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Sample records for based observational study

  1. Passive output feedback and observer based autopilots: A comparative study

    Directory of Open Access Journals (Sweden)

    Marit Paulsen

    1996-04-01

    Full Text Available Two methods for course-keeping of a ship are studied where no measurements of the yaw rate are available. The two methods are a passive output feedback controller and a controller-observer structure. A comparison with special attention to stability and wave filtering properties, is provided. Finally, a case study of a ship autopilot is included.

  2. The reporting of observational research studies in dermatology journals: a literature-based study.

    Science.gov (United States)

    Langan, Sinéad; Schmitt, Jochen; Coenraads, Pieter-Jan; Svensson, Ake; von Elm, Erik; Williams, Hywel

    2010-05-01

    To assess the quality of reporting in observational studies in dermatology. Five dermatology journals-the Archives of Dermatology, the British Journal of Dermatology, the Journal of the American Academy of Dermatology, the Journal of Investigative Dermatology, and Acta Dermato-Venereologica. Cohort, case-control, and cross-sectional studies published as original articles during the period January 2005 through December 2007. Studies were identified with a literature search of PubMed combining the journal title and the term epidemiological studies (free text) and by hand searching all of the issues of each journal to identify relevant articles. All articles were extracted by 2 reviewers independently using standardized checklists based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations. The number and proportion of reported STROBE items were analyzed for each article. The proportion of studies with good reporting for each item was also assessed. A total of 138 articles were included and analyzed. Reporting quality was very mixed. Key areas that were infrequently reported included sample size calculations (n = 10 [7%]), missing data (n = 8 [6%]), losses to follow-up (n = 17 [12%]), and statistical methods (n = 19 [14%]). Only 13 studies (9%) explained the role of funders in the research. The quality of reporting was similar across study designs for "critical" questions with the exception of reporting of participant details, which was better reported in cohort studies (96%) compared with cross-sectional (80%) and case-control (70%) studies. It is difficult to judge the quality of dermatological research unless it is reported well. This study has identified a clear need to improve the quality of reporting of observational studies in dermatology. We recommend that dermatology journals adopt the STROBE criteria.

  3. The Reporting of Observational Research Studies in Dermatology Journals A Literature-Based Study

    NARCIS (Netherlands)

    Langan, Sinead; Schmitt, Jochen; Coenraads, Pieter-Jan; Svensson, Ake; von Elm, Erik; Williams, Hywel

    Objective: To assess the quality of reporting in observational studies in dermatology. Data Sources: Five dermatology journals-the Archives of Dermatology, the British Journal of Dermatology, the Journal of the American Academy of Dermatology, the Journal of Investigative Dermatology, and Acta

  4. Evidence-based medicine, systematic reviews, and guidelines in interventional pain management: part 4: observational studies.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Singh, Vijay; Smith, Howard S; Hirsch, Joshua A

    2009-01-01

    Evidence-based medicine (EBM) stresses the examination of evidence from clinical research and describes it as a shift in medical paradigms, in contrast to intuition, unsystematic clinical experience, and pathophysiologic rationale. While the importance of randomized trials has been created by the concept of the hierarchy of evidence in guiding therapy, much of the medical research is observational. There is competition, contrast, and a feeling of inferiority and uselessness for observational studies, created by a lack of understanding of medical research. However, observational studies and randomized clinical trials (RCTs) can be viewed as the steps of observation and experimentation that form the basis of the scientific methodology. Further, rational healthcare practices require knowledge about the etiology and pathogenesis, diagnosis, prognosis, and treatment of disorders. The reporting of observational research is often not detailed and clear enough with insufficient quality and poor reporting, which hampers the assessment of strengths and weaknesses of the study and the generalizability of the mixed results. Thus, design, implementation, and reporting of observational studies is crucial. The biased interpretation of results from observational studies, either in favor of or opposed to a treatment, and lack of proper understanding of observational studies, leads to a poor appraisal of the quality. Similar to the Consolidated Standards of Reporting Trials (CONSORT) statement for the reporting of randomized trials, the Strengthening of the Reporting of Observational Studies in Epidemiology (STROBE) statement was developed with recommendations to improve the quality of reporting observational studies. The STROBE statement consists of a checklist of 22 items, which relate to the title, abstract, introduction, methods, results, and discussion sections of articles. Multiple types of observational studies are conducted; however, 3 types have been highlighted in the

  5. Studying Children’s friendship activities ethically using the Interaction Based Observation Method

    DEFF Research Database (Denmark)

    Sørensen, Hanne Værum

    2018-01-01

    The aim of this chapter is to acknowledge the influence that the interaction based observation method developed by Mariane Hedegaard has had on my studies of young children’s friendship activities. Hedegaard has problematized how existing methods of evaluating children’s development were inadequate...

  6. Evaluation of the Quality of Reporting of Observational Studies in Otorhinolaryngology - Based on the STROBE Statement.

    Science.gov (United States)

    Hendriksma, Martine; Joosten, Michiel H M A; Peters, Jeroen P M; Grolman, Wilko; Stegeman, Inge

    2017-01-01

    Observational studies are the most frequently published studies in literature. When randomized controlled trials cannot be conducted because of ethical or practical considerations, an observational study design is the first choice. The STROBE Statement (STrengthening the Reporting of OBservational studies in Epidemiology) was developed to provide guidance on how to adequately report observational studies. The objectives were 1) to evaluate the quality of reporting of observational studies of otorhinolaryngologic literature using the STROBE Statement checklist, 2) to compare the quality of reporting of observational studies in the top 5 Ear, Nose, Throat (ENT) journals versus the top 5 general medical journals and 3) to formulate recommendations to improve adequate reporting of observational research in otorhinolaryngologic literature. The top 5 general medical journals and top 5 otorhinolaryngologic journals were selected based on their ISI Web of Knowledge impact factors. On August 3rd, 2015, we performed a PubMed search using different filters to retrieve observational articles from these journals. Studies were selected from 2010 to 2014 for the general medical journals and from 2015 for the ENT journals. We assessed all STROBE items to examine how many items were reported adequately for each journal type. The articles in the top 5 general medical journals (n = 11) reported a mean of 69.2% (95% confidence interval (CI): 65.8%-72.7%; median 70.6%), whereas the top 5 ENT journals (n = 29) reported a mean of 51.4% (95% CI: 47.7%-55.0%; median 50.0%). The two journal types reported STROBE items significantly different (p STROBE Statement.

  7. Evaluation of the Quality of Reporting of Observational Studies in Otorhinolaryngology - Based on the STROBE Statement

    NARCIS (Netherlands)

    Hendriksma, Martine; Joosten, Michiel H M A; Peters, Jeroen P M; Grolman, Wilko; Stegeman, Inge

    2017-01-01

    BACKGROUND: Observational studies are the most frequently published studies in literature. When randomized controlled trials cannot be conducted because of ethical or practical considerations, an observational study design is the first choice. The STROBE Statement (STrengthening the Reporting of

  8. The study and realization of BDS un-differenced network-RTK based on raw observations

    Science.gov (United States)

    Tu, Rui; Zhang, Pengfei; Zhang, Rui; Lu, Cuixian; Liu, Jinhai; Lu, Xiaochun

    2017-06-01

    A BeiDou Navigation Satellite System (BDS) Un-Differenced (UD) Network Real Time Kinematic (URTK) positioning algorithm, which is based on raw observations, is developed in this study. Given an integer ambiguity datum, the UD integer ambiguity can be recovered from Double-Differenced (DD) integer ambiguities, thus the UD observation corrections can be calculated and interpolated for the rover station to achieve the fast positioning. As this URTK model uses raw observations instead of the ionospheric-free combinations, it is applicable for both dual- and single-frequency users to realize the URTK service. The algorithm was validated with the experimental BDS data collected at four regional stations from day of year 080 to 083 in 2016. The achieved results confirmed the high efficiency of the proposed URTK for providing the rover users a rapid and precise positioning service compared to the standard NRTK. In our test, the BDS URTK can provide a positioning service with cm level accuracy, i.e., 1 cm in the horizontal components, and 2-3 cm in the vertical component. Within the regional network, the mean convergence time for the users to fix the UD ambiguities is 2.7 s for the dual-frequency observations and of 6.3 s for the single-frequency observations after the DD ambiguity resolution. Furthermore, due to the feature of realizing URTK technology under the UD processing mode, it is possible to integrate the global Precise Point Positioning (PPP) and the local NRTK into a seamless positioning service.

  9. Virtual colleagues, virtually colleagues--physicians' use of Twitter: a population-based observational study.

    Science.gov (United States)

    Brynolf, Anne; Johansson, Stefan; Appelgren, Ester; Lynoe, Niels; Edstedt Bonamy, Anna-Karin

    2013-01-01

    To investigate potential violations of patient confidentiality or other breaches of medical ethics committed by physicians and medical students active on the social networking site Twitter. Population-based cross-sectional observational study. The social networking site Twitter (Swedish-speaking users, n=298819). Physicians and medical students (Swedish-speaking users, n=237) active on the social networking site Twitter between July 2007 and March 2012. Postings that reflect unprofessional behaviour and ethical breaches among physicians and medical students. In all, 237 Twitter accounts were established as held by physicians and medical students and a total of 13 780 tweets were analysed by content. In all, 276 (1.9%) tweets were labelled as 'unprofessional'. Among these, 26 (0.2%) tweets written by 15 (6.3%) physicians and medical students included information that could violate patient privacy. No information on the personal ID number or names was disclosed, but parts of the patient documentation or otherwise specific indicatory information on patients were found. Unprofessional tweets were more common among users writing under a pseudonym and among medical students. In this study of physicians and medical students on Twitter, we observed potential violations of patient privacy and other breaches of medical ethics. Our findings underline that every physician and medical student has to consider his or her presence on social networking sites. It remains to be investigated if the introduction of social networking site guidelines for medical professionals will improve awareness.

  10. National observational study to evaluate the "cleanyourhands" campaign (NOSEC): a questionnaire based study of national implementation.

    Science.gov (United States)

    Fuller, Christopher; Savage, Joanne; Cookson, Barry; Hayward, Andrew; Cooper, Ben; Duckworth, Georgia; Michie, Susan; Jeanes, Annette; Teare, Louise; Charlett, Andre; Stone, Sheldon Paul

    2015-01-01

    The number of national hand-hygiene campaigns has increased recently, following the World Health Organisation's (WHO) "Save Lives: clean your hands" initiative (2009), which offers hospitals a multi-component hand-hygiene intervention. The number of campaigns to be evaluated remains small. Most evaluations focus on consumption of alcohol hand rub (AHR). We are not aware of any evaluation reporting implementation of all campaign components. In a previously published report, we evaluated the effects of the English and Welsh cleanyourhands campaign (2004-8) on procurement of AHR and soap, and on selected healthcare associated infections. We now report on the implementation of each individual campaign component: provision of bedside AHR, ward posters, patient empowerment materials, audit and feedback, and guidance to secure institutional engagement. all 189 acute National Health Service (NHS) hospitals in England and Wales (December 2005-June 2008). Six postal questionnaires (five voluntary, one mandatory) were distributed to infection control teams six-monthly from 6 to 36 months post roll-out. Selection and attrition bias were measured. Response rates fell from 134 (71 %) at 6 months to 82 (44 %) at 30 months, rising to 167 (90 %) for the final mandatory one (36 months). There was no evidence of attrition or selection bias. Hospitals reported widespread early implementation of bedside AHR and posters and a gradual rise in audit. At 36 months, 90 % of respondents reported the campaign to be a top hospital priority, with implementation of AHR, posters and audit reported by 96 %, 97 % and 91 % respectively. Patient empowerment was less successful. The study suggests that all campaign components, apart from patient empowerment, were widely implemented and sustained. It supports previous work suggesting that adequate piloting, strong governmental support, refreshment of campaigns, and sufficient time to engage institutions help secure sustained implementation

  11. Observational and Modeling-based Study of Electrified Thunderstorms in Corsica

    Science.gov (United States)

    Defer, Eric; Pinty, Jean-Pierre; Coquillat, Sylvain; Prieur, Serge; Lambert, Dominique; Pedeboy, Stéphane

    2017-04-01

    To demonstrate the strong synergy between instrumentation and modeling tools to support the interpretation of lightning optical data of up-coming space-based geostationary missions, the temporal and spatial evolution of two thunderstorms in Corsica, one with a regular polarity (25 July 2014) and one with an inverted polarity (13 June 2015), were investigated through a detailed analysis of concurrent observations and numerical simulations. The electrical activity was simultaneously documented with the Lightning Mapping Array SAETTA (Suivi de l'Activité Electrique Tridimensionnelle Totale de l'Atmosphère; this conference) operated in Corsica since July 2014 and with the French operational lightning detection network Météorage. The cloud resolving model MesoNH and its explicit electrification and lightning schemes, successively simulated the spatial and temporal locations of the storms but also the number of flashes and the storm polarity. Both SAETTA and Meteorage networks, and MesoNH electrification and lightning modules will be first introduced. Then, observations and simulations will be discussed for the two studied storms with an emphasis on the causes of the different storm polarities. Acknowledgments: ANR-16-CE04-005 EXAEDRE project; the MISTRALS/HyMeX Program; Collectivité Territoriale de Corse through the Fonds Européen de Développement Régional of the European Operational Program 2007-2013 and the Contrat de Plan Etat Région;

  12. Virtual colleagues, virtually colleagues—physicians’ use of Twitter: a population-based observational study

    Science.gov (United States)

    Brynolf, Anne; Johansson, Stefan; Appelgren, Ester; Lynoe, Niels; Edstedt Bonamy, Anna-Karin

    2013-01-01

    Objective To investigate potential violations of patient confidentiality or other breaches of medical ethics committed by physicians and medical students active on the social networking site Twitter. Design Population-based cross-sectional observational study. Setting The social networking site Twitter (Swedish-speaking users, n=298819). Population Physicians and medical students (Swedish-speaking users, n=237) active on the social networking site Twitter between July 2007 and March 2012. Main outcome measure Postings that reflect unprofessional behaviour and ethical breaches among physicians and medical students. Results In all, 237 Twitter accounts were established as held by physicians and medical students and a total of 13 780 tweets were analysed by content. In all, 276 (1.9%) tweets were labelled as ‘unprofessional’. Among these, 26 (0.2%) tweets written by 15 (6.3%) physicians and medical students included information that could violate patient privacy. No information on the personal ID number or names was disclosed, but parts of the patient documentation or otherwise specific indicatory information on patients were found. Unprofessional tweets were more common among users writing under a pseudonym and among medical students. Conclusions In this study of physicians and medical students on Twitter, we observed potential violations of patient privacy and other breaches of medical ethics. Our findings underline that every physician and medical student has to consider his or her presence on social networking sites. It remains to be investigated if the introduction of social networking site guidelines for medical professionals will improve awareness. PMID:23883885

  13. Survival in pediatric medulloblastoma: a population-based observational study to improve prognostication.

    Science.gov (United States)

    Weil, Alexander G; Wang, Anthony C; Westwick, Harrison J; Ibrahim, George M; Ariani, Rojine T; Crevier, Louis; Perreault, Sebastien; Davidson, Tom; Tseng, Chi-Hong; Fallah, Aria

    2017-03-01

    Medulloblastoma is the most common form of brain malignancy of childhood. The mainstay of epidemiological data regarding childhood medulloblastoma is derived from case series, hence population-based studies are warranted to improve the accuracy of survival estimates. To utilize a big-data approach to update survival estimates in a contemporary cohort of children with medulloblastoma. We performed a population-based retrospective observational cohort study utilizing the Surveillance, Epidemiology, and End Results Program database that captures all children, less than 20 years of age, between 1973 and 2012 in 18 geographical regions representing 28% of the US population. We included all participants with a presumed or histologically diagnosis of medulloblastoma. The main outcome of interest is survivors at 1, 5 and 10 years following diagnosis. A cohort of 1735 children with a median (interquartile range) age at diagnosis of 7 (4-11) years, with a diagnosis of medulloblastoma were identified. The incidence and prevalence of pediatric medulloblastoma has remained stable over the past 4 decades. There is a critical time point at 1990 when the overall survival has drastically improved. In the contemporary cohort (1990 onwards), the percentage of participants alive was 86, 70 and 63% at 1, 5 and 10 years, respectively. Multivariate Cox-Regression model demonstrated Radiation (HR 0.37; 95% CI 0.30-0.46, p < 0.001) and Surgery (HR 0.42; 95% CI 0.30-0.58, p < 0.001) independently predict survival. The probability of mortality from a neurological cause is <5% in patients who are alive 8 years following diagnosis. The SEER cohort analysis demonstrates significant improvements in pediatric medulloblastoma survival. In contrast to previous reports, the majority of patients survive in the modern era, and those alive 8 years following initial diagnosis are likely a long-term survivor. The importance of minimizing treatment-related toxicity is increasingly apparent given

  14. [Acetylsalicylic acid in self-medication of migraine. A pharmacy-based observational study].

    Science.gov (United States)

    Göbel, H; Gessner, U; Petersen-Braun, M; Weingärtner, U

    2007-02-01

    The aim of the study was to investigate the efficacy and tolerability of acetylsalicylic acid in the treatment of acute migraine attacks by self-medication under daily life conditions when bought in a pharmacy and also the ability of patients to self-diagnose correctly. A total of 296 patients were recruited from 156 pharmacies and recorded up to 3 migraine attacks. Following an advisory discussion the pharmacists gave a questionnaire to persons who had purchased acetylsalicylic acid (Aspirin Migraine) in the pharmacy to treat migraine. A total of 578 questionnaires containing 36 questions about demographic details, headache phenotype, medical history, efficacy over 2 h and tolerability of the preparation were analyzed. The IHS criteria (1988) for migraine were identified correctly by 92.7% of the patients. In 66.3% of the attacks, the intensity of the headache was reported as severe. In 60% of the documented attacks, a decrease from severe or moderate to mild or no headache was recorded after medication, and freedom from headache was achieved in 35.8%. The effect was reproducible over 3 migraine attacks. Nausea, photophobia and phonophobia were reduced by 71-86% compared to the baseline level. Side-effects were reported twice as often by the participants in response to closed questions than to open questions (16.6 vs. 8.3%). A high percentage of migraine patients are capable of diagnosing their condition themselves when they seek advice in a pharmacy. The data on efficacy confirm the results from controlled clinical studies. The same parameters as those used in controlled clinical studies can also be recorded in pharmacy-based observational studies, therefore, the safety and tolerability of the medication can be recorded under real conditions.

  15. The value of site-based observations complematary to naturalistic driving observations : a pilot study on the right turn manoeuvre.

    NARCIS (Netherlands)

    Nes, N. van Christoph, M.W.T. Hoedemaeker, M. & Horst, A.R.A. van der

    2013-01-01

    Naturalistic driving studies are increasingly applied in different shapes and sizes. The European project PROLOGUE has investigated the value and feasibility of a large-scale naturalistic driving study in Europe. Within PROLOGUE several pilot studies have been conducted in different countries. The

  16. Analysis and study of magnetospheric ULF waves using multi-spacecraft and ground-based observations

    Science.gov (United States)

    Balasis, Georgios; Daglis, Ioannis A.; Papadimitriou, Constantinos; Georgiou, Marina; Giamini, Sigiava

    In the past decade, a critical mass of high-quality scientific data on the electric and magnetic fields in the Earth’s magnetosphere and topside ionosphere has been progressively collected. This data pool will be further enriched by the measurements of ESA's Swarm mission, a constellation of three satellites in three different polar orbits between 400 and 550 km altitude, which was launched on the 22nd of November 2013. New analysis tools that can cope with measurements of various spacecraft at various regions of the magnetosphere and in the topside ionosphere as well as ground stations will effectively enhance the scientific exploitation of the accumulated data. Here, we report on a new suite of algorithms aiming at automated detection and classification of ultra-low frequency (ULF) wave events. Our approach is based on a combination of wavelet spectral methods and artificial neural network techniques. Moreover, we demonstrate the applicability of these recently developed analysis tools both for individual case studies and statistical studies of ULF waves. First, we provide evidence for a rare simultaneous observation of a ULF wave event in the Earth's magnetosphere, topside ionosphere and surface: we have found a specific time interval during the Halloween 2003 magnetic storm, when the Cluster and CHAMP spacecraft were in good local time (LT) conjunction, and have examined the ULF wave activity in the Pc3 (22-100 mHz) and Pc4-5 (1-22 mHz) frequency bands using data from the Geotail, Cluster and CHAMP missions, as well as the CARISMA and GIMA magnetometer networks. Then, we perform a statistical study of Pc3 wave events observed by CHAMP: the creation of a database of such events enabled us to derive valuable statistics for many important physical properties relating to the spatio-temporal location of these waves, the wave power and frequency, as well as other parameters and their correlation with solar wind conditions, magnetospheric indices, electron density

  17. Bacterial meningitis in Finland, 1995-2014: a population-based observational study.

    Science.gov (United States)

    Polkowska, Aleksandra; Toropainen, Maija; Ollgren, Jukka; Lyytikäinen, Outi; Nuorti, J Pekka

    2017-06-06

    Bacterial meningitis remains an important cause of morbidity and mortality worldwide. Its epidemiological characteristics, however, are changing due to new vaccines and secular trends. Conjugate vaccines against Haemophilus influenzae type b and Streptococcus pneumoniae (10-valent) were introduced in 1986 and 2010 in Finland. We assessed the disease burden and long-term trends of five common causes of bacterial meningitis in a population-based observational study. A case was defined as isolation of S. pneumoniae , Neisseria meningitidis , Streptococcus agalactiae , Listeria monocytogenes or H. influenzae from cerebrospinal fluid and reported to national, population-based laboratory surveillance system during 1995-2014. We evaluated changes in incidence rates (Poisson or negative binomial regression), case fatality proportions (χ 2 ) and age distribution of cases (Wilcoxon rank-sum). During 1995-2014, S. pneumoniae and N. meningitidis accounted for 78% of the total 1361 reported bacterial meningitis cases. H. influenzae accounted for 4% of cases (92% of isolates were non-type b). During the study period, the overall rate of bacterial meningitis per 1 00 000 person-years decreased from 1.88 cases in 1995 to 0.70 cases in 2014 (4% annual decline (95% CI 3% to 5%). This was primarily due to a 9% annual reduction in rates of N. meningitidis (95% CI 7% to 10%) and 2% decrease in S. pneumoniae (95% CI 1% to 4%). The median age of cases increased from 31 years in 1995-2004 to 43 years in 2005-2014 (p=0.0004). Overall case fatality proportion (10%) did not change from 2004 to 2009 to 2010-2014. Substantial decreases in bacterial meningitis were associated with infant conjugate vaccination against pneumococcal meningitis and secular trend in meningococcal meningitis in the absence of vaccination programme. Ongoing epidemiological surveillance is needed to identify trends, evaluate serotype distribution, assess vaccine impact and develop future vaccination strategies

  18. [Observational studies in the era of evidence based medicine: short review on their relevance, taxonomy and designs].

    Science.gov (United States)

    Fronteira, Ines

    2013-01-01

    In this review of the literature, we distinguish between experimental and observational studies, highlighting the importance that the later have gained in the era of evidence-based medicine. We further analyze the value of observational studies in light of experimental studies. We present a taxonomy for observational studies based on units of observation and measurement (cross-sectional or longitudinal). We distinguish between descriptive studies and analytical studies. Then, and given its specificity, we define and present a classification for ecological studies. We define and consider the advantages and disadvantages of cross-sectional, case control and cohort studies. We analyze the strength of the evidence given by each study design. We finished by examining what should guide the choice of a study design.

  19. A population-based observational study of diabetes during pregnancy in Victoria, Australia, 1999–2008

    Science.gov (United States)

    Abouzeid, Marian; Versace, Vincent L; Janus, Edward D; Davey, Mary-Ann; Philpot, Benjamin; Oats, Jeremy; Dunbar, James A

    2014-01-01

    Objectives This paper reports secular trends in diabetes in pregnancy in Victoria, Australia and examines the effect of including or excluding women with pre-existing diabetes on gestational diabetes (GDM) prevalence estimates. Design Population-based observational study. Setting All births in Victoria, Australia between 1999 and 2008 Participants 634 932 pregnancies resulting in a birth registered with the Victorian Perinatal Data Collection Outcome measures Crude and age-standardised secular trends in pre-existing diabetes and GDM prevalence; secular GDM trends by maternal birthplace; effects on GDM prevalence of including and excluding pre-existing diabetes from the denominator. Results Of the 634 932 pregnancies, 2954 (0.5%) occurred in women with pre-existing diabetes and 29 147 (4.6%) were complicated by GDM. Mean maternal age increased from 29.7 years in 1999 to 30.8 years in 2008. GDM prevalence increased in most maternal age groups. In 2008, age-standardised GDM prevalence was 31% higher than in 1999; secular increases were greater for Australian-born non-Indigenous (29% increase) than immigrant women (12.3% increase). The annual number of pregnancies in women with pre-existing diabetes almost doubled from 1999 to 2008 and prevalence increased from 0.4% to 0.6%. However, including or excluding pre-existing diabetes had little effect on GDM prevalence estimates. Conclusions Pre-existing diabetes and GDM prevalence increased in Victoria between 1999 and 2008 and rising maternal age does not fully explain these trends. These findings have important implications for preventive initiatives. Including or excluding small numbers of women with pre-existing diabetes resulted in minimal changes in GDM estimates. As pre-existing diabetes in young women increases, this methodological issue will likely become important. PMID:25398676

  20. Multiple Integrated Examinations: An Observational Study of Different Academic Curricula Based on a Business Administration Assessment

    Science.gov (United States)

    Ardolino, Piermatteo; Noventa, Stefano; Formicuzzi, Maddalena; Cubico, Serena; Favretto, Giuseppe

    2016-01-01

    An observational study has been carried out to analyse differences in performance between students of different undergraduate curricula in the same written business administration examination, focusing particularly on possible effects of "integrated" or "multi-modular" examinations, a recently widespread format in Italian…

  1. A mixed methods observational simulation-based study of interprofessional team communication

    DEFF Research Database (Denmark)

    Paltved, Charlotte; Nielsen, Kurt; Musaeus, Peter

    2013-01-01

    Interprofessional team communication has been identified as an important focus for safety in medical emergency care. However, in-depth insight into the complexity of team communication is limited. Video observational studies might fill a gap in terms of understanding the meaning of specific...

  2. Reluctance to screening colonoscopy in Arab Americans: a community based observational study.

    Science.gov (United States)

    Talaat, Nizar; Harb, Walid

    2013-08-01

    To explore compliance of Arab-Americans to colorectal cancer (CRC) screening and identify the barriers for non-compliance. An observational community based study. Arab-American Friday prayer attendees' ≥50 years in three mosques in Dearborn, MI volunteered. Demographics, health insurance status, screening history, availability of a primary care physician (PCP) and the ability to communicate in Arabic were inquired. The responses were compared using a student t test between respondents who have had CRC screening with colonoscopy and those who have not had any screening tests. A p value of 0.05 or lower was considered statistically significant. Total number surveyed was 130. Average age is 64 years. Males were 76 % (99) and females 24 % (31). More than 50 % were Lebanese and 28 % were from Yemen. Majority had health insurance (89 %), and 86 % had a primary care physician of which 79 % of them spoke Arabic. Half of the participants had colonoscopy mostly for screening purposes. Fifty-eight (45 %) participants did not have CRC screening. Majority of the females (72.4 %) had colonoscopy compared to 46.8 % of the males (p value = 0.016). The mean length of stay in the U.S was 39.16 years in the colonoscopy group compared to 30.77 years in the non-screening group (p value = 0.006). Participants without a PCP did not have CRC screening (77.8 %) (p value = 0.005). Participants with a non-Arabic speaking PCP had more colonoscopy rates (77.3 %) compared to those with an Arabic speaking PCP (50 %) (p value = 0.027). More Lebanese had colonoscopy (71.9 %) compared to 25.7 % of the surveyed Yemenis (p value = 0.00). Discomfort, unawareness about CRC screening, and nonrecommendation by PCP were reported barriers. Arab-Americans have lower screening colonoscopy rates. Unfamiliarity of the importance of screening is a principal issue. Having a non-arabic speaking PCP is beneficial. Better education to this population about the benefits and ease of

  3. An observational study based on the interaction between the paediatric patient and radiographer

    International Nuclear Information System (INIS)

    Harding, J.; Davis, M.

    2015-01-01

    Background: The practice of paediatric radiography requires a completely different skill set to that of adult radiography. Often, obtaining a paediatric patient's cooperation is the most difficult aspect of the role. Ensuring that a child cooperates for the examination can make positioning easier, thereby potentially providing a more diagnostic image. Aim: The aim of this study was to observe the interaction between the paediatric patient and the radiographer and to uncover techniques used by the radiographer to help alleviate any fear or stress that the child might have had. Method: A direct observational method was conducted, after both the radiographer and the child's guardians provided full written consent. The actions of the radiographer and resultant reactions from the child were recorded on an observational checklist designed for paediatric examinations. Results: Seventy-nine patients aged between three months to fifteen years and thirteen radiographers with no specific paediatric training other than experience were observed. Examinations observed included lower limb, upper limb, pelvis, abdomen and chest projections. The data gathered were the result of radiographer actions when interacting with both happy and sad children. Conclusions: Successful methods of alleviating a child's fear and anxiety whilst in the X-ray room included the use of child friendly equipment such as colourful lead protection and posters on the wall, a simple explanation of what the equipment is before moving it, offering rewards such as stickers and praise and showing the child their image after the examination. When time was short and the workload was high, it was observed that radiographers were less likely to spend time calming the child down and instead were more focused on completing the examination as quickly as possible. - Highlights: • Seventy-nine patients and thirteen radiographers were observed in this study. • The use of child-friendly equipment and

  4. Sounding rocket/ground-based observation campaign to study Medium-Scale Traveling Ionospheric Disturbances (MSTID)

    Science.gov (United States)

    Yamamoto, M.; Yokoyama, T.; Saito, A.; Otsuka, Y.; Yamamoto, M.; Abe, T.; Watanabe, S.; Ishisaka, K.; Saito, S.; Larsen, M.; Pfaff, R. F.; Bernhardt, P. A.

    2012-12-01

    An observation campaign is under preparation. It is to launch sounding rockets S-520-27 and S-310-42 from Uchinoura Space Center of JAXA while ground-based instruments measure waves in the ionosphere. It is scheduled in July/August 2013. The main purpose of the experiment is to reveal generation mechanism of Medium-Scale Traveling Ionospheric Disturbance (MSTID). The MSTID is the ionospheric wave with 1-2 hour periodicity, 100-200 km horizontal wavelength, and southwestward propagation. It is enhanced in the summer nighttime of the mid-latitude ionosphere. The MSTID is not only a simple atmospheric-wave modulation of the ionosphere, but shows similarity to characteristics of the Perkins instability. A problem is that growth rate of the Perkins instability is too small to explain the phenomena. We now hypothesize a generation mechanism that electromagnetic coupling of the F- and E-regions help rapid growth of the MSTID especially at its initial stage. In the observation campaign, we will use the sounding rocket S-520-27 for in-situ measurement of ionospheric parameters, i.e., electron density and electric fields. Wind velocity measurements in both F- and E-regions are very important as well. For the F-region winds, we will conduct Lithium-release experiment under the full-moon condition. This is a big technical challenge. Another rocket S-310-42 will be used for the E-region wind measurement with the TMA release. On the ground, we will use GEONET (Japanese vast GPS receiver network) to monitor horizontal distribution of GPS-TEC on the realtime bases. In the presentation we will show MSTID characteristics and the proposed generation mechanism, and discuss plan and current status of the project.

  5. Wind‐gust parametrizations at heights relevant for wind energy: a study based on mast observations

    DEFF Research Database (Denmark)

    Suomi, I.; Vihma, T.; Gryning, Sven-Erik

    2013-01-01

    Wind gusts are traditionally observed and reported at the reference height of 10 m and most gust parametrization methods have been developed only for this height. In many practical applications, e.g. in wind energy, the relevant heights are, however, up to a few hundred metres. In this study, mean...... speed, which is parametrized on the basis of the surface friction velocity, the Obukhov length and height and the boundary‐layer height. The new gust parametrization method outperformed the two older methods: the effects of surface roughness, stability and the height above the surface were well...

  6. Risk factors of asthma exacerbation based on asthma severity: a nationwide population-based observational study in South Korea.

    Science.gov (United States)

    Kang, Hye-Rim; Song, Hyun Jin; Nam, Jin Hyun; Hong, Sung-Hyun; Yang, So-Young; Ju, SangEun; Lee, Sang Won; Kim, Tae-Bum; Kim, Hye-Lin; Lee, Eui-Kyung

    2018-03-22

    Asthma exacerbation, associated with many risks factors, can reflect management failure. However, little is known about how risk factors are associated with exacerbation, according to asthma severity. We aimed to investigate differences in risk factors in patients with different asthma severity and evaluate whether risk factors differed between frequent exacerbators and patients with single exacerbation. Nationwide population-based observational study. Korean National Sample Cohort database. We included 22 130 adults with asthma diagnoses more than twice (ICD-10 (International Classification of Diseases, Tenth revision) codes J45 and J46) and one prescription for asthma medication from 2010 to 2011. Asthma exacerbation was defined as having a corticosteroid (CS) burst characterised by a prescription of high-dose oral CS for ≥3 days or one systemic CS injection, hospitalisation or emergency department visit. Among severities, history of CS bursts was significantly associated with exacerbation. In mild and moderate asthma, exacerbation was significantly associated with age ≥45 years, being female, gastro-oesophageal reflux disease and chronic rhinitis. High medication possession ratio (MPR≥50%), compared with low MPR (factors in mild and moderate asthma, whereas no risk factors were significant in severe asthma. Different associations between risk factors and asthma exacerbations based on asthma severity suggest that patients with mild asthma require greater attention to their age and comorbidities, whereas those with severe asthma require greater attention to hospitalisation history and drug adherence. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Association between anthropometry-based nutritional status and malaria: a systematic review of observational studies.

    Science.gov (United States)

    Ferreira, Efrem d'Avila; Alexandre, Márcia A; Salinas, Jorge L; de Siqueira, André M; Benzecry, Silvana G; de Lacerda, Marcus V G; Monteiro, Wuelton M

    2015-09-17

    Multiple studies in various parts of the world have analysed the association of nutritional status on malaria using anthropometric measures, but results differ due to the heterogeneity of the study population, species of the parasite, and other factors involved in the host and parasite relationship. The aim of this study was to perform a systematic review on the inter-relationship of nutritional status based on anthropometry and malarial infection. Two independent reviewers accessed the MEDLINE and LILACS databases using the same search terms related to malaria and anthropometry. Prospective studies associating anthropometry and malaria (incidence or severity) were selected. References from the included studies and reviews were used to increase the review sensitivity. Data were extracted using a standardized form and the quality of the prospective studies was assessed. Selected articles were grouped based on exposures and outcomes. The search identified a total of 1688 studies: 1629 from MEDLINE and 59 from LILACS. A total of 23 met the inclusion criteria. Five additional studies were detected by reading the references of the 23 included studies and reviews, totaling 28 studies included. The mean sample size was 662.1 people, ranging from 57 to 5620. The mean follow-up was 365.8 days, ranging from 14 days to 1 year and 9 months, and nine studies did not report the follow-up period. Prospective studies assessing the relationship between malaria and malnutrition were mostly carried out in Africa. Of the 20 studies with malarial outcomes, fifteen had high and five had average quality, with an average score of 80.5 %. Most anthropometric parameters had no association with malaria incidence (47/52; 90.4 %) or parasite density (20/25; 80 %). However, the impact of malnutrition was noted in malaria mortality and severity (7/17; 41.2 %). Regarding the effects of malaria on malnutrition, malaria was associated with very few anthropometric parameters (8/39; 20.6

  8. Designing Health Websites Based on Users' Web-Based Information-Seeking Behaviors: A Mixed-Method Observational Study.

    Science.gov (United States)

    Pang, Patrick Cheong-Iao; Chang, Shanton; Verspoor, Karin; Pearce, Jon

    2016-06-06

    Laypeople increasingly use the Internet as a source of health information, but finding and discovering the right information remains problematic. These issues are partially due to the mismatch between the design of consumer health websites and the needs of health information seekers, particularly the lack of support for "exploring" health information. The aim of this research was to create a design for consumer health websites by supporting different health information-seeking behaviors. We created a website called Better Health Explorer with the new design. Through the evaluation of this new design, we derive design implications for future implementations. Better Health Explorer was designed using a user-centered approach. The design was implemented and assessed through a laboratory-based observational study. Participants tried to use Better Health Explorer and another live health website. Both websites contained the same content. A mixed-method approach was adopted to analyze multiple types of data collected in the experiment, including screen recordings, activity logs, Web browsing histories, and audiotaped interviews. Overall, 31 participants took part in the observational study. Our new design showed a positive result for improving the experience of health information seeking, by providing a wide range of information and an engaging environment. The results showed better knowledge acquisition, a higher number of page reads, and more query reformulations in both focused and exploratory search tasks. In addition, participants spent more time to discover health information with our design in exploratory search tasks, indicating higher engagement with the website. Finally, we identify 4 design considerations for designing consumer health websites and health information-seeking apps: (1) providing a dynamic information scope; (2) supporting serendipity; (3) considering trust implications; and (4) enhancing interactivity. Better Health Explorer provides strong

  9. Designing Health Websites Based on Users’ Web-Based Information-Seeking Behaviors: A Mixed-Method Observational Study

    Science.gov (United States)

    Pang, Patrick Cheong-Iao; Verspoor, Karin; Pearce, Jon

    2016-01-01

    Background Laypeople increasingly use the Internet as a source of health information, but finding and discovering the right information remains problematic. These issues are partially due to the mismatch between the design of consumer health websites and the needs of health information seekers, particularly the lack of support for “exploring” health information. Objective The aim of this research was to create a design for consumer health websites by supporting different health information–seeking behaviors. We created a website called Better Health Explorer with the new design. Through the evaluation of this new design, we derive design implications for future implementations. Methods Better Health Explorer was designed using a user-centered approach. The design was implemented and assessed through a laboratory-based observational study. Participants tried to use Better Health Explorer and another live health website. Both websites contained the same content. A mixed-method approach was adopted to analyze multiple types of data collected in the experiment, including screen recordings, activity logs, Web browsing histories, and audiotaped interviews. Results Overall, 31 participants took part in the observational study. Our new design showed a positive result for improving the experience of health information seeking, by providing a wide range of information and an engaging environment. The results showed better knowledge acquisition, a higher number of page reads, and more query reformulations in both focused and exploratory search tasks. In addition, participants spent more time to discover health information with our design in exploratory search tasks, indicating higher engagement with the website. Finally, we identify 4 design considerations for designing consumer health websites and health information–seeking apps: (1) providing a dynamic information scope; (2) supporting serendipity; (3) considering trust implications; and (4) enhancing interactivity

  10. US Air Force Base Observations

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Hourly observations taken by U.S. Air Force personnel at bases in the United States and around the world. Foreign observations concentrated in the Middle East and...

