdam (Netherlands)], E-mail: f.j.tencate@erasmusmc.nl; Roijen, L. Hakkaart-van [Erasmus MC University Medical Center, Institute for Medical Technology Assessment, P.O. Box 1738, 3000 DR Rotterdam (Netherlands)], E-mail: l.hakkaart-vanroijen@erasmusmc.nl

    2009-10-15

    Objective: The primary aim of the present study was to calculate the actual costs of four diagnostic tests for the detection of coronary artery disease in the Netherlands using a microcosting methodology. As a secondary objective, the cost effectiveness of eight diagnostic strategies was examined, using microcosting and reimbursement fees subsequently as the cost estimate. Design: A multicenter, retrospective cost analysis from a hospital perspective. Setting: The study was conducted in three general hospitals in the Netherlands for 2006. Interventions: Exercise electrocardiography (exECG), stress echocardiography (sECHO), single-photon emission computed tomography (SPECT) and coronary angiography (CA). Results: The actual costs of exECG, sECHO, SPECT and CA were Euro 33, 216, 614 and 1300 respectively. For all diagnostic tests, labour and indirect cost components (overheads and capital) together accounted for over 75% of the total costs. Consumables played a relatively important role in SPECT (14%). Hotel and nutrition were only applicable to SPECT and CA. Diagnostic services were solely performed for CA, but their costs were negligible (2%). Using microcosting estimates, exECG-sECHO-SPECT-CA was the most and CA the least cost effective strategy ( Euro 397 and 1302 per accurately diagnosed patient). Using reimbursement fees, exECG-sECHO-CA was most and SPECT-CA least cost effective ( Euro 147 and 567 per accurately diagnosed patient). Conclusions: The use of microcosting estimates instead of reimbursement fees led to different conclusions regarding the relative cost effectiveness of alternative strategies.

  6. Alternative fuelds in urban fleets

    International Nuclear Information System (INIS)

    Lindsay, T.

    1994-01-01

    In this presentation the author addresses four main objectives. They are to: discuss programs that are driving the introduction of alternative fuels into fleet operations in urban areas around the country; define alternative fuels; quantify the present use and future projections on alternative fuel vehicles (AVFs) in the Chicago metropolitan statistical area; and discuss benefits of increased use of alternative fuels in urban areas. Factors which touch on these points include: present domestic dependence on petroleum for autos, with usage exceeding production; the large populations in urban areas which do not meet Clean Air Standards; recent legislative initiatives which give guidance and aid in the adoption of such strategies

  7. Alternative fuelds in urban fleets

    Energy Technology Data Exchange (ETDEWEB)

    Lindsay, T.

    1994-12-31

    In this presentation the author addresses four main objectives. They are to: discuss programs that are driving the introduction of alternative fuels into fleet operations in urban areas around the country; define alternative fuels; quantify the present use and future projections on alternative fuel vehicles (AVFs) in the Chicago metropolitan statistical area; and discuss benefits of increased use of alternative fuels in urban areas. Factors which touch on these points include: present domestic dependence on petroleum for autos, with usage exceeding production; the large populations in urban areas which do not meet Clean Air Standards; recent legislative initiatives which give guidance and aid in the adoption of such strategies.

  8. Alternative BCG delivery strategies improve protection against Mycobacterium tuberculosis in non-human primates: Protection associated with mycobacterial antigen-specific CD4 effector memory T-cell populations.

    Science.gov (United States)

    Sharpe, S; White, A; Sarfas, C; Sibley, L; Gleeson, F; McIntyre, A; Basaraba, R; Clark, S; Hall, G; Rayner, E; Williams, A; Marsh, P D; Dennis, M

    2016-12-01

    Intradermal (ID) BCG injection provides incomplete protection against TB in humans and experimental models. Alternative BCG vaccination strategies may improve protection in model species, including rhesus macaques. This study compares the immunogenicity and efficacy of BCG administered by ID and intravenous (IV) injection, or as an intratracheal mucosal boost (ID + IT), against aerosol challenge with Mycobacterium tuberculosis Erdman strain. Disease pathology was significantly reduced, and survival improved, by each BCG vaccination strategy, relative to unvaccinated animals. However, IV induced protection surpassed that achieved by all other routes, providing an opportunity to explore protective immunological mechanisms using antigen-specific IFN-γ ELISpot and polychromatic flow cytometry assays. IFN-γ spot forming units and multifunctional CD4 T-cell frequencies increased significantly following each vaccination regimen and were greatest following IV immunisation. Vaccine-induced multifunctional CD4 T-cells producing IFN-γ and TNF-α were associated with reduced disease pathology following subsequent M.tb challenge; however, high frequencies of this population following M.tb infection correlated with increased pathology. Cytokine producing T-cells primarily occupied the CD4 transitional effector memory phenotype, implicating this population as central to the mycobacterial response, potentially contributing to the stringent control observed in IV vaccinated animals. This study demonstrates the protective efficacy of IV BCG vaccination in rhesus macaques, offering a valuable tool for the interrogation of immunological mechanisms and potential correlates of protection. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  9. OECD Skills Strategy Diagnostic Report: Italy 2017