  11. SELF-LEARNING METHODS PREFERRED BY SECOND YEAR MBBS STUDENTS IN UNDERSTANDING PHARMACOLOGY: AN OBSERVATIONAL QUESTIONNAIRE BASED STUDY

    OpenAIRE

    Padmanabha Thiruganahalli; Manu; Chandrakantha; Neha; Narasimhamurthy Kalenahally

    2016-01-01

    BACKGROUND AIMS To evaluate the self-learning habits via different learning styles which can influence and be a useful indicator for potential learning performance of an individual. MATERIAL & METHODS Observational questionnaire based study to evaluate self-learning habits among Second year undergraduates, Adichunchanagiri Institute of Medical Sciences, B. G. Nagara, Mandya, Karnataka. RESULTS 50.55% had an opinion that Problem Based Learning (PBL) stimulates self-d...

  12. Prevalence of abnormalities in knees detected by MRI in adults without knee osteoarthritis: population based observational study (Framingham Osteoarthritis Study).

    Science.gov (United States)

    Guermazi, Ali; Niu, Jingbo; Hayashi, Daichi; Roemer, Frank W; Englund, Martin; Neogi, Tuhina; Aliabadi, Piran; McLennan, Christine E; Felson, David T

    2012-08-29

    To examine use of magnetic resonance imaging (MRI) of knees with no radiographic evidence of osteoarthritis to determine the prevalence of structural lesions associated with osteoarthritis and their relation to age, sex, and obesity. Population based observational study. Community cohort in Framingham, MA, United States (Framingham osteoarthritis study). 710 people aged >50 who had no radiographic evidence of knee osteoarthritis (Kellgren-Lawrence grade 0) and who underwent MRI of the knee. Prevalence of MRI findings that are suggestive of knee osteoarthritis (osteophytes, cartilage damage, bone marrow lesions, subchondral cysts, meniscal lesions, synovitis, attrition, and ligamentous lesions) in all participants and after stratification by age, sex, body mass index (BMI), and the presence or absence of knee pain. Pain was assessed by three different questions and also by WOMAC questionnaire. Of the 710 participants, 393 (55%) were women, 660 (93%) were white, and 206 (29%) had knee pain in the past month. The mean age was 62.3 years and mean BMI was 27.9. Prevalence of "any abnormality" was 89% (631/710) overall. Osteophytes were the most common abnormality among all participants (74%, 524/710), followed by cartilage damage (69%, 492/710) and bone marrow lesions (52%, 371/710). The higher the age, the higher the prevalence of all types of abnormalities detectable by MRI. There were no significant differences in the prevalence of any of the features between BMI groups. The prevalence of at least one type of pathology ("any abnormality") was high in both painful (90-97%, depending on pain definition) and painless (86-88%) knees. MRI shows lesions in the tibiofemoral joint in most middle aged and elderly people in whom knee radiographs do not show any features of osteoarthritis, regardless of pain.

  13. Maternal infection and risk of intrapartum death: a population based observational study in South Asia

    Science.gov (United States)

    2013-01-01

    Background Approximately 1.2 million stillbirths occur in the intrapartum period, and a further 717,000 annual neonatal deaths are caused by intrapartum events, most of which occur in resource poor settings. We aim to test the ‘double-hit’ hypothesis that maternal infection in the perinatal period predisposes to neurodevelopmental sequelae from an intrapartum asphyxia insult, increasing the likelihood of an early neonatal death compared with asphyxia alone. This is an observational study of singleton newborn infants with signs of intrapartum asphyxia that uses data from three previously conducted cluster randomized controlled trials taking place in rural Bangladesh and India. Methods From a population of 81,778 births in 54 community clusters in rural Bangladesh and India, we applied mixed effects logistic regression to data on 3890 singleton infants who had signs of intrapartum asphyxia, of whom 769 (20%) died in the early neonatal period. Poor infant condition at five minutes post-delivery was our proxy measure of intrapartum asphyxia. We had data for two markers of maternal infection: fever up to three days prior to labour, and prolonged rupture of membranes (PROM). Cause-specific verbal autopsy data were used to validate our findings using previously mentioned mixed effect logistic regression methods and the outcome of a neonatal death due to intrapartum asphyxia. Results Signs of maternal infection as indicated by PROM, combined with intrapartum asphyxia, increased the risk of an early neonatal death relative to intrapartum asphyxia alone (adjusted odds ratio (AOR) 1.28, 95% CI 1.03 – 1.59). Results from cause-specific verbal autopsy data verified our findings where there was a significantly increased odds of a early neonatal death due to intrapartum asphyxia in newborns exposed to both PROM and intrapartum asphyxia (AOR: 1.52, 95% CI 1.15 – 2.02). Conclusions Our data support the double-hit hypothesis for signs of maternal infection as indicated by

  14. Study on Chaotic Fault Tolerant Synchronization Control Based on Adaptive Observer

    Directory of Open Access Journals (Sweden)

    Dongming Chen

    2014-01-01

    Full Text Available Aiming at the abrupt faults of the chaotic system, an adaptive observer is proposed to trace the states of the master system. The sufficient conditions for synchronization of such chaotic systems are also derived. Then the feasibility and effectiveness of the proposed method are illustrated via numerical simulations of chaotic Chen system. Finally, the proposed synchronization schemes are applied to secure communication system successfully. The experimental results demonstrate that the employed observer can manage real-time fault diagnosis and parameter identification as well as states tracing of the master system, and so the synchronization of master system and slave system is achieved.

  15. Immigrants’ use of emergency primary health care in Norway: a registry-based observational study

    Directory of Open Access Journals (Sweden)

    Sandvik Hogne

    2012-09-01

    Full Text Available Abstract Background Emigrants are often a selected sample and in good health, but migration can have deleterious effects on health. Many immigrant groups report poor health and increased use of health services, and it is often claimed that they tend to use emergency primary health care (EPHC services for non-urgent purposes. The aim of the present study was to analyse immigrants’ use of EPHC, and to analyse variations according to country of origin, reason for immigration, and length of stay in Norway. Methods We conducted a registry based study of all immigrants to Norway, and a subsample of immigrants from Poland, Germany, Iraq and Somalia, and compared them with native Norwegians. The material comprised all electronic compensation claims for EPHC in Norway during 2008. We calculated total contact rates, contact rates for selected diagnostic groups and for services given during consultations. Adjustments for a series of socio-demographic and socio-economic variables were done by multiple logistic regression analyses. Results Immigrants as a whole had a lower contact rate than native Norwegians (23.7% versus 27.4%. Total contact rates for Polish and German immigrants (mostly work immigrants were 11.9% and 7.0%, but for Somalis and Iraqis (mostly asylum seekers 31.8% and 33.6%. Half of all contacts for Somalis and Iraqis were for non-specific pain, and they had relatively more of their contacts during night than other groups. Immigrants’ rates of psychiatric diagnoses were low, but increased with length of stay in Norway. Work immigrants suffered less from respiratory and gastrointestinal infections, but had more injuries and higher need for sickness certification. All immigrant groups, except Germans, were more often given a sickness certificate than native Norwegians. Use of interpreter was reduced with increasing length of stay. All immigrant groups had an increased need for long consultations, while laboratory tests were most often used

  16. Immigrants’ use of emergency primary health care in Norway: a registry-based observational study

    Science.gov (United States)

    2012-01-01

    Background Emigrants are often a selected sample and in good health, but migration can have deleterious effects on health. Many immigrant groups report poor health and increased use of health services, and it is often claimed that they tend to use emergency primary health care (EPHC) services for non-urgent purposes. The aim of the present study was to analyse immigrants’ use of EPHC, and to analyse variations according to country of origin, reason for immigration, and length of stay in Norway. Methods We conducted a registry based study of all immigrants to Norway, and a subsample of immigrants from Poland, Germany, Iraq and Somalia, and compared them with native Norwegians. The material comprised all electronic compensation claims for EPHC in Norway during 2008. We calculated total contact rates, contact rates for selected diagnostic groups and for services given during consultations. Adjustments for a series of socio-demographic and socio-economic variables were done by multiple logistic regression analyses. Results Immigrants as a whole had a lower contact rate than native Norwegians (23.7% versus 27.4%). Total contact rates for Polish and German immigrants (mostly work immigrants) were 11.9% and 7.0%, but for Somalis and Iraqis (mostly asylum seekers) 31.8% and 33.6%. Half of all contacts for Somalis and Iraqis were for non-specific pain, and they had relatively more of their contacts during night than other groups. Immigrants’ rates of psychiatric diagnoses were low, but increased with length of stay in Norway. Work immigrants suffered less from respiratory and gastrointestinal infections, but had more injuries and higher need for sickness certification. All immigrant groups, except Germans, were more often given a sickness certificate than native Norwegians. Use of interpreter was reduced with increasing length of stay. All immigrant groups had an increased need for long consultations, while laboratory tests were most often used for Somalis and Iraqis

  17. Web-Based Activity Within a Sexual Health Economy: Observational Study.

    Science.gov (United States)

    Turner, Katy Me; Zienkiewicz, Adam K; Syred, Jonathan; Looker, Katharine J; de Sa, Joia; Brady, Michael; Free, Caroline; Holdsworth, Gillian; Baraitser, Paula

    2018-03-07

    Regular testing for sexually transmitted infections (STIs) is important to maintain sexual health. Self-sampling kits ordered online and delivered in the post may increase access, convenience, and cost-effectiveness. Sexual health economies may target limited resources more effectively by signposting users toward Web-based or face-to-face services according to clinical need. The aim of this paper was to investigate the impact of two interventions on testing activity across a whole sexual health economy: (1) the introduction of open access Web-based STI testing services and (2) a clinic policy of triage and signpost online where users without symptoms who attended clinics for STI testing were supported to access the Web-based service instead. Data on attendances at all specialist public sexual health providers in an inner-London area were collated into a single database. Each record included information on user demographics, service type accessed, and clinical activity provided, including test results. Clinical activity was categorized as a simple STI test (could be done in a clinic or online), a complex visit (requiring face-to-face consultation), or other. Introduction of Web-based services increased total testing activity across the whole sexual health economy by 18.47% (from 36,373 to 43,091 in the same 6-month period-2014-2015 and 2015-2016), suggesting unmet need for testing in the area. Triage and signposting shifted activity out of the clinic onto the Web-based service, with simple STI testing in the clinic decreasing from 16.90% (920/5443) to 12.25% (511/4172) of total activity, PWeb-based services spontaneously. Some triage and signposted users (29.62%, 375/1266) did not complete the Web-based testing process, suggesting the potential for missed diagnoses. This evaluation shows that users can effectively be transitioned from face-to-face to Web-based services and that this introduces a new population to Web-based service use and changes the focus of clinic-based

  18. Comparative safety of direct oral anticoagulants and warfarin in venous thromboembolism: multicentre, population based, observational study

    Science.gov (United States)

    Jun, Min; Lix, Lisa M; Durand, Madeleine; Dahl, Matt; Paterson, J Michael; Dormuth, Colin R; Ernst, Pierre; Yao, Shenzhen; Renoux, Christel; Tamim, Hala; Wu, Cynthia; Mahmud, Salaheddin M

    2017-01-01

    Objective To determine the safety of direct oral anticoagulant (DOAC) use compared with warfarin use for the treatment of venous thromboembolism. Design Retrospective matched cohort study conducted between 1 January 2009 and 31 March 2016. Setting Community based, using healthcare data from six jurisdictions in Canada and the United States. Participants 59 525 adults (12 489 DOAC users; 47 036 warfarin users) with a new diagnosis of venous thromboembolism and a prescription for a DOAC or warfarin within 30 days of diagnosis. Main outcome measures Outcomes included hospital admission or emergency department visit for major bleeding and all cause mortality within 90 days after starting treatment. Propensity score matching and shared frailty models were used to estimate adjusted hazard ratios of the outcomes comparing DOACs with warfarin. Analyses were conducted independently at each site, with meta-analytical methods used to estimate pooled hazard ratios across sites. Results Of the 59 525 participants, 1967 (3.3%) had a major bleed and 1029 (1.7%) died over a mean follow-up of 85.2 days. The risk of major bleeding was similar for DOAC compared with warfarin use (pooled hazard ratio 0.92, 95% confidence interval 0.82 to 1.03), with the overall direction of the association favouring DOAC use. No difference was found in the risk of death (pooled hazard ratio 0.99, 0.84 to 1.16) for DOACs compared with warfarin use. There was no evidence of heterogeneity across centres, between patients with and without chronic kidney disease, across age groups, or between male and female patients. Conclusions In this analysis of adults with incident venous thromboembolism, treatment with DOACs, compared with warfarin, was not associated with an increased risk of major bleeding or all cause mortality in the first 90 days of treatment. Trial registration Clinical trials NCT02833987. PMID:29042362

  19. Studying aerosol light scattering based on aspect ratio distribution observed by fluorescence microscope.

    Science.gov (United States)

    Li, Li; Zheng, Xu; Li, Zhengqiang; Li, Zhanhua; Dubovik, Oleg; Chen, Xingfeng; Wendisch, Manfred

    2017-08-07

    Particle shape is crucial to the properties of light scattered by atmospheric aerosol particles. A method of fluorescence microscopy direct observation was introduced to determine the aspect ratio distribution of aerosol particles. The result is comparable with that of the electron microscopic analysis. The measured aspect ratio distribution has been successfully applied in modeling light scattering and further in simulation of polarization measurements of the sun/sky radiometer. These efforts are expected to improve shape retrieval from skylight polarization by using directly measured aspect ratio distribution.

  20. Beyond the archaeological imagination. Observations about Kodjadermengumelnita - Karanovo vi architecture based on study of experiment archaeology.

    Science.gov (United States)

    Lazăr, Cătălin; Ignat, Theodor; Stan, Sebastian; Moldoveanu, Katia; Rădulescu, Florin

    The experimental archaeology project presented here aimed at the reconstruction of a dwelling, at the 1:1 scale, belonging to the Kodjadermen-Gumelnitsa-Karanovo VI culture (5th millennium BC), based on archaeological data accumulated from research carried out mainly at the site of Sultana-Malu Roşu (South-East Romania). This reconstruction was followed by the estimation of the volume of materials used for raising the construction in conjunction with the human factor and the time needed for building it. Further, a reconstruction and verification of different techniques for the construction of surface area houses was made. The sources for this project were based on archaeological remains discovered in the field, such as, fragments of walls with impressions of building materials, charred fragments of posts, the size and arrangement of the post holes, and on the indirect information provided by miniature house models of Kodjadermen-Gumelnitsa-Karanovo VI dwellings, which are mostly reflected by ethnographic data. These data were used to verify some of our hypotheses.

  1. Solvent effects on first-order molecular hyperpolarizability: A study based on vibrational observables

    Science.gov (United States)

    Zuliani, P.; Del Zoppo, M.; Castiglioni, C.; Zerbi, G.; Marder, S. R.; Perry, J. W.

    1995-12-01

    Using a recently developed method, we show here that solvent effects on the first molecular hyperpolarizabilities of push-pull polyenes can be predicted by evaluation of the relaxation contribution βr to the hyperpolarizability from vibrational infrared and Raman intensities and vibrational frequencies. The molecules studied in this work are a few organic polymethine dyes with different donor and acceptor groups. The analysis of their vibrational spectra confirms the key role played by the structural parameters of the polyene chain in determining the nonlinear optical response.

  2. Satellite-based GNSS-R observations from TDS-1 for soil moisture studies in agricultural vegetation landscapes

    Science.gov (United States)

    Liu, P. W.; Clarizia, M. P.; Judge, J.; Camps, A.; Ruf, C. S.; Bongiovanni, T. E.

    2015-12-01

    Soil moisture (SM) is a critical factor governing the water and energy fluxes at the land surface that are important for near-term climate forecasting, drought monitoring, crop yield estimation, and better water resources management. Remotely sensed observations at microwave frequencies are the most sensitive to changes of water in the soil. Particularly, frequencies at L-band (1-2 GHz) have been widely used for SM studies under the vegetated land covers because of their minimal atmospheric interference and attenuation by vegetation, allowing observations from the soil surface. In addition to current satellite based microwave sensors, such as the Soil Moisture Active Passive (SMAP) missions, the Global Navigation Satellite System-Reflectometry technique is capable of observing the GNSS signal reflected from the terrain that contains combined information of soil and vegetation characteristics. The technique has recently attracted attention for global SM monitoring because its receiver is small in size and light weight and can be on board the low orbit, small satellites with low power consumption and low cost. Therefore the GNSS-R remote sensing may lead to affordable multi-satellite constellations that enable improved temporal resolution for highly dynamic hydrologic conditions. The current UK Technology Demonstration Satellite (TDS-1) has been providing global GNSS-R observations since September 2014 for experimental purposes and the receiver is accessed and operated for 2 days during every 8-day cycle. In the near future, the NASA Cyclone GNSS (CYGNSS) mission, scheduled to be launched in 2016, will consist of 8 satellites observing GPS L1 signal at a frequency of 1.5754 GHz with a spatial resolution of 10-25 km and a temporal resolution of < 12 hours. The goal of this study is to understand the impacts of SM and characteristics of agricultural vegetation on the forward scattering mechanisms of satellite-based GNSS-R observations. The GNSS-R observations from TDS

  3. Digital Transformation and Disruption of the Health Care Sector: Internet-Based Observational Study.

    Science.gov (United States)

    Herrmann, Maximilian; Boehme, Philip; Mondritzki, Thomas; Ehlers, Jan P; Kavadias, Stylianos; Truebel, Hubert

    2018-03-27

    Digital innovation, introduced across many industries, is a strong force of transformation. Some industries have seen faster transformation, whereas the health care sector only recently came into focus. A context where digital corporations move into health care, payers strive to keep rising costs at bay, and longer-living patients desire continuously improved quality of care points to a digital and value-based transformation with drastic implications for the health care sector. We tried to operationalize the discussion within the health care sector around digital and disruptive innovation to identify what type of technological enablers, business models, and value networks seem to be emerging from different groups of innovators with respect to their digital transformational efforts. From the Forbes 2000 and CBinsights databases, we identified 100 leading technology, life science, and start-up companies active in the health care sector. Further analysis identified projects from these companies within a digital context that were subsequently evaluated using the following criteria: delivery of patient value, presence of a comprehensive and distinctive underlying business model, solutions provided, and customer needs addressed. Our methodological approach recorded more than 400 projects and collaborations. We identified patterns that show established corporations rely more on incremental innovation that supports their current business models, while start-ups engage their flexibility to explore new market segments with notable transformations of established business models. Thereby, start-ups offer higher promises of disruptive innovation. Additionally, start-ups offer more diversified value propositions addressing broader areas of the health care sector. Digital transformation is an opportunity to accelerate health care performance by lowering cost and improving quality of care. At an economic scale, business models can be strengthened and disruptive innovation models

  4. Periodontal progression based on radiographic records: An observational study in chronic and aggressive periodontitis.

    Science.gov (United States)

    Onabolu, Olanrewaju; Donos, Nikos; Tu, Yu-Kang; Darbar, Ulpee; Nibali, Luigi

    2015-06-01

    The current classification assumes that aggressive periodontitis (AgP) has a faster rate of progression than chronic periodontitis (CP). However, this has not been clearly proven and difficulties exist in establishing progression. This study aimed to assess the feasibility of retrospectively utilising previous records for clinical diagnosis of periodontal diseases and to assess if two different patterns of disease progression exist between AgP and CP. Previous radiographic records of a cohort of 235 patients clinically diagnosed with AgP or CP were requested from the referring general dental practitioners (GDPs). Comparable radiographic records were analysed in order to assess progression patterns and associate these with clinical diagnosis, by multilevel analysis. 43 patients out of the initial 235 had comparable radiographs retrieved from the GDPs. 858 sites were followed for an average 6.6 years. Radiographically, AgP showed a faster linear pattern of progression than CP (0.31mm/year vs. 0.20mm/year, pperiodontal disease progression and may have an impact on the clinical management of aggressive periodontitis, since our findings show that there is continuous destruction in patients with aggressive periodontitis if left untreated. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. An intercomparison between the GSWM, UARS, and ground based radar observations: a case-study in January 1993

    Directory of Open Access Journals (Sweden)

    S. E. Palo

    Full Text Available The Global-Scale Wave Model (GSWM is a steady-state two-dimensional linearized model capable of simulating the solar tides and planetary waves. In an effort to understand the capabilities and limitations of the GSWM throughout the upper mesosphere and thermosphere a comparative analysis with observational data is presented. A majority of the observational data used in this study was collected during the World Day campaign which ran from 20 January to 30 January 1993. During this campaign data from 18 ground-based observational sites across the globe and two instruments located on the UARS spacecraft were analyzed. Comparisons of these data with the simulations from the GSWM indicate that the GSWM results are in reasonable agreement with the observations. However, there are a number of cases where the agreement is not particularly good. One such instance is for the semidiurnal tide in the northern hemisphere, where the GSWM estimates may exceed observations by 50% . Through a number of numerical simulations, it appears that this discrepancy may be due to the eddy diffusivity profiles used by the GSWM. Other differences relating to the diurnal tide and the quasi-two-day wave are presented and discussed. Additionally, a discussion on the biases and aliasing difficulties which may arise in the observational data is also presented.

  6. An intercomparison between the GSWM, UARS, and ground based radar observations: a case-study in January 1993

    Directory of Open Access Journals (Sweden)

    S. E. Palo

    1997-09-01

    Full Text Available The Global-Scale Wave Model (GSWM is a steady-state two-dimensional linearized model capable of simulating the solar tides and planetary waves. In an effort to understand the capabilities and limitations of the GSWM throughout the upper mesosphere and thermosphere a comparative analysis with observational data is presented. A majority of the observational data used in this study was collected during the World Day campaign which ran from 20 January to 30 January 1993. During this campaign data from 18 ground-based observational sites across the globe and two instruments located on the UARS spacecraft were analyzed. Comparisons of these data with the simulations from the GSWM indicate that the GSWM results are in reasonable agreement with the observations. However, there are a number of cases where the agreement is not particularly good. One such instance is for the semidiurnal tide in the northern hemisphere, where the GSWM estimates may exceed observations by 50% . Through a number of numerical simulations, it appears that this discrepancy may be due to the eddy diffusivity profiles used by the GSWM. Other differences relating to the diurnal tide and the quasi-two-day wave are presented and discussed. Additionally, a discussion on the biases and aliasing difficulties which may arise in the observational data is also presented.

  7. Remote Sensing based multi-temporal observation of North Korea mining activities : A case study of Rakyeon mine

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    Lim, J. H.; Yu, J.; Koh, S. M.; Lee, G.

    2017-12-01

    Mining is a major industrial business of North Korea accounting for significant portion of an export for North Korean economy. However, due to its veiled political system, details of mining activities of North Korea is rarely known. This study investigated mining activities of Rakyeon Au-Ag mine, North Korea based on remote sensing based multi-temporal observation. To monitor the mining activities, CORONA data acquired in 1960s and 1970s, SPOT and Landsat data acquired in 1980s and 1990s and KOMPSAT-2 data acquired in 2010s are utilized. The results show that mining activities of Rakyeon mine continuously carried out for the observation period expanding tailing areas of the mine. However, its expanding rate varies between the period related to North Korea's economic and political situations.

  8. Combining dual-polarization radar and ground-based observations to study the effect of riming on ice particles

    Science.gov (United States)

    Moisseev, Dmitri; von Lerber, Annakaisa; Tiira, Jussi

    2017-04-01

    Recently a new microphysical scheme based on a single ice-phase category was proposed for the use in numerical weather prediction models. In the proposed scheme, ice particle properties are predicted and vary in time and space. One of the attributes of the proposed scheme is that the prefactor of a power-law relation that links mass and size of ice particles is determined by the rime mass fraction, while the exponent is kept constant. According to this the maximum dimensions of ice particles do not change during riming until graupel growth phase is reached. The dual-polarization radar observations given an additional insight on what are the physical properties of ice particles. Often, it is assumed that differential reflectivity should decrease because of riming. The motivation for this is that heavy riming would transform an ice particle to graupel. A graupel particle typically would have an almost spherical shape and therefore the differential reflectivity will become smaller. On the other hand, at the earlier stages ice particle shape may not change much, while its mass and therefore the density increases. This would lead to the increase of the differential reflectivity, for example. By combining ground-based observations, which allow to quantify the effect of riming on snowfall, and dual-polarization radar observations we investigate the impact of riming on ice particle properties, i.e. mass, density and shape. Furthermore, a connection between, bulk properties of ice particles, liquid water path, radar equivalent reflectivity factor and precipitation rate observations is established. The study is based on data collected during US DOE Biogenic Aerosols - Effects on Clouds and Climate (BAECC) field campaign that took place in Hyytiala, Finland. A detailed analysis of two events is presented to illustrate the method.

  9. Protocol-Based Resuscitation for Septic Shock: A Meta-Analysis of Randomized Trials and Observational Studies.

    Science.gov (United States)

    Lee, Woo Kyung; Kim, Ha Yeon; Lee, Jinae; Koh, Shin Ok; Kim, Jeong Min; Na, Sungwon

    2016-09-01

    Owing to the recommendations of the Surviving Sepsis Campaign guidelines, protocol-based resuscitation or goal-directed therapy (GDT) is broadly advocated for the treatment of septic shock. However, the most recently published trials showed no survival benefit from protocol-based resuscitation in septic shock patients. Hence, we aimed to assess the effect of GDT on clinical outcomes in such patients. We performed a systematic review that included a meta-analysis. We used electronic search engines including PubMed, Embase, and the Cochrane database to find studies comparing protocol-based GDT to common or standard care in patients with septic shock and severe sepsis. A total of 13269 septic shock patients in 24 studies were included [12 randomized controlled trials (RCTs) and 12 observational studies]. The overall mortality odds ratio (OR) [95% confidence interval (CI)] for GDT versus conventional care was 0.746 (0.631-0.883). In RCTs only, the mortality OR (95% CI) for GDT versus conventional care in the meta-analysis was 0.93 (0.75-1.16). The beneficial effect of GDT decreased as more recent studies were added in an alternative, cumulative meta-analysis. No significant publication bias was found. The result of this meta-analysis suggests that GDT reduces mortality in patients with severe sepsis or septic shock. However, our cumulative meta-analysis revealed that the reduction of mortality risk was diminished as more recent studies were added.

  10. SELF-LEARNING METHODS PREFERRED BY SECOND YEAR MBBS STUDENTS IN UNDERSTANDING PHARMACOLOGY: AN OBSERVATIONAL QUESTIONNAIRE BASED STUDY

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    Padmanabha Thiruganahalli

    2016-05-01

    Full Text Available BACKGROUND AIMS To evaluate the self-learning habits via different learning styles which can influence and be a useful indicator for potential learning performance of an individual. MATERIAL & METHODS Observational questionnaire based study to evaluate self-learning habits among Second year undergraduates, Adichunchanagiri Institute of Medical Sciences, B. G. Nagara, Mandya, Karnataka. RESULTS 50.55% had an opinion that Problem Based Learning (PBL stimulates self-directed learning. 76.92% were said self-learning process should include both LBL (Literature Based Learning & PBL together. Majority of the students said the learning is boring through Literature based learning. And 59.34% said topic could be more interesting & less boring if both were included according to the situation. 84.62% said self-learning through LBL is more time consuming over PBL. 80% preferred to integrate all the subjects. 46.45% said it is better to start the PBL early in the 1 st year itself. CONCLUSION 'Learning to learn' is a crucial skill. Continued additions can lead to “Curriculum Hypertrophy”, emphasising on "Lifelong learning” skills in students & who develop such skills will be equipped for whatever the future holds and will keep up to date when they are no longer on formal training programs

  11. Family-based behavioural intervention program for obese children: an observational study of child and parent lifestyle interpretations.

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    Marie Teder

    Full Text Available BACKGROUND: Family-based behavioural intervention programs (FBIPs against childhood obesity have shown promising results, but the mediating mechanisms have not been identified. The aim of this study was to examine changes in obese childreńs lifestyle habits during a 2-year FBIP according to their own and parents' reports, the concordance between these reports and the correlations to change in post-intervention z-BMI. METHODS: An observational study of 26 children (8.3-12.0 years and their parents participating in a 2-year FBIP was performed. Weight and height were measured from baseline to 12 months after the end of the program. Eating habits and physical- and sedentary activity were reported separately by children and parents. Data were analysed with regard to concordance between parents' and children's reports and association between the lifestyle reports and change in z-BMI at the study endpoint using descriptive statistics and parametric and non-parametric tests. RESULTS: According to both children's and parents' reports, the level of physical activity among the children had increased after the intervention as well as the agreement between the informants' reports. According to the children, eating habits had improved, while the parents' reports showed an improvement only with regard to binge eating. The concordance between children and parents regarding eating habits was slight to fair also after the intervention. No statistically significant associations between changes in lifestyle reports and changes in z-BMI were observed. CONCLUSIONS: Child and parent reports of physical activity were found to converge and display an improvement in a 2-year FBIP, while the reports on eating habits showed a more refractory pattern. Changes in concordance and agreement between children and parents reports did not correlate with weight reduction. Further methods development and studies of the processes during family-based interventions against childhood

  12. Study of midlatitude ionospheric irregularities and E- and F-region coupling based on rocket and radar observations from Japan

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    Yamamoto, M.

    2015-12-01

    We have been studying ionspheric irregularities in mid-latitude region by using radars, sounding rockets, etc. The mid-latitude ionosphere was considered much stable than those in the equatorial or polar region in the past, but our studies for years have revealed that there are much active variabilities. We found variety of wave-like structures that are specific in the mid-latitudes. One of the phenomena is quasi-periodic echoes (QP echoes) first observed by the MU radar that reflects horizontal plasma-density structures associated to sporadic-E layers. Another phenomenon is medium-scale traveling ionospheric disturbance (MSTID) in the F-region. In the generation mechanism we think that Ionospheric E- and F-region coupling process is important. In this presentation, we will discuss nature of mid-latitude ionosphere based on our observations; the MU radar, sounding rocket campaigns of SEEK-1/2, and recent MSTID rocket experiment from JAXA Uchinoura Space Center in July 2013.

  13. Stem cell-based treatments against stroke: observations from human proof-of-concept studies and considerations regarding clinical applicability

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    Thorsten Roland Doeppner

    2014-10-01

    Full Text Available Ischemic stroke remains a heavy burden for industrialized countries. The only causal therapy is the recanalization of occluded vessels via thrombolysis, which due to a narrow time window still can be offered only to a minority of patients. Since the majority of patients continues to exhibit neurological deficits even following successful thrombolysis, restorative therapies are urgently needed that promote brain remodeling and repair once stroke injury has occurred. Due to their unique properties of action, stem cell-based strategies gained increasing interest during recent years. Using various stroke models in both rodents and primates, the transplantation of stem cells, namely of bone marrow derived mesenchymal stem cells (MSCs or neural progenitor cells (NPCs, has been shown to promote neurological recovery most likely via indirect bystander actions. In view of promising observations, clinical proof-of-concept studies are currently under way, in which effects of stem and precursor cells are evaluated in human stroke patients. In this review we summarize already published studies, which due to the broad experience in other medical contexts mostly employed bone marrow-derived MSCs by means of intravenous transplantation. With the overall number of clinical trials limited in number, only a fraction of these studies used non-treated control groups, and only single studies were adequately blinded. Despite these limitations, first promising results justify the need for more elaborate clinical trials in order to make stem cell transplantation a success for stroke treatment in the future.

  14. Shock in the first 24 h of intensive care unit stay: observational study of protocol-based fluid management.

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    See, Kay Choong; Mukhopadhyay, Amartya; Lau, Samuel Chuan-Xian; Tan, Sandra Ming-Yien; Lim, Tow Keang; Phua, Jason

    2015-05-01

    Precision in fluid management for shock could lead to better clinical outcomes. We evaluated the association of protocol-based fluid management with intensive care unit (ICU) and hospital mortality. We performed an observational study of mechanically ventilated patients admitted directly from our emergency department to the ICU from August 2011 to December 2013, who had circulatory shock in the first 24 h of ICU stay (systolic blood pressure 4 mmol/L). Patients with onset of shock beyond 24 h of ICU stay were excluded. Protocol-based fluid management required close physician-nurse cooperation and computerized documentation, checking for fluid response (≥10% arterial pulse pressure or stroke volume increase after two consecutive 250-mL crystalloid boluses), and fluid loading with repeated 500-mL boluses until fluid response became negative. Six hundred twelve mechanically ventilated patients with shock (mean [±SD] age, 63.0 years [16.5]; 252 or 41.2% females; mean Acute Physiology and Chronic Health Evaluation II score, 30.2 [8.8]) were studied. The fluid management protocol was used 455 times for 242 patients (39.5% of 612 patients) within the first 24 h of ICU stay, with 244 (53.6% of 455) positive responses. Adjusted for age, sex, Acute Physiology and Chronic Health Evaluation II score, comorbidity, and admission year, protocol use was associated with reduced ICU mortality (odds ratio, 0.60; 95% confidence interval, 0.39-0.94; P = 0.025) but not hospital mortality (odds ratio, 0.82; 95% confidence interval, 0.54-1.23; P = 0.369). Among mechanically ventilated patients with shock within the first 24 h of ICU stay, about half had positive fluid responses. Adherence to protocol-based fluid management was associated with improved ICU survival.

  15. Object-based change detection in rapid urbanization regions with remotely sensed observations: a case study of Shenzhen, China

    Science.gov (United States)

    He, Lihuang; Dong, Guihua; Wang, Wei-Min; Yang, Lijun; Liang, Hong

    2013-10-01

    China, the most populous country on Earth, has experienced rapid urbanization which is one of the main causes of many environmental and ecological problems. Therefore, the monitoring of rapid urbanization regions and the environment is of critical importance for their sustainable development. In this study, the object-based classification is employed to detect the change of land cover in Shenzhen, which is located in South China and has been urbanized rapidly in recent three decades. First, four Landsat TM images, which were acquired on 1990, 2000 and 2010, respectively, are selected from the image database. Atmospheric corrections are conducted on these images with improved dark-object subtraction technique and surface meteorological observations. Geometric correction is processed with ground control points derived from topographic maps. Second, a region growing multi-resolution segmentation and a soft nearest neighbour classifier are used to finish object-based classification. After analyzing the fraction of difference classes over time series, we conclude that the comparison of derived land cover classes with socio-economic statistics demonstrates the strong positive correlation between built-up classes and urban population as well as gross GDP and GDPs in second and tertiary industries. Two different mechanisms of urbanization, namely new land development and redevelopment, are revealed. Consequently, we found that, the districts of Shenzhen were urbanized through different mechanisms.

  16. A Pilot Study Examining the Use of the Autism Diagnostic Observation Schedule in Community-Based Mental Health Clinics.

    Science.gov (United States)

    Stadnick, Nicole; Brookman-Frazee, Lauren; Williams, Katherine Nguyen; Cerda, Gabrielle; Akshoomoff, Natacha

    2015-12-01

    Community-based mental health (CMH) services play an important, but relatively understudied role in the identification and treatment of youth with autism spectrum disorder (ASD) who may be receiving care for other psychiatric conditions. Little is known about the role of standardized ASD assessment measures administered by providers working in generalist community-based mental health (CMH) settings. This pilot study extracted data from three CMH clinics to examine the use of the Autism Diagnostic Observation Schedule (ADOS) by 17 CMH providers who received ASD assessment training with 62 youth ( Mean = 10.69 years) referred for an ASD diagnostic evaluation. Results indicated that 57% of youths assessed ultimately received an ASD diagnosis. All cases given a final ASD diagnosis were classified as "Autism" or "ASD" on the ADOS. Seventy percent of youth who did not receive a final ASD diagnosis were classified as "Non-Spectrum" on the ADOS. In these false positive cases, report narratives indicated that social communication difficulties identified on the ADOS were explained by symptoms of other mental health conditions (e.g., ADHD, anxiety). Future research is needed to examine the utility of the ADOS when used by CMH providers to facilitate CMH capacity to identify ASD.

  17. Analysis of home-based rehabilitation in patients with motor impairment in primary care: a prospective observational study.

    Science.gov (United States)

    Vega-Ramírez, Francisco Antonio; López-Liria, Remedios; Granados-Gámez, Genoveva; Aguilar-Parra, Jose Manuel; Padilla-Góngora, David

    2017-07-14

    The purpose of health and social policies is to encourage older people more longevity, remain free of disability and experience quality of life while living in their homes. The aim of this study was to describe the characteristics of 473 patients diagnosed with motor impairment in primary care, the objectives of home-based rehabilitation and its functional impact. This prospective observational study was conducted in the Almería Health District. The analysed variables included age, gender, secondary diagnosis, Barthel Index (BI), physiotherapeutic objectives and techniques, and number of sessions. The sample had a mean age of 83 years, and 59% were women. The assessed conditions with a high prevalence included osteoarticular pathology (55%), Alzheimer's disease (15.1%), cardiovascular disease (13.7%) and stroke (6.5%). The techniques applied mainly consisted of functional exercises (57.1%), caregiver education (13.8%), and technical assistance (5.7%). There were statistically significant differences (t = -15.79; p physiotherapy. Lower patient age was correlated with higher initial and final functional capacities in primary care. This study aimed to present a useful starting point for decision making among management and health administration regarding this population group by approaching the process from the reality of practice and in relation to the rehabilitation provided. ClinicalTrials.gov identifier: NCT02715245 ; Date of registration: 18 January 2016.

  18. A study of variation characteristics of Gobi broadband emissivity based on field observational experiments in northwestern China

    Science.gov (United States)

    Zheng, Zhi-yuan; Wei, Zhi-gang; Wen, Zhi-ping; Dong, Wen-jie; Li, Zhen-chao; Wen, Xiao-hang; Zhu, Xian; Chen, Chen; Hu, Shan-shan

    2018-02-01

    Land surface emissivity is a significant variable in energy budgets, land cover assessments, and environment and climate studies. However, the assumption of an emissivity constant is being used in Gobi broadband emissivity (GbBE) parameterization scheme in numerical models because of limited knowledge surrounding the spatiotemporal variation characteristics of GbBE. To address this issue, we analyzed the variation characteristics of GbBE and possible impact factor-surface soil moisture based on long-term continuous and high temporal resolution field observational experiments over a typical Gobi underlying surface in arid and semiarid areas in northwestern China. The results indicate that GbBE has obvious daily and diurnal variation features, especially diurnal cycle characteristics. The multi-year average of the daily average of GbBE is in the range of 0.932 to 0.970 with an average of 0.951 ± 0.008, and the average diurnal GbBE is in the range of 0.880 to 0.940 with an average of 0.906 ± 0.018. GbBE varies with surface soil moisture content. We observed a slight decrease in GbBE with an increase in soil moisture, although this change was not very obvious because of the low soil moisture in this area. Nevertheless, we think that soil moisture must be one of the most significant impact factors on GbBE in arid and semiarid areas. Soil moisture must be taken into account into the parameterization schemes of bare soil broadband emissivity in land surface models. Additional field experiments and studies should be carried out in order to clarify this issue.

  19. Routine delivery of artemisinin-based combination treatment at fixed health facilities reduces malaria prevalence in Tanzania: an observational study

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    Khatib Rashid A

    2012-04-01

    Full Text Available Abstract Background Artemisinin-based combination therapy (ACT has been promoted as a means to reduce malaria transmission due to their ability to kill both asexual blood stages of malaria parasites, which sustain infections over long periods and the immature derived sexual stages responsible for infecting mosquitoes and onward transmission. Early studies reported a temporal association between ACT introduction and reduced malaria transmission in a number of ecological settings. However, these reports have come from areas with low to moderate malaria transmission, been confounded by the presence of other interventions or environmental changes that may have reduced malaria transmission, and have not included a comparison group without ACT. This report presents results from the first large-scale observational study to assess the impact of case management with ACT on population-level measures of malaria endemicity in an area with intense transmission where the benefits of effective infection clearance might be compromised by frequent and repeated re-infection. Methods A pre-post observational study with a non-randomized comparison group was conducted at two sites in Tanzania. Both sites used sulphadoxine-pyrimethamine (SP monotherapy as a first-line anti-malarial from mid-2001 through 2002. In 2003, the ACT, artesunate (AS co-administered with SP (AS + SP, was introduced in all fixed health facilities in the intervention site, including both public and registered non-governmental facilities. Population-level prevalence of Plasmodium falciparum asexual parasitaemia and gametocytaemia were assessed using light microscopy from samples collected during representative household surveys in 2001, 2002, 2004, 2005 and 2006. Findings Among 37,309 observations included in the analysis, annual asexual parasitaemia prevalence in persons of all ages ranged from 11% to 28% and gametocytaemia prevalence ranged from Interpretation The introduction of ACT at

  20. Influence of an acetate- and a lactate-based balanced infusion solution on acid base physiology and hemodynamics: an observational pilot study.

    Science.gov (United States)

    Hofmann-Kiefer, Klaus F; Chappell, Daniel; Kammerer, Tobias; Jacob, Matthias; Paptistella, Michaela; Conzen, Peter; Rehm, Markus

    2012-07-06

    The current pilot study compares the impact of an intravenous infusion of Ringer's lactate to an acetate-based solution with regard to acid-base balance. The study design included the variables of the Stewart approach and focused on the effective strong ion difference. Because adverse hemodynamic effects have been reported when using acetate buffered solutions in hemodialysis, hemodynamics were also evaluated. Twenty-four women who had undergone abdominal gynecologic surgery and who had received either Ringer's lactate (Strong Ion Difference 28 mmol/L; n = 12) or an acetate-based solution (Strong Ion Difference 36.8 mmol/L; n = 12) according to an established clinical protocol and its precursor were included in the investigation. After induction of general anesthesia, a set of acid-base variables, hemodynamic values and serum electrolytes was measured three times during the next 120 minutes. Patients received a mean dose of 4,054 ± 450 ml of either one or the other of the solutions. In terms of mean arterial blood pressure and norepinephrine requirements there were no differences to observe between the study groups. pH and serum HCO3- concentration decreased slightly but significantly only with Ringer's lactate. In addition, the acetate-based solution kept the plasma effective strong ion difference more stable than Ringer's lactate. Both of the solutions provided hemodynamic stability. Concerning consistency of acid base parameters none of the solutions seemed to be inferior, either. Whether the slight advantages observed for the acetate-buffered solution in terms of stability of pH and plasma HCO3- are clinically relevant, needs to be investigated in a larger randomized controlled trial.

  1. Inpatient mortality resulting from dermatological disorders at a tertiary care center in Eastern India: A record-based observational study

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    Satyendranath Chowdhury

    2017-01-01

    Full Text Available Background: Contrary to popular perception, several dermatological conditions may be associated with lethal outcome in the absence of timely intervention or due to complications. Aims: The aim was to estimate the number of deaths and analyze their causes due to skin disorders at a tertiary level inpatient dermatology ward. Materials and Methods: We conducted a retrospective, record-based observational study involving 538 patients spanning over 4 years (2013–2016 at our dermatology indoor setup. Results: There were 45 deaths (male:female = 1.5:1, accounting for 8.4% or total admissions, occurring mostly in patients in their 7th decade. Vesiculobullous disorders were the most frequent cause of mortality (57.8%, followed by drug reactions accounting for 17.8% of cases. In the former group pemphigus vulgaris accounted for most deaths (31.1% followed by bullous pemphigoid (17.8% and pemphigus foliaceus (8.9%, whereas toxic epidermal necrolysis was the most frequent cause of death from drug reactions (8.9%. Almost half of all deaths (48.9% occurred due to septicemia followed by cardiopulmonary complications (40%. Most of the cases presented to us at an advanced state of the disease previously being treated inappropriately. Conclusion: Prompt diagnosis and treatment of such dermatological conditions are mandated, preferably in an intensive care set-up, to reduce mortality rates. Advanced age, the area of skin involvement, mucosal involvement, and septicemia were adverse prognostic factors in these patients.

  2. Health Care Consumption during Pregnancy in relation to Maternal Body Mass Index: A Swedish Population Based Observational Study

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    Elisabeth S. Lindholm

    2015-01-01

    Full Text Available Objective. To assess whether antenatal health care consumption is associated with maternal body mass index (BMI. Design. A register based observational study. Methods. The Swedish Medical Birth Register, the Maternal Health Care Register, and the Inpatient Register were used to determine antenatal health care consumption according to BMI categories for primiparous women with singleton pregnancies, from 2006 to 2008, n=71,638. Pairwise comparisons among BMI groups are obtained post hoc by Tukey HSD test. Result. Obese women were more often admitted for in-patient care (p<0.001, had longer antenatal hospital stays (p<0.001, and were more often sick-listed by an obstetrician (p<0.001 during their pregnancy, compared to women with normal weight women. Preeclampsia was more than four times as common, hypertension five times as common, and gestational diabetes 11 times as common when comparing in-patient care, obese to normal weight women (p<0.001 for all comparisons. Underweight mothers had longer stay in hospitals (p<0.05 and hydronephrosis and hyperemesis gravidarum were more than twice as common (both p<0.001. Conclusion. Obese and underweight mothers consumed significantly more health care resources and obese women were significantly more often sick-listed during their pregnancy when compared to pregnant women of normal weight.

  3. A Simulation-based Approach to Measuring Team Situational Awareness in Emergency Medicine: A Multicenter, Observational Study.

    Science.gov (United States)

    Rosenman, Elizabeth D; Dixon, Aurora J; Webb, Jessica M; Brolliar, Sarah; Golden, Simon J; Jones, Kerin A; Shah, Sachita; Grand, James A; Kozlowski, Steve W J; Chao, Georgia T; Fernandez, Rosemarie

    2018-02-01

    Team situational awareness (TSA) is critical for effective teamwork and supports dynamic decision making in unpredictable, time-pressured situations. Simulation provides a platform for developing and assessing TSA, but these efforts are limited by suboptimal measurement approaches. The objective of this study was to develop and evaluate a novel approach to TSA measurement in interprofessional emergency medicine (EM) teams. We performed a multicenter, prospective, simulation-based observational study to evaluate an approach to TSA measurement. Interprofessional emergency medical teams, consisting of EM resident physicians, nurses, and medical students, were recruited from the University of Washington (Seattle, WA) and Wayne State University (Detroit, MI). Each team completed a simulated emergency resuscitation scenario. Immediately following the simulation, team members completed a TSA measure, a team perception of shared understanding measure, and a team leader effectiveness measure. Subject matter expert reviews and pilot testing of the TSA measure provided evidence of content and response process validity. Simulations were recorded and independently coded for team performance using a previously validated measure. The relationships between the TSA measure and other variables (team clinical performance, team perception of shared understanding, team leader effectiveness, and team experience) were explored. The TSA agreement metric was indexed by averaging the pairwise agreement for each dyad on a team and then averaging across dyads to yield agreement at the team level. For the team perception of shared understanding and team leadership effectiveness measures, individual team member scores were aggregated within a team to create a single team score. We computed descriptive statistics for all outcomes. We calculated Pearson's product-moment correlations to determine bivariate correlations between outcome variables with two-tailed significance testing (p teams (n = 41

  4. Perceptual variation in grading hand, hip and knee radiographs: observations based on an Australian twin registry study of osteoarthritis.

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    Bellamy, N; Tesar, P; Walker, D; Klestov, A; Muirden, K; Kuhnert, P; Do, K A; O'Gorman, L; Martin, N

    1999-12-01

    The radiographic diagnosis of osteoarthritis (OA) in the peripheral skeleton is dependent on the skilled examination of several morphological characteristics of the condition as visualised on plain radiographs. However, the process is perceptual and generally enhanced by comparison against photographic standards. This study assessed the intra-rater and inter-rater reliability of radiologists experienced in reporting hand, hip and knee films derived from a community-based sample when using the photographic atlas recently developed by Burnett et al. This study was part of a multifaceted diagnostics protocol, evaluating methodological issues, in the conduct of genetic research in osteoarthritis. From a cohort of 118 twin pairs, registered with the Australian Twins Registry (ATR), standard clinical examinations were performed on 74 complete and 11 incomplete pairs of twins over age 50 years, followed by standard AP hand, AP pelvis and AP standing radiographs of the knees. The pairs were selected both to represent twin pairs who had previously self reported a diagnosis of OA, as well as those who had not. Radiologists read the films blind to the original self reported diagnosis and without reference to their pairing. The films were read by comparison against photographic standards and were scored according to specific features. All films were read independently by two consultant radiologists blind to one another's assessments, and selected films were thereafter assigned for rereading. Inter-rater and intra-rater agreement were different for different features, different anatomic areas, and, for the former, were different for the two radiologists. Inter-rater agreement was different for different anatomic areas, different radiographic features, and the two radiologists. Intra-rater agreement for the presence or absence of OA was as follows: actual observed agreement = 0.79 to 0.97 and 0.83 to 0.98; adjusted kappa statistic = 0.58 to 0.94 and 0.67 to 0.96; inter

  5. Association between Perceived Value and Self-Medication with Antibiotics: An Observational Study Based on Health Belief Model Theory

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    Annisa N. Insany

    2015-06-01

    Full Text Available High prevalence of self medication with antibiotics can increase the probability of irrational use of antibiotics which may lead antibiotics resistance. Thus, shifting of behavior is required to minimize the irrational use of antibiotics. This study was aimed to determine the association between public perceived value and self-medication with antibiotics which can be used to develop an intervention model in order to reduce the practice of self-medication with antibiotics. An observational study was conducted during the period of November–December 2014.The subjects were patients who visit primary health care facilities in Bandung. A structured-interview that has been validated was used to investigate the association between perceived value and self-medication behavior based on the Health Belief Model theory (perceived susceptibility, benefits, barrier, and cues to action. Approximately 506 respondents were drawn randomly from 43 community healthcare centers and 8 pharmacies. Data was analyzed by using descriptive statistics and logistic regression (CI 95%, α = 5%. Validity and reliability of the questionnaire were shown with a correlation coefficient of >0.3 and a cronbach-alpha value of 0.719, respectively. We found that 29.45% of respondents practiced self-medication with antibiotics over the last six months. Additionally, there was no significant association between the perceived susceptibility, benefits, barrier, and cues to action with self-medication behavior (p>0.05. Easiness to access antibiotics without prescription was presumed as a factor that contribute to self-medication with antibiotics, therefore strict regulation in antibiotics use is very needed as a basic intervention to decrease self-medication with antibiotic.

  6. Characterization and utilization of an international neurofibromatosis web-based, patient-entered registry: An observational study.

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    Mindell Seidlin

    Full Text Available The neurofibromatoses (neurofibromatosis type 1, neurofibromatosis type 2 and schwannomatosis are rare disorders having clinical manifestations that vary greatly from patient to patient. The rarity and variability of these disorders has made it challenging for investigators to identify sufficient numbers of patients with particular clinical characteristics or specific germline mutations for participation in interventional studies. Similarly, because the natural history of all types of neurofibromatosis (NF is variable and unique for each individual, it is difficult to identify meaningful clinical outcome measures for potential therapeutic interventions. In 2012, the Children's Tumor Foundation created a web-based patient-entered database, the NF Registry, to inform patients of research opportunities for which they fit general eligibility criteria and enable patients to contact investigators who are seeking to enroll patients in approved trials. Registrants were recruited through CTF-affiliated NF clinics and conferences, through its website, and by word-of-mouth and social media. Following online consent, demographic information and details regarding manifestations of NF were solicited on the Registry website. Statistical analyses were performed on data from a cohort of 4680 registrants (the number of registrants as of October 9, 2015 who met diagnostic criteria for one of the 3 NF conditions. The analyses support our hypothesis that patient-reported symptom incidences in the NF Registry are congruent with published clinician-sourced data. Between April 26, 2013 and July 8, 2016, the registry has been useful to investigators in recruitment, particularly for observational trials, especially those for development of patient-reported outcomes.

  7. DO INTERACTIONAL CAPACITIES BASED ON OBSERVED BEHAVIOR INTERFERE WITH IMPROVEMENT IN SEVERELY DEPRESSED-PATIENTS - A LONGITUDINAL-STUDY

    NARCIS (Netherlands)

    BOUHUYS, AL; ALBERSNAGEL, FA

    This study examined whether the interaction of severely depressed patients and a psychiatrist was related to the course of depression during hospitalization. Interactional Processes were defined on the basis of directly observed behaviour displayed during an interview and by the use of ethological

  8. Cardiovascular risk with non-steroidal anti-inflammatory drugs: systematic review of population-based controlled observational studies.

    Directory of Open Access Journals (Sweden)

    Patricia McGettigan

    2011-09-01

    Full Text Available BACKGROUND: Randomised trials have highlighted the cardiovascular risks of non-steroidal anti-inflammatory drugs (NSAIDs in high doses and sometimes atypical settings. Here, we provide estimates of the comparative risks with individual NSAIDs at typical doses in community settings. METHODS AND FINDINGS: We performed a systematic review of community-based controlled observational studies. We conducted comprehensive literature searches, extracted adjusted relative risk (RR estimates, and pooled the estimates for major cardiovascular events associated with use of individual NSAIDs, in different doses, and in populations with low and high background risks of cardiovascular events. We also compared individual drugs in pair-wise (within study analyses, generating ratios of RRs (RRRs. Thirty case-control studies included 184,946 cardiovascular events, and 21 cohort studies described outcomes in >2.7 million exposed individuals. Of the extensively studied drugs (ten or more studies, the highest overall risks were seen with rofecoxib, 1.45 (95% CI 1.33, 1.59, and diclofenac, 1.40 (1.27, 1.55, and the lowest with ibuprofen, 1.18 (1.11, 1.25, and naproxen, 1.09 (1.02, 1.16. In a sub-set of studies, risk was elevated with low doses of rofecoxib, 1.37 (1.20, 1.57, celecoxib, 1.26 (1.09, 1.47, and diclofenac, 1.22 (1.12, 1.33, and rose in each case with higher doses. Ibuprofen risk was seen only with higher doses. Naproxen was risk-neutral at all doses. Of the less studied drugs etoricoxib, 2.05 (1.45, 2.88, etodolac, 1.55 (1.28, 1.87, and indomethacin, 1.30 (1.19, 1.41, had the highest risks. In pair-wise comparisons, etoricoxib had a higher RR than ibuprofen, RRR = 1.68 (99% CI 1.14, 2.49, and naproxen, RRR = 1.75 (1.16, 2.64; etodolac was not significantly different from naproxen and ibuprofen. Naproxen had a significantly lower risk than ibuprofen, RRR = 0.92 (0.87, 0.99. RR estimates were constant with different background risks for

  9. Importance of observational studies in clinical practice.

    Science.gov (United States)

    Ligthelm, Robert J; Borzì, Vito; Gumprecht, Janusz; Kawamori, Ryuzo; Wenying, Yang; Valensi, Paul

    2007-06-01

    In this era of evidence-based medicine, clinicians require a comprehensive range of well-designed studies to support prescribing decisions and patient management. In recent years, data from observational studies have become an increasingly important source of evidence because of improvements in observational-study methods and advances in statistical analysis. This article reviews the current literature and reports some of the key studies indicating that observational studies can both complement and build on the evidence base established by randomized controlled trials (RCTs). A literature search using the MEDLINE/PubMed database (years: 1966-present) was carried out using the search terms observational or observational study(ies), historical control, nonrandomized, and postmarketing surveillance. All references comparing observational studies with randomized controlled trials were obtained and reviewed and were also hand-checked for studies not identified in the database searches. Observational studies play an important role in investigating treatment outcomes. Data from large observational studies can clarify the tolerability profile of marketed medicines. In particular, observational studies can be of benefit in the study of large, heterogeneous patient populations with complex, chronic diseases such as diabetes mellitus. Observational studies have played a key role in supporting the results of Phase III studies of insulin analogues for the treatment of patients with type 1 and type 2 diabetes. Future observational studies in the field of diabetes such as PREDICTIVE (Predictable Results and Experience in Diabetes through Intensification and Control to Target: an International Variability Evaluation) and IMPROVE will further our understanding of this global pandemic. Well-designed observational studies can play a key role in supporting the evidence base for drugs and therapies. Current evidence suggests that observational studies can be conducted using the same

  10. A Model-Based Study of On-Board Data Processing Architecture for Balloon-Borne Aurora Observation

    Science.gov (United States)

    Lim, Chester

    2011-01-01

    This paper discusses an application of ISAAC design methodology to a balloon-borne payload electronic system for aurora observation. The methodology is composed of two phases, high level design and low level implementation, the focus of this paper is on the high level design. This paper puts the system architecture in the context of a balloon based application but it can be generalized to any airborne/space-borne application. The system architecture includes a front-end detector, its corresponding data processing unit, and a controller. VisualSim has been used to perform modeling and simulations to explore the entire design space, finding optimal solutions that meet system requirements.

  11. Study on team evaluation (5). On application of behavior observation-based teamwork evaluation sheet for power plant operator team

    International Nuclear Information System (INIS)

    Sasou, Kunihide; Sugihara, Yoshikuni

    2009-01-01

    This report discusses the range of application of the behavior observation-based teamwork evaluation sheet. Under the concept of this method, teamwork evaluation sheet is developed, which assumes a certain single failure (failure of feed water transmitter). The evaluation sheets are applied to evaluate team work of 26 thermal power plant operator teams in combined under abnormal operating conditions of failure of feed water transmitter, feed draft fan or steam flow governor. As a result of ANOVA, it finds that there are no differences between 3 kinds of single failure. In addition, the similar analysis is executed to 3 kinds of multiple failures (steam generator tube rapture, loss of coolant accident and loss of secondary coolant accident) under which 7 PWR nuclear power plant operator teams are evaluated. As a result, ANOVA shows no differences between 3 kinds of multiple failures. These results indicate that a behavior observation-based team work evaluation sheet, which is designed for a certain abnormal condition, is applicable to the abnormal conditions that have the same development of abnormal conditions. (author)

  12. Combining artefact analysis, interview and participant observation to study the organizational sensemaking of knowledge-based innovation

    OpenAIRE

    Reischauer, Georg

    2015-01-01

    "Innovation studies have hardly investigated the link between innovation and organization with respect to what individual actors in organizations mean when they refer to innovation. More precisely, there are few research designs with the goal to understand (Verstehen) the meaning of innovation in organizations. To address this gap on a methodological level, I introduce an interpretative research design to study the organizational sense-making of innovation. Informed by the knowledge-based vie...

  13. Measurements based dynamic climate observer

    Energy Technology Data Exchange (ETDEWEB)

    Chaabene, Maher [The High Institute of Technological Studies (ISET), Sfax (Tunisia); Unite de Commande de Machines et Reseaux de Puissance CMERP-ENIS, Tunisia, Rte Mahdia Km 2, BP88A, ElBustan 3099 Sfax (Tunisia)

    2008-09-15

    This paper introduces a dynamic prediction of solar radiation and ambient temperature. Medium term prediction is based on climatic parameters behaviours during the day before and on time distribution models. As for short term prediction, it is ensured by an ARMA predictor using Kalman filter. Herein, we describe our method and present prediction results. Validation is based on measures taken during the year 2005 in the north of Tunisia. The work effectiveness is illustrated by a short term and medium term prediction of the electric energy produced by a 1 KWp photovoltaic panel (PVP) installed at the Energy and Thermal Research Centre (CRTEn) in the north of Tunisia. Since our work delivers accurate climatic parameters prediction, the obtained results can be easily adapted to predict any other solar conversion system output. (author)

  14. A virtual reality-based system integrated with fmri to study neural mechanisms of action observation-execution: a proof of concept study.

    Science.gov (United States)

    Adamovich, S V; August, K; Merians, A; Tunik, E

    2009-01-01

    Emerging evidence shows that interactive virtual environments (VEs) may be a promising tool for studying sensorimotor processes and for rehabilitation. However, the potential of VEs to recruit action observation-execution neural networks is largely unknown. For the first time, a functional MRI-compatible virtual reality system (VR) has been developed to provide a window into studying brain-behavior interactions. This system is capable of measuring the complex span of hand-finger movements and simultaneously streaming this kinematic data to control the motion of representations of human hands in virtual reality. In a blocked fMRI design, thirteen healthy subjects observed, with the intent to imitate (OTI), finger sequences performed by the virtual hand avatar seen in 1st person perspective and animated by pre-recorded kinematic data. Following this, subjects imitated the observed sequence while viewing the virtual hand avatar animated by their own movement in real-time. These blocks were interleaved with rest periods during which subjects viewed static virtual hand avatars and control trials in which the avatars were replaced with moving non-anthropomorphic objects. We show three main findings. First, both observation with intent to imitate and imitation with real-time virtual avatar feedback, were associated with activation in a distributed frontoparietal network typically recruited for observation and execution of real-world actions. Second, we noted a time-variant increase in activation in the left insular cortex for observation with intent to imitate actions performed by the virtual avatar. Third, imitation with virtual avatar feedback (relative to the control condition) was associated with a localized recruitment of the angular gyrus, precuneus, and extrastriate body area, regions which are (along with insular cortex) associated with the sense of agency. Our data suggest that the virtual hand avatars may have served as disembodied training tools in the

  15. How to determine bortezomib-based regimen for elderly patients with multiple myeloma: PAD versus CBd, an observational study.

    Science.gov (United States)

    Huang, Bin-Tao; Tan, Yan; Zhao, Wei-Hong; Zeng, Qing-Chun; Li, Bing-Sheng; Chen, Rui-Lin

    2014-02-01

    This was an open-label, observational, prospective assessment. We conducted an analysis of the impact of bortezomib-based therapy (PAD: bortezomib, doxorubicin, high-dose dexamethasone vs. CBd: cyclophosphamide bortezomib, low-dose dexamethasone) on the survival rates and adverse events in elderly patients with newly diagnosed multiple myeloma (MM). Out of 303 patients, 128 received the PAD regimen and the other 175 patients received the CBd induction therapy (age 65-89 years). Baseline patient characteristics between the two cohorts were balanced in age (P = 0.69), international staging system (ISS) prognostic stages (P = 0.90), serum calcium (P = 0.70), and serum creatinine (P = 0.52). Overall response (OS) after the induction chemotherapy was achieved in 214 of 303 patients (70.6 %), with no significant differences observed between the two treatment groups (71.9 vs. 69.7 %, P = 0.68). Patients with ISS stage 2 reached the same 5-year OS advantages compared to patients with ISS stage 1, because they received bortezomib-based PAD or CBd treatments. Patients receiving CBd protocol gained similar satisfactory progression-free survival (PFS) results when compared to the PAD regimen group: PFS at 5 years reached 58.2 versus 58.9 % (P = 0.85). Five-year OS in the CBd arm had significant advantages compared to the PAD group, 79.9 versus 49.9 % (P CBd group (P CBd arm (39.2 vs. 13.1 %, P CBd have superior treatment advantages, with a predictable safety profile, when compared to the PAD regimen.

  16. Chemical and physical influences on aerosol activation in liquid clouds: a study based on observations from the Jungfraujoch, Switzerland

    Directory of Open Access Journals (Sweden)

    C. R. Hoyle

    2016-03-01

    Full Text Available A simple statistical model to predict the number of aerosols which activate to form cloud droplets in warm clouds has been established, based on regression analysis of data from four summertime Cloud and Aerosol Characterisation Experiments (CLACE at the high-altitude site Jungfraujoch (JFJ. It is shown that 79 % of the observed variance in droplet numbers can be represented by a model accounting only for the number of potential cloud condensation nuclei (defined as number of particles larger than 80 nm in diameter, while the mean errors in the model representation may be reduced by the addition of further explanatory variables, such as the mixing ratios of O3, CO, and the height of the measurements above cloud base. The statistical model has a similar ability to represent the observed droplet numbers in each of the individual years, as well as for the two predominant local wind directions at the JFJ (northwest and southeast. Given the central European location of the JFJ, with air masses in summer being representative of the free troposphere with regular boundary layer in-mixing via convection, we expect that this statistical model is generally applicable to warm clouds under conditions where droplet formation is aerosol limited (i.e. at relatively high updraught velocities and/or relatively low aerosol number concentrations. A comparison between the statistical model and an established microphysical parametrization shows good agreement between the two and supports the conclusion that cloud droplet formation at the JFJ is predominantly controlled by the number concentration of aerosol particles.

  17. Effectiveness of dasabuvir/ombitasvir/paritaprevir/ritonavir for hepatitis C virus in clinical practice: A population-based observational study.

    Directory of Open Access Journals (Sweden)

    Maya Leventer-Roberts

    Full Text Available Direct acting antivirals for hepatitis C virus have shown dramatic results in clinical trials. However, their effectiveness has yet to be demonstrated within observational cohorts which lack exclusion criteria found in randomized control trials.To determine the effectiveness of dasabuvir/ombitasvir/paritaprevir/ritonavir in achieving sustained virological response.Retrospective observational cohort study of all Clalit Health Services members with hepatitis C virus genotype 1 who were dispensed dasabuvir/ombitasvir/paritaprevir/ritonavir from January 1, 2015 to-November 31, 2015.There were 564 participants during the study period. The average age was 61.9 years, 52.0% were male, and 61.5% were born Eastern/Central Europe or Central Asia. The prevalence of diabetes was 31.7% and 70.3% were overweight/obese. Cirrhosis was present in 41.0% of participants, of whom 52.8% had stage 4 fibrosis. Of the cohort, 416 (74.8% had follow-up viral load testing at 10 or more weeks after the end of treatment. We report a sustained virological response of 98.8% among those tested.Treatment with dasabuvir/ombitasvir/paritaprevir/ritonavir demonstrated a near universal effectiveness in achieving a sustained virological response among HCV patients in a large cohort.

  18. Correlation between MGMT promoter methylation and response to temozolomide-based therapy in neuroendocrine neoplasms: an observational retrospective multicenter study.

    Science.gov (United States)

    Campana, Davide; Walter, Thomas; Pusceddu, Sara; Gelsomino, Fabio; Graillot, Emmanuelle; Prinzi, Natalie; Spallanzani, Andrea; Fiorentino, Michelangelo; Barritault, Marc; Dall'Olio, Filippo; Brighi, Nicole; Biasco, Guido

    2017-11-17

    Temozolomide (TEM) based therapy has been reported being effective in the treatment of metastatic neuroendocrine neoplasms (NEN), with response rates ranging from 30 to 70%. Among patients affected by advanced glioblastoma or melanoma and treated with TEM, loss of tumoral O6-methylguanine DNA methyltransferase (MGMT) is correlated with improved survival. In NEN patients, the role of MGMT deficiency in predicting clinical outcomes of TEM treatment is still under debate. In this study we evaluated 95 patients with advanced NENs undergoing treatment with TEM-based therapy. MGMT promoter methylation status was evaluated with two techniques: methylation specific-polymerase chain reaction or pyrosequencing. Treatment with TEM-based therapy was associated with an overall response rate of 27.4% according to RECIST criteria (51.8% of patients with and 17.7% without MGMT promoter methylation). Response to therapy, progression free survival and overall survival was correlated to MGMT status at univariate and multivariate analysis. Methylation of MGMT promoter could be a strong predictive factor of objective response and an important prognostic factor of a longer PFS and OS. According to our results, MGMT methylation status, evaluated with methylation specific-polymerase chain reaction or pyrosequencing, should have an important role in patients with metastatic NENs, in order to guide therapeutic options. These results need further confirmation with prospective studies.

  19. A large web-based observer reliability study of early ischaemic signs on computed tomography. The Acute Cerebral CT Evaluation of Stroke Study (ACCESS.

    Directory of Open Access Journals (Sweden)

    Joanna M Wardlaw

    Full Text Available BACKGROUND: Early signs of ischaemic stroke on computerised tomography (CT scanning are subtle but CT is the most widely available diagnostic test for stroke. Scoring methods that code for the extent of brain ischaemia may improve stroke diagnosis and quantification of the impact of ischaemia. METHODOLOGY AND PRINCIPAL FINDINGS: We showed CT scans from patients with acute ischaemic stroke (n = 32, with different patient characteristics and ischaemia signs to doctors in stroke-related specialties world-wide over the web. CT scans were shown twice, randomly and blindly. Observers entered their scan readings, including early ischaemic signs by three scoring methods, into the web database. We compared observers' scorings to a reference standard neuroradiologist using area under receiver operator characteristic curve (AUC analysis, Cronbach's alpha and logistic regression to determine the effect of scales, patient, scan and observer variables on detection of early ischaemic changes. Amongst 258 readers representing 33 nationalities and six specialties, the AUCs comparing readers with the reference standard detection of ischaemic signs were similar for all scales and both occasions. Being a neuroradiologist, slower scan reading, more pronounced ischaemic signs and later time to CT all improved detection of early ischaemic signs and agreement on the rating scales. Scan quality, stroke severity and number of years of training did not affect agreement. CONCLUSIONS: Large-scale observer reliability studies are possible using web-based tools and inform routine practice. Slower scan reading and use of CT infarct rating scales improve detection of acute ischaemic signs and should be encouraged to improve stroke diagnosis.

  20. Systematic study of intermediate-scale structures of equatorial plasma irregularities in the ionosphere based on CHAMP observations

    Directory of Open Access Journals (Sweden)

    Hermann eLühr

    2014-03-01

    Full Text Available Equatorial spread-F ionospheric plasma irregularities on the night-side, commonly called equatorial plasma bubbles (EPB, include electron density variations over a wide range of spatial scales. Here we focus on intermediate-scale structures ranging from 100 m to 10 km, which play an important role in the evolution of EPBs. High-resolution CHAMP magnetic field measurements sampled along north-south track at 50 Hz are interpreted in terms of diamagnetic effect for illustrating the details of electron density variations. We provide the first comprehensive study on intermediate-scale density structures associated with EPBs, covering a whole solar cycle from 2000 to 2010. The large number of detected events, almost 9000, allows us to draw a detailed picture of the plasma fine structure. The occurrence of intermediate-scale events is strongly favoured by high solar flux. During times of F10.7 < 100 sfu practically no events were observed. The longitudinal distribution of our events with respect to season or local time agrees well with that of the EPBs, qualifying the fine structure as a common feature, but the occurrence rates are smaller by a factor of 4 during the period 2000-2005. Largest amplitude electron density variations appear at the poleward boundaries of plasma bubbles. Above the dip-equator recorded amplitudes are small and fall commonly below our resolution. Events can generally be found at local times between 19 and 24 LT, with a peak lasting from 20 to 22 LT. The signal spectrum can be approximated by a power law. Over the frequency range 1 – 25 Hz we observe spectral indices between -1.4 and -2.6 with peak occurrence rates around -1.9. There is a weak dependence observed of the spectral index on local time. Towards later hours the spectrum becomes shallower. Similarly for the latitude dependence, there is a preference of shallower spectra for latitudes poleward of the ionisation anomaly crest. Our data suggest that the generation of

  1. Frequency of GP communication addressing the patient's resources and coping strategies in medical interviews: a video-based observational study

    Directory of Open Access Journals (Sweden)

    Finset Arnstein

    2009-07-01

    Full Text Available Abstract Background There is increasing focus on patient-centred communicative approaches in medical consultations, but few studies have shown the extent to which patients' positive coping strategies and psychological assets are addressed by general practitioners (GPs on a regular day at the office. This study measures the frequency of GPs' use of questions and comments addressing their patients' coping strategies or resources. Methods Twenty-four GPs were video-recorded in 145 consultations. The consultations were coded using a modified version of the Roter Interaction Analysis System. In this study, we also developed four additional coding categories based on cognitive therapy and solution-focused therapy: attribution, resources, coping, and solution-focused techniques. The reliability between coders was established, a factor analysis was applied to test the relationship between the communication categories, and a tentative validating exercise was performed by reversed coding. Results Cohen's kappa was 0.52 between coders. Only 2% of the utterances could be categorized as resource or coping oriented. Six GPs contributed 59% of these utterances. The factor analysis identified two factors, one task oriented and one patient oriented. Conclusion The frequency of communication about coping and resources was very low. Communication skills training for GPs in this field is required. Further validating studies of this kind of measurement tool are warranted.

  2. Influence of spatial heterogeneity on the type of zooplankton functional response: A study based on field observations

    Science.gov (United States)

    Morozov, Andrew; Arashkevich, Elena; Reigstad, Marit; Falk-Petersen, Stig

    2008-10-01

    Mathematical models of plankton dynamics are sensitive to the choice of type of zooplankton functional response, i.e., to how the rate of intake of food varies with the food density. Conventionally, the conclusion on the actual type of functional response for a given zooplankton species is made based upon laboratory analysis on experimental feeding. In this paper, we show that such an approach can be too simplistic and misleading. Based on real ocean data obtained from three expeditions of R/V Jan Mayen in the Barents Sea in 2003-2005, we demonstrate that vertical heterogeneity in algal distribution as well as active vertical movement of herbivorous zooplankton can modify the type of trophic response completely. In particular, we found that the rate of average intake of algae by Calanus glacialis exhibits a Holling type III response, instead of Holling type I or II found previously in laboratory experiments. We argue that this conceptual discrepancy is due to the ability of the zooplankton to feed in layers with high algal density and to avoid depths with lower algal density. Since theoretical studies would predict enhancing in system stability in the case of Holling type III, our results may be of importance for understanding the main factors controlling plankton dynamics.

  3. Physicians' responses to patients' expressions of negative emotions in hospital consultations: a video-based observational study.

    Science.gov (United States)

    Mjaaland, Trond A; Finset, Arnstein; Jensen, Bård Fossli; Gulbrandsen, Pål

    2011-09-01

    Patients express their negative emotions in medical consultations either implicitly as cue to an underlying unpleasant emotion or explicitly as a clear, unambiguous concern. The health provider's response to such cues and concerns is important for the outcome of consultations. Yet, physicians often neglect patient's negative emotions. Most studies of this subject are from primary health care. We aimed to describe how physicians in a hospital respond to negative emotions in an outpatient setting. Ninety six consultations were videotaped in a general teaching hospital. The Verona Coding Definitions of Emotional Sequences was used to identify patients' expression of negative emotions in terms of cue and concern and to code physicians' subsequent responses. Cohen's kappa was used as interrater reliability measure. Acceptable kappa level was set to .60. We observed 163 expressions of negative emotions. In general, the physician responses to patients' cues and concerns did not include follow up or exploration. Concerns more often than cues led to lack of emotional exploration. When patients expressed negative emotions or cues to such, hospital physicians tended to move away from emotional communication, particularly if the emotion was expressed as an explicit concern. Medical training should enable physicians' to explore the patients' emotions in situations where it will improve the medical treatment. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  4. An observational study of the relationship between meaningful use-based electronic health information exchange, interoperability, and medication reconciliation capabilities.

    Science.gov (United States)

    Elysee, Gerald; Herrin, Jeph; Horwitz, Leora I

    2017-10-01

    Stagnation in hospitals' adoption of data integration functionalities coupled with reduction in the number of operational health information exchanges could become a significant impediment to hospitals' adoption of 3 critical capabilities: electronic health information exchange, interoperability, and medication reconciliation, in which electronic systems are used to assist with resolving medication discrepancies and improving patient safety. Against this backdrop, we assessed the relationships between the 3 capabilities.We conducted an observational study applying partial least squares-structural equation modeling technique to 27 variables obtained from the 2013 American Hospital Association annual survey Information Technology (IT) supplement, which describes health IT capabilities.We included 1330 hospitals. In confirmatory factor analysis, out of the 27 variables, 15 achieved loading values greater than 0.548 at P building blocks of the 3 capabilities. Subsequent path analysis showed a significant, positive, and cyclic relationship between the capabilities, in that decreases in the hospitals' adoption of one would lead to decreases in the adoption of the others.These results show that capability for high quality medication reconciliation may be impeded by lagging adoption of interoperability and health information exchange capabilities. Policies focused on improving one or more of these capabilities may have ancillary benefits.