    Science.gov (United States)

    OECD Publishing, 2017

    2017-01-01

    Skills demands are increasing and changing rapidly everywhere, as advanced economies adapt to globalisation, technological change and ageing. Yet Italy is struggling more than other advanced economies to make the transition towards a thriving and dynamic skills-based society. The Organisation for Economic Cooperation and Development (OECD) Skills…

  10. Presacral ganglioneuroma: diagnostic considerations and therapeutic strategy.

    Science.gov (United States)

    Vardas, Konstantinos; Manganas, Dimitrios; Papadimitriou, Georgios; Vougas, Vasileios; Bakalis, Athanasios; Chantziara, Maria; Exarhos, Dimitrios; Drakopoulos, Spiros

    2013-01-01

    Presacral ganglioneuroma is an extremely rare tumor of neural crest origin. To the best of our knowledge, less than 20 cases have been reported previously. The present study reports on a presacral ganglioneuroma, 10.5 × 8 × 4 cm in size, that was found incidentally in a 35-year-old man with prior history of diverticulitis. He was admitted to our hospital due to lower left abdominal pain. Abdominal computed tomography and magnetic resonance imaging confirmed the extension of the lesion from the S2 level to the coccyx. The mass had low signal intensity on T1-weighted images and heterogeneous high signal intensity on T2-weighted images with no intraspinal or rectal extension. T2-weighted images demonstrated a compartmentalized solid tumor with cystic components. Complete tumor resection with free surgical margins was achieved using an abdominal approach. The patient remains asymptomatic 2 years after surgery. We emphasize on clinical features, radiologic appearance and surgical treatment of this rare entity. The clinical and pathologic features of previously reported studies are also briefly reviewed.

  11. Presacral Ganglioneuroma: Diagnostic Considerations and Therapeutic Strategy

    Directory of Open Access Journals (Sweden)

    Konstantinos Vardas

    2013-11-01

    Full Text Available Presacral ganglioneuroma is an extremely rare tumor of neural crest origin. To the best of our knowledge, less than 20 cases have been reported previously. The present study reports on a presacral ganglioneuroma, 10.5 × 8 × 4 cm in size, that was found incidentally in a 35-year-old man with prior history of diverticulitis. He was admitted to our hospital due to lower left abdominal pain. Abdominal computed tomography and magnetic resonance imaging confirmed the extension of the lesion from the S2 level to the coccyx. The mass had low signal intensity on T1-weighted images and heterogeneous high signal intensity on T2-weighted images with no intraspinal or rectal extension. T2-weighted images demonstrated a compartmentalized solid tumor with cystic components. Complete tumor resection with free surgical margins was achieved using an abdominal approach. The patient remains asymptomatic 2 years after surgery. We emphasize on clinical features, radiologic appearance and surgical treatment of this rare entity. The clinical and pathologic features of previously reported studies are also briefly reviewed.

  12. Fetal exposure in diagnostic radiology

    International Nuclear Information System (INIS)

    Baker, M.L.; Vandergrift, J.F.; Dalrymple, G.V.

    1979-01-01

    The problem of possible radiation damage to the fetus or embryo as a result of diagnostic radiography during pregnancy, particularly in the early stages, is discussed. Recommendations of therapeutic abortion after fetal exposure require an adequate knowledge of the doses involved. In the absence of actual dose measurements or estimates, approximate exposure levels may be determined from the literature. A summary of published values for radiography involving the lower abdomen is given. Data is also presented from a series of fetal exposures resulting mostly from routine diagnostic radiography when pregnancy was not known at the time but was established later. Results of actual dose measurements using a phantom and of dose calculations based on published values are in reasonable agreement indicating that literature values of dose provide a satisfactory alternative to measurement. These data suggest that diagnostic radiography rarely, if ever, results in fetal exposures high enough to justify therapeutic abortion. (author)

  13. CT guided diagnostic foot injections

    International Nuclear Information System (INIS)

    Saifuddin, A.; Abdus-Samee, M.; Mann, C.; Singh, D.; Angel, J.C.

    2005-01-01

    AIM: To describe a CT technique for guiding diagnostic and therapeutic injections in the hind- and mid-foot. MATERIALS AND METHODS: Over a period of 50 months, 28 individuals were referred for diagnostic and therapeutic hind- and mid-foot injections before possible arthrodesis. A CT technique was developed that allowed entry into the various joints using a vertical approach. Numbers of joints injected were as follows: posterior subtalar, 21; talonavicular, 4; calcaneonavicular, calcaneocuboid, navicular-cuneiform and 5th metatarsocuboid joints, 1 each. RESULTS: All injections but one were technically successful. Significant relief of symptoms was noted by 16 participants, whereas for 9 there was no improvement and for 3 a partial response was achieved. CONCLUSION: CT is a simple and safe alternative to fluoroscopy for guiding diagnostic and therapeutic foot injections, and may be the technique of choice in cases of disordered anatomy