  5. Observational Study of Travelers' Diarrhea.

    Science.gov (United States)

    Meuris

    1995-03-01

    Background: European air travelers returning from Algeria, Egypt, Mexico, Morocco, and Tunisia were interviewed about their experience of travelers' diseases upon arrival in Brussels. Diarrhea was mentioned by 37% of the adults and 27% of the children. These subjects were questioned about the types of measures taken, type and duration of drug treatment (if any), and about duration of diarrhea and side effects experienced. Methods: Final analysis was performed based on 2160 interviews. The largest proportion of diarrhea was reported in the age group 15-24 years (46%). Results: The majority of the 2160 subjects had opted for drug treatment (81%): 927 subjects for loperamide alone, 235 for loperamide in combination with nifuroxazide, and 178 for nifuroxazide alone. Other drugs had been used less frequently. The median time to recovery was 2.4 days with loperamide compared to 3.2 days with nifuroxazide and to 3.4 days for the no-treatment group. Conclusions: A stratification of the results by severity of the diarrhea suggests a rank of antidiarrheal potency as follows: loperamide > nifuroxazide > no-drug treatment. The side effect with the highest incidence was constipation (2.4% with loperamide). (J Travel Med 2:11-15, 1995) Travelers' diarrhea is usually defined as the passage of at least three unformed stools per day or any number of such stools when accompanied by fever, abdominal cramping, or vomiting. The definition may be broadened to include more trivial bowel disturbance.1,2 The duration of this self-limited disease generally is 3 to 5 days. Medical intervention aims at shortening the duration of disease, thus allowing the sufferer to resume his or her usual activities at an early stage. A shortened period of recovery to physical well-being has obvious favorable economic implications if the traveler is on business and may help the maintenance of a desired level of quality of life while a traveler is on holiday. An observational study of various medical

  6. Directly Observed Therapy Reduces Tuberculosis-Specific Mortality: A Population-Based Follow-Up Study in Taipei, Taiwan

    Science.gov (United States)

    Yen, Yung-Feng; Yen, Muh-Yong; Lin, Yi-Ping; Shih, Hsiu-Chen; Li, Lan-Huei; Chou, Pesus; Deng, Chung-Yeh

    2013-01-01

    Objectives To determine the effect of directly observed therapy (DOT) on tuberculosis-specific mortality and non-TB-specific mortality and identify prognostic factors associated with mortality among adults with culture-positive pulmonary TB (PTB). Methods All adult Taiwanese with PTB in Taipei, Taiwan were included in a retrospective cohort study in 2006–2010. Backward stepwise multinomial logistic regression was used to identify risk factors associated with each mortality outcome. Results Mean age of the 3,487 patients was 64.2 years and 70.4% were male. Among 2471 patients on DOT, 4.2% (105) died of TB-specific causes and 15.4% (381) died of non-TB-specific causes. Among 1016 patients on SAT, 4.4% (45) died of TB-specific causes and 11.8% (120) died of non-TB-specific causes. , After adjustment for potential confounders, the odds ratio for TB-specific mortality was 0.45 (95% CI: 0.30–0.69) among patients treated with DOT as compared with those on self-administered treatment. Independent predictors of TB-specific and non-TB-specific mortality included older age (ie, 65–79 and ≥80 years vs. 18–49 years), being unemployed, a positive sputum smear for acid-fast bacilli, and TB notification from a general ward or intensive care unit (reference: outpatient services). Male sex, end-stage renal disease requiring dialysis, malignancy, and pleural effusion on chest radiography were associated with increased risk of non-TB-specific mortality, while presence of lung cavities on chest radiography was associated with lower risk. Conclusions DOT reduced TB-specific mortality by 55% among patients with PTB, after controlling for confounders. DOT should be given to all TB patients to further reduce TB-specific mortality. PMID:24278152

  7. Demographic and circumstantial accounts of burn mortality in Cape Town, South Africa, 2001-2004: An observational register based study

    Directory of Open Access Journals (Sweden)

    Laflamme L

    2009-10-01

    Full Text Available Abstract Background Burns are a persisting public health problem in low- and middle-income countries; however, epidemiologic data for these settings is scarce. South Africa is no exception although there is an emerging knowledge base, especially for paediatric burns. The current study describes the epidemiology of burn mortality across the lifespan in Cape Town (2.9 million inhabitants in 2001, one of the six South African metropolitan centres. Methods The distribution of burn mortality across socio-demographic groups and also their circumstances of occurrence were investigated using four year (2001 to 2004 surveillance data from the National Injury Mortality Surveillance System (n = 1024 cases. Results Burn mortality occurred at a rate of 7.9 per 100 000 person-years (95% CI: 7.3-8.3. Males sustained fatal rates 2.2 times more than that for females (p Conclusion Besides paediatric burns, the high prevalence and circumstances of occurrence of burns among middle age men are a source of concern. There are reasons to believe that this over-representation is a reflection of detrimental living conditions, life-style and poor socio-economic status. It is recommended that there be greater prioritisation of prevention activities that involve the control or management of kerosene heat sources, the provision of alternatives to flammable housing materials, and the implementation of strategies to reduce harmful drinking practices.

  8. Study of seasonal and long-term vertical deformation in Nepal based on GPS and GRACE observations

    Science.gov (United States)

    Zhang, Tengxu; Shen, WenBin; Pan, Yuanjin; Luan, Wei

    2018-02-01

    Lithospheric deformation signal can be detected by combining data from continuous global positioning system (CGPS) and satellite observations from the Gravity Recovery and Climate Experiment (GRACE). In this paper, we use 2.5- to 19-year-long time series from 35 CGPS stations to estimate vertical deformation rates in Nepal, which is located in the southern side of the Himalaya. GPS results were compared with GRACE observations. Principal component analysis was conducted to decompose the time series into three-dimensional principal components (PCs) and spatial eigenvectors. The top three high-order PCs were calculated to correct common mode errors. Both GPS and GRACE observations showed significant seasonal variations. The observed seasonal GPS vertical variations are in good agreement with those from the GRACE-derived results, particularly for changes in surface pressure, non-tidal oceanic mass loading, and hydrologic loading. The GPS-observed rates of vertical deformation obtained for the region suggest both tectonic impact and mass decrease. The rates of vertical crustal deformation were estimated by removing the GRACE-derived hydrological vertical rates from the GPS measurements. Most of the sites located in the southern part of the Main Himalayan Thrust subsided, whereas the northern part mostly showed an uplift. These results may contribute to the understanding of secular vertical crustal deformation in Nepal.

  9. Antimicrobial consumption on Austrian dairy farms: an observational study of udder disease treatments based on veterinary medication records

    Directory of Open Access Journals (Sweden)

    Clair L. Firth

    2017-11-01

    Full Text Available Background Antimicrobial use in livestock production is an important contemporary issue, which is of public interest worldwide. Antimicrobials are not freely available to Austrian farmers and can only be administered to livestock by veterinarians, or by farmers who are trained members of the Animal Health Service. Since 2015, veterinarians have been required by law to report antimicrobials dispensed to farmers for use in food-producing animals. The study presented here went further than the statutory framework, and collected data on antimicrobials dispensed to farmers and those administered by veterinarians. Methods Seventeen veterinary practices were enrolled in the study via convenience sampling. These veterinarians were asked to contact interested dairy farmers regarding participation in the study (respondent-driven sampling. Data were collected from veterinary practice software between 1st October 2015 and 30th September 2016. Electronic data (89.4% were transferred via an online interface and paper records (10.6% were entered by the authors. Antimicrobial treatments with respect to udder disease were analysed by number of defined daily doses per cow and year (nDDDvet/cow/year, based on the European Medicines Agency technical unit, Defined Daily Dose for animals (DDDvet. Descriptive statistics and the Wilcoxon rank sum test were used to analyse the results. Results Antimicrobial use data from a total of 248 dairy farms were collected during the study, 232 of these farms treated cows with antibiotics; dry cow therapy was excluded from the current analysis. The mean number of DDDvet/cow/year for the antimicrobial treatment of all udder disease was 1.33 DDDvet/cow/year. Of these treatments, 0.73 DDDvet/cow/year were classed as highest priority critically important antimicrobials (HPCIAs, according to the World Health Organization (WHO definition. The Wilcoxon rank sum test determined a statistically significant difference between the median

  10. Awareness of knowledge and practice regarding physical activity: A population-based prospective, observational study among students in Nanjing, China.

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    Fei Xu

    Full Text Available Physical activity (PA promotion has proven effectiveness in preventing childhood obesity. Increasing children's health knowledge is the most frequently used approach in PA intervention programs targeting childhood obesity prevention. However, little is known about the specific association between the change in a child's knowledge awareness and their PA practice.A one-year follow-up study was conducted among primary and junior high school students in Nanjing, China. At baseline students' knowledge of healthy behavior, and their PA levels, were assessed. Students who were unaware of the association between PA and obesity were followed for one academic year. After nine-months their knowledge and PA levels were re-measured using the same validated questionnaire. Mixed effects regression models were used to estimate the relationship between awareness of knowledge about the link between PA and obesity and PA changes.Of the 1899 students who were unaware of the association between PA and obesity at baseline, 1859 (follow-up rate = 97.9% were successfully followed-up. After nine months 1318 (70.9% participants had become aware of PA-obesity association. Compared to their counterparts who remained unaware, students who became aware of the PA-obesity association were more likely to increase both the frequency (odds ratio (OR = 1.34, 95%CI = 1.09, 1.64 and duration (OR = 1.34, 95%CI = 1.09, 1.65 of PA, after adjusting for potentially confounding variables.Becoming aware of the known link between PA and obesity led to positive behavior modification regarding PA in this cohort of Chinese students. This is of particular importance that knowledge disimination and health education may be a useful approach for population-based physical activity promotion aiming at childhood obesity prevention in China.

  11. Verbal and physical violence towards hospital- and community-based physicians in the Negev: an observational study

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    Freud Tami

    2005-08-01

    Full Text Available Abstract Background Over recent years there has been an increasing prevalence of verbal and physical violence in Israel, including in the work place. Physicians are exposed to violence in hospitals and in the community. The objective was to characterize acts of verbal and physical violence towards hospital- and community-based physicians. Methods A convenience sample of physicians working in the hospital and community completed an anonymous questionnaire about their experience with violence. Data collection took place between November 2001 and July 2002. One hundred seventy seven physicians participated in the study, 95 from the hospital and 82 from community clinics. The community sample included general physicians, pediatricians, specialists and residents. Results Ninety-nine physicians (56% reported at least one act of verbal violence and 16 physicians (9% reported exposure to at least one act of physical violence during the previous year. Fifty-one hospital physicians (53.7% were exposed to verbal violence and 9 (9.5% to physical violence. Forty-eight community physicians (58.5% were exposed to verbal violence and 7 (8.5% to physical violence. Seventeen community physicians (36.2% compared to eleven hospital physicians (17.2% said that the violence had a negative impact on their family and on their quality of life (p Conclusion Verbal and/or physical violence against physicians is common in both the hospital and in community clinics. The impatience that accompanies waiting times may have a cultural element. Shortening waiting times and providing more information to patients and families could reduce the rate of violence, but a cultural change may also be required.

  12. Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infection in adolescents in Northern Italy: an observational school-based study

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    Alberto Matteelli

    2016-02-01

    Full Text Available Abstract Background We carried out a study to evaluate the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae genital infections in school-based adolescents in Northern Italy. Methods Systematic screening for C. trachomatis and N. gonorrhoeae genital infection was performed in 13th grade students in the province of Brescia, an industrialized area in Northern Italy. Student filled in a questionnaire on sexual behaviour and provided a urine sample for microbiological testing. Results A total of 2,718 students (mean age: 18.4 years; 59.1 % females provided complete data (62.2 % of those eligible. Overall 2,059 students (75.8 % were sexually active (i.e. had had at least one partner, and the mean age at sexual debut was 16.1 years (SD: 1.4. Only 27.5 % of the sexually active students reported regular condom use during the previous 6 months, with higher frequency in males than in females (33.8 % vs 24.2 %. No case of N. gonorrhoeae infection was detected, while C. trachomatis was found in 36 adolescents, with a prevalence of 1.7 % (95 % CI: 1.2–2.4 among sexually active students, and no statistical difference between females and males (1.9 and 1.4 %, respectively. Inconsistent condom use (odds ratio, OR = 5.5 and having had more than one sexual partner during the previous 6 months (OR = 6.8 were associated with an increased risk of Chlamydia infection at multivariate analysis. Conclusion The prevalence of C. trachomatis infection among sexually active adolescents in Northern Italy was low, despite a high proportion of students who engage in risky sexual behaviour. No cases of N. gonorrhoeae infection were identified.

  13. 30-day mortality after systemic anticancer treatment for breast and lung cancer in England: a population-based, observational study.

    Science.gov (United States)

    Wallington, Michael; Saxon, Emma B; Bomb, Martine; Smittenaar, Rebecca; Wickenden, Matthew; McPhail, Sean; Rashbass, Jem; Chao, David; Dewar, John; Talbot, Denis; Peake, Michael; Perren, Timothy; Wilson, Charles; Dodwell, David

    2016-09-01

    30-day mortality might be a useful indicator of avoidable harm to patients from systemic anticancer treatments, but data for this indicator are limited. The Systemic Anti-Cancer Therapy (SACT) dataset collated by Public Health England allows the assessment of factors affecting 30-day mortality in a national patient population. The aim of this first study based on the SACT dataset was to establish national 30-day mortality benchmarks for breast and lung cancer patients receiving SACT in England, and to start to identify where patient care could be improved. In this population-based study, we included all women with breast cancer and all men and women with lung cancer residing in England, who were 24 years or older and who started a cycle of SACT in 2014 irrespective of the number of previous treatment cycles or programmes, and irrespective of their position within the disease trajectory. We calculated 30-day mortality after the most recent cycle of SACT for those patients. We did logistic regression analyses, adjusting for relevant factors, to examine whether patient, tumour, or treatment-related factors were associated with the risk of 30-day mortality. For each cancer type and intent, we calculated 30-day mortality rates and patient volume at the hospital trust level, and contrasted these in a funnel plot. Between Jan 1, and Dec, 31, 2014, we included 23 228 patients with breast cancer and 9634 patients with non-small cell lung cancer (NSCLC) in our regression and trust-level analyses. 30-day mortality increased with age for both patients with breast cancer and patients with NSCLC treated with curative intent, and decreased with age for patients receiving palliative SACT (breast curative: odds ratio [OR] 1·085, 99% CI 1·040-1·132; p<0·0001; NSCLC curative: 1·045, 1·013-1·079; p=0·00033; breast palliative: 0·987, 0·977-0·996; p=0·00034; NSCLC palliative: 0·987, 0·976-0·998; p=0·0015). 30-day mortality was also significantly higher for patients

  14. Trace gas composition in the Asian summer monsoon anticyclone: a case study based on aircraft observations and model simulations

    Science.gov (United States)

    Gottschaldt, Klaus-D.; Schlager, Hans; Baumann, Robert; Bozem, Heiko; Eyring, Veronika; Hoor, Peter; Jöckel, Patrick; Jurkat, Tina; Voigt, Christiane; Zahn, Andreas; Ziereis, Helmut

    2017-05-01

    We present in situ measurements of the trace gas composition of the upper tropospheric (UT) Asian summer monsoon anticyclone (ASMA) performed with the High Altitude and Long Range Research Aircraft (HALO) in the frame of the Earth System Model Validation (ESMVal) campaign. Air masses with enhanced O3 mixing ratios were encountered after entering the ASMA at its southern edge at about 150 hPa on 18 September 2012. This is in contrast to the presumption that the anticyclone's interior is dominated by recently uplifted air with low O3 in the monsoon season. We also observed enhanced CO and HCl in the ASMA, which are tracers for boundary layer pollution and tropopause layer (TL) air or stratospheric in-mixing respectively. In addition, reactive nitrogen was enhanced in the ASMA. Along the HALO flight track across the ASMA boundary, strong gradients of these tracers separate anticyclonic from outside air. Lagrangian trajectory calculations using HYSPLIT show that HALO sampled a filament of UT air three times, which included air masses uplifted from the lower or mid-troposphere north of the Bay of Bengal. The trace gas gradients between UT and uplifted air masses were preserved during transport within a belt of streamlines fringing the central part of the anticyclone (fringe), but are smaller than the gradients across the ASMA boundary. Our data represent the first in situ observations across the southern part and downstream of the eastern ASMA flank. Back-trajectories starting at the flight track furthermore indicate that HALO transected the ASMA where it was just splitting into a Tibetan and an Iranian part. The O3-rich filament is diverted from the fringe towards the interior of the original anticyclone, and is at least partially bound to become part of the new Iranian eddy. A simulation with the ECHAM/MESSy Atmospheric Chemistry (EMAC) model is found to reproduce the observations reasonably well. It shows that O3-rich air is entrained by the outer streamlines of the

  15. Ensemble-based approximation of observation impact using an observation-based verification metric

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    Matthias Sommer

    2016-07-01

    Full Text Available Knowledge on the contribution of observations to forecast accuracy is crucial for the refinement of observing and data assimilation systems. Several recent publications highlighted the benefits of efficiently approximating this observation impact using adjoint methods or ensembles. This study proposes a modification of an existing method for computing observation impact in an ensemble-based data assimilation and forecasting system and applies the method to a pre-operational, convective-scale regional modelling environment. Instead of the analysis, the modified approach uses observation-based verification metrics to mitigate the effect of correlation between the forecast and its verification norm. Furthermore, a peculiar property in the distribution of individual observation impact values is used to define a reliability indicator for the accuracy of the impact approximation. Applying this method to a 3-day test period shows that a well-defined observation impact value can be approximated for most observation types and the reliability indicator successfully depicts where results are not significant.

  16. An 8-week web-based weight loss challenge with celebrity endorsement and enhanced social support: observational study.

    Science.gov (United States)

    Hutchesson, Melinda J; Collins, Clare E; Morgan, Philip J; Callister, Robin

    2013-07-04

    Initial engagement and weight loss within Web-based weight loss programs may predict long-term success. The integration of persuasive Web-based features may boost engagement and therefore weight loss. To determine whether an 8-week challenge within a commercial Web-based weight loss program influenced weight loss, website use, and attrition in the short term, when compared to the standard program. De-identified data for participants (mean age 36.7±10.3 years; 86% female) who enrolled in the Biggest Loser Club (BLC) (n=952) and the BLC's Shannan Ponton Fast Track Challenge (SC) for 8 weeks (n=381) were compared. The BLC program used standard evidence-based website features, with individualized calorie and exercise targets to facilitate a weight loss of 0.5-1 kg per week (-500kcal/day less than estimated energy expenditure). SC used the same website features but in addition promoted greater initial weight loss using a 1200 kcal/day energy intake target and physical activity energy expenditure of 600 kcal/day. SC used persuasive features to facilitate greater user engagement, including offering additional opportunities for social support (eg, webinar meetings with a celebrity personal trainer and social networking) endorsed by a celebrity personal trainer. Self-reported weekly weight records were used to determine weight change after 8 weeks. A primary analysis was undertaken using a generalized linear mixed model (GLMM) with all available weight records for all participants included. Dropout (participants who cancelled their subscription) and nonusage (participants who stopped using the Web-based features) attrition rates at 8 weeks were calculated. The number of participants who accessed each website feature and the total number of days each feature was used were calculated. The difference between attrition rates and website use for the two programs were tested using chi-square and Wilcoxon Rank Sum tests, respectively. Using GLMM, including weight data for all

  17. An 8-Week Web-Based Weight Loss Challenge With Celebrity Endorsement and Enhanced Social Support: Observational Study

    Science.gov (United States)

    Collins, Clare E; Morgan, Philip J; Callister, Robin

    2013-01-01

    Background Initial engagement and weight loss within Web-based weight loss programs may predict long-term success. The integration of persuasive Web-based features may boost engagement and therefore weight loss. Objective To determine whether an 8-week challenge within a commercial Web-based weight loss program influenced weight loss, website use, and attrition in the short term, when compared to the standard program. Methods De-identified data for participants (mean age 36.7±10.3 years; 86% female) who enrolled in the Biggest Loser Club (BLC) (n=952) and the BLC’s Shannan Ponton Fast Track Challenge (SC) for 8 weeks (n=381) were compared. The BLC program used standard evidence-based website features, with individualized calorie and exercise targets to facilitate a weight loss of 0.5-1 kg per week (–500kcal/day less than estimated energy expenditure). SC used the same website features but in addition promoted greater initial weight loss using a 1200 kcal/day energy intake target and physical activity energy expenditure of 600 kcal/day. SC used persuasive features to facilitate greater user engagement, including offering additional opportunities for social support (eg, webinar meetings with a celebrity personal trainer and social networking) endorsed by a celebrity personal trainer. Self-reported weekly weight records were used to determine weight change after 8 weeks. A primary analysis was undertaken using a generalized linear mixed model (GLMM) with all available weight records for all participants included. Dropout (participants who cancelled their subscription) and nonusage (participants who stopped using the Web-based features) attrition rates at 8 weeks were calculated. The number of participants who accessed each website feature and the total number of days each feature was used were calculated. The difference between attrition rates and website use for the two programs were tested using chi-square and Wilcoxon Rank Sum tests, respectively. Results

  18. Reasons for computerised provider order entry (CPOE)-based inpatient medication ordering errors: an observational study of voided orders.

    Science.gov (United States)

    Abraham, Joanna; Kannampallil, Thomas G; Jarman, Alan; Sharma, Shivy; Rash, Christine; Schiff, Gordon; Galanter, William

    2017-07-11

    Medication voiding is a computerised provider order entry (CPOE)-based discontinuation mechanism that allows clinicians to identify erroneous medication orders. We investigated the accuracy of voiding as an indicator of clinician identification and interception of a medication ordering error, and investigated reasons and root contributors for medication ordering errors. Using voided orders identified with a void alert, we conducted interviews with ordering and voiding clinicians, followed by patient chart reviews. A structured coding framework was used to qualitatively analyse the reasons for medication ordering errors. We also compared clinician-CPOE-selected (at time of voiding), clinician-reported (interview) and chart review-based reasons for voiding. We conducted follow-up interviews on 101 voided orders. The positive predictive value (PPV) of voided orders that were medication ordering errors was 93.1% (95% CI 88.1% to 98.1%, n=94). Using chart review-based reasons as the gold standard, we found that clinician-CPOE-selected reasons were less reflective (PPV=70.2%, 95% CI 61.0% to 79.4%) than clinician-reported (interview) (PPV=86.1%, 95%CI 78.2% to 94.1%) reasons for medication ordering errors. Duplicate (n=44) and improperly composed (n=41) ordering errors were common, often caused by predefined order sets and data entry issues. A striking finding was the use of intentional violations as a mechanism to notify and seek ordering assistance from pharmacy service. Nearly half of the medication ordering errors were voided by pharmacists. We demonstrated that voided orders effectively captured medication ordering errors. The mismatch between clinician-CPOE-selected and the chart review-based reasons for error emphasises the need for developing standardised operational descriptions for medication ordering errors. Such standardisation can help in accurately identifying, tracking, managing and sharing erroneous orders and their root contributors between healthcare

  19. Study on formation process of layered MMEs based on field observation and petrographic characteristics: A case study from Taejongdae, Busan Korea.

    Science.gov (United States)

    Adam, M. S. A.; Kim, Y. S.; Kim, T.

    2016-12-01

    Mafic Magmatic Enclaves (MME) are a common feature in granitic rocks. However, the Multi-layered MME developed in the outcrop of Cretaceous granite in Taejongdae National Geopark, Busan is a unique phenomenon providing useful information on the formation of MMEs. Multi-layered MME is defined here as MME composed of several contrasting rock shells. Characteristics and origin of MMEs have been studied by several ways; descriptively, geochemically and isotopically due to their importance in the evolution of igneous rocks. This study focuses on the understanding of the formation mechanism of the multi-layers and their rock type diversity. To achieve these goals, field observation between the MMEs and the host granite, petrographic studies and XRF analysis have been carried out. The results show that the MMEs have different shapes and sizes, ranging from elliptical to angular, and from a few centimeters to a meter, respectively. Based on the lithology and the number of layers, the studied MMEs are subdivided into three types as followed; a) single layer type, b) double layer type, and c) triple layer type. The single and double layer types have relatively angular shapes, and their contacts with the host granite are commonly sharp. Layer-forming rocks are variable from mafic porphyritic, mafic fine- to medium- and felsic coarse-grained. The triple layer type has a circular to elliptical shape, while its contact with the host granite is gradual indicating diffusion. It also shows gradual compositional change from mafic to felsic. It is interesting that some of the triple MMEs are injected by granitic materials through cracks. That may indicate brittle deformation during cooling process. The two internal layers of the triple layer MMEs have almost the same mineral composition with different textures indicating the result of cooling process. However, the outer dioritic layer shows mixing composition of mafic and felsic magma, and thus it may indicate that it was generated

  20. A Left-Sided Prevalence of Lentigo Maligna: A UK Based Observational Study and Review of the Evidence

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    Mark Gorman

    2015-01-01

    Full Text Available Skin cancer has been shown to present asymmetrically, prevalent on the left side of the body, more so in subtypes of cutaneous melanoma such as lentigo maligna. Biases have been linked to cumulative UV light exposure and automobile driving patterns. Though left-right ratios have previously correlated with the side men or women tend to position themselves or countries drive on, more recent trends indicate a consistent left-sided bias. To clarify reasons for changing trends, a review of the evidence base and LM’s laterality in a UK cohort (99 cases 2000–2011 was conducted for the first time. The strong correlation of left-sided excess, found in both genders (ratios 1.381–1.5, P<0.05  X2 0.841, is congruent with more recent findings. Though evidence indicates that driving position is no longer a risk factor for LM, due most likely to improved car window UV protection, it remains the most commonly attributed cause. Understanding phenomena such as UV lights “scatter effect” or that cumulative exposure may not be a significant risk factor helps rationalize older conclusions that would otherwise appear contradictory. The reasons for left-sided excess remain unclear but may be due to factors requiring further research such as the body’s anatomical/embryological asymmetry.

  1. The changing trend of cardiovascular disease and its clinical characteristics in Ethiopia: hospital‑based observational study

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    Tefera YG

    2017-04-01

    Full Text Available Yonas Getaye Tefera,1 Tadesse Melaku Abegaz,1 Tamrat Befekadu Abebe,1 Abebe Basazn Mekuria2 1Department of Clinical Pharmacy, 2Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia Objective: The aim of this study was to assess the pattern of cardiovascular diseases (CVDs, their clinical characteristics, and associated factors in the outpatient department of the chronic illness clinic of Gondar University Referral Hospital. Method: A retrospective cross-sectional study was conducted among patients on follow-up at the outpatient chronic illness clinic of the hospital from October 2010 to October 2015. The source population for the study included patients with a diagnosis of CVD whose medical records have the required socio-demographic information during the study period. The data were collected from August 2015 to December 2015. Chi-square and binary logistic regression tests were performed to test the significance of difference among predictive variables and CVDs. Results: Of 1105 patient medical records, 862 fulfilled the inclusion criteria. The majority of the patients were females (65% and living in urban areas (62.7%. Hypertension accounted for the majority (62.3% of CVDs followed by heart failure (HF (23.9%. Headache was the leading chief complaint among the patients (37.7% upon diagnosis and was the prominent clinical feature in more than half of the patients during their course of follow-up. Higher proportions of dyslipidemia (85.7%, hypertension (72.8%, and ischemic heart disease (IHD (73.2% were associated with urban residency (P<0.01. Patients from rural areas (crude odds ratio [COR] =1.306 [95% confidence interval 1.026–2.166], adjusted odds ratio [AOR] =1.272 [95% confidence interval 1.017–2.030] and those with comorbidity illnesses (COR= 1.813 [1.279–2.782], AOR =1.551 [95% confidence interval 1.177–2.705] were more likely to have poor CVD outcome (P<0

  2. Impact of physical and mental health on life satisfaction in old age: a population based observational study.

    Science.gov (United States)

    Puvill, Thomas; Lindenberg, Jolanda; de Craen, Antonius J M; Slaets, Joris P J; Westendorp, Rudi G J

    2016-11-25

    It is widely assumed that poor health lowers life satisfaction when ageing. Yet, research suggests this relationship is not straightforward. This study investigated how older people evaluate their life when facing disease and disabilities. The Leiden 85-plus Study, a prospectively followed cohort of a cohort of a middle-sized city in the Netherlands, all aged 85 years, that was age-representative of the general population, was used. Those with severe cognitive dysfunction were excluded (n = 501). Comorbidities, physical performance, cognitive function, functional status, residual lifespan, depressive symptoms and experienced loneliness were measured during home visits. Life satisfaction was self-reported with Cantril's ladder. All analyses were performed using regression analysis. Participants reported high life satisfaction (median 8 out of 10 points) despite having representative levels of disease and disability. Comorbidity, low cognitive function, and residual lifespan as markers of health were not associated with life satisfaction. Poor physical performance and low functional status were weakly but significantly associated with lower life satisfaction (p life satisfaction (both p life satisfaction, whereas poor mental health was strongly related to lower life satisfaction. This indicates that mental health has a greater impact on life satisfaction at old age than physical health, and that physical health is less relevant for a satisfactory old age.

  3. Glycaemic Control and Associated Self-Management Behaviours in Diabetic Outpatients: A Hospital Based Observation Study in Lusaka, Zambia

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    Emmanuel Mwila Musenge

    2016-01-01

    Full Text Available Background. The control of diabetes mellitus depends on several factors that also include individual lifestyles. We assessed glycaemic control status and self-management behaviours that may influence glycaemic control among diabetic outpatients. Methods. This cross-sectional study among 198 consenting randomly selected patients was conducted at the University Teaching Hospital diabetic clinic between September and December 2013 in Lusaka, Zambia. A structured interview schedule was used to collect data on demographic characteristics, self-management behaviours, and laboratory measurements. Binary logistic regression analysis using IBM SPSS for Windows version 20.0 was carried out to predict behaviours that were associated with glycaemic control status. Results. The proportion of patients that had good glycaemic control status (HbA1c≤ 48 mmol/mol was 38.7% compared to 61.3% that had poor glycaemic control status (HbA1c≥ 49 mmol/mol. Adherence to antidiabetic treatment and fasting plasma glucose predicted glycaemic control status of the patients. However, self-blood glucose monitoring, self-blood glucose monitoring means and exercise did not predict glycaemic control status of the patients.  Conclusion. We find evidence of poor glycaemic control status among most diabetic patients suggesting that health promotion messages need to take into account both individual and community factors to promote behaviours likely to reduce nonadherence.

  4. Ground-based observations of exoplanet atmospheres

    NARCIS (Netherlands)

    Mooij, Ernst Johan Walter de

    2011-01-01

    This thesis focuses on the properties of exoplanet atmospheres. The results for ground-based near-infrared secondary eclipse observations of three different exoplanets, TrES-3b, HAT-P-1b and WASP-33b, are presented which have been obtained with ground-based telescopes as part of the GROUSE project.

  5. Observational Study of Infective Endocarditis at a Community-based Hospital: Dominance of Elderly Patients with Comorbidity.

    Science.gov (United States)

    Nagai, Tomoo; Takase, Yoshiyuki; Hamabe, Akira; Tabata, Hirotsugu

    2018-02-01

    Objective The purpose of this study was to present the recent clinical profiles and the real-world management of infective endocarditis (IE). Methods All medical records of patients with IE were reviewed retrospectively for their clinical data, including clinical presentation, laboratory results, blood cultures, echocardiographic findings, treatments and complications. Using the clinical data collected, we calculated the EuroSCORE II, the European risk score for adult cardiac surgery, the Charlson Comorbidity Index as a surrogate of comordibity, and the Katz Index as a surrogate of frailty. Results Thirty-eight patients were identified as having IE (24 men, age: 71.8±13.1 years). Congestive heart failure occurred in 16 patients (42%), stroke in 14 (50%), and systemic embolism in 5 (13%). The EuroSCORE II and Charlson Comorbidity Index were high (7.7±5.8% and 5.5±2.8%, respectively). The Katz Index was fair (5.5±1.4) before the onset but deteriorated to 2.8±2.7 at the time of establishing the diagnosis of IE (p<0.001). Early surgery was performed in 22 cases (61%). In-hospital death occurred in 10 cases (26%). A EuroSCORE II ≥9%, Staphylococcus aureus etiology, and a Charlson Comorbidity Index were suggested as determinants of in-hospital death (hazard ratios: 173.60, 9.31, 1.57, respectively). In contrast, early surgery was suggested as a determinant of the survival (hazard ratio: 0.04). The Charlson Comorbidity Index was also suggested as a determinant for selecting conservative management (odds ratio: 1.40). Conclusion Comorbidity may influence the treatment selection and outcome of elderly patients with IE.

  6. The health impacts of women's low control in their living environment: A theory-based systematic review of observational studies in societies with profound gender discrimination.

    Science.gov (United States)

    Pennington, Andy; Orton, Lois; Nayak, Shilpa; Ring, Adele; Petticrew, Mark; Sowden, Amanda; White, Martin; Whitehead, Margaret

    2018-02-23

    We conducted a systematic review of observational evidence on the health impacts of women's low control/autonomy in the living environment in societies with profound gender discrimination and gender bias. Thirty observational studies of varying methodological quality were included. Overall, the evidence suggests that women's lower control or autonomy (for example lack of freedom of movement outside the home, lack of authority to access healthcare for sick children) was associated with poorer mental and physical health for women and higher morbidity and mortality for their children, after adjusting for their socioeconomic circumstances. Further studies are needed to disentangle and understand the pathways between low control and health outcomes in contexts of profound gender discrimination. This systematic review has highlighted the general low quality of the evidence base on this research question. It identifies the pressing need for high quality, longitudinal studies in the future. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

  7. The Alberta smoke plume observation study

    Science.gov (United States)

    Anderson, Kerry; Pankratz, Al; Mooney, Curtis; Fleetham, Kelly

    2018-02-01

    A field project was conducted to observe and measure smoke plumes from wildland fires in Alberta. This study used handheld inclinometer measurements and photos taken at lookout towers in the province. Observations of 222 plumes were collected from 21 lookout towers over a 6-year period from 2010 to 2015. Observers reported the equilibrium and maximum plume heights based on the plumes' final levelling heights and the maximum lofting heights, respectively. Observations were tabulated at the end of each year and matched to reported fires. Fire sizes at assessment times and forest fuel types were reported by the province. Fire weather conditions were obtained from the Canadian Wildland Fire Information System (CWFIS). Assessed fire sizes were adjusted to the appropriate size at plume observation time using elliptical fire-growth projections. Though a logical method to collect plume observations in principle, many unanticipated issues were uncovered as the project developed. Instrument limitations and environmental conditions presented challenges to the investigators, whereas human error and the subjectivity of observations affected data quality. Despite these problems, the data set showed that responses to fire behaviour conditions were consistent with the physical processes leading to plume rise. The Alberta smoke plume observation study data can be found on the Canadian Wildland Fire Information System datamart (Natural Resources Canada, 2018) at datamart" target="_blank">http://cwfis.cfs.nrcan.gc.ca/datamart.

  8. The Alberta smoke plume observation study

    Directory of Open Access Journals (Sweden)

    K. Anderson

    2018-02-01

    Full Text Available A field project was conducted to observe and measure smoke plumes from wildland fires in Alberta. This study used handheld inclinometer measurements and photos taken at lookout towers in the province. Observations of 222 plumes were collected from 21 lookout towers over a 6-year period from 2010 to 2015. Observers reported the equilibrium and maximum plume heights based on the plumes' final levelling heights and the maximum lofting heights, respectively. Observations were tabulated at the end of each year and matched to reported fires. Fire sizes at assessment times and forest fuel types were reported by the province. Fire weather conditions were obtained from the Canadian Wildland Fire Information System (CWFIS. Assessed fire sizes were adjusted to the appropriate size at plume observation time using elliptical fire-growth projections. Though a logical method to collect plume observations in principle, many unanticipated issues were uncovered as the project developed. Instrument limitations and environmental conditions presented challenges to the investigators, whereas human error and the subjectivity of observations affected data quality. Despite these problems, the data set showed that responses to fire behaviour conditions were consistent with the physical processes leading to plume rise. The Alberta smoke plume observation study data can be found on the Canadian Wildland Fire Information System datamart (Natural Resources Canada, 2018 at http://cwfis.cfs.nrcan.gc.ca/datamart.

  9. Observer-Based Fuel Control Using Oxygen Measurement. A study based on a first-principles model of a pulverized coal fired Benson Boiler

    Energy Technology Data Exchange (ETDEWEB)

    Andersen, Palle; Bendtsen, Jan Dimon; Mortensen, Jan Henrik; Just Nielsen, Rene; Soendergaard Pedersen, Tom [Aalborg Univ. (Denmark). Dept. of Control Engineering

    2005-01-01

    This report describes an attempt to improve the existing control of coal mills used at the Danish power plant Nordjyllandsvaerket Unit 3. The coal mills pulverize raw coal to a fine-grained powder, which is injected into the furnace of the power plant. In the furnace the coal is combusted, producing heat, which is used for steam production. With better control of the coal mills, the power plant can be controlled more efficiently during load changes, thus improving the overall availability and efficiency of the plant. One of the main difficulties from a control point of view is that the coal mills are not equipped with sensors that detect how much coal is injected into the furnace. During the project, a fairly detailed, non-linear differential equation model of the furnace and the steam circuit was constructed and validated against data obtained at the plant. It was observed that this model was able to capture most of the important dynamics found in the data. Based on this model, it is possible to extract linearized models in various operating points. The report discusses this approach and illustrates how the model can be linearized and reduced to a lower-order linear model that is valid in the vicinity of an operating point by removing states that have little influence on the overall response. A viable adaptive control strategy would then be to design controllers for each of these simplified linear models, i.e., the control loop that sets references to the coal mills and feedwater, and use the load as a separate input to the control. The control gains should then be scheduled according to the load. However, the variations and uncertainties in the coal mill are not addressed directly in this approach. Another control approach was taken in this project, where a Kalman filter based on measurements of air flow blown into the furnace and the oxygen concentration in the flue gas is designed to estimate the actual coal flow injected into the furnace. With this estimate

  10. Study of Solar-Terrestrial Connections in the Highlight of Simultaneous Observations with STEREO and UTR-2, URAN, NDA Ground-Based Radio Telescopes

    Science.gov (United States)

    Melnik, V. N.; Rucker, H. O.; Konovalenko, A. A.; Lecacheux, A.; Falkovich, I. S.

    In the present paper new opportunities, which will be appeared at simultaneous observations by STEREO and ground-based radio telescopes (UTR-2, URAN, NDA), in study of solar sporadic phenomena, having essential effects on the Earth, are discussed. CMEs, which manifest themselves in radio emission as Type II and Type IY bursts, are the most important of them. Studying of these bursts during simultaneous observations with the help of STEREO and ground-based radio telescopes will allow to find the direction of CME movement, 3D images of CME, its beaming pattern, bulk energy of both CME and shock before it, particle acceleration sites and directions of propagation of accelerated particles. Analyses of radio observations of active and quiet Sun will allow to understand pre-CME conditions in the solar corona and will give an opportunity to forecast CME appearance. Observations of different types of sporadic radio emissions (Type III bursts, drift pairs, s-bursts, bursts in absorption etc.) with high sensitivity, high frequency and time resolutions in decameter range by ground-based radio telescopes and detection of regions, where this radio emission goes out from (using STEREO results), will allow to diagnose the coronal plasmas (to define their density, magnetic fields, parameters of inhomogenieties) at altitudes 0.5-2Rs and to build adequate model of CME formation and its evolution. Using of interplanetary scintillation methods tested on UTR-2 and URAN radio telescope as well as in situ measurements on STEREO will give the information about both CME structure and shock associated with it, about spectra of density fluctuations and turbulences connected with CME at distances about 1a.u. from the Sun.

  11. Exploring the influence of citizen involvement on the assimilation of crowdsourced observations: a modelling study based on the 2013 flood event in the Bacchiglione catchment (Italy

    Directory of Open Access Journals (Sweden)

    M. Mazzoleni

    2018-01-01

    Full Text Available To improve hydrological predictions, real-time measurements derived from traditional physical sensors are integrated within mathematic models. Recently, traditional sensors are being complemented with crowdsourced data (social sensors. Although measurements from social sensors can be low cost and more spatially distributed, other factors like spatial variability of citizen involvement, decreasing involvement over time, variable observations accuracy and feasibility for model assimilation play an important role in accurate flood predictions. Only a few studies have investigated the benefit of assimilating uncertain crowdsourced data in hydrological and hydraulic models. In this study, we investigate the usefulness of assimilating crowdsourced observations from a heterogeneous network of static physical, static social and dynamic social sensors. We assess improvements in the model prediction performance for different spatial–temporal scenarios of citizen involvement levels. To that end, we simulate an extreme flood event that occurred in the Bacchiglione catchment  (Italy in May 2013 using a semi-distributed hydrological model with the station at Ponte degli Angeli (Vicenza as the prediction–validation point. A conceptual hydrological model is implemented by the Alto Adriatico Water Authority and it is used to estimate runoff from the different sub-catchments, while a hydraulic model is implemented to propagate the flow along the river reach. In both models, a Kalman filter is implemented to assimilate the crowdsourced observations. Synthetic crowdsourced observations are generated for either static social or dynamic social sensors because these measures were not available at the time of the study. We consider two sets of experiments: (i assuming random probability of receiving crowdsourced observations and (ii using theoretical scenarios of citizen motivations, and consequent involvement levels, based on population distribution. The

  12. Exploring the influence of citizen involvement on the assimilation of crowdsourced observations: a modelling study based on the 2013 flood event in the Bacchiglione catchment (Italy)

    Science.gov (United States)

    Mazzoleni, Maurizio; Cortes Arevalo, Vivian Juliette; Wehn, Uta; Alfonso, Leonardo; Norbiato, Daniele; Monego, Martina; Ferri, Michele; Solomatine, Dimitri P.

    2018-01-01

    To improve hydrological predictions, real-time measurements derived from traditional physical sensors are integrated within mathematic models. Recently, traditional sensors are being complemented with crowdsourced data (social sensors). Although measurements from social sensors can be low cost and more spatially distributed, other factors like spatial variability of citizen involvement, decreasing involvement over time, variable observations accuracy and feasibility for model assimilation play an important role in accurate flood predictions. Only a few studies have investigated the benefit of assimilating uncertain crowdsourced data in hydrological and hydraulic models. In this study, we investigate the usefulness of assimilating crowdsourced observations from a heterogeneous network of static physical, static social and dynamic social sensors. We assess improvements in the model prediction performance for different spatial-temporal scenarios of citizen involvement levels. To that end, we simulate an extreme flood event that occurred in the Bacchiglione catchment (Italy) in May 2013 using a semi-distributed hydrological model with the station at Ponte degli Angeli (Vicenza) as the prediction-validation point. A conceptual hydrological model is implemented by the Alto Adriatico Water Authority and it is used to estimate runoff from the different sub-catchments, while a hydraulic model is implemented to propagate the flow along the river reach. In both models, a Kalman filter is implemented to assimilate the crowdsourced observations. Synthetic crowdsourced observations are generated for either static social or dynamic social sensors because these measures were not available at the time of the study. We consider two sets of experiments: (i) assuming random probability of receiving crowdsourced observations and (ii) using theoretical scenarios of citizen motivations, and consequent involvement levels, based on population distribution. The results demonstrate the

  13. The safety and efficacy of EGF-based cream for the prevention of radiotherapy-induced skin injury: results from a multicenter observational study

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Hyun Cheol [Dept.of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Ahn, Seung Do [Dept.of Radiation Oncology, Asan Medical Center, Seoul (Korea, Republic of); Choi, Doo Ho [Dept.of Radiation Oncology, Samsung Medical Center, Seoul (Korea, Republic of); Kang, Min Kyu [Dept.of Radiation Oncology, eungnam University College of Medicine, Daegu (Korea, Republic of); Wu, Hong Gyun [Dept.of Radiation Oncology, Chonnam National University Hwasun Hospital, Huasun (Korea, Republic of)

    2014-09-15

    This study was designed to evaluate the efficacy and safety of topically applied recombinant human epidermal growth factor (rhEGF) for the prevention of radiation-induced dermatitis in cancer patients. From December 2010 to April 2012, a total of 1,172 cancer patients who received radiotherapy (RT) of more than 50 Gy were prospectively enrolled and treated with EGF-based cream. An acute skin reaction classified according to the Radiation Therapy Oncology Group 6-point rating scale was the primary end point and we also assessed the occurrence of edema, dry skin, or pruritus. The percentage of radiation dermatitis with maximum grade 0 and grade 1 was 19% and 58% at the time of 50 Gy, and it became 29% and 47% after completion of planned RT. This increment was observed only in breast cancer patients (from 18%/62% to 32%/49%). Adverse events related to the EGF-based cream developed in 49 patients (4%) with mild erythema the most common. Skin toxicity grade >2 was observed in 5% of the patients. Edema, dry skin, and pruritus grade > or =3 developed in 9%, 9%, and 1% of the patients, respectively. Prophylactic use of an EGF-based cream is effective in preventing radiation dermatitis with tolerable toxicity. Further studies comparing EGF cream with other topical agents may be necessary.

  14. Dose Titration of Pregabalin in Patients with Painful Diabetic Peripheral Neuropathy: Simulation Based on Observational Study Patients Enriched with Data from Randomized Studies.

    Science.gov (United States)

    Alexander, Joe; Edwards, Roger A; Manca, Luigi; Grugni, Roberto; Bonfanti, Gianluca; Emir, Birol; Whalen, Edward; Watt, Stephen; Parsons, Bruce

    2018-03-01

    Achieving a therapeutic response to pregabalin in patients with painful diabetic peripheral neuropathy (pDPN) requires adequate upward dose titration. Our goal was to identify relationships between titration and response to pregabalin in patients with pDPN. Data were integrated from nine randomized, placebo-controlled clinical trials as well as one 6-week open-label observational study conducted by 5808 physicians (2642 patients with pDPN) in standard outpatient settings in Germany. These studies evaluated pregabalin for treatment of pDPN. Using these data, we examined "what if" scenarios using a microsimulation platform that integrates data from randomized and observational sources as well as autoregressive-moving-average with exogenous inputs models that predict pain outcomes, taking into account weekly changes in pain, sleep interference, dose, and other patient characteristics that were unchanging. Final pain levels were significantly different depending on dose changes (P titration regardless of baseline pain severity. Altogether, 78.5% of patients with pDPN had 0-1 dose change, and 15.2% had ≥ 2 dose changes. Simulation demonstrated that the 4.8% of inadequately titrated patients who did not improve/very much improve their pain levels would have benefited from ≥ 2 dose changes. Patient satisfaction with tolerability (range 90.3-96.2%) was similar, regardless of baseline pain severity, number of titrations, or extent of improvement, suggesting that tolerability did not influence treatment response patterns. Upward dose titration reduced pain in patients with pDPN who actually received it. Simulation also predicted pain reduction in an inadequately titrated nonresponder subgroup of patients had they actually received adequate titration. The decision not to uptitrate must have been driven by factors other than tolerability. Pfizer, Inc.

  15. UFOs: Observations, Studies and Extrapolations

    CERN Document Server

    Baer, T; Barnes, M J; Bartmann, W; Bracco, C; Carlier, E; Cerutti, F; Dehning, B; Ducimetière, L; Ferrari, A; Ferro-Luzzi, M; Garrel, N; Gerardin, A; Goddard, B; Holzer, E B; Jackson, S; Jimenez, J M; Kain, V; Zimmermann, F; Lechner, A; Mertens, V; Misiowiec, M; Nebot Del Busto, E; Morón Ballester, R; Norderhaug Drosdal, L; Nordt, A; Papotti, G; Redaelli, S; Uythoven, J; Velghe, B; Vlachoudis, V; Wenninger, J; Zamantzas, C; Zerlauth, M; Fuster Martinez, N

    2012-01-01

    UFOs (“ Unidentified Falling Objects”) could be one of the major performance limitations for nominal LHC operation. Therefore, in 2011, the diagnostics for UFO events were significantly improved, dedicated experiments and measurements in the LHC and in the laboratory were made and complemented by FLUKA simulations and theoretical studies. The state of knowledge is summarized and extrapolations for LHC operation in 2012 and beyond are presented. Mitigation strategies are proposed and related tests and measures for 2012 are specified.

  16. An observational study of excellence in science teaching based on a sample of outstanding science teachers: Methods of teaching excellence in science

    Science.gov (United States)

    Mazmanian, Victor

    The aim of this study was to document the teaching and learning strategies utilized by a group of science teachers, who were recipients of the Presidential Awards for Excellence in Science and Math Teaching (PAESMT). Six science teachers were observed in their classrooms while they were teaching. Thirty-six lessons were analyzed using a framework of categories of analysis to determine the special traits and common exceptional methods that these teachers had. The findings confirmed the ones predicted by theoretical frameworks of cognitive science and current models of constructivism in teaching. The results of the study supported the importance of the role of the teacher as an active agent in construction of knowledge while also providing sufficient student freedom of exploration and self-realization as needed to grow intellectually and develop skills in metacognition (e.g., reflective critical thought, and learning how to learn). Further, the analyses revealed the complementarity between the teacher's methodology and the processes of student cognition. Some misconceptions that commonly appeared among the observed science students were also documented. The study also explored possible methods to rectify these misconceptions, based in part on prior publications and also on observations of the PAESMT teachers' strategies. The results of this study showed the unique methods of teaching employed by PAESMT recipients to an extent that reached beyond the results of previous research, which published traits and characteristics of such teachers. This study determined the common traits among these teachers and identified their common methods of teaching science. The teacher's role as a facilitator was documented repeatedly among these award-winning teachers and was determined to be an integral tool for the students' successful knowledge construction and development of accurate scientific ways of thinking.

  17. Observing Trip Chain Characteristics of Round-Trip Carsharing Users in China: A Case Study Based on GPS Data in Hangzhou City

    Directory of Open Access Journals (Sweden)

    Ying Hui

    2017-06-01

    Full Text Available Carsharing as a means to provide individuals with access to automobiles to complete a personal trip has grown significantly in recent years in China. However, there are few case studies based on operational data to show the role carsharing systems play in citizens’ daily trips. In this study, vehicle GPS data of a round-trip carsharing system in Hangzhou, China was used to describe the trip chain characteristics of users. For clearer delineation of carshare usage, the car use time length of all observations chosen in the study was within 24 h or less. Through data preprocessing, a large pool (26,085 of valid behavior samples was obtained, and several trip chaining attributes were selected to describe the characteristics. The pool of observations was then classified into five clusters, with each cluster having significant differences in one or two trip chain characteristics. The cluster results reflected that different use patterns exist. By a comparative analysis with trip survey data in Hangzhou, differences in trip chain characteristics exist between carsharing and private cars, but in some cases, shared vehicles can be a substitute for private cars to satisfy motorized travel. The proposed method could facilitate companies in formulating a flexible pricing strategy and determining target customers. In addition, traffic administration agencies could have a deeper understanding of the position and function of various carsharing modes in an urban transportation system.

  18. A model of scientific attitudes assessment by observation in physics learning based scientific approach: case study of dynamic fluid topic in high school

    Science.gov (United States)

    Yusliana Ekawati, Elvin

    2017-01-01

    This study aimed to produce a model of scientific attitude assessment in terms of the observations for physics learning based scientific approach (case study of dynamic fluid topic in high school). Development of instruments in this study adaptation of the Plomp model, the procedure includes the initial investigation, design, construction, testing, evaluation and revision. The test is done in Surakarta, so that the data obtained are analyzed using Aiken formula to determine the validity of the content of the instrument, Cronbach’s alpha to determine the reliability of the instrument, and construct validity using confirmatory factor analysis with LISREL 8.50 program. The results of this research were conceptual models, instruments and guidelines on scientific attitudes assessment by observation. The construct assessment instruments include components of curiosity, objectivity, suspended judgment, open-mindedness, honesty and perseverance. The construct validity of instruments has been qualified (rated load factor > 0.3). The reliability of the model is quite good with the Alpha value 0.899 (> 0.7). The test showed that the model fits the theoretical models are supported by empirical data, namely p-value 0.315 (≥ 0.05), RMSEA 0.027 (≤ 0.08)

  19. Claims-based studies of oral glucose-lowering medications can achieve balance in critical clinical variables only observed in electronic health records.

    Science.gov (United States)

    Patorno, Elisabetta; Gopalakrishnan, Chandrasekar; Franklin, Jessica M; Brodovicz, Kimberly G; Masso-Gonzalez, Elvira; Bartels, Dorothee B; Liu, Jun; Schneeweiss, Sebastian

    2018-04-01

    To evaluate the extent to which balance in unmeasured characteristics of patients with type 2 diabetes (T2DM) was achieved in claims data, by comparing against more detailed information from linked electronic health records (EHR) data. Within a large US commercial insurance database and using a cohort design, we identified patients with T2DM initiating linagliptin or a comparator agent within class (ie, another dipeptidyl peptidase-4 inhibitor) or outside class (ie, pioglitazone or a sulphonylurea) between May 2011 and December 2012. We focused on comparators used at a similar stage of diabetes to linagliptin. For each comparison, 1:1 propensity score (PS) matching was used to balance >100 baseline claims-based characteristics, including proxies of diabetes severity and duration. Additional clinical data from EHR were available for a subset of patients. We assessed representativeness of the claims-EHR-linked subset, evaluated the balance of claims- and EHR-based covariates before and after PS-matching via standardized differences (SDs), and quantified the potential bias associated with observed imbalances. From a claims-based study population of 166 613 patients with T2DM, 7219 (4.3%) patients were linked to their EHR data. Claims-based characteristics in the EHR-linked and EHR-unlinked patients were similar (SD balance of claims-based and EHR-based patient characteristics appeared to be reasonable before PS-matching and generally improved in the PS-matched population, to be SD balance in covariates typically unmeasured in administrative claims datasets, to the extent that residual confounding is unlikely. © 2017 John Wiley & Sons Ltd.

  20. Community-based directly observed treatment for TB patients to improve HIV services: a cross-sectional study in a South African province.

    Science.gov (United States)

    Howell, Embry M; Kigozi, N Gladys; Heunis, J Christo

    2018-04-07

    There is uncertainty about how directly observed treatment (DOT) support for tuberculosis (TB) can be delivered most effectively and how DOT support can simultaneously be used to strengthen human immunodeficiency virus (HIV) prevention and control among TB patients. This study describes how DOT support by community health workers (CHWs) was used in four municipalities in the Free State province - a high TB/HIV burden, poorly-resourced setting - to provide HIV outreach, referrals, and health education for TB patients. The study was part of a larger cross-sectional study of HIV counselling and testing (HCT) among 1101 randomly-selected TB patients registered at 40 primary health care (PHC) facilities (clinics and community health centres) across small town/rural and large town/urban settings. Univariate analysis of percentages, chi-square tests and t-tests for difference in means were used to describe differences between the types of TB treatment support and patient characteristics, as well as the types of - and patient satisfaction with - HIV information and referrals received from various types of treatment supporters including home-based DOT supporters, clinic-based DOT supporters or support from family/friends/employers. Multivariate logistic regression was used to predict the likelihood of not having receiving home-based DOT and of never having received HIV counselling. The independent variables include poverty-related health and socio-economic risk factors for poor outcomes. Statistical significance is shown using a 95% confidence interval and a 0.05 p-value. Despite the fact that DOT support for all TB patients was the goal of South African health policy at the time (2012), most TB patients were not receiving formal DOT support. Only 155 (14.1%) were receiving home-based DOT, while 114 (10.4%) received clinic-based DOT. TB patients receiving home-based DOT reported higher rates of HIV counselling than other patients. Public health providers should train DOT

  1. Fuzzy model-based observers for fault detection in CSTR.

    Science.gov (United States)

    Ballesteros-Moncada, Hazael; Herrera-López, Enrique J; Anzurez-Marín, Juan

    2015-11-01

    Under the vast variety of fuzzy model-based observers reported in the literature, what would be the properone to be used for fault detection in a class of chemical reactor? In this study four fuzzy model-based observers for sensor fault detection of a Continuous Stirred Tank Reactor were designed and compared. The designs include (i) a Luenberger fuzzy observer, (ii) a Luenberger fuzzy observer with sliding modes, (iii) a Walcott-Zak fuzzy observer, and (iv) an Utkin fuzzy observer. A negative, an oscillating fault signal, and a bounded random noise signal with a maximum value of ±0.4 were used to evaluate and compare the performance of the fuzzy observers. The Utkin fuzzy observer showed the best performance under the tested conditions. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

  2. A Complex Multiherbal Regimen Based on Ayurveda Medicine for the Management of Hepatic Cirrhosis Complicated by Ascites: Nonrandomized, Uncontrolled, Single Group, Open-Label Observational Clinical Study.

    Science.gov (United States)

    Patel, Manish V; Patel, Kalapi B; Gupta, Shivenarain; Michalsen, Andreas; Stapelfeldt, Elmar; Kessler, Christian S

    2015-01-01

    Hepatic cirrhosis is one of the leading causes of death worldwide, especially if complicated by ascites. This chronic condition can be related to the classical disease entity jalodara in Traditional Indian Medicine (Ayurveda). The present paper aims to evaluate the general potential of Ayurvedic therapy for overall clinical outcomes in hepatic cirrhosis complicated by ascites (HCcA). In form of a nonrandomized, uncontrolled, single group, open-label observational clinical study, 56 patients fulfilling standardized diagnostic criteria for HCcA were observed during their treatment at the P. D. Patel Ayurveda Hospital, Nadiad, India. Based on Ayurvedic tradition, a standardized treatment protocol was developed and implemented, consisting of oral administration of single and compound herbal preparations combined with purificatory measures as well as dietary and lifestyle regimens. The outcomes were assessed by measuring liver functions through specific clinical features and laboratory parameters and by evaluating the Child-Pugh prognostic grade score. After 6 weeks of treatment and a follow-up period of 18 weeks, the outcomes showed statistically significant and clinically relevant improvements. Further larger and randomized trials on effectiveness, safety, and quality of the Ayurvedic approach in the treatment of HCcA are warranted to support these preliminary findings.

  3. Observation of an Aligned Gas - Solid "Eutectic" during Controlled Directional Solidification Aboard the International Space Station - Comparison with Ground-based Studies

    Science.gov (United States)

    Grugel, R. N.; Anilkumar, A.

    2005-01-01

    Direct observation of the controlled melting and solidification of succinonitrile was conducted in the glovebox facility of the International Space Station (ISS). The experimental samples were prepared on ground by filling glass tubes, 1 cm ID and approximately 30 cm in length, with pure succinonitrile (SCN) in an atmosphere of nitrogen at 450 millibar pressure for eventual processing in the Pore Formation and Mobility Investigation (PFMI) apparatus in the glovebox facility (GBX) on board the ISS. Real time visualization during controlled directional melt back of the sample showed nitrogen bubbles emerging from the interface and moving through the liquid up the imposed temperature gradient. Over a period of time these bubbles disappear by dissolving into the melt. Translation is stopped after melting back of about 9 cm of the sample, with an equilibrium solid-liquid interface established. During controlled re-solidification, aligned tubes of gas were seen growing perpendicular to the planar solid/liquid interface, inferring that the nitrogen previously dissolved into the liquid SCN was now coming out at the solid/liquid interface and forming the little studied liquid = solid + gas eutectic-type reaction. The observed structure is evaluated in terms of spacing dimensions, interface undercooling, and mechanisms for spacing adjustments. Finally, the significance of processing in a microgravity environment is ascertained in view of ground-based results.

  4. Diagnostic Support for Selected Paediatric Pulmonary Diseases Using Answer-Pattern Recognition in Questionnaires Based on Combined Data Mining Applications--A Monocentric Observational Pilot Study.

    Directory of Open Access Journals (Sweden)

    Ann-Katrin Rother

    Full Text Available Clinical symptoms in children with pulmonary diseases are frequently non-specific. Rare diseases such as primary ciliary dyskinesia (PCD, cystic fibrosis (CF or protracted bacterial bronchitis (PBB can be easily missed at the general practitioner (GP.To develop and test a questionnaire-based and data mining-supported tool providing diagnostic support for selected pulmonary diseases.First, interviews with parents of affected children were conducted and analysed. These parental observations during the pre-diagnostic time formed the basis for a new questionnaire addressing the parents' view on the disease. Secondly, parents with a sick child (e.g. PCD, PBB answered the questionnaire and a data base was set up. Finally, a computer program consisting of eight different classifiers (support vector machine (SVM, artificial neural network (ANN, fuzzy rule-based, random forest, logistic regression, linear discriminant analysis, naive Bayes and nearest neighbour and an ensemble classifier was developed and trained to categorise any given new questionnaire and suggest a diagnosis. For estimating the diagnostic accuracy, we applied ten-fold stratified cross validation.All questionnaires of patients suffering from CF, asthma (AS, PCD, acute bronchitis (AB and the healthy control group were correctly diagnosed by the fusion algorithm. For the pneumonia (PM group 19/21 (90.5% and for the PBB group 17/18 (94.4% correct diagnoses could be reached. The program detected the correct diagnoses with an overall sensitivity of 98.8%. Receiver operating characteristics (ROC analyses confirmed the accuracy of this diagnostic tool. Case studies highlighted the applicability of the tool in the daily work of a GP.For children with symptoms of pulmonary diseases a questionnaire-based diagnostic support tool using data mining techniques exhibited good results in arriving at diagnostic suggestions. In the hands of a doctor, this tool could be of value in arousing awareness for

  5. An Observation-based Study of the Sensitivity of Dust Aerosol Net Direct Radiative Effects to the Physical and Optical Properties of Dust

    Science.gov (United States)

    Song, Q.; Zhang, Z.; Yu, H.; Kato, S.

    2017-12-01

    Dust aerosols play an important role in the radiative energy budget of Earth-Atmospheric system. They participate in Earth's energy budget directly by absorbing and scattering radiation, which is so called direct radiative effect (DRE). Many previous studies have focused on studying the DRE of dust in the shortwave (SW) domain. However, dust aerosols are large enough in size to have significant longwave(LW) DRE. Recently, dust longwave(LW) DRE have obtained more and more interest from scientists, but the DRE of dust aerosols remains uncertain in magnitude and even sign in recent assessments. These uncertainties are mainly in the microphysical and optical properties of dust. The first objective of this research is to perform an observation-based sensitivity study of dust SW, LW and net DRE to dust size distribution, shape and refractive index. Different sets of dust size distribution, shape and refractive index are used in this research to compute the optical properties. We use the Rapid Radiative Transfer Model driven by atmospheric profiles and aerosol extinction profiles derived from CALIPSO in CERES, CALIPSO, CloudSat and MODIS merged product (CCCM) to compute both SW and LW forcing efficiency. Then the sensitivity of dust DRE to those properties will be analyzed. In addition, an optimal combination of dust size distribution and refractive index, which provides good agreement with CERES observation in both outgoing longwave radiation and upward shortwave radiation, will be found. The second objective of this research is to evaluate dust net DRE in North Atlantic region by using the optimal combination mentioned previously.

  6. Effect of minodronate on the speed of sound of the calcaneus in postmenopausal women with an increased risk of fractures: A clinical practice-based observational study.

    Science.gov (United States)

    Iwamoto, Jun; Takada, Tetsuya

    2015-10-01

    We previously reported that alendronate and risedronate reduce the urinary levels of cross-linked N-terminal telopeptides of type I collagen (NTX) by 44.9% and 34.7%, respectively, at 3 months after the start of treatment, and increase the speed of sound (SOS) of the calcaneus by 0.6% and 0.65%, respectively, at 12 months after the start of treatment in postmenopausal women with osteoporosis. The aim of the present clinical practice-based observational study was to examine the effect of treatment with minodronate for 12 months on the SOS of the calcaneus and on bone turnover markers in postmenopausal women with an increased risk of fractures. Forty-two postmenopausal women with osteoporosis or osteopenia with a clinical risk factor for fractures who had been treated with minodronate for > 12 months were enrolled in the study. The SOS and bone turnover markers were monitored during treatment with minodronate for 12 months. Compared to their baseline values, the urinary levels of NTX at 3 months and the serum levels of alkaline phosphatase at 12 months were significantly decreased at 47.5% and 25.8%, respectively. At 12 months, the SOS increased modestly, but significantly, by 0.47%, compared to the baseline value. The present study confirmed that minodronate suppressed bone turnover and modestly increased the SOS of the calcaneus in postmenopausal women with an increased risk of fractures. Copyright © 2015. Published by Elsevier Taiwan.

  7. Evidence-based obstetrics in four hospitals in China: An observational study to explore clinical practice, women's preferences and provider's views

    Directory of Open Access Journals (Sweden)

    Liang Ji

    2001-05-01

    Full Text Available Abstract Background Evidence-based obstetric care is widely promoted in developing countries, but the success of implementation is not known. Using selected childbirth care procedures in four hospitals in Shanghai, we compared practice against evidence-based information, and explored user and provider views about each procedure. Methods Observational study. Using the Cochrane Library, we identified six procedures that should be avoided as routine and two that should be encouraged. Procedure rate determined by exit interviews with women, verified using hospital notes. Views of women and providers explored with in depth interviews. The study sites were three hospitals in Shanghai and one in neighbouring province of Jiangsu. 150 women at each centre for procedure rate, and 48 in-depth interviews with women and providers. Results Vaginal births were 50% (303/599 of the total. Of the six practices where evidence suggests they should be avoided as routine, three were performed with rates above 70%: pubic shaving (3 hospitals, rectal examination (3 hospitals, and episiotomy (3 hospitals. Most women delivered lying down, pain relief was rarely given, and only in the urban district hospital did women routinely have a companion. Most women wanted support or companionship during labour and to be given pain relief; but current practice is insufficient to meet women's needs. Conclusion Obstetric practice is not following best available evidence in the hospitals studied. There is a need to adjust hospital policy to support the use of interventions proven to be of benefit to women during childbirth, and develop approaches that ensure clinical practice changes.

  8. Primer: challenges in randomized and observational studies

    NARCIS (Netherlands)

    Landewé, Robert; van der Heijde, Désirée

    2007-01-01

    Randomized controlled trials (RCTs) are considered superior to observational studies, and both clinicians and researchers believe that conclusions that stem from observational research are flawed. RCTs, however, have important methodological and interpretational limitations, and particular clinical

  9. Operational evapotranspiration based on Earth observation satellites

    Science.gov (United States)

    Gellens-Meulenberghs, Françoise; Ghilain, Nicolas; Arboleda, Alirio; Barrios, Jose-Miguel

    2016-04-01

    Geostationary satellites have the potential to follow fast evolving atmospheric and Earth surface phenomena such those related to cloud cover evolution and diurnal cycle. Since about 15 years, EUMETSAT has set up a network named 'Satellite Application Facility' (SAF, http://www.eumetsat.int/website/home/Satellites/GroundSegment/Safs/index.html) to complement its ground segment. The Land Surface Analysis (LSA) SAF (http://landsaf.meteo.pt/) is devoted to the development of operational products derived from the European meteorological satellites. In particular, an evapotranspiration (ET) product has been developed by the Royal Meteorological Institute of Belgium. Instantaneous and daily integrated results are produced in near real time and are freely available respectively since the end of 2009 and 2010. The products cover Europe, Africa and the Eastern part of South America with the spatial resolution of the SEVIRI sensor on-board Meteosat Second Generation (MSG) satellites. The ET product algorithm (Ghilain et al., 2011) is based on a simplified Soil-Vegetation-Atmosphere transfer (SVAT) scheme, forced with MSG derived radiative products (LSA SAF short and longwave surface fluxes, albedo). It has been extensively validated against in-situ validation data, mainly FLUXNET observations, demonstrating its good performances except in some arid or semi-arid areas. Research has then been pursued to develop an improved version for those areas. Solutions have been found in reviewing some of the model parameterizations and in assimilating additional satellite products (mainly vegetation indices and land surface temperature) into the model. The ET products will be complemented with related latent and sensible heat fluxes, to allow the monitoring of land surface energy partitioning. The new algorithm version should be tested in the LSA-SAF operational computer system in 2016 and results should become accessible to beta-users/regular users by the end of 2016/early 2017. In

  10. Confounding in publications of observational intervention studies

    NARCIS (Netherlands)

    Groenwold, Rolf H. H.; Hoes, Arno W.; Hak, Eelko

    We conducted a systematic literature search in Medline to assess the proportion of observational intervention studies appreciating confounding bias in peer-reviewed medical literature from 1985 through 2005. This study shows only 9% of all papers on observational intervention studies published in

  11. Burden and outcomes of pressure ulcers in cancer patients receiving the Kerala model of home based palliative care in India: Results from a prospective observational study

    Directory of Open Access Journals (Sweden)

    Biji M Sankaran

    2015-01-01

    Full Text Available Aim: To report the prevalence and outcomes of pressure ulcers (PU seen in a cohort of cancer patients requiring home-based palliative care. Materials and Methods: All patients referred for home care were eligible for this prospective observational study, provided they were living within a distance of 35 km from the institute and gave informed consent. During each visit, caregivers were trained and educated for providing nursing care for the patient. Dressing material for PU care was provided to all patients free of cost and care methods were demonstrated. Factors influencing the occurrence and healing of PUs were analyzed using logistic regression. Duration for healing of PU was calculated using the Kaplan Meier method. P < 0.05 are taken as significant. Results: Twenty-one of 108 (19.4% enrolled patients had PU at the start of homecare services. None of the patients developed new PU during the course of home care. Complete healing of PU was seen in 9 (42.9% patients. The median duration for healing of PU was found to be 56 days. Median expenditure incurred in patients with PU was Rs. 2323.40 with a median daily expenditure of Rs. 77.56. Conclusions: The present model of homecare service delivery was found to be effective in the prevention and management of PUs. The high prevalence of PU in this cohort indicates a need for greater awareness for this complication. Clinical Trial Registry Number: CTRI/2014/03/004477

  12. Burden of herpes zoster and postherpetic neuralgia in Japanese adults 60 years of age or older: Results from an observational, prospective, physician practice-based cohort study.

    Science.gov (United States)

    Sato, Keiko; Adachi, Koichi; Nakamura, Hiroyuki; Asano, Kazuhiro; Watanabe, Akihiro; Adachi, Riri; Kiuchi, Mariko; Kobayashi, Keiju; Matsuki, Taizo; Kaise, Toshihiko; Gopala, Kusuma; Holl, Katsiaryna

    2017-04-01

    Approximately one in three persons will develop herpes zoster during their lifetime, and it can lead to serious complications such as postherpetic neuralgia. However, evidence on burden of herpes zoster and postherpetic neuralgia in Japan is limited. This prospective, observational, multicenter, physician practice-based cohort study was conducted in Kushiro, Hokkaido, Japan (Clinicaltrials.gov identifier NCT01873365) to assess the incidence and hospitalization rates of herpes zoster, and the proportion, clinical burden and risk factors for postherpetic neuralgia in adults aged 60 years or more. Within the study area, 800 subjects developed herpes zoster and 412 were eligible for the study. Herpes zoster incidence was 10.2/1000 person-years and higher among women and older subjects. Subjects with herpes zoster required on average 5.7 outpatient consultations. Herpes zoster-associated hospitalization rate was 3.4% (27/800). The proportion of postherpetic neuralgia and other complications was 9.2% (38/412) and 26.5% (109/412), respectively. Statistically significant association with the development of postherpetic neuralgia was male sex (odds ratio [OR], 2.51; 95% confidence interval [CI], 1.17-5.38), age of 70-74 years (OR, 3.51; 95% CI, 1.09-11.3), immunosuppressive therapy (OR, 6.44; 95% CI, 1.26-32.9), severe herpes zoster pain at first consultation (OR, 3.08; 95% CI, 1.10-8.62) and rash on upper arms (vs no rash on upper arms; OR, 3.46; 95% CI, 1.10-10.9). Considerable herpes zoster and postherpetic neuralgia burden exists among elderly in Japan, and there may be predictive factors at the first visit which could be indicative of the risk of developing postherpetic neuralgia. © 2016 The Authors. The Journal of Dermatology published by John Wiley & Sons Australia, Ltd on behalf of Japanese Dermatological Association.

  13. STROBE initiative: guidelines on reporting observational studies.

    Science.gov (United States)

    Malta, Monica; Cardoso, Leticia Oliveira; Bastos, Francisco Inacio; Magnanini, Monica Maria Ferreira; Silva, Cosme Marcelo Furtado Passos da

    2010-06-01

    Reporting of observational studies is often inadequate, hampering the assessment of their strengths and weaknesses and, consequently, the generalization of study results. The initiative named Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) developed a checklist of 22 items, the STROBE Statement, with recommendations about what should be included in a more accurate and complete description of observational studies. Between June and December 2008, a group of Brazilian researchers was dedicated to the translation and adaptation of the STROBE Statement into Portuguese. The present study aimed to show the translation into Portuguese, introduce the discussion on the context of use, the potential and limitations of the STROBE initiative.

  14. Guidelines for reporting evaluations based on observational methodology.

    Science.gov (United States)

    Portell, Mariona; Anguera, M Teresa; Chacón-Moscoso, Salvador; Sanduvete-Chaves, Susana

    2015-01-01

    Observational methodology is one of the most suitable research designs for evaluating fidelity of implementation, especially in complex interventions. However, the conduct and reporting of observational studies is hampered by the absence of specific guidelines, such as those that exist for other evaluation designs. This lack of specific guidance poses a threat to the quality and transparency of these studies and also constitutes a considerable publication hurdle. The aim of this study thus was to draw up a set of proposed guidelines for reporting evaluations based on observational methodology. The guidelines were developed by triangulating three sources of information: observational studies performed in different fields by experts in observational methodology, reporting guidelines for general studies and studies with similar designs to observational studies, and proposals from experts in observational methodology at scientific meetings. We produced a list of guidelines grouped into three domains: intervention and expected outcomes, methods, and results. The result is a useful, carefully crafted set of simple guidelines for conducting and reporting observational studies in the field of program evaluation.

  15. Transport pathways of CO in the African upper troposphere during the monsoon season: a study based upon the assimilation of spaceborne observations

    Directory of Open Access Journals (Sweden)

    B. Barret

    2008-06-01

    Full Text Available The transport pathways of carbon monoxide (CO in the African Upper Troposphere (UT during the West African Monsoon (WAM is investigated through the assimilation of CO observations by the Aura Microwave Limb Sounder (MLS in the MOCAGE Chemistry Transport Model (CTM. The assimilation setup, based on a 3-D First Guess at Assimilation Time (3-D-FGAT variational method is described. Comparisons between the assimilated CO fields and in situ airborne observations from the MOZAIC program between Europe and both Southern Africa and Southeast Asia show an overall good agreement around the lowermost pressure level sampled by MLS (~215 hPa. The 4-D assimilated fields averaged over the month of July 2006 have been used to determine the main dynamical processes responsible for the transport of CO in the African UT. The studied period corresponds to the second AMMA (African Monsoon Multidisciplinary Analyses aircraft campaign. At 220 hPa, the CO distribution is characterized by a latitudinal maximum around 5° N mostly driven by convective uplift of air masses impacted by biomass burning from Southern Africa, uplifted within the WAM region and vented predominantly southward by the upper branch of the winter hemisphere Hadley cell. Above 150 hPa, the African CO distribution is characterized by a broad maximum over northern Africa. This maximum is mostly controlled by the large scale UT circulation driven by the Asian Summer Monsoon (ASM and characterized by the Asian Monsoon Anticyclone (AMA centered at 30° N and the Tropical Easterly Jet (TEJ on the southern flank of the anticyclone. Asian pollution uplifted to the UT over large region of Southeast Asia is trapped within the AMA and transported by the anticyclonic circulation over Northeast Africa. South of the AMA, the TEJ is responsible for the tranport of CO-enriched air masses from India and Southeast Asia over Africa. Using the high time resolution provided by the 4-D assimilated fields, we give evidence

  16. Look who's talking : A Motivational Interviewing based observation study of one-on-one conversations between residential care workers and adolescents

    NARCIS (Netherlands)

    Eenshuistra, Annika; Harder, Annemiek T.; Van Zonneveld, Neeltje L.; Knorth, Erik J.

    Despite its relevance and effectiveness in adjoining fields, still surprisingly little attention has been paid to Motivational Interviewing (MI) in the context of residential youth care. This study aims to analyse observed interactions between adolescents and group care workers during one-on-one

  17. Feasibility of CBCT-based target and normal structure delineation in prostate cancer radiotherapy: Multi-observer and image multi-modality study

    International Nuclear Information System (INIS)

    Luetgendorf-Caucig, Carola; Fotina, Irina; Stock, Markus; Poetter, Richard; Goldner, Gregor; Georg, Dietmar

    2011-01-01

    Background and purpose: In-room cone-beam CT (CBCT) imaging and adaptive treatment strategies are promising methods to decrease target volumes and to spare organs at risk. The aim of this work was to analyze the inter-observer contouring uncertainties of target volumes and organs at risks (oars) in localized prostate cancer radiotherapy using CBCT images. Furthermore, CBCT contouring was benchmarked against other image modalities (CT, MR) and the influence of subjective image quality perception on inter-observer variability was assessed. Methods and materials: Eight prostate cancer patients were selected. Seven radiation oncologists contoured target volumes and oars on CT, MRI and CBCT. Volumes, coefficient of variation (COV), conformity index (cigen), and coordinates of center-of-mass (COM) were calculated for each patient and image modality. Reliability analysis was performed for the support of the reported findings. Subjective perception of image quality was assessed via a ten-scored visual analog scale (VAS). Results: The median volume for prostate was larger on CT compared to MRI and CBCT images. The inter-observer variation for prostate was larger on CBCT (CIgen = 0.57 ± 0.09, 0.61 reliability) compared to CT (CIgen = 0.72 ± 0.07, 0.83 reliability) and MRI (CIgen = 0.66 ± 0.12, 0.87 reliability). On all image modalities values of the intra-observer reliability coefficient (0.97 for CT, 0.99 for MR and 0.94 for CBCT) indicated high reproducibility of results. For all patients the root mean square (RMS) of the inter-observer standard deviation (σ) of the COM was largest on CBCT with σ(x) = 0.4 mm, σ(y) = 1.1 mm, and σ(z) = 1.7 mm. The concordance in delineating OARs was much stronger than for target volumes, with average CIgen > 0.70 for rectum and CIgen > 0.80 for bladder. Positive correlations between CIgen and VAS score of the image quality were observed for the prostate, seminal vesicles and rectum. Conclusions: Inter-observer variability for target

  18. A Case Study on Observed and Simulated CO2 Concentration Profiles in Hefei based on Raman Lidar and GEOS-Chem Model

    Directory of Open Access Journals (Sweden)

    Wang Yinan

    2016-01-01

    Full Text Available Observations of atmospheric CO2 concentration profiles provide significative constraints on the global/regional inversions of carbon sources and sinks. Anhui Institute of Optics and Fine Mechanics of Chinese Academy of Sciences developed a Raman Lidar system to detect the vertical distribution of atmospheric CO2. This paper compared the observations with the modeled results from a three-dimensional global chemistry transport model-GEOS-Chem, which showed a good agreement in the trend of change with lidar measurements. The case study indicated a potential for better simulating vertical distribution of atmospheric CO2 by combining with lidar measurements.

  19. Does long-term care use within primary health care reduce hospital use among older people in Norway? A national five-year population-based observational study

    Directory of Open Access Journals (Sweden)

    Deraas Trygve S

    2011-10-01

    Full Text Available Abstract Background Population ageing may threaten the sustainability of future health care systems. Strengthening primary health care, including long-term care, is one of several measures being taken to handle future health care needs and budgets. There is limited and inconsistent evidence on the effect of long-term care on hospital use. We explored the relationship between the total use of long-term care within public primary health care in Norway and the use of hospital beds when adjusting for various effect modifiers and confounders. Methods This national population-based observational study consists of all Norwegians (59% women older than 66 years (N = 605676 (13.2% of total population in 2002-2006. The unit of analysis was defined by municipality, age and sex. The association between total number of recipients of long-term care per 1000 inhabitants (LTC-rate and hospital days per 1000 inhabitants (HD-rate was analysed in a linear regression model. Modifying and confounding effects of socioeconomic, demographic and geographic variables were included in the final model. We defined a difference in hospitalization rates of more than 1000 days per 1000 inhabitants as clinically important. Results Thirty-one percent of women and eighteen percent of men were long-term care users. Men had higher HD-rates than women. The crude association between LTC-rate and HD-rate was weakly negative. We identified two effect modifiers (age and sex and two strong confounders (travel time to hospital and mortality. Age and sex stratification and adjustments for confounders revealed a positive statistically significant but not clinically important relationship between LTC-rates and hospitalization for women aged 67-79 years and all men. For women 80 years and over there was a weak but negative relationship which was neither statistically significant nor clinically important. Conclusions We found a weak positive adjusted association between LTC-rates and HD

  20. Observing Protein & Energy Nutrition (OPEN) Study

    Science.gov (United States)

    The Observing Protein and Energy Nutrition (OPEN) Study was designed to assess dietary measurement error by comparing results from self-reported dietary intake data with four dietary biomarkers: doubly labeled water and urinary nitrogen, sodium, and potassium.

  1. STRengthening analytical thinking for observational studies

    DEFF Research Database (Denmark)

    Sauerbrei, Willi; Abrahamowicz, Michal; Altman, Douglas G.

    2014-01-01

    The validity and practical utility of observational medical research depends critically on good study design, excellent data quality, appropriate statistical methods and accurate interpretation of results. Statistical methodology has seen substantial development in recent times. Unfortunately, many...

  2. Observer-based monitoring of heat exchangers.

    Science.gov (United States)

    Astorga-Zaragoza, Carlos-Manuel; Alvarado-Martínez, Víctor-Manuel; Zavala-Río, Arturo; Méndez-Ocaña, Rafael-Maxim; Guerrero-Ramírez, Gerardo-Vicente

    2008-01-01

    The goal of this work is to provide a method for monitoring performance degradation in counter-flow double-pipe heat exchangers. The overall heat transfer coefficient is estimated by an adaptive observer and monitored in order to infer when the heat exchanger needs preventive or corrective maintenance. A simplified mathematical model is used to synthesize the adaptive observer and a more complex model is used for simulation. The reliability of the proposed method was demonstrated via numerical simulations and laboratory experiments with a bench-scale pilot plant.

  3. The TRIAGE-ProADM Score for an Early Risk Stratification of Medical Patients in the Emergency Department - Development Based on a Multi-National, Prospective, Observational Study.

    Science.gov (United States)

    Kutz, Alexander; Hausfater, Pierre; Amin, Devendra; Amin, Adina; Canavaggio, Pauline; Sauvin, Gabrielle; Bernard, Maguy; Conca, Antoinette; Haubitz, Sebastian; Struja, Tristan; Huber, Andreas; Mueller, Beat; Schuetz, Philipp

    2016-01-01

    The inflammatory biomarker pro-adrenomedullin (ProADM) provides additional prognostic information for the risk stratification of general medical emergency department (ED) patients. The aim of this analysis was to develop a triage algorithm for improved prognostication and later use in an interventional trial. We used data from the multi-national, prospective, observational TRIAGE trial including consecutive medical ED patients from Switzerland, France and the United States. We investigated triage effects when adding ProADM at two established cut-offs to a five-level ED triage score with respect to adverse clinical outcome. Mortality in the 6586 ED patients showed a step-wise, 25-fold increase from 0.6% to 4.5% and 15.4%, respectively, at the two ProADM cut-offs (≤0.75nmol/L, >0.75-1.5nmol/L, >1.5nmol/L, p ANOVA triage score resulted in the identification of 1662 patients (25.2% of the population) at a very low risk of mortality (0.3%, n = 5) and 425 patients (6.5% of the population) at very high risk of mortality (19.3%, n = 82). Risk estimation by using ProADM and the triage score from a logistic regression model allowed for a more accurate risk estimation in the whole population with a classification of 3255 patients (49.4% of the population) in the low risk group (0.3% mortality, n = 9) and 1673 (25.4% of the population) in the high-risk group (15.1% mortality, n = 252). Within this large international multicenter study, a combined triage score based on ProADM and established triage scores allowed a more accurate mortality risk discrimination. The TRIAGE-ProADM score improved identification of both patients at the highest risk of mortality who may benefit from early therapeutic interventions (rule in), and low risk patients where deferred treatment without negatively affecting outcome may be possible (rule out).

  4. Nonlinear Disturbance Observer Based Robust Tracking Control of Pneumatic Muscle

    Directory of Open Access Journals (Sweden)

    Youssif Mohamed Toum Elobaid

    2014-01-01

    Full Text Available Presently pneumatic muscles (PMs are used in various applications due to their simple construction, lightweight, and high force-to-weight ratio. However, pneumatic muscles are facing various problems due to their nonlinear characteristics and various uncertainties in real applications. To cope with the uncertainties and strong nonlinearity of a PM model, a nonlinear disturbance observer (NDO is designed to estimate the lumped disturbance. Based on the disturbance observer, the tracking control of PM is studied. Stability analysis based on Lyapunov method with respect to our proposed control law is discussed. The simulation results show the validity, effectiveness, and enhancing robustness of the proposed methods.

  5. [The Strengthening the Reporting of Observational Studies in Epidemiology [STROBE] statement: guidelines for reporting observational studies

    DEFF Research Database (Denmark)

    Elm, E. von; Altman, D.G.; Egger, M.

    2008-01-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed rec...

  6. Part III: Comparing observed growth of selected test organisms in food irradiation studies with growth predictions calculated by ComBase softwares

    International Nuclear Information System (INIS)

    Farkas, J.; Andrassy, E.; Meszaros, L.; Beczner, J.; Polyak-Feher, K.; Gaal, O.; Lebovics, V.K.; Lugasi, A.

    2009-01-01

    As a result of intensive predictive microbiological modelling activities, several computer programs and softwares became available recently for facilitating microbiological risk assessment. Among these tools, the establishment of the ComBase, an international database and its predictive modelling softwares of the Pathogen Modelling Program (PMP) set up by the USDA Eastern Regional Research Center, Wyndmore, PA, and the Food Micromodel/Growth Predictor by the United Kingdom's Institute of Food Research, Norwich, are most important. The authors have used the PMP 6.1 software version of ComBase as a preliminary trial to compare observed growth of selected test organisms in relation to their food irradiation work during recent years within the FAO/IAEA Coordinated Food Irradiation Research Projects (D6.10.23 and D6.20.07) with the predicted growth on the basis of growth models available in ComBase for the same species as those of the authors' test organisms. The results of challenge tests with Listeria monocytogenes inoculum in untreated or irradiated experimental batches of semi-prepared breaded turkey meat steaks (cordon bleu), sliced tomato, sliced watermelon, sliced cantaloupe and sous vide processed mixed vegetables, as well as Staphylococcus aureus inoculum of a pasta product, tortellini, were compared with their respective growth models under relevant environmental conditions. This comparison showed good fits in the case of non-irradiated and high moisture food samples, but growth of radiation survivors lagged behind the predicted values. (author)

  7. Century Scale Evaporation Trend: An Observational Study

    Science.gov (United States)

    Bounoui, Lahouari

    2012-01-01

    Several climate models with different complexity indicate that under increased CO2 forcing, runoff would increase faster than precipitation overland. However, observations over large U.S watersheds indicate otherwise. This inconsistency between models and observations suggests that there may be important feedbacks between climate and land surface unaccounted for in the present generation of models. We have analyzed century-scale observed annual runoff and precipitation time-series over several United States Geological Survey hydrological units covering large forested regions of the Eastern United States not affected by irrigation. Both time-series exhibit a positive long-term trend; however, in contrast to model results, these historic data records show that the rate of precipitation increases at roughly double the rate of runoff increase. We considered several hydrological processes to close the water budget and found that none of these processes acting alone could account for the total water excess generated by the observed difference between precipitation and runoff. We conclude that evaporation has increased over the period of observations and show that the increasing trend in precipitation minus runoff is correlated to observed increase in vegetation density based on the longest available global satellite record. The increase in vegetation density has important implications for climate; it slows but does not alleviate the projected warming associated with greenhouse gases emission.

  8. Statistical challenges in observational cohort studies

    NARCIS (Netherlands)

    Hof, M.H.P.

    2015-01-01

    For over a century observational cohort studies have been used to study determinants of health and disease. Within a sample from the population, we can determine the relation between health outcomes (e.g. death) and a broad range of factors as genetic markers, environmental exposures, and lifestyle

  9. Data base to compare calculations and observations

    Energy Technology Data Exchange (ETDEWEB)

    Tichler, J.L.

    1985-01-01

    Meteorological and climatological data bases were compared with known tritium release points and diffusion calculations to determine if calculated concentrations could replace measure concentrations at the monitoring stations. Daily tritium concentrations were monitored at 8 stations and 16 possible receptors. Automated data retrieval strategies are listed. (PSB)

  10. Data base to compare calculations and observations

    International Nuclear Information System (INIS)

    Tichler, J.L.

    1985-01-01

    Meteorological and climatological data bases were compared with known tritium release points and diffusion calculations to determine if calculated concentrations could replace measure concentrations at the monitoring stations. Daily tritium concentrations were monitored at 8 stations and 16 possible receptors. Automated data retrieval strategies are listed

  11. Cloud Based Earth Observation Data Exploitation Platforms

    Science.gov (United States)

    Romeo, A.; Pinto, S.; Loekken, S.; Marin, A.

    2017-12-01

    In the last few years data produced daily by several private and public Earth Observation (EO) satellites reached the order of tens of Terabytes, representing for scientists and commercial application developers both a big opportunity for their exploitation and a challenge for their management. New IT technologies, such as Big Data and cloud computing, enable the creation of web-accessible data exploitation platforms, which offer to scientists and application developers the means to access and use EO data in a quick and cost effective way. RHEA Group is particularly active in this sector, supporting the European Space Agency (ESA) in the Exploitation Platforms (EP) initiative, developing technology to build multi cloud platforms for the processing and analysis of Earth Observation data, and collaborating with larger European initiatives such as the European Plate Observing System (EPOS) and the European Open Science Cloud (EOSC). An EP is a virtual workspace, providing a user community with access to (i) large volume of data, (ii) algorithm development and integration environment, (iii) processing software and services (e.g. toolboxes, visualization routines), (iv) computing resources, (v) collaboration tools (e.g. forums, wiki, etc.). When an EP is dedicated to a specific Theme, it becomes a Thematic Exploitation Platform (TEP). Currently, ESA has seven TEPs in a pre-operational phase dedicated to geo-hazards monitoring and prevention, costal zones, forestry areas, hydrology, polar regions, urban areas and food security. On the technology development side, solutions like the multi cloud EO data processing platform provides the technology to integrate ICT resources and EO data from different vendors in a single platform. In particular it offers (i) Multi-cloud data discovery, (ii) Multi-cloud data management and access and (iii) Multi-cloud application deployment. This platform has been demonstrated with the EGI Federated Cloud, Innovation Platform Testbed Poland

  12. Impact of regulatory spin of pioglitazone on prescription of antidiabetic drugs among physicians in India: A multicentre questionnaire-based observational study

    Directory of Open Access Journals (Sweden)

    Aman Goyal

    2017-01-01

    Interpretation & conclusions: Majority of the physicians though were aware of the regulatory changes with regard to pioglitazone, but their prescribing patterns were not changed for this drug. However, it was being used at lower than the recommended dose. There is a need for generating more evidence through improved pharmacovigilance activities and large-scale population-based prospective studies regarding the safety issues of pioglitazone, so as to make effectual risk-benefit analysis for its continual use in T2DM.

  13. Effects of Aerosol on Cloud Liquid Water Path: Statistical Method a Potential Source for Divergence in Past Observation Based Correlative Studies

    Directory of Open Access Journals (Sweden)

    Ousmane Sy Savane

    2015-03-01

    Full Text Available Studies show a divergence in correlation between aerosol and cloud proxies, which has been thought of in the past as the results of varying physical mechanisms. Though modeling studies have supported this idea, from an observational standpoint it is difficult to attribute with confidence the correlations to specific physical mechanisms. We explore a methodology to assess the correlation between cloud water path and aerosol optical depth using Moderate-resolution Imaging Spectroradiometer (MODIS Aqua retrieved aerosol and cloud properties for absorbing and non-absorbing aerosol types over land and over the Atlantic Ocean for various meteorological conditions. The data covers a three-month period, June through August, during which different aerosol types are predominant in specific regions. Our approach eliminates outliers; sorts the data into aerosol bins; and the mean Aerosol Optical Depth (AOD value for each bin and the corresponding mean Cloud Water Path (CWP value are determined. The mean CWP is plotted against the mean AOD. The response curve for all aerosol types shows a peak CWP value corresponding to an aerosol loading value AODpeak. The peak is used to divide the total range of aerosol loading into two sub ranges. For AOD value below AODpeak, mean CWP and mean AOD are positively correlated. The correlation between mean CWP and mean AOD is negative for aerosol loading above AODpeak. Irrespective of aerosol type, atmospheric water vapor content and lower tropospheric static stability, the peak observed for each aerosol type seems to describe a universal feature that calls for further investigation. It has been observed for a variety of geographical locations and different seasons.

  14. Pregnancy physiology pattern prediction study (4P study): protocol of an observational cohort study collecting vital sign information to inform the development of an accurate centile-based obstetric early warning score.

    Science.gov (United States)

    Kumar, Fiona; Kemp, Jude; Edwards, Clare; Pullon, Rebecca M; Loerup, Lise; Triantafyllidis, Andreas; Salvi, Dario; Gibson, Oliver; Gerry, Stephen; MacKillop, Lucy H; Tarassenko, Lionel; Watkinson, Peter J

    2017-09-01

    Successive confidential enquiries into maternal deaths in the UK have identified an urgent need to develop a national early warning score (EWS) specifically for pregnant or recently pregnant women to aid more timely recognition, referral and treatment of women who are developing life-threatening complications in pregnancy or the puerperium. Although many local EWS are in use in obstetrics, most have been developed heuristically. No current obstetric EWS has defined the thresholds at which an alert should be triggered using evidence-based normal ranges, nor do they reflect the changing physiology that occurs with gestation during pregnancy. An observational cohort study involving 1000 participants across three UK sites in Oxford, London and Newcastle. Pregnant women will be recruited at approximately 14 weeks' gestation and have their vital signs (heart rate, blood pressure, respiratory rate, oxygen saturation and temperature) measured at 4 to 6-week intervals during pregnancy. Vital signs recorded during labour and delivery will be extracted from hospital records. After delivery, participants will measure and record their own vital signs daily for 2 weeks. During the antenatal and postnatal periods, vital signs will be recorded on an Android tablet computer through a custom software application and transferred via mobile internet connection to a secure database. The data collected will be used to define reference ranges of vital signs across normal pregnancy, labour and the immediate postnatal period. This will inform the design of an evidence-based obstetric EWS. The study has been approved by the NRES committee South East Coast-Brighton and Sussex (14/LO/1312) and is registered with the ISRCTN (10838017). All participants will provide written informed consent and can withdraw from the study at any point. All data collected will be managed anonymously. The findings will be disseminated in international peer-reviewed journals and through research conferences.

  15. Studies of Solar Flare and Interplanetary Particle Acceleration and Coordination of Ground-Based Solar Observations in Support of US and International Space Missions

    Science.gov (United States)

    Kiplinger, Alan L.

    1998-01-01

    A primary focus has been to conduct studies of particular types of hard X-ray evolution in solar flares and their associations with high energy interplanetary protons observed near Earth. Previously, two large investigations were conducted that revealed strong associations between episodes of progressive spectral hardening seen in solar events and interplanetary proton events (Kiplinger, 1995). An algorithm was developed for predicting interplanetary protons that is more accurate than those currently in use when hard X-ray spectra are available. The basic research on a third study of the remaining independent subset of Hard X-ray Burst Spectrometer (HXRBS) events randomly not selected by the original studies was completed. This third study involves independent analyses of the data by two analysts. The results echo the success of the earlier studies. Of 405 flares analyzed, 12 events were predicted to have associated interplanetary protons at the Space Environment Service Center (SESC) level. Of these, five events appear to be directly associated with SESC proton events, six other events had lower level associated proton events, and there was only one false alarm with no protons. Another study by Garcia and Kiplinger (1995) established that progressively hardening hard X-ray flares associated with interplanetary proton events are intrinsically cooler and not extremely intense in soft X-rays unless a "contaminating" large impulsive flare accompanies the hardening flare.

  16. Direct observation of the substitution effects on the hydrogen bridge dynamics in selected Schiff bases--a comparative molecular dynamics study.

    Science.gov (United States)

    Jezierska-Mazzarello, Aneta; Panek, Jarosław J; Vuilleumier, Rodolphe; Koll, Aleksander; Ciccotti, Giovanni

    2011-01-21

    We have studied substituent effects on the properties of the intramolecular hydrogen bond of some ortho-hydroxy Schiff bases using density functional theory (DFT) based first-principle molecular dynamics (FPMD) and path integral molecular dynamics. The studied compounds possess a strong intramolecular hydrogen bond (r((O⋅⋅⋅N)) ≤ 2.6 Å), which can be tuned by substitution to either (i) enhance the basicity of the acceptor moiety by induction effects or (ii) decrease the hydrogen bond length through steric repulsion. DFT calculations and FPMD were employed to investigate structural and dynamical properties of the selected molecules, while quantum effects on the structural properties were assessed using path integral FPMD. The simulations were performed in vacuo and in the solid state to study the influence of the environment on the hydrogen bond and spectroscopic properties. We give computational support to the suggestion that induction effects are less effective to tune the intramolecular hydrogen bond properties of the discussed ortho-hydroxy Schiff bases than the steric or the environmental effects.

  17. Risk factors for surgical site infections among 1,772 patients operated on for lumbar disc herniation: a multicentre observational registry-based study.

    Science.gov (United States)

    Habiba, Samer; Nygaard, Øystein P; Brox, Jens I; Hellum, Christian; Austevoll, Ivar M; Solberg, Tore K

    2017-06-01

    There are no previous studies evaluating risk factors for surgical site infections (SSIs) and the effectiveness of prophylactic antibiotic treatment (PAT), specifically for patients operated on for lumbar disc herniation. This observational multicentre study comprises a cohort of 1,772 consecutive patients operated on for lumbar disc herniation without laminectomy or fusion at 23 different surgical units in Norway. The patients were interviewed about SSIs according to a standardised questionnaire at 3 months' follow-up. Three months after surgery, 2.3% of the patients had an SSI. Only no PAT (OR = 5.3, 95% CI = 2.2-12.7, pdisc herniation. Senior surgeons assisting inexperienced colleagues to avoid prolonged duration of surgery could also reduce the occurrence of SSI.

  18. New analysis tools for observational studies

    NARCIS (Netherlands)

    Landewé, R. B. M.

    2015-01-01

    Observational studies, which are very common in rheumatology, usually follow a selected group of patients for a predetermined period of time, or infinitely, with regard to a certain outcome. Such an outcome could be a "score" reflecting an important aspect of the disease (e.g., a disease activity

  19. How labour intensive is a doctor-based delivery model for antiretroviral treatment (ART)? Evidence from an observational study in Siem Reap, Cambodia.

    Science.gov (United States)

    Van Damme, Wim; Kheang, Soy Ty; Janssens, Bart; Kober, Katharina

    2007-05-01

    Funding for scaling-up antiretroviral treatment (ART) in low-income countries has increased substantially, but the lack of human resources for health (HRH) is increasingly being identified as an important constraint for scaling-up ART. In a clinic run by Médecins Sans Frontières in Siem Reap, Cambodia, we documented the use of doctor-time for ART in September 2004 and in August 2005, for different phases in ART (pre-ART, ART initiation, ART follow-up Year 1, & ART follow-up Year 2). Based on these observations and using a variety of assumptions for survival of patients on ART (between 90 and 95% annually) and for further reductions in doctor-time per patient (between 0 and 10% annually), we estimated the need for doctors for the period 2004 till 2013 in the Siem Reap clinic, and in a hypothetical district in sub-Saharan Africa. In the Siem Reap clinic, we found that from 2004 to 2005 the doctor-time needed per patient was reduced by between 14% and 33%, thanks to a reduction in number of visits per patient and shorter consultation times. In 2004, 2.06 full-time equivalent (FTE) doctors were needed for 522 patients on ART, and in 2005 this was slightly reduced to 1.97 FTE doctors for 911 patients on ART. By 2013, Siem Reap clinic will need between 2 and 5 FTE doctors for ART. In a district in sub-Saharan Africa with 200,000 inhabitants and 20% adult HIV prevalence, using a similar doctor-based ART delivery model, between 4 and 11 FTE doctors would be needed to cover 50% of ART needs. ART is labour intensive. Important reductions in doctor-time per patient can be realized during scaling-up. The doctor-based ART delivery model analysed seems adequate for Cambodia. However, for many districts in sub-Saharan Africa a doctor-based ART delivery model may be incompatible with their HRH constraints.

  20. How labour intensive is a doctor-based delivery model for antiretroviral treatment (ART? Evidence from an observational study in Siem Reap, Cambodia

    Directory of Open Access Journals (Sweden)

    Janssens Bart

    2007-05-01

    Full Text Available Abstract Background Funding for scaling-up antiretroviral treatment (ART in low-income countries has increased substantially, but the lack of human resources for health (HRH is increasingly being identified as an important constraint for scaling-up ART. Methods In a clinic run by Médecins Sans Frontières in Siem Reap, Cambodia, we documented the use of doctor-time for ART in September 2004 and in August 2005, for different phases in ART (pre-ART, ART initiation, ART follow-up Year 1, & ART follow-up Year 2. Based on these observations and using a variety of assumptions for survival of patients on ART (between 90 and 95% annually and for further reductions in doctor-time per patient (between 0 and 10% annually, we estimated the need for doctors for the period 2004 till 2013 in the Siem Reap clinic, and in a hypothetical district in sub-Saharan Africa. Results In the Siem Reap clinic, we found that from 2004 to 2005 the doctor-time needed per patient was reduced by between 14% and 33%, thanks to a reduction in number of visits per patient and shorter consultation times. In 2004, 2.06 full-time equivalent (FTE doctors were needed for 522 patients on ART, and in 2005 this was slightly reduced to 1.97 FTE doctors for 911 patients on ART. By 2013, Siem Reap clinic will need between 2 and 5 FTE doctors for ART. In a district in sub-Saharan Africa with 200,000 inhabitants and 20% adult HIV prevalence, using a similar doctor-based ART delivery model, between 4 and 11 FTE doctors would be needed to cover 50% of ART needs. Conclusion ART is labour intensive. Important reductions in doctor-time per patient can be realized during scaling-up. The doctor-based ART delivery model analysed seems adequate for Cambodia. However, for many districts in sub-Saharan Africa a doctor-based ART delivery model may be incompatible with their HRH constraints.

  1. Different responses of northern and southern high latitude ionospheric convection to IMF rotations: a case study based on SuperDARN observations

    Directory of Open Access Journals (Sweden)

    D. Ambrosino

    2009-06-01

    Full Text Available We use SuperDARN data to study high-latitude ionospheric convection over a three hour period (starting at 22:00 UT on 2 January 2003, during which the Interplanetary Magnetic Field (IMF flipped between two states, one with By>>|Bz| and one with Bz>0, both with negative Bx. We find, as expected from previous works, that day side ionospheric convection is controlled by the IMF in both hemispheres. For strongly northward IMF, we observed signatures of two reverse cells, both in the Northern Hemisphere (NH and in the Southern Hemisphere (SH, due to lobe reconnection. On one occasion, we also observed in the NH two viscous cells at the sides of the reverse cell pair. For duskward IMF, we observed in the NH a large dusk clockwise cell, accompanied by a smaller dawn cell, and the signature of a corresponding pattern in the SH. On two occasions, a three cell pattern, composed of a large clockwise cell and two viscous cells, was observed in the NH. As regards the timings of the NH and SH convection reconfigurations, we find that the convection reconfiguration from a positive Bz dominated to a positive By dominated pattern occurred almost simultaneously (i.e. within a few minutes in the two hemispheres. On the contrary, the reconfiguration from a By dominated to a northward IMF pattern started in the NH 8–13 min earlier than in the SH. We suggest that part of such a delay can be due to the following mechanism: as IMF Bx<0, the northward-tailward magnetosheath magnetic field reconnects with the magnetospheric field first tailward of the northern cusp and later on tailward of the southern cusp, due to the IMF draping around the magnetopause.

  2. Long-term follow-up after epilepsy surgery in infancy and early childhood--a prospective population based observational study.

    Science.gov (United States)

    Reinholdson, Jesper; Olsson, Ingrid; Edelvik, Anna; Hallböök, Tove; Lundgren, Johan; Rydenhag, Bertil; Malmgren, Kristina

    2015-08-01

    To describe 2-year and long-term outcomes (five or ten years) after resective epilepsy surgery in children operated before the age of four years. This prospective, population based, longitudinal study is based on data from the Swedish National Epilepsy Surgery Register 1995-2010. The following variables were analysed: seizure frequency, antiepileptic drug treatment (AED), neurological deficits, type of operation, histopathological diagnosis and perioperative complications. During the study period 47 children under four years had resective surgery. A majority had seizure onset within the first year of life, and the median age at surgery was two years and one month. Two thirds had neurodevelopmental abnormalities. Temporal lobe resection, frontal lobe resection and hemispherotomy predominated. A majority had malformations of cortical development. There was one major perioperative complication. At the 2-year follow-up, 21/47 children (45%) were seizure free, eight of whom were off medication. At the long-term follow-up, 16/32 (50%) were seizure-free and 11 of them off medication. Another ten (31%) had ≥75% reduction in seizure frequency. Fourteen children (44%) had sustained seizure freedom from surgery to the long-term follow-up. This is the first prospective, population based, longitudinal study to show that a favourable seizure outcome is achievable in a majority of infants and young children undergoing resective epilepsy surgery and that the improvements are consistent over time. Many can also stop taking AEDs. The findings emphasise the importance of early referral to epilepsy surgery evaluation in cases of medically intractable epilepsy in infants and young children. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  3. Dose-response association of screen time-based sedentary behaviour in children and adolescents and depression: a meta-analysis of observational studies.

    Science.gov (United States)

    Liu, Mingli; Wu, Lang; Yao, Shuqiao

    2016-10-01

    Depression represents a growing public health burden. Understanding how screen time (ST) in juveniles may be associated with risk of depression is critical for the development of prevention and intervention strategies. Findings from studies addressing this question thus far have been inconsistent. Therefore, we conducted a comprehensive systematic review and meta-analysis of data related to this question. The meta-analysis was conducted in accordance with the PRISMA guideline. We searched the electronic databases of PubMed, Web of Science and EBSCO systematically (up to 6 May 2015). OR was adopted as the pooled measurement of association between ST and depression risk. Dose-response was estimated by a generalised least squares trend estimation. Twelve cross-sectional studies and four longitudinal studies (including 1 cohort study) involving a total of 127 714 participants were included. Overall, higher ST in preadolescent children and adolescents was significantly associated with a higher risk of depression (OR=1.12; 95% CI 1.03 to 1.22). Screen type, age, population and reference category acted as significant moderators. Compared with the reference group who had no ST, there was a non-linear dose-response association of ST with a decreasing risk of depression at ST<2 h/day, with the lowest risk being observed for 1 h/day (OR=0.88; 95% CI 0.84 to 0.93). Our meta-analysis suggests that ST in children and adolescents is associated with depression risk in a non-linear dose-response manner. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies

    OpenAIRE

    von Elm, Erik; Altman, Douglas G; Egger, Matthias; Pocock, Stuart J; Gøtzsche, Peter C; Vandenbroucke, Jan P

    2014-01-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study’s generalizability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-contro...

  5. Ozone Lidar Observations for Air Quality Studies

    Science.gov (United States)

    Wang, Lihua; Newchurch, Mike; Kuang, Shi; Burris, John F.; Huang, Guanyu; Pour-Biazar, Arastoo; Koshak, William; Follette-Cook, Melanie B.; Pickering, Kenneth E.; McGee, Thomas J.; hide

    2015-01-01

    Tropospheric ozone lidars are well suited to measuring the high spatio-temporal variability of this important trace gas. Furthermore, lidar measurements in conjunction with balloon soundings, aircraft, and satellite observations provide substantial information about a variety of atmospheric chemical and physical processes. Examples of processes elucidated by ozone-lidar measurements are presented, and modeling studies using WRF-Chem, RAQMS, and DALES/LES models illustrate our current understanding and shortcomings of these processes.

  6. A phantom-based JAFROC observer study of two CT reconstruction methods: the search for optimisation of lesion detection and effective dose

    Science.gov (United States)

    Thompson, John D.; Chakraborty, Dev P.; Szczepura, Katy; Vamvakas, Ioannis; Tootell, Andrew; Manning, David J.; Hogg, Peter

    2015-03-01

    Purpose: To investigate the dose saving potential of iterative reconstruction (IR) in a computed tomography (CT) examination of the thorax. Materials and Methods: An anthropomorphic chest phantom containing various configurations of simulated lesions (5, 8, 10 and 12mm; +100, -630 and -800 Hounsfield Units, HU) was imaged on a modern CT system over a tube current range (20, 40, 60 and 80mA). Images were reconstructed with (IR) and filtered back projection (FBP). An ATOM 701D (CIRS, Norfolk, VA) dosimetry phantom was used to measure organ dose. Effective dose was calculated. Eleven observers (15.11+/-8.75 years of experience) completed a free response study, localizing lesions in 544 single CT image slices. A modified jackknife alternative free-response receiver operating characteristic (JAFROC) analysis was completed to look for a significant effect of two factors: reconstruction method and tube current. Alpha was set at 0.05 to control the Type I error in this study. Results: For modified JAFROC analysis of reconstruction method there was no statistically significant difference in lesion detection performance between FBP and IR when figures-of-merit were averaged over tube current (F(1,10)=0.08, p = 0.789). For tube current analysis, significant differences were revealed between multiple pairs of tube current settings (F(3,10) = 16.96, pConclusion: The free-response study suggests that lesion detection can be optimized at 40mA in this phantom model, a measured effective dose of 0.97mSv. In high-contrast regions the diagnostic value of IR, compared to FBP, is less clear.

  7. An observational study on the outcome after surgery for lumbar disc herniation in adolescents compared with adults based on the Swedish Spine Register.

    Science.gov (United States)

    Lagerbäck, Tobias; Elkan, Peter; Möller, Hans; Grauers, Anna; Diarbakerli, Elias; Gerdhem, Paul

    2015-06-01

    Disc-related sciatica has a prevalence of about 2% in adults, but is rare in adolescents. If conservative treatment is unsuccessful, surgery is an option. The aim of this study was to compare the outcomes of surgery for lumbar disc herniation in adolescents with adults in the Swedish Spine Register. This is a prospective observational study: National Quality Register. This study included 151 patients, 18 years or younger, 4,386 patients, 19-39 years, and 6,078 patients, 40 years or older, followed for 1-2 years after surgery. The primary outcomes were patient satisfaction and global assessment of leg and back pain. Secondary outcomes were Visual Analog Scale (VAS) leg pain, VAS back pain, Oswestry disability index (ODI), and EuroQol-5 dimensions (EQ-5D). Statistical analyses were performed with the Welch F test, the chi-square test, and the Wilcoxon signed-rank test. At follow-up, 86% of the adolescents were satisfied compared with 78% in the younger adults and 76% in the older adults group (p<.001). According to the global assessment, significantly decreased leg pain was experienced by 87% of the adolescents, 78% of the younger adults, and 71% of the older adults (p<.001). Corresponding figures for back pain were 88%, 73%, and 70%, respectively (p<.001). All groups experienced significant postoperative improvement of VAS leg pain, VAS back pain, ODI, and EQ-5D (all p<.001). The adolescent age group was more satisfied with the treatment than the adult groups. There was a significant improvement in all age groups after surgery. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Effectiveness of a community-based program for suicide prevention among elders with early-stage dementia: A controlled observational study.

    Science.gov (United States)

    Kim, Jong-Pill; Yang, Jinhyang

    The purpose of this study was to develop a small-group-focused suicide prevention program for elders with early-stage dementia and to assess its effects. This was a quasi-experimental study with a control group pretest-posttest design. A total of 62 elders diagnosed with early-stage dementia who were receiving care services at nine daycare centers in J City Korea participated in this study. The experimental group participated in the suicide prevention program twice a week for 5 weeks with a pretest and two posttests The developed suicide prevention program had a significant effect on the perceived health status, social support, depression, and suicidal ideation of elders with early-stage dementia. Nurses should integrate risk factors such as depression and protective factors such as health status and social support into a suicide prevention program. This community-based program in geriatric nursing practice can be effective in preventing suicide among elders with early-stage dementia. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Non-uptake of facility-based maternity services in an inner-city community in Lagos, Nigeria: an observational study.

    Science.gov (United States)

    Olusanya, B O; Alakija, O P; Inem, V A

    2010-05-01

    Scaling-up of skilled attendants and facility-based services is necessary for improving maternal and child care in developing countries but their effectiveness is crucially influenced by the uptake of such services. This study set out to establish the pattern and uptake of maternity services and associated factors against the backdrop of rapid urbanization in Nigeria. A cross-sectional study of socio-demographic and obstetric characteristics of mothers attending the Bacille Calmette-Guérin (BCG) immunization clinics in inner-city Lagos was conducted from July 2005 to December 2007, and their association with non-hospital delivery and use of unskilled attendants was determined by multiple logistic regression analyses. Of the 6465 participants, over half (51.4%) delivered outside hospital facilities and 81.8% of this group had no skilled attendants at delivery. Non-hospital delivery or the presence of unskilled attendants at delivery was associated with teenage mothers, Muslim religion, low or middle social class and use of herbal drugs in pregnancy. Additionally, non-hospital delivery was associated with ethnicity (Yoruba tribe), lack of tertiary education or full-time employment, accommodation with shared sanitation facilities and multiparity. The results suggest that availability of and access/proximity to hospital facilities or skilled attendants is no guarantee of uptake of maternity services. Efforts aimed at improving maternal and child health in developing countries should take cognisance of the socio-demographic and cultural underpinnings of maternal health-seeking behaviour of urban mothers beyond the provision of facility-based services or strengthening of the existing health care systems.

  10. Does daily tobacco smoking affect outcomes after microdecompression for degenerative central lumbar spinal stenosis? - A multicenter observational registry-based study.

    Science.gov (United States)

    Gulati, Sasha; Nordseth, Trond; Nerland, Ulf S; Gulati, Michel; Weber, Clemens; Giannadakis, Charalampis; Nygaard, Øystein P; Solberg, Tore K; Solheim, Ole; Jakola, Asgeir S

    2015-07-01

    There are limited scientific data on the impact of smoking on patient-reported outcomes following minimally invasive spine surgery. The aim of this multicenter observational study was to examine the relationship between daily smoking and patient-reported outcome at 1 year using the Oswestry Disability Index (ODI) after microdecompression for single- and two-level central lumbar spinal stenosis (LSS). Secondary outcomes were the length of hospital stays, perioperative and postoperative complications. Data were collected through the Norwegian Registry for Spine Surgery (NORspine). A total of 825 patients were included (619 nonsmokers and 206 smokers). For the whole patient population there was a significant difference between preoperative ODI and ODI at 1 year (17.3 points, 95% CI 15.93-18.67, p Smoking was identified as a negative predictor for ODI change in a multiple regression analysis (p = 0.001) CONCLUSIONS: Nonsmokers experienced a significantly larger improvement at 1 year following microdecompression for LSS compared to smokers. Smokers were less likely to achieve a minimal clinically important difference. However, it should be emphasized that considerable improvement also was found among smokers.

  11. In-situ study of migration and transformation of nitrogen in groundwater based on continuous observations at a contaminated desert site

    Science.gov (United States)

    Zuo, Rui; Jin, Shuhe; Chen, Minhua; Guan, Xin; Wang, Jinsheng; Zhai, Yuanzheng; Teng, Yanguo; Guo, Xueru

    2018-04-01

    The objective of this study was to explore the controlling factors on the migration and transformation of nitrogenous wastes in groundwater using long-term observations from a contaminated site on the southwestern edge of the Tengger Desert in northwestern China. Contamination was caused by wastewater discharge rich in ammonia. Two long-term groundwater monitoring wells (Wells 1# and 2#) were constructed, and 24 water samples were collected. Five key indicators were tested: ammonia, nitrate, nitrite, dissolved oxygen, and manganese. A numerical method was used to simulate the migration process and to determine the migration stage of the main pollutant plume in groundwater. The results showed that at Well 1# the nitrogenous waste migration process had essentially been completed, while at Well 2# ammonia levels were still rising and gradually transitioning to a stable stage. The differences for Well 1# and Well 2# were primarily caused by differences in groundwater flow. The change in ammonia concentration was mainly controlled by the migration of the pollution plume under nitrification in groundwater. The nitrification rate was likely affected by changes in dissolved oxygen and potentially manganese.

  12. Relationship between ambient temperature and frequency and severity of cardiovascular emergencies: A prospective observational study based on out-of-hospital care data.

    Science.gov (United States)

    Hensel, Mario; Stuhr, Markus; Geppert, Daniel; Kersten, Jan F; Lorenz, Jürgen; Kerner, Thoralf

    2017-02-01

    To test the hypothesis that more cardiovascular emergencies occur at low rather than at high temperatures under moderate climatic conditions. This was a prospective observational study performed in a prehospital setting. Data from the Emergency Medical Service in Hamburg (Germany) and from the local weather station were evaluated over a 5-year period. Temperature data were matched with the associated rescue mission data. Lowess-Regression analysis was performed to assess the relationship between the temperature and the frequency of individual cardiovascular emergencies. In addition, three threshold-temperatures (0°C, 10°C, 20°C) were defined in order to determine the frequency of cardiovascular emergencies above and below each cut-off value. The severity of emergencies was assessed using the National Advisory Committee for Aeronautics (NACA) scoring system. A total of 35,390 cardiovascular emergencies were treated by Emergency Physicians. Transient Loss of Consciousness increased at high temperatures (above 20°C): +43% (95%-CI: [27%; 59%]). In contrast, Coronary Artery Disease +26% (95%-CI: [17%; 34%]), Cardiac Pulmonary Edema +21% (95%-CI: [14%; 27%]), Hypertensive Urgency +18% (95%-CI: [10%; 25%]) and Cerebrovascular Accident +17% (95%-CI: [8%; 24%]) increased at low temperatures, particularly below 10°C (significance level for all: pcardiovascular emergencies such as Coronary Artery Disease, Cardiac Pulmonary Edema, Hypertensive Urgency and Cerebrovascular Accident are more frequent in low temperatures even under mild climatic conditions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Sex-differential effects of diphtheria-tetanus-pertussis vaccine for the outcome of paediatric admissions? A hospital based observational study from Guinea-Bissau

    DEFF Research Database (Denmark)

    Andersen, Annemette; Bjerregaard-Andersen, Morten; Rodrigues, Amabelia

    2017-01-01

    Background: In spite of protection against the targeted infections, a large volume of observational data indicates that diphtheria-tetanus-pertussis (DTP) vaccine may have a negative impact on overall childhood mortality in low-income countries, especially in girls. Methods: In an observational...

  14. Does present use of cardiovascular medication reflect elevated cardiovascular risk scores estimated ten years ago? A population based longitudinal observational study

    Directory of Open Access Journals (Sweden)

    Straand Jørund

    2011-03-01

    Full Text Available Abstract Background It is desirable that those at highest risk of cardiovascular disease should have priority for preventive measures, eg. treatment with prescription drugs to modify their risk. We wanted to investigate to what extent present use of cardiovascular medication (CVM correlates with cardiovascular risk estimated by three different risk scores (Framingham, SCORE and NORRISK ten years ago. Methods Prospective logitudinal observational study of 20 252 participants in The Hordaland Health Study born 1950-57, not using CVM in 1997-99. Prescription data obtained from The Norwegian Prescription Database in 2008. Results 26% of men and 22% of women aged 51-58 years had started to use some CVM during the previous decade. As a group, persons using CVM scored significantly higher on the risk algorithms Framingham, SCORE and NORRISK compared to those not treated. 16-20% of men and 20-22% of women with risk scores below the high-risk thresholds for the three risk scores were treated with CVM, while 60-65% of men and 25-45% of women with scores above the high-risk thresholds received no treatment. Among women using CVM, only 2.2% (NORRISK, 4.4% (SCORE and 14.5% (Framingham had risk scores above the high-risk values. Low education, poor self-reported general health, muscular pains, mental distress (in females only and a family history of premature cardiovascular disease correlated with use of CVM. Elevated blood pressure was the single factor most strongly predictive of CVM treatment. Conclusion Prescription of CVM to middle-aged individuals by large seems to occur independently of estimated total cardiovascular risk, and this applies especially to females.

  15. The role of general psychosocial factors for the use of cancer screening-Findings of a population-based observational study among older adults in Germany.

    Science.gov (United States)

    Hajek, André; Bock, Jens-Oliver; König, Hans-Helmut

    2017-12-01

    Within the framework of the health-belief model, some studies exist investigating the association between illness-specific psychosocial factors and the use of cancer screenings. However, studies investigating the association between general psychosocial factors and the use of cancer screenings are missing. Thus, this study aimed at examining the association between well-established general psychosocial factors and the use of cancer screenings. Data were gathered from a large, population-based sample of community-dwelling individuals aged 40 and above in Germany (n = 7673; in 2014). Loneliness, cognitive well-being, affective well-being (negative and positive affect), optimism, self-efficacy, self-esteem, self-regulation, perceived autonomy, perceived stress, and perceived social exclusion were used as general psychosocial factors. Furthermore, individuals were asked whether they regularly underwent early cancer screening in the past years (yes; no). A total of 65.6% of the individuals used cancer screening. Adjusting for sociodemographic factors, self-rated health, morbidity and lifestyle factors, multiple logistic regressions revealed that the use of cancer screening is positively associated with decreased loneliness, cognitive well-being, optimism, self-efficacy, self-esteem, self-regulation, perceived autonomy, decreased perceived stress, decreased perceived social exclusion, and positive affect, while it is not associated with negative affect. This study stresses the strong association between general psychosocial factors and the use of cancer screening. This knowledge might be fruitful to address individuals at risk for underuse. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  16. The NOAA Satellite Observing System Architecture Study

    Science.gov (United States)

    Volz, Stephen; Maier, Mark; Di Pietro, David

    2016-01-01

    NOAA is beginning a study, the NOAA Satellite Observing System Architecture (NSOSA) study, to plan for the future operational environmental satellite system that will follow GOES and JPSS, beginning about 2030. This is an opportunity to design a modern architecture with no pre-conceived notions regarding instruments, platforms, orbits, etc. The NSOSA study will develop and evaluate architecture alternatives to include partner and commercial alternatives that are likely to become available. The objectives will include both functional needs and strategic characteristics (e.g., flexibility, responsiveness, sustainability). Part of this study is the Space Platform Requirements Working Group (SPRWG), which is being commissioned by NESDIS. The SPRWG is charged to assess new or existing user needs and to provide relative priorities for observational needs in the context of the future architecture. SPRWG results will serve as input to the process for new foundational (Level 0 and Level 1) requirements for the next generation of NOAA satellites that follow the GOES-R, JPSS, DSCOVR, Jason-3, and COSMIC-2 missions.

  17. Safety and tolerability of tigecycline for the treatment of complicated skin and soft-tissue and intra-abdominal infections: an analysis based on five European observational studies.

    Science.gov (United States)

    Guirao, Xavier; Sánchez García, Miguel; Bassetti, Matteo; Bodmann, Klaus Friedrich; Dupont, Hervé; Montravers, Philippe; Heizmann, Wolfgang R; Capparella, Maria Rita; Simoneau, Damien; Eckmann, Christian

    2013-07-01

    Tigecycline is approved for the treatment of complicated skin and soft-tissue infections (cSSTIs) and complicated intra-abdominal infections (cIAIs) in adults. In this analysis the safety and tolerability profile of tigecycline (used alone or in combination) for the treatment of patients with approved indications of cSSTI and cIAI were examined under real-life clinical conditions. Individual patient-level data were pooled from five European observational studies (July 2006 to October 2011). A total of 254 cSSTI and 785 cIAI patients were included. The mean age was 63 years; 34.4% and 56.6% were in intensive care units, 90.9% and 88.1% had at least one comorbidity and mean Acute Physiology and Chronic Health Evaluation (APACHE) II scores at the beginning of treatment were 15.0 ± 7.9 and 16.9 ± 7.6, respectively. Data on adverse events (AEs) were available for 198 cSSTI and 590 cIAI patients in three studies. Nausea and vomiting were reported in ≤ 2% of patients. The most common serious AEs were multi-organ failure (4.0% and 10.0% in cSSTI and cIAI patients, respectively) and sepsis (4.0% and 6.1%, respectively). Death was recorded for 24/254 (9.4%) cSSTI and 147/785 (18.7%) cIAI patients. Mortality rates were higher in the group with a baseline APACHE II score of >15 compared with those with a score of ≤ 15 (18.7% versus 3.5% for cSSTI patients and 23.8% versus 16.0% for cIAI patients). A similar trend was seen when cIAI patients were stratified by Sequential Organ Failure Assessment (SOFA) score. The safety and tolerability of tigecycline, alone and in combination, are consistent with the level of critical illness among patients in these real-life studies.

  18. Shooting history and presence of high-frequency hearing impairment in swedish hunters: A cross-sectional internet-based observational study.

    Science.gov (United States)

    Honeth, Louise; Ström, Peter; Ploner, Alexander; Bagger-Sjöbäck, Dan; Rosenhall, Ulf; Nyrén, Olof

    2015-01-01

    The aim of this cross-sectional study among Swedish hunters was to examine the association between shooting history and presence of high-frequency hearing impairment (HFHI). All hunters registered with an e-mail address in the membership roster of the Swedish Hunters' Association were invited via e-mail to a secure website with a questionnaire and an Internet-based audiometry test. Associations, expressed as prevalence ratio (PR), were multivariately modelled using Poisson regression. The questionnaire was answered by 1771 hunters (age 11-91 years), and 202 of them also completed the audiometry test. Subjective severe hearing loss was reported by 195/1771 (11%), while 23/202 (11%) exhibited HFHI upon testing with Internet-based audiometry. As many as 328/1771 (19%) had never used hearing protection during hunting. In the preceding 5 years, 785/1771 (45%), had fired >6 unprotected gunshots with hunting rifle calibers. The adjusted PR of HFHI when reporting 1-6 such shots, relative to 0, was 1.5 [95% confidence interval (CI) 1.1-2.1; P = 0.02]. We could not verify any excessive HFHI prevalence among 89 hunters reporting unprotected exposure to such gunshot noise >6 times. Nor did the total number of reported rifle shots seem to matter. These findings support the notion of a wide variation in individual susceptibility to impulse noise; that significant sound energy, corresponding to unprotected noise from hunting rifle calibers, seems to be required; that susceptible individuals may sustain irreversible damage to the inner ear from just one or a few shots; and that use of hearing protection should be encouraged from the first shot with such weapons.

  19. General practice variation in spirometry testing among patients receiving first-time prescriptions for medication targeting obstructive lung disease in Denmark: a population-based observational study.

    Science.gov (United States)

    Koefoed, Mette M; Søndergaard, Jens; Christensen, René dePont; Jarbøl, Dorte E

    2013-08-07

    Spirometry testing is essential to confirm an obstructive lung disease, but studies have reported that a large proportion of patients diagnosed with COPD or asthma have no history of spirometry testing. Also, it has been shown that many patients are prescribed medication for obstructive lung disease without a relevant diagnosis or spirometry test registered. General practice characteristics have been reported to influence diagnosis and management of several chronic diseases. However, these findings are inconsistent, and it is uncertain whether practice characteristics influence spirometry testing among patients receiving medication for obstructive lung disease. The aim of this study was therefore to examine if practice characteristics are associated with spirometry testing among patients receiving first-time prescriptions for medication targeting obstructive lung disease. A national register-based cohort study was performed. All patients over 18 years receiving first-time prescriptions for medication targeting obstructive lung disease in 2008 were identified and detailed patient-specific data on sociodemographic status and spirometry tests were extracted. Information on practice characteristics like number of doctors, number of patients per doctor, training practice status, as well as age and gender of the general practitioners was linked to each medication user. Partnership practices had a higher odds ratio (OR) of performing spirometry compared with single-handed practices (OR 1.24, CI 1.09-1.40). We found a significant association between increasing general practitioner age and decreasing spirometry testing. This tendency was most pronounced among partnership practices, where doctors over 65 years had the lowest odds of spirometry testing (OR 0.25, CI 0.10-0.61). Training practice status was significantly associated with spirometry testing among single-handed practices (OR 1.40, CI 1.10-1.79). Some of the variation in spirometry testing among patients receiving

  20. Hospitalisation with community-acquired pneumonia among patients with type 2 diabetes: an observational population-based study in Spain from 2004 to 2013

    Science.gov (United States)

    López-de-Andrés, Ana; de Miguel-Díez, Javier; Jiménez-Trujillo, Isabel; Hernández-Barrera, Valentín; de Miguel-Yanes, José M; Méndez-Bailón, Manuel; Pérez-Farinós, Napoleón; Salinero-Fort, Miguel Á ngel; Jiménez-García, Rodrigo

    2017-01-01

    Objectives To describe trends in the incidence and outcomes of community-acquired pneumonia (CAP) hospitalisations among patients with or without diabetes in Spain (2004–2013). Design Retrospective, observational study using the Spanish National Hospital Discharge Database (Conjunto Mínimo Básico de Datos (CMBD)). Setting Spain. Participants We used national hospital discharge data to select all hospital admissions for CAP. Main outcome measures Incidence was calculated overall and stratified by diabetes status: type 2 diabetes mellitus (T2DM) and no diabetes. Results We identified 901 136 admissions for CAP (24.8% with T2DM). Incidence rates of CAP increased significantly in patients with T2DM over time. The incidence was higher among people with T2DM for all time periods. Patients with T2DM were older and had higher comorbidity index than non-diabetics. Streptococcus pneumoniae decreased over time for both groups. Time trend analyses showed significant decreases in mortality during admission for CAP for patients with and without T2DM. Factors associated with higher mortality in both groups included: older age, higher comorbidity, mechanical ventilation, red cell transfusion, readmission and Staphylococcus aureus detection. Diabetes was associated with a lower in-hospital mortality (OR 0.92, 95% CI 0.91 to 0.94) after a CAP hospitalisation. Conclusions CAP incidence rates were higher and increased over time at a higher rate among patients with T2DM. Mortality decreased over time in all groups. The presence of diabetes is not a risk factor for death during admission for CAP. PMID:28057653

  1. A comparative hospital-based observational study of mono- and co-infections of malaria, dengue virus and scrub typhus causing acute undifferentiated fever.

    Science.gov (United States)

    Ahmad, S; Dhar, M; Mittal, G; Bhat, N K; Shirazi, N; Kalra, V; Sati, H C; Gupta, V

    2016-04-01

    Positive serology for dengue and/or scrub typhus infection with/without positive malarial smear (designated as mixed or co-infection) is being increasingly observed during epidemics of acute undifferentiated febrile illnesses (AUFIs). We planned to study the clinical and biochemical spectrum of co-infections with Plasmodium sp., dengue virus and scrub typhus and compare these with mono-infection by the same organisms. During the period from December 2012 to December 2013, all cases presenting with AUFIs to a single medical unit of a referral centre in Garhwal region of the north Indian state of Uttarakhand were retrospectively selected and categorised aetiologically as co-infections, malaria, dengue or scrub typhus. The groups thus created were compared in terms of demographic, clinical, biochemical and outcome parameters. The co-infection group (n = 49) was associated with milder clinical manifestations, fewer, milder and non-progressive organ dysfunction, and lesser need for intensive care, mechanical ventilation and dialysis as compared to mono-infections. When co-infections were sub-grouped and compared with the relevant mono-infections, there were differences in certain haematological and biochemical parameters; however, this difference did not translate into differential outcomes. Scrub typhus mono-infection was associated with severe disease in terms of both morbidity and mortality. Malaria, dengue and scrub typhus should be routinely tested in all patients with AUFIs. Co-infections, whether true or due to serological cross-reactivity, appear to be a separate entity so far as presentation and morbidity is concerned. Further insight is needed into the mechanism and identification of the protective infection.

  2. Model-based estimates of annual survival rate are preferable to observed maximum lifespan statistics for use in comparative life-history studies

    Science.gov (United States)

    Krementz, D.G.; Sauer, J.R.; Nichols, J.D.

    1989-01-01

    Estimates of longevity are available for many animals, and are commonly used in comparative life-history analyses. We suggest that annual survival rate is more appropriate life history parameter for most comparative life history analyses. Observed maximum longevities were not correlated with the annual survival rate estimates and appear to be unstable over time. We recommend that observed maximum lifespans not be used in life history analyses.

  3. Reduced pre-hospital and in-hospital survival rates after out-of-hospital cardiac arrest of patients with type-2 diabetes mellitus: an observational prospective community-based study

    NARCIS (Netherlands)

    van Hoeijen, Daniel A.; Blom, Marieke T.; Bardai, Abdennasser; Souverein, Patrick C.; de Boer, Anthonius; Tan, Hanno L.

    2015-01-01

    Out-of-hospital cardiac arrest (OHCA) remains a major cause of death. We aimed to determine whether type-2 diabetes mellitus (T2DM) is associated with reduced pre-hospital and in-hospital survival rates after OHCA. An observational community-based cohort study was performed among 1549 OHCA patients

  4. Reduced pre-hospital and in-hospital survival rates after out-of-hospital cardiac arrest of patients with type-2 diabetes mellitus : An observational prospective community-based study

    NARCIS (Netherlands)

    Van Hoeijen, Daniel A.; Blom, Marieke T.; Bardai, Abdennasser; Souverein, Patrick C.; De Boer, Anthonius; Tan, Hanno L.

    2015-01-01

    Aims Out-of-hospital cardiac arrest (OHCA) remains a major cause of death. We aimed to determine whether type-2 diabetes mellitus (T2DM) is associated with reduced pre-hospital and in-hospital survival rates after OHCA. Methods and results An observational community-based cohort study was performed

  5. Estimating Evapotranspiration Using an Observation Based Terrestrial Water Budget

    Science.gov (United States)

    Rodell, Matthew; McWilliams, Eric B.; Famiglietti, James S.; Beaudoing, Hiroko K.; Nigro, Joseph

    2011-01-01

    Evapotranspiration (ET) is difficult to measure at the scales of climate models and climate variability. While satellite retrieval algorithms do exist, their accuracy is limited by the sparseness of in situ observations available for calibration and validation, which themselves may be unrepresentative of 500m and larger scale satellite footprints and grid pixels. Here, we use a combination of satellite and ground-based observations to close the water budgets of seven continental scale river basins (Mackenzie, Fraser, Nelson, Mississippi, Tocantins, Danube, and Ubangi), estimating mean ET as a residual. For any river basin, ET must equal total precipitation minus net runoff minus the change in total terrestrial water storage (TWS), in order for mass to be conserved. We make use of precipitation from two global observation-based products, archived runoff data, and TWS changes from the Gravity Recovery and Climate Experiment satellite mission. We demonstrate that while uncertainty in the water budget-based estimates of monthly ET is often too large for those estimates to be useful, the uncertainty in the mean annual cycle is small enough that it is practical for evaluating other ET products. Here, we evaluate five land surface model simulations, two operational atmospheric analyses, and a recent global reanalysis product based on our results. An important outcome is that the water budget-based ET time series in two tropical river basins, one in Brazil and the other in central Africa, exhibit a weak annual cycle, which may help to resolve debate about the strength of the annual cycle of ET in such regions and how ET is constrained throughout the year. The methods described will be useful for water and energy budget studies, weather and climate model assessments, and satellite-based ET retrieval optimization.

  6. Validation of a Dutch version of the Actionable 8-item screening questionnaire for neurogenic bladder overactivity in multiple sclerosis: an observational web-based study.

    Science.gov (United States)

    Jongen, Peter Joseph; Blok, Bertil F M; Heesakkers, John P; Heerings, Marco; Lemmens, Wim A; Donders, Rogier

    2015-10-30

    In patients with multiple sclerosis (MS) the impact of urological symptoms on quality of life and daily activities is considerable. Yet, a substantial percentage of patients may not be urologically evaluated and thus fail to be treated concordantly. The 8-item Actionable questionnaire is a validated English screening tool for the detection of neurogenic bladder overactivity in MS. To enable the use of the 8-item Actionable in The Netherlands and Belgium we translated the questionnaire into the Dutch language and investigated the test-retest reliability and the concurrent validity of the Dutch version. The process of translating the English Actionable questionnaire into the Dutch language included forward translations and back-translations. Then, in an online observational study, MS patients completed the Dutch Actionable at Days 1 and 8, and the Multiple Sclerosis Quality of Life 54-Items (MSQoL-54) and Multiple Sclerosis Impact Profile (MSIP) questionnaires at Day 1; the Expanded Disability Status Scale (EDSS) score was assessed by phone at Day 1. For assessment of the test-retest reliability Pearson's correlation coefficient (r) between the Day 1 and Day 8 Actionable scores was calculated. For assessment of the concurrent validity r values were calculated between the Day 1 Actionable score and the EDSS score, the Physical and Mental MSQoL-54 composites, and the MSIP domain and symptom disability scores. N = 141 (106 female, 35 male) (80 relapsing remitting, 48 progressive, 13 unknown), mean age 47.8 (standard deviation [SD] 10.4) years, mean EDSS score 4.7 (SD 1.8); 137 patients completed the Day 8 assessment. Pearson's r between Actionable scores Day 1 and Day 8: 0.85 (P < .0001). Pearson's r between Actionable score Day 1 and scores for EDSS 0.41 (P < 0.0001), MSQoL-54 Physical -0.31 (P = 0.0002), MSQoL-54 Mental -0.29 (P = 0.0005), MSIP Excretion and Reproductive Functions 0.44 (P < 0.0001), Muscle and Movement Functions 0.39 (P

  7. Universal HbA1c Measurement in Early Pregnancy to Detect Type 2 Diabetes Reduces Ethnic Disparities in Antenatal Diabetes Screening: A Population-Based Observational Study.

    Directory of Open Access Journals (Sweden)

    R C E Hughes

    Full Text Available In response to the type 2 diabetes epidemic, measuring HbA1c with the first-antenatal blood screen was recently recommended in NZ. This would enable prompt treatment of women with unrecognised type 2 diabetes, who may otherwise go undetected until the gestational diabetes (GDM screen. We compare inter-ethnic antenatal screening practices to examine whether the HbA1c test would be accessed by ethnicities most at risk of diabetes, and we determined the prevalence of unrecognised type 2 diabetes and prediabetes in our pregnant population. This is an observational study of pregnancies in Christchurch NZ during 2008-2010. Utilising electronic databases, we matched maternal characteristics to first-antenatal bloods, HbA1c, and GDM screens (glucose challenge tests and oral glucose tolerance tests. Overall uptake of the first-antenatal bloods versus GDM screening was 83.1% and 53.8% respectively in 11,580 pregnancies. GDM screening was lowest in Māori 39.3%, incidence proportion ratio (IPR 0.77 (0.71, 0.84 compared with Europeans. By including HbA1c with the first-antenatal bloods, the number screened for diabetes increases by 28.5% in Europeans, 40.0% in Māori, 28.1% in Pacific People, and 26.7% in 'Others' (majority of Asian descent. The combined prevalence of unrecognised type 2 diabetes and prediabetes by NZ criteria, HbA1c ≥5.9% (41mmol/mol, was 2.1% in Europeans, Māori 4.7% IPR 2.59 (1.71, 3.93, Pacific People 9.5% IPR 4.76 (3.10, 7.30, and 'Others' 6.2% IPR 2.99 (2.19, 4.07. Applying these prevalence data to 2013 NZ national births data, routine antenatal HbA1c testing could have identified type 2 diabetes in 0.44% and prediabetes in 3.96% of women. Routine HbA1c measurement in early pregnancy is an ideal screening opportunity, particularly benefitting vulnerable groups, reducing ethnic disparities in antenatal diabetes screening. This approach is likely to have world-wide relevance and applicability. Further research is underway to

  8. Evidence From Web-Based Dietary Search Patterns to the Role of B12 Deficiency in Non-Specific Chronic Pain: A Large-Scale Observational Study.

    Science.gov (United States)

    Giat, Eitan; Yom-Tov, Elad

    2018-01-05

    Profound vitamin B12 deficiency is a known cause of disease, but the role of low or intermediate levels of B12 in the development of neuropathy and other neuropsychiatric symptoms, as well as the relationship between eating meat and B12 levels, is unclear. The objective of our study was to investigate the role of low or intermediate levels of B12 in the development of neuropathy and other neuropsychiatric symptoms. We used food-related Internet search patterns from a sample of 8.5 million people based in the US as a proxy for B12 intake and correlated these searches with Internet searches related to possible effects of B12 deficiency. Food-related search patterns were highly correlated with known consumption and food-related searches (ρ=.69). Awareness of B12 deficiency was associated with a higher consumption of B12-rich foods and with queries for B12 supplements. Searches for terms related to neurological disorders were correlated with searches for B12-poor foods, in contrast with control terms. Popular medicines, those having fewer indications, and those which are predominantly used to treat pain, were more strongly correlated with the ability to predict neuropathic pain queries using the B12 contents of food. Our findings show that Internet search patterns are a useful way of investigating health questions in large populations, and suggest that low B12 intake may be associated with a broader spectrum of neurological disorders than previously thought. ©Eitan Giat, Elad Yom-Tov. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 05.01.2018.

  9. Impact of home environment interventions on the risk of influenza-associated ARI in Andean children: observations from a prospective household-based cohort study.

    Directory of Open Access Journals (Sweden)

    Philip J Budge

    Full Text Available The Respiratory Infections in Andean Peruvian Children (RESPIRA-PERU study enrolled children who participated in a community-cluster randomized trial of improved stoves, solar water disinfection, and kitchen sinks (IHIP trial and children from additional Andean households. We quantified the burden of influenza-associated acute respiratory illness (ARI in this household-based cohort.From May 2009 to September 2011, we conducted active weekly ARI surveillance in 892 children age <3 years, of whom 272 (30.5% had participated in the IHIP trial. We collected nasal swabs during ARI, tested for influenza and other respiratory viruses by RT-PCR, and determined influenza incidence and risk factors using mixed-effects regression models.The overall incidence of influenza-associated ARI was 36.6/100 child-years; incidence of influenza A, B, and C was 20.5, 8.7, and 5.2/100 child-years, respectively. Influenza C was associated with fewer days of subjective fever (median 1 vs. 2 and malaise (median 0 vs. 2 compared to influenza A. Non-influenza ARI also resulted in fewer days of fever and malaise, and fewer healthcare visits than influenza A-associated ARI. Influenza incidence varied by calendar year (80% occurred in the 2010 season and IHIP trial participation. Among households that participated in the IHIP trial, influenza-associated ARI incidence was significantly lower in intervention than in control households (RR 0.40, 95% CI: 0.20-0.82.Influenza burden is high among Andean children. ARI associated with influenza A and B had longer symptom duration and higher healthcare utilization than influenza C-associated ARI or non-influenza ARI. Environmental community interventions may reduce influenza morbidity.

  10. Impact of home environment interventions on the risk of influenza-associated ARI in Andean children: observations from a prospective household-based cohort study.

    Science.gov (United States)

    Budge, Philip J; Griffin, Marie R; Edwards, Kathryn M; Williams, John V; Verastegui, Hector; Hartinger, Stella M; Mäusezahl, Daniel; Johnson, Monika; Klemenc, Jennifer M; Zhu, Yuwei; Gil, Ana I; Lanata, Claudio F; Grigalva, Carlos G

    2014-01-01

    The Respiratory Infections in Andean Peruvian Children (RESPIRA-PERU) study enrolled children who participated in a community-cluster randomized trial of improved stoves, solar water disinfection, and kitchen sinks (IHIP trial) and children from additional Andean households. We quantified the burden of influenza-associated acute respiratory illness (ARI) in this household-based cohort. From May 2009 to September 2011, we conducted active weekly ARI surveillance in 892 children age <3 years, of whom 272 (30.5%) had participated in the IHIP trial. We collected nasal swabs during ARI, tested for influenza and other respiratory viruses by RT-PCR, and determined influenza incidence and risk factors using mixed-effects regression models. The overall incidence of influenza-associated ARI was 36.6/100 child-years; incidence of influenza A, B, and C was 20.5, 8.7, and 5.2/100 child-years, respectively. Influenza C was associated with fewer days of subjective fever (median 1 vs. 2) and malaise (median 0 vs. 2) compared to influenza A. Non-influenza ARI also resulted in fewer days of fever and malaise, and fewer healthcare visits than influenza A-associated ARI. Influenza incidence varied by calendar year (80% occurred in the 2010 season) and IHIP trial participation. Among households that participated in the IHIP trial, influenza-associated ARI incidence was significantly lower in intervention than in control households (RR 0.40, 95% CI: 0.20-0.82). Influenza burden is high among Andean children. ARI associated with influenza A and B had longer symptom duration and higher healthcare utilization than influenza C-associated ARI or non-influenza ARI. Environmental community interventions may reduce influenza morbidity.

  11. The design, fate and impact of a hospital-wide training program in evidence-based medicine for physicians - an observational study.

    Science.gov (United States)

    Thor, Johan; Olsson, Daniel; Nordenström, Jörgen

    2016-03-08

    Many doctors fail to practice Evidence-Based Medicine (EBM) effectively, in part due to insufficient training. We report on the design, fate and impact of a short learner-centered EBM train-the-trainer program aimed at all 2400 doctors at the Karolinska University Hospital in Sweden on the heels of a tumultuous merger, focusing particularly on whether it affected the doctors' knowledge, attitudes and skills regarding EBM. We used a validated EBM instrument in a before-and-after design to assess the impact of the training. Changes in responses were analyzed at the individual level using the Wilcoxon matched pairs test. We also reviewed documentation from the program - including the modular EBM training schedule and the template for participants' Critically Appraised Topic reports - to describe the training's content, design, conduct, and fate. The training, designed to be delivered in modules of 45 min totaling 1.5 days, failed to reach most doctors at the hospital, due to cost cutting pressures and competing demands. Among study participants (n = 174), many reported suboptimal EBM knowledge and skills before the training. Respondents' strategies for solving clinical problems changed after the training: the proportion of respondents reporting to use (or intend to use) secondary sources "Often/very often" changed from 5 % before the training to 76 % after the training; in parallel, reliance on textbooks and on colleagues fell (48 to 23 % and 79 to 65 %, respectively). Participants' confidence in assessing scientific articles increased and their attitudes toward EBM became more positive. The proportion of correct answers in the EBM knowledge test increased from 52 to 71 %. All these changes were statistically significant at p doctors who were able to participate and, if applied widely, could contribute to better, safer and more cost-effective care.

  12. Motion based parsing for video from observational psychology

    Science.gov (United States)

    Kokaram, Anil; Doyle, Erika; Lennon, Daire; Joyeux, Laurent; Fuller, Ray

    2006-01-01

    In Psychology it is common to conduct studies involving the observation of humans undertaking some task. The sessions are typically recorded on video and used for subjective visual analysis. The subjective analysis is tedious and time consuming, not only because much useless video material is recorded but also because subjective measures of human behaviour are not necessarily repeatable. This paper presents tools using content based video analysis that allow automated parsing of video from one such study involving Dyslexia. The tools rely on implicit measures of human motion that can be generalised to other applications in the domain of human observation. Results comparing quantitative assessment of human motion with subjective assessment are also presented, illustrating that the system is a useful scientific tool.

  13. A LONGITUDINAL-STUDY OF INTERACTION PATTERNS OF A PSYCHIATRIST AND SEVERELY DEPRESSED-PATIENTS BASED ON OBSERVED BEHAVIOR - AN ETHOLOGICAL APPROACH OF INTERPERSONAL THEORIES OF DEPRESSION

    NARCIS (Netherlands)

    BOUHUYS, AL; VANDENHOOFDAKKER, RH

    Observed behaviour of a psychiatrist interacting with severely depressed patients during an interview was related to the course of depression during hospitalization. The behavioural structure of such interaction could be described by 6 factors for the patients and 7 factors for the psychiatrist. The

  14. How Well Are Pulses Measured? Practice-Based Evidence from an Observational Study of Acutely Ill Medical Patients During Hospital Admission

    DEFF Research Database (Denmark)

    Opio, Martin Otyek; Kellett, John

    2017-01-01

    quality audit carried out as part of a larger ongoing prospective observational trial. The radial pulse rates recorded by 2 research nurses were compared with the electrocardiogram (ECG) heart rates measured on acutely ill medical patients during their admission to a resource-poor hospital in sub...

  15. Mutually unbiased bases and complementary spin 1 observables

    Energy Technology Data Exchange (ETDEWEB)

    Kurzynski, Pawel; Kaszub, Wawrzyniec; Czechlewski, Mikolaj, E-mail: cqtpkk@nus.edu.s [Faculty of Physics, Adam Mickiewicz University, Umultowska 85, 61-614 Poznan (Poland)

    2010-07-02

    The two observables are incompatible if they cannot be measured simultaneously; however, they become maximally incompatible (complementary) if their eigenstates are mutually unbiased. Only then does the measurement of one observable give no information about the other observable. The spin projection operators onto three mutually orthogonal directions are complementary only for spin 1/2. For higher spin numbers the corresponding eigenstates are no longer unbiased. In this work we examine the properties of spin 1 mutually unbiased bases (MUB) and look for the physical meaning of the corresponding operators. We show that if the computational basis is chosen to be the eigenbasis of the spin projection operator along some direction z, then all the states, which are unbiased to this basis, have to be squeezed. Next, we study the generation and the measurement of MUB states by introducing the Fourier-like transform through spin squeezing. Finally, we try to ascribe some classical interpretation to the operators corresponding to MUB and study what information the observer gains while measuring them. Higher spin numbers are also considered.

  16. Globular Cluster Tidal Streams: An Observational Study

    Science.gov (United States)

    Powell, William L.; Lauchner, A.; Wilhelm, R.; McWilliam, A.

    2006-12-01

    Globular cluster tidal streams are of interest for what they can tell us of the dynamical evolution of the clusters and of our Galaxy. Recent studies have used photometric and statistical subtraction methods to attempt to separate potential streams from the field stars that contaminate the samples. We chose instead as our primary method to use photometry to select blue stars that match the horizontal branch of the clusters. We then make spectroscopic observations of these candidates to determine their metallicity and radial velocities. Combining these results with the photometric data offers a better picture of the structure and validity of tidal streams. We present photometric and spectroscopic results for several globular clusters and their surrounding fields. Data were obtained at McDonald Observatory, Kitt Peak, and Las Campanas Observatory. SDSS data were also used. WLP acknowledges the support of a Sigma Xi Grant-In-Aid of research. RW acknowledges the support of a AAS Small Research Grant.

  17. Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies

    OpenAIRE

    von Elm, Erik; Altman, Douglas G; Egger, Matthias; Pocock, Stuart J; Gøtzsche, Peter C; Vandenbroucke, Jan P

    2007-01-01

    Poor reporting of research hampers assessment and makes it less useful. An international group of methodologists, researchers, and journal editors sets out guidelines to improve reports of observational studies

  18. The study of seasonal composition and dynamics of wetland ecosystems and wintering bird habitat at Poyang Lake, PR China using object-based image analysis and field observations

    Science.gov (United States)

    Dronova, Iryna

    Wetlands are among the most productive ecosystems in the world which support critical ecological services and high biological diversity yet are vulnerable to climate change and human activities. In this thesis, I investigated the capabilities of satellite remote sensing with medium spatial resolution and object-based image analysis (OBIA) methods to elucidate seasonal composition and dynamics of wetland ecosystems and indicators of habitat for wintering waterbirds in a large conservation hotspot of Poyang Lake, PR China. I first examined changes in major wetland cover types during the low water period when Poyang Lake provides habitat to large numbers of migratory birds from the East Asian pathway. I used OBIA to map and analyze the transitions among water, vegetation, mudflat and sand classes from four 32-m Beijing-1 microsatellite images between late fall 2007 and early spring 2008. This analysis revealed that, while transitions among wetland classes were strongly associated with precipitation and flood-driven hydrological variation, the overall dynamics were a more complex interplay of vegetation phenology, disturbance and post-flood exposure. Remote sensing signals of environmental processes were more effectively captured by changes in fuzzy memberships to each class per location than by changes in spatial extents of the best-matching classes alone. The highest uncertainty in the image analysis corresponded to transitional wetland states at the end of the major flood recession in November and to heterogeneous mudflat areas at the land-water interface during the whole study period. Results suggest seasonally exposed mudflat features as important targets for future research due to heterogeneity and uncertainty of their composition, variable spatial distribution and sensitivity to hydrological dynamics. I further explored the potential of OBIA to overcome the limitations of the traditional pixel-based image classification methods in characterizing Poyang Lake

  19. Atrial fibrillation: an observational study with outpatients.

    Science.gov (United States)

    Albina, Gastón; De Luca, Julián; Conde, Diego; Giniger, Alberto

    2014-11-01

    Atrial fibrillation (AF) is the most common sustained arrhythmia with serious clinical consequences in the absence of treatment. However, there are limited data on the treatment of these patients in Argentina. The objective was to describe the therapeutic management of patients with nonacute AF by Argentinean cardiologists and to determine the incidence of clinical events after 12 months follow-up. The Atrial Fibrillation study in Argentina (FARAON) was an observational, descriptive, prospective, national, and multicentric study that included outpatients with AF, followed for 12 months. The study included 38 sites in Argentina. Each researcher included the first 10 patients who met the inclusion criteria of being over 21 and also being an AF carrier documented by electrocardiogram or Holter within 12 months prior to or at the time of enrollment. A total of 373 patients were included, mean age 70 ± 11.5 years, 40% women; 65% had AF rhythm at the time of inclusion, 57% had permanent AF, and 56% were asymptomatic. At the time of enrollment, 40% of physicians opted for rhythm control strategy. β-blockers and amiodarone were the most used drugs. Patients with rhythm control drugs had higher success rate than those with frequency control drug therapy (80% vs 57%). Cardiologists in Argentina receive patients with AF that are mostly permanent AF. More than half of the patients are asymptomatic. They opt primarily by controlling the pace. When choosing antiarrhythmic drugs, nearly half of them indicated amiodarone. © 2014 Wiley Periodicals, Inc.

  20. Fasting with diabetes: a prospective observational study

    Science.gov (United States)

    Noon, Muhammad Jawad; Khawaja, Haseeb Ahmad; Ishtiaq, Osama; Khawaja, Quratulain; Minhas, Sana; Niazi, Asfandyar Khan; Minhas, Abdul Mannan Khan; Malhi, Umar Rasool

    2016-01-01

    Objectives To determine the proportion of diabetic patients who develop adverse glycaemic events when fasting regularly. Design Prospective observational study conducted at a tertiary care hospital in South Asia. Five hundred and twenty-three patients were assessed for eligibility, and 150 were included in the final analysis. Diabetic patients over 18 years of age who were willing to fast regularly and make a chart of their daily blood sugar levels were included in the study. The main outcome measures were hypoglycaemic and hyperglycaemic events. Frequencies and percentages were calculated for quantitative variables, while mean±SD were documented for qualitative variables. Relative risk was calculated as a measure of association. Results Of a total of 150 individuals, 10% experienced hypoglycaemia, while 3.3% reported hyperglycaemic episodes. Only 8.7% of the participants discontinued one or more fasts; however, none of them required hospitalisation. There is a negative association between a visit to a physician by diabetic patients before they begin to fast regularly and the risk of developing hypoglycaemia (relative risk 0.73). Conclusions Many diabetic patients who fast regularly are at high risk of adverse glycaemic events. Most diabetics do not consult their physicians before fasting to adjust medications and lifestyle. Various strategies should be planned and implemented for the awareness and education of such patients to avoid adverse glycaemic events and subsequent complications. PMID:28588932

  1. Plasma blob observed by ground-based optical and radio techniques in the F-region - A case study on 27-28 August 1987

    Science.gov (United States)

    Pimenta, A. A.; Amorim, D.

    2011-12-01

    An interesting case of plasma blob event was observed on August 27-28, 1987 over Cachoeira Paulista (22.7°S, 45.0°W; 13.25°S MLAT, declination 20°W) showing localized plasma density enhanced by a factor of, approximately, 2 above the background level. On this night, geomagnetic activity was moderately disturbed with Dst> -70 nT. An all-sky imager operating in the OI 630 nm emission was used to map the spatial extension and temporal location of plasma blob that showed, typically, east-west and north-south extensions of 320-350 km and 360-380km, respectively. The F-region parameters were obtained from a Digisonde 256, which provide a good idea of the ionospheric behavior during the event. In this paper, important features from this localized electron density enhancement in the low latitude region is presented and discussed.

  2. Data quality monitoring and performance metrics of a prospective, population-based observational study of maternal and newborn health in low resource settings.

    Science.gov (United States)

    Goudar, Shivaprasad S; Stolka, Kristen B; Koso-Thomas, Marion; Honnungar, Narayan V; Mastiholi, Shivanand C; Ramadurg, Umesh Y; Dhaded, Sangappa M; Pasha, Omrana; Patel, Archana; Esamai, Fabian; Chomba, Elwyn; Garces, Ana; Althabe, Fernando; Carlo, Waldemar A; Goldenberg, Robert L; Hibberd, Patricia L; Liechty, Edward A; Krebs, Nancy F; Hambidge, Michael K; Moore, Janet L; Wallace, Dennis D; Derman, Richard J; Bhalachandra, Kodkany S; Bose, Carl L

    2015-01-01

    To describe quantitative data quality monitoring and performance metrics adopted by the Global Network's (GN) Maternal Newborn Health Registry (MNHR), a maternal and perinatal population-based registry (MPPBR) based in low and middle income countries (LMICs). Ongoing prospective, population-based data on all pregnancy outcomes within defined geographical locations participating in the GN have been collected since 2008. Data quality metrics were defined and are implemented at the cluster, site and the central level to ensure data quality. Quantitative performance metrics are described for data collected between 2010 and 2013. Delivery outcome rates over 95% illustrate that all sites are successful in following patients from pregnancy through delivery. Examples of specific performance metric reports illustrate how both the metrics and reporting process are used to identify cluster-level and site-level quality issues and illustrate how those metrics track over time. Other summary reports (e.g. the increasing proportion of measured birth weight compared to estimated and missing birth weight) illustrate how a site has improved quality over time. High quality MPPBRs such as the MNHR provide key information on pregnancy outcomes to local and international health officials where civil registration systems are lacking. The MNHR has measures in place to monitor data collection procedures and improve the quality of data collected. Sites have increasingly achieved acceptable values of performance metrics over time, indicating improvements in data quality, but the quality control program must continue to evolve to optimize the use of the MNHR to assess the impact of community interventions in research protocols in pregnancy and perinatal health. NCT01073475.

  3. [The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies].

    Science.gov (United States)

    von Elm, Erik; Altman, Douglas G; Egger, Matthias; Pocock, Stuart J; Gøtzsche, Peter C; Vandenbroucke, Jan P

    2008-01-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September, 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed explanation and elaboration document is published separately and is freely available on the websites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE statement will contribute to improving the quality of reporting of observational studies.

  4. [The Strengthening the Reporting of Observational Studies in Epidemiology [STROBE] statement: guidelines for reporting observational studies].

    Science.gov (United States)

    von Elm, Erik; Altman, Douglas G; Egger, Matthias; Pocock, Stuart J; Gøtzsche, Peter C; Vandenbroucke, Jan P

    2008-01-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September, 2004, with methodologists, researchers, and journal editors to draft a che-cklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed explanation and elaboration document is published separately and is freely available on the websites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE statement will contribute to improving the quality of reporting of observational studies.

  5. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies.

    Science.gov (United States)

    von Elm, Erik; Altman, Douglas G; Egger, Matthias; Pocock, Stuart J; Gøtzsche, Peter C; Vandenbroucke, Jan P

    2014-12-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the Web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE statement: guidelines for reporting observational studies.

    Directory of Open Access Journals (Sweden)

    Erik von Elm

    2007-10-01

    Full Text Available Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the Web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies.

  7. Age at Menarche, Level of Education, Parity and the Risk of Hysterectomy: A Systematic Review and Meta-Analyses of Population-Based Observational Studies.

    Directory of Open Access Journals (Sweden)

    Louise F Wilson

    Full Text Available Although rates have declined, hysterectomy is still a frequent gynaecological procedure. To date, there has been no systematic quantification of the relationships between early/mid-life exposures and hysterectomy. We performed a systematic review and meta-analyses to quantify the associations between age at menarche, education level, parity and hysterectomy.Eligible studies were identified by searches in PubMed and Embase through March 2015. Study-specific estimates were summarised using random effects meta-analysis. Heterogeneity was explored using sub-group analysis and meta-regression.Thirty-two study populations were identified for inclusion in at least one meta-analysis. Each year older at menarche was associated with lower risk of hysterectomy-summary hazard ratio 0.86 (95% confidence interval: 0.78, 0.95; I2 = 0%; summary odds ratio 0.88 (95% confidence interval: 0.82, 0.94; I2 = 61%. Low education levels conferred a higher risk of hysterectomy in the lowest versus highest level meta-analysis (summary hazard ratio 1.87 (95% confidence interval: 1.25, 2.80; I2 = 86%, summary odds ratio 1.51 (95% confidence interval: 1.35, 1.69; I2 = 90% and dose-response meta-analysis (summary odds ratio 1.17 (95% confidence interval: 1.12, 1.23; I2 = 85% per each level lower of education. Sub-group analysis showed that the birth cohort category of study participants, the reference category used for level of education, the year the included article was published, quality of the study (as assessed by the authors and control for the key variables accounted for the high heterogeneity between studies in the education level meta-analyses. In the meta-analyses of studies of parity and hysterectomy the results were not statistically significant.The present meta-analyses suggest that the early life factors of age at menarche and lower education level are associated with hysterectomy, although this evidence should be interpreted with some caution due to variance

  8. Evaluation of a Computer-Based Recruitment System for Enrolling Men Who Have Sex With Men Into an Observational HIV Behavioral Risk Study.

    Science.gov (United States)

    Khosropour, Christine M; Dombrowksi, Julia C; Hughes, James P; Manhart, Lisa E; Golden, Matthew R

    2016-09-15

    Enrolling large numbers of high-risk men who have sex with men (MSM) into human immunodeficiency virus (HIV) prevention studies is necessary for research with an HIV outcome, but the resources required for in-person recruitment can be prohibitive. New methods with which to efficiently recruit large samples of MSM are needed. At a sexually transmitted disease clinic in Seattle, Washington, in 2013-2014, we used an existing clinical computer-assisted self-interview that collects patients' medical and sexual history data to recruit, screen, and enroll MSM into an HIV behavioral risk study and compared enrollees with men who declined to enroll. After completing the clinical computer-assisted self-interview, men aged ≥18 years who reported having had sex with men in the prior year were presented with an electronic study description and consent statement. We enrolled men at 2,661 (54%) of 4,944 visits, including 1,748 unique individuals. Enrolled men were younger (mean age = 34 years vs. 37 years; P partners (11 vs. 8; P use (15% vs. 8%; P < 0.001) than men who declined to enroll, but the HIV test positivity of the two groups was similar (1.9% vs. 2.0%; P = 0.80). Adapting an existing computerized clinic intake system, we recruited a large sample of MSM who may be an ideal population for an HIV prevention study. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Multicenter observational prehospital resuscitation on helicopter study.

    Science.gov (United States)

    Holcomb, John B; Swartz, Michael D; DeSantis, Stacia M; Greene, Thomas J; Fox, Erin E; Stein, Deborah M; Bulger, Eileen M; Kerby, Jeffrey D; Goodman, Michael; Schreiber, Martin A; Zielinski, Martin D; O'Keeffe, Terence; Inaba, Kenji; Tomasek, Jeffrey S; Podbielski, Jeanette M; Appana, Savitri N; Yi, Misung; Wade, Charles E

    2017-07-01

    Earlier use of in-hospital plasma, platelets, and red blood cells (RBCs) has improved survival in trauma patients with severe hemorrhage. Retrospective studies have associated improved early survival with prehospital blood product transfusion (PHT). We hypothesized that PHT of plasma and/or RBCs would result in improved survival after injury in patients transported by helicopter. Adult trauma patients transported by helicopter from the scene to nine Level 1 trauma centers were prospectively observed from January to November 2015. Five helicopter systems had plasma and/or RBCs, whereas the other four helicopter systems used only crystalloid resuscitation. All patients meeting predetermined high-risk criteria were analyzed. Patients receiving PHT were compared with patients not receiving PHT. Our primary analysis compared mortality at 3 hours, 24 hours, and 30 days, using logistic regression to adjust for confounders and site heterogeneity to model patients who were matched on propensity scores. Twenty-five thousand one hundred eighteen trauma patients were admitted, 2,341 (9%) were transported by helicopter, of which 1,058 (45%) met the highest-risk criteria. Five hundred eighty-five of 1,058 patients were flown on helicopters carrying blood products. In the systems with blood available, prehospital median systolic blood pressure (125 vs 128) and Glasgow Coma Scale (7 vs 14) was significantly lower, whereas median Injury Severity Score was significantly higher (21 vs 14). Unadjusted mortality was significantly higher in the systems with blood products available, at 3 hours (8.4% vs 3.6%), 24 hours (12.6% vs 8.9%), and 30 days (19.3% vs 13.3%). Twenty-four percent of eligible patients received a PHT. A median of 1 unit of RBCs and plasma were transfused prehospital. Of patients receiving PHT, 24% received only plasma, 7% received only RBCs, and 69% received both. In the propensity score matching analysis (n = 109), PHT was not significantly associated with mortality

  10. The clinical utility of the urine-based lateral flow lipoarabinomannan assay in HIV-infected adults in Myanmar: an observational study.

    Science.gov (United States)

    Thit, Swe Swe; Aung, Ne Myo; Htet, Zaw Win; Boyd, Mark A; Saw, Htin Aung; Anstey, Nicholas M; Kyi, Tint Tint; Cooper, David A; Kyi, Mar Mar; Hanson, Josh

    2017-08-04

    The use of the point-of-care lateral flow lipoarabinomannan (LF-LAM) test may expedite tuberculosis (TB) diagnosis in HIV-positive patients. However, the test's clinical utility is poorly defined outside sub-Saharan Africa. The study enrolled consecutive HIV-positive adults at a tertiary referral hospital in Yangon, Myanmar. On enrolment, patients had a LF-LAM test performed according to the manufacturer's instructions. Clinicians managing the patients were unaware of the LF-LAM result, which was correlated with the patient's clinical course over the ensuing 6 months. The study enrolled 54 inpatients and 463 outpatients between July 1 and December 31, 2015. On enrolment, the patients' median (interquartile range) CD4 T-cell count was 270 (128-443) cells/mm 3 . The baseline LF-LAM test was positive in 201/517 (39%). TB was confirmed microbiologically during follow-up in 54/517 (10%), with rifampicin resistance present in 8/54 (15%). In the study's resource-limited setting, extrapulmonary testing for TB was not possible, but after 6 months, 97/201 (48%) with a positive LF-LAM test on enrolment had neither died, required hospitalisation, received a TB diagnosis or received empirical anti-TB therapy, suggesting a high rate of false-positive results. Of the 97 false-positive tests, 89 (92%) were grade 1 positive, suggesting poor test specificity using this cut-off. Only 21/517 (4%) patients were inpatients with TB symptoms and a CD4 T-cell count of < 100 cells/mm 3 . Five (24%) of these 21 died, three of whom had a positive LF-LAM test on enrolment. However, all three received anti-TB therapy before death - two after diagnosis with Xpert MTB/RIF testing, while the other received empirical treatment. It is unlikely that knowledge of the baseline LF-LAM result would have averted any of the study's other 11 deaths; eight had a negative test, and of the three patients with a positive test, two received anti-TB therapy before death, while one died from laboratory

  11. Influence of seabed topography on the distribution of manganese nodules and associated features in the Central Indian Basin: A study based on photographic observations

    Digital Repository Service at National Institute of Oceanography (India)

    Sharma, R.; Kodagali, V.N.

    value of R, whereas the slopes and plains have a variable R, and the valleys have very low R-values. The studies on nodules in box cores by Sorem et al. (1979b), suggest that the burial varies depend- ing upon the physical features of the underlying... Ocean Explor., 8: 20. lyer, S.D. and Karisiddaiah, S.M., 1990. Petrology of ocean- floor rocks from the Central Indian Ocean Basin. Indian J. Mar. Sci., 19: 13-16. lyer, S.D. and Sharma, R., 1990. Correlation between occur- rence of manganese...

  12. The positive role of breastfeeding on infant health during the first 6 weeks: findings from a prospective observational study based on maternal reports.

    LENUS (Irish Health Repository)

    Tarrant, R C

    2012-03-01

    This study aimed to report on adverse infant and maternal clinical outcomes, and investigate the relationship between infant feeding practice and such adverse clinical outcomes in infants during the first 6 weeks postpartum. From an eligible sample of 450 mother-term infant pairs recruited from the Coombe Women and Infants University Hospital in Dublin, 27.1% of infants (n=122) were maternally reported to have had an illness during the first 6 weeks that necessitated the provision of prescribed medication +\\/- general practitioner\\/paediatrician attendance +\\/- hospitalisation. Of these, 90 infants had > or =1 episode of infection +\\/- viral +\\/- gastro-intestinal-related condition. After adjustment, \\'any\\' breastfeeding to 6 weeks was protective against such adverse infant outcomes (adjusted odds ratio [aOR] 0.44, P = 0.022). Attendance to the GP\\/paediatrician for > 1 visit (aOR 3.44, P = 0.000) and multiparity (aOR 1.76, P = 0.041) were also positively associated with such adverse infant outcomes. To decrease infant morbidity rates in Ireland, government investment in breastfeeding promotion, support and research should be a continued public health priority.

  13. Tobacco Price Increase and Smoking Cessation in Japan, a Developed Country With Affordable Tobacco: A National Population-Based Observational Study.

    Science.gov (United States)

    Tabuchi, Takahiro; Nakamura, Masakazu; Nakayama, Tomio; Miyashiro, Isao; Mori, Jun-Ichiro; Tsukuma, Hideaki

    2016-01-01

    Longitudinal assessment of the impact of tobacco price on smoking cessation is scarce. Our objective was to investigate the effect of a price increase in October 2010 on cessation rates according to gender, age, socioeconomic status, and level of tobacco dependence in Japan. We used longitudinal data linkage of two nationally representative studies and followed 2702 smokers for assessment of their cessation status. The odds ratios (ORs) for cessation were calculated using logistic regression. To estimate the impact of the 2010 tobacco price increase on cessation, data from 2007 were used as a reference category. Overall cessation rates significantly increased from 2007 to 2010, from 3.7% to 10.7% for men and from 9.9% to 16.3% for women. Cessation rates were 9.3% for men who smoked 1-10 cigarettes per day, 2.7% for men who smoked 11-20 cigarettes per day, and 2.0% for men who smoked more than 20 cigarettes per day in 2007. These rates increased to 15.5%, 10.0%, and 8.0%, respectively, in 2010. The impact was stronger among subjects who smoked more than 11 cigarettes per day than those who smoked 1-10 cigarettes per day in both sexes: ORs for 2010 were 4.04 for those smoking 11-20 cigarettes per day, 4.26 for those smoking more than 20 cigarettes per day, and 1.80 for those smoking 1-10 cigarettes per day in the main model in men. There were no obvious differences in the relationship between tobacco price increase and smoking cessation across age and household expenditure groups. The tobacco price increase in Japan had a significant impact on smoking cessation in both sexes, especially among heavy smokers, with no clear difference in effect by socio-demographic status.

  14. Neuronal bases of structural coherence in contemporary dance observation.

    Science.gov (United States)

    Bachrach, Asaf; Jola, Corinne; Pallier, Christophe

    2016-01-01

    The neuronal processes underlying dance observation have been the focus of an increasing number of brain imaging studies over the past decade. However, the existing literature mainly dealt with effects of motor and visual expertise, whereas the neural and cognitive mechanisms that underlie the interpretation of dance choreographies remained unexplored. Hence, much attention has been given to the action observation network (AON) whereas the role of other potentially relevant neuro-cognitive mechanisms such as mentalizing (theory of mind) or language (narrative comprehension) in dance understanding is yet to be elucidated. We report the results of an fMRI study where the structural coherence of short contemporary dance choreographies was manipulated parametrically using the same taped movement material. Our participants were all trained dancers. The whole-brain analysis argues that the interpretation of structurally coherent dance phrases involves a subpart (superior parietal) of the AON as well as mentalizing regions in the dorsomedial prefrontal cortex. An ROI analysis based on a similar study using linguistic materials (Pallier et al., 2011) suggests that structural processing in language and dance might share certain neural mechanisms. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. A trajectory observer for camera-based underwater motion measurements

    DEFF Research Database (Denmark)

    Berg, Tor; Jouffroy, Jerome; Johansen, Vegar

    This work deals with the issue of estimating the trajectory of a vehicle or object moving underwater based on camera measurements. The proposed approach consists of a diffusion-based trajectory observer (Jouffroy and Opderbecke, 2004) processing whole segments of a trajectory at a time. Additiona....... Additionally, the observer contains a Tikhonov regularizer for smoothing the estimates. Then, a method for including the camera measurements in an appropriate manner is proposed....

  16. Nonlinear observer based phase synchronization of chaotic systems

    International Nuclear Information System (INIS)

    Meng Juan; Wang Xingyuan

    2007-01-01

    This Letter analyzes the phase synchronization problem of autonomous chaotic systems. Based on the nonlinear state observer algorithm and the pole placement technique, a phase synchronization scheme is designed. The phase synchronization of a new chaotic system is achieved by using this observer controller. Numerical simulations further demonstrate the effectiveness of the proposed phase synchronization scheme

  17. ON ESTIMATING FORCE-FREENESS BASED ON OBSERVED MAGNETOGRAMS

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, X. M.; Zhang, M.; Su, J. T., E-mail: xmzhang@nao.cas.cn [Key Laboratory of Solar Activity, National Astronomical Observatories, Chinese Academy of Sciences, A20 Datun Road, Chaoyang District, Beijing 100012 (China)

    2017-01-01

    It is a common practice in the solar physics community to test whether or not measured photospheric or chromospheric vector magnetograms are force-free, using the Maxwell stress as a measure. Some previous studies have suggested that magnetic fields of active regions in the solar chromosphere are close to being force-free whereas there is no consistency among previous studies on whether magnetic fields of active regions in the solar photosphere are force-free or not. Here we use three kinds of representative magnetic fields (analytical force-free solutions, modeled solar-like force-free fields, and observed non-force-free fields) to discuss how measurement issues such as limited field of view (FOV), instrument sensitivity, and measurement error could affect the estimation of force-freeness based on observed magnetograms. Unlike previous studies that focus on discussing the effect of limited FOV or instrument sensitivity, our calculation shows that just measurement error alone can significantly influence the results of estimates of force-freeness, due to the fact that measurement errors in horizontal magnetic fields are usually ten times larger than those in vertical fields. This property of measurement errors, interacting with the particular form of a formula for estimating force-freeness, would result in wrong judgments of the force-freeness: a truly force-free field may be mistakenly estimated as being non-force-free and a truly non-force-free field may be estimated as being force-free. Our analysis calls for caution when interpreting estimates of force-freeness based on measured magnetograms, and also suggests that the true photospheric magnetic field may be further away from being force-free than it currently appears to be.

  18. Self-testing of binary observables based on commutation

    DEFF Research Database (Denmark)

    Kaniewski, Jędrzej

    2017-01-01

    We consider the problem of certifying binary observables based on a Bell inequality violation alone, a task known as self-testing of measurements. We introduce a family of commutation-based measures, which encode all the distinct arrangements of two projective observables on a qubit. These quanti......We consider the problem of certifying binary observables based on a Bell inequality violation alone, a task known as self-testing of measurements. We introduce a family of commutation-based measures, which encode all the distinct arrangements of two projective observables on a qubit....... These quantities by construction take into account the usual limitations of self-testing and since they are “weighted” by the (reduced) state, they automatically deal with rank-deficient reduced density matrices. We show that these measures can be estimated from the observed Bell violation in several scenarios...... and the proofs rely only on standard linear algebra. The trade-offs turn out to be tight, and in particular, they give nontrivial statements for arbitrarily small violations. On the other extreme, observing the maximal violation allows us to deduce precisely the form of the observables, which immediately leads...

  19. [The Strengthening the Reporting of Observational Studies in Epidemiology [STROBE] statement: guidelines for reporting observational studies

    DEFF Research Database (Denmark)

    Elm, E. von; Altman, D.G.; Egger, M.

    2008-01-01

    Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) initiative developed......, researchers, and journal editors to draft a che-cklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop...... and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case...

  20. Geomagnetic Observations for Main Field Studies

    DEFF Research Database (Denmark)

    Matzka, Jürgen; Chulliat, A.; Mandea, M.

    2010-01-01

    and the beginning of geomagnetic repeat stations surveys in the 19th century. In the second half of the 20th century, true global coverage with geomagnetic field measurements was accomplished by magnetometer payloads on low-Earth-orbiting satellites. This article describes the procedures and instruments...... for magnetic field measurements on ground and in space and covers geomagnetic observatories, repeat stations, automatic observatories, satellites and historic observations. Special emphasis is laid on the global network of geomagnetic observatories....

  1. A statistical study of ion frictional heating observed by EISCAT

    Directory of Open Access Journals (Sweden)

    J. A. Davies

    1997-11-01

    Full Text Available Results of a statistical survey of F-region ion frictional heating are presented, a survey which is based on over 4000 h of common programme observations taken by the European incoherent scatter (EISCAT UHF radar facility. The criterion adopted in this study for the identification of ion frictional heating was that defined by McCrea et al., requiring an enhancement in the F-region field-parallel ion temperature exceeding 100 K over two consecutive integration periods, which was itself based on a selection criterion for frictional heating derived for the study of high-latitude F-region ion temperature observations from the Atmospheric Explorer-C satellite. In the present study, the diurnal distribution of ion frictional heating observed by EISCAT is established and, furthermore, its dependence on geomagnetic activity and the orientation of the interplanetary magnetic field (IMF is investigated; results are interpreted with reference to corresponding distributions of enhanced ion velocity, again derived from the extended set of EISCAT UHF common programme observations. The radar, due to its location relative to the large-scale convection pattern, observes ion frictional heating principally during the night, although preferentially during the post-midnight hours where there is reduced coupling between the ion and neutral populations. There is an increased preponderance of frictional heating during intervals of high geomagnetic activity and for a southward z component of the IMF and, moreover, evidence of asymmetries introduced by the y component of the IMF.

  2. Independent Component Analysis applied to Ground-based observations

    Science.gov (United States)

    Martins-Filho, Walter; Griffith, Caitlin; Pearson, Kyle; Waldmann, Ingo; Alvarez-Candal, Alvaro; Zellem, Robert Thomas

    2018-01-01

    Transit measurements of Jovian-sized exoplanetary atmospheres allow one to study the composition of exoplanets, largely independent of the planet’s temperature profile. However, measurements of hot-Jupiter transits must archive a level of accuracy in the flux to determine the spectral modulation of the exoplanetary atmosphere. To accomplish this level of precision, we need to extract systematic errors, and, for ground-based measurements, the effects of Earth’s atmosphere, from signal due to the exoplanet, which is several orders of magnitude smaller. The effects of the terrestrial atmosphere and some of the time-dependent systematic errors of ground-based transit measurements are treated mainly by dividing the host star by a reference star at each wavelength and time step of the transit. Recently, Independent Component Analysis (ICA) have been used to remove systematics effects from the raw data of space-based observations (Waldmann, 2014, 2012; Morello et al., 2016, 2015). ICA is a statistical method born from the ideas of the blind-source separations studies, which can be used to de-trend several independent source signals of a data set (Hyvarinen and Oja, 2000). This technique requires no additional prior knowledge of the data set. In addition, this technique has the advantage of requiring no reference star. Here we apply the ICA to ground-based photometry of the exoplanet XO-2b recorded by the 61” Kuiper Telescope and compare the results of the ICA to those of a previous analysis from Zellem et al. (2015), which does not use ICA. We also simulate the effects of various conditions (concerning the systematic errors, noise and the stability of object on the detector) to determine the conditions under which an ICA can be used with high precision to extract the light curve of exoplanetary photometry measurements

  3. Disturbance observer based current controller for vector controlled IM drives

    DEFF Research Database (Denmark)

    Teodorescu, Remus; Dal, Mehmet

    2008-01-01

    In order to increase the accuracy of the current control loop, usually, well known parameter compensation and/or cross decoupling techniques are employed for advanced ac drives. In this paper, instead of using these techniques an observer-based current controller is proposed for vector controlled...... induction motor (IM) drives. The control design, based on synchronously rotating d-q frame model of the machine, has a simple structure that combines the proportional portion of a conventional PI control and output of the observer. The observer is predicted to estimate the disturbances caused by parameters...... change in current control loop and, also to remove undesired cross coupling existing between components of the stator current. The observer uses the measured stator currents and estimated PWM voltages, and produces a disturbance signal with a low pass filter. The proposed control scheme reduces cross...

  4. Ensemble-based observation impact estimates using the NCEP GFS

    Directory of Open Access Journals (Sweden)

    Yoichiro Ota

    2013-09-01

    Full Text Available The impacts of the assimilated observations on the 24-hour forecasts are estimated with the ensemble-based method proposed by Kalnay et al. using an ensemble Kalman filter (EnKF. This method estimates the relative impact of observations in data assimilation similar to the adjoint-based method proposed by Langland and Baker but without using the adjoint model. It is implemented on the National Centers for Environmental Prediction Global Forecasting System EnKF that has been used as part of operational global data assimilation system at NCEP since May 2012. The result quantifies the overall positive impacts of the assimilated observations and the relative importance of the satellite radiance observations compared to other types of observations, especially for the moisture fields. A simple moving localisation based on the average wind, although not optimal, seems to work well. The method is also used to identify the cause of local forecast failure cases in the 24-hour forecasts. Data-denial experiments of the observations identified as producing a negative impact are performed, and forecast errors are reduced as estimated, thus validating the impact estimation.

  5. OBSERVED AIR POLLUTION SPECIFICS OF THE VALLEY-BASED TOWNS

    OpenAIRE

    ZOLTÁN UTASI; ILONA PAJTÓK-TARI; JÁNOS MIKA; CSABA PATKÓS; ANTAL TÓTH

    2012-01-01

    Observed air pollution specifics of the valley-based towns. There are 21 valley-based towns in the 100 most populated ones of Hungary. This topographical feature may be advantageous due to mezoscale circulation between the valley or basin, containing these settlements and the surrounding hills. On the other hand, the hills form a mechanical obstacle that may limit the vertical mixing of pollution. Final result of these counteracting features are analysed by comparing air pollution characteris...

  6. Ground-based observations of Kepler asteroseismic targets

    DEFF Research Database (Denmark)

    Uyttterhoeven , K.; Karoff, Christoffer

    2010-01-01

    We present the ground-based activities within the different working groups of the Kepler Asteroseismic Science Consortium (KASC). The activities aim at the systematic characterization of the 5000+ KASC targets, and at the collection of ground-based follow-up time-series data of selected promising...... Kepler pulsators. So far, 36 different instruments at 31 telescopes on 23 different observatories in 12 countries are in use, and a total of more than 530 observing nights has been awarded....

  7. Rating scales for observer performance studies

    Science.gov (United States)

    Nishikawa, Robert M.; Jiang, Yulei; Metz, Charles E.

    2010-02-01

    We compared the performance of radiologists reading a set of screening mammograms with and without CADe as measured by the BI-RADS assessment scale to that measured by a 9-point rating scale. Eight MQSA radiologists read 300 screening mammograms, of which 66 cases contained at least one cancer and 234 were normal based on two-year follow-up. Both without and then with CADe, the radiologists gave their BI-RADS assessment for each case and, for each suspicious lesion in the image, reported their confidence on a 9-point scale (1=no evidence for recall; 5=equivocal; 9=overwhelming evidence for recall) that the lesion needed to be worked up. The radiologists were instructed to read the cases as they would clinically. We used MRMC ROC analysis employing PROPROC curve fitting to analyze the data, once for the BI-RADS data and again for that collected on the 9-point scale. Given that the radiologists were reading screening mammograms and were instructed to read in their normal clinical manner, not all radiologists used the full BI-RADS scale. Two radiologists used only BI-RADS 0,1 and 2, three used the full scale, and three used the full scale but employed categories 3, 4 and 5 sparingly. This mimics what occurs clinically, according to the literature. The BI-RADS and the 9-point rating scales gave similar results in terms of AUC. However, the 95% CIs of the estimates of AUC were substantially smaller for the 9-point scale.

  8. Complicated Intra-Abdominal Infections Observational European study (CIAO Study

    Directory of Open Access Journals (Sweden)

    Sartelli Massimo

    2011-12-01

    Full Text Available Abstract Complicated intra-abdominal infections are frequently associated with poor prognoses and high morbidity and mortality rates. Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. In order to describe the clinical, microbiological, and management-related profiles of both community-acquired and healthcare-acquired complicated intra-abdominal infections (IAIs, the World Society of Emergency Surgery (WSES, in collaboration with the Surgical Infections Society of Europe (SIS-E and other prominent European surgical societies, has designed the CIAO study. The CIAO study is a multicenter, observational study and will be carried out in various surgical departments throughout Europe. The study will include patients undergoing surgery or interventional drainage for complicated IAI.

  9. A cooperative control algorithm for camera based observational systems.

    Energy Technology Data Exchange (ETDEWEB)

    Young, Joseph G.

    2012-01-01

    Over the last several years, there has been considerable growth in camera based observation systems for a variety of safety, scientific, and recreational applications. In order to improve the effectiveness of these systems, we frequently desire the ability to increase the number of observed objects, but solving this problem is not as simple as adding more cameras. Quite often, there are economic or physical restrictions that prevent us from adding additional cameras to the system. As a result, we require methods that coordinate the tracking of objects between multiple cameras in an optimal way. In order to accomplish this goal, we present a new cooperative control algorithm for a camera based observational system. Specifically, we present a receding horizon control where we model the underlying optimal control problem as a mixed integer linear program. The benefit of this design is that we can coordinate the actions between each camera while simultaneously respecting its kinematics. In addition, we further improve the quality of our solution by coupling our algorithm with a Kalman filter. Through this integration, we not only add a predictive component to our control, but we use the uncertainty estimates provided by the filter to encourage the system to periodically observe any outliers in the observed area. This combined approach allows us to intelligently observe the entire region of interest in an effective and thorough manner.

  10. The observer-based synchronization and parameter estimation of a ...

    Indian Academy of Sciences (India)

    Haipeng Su

    2017-10-31

    Oct 31, 2017 ... Chaotic system; observer-based synchronization; parameter estimation; single output. PACS No. 05.45.Gg. 1. Introduction. Chaos is a widespread phenomenon occurring in many nonlinear systems, such as communication system, meteorological system etc. Since Pecora and Carroll. [1] developed a ...

  11. Gain Scheduling of Observer-Based Controllers with Integral Action

    DEFF Research Database (Denmark)

    Trangbæk, Klaus; Stoustrup, Jakob; Bendtsen, Jan Dimon

    2006-01-01

     This paper presents a method for continuous gain scheduling of  observer-based controllers with integral action. Given two stabilising controllers for a given system, explicit state space formulae are presented, allowing to change gradually from one  controller to the other while preserving...

  12. Management of rheumatic chorea: an observational study

    Directory of Open Access Journals (Sweden)

    Araújo Alexandra Prufer de Queiroz Campos

    2002-01-01

    Full Text Available BACKGROUND: Rheumatic chorea (RC has recently been linked to an antibody-mediated immune mechanism. OBJECTIVE/METHOD: To verify if this knowledge reflected in management changes we conceived a descriptive study. RESULTS: The medical charts of 20 children (13 females aged 6 to 12 years (mean 8 years, diagnosed as RC from June 1996 to June 1999, were reviewed. All patients received some medical treatment. Haloperidol was the most prescribed medication (15 patients - 75 %. Sulpiride, diazepam and valproate were also used as symptomatic treatment. Imune-modulating therapy with prednisone was prescribed for seven children. The shortest course of chorea (16 days occurred in a patient treated with prednisone. CONCLUSION: Prednisone has been prescribed for rheumatic chorea besides the traditional symptomatic approach. A great variety of antichoreic drugs are being employed.

  13. [Difficult laryngoscopy and tracheal intubation: observational study].

    Science.gov (United States)

    Andrade, Rebeca Gonelli Albanez da Cunha; Lima, Bruno Luís Soares; Lopes, Douglas Kaíque de Oliveira; Couceiro Filho, Roberto Oliveira; Lima, Luciana Cavalcanti; Couceiro, Tania Cursino de Menezes

    Since anesthesia complications associated with unexpected difficult airway are potentially catastrophic, they should be avoided. The modified Mallampati test and jaw-thrust maneuver enable the identification of difficult airway. The aim of this study was to associate the modified Mallampati test and the jaw-thrust maneuver with laryngoscopy (Cormack-Lehane) in an attempt to identify a better predictor of difficult airway in an adult population undergoing elective surgery. A cross-sectional study in which 133 adult patients undergoing elective surgery requiring tracheal intubation were analyzed. The accuracy and specificity of the modified Mallampati test and jaw-thrust maneuver were assessed by correlating them with difficult laryngoscopy (Cormack-Lehane Degrees 3 and 4). In the 133 patients evaluated the difficult intubation rate found was 0.8%; there was association between the two predictive tests proposed (p=0.012). The values of 94.5% for specificity and 95.4% for accuracy were found for the jaw-thrust maneuver and for the modified Mallampati test, the values found were 81.1% and 81.2%, respectively. Kappa agreement identified a result of 0.240 between jaw-thrust maneuver and Cormarck-Lehane, which was considered reasonable. On the other hand, a poor agreement (κ=0.06) was seen between modified Mallampati test and Cormarck-Lehane test. The jaw-thrust maneuver presented superior accuracy and agreement than the modified Mallampati test, showing the ability to identify a difficult airway. It is necessary to emphasize the association of tests in the evaluation of patients, emphasizing their complementarity to minimize the negative consequences of repeated laryngoscopies. Copyright © 2017 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  14. Diffusion-Based Trajectory Observers with Variance Constraints

    DEFF Research Database (Denmark)

    Alcocer, Alex; Jouffroy, Jerome; Oliveira, Paulo

    Diffusion-based trajectory observers have been recently proposed as a simple and efficient framework to solve diverse smoothing problems in underwater navigation. For instance, to obtain estimates of the trajectories of an underwater vehicle given position fixes from an acoustic positioning system...... and velocity measurements from a DVL. The observers are conceptually simple and can easily deal with the problems brought about by the occurrence of asynchronous measurements and dropouts. In its original formulation, the trajectory observers depend on a user-defined constant gain that controls the level...... of smoothing and is determined by resorting to trial and error. This paper presents a methodology to choose the observer gain by taking into account a priori information on the variance of the position measurement errors. Experimental results with data from an acoustic positioning system are presented...

  15. TORCH screening in polyhydramnios: an observational study.

    Science.gov (United States)

    Fayyaz, Humera; Rafi, Junaid

    2012-07-01

    The aim of this study was to understand the TORCH test and to evaluate its significance in women with polyhydramnios in singleton pregnancies. Retrospective analysis of indications and results of TORCH referrals made from November 2007 to 2009 with detailed review of case notes of women with polyhydramnios who had TORCH test. The total number of deliveries during specimen time was 3004, out of which 110(3.6%) had serum TORCH screening. The main indication for this test was polyhydramnios 62 (56.36%) followed by obstetric cholestasis 20 (18.18%), Intra-uterine fetal demise 6 (5.45%), fetal anomalies 5(4.54%), and deranged liver function tests (LFTs) 2 (1.8%). 15 (13.6%) women had TORCH screening for other indications such as clinical polyhydramnios, increased nuchal translucency (>2.5 mm). cytomegalovirus (CMV) and toxoplasmosis antibodies were tested in all cases whereas, parvovirus and herpes simplex virus screen were carried out in 4 (12.7%) and 2 (1.8%) patients, respectively. One woman (0.09%) had infection with CMV who had TORCH screening carried out for deranged LFTs. None of these women had positive TORCH screening giving the p value of TORCH test in polyhydramnios, the statistical evaluation shows that this test is not beneficial in women in whom polyhydramnios is an isolated ultrasound finding, especially when it is diagnosed in third trimester.

  16. Traction control of an electric vehicle based on nonlinear observers

    Directory of Open Access Journals (Sweden)

    Diego A. Aligia

    2017-12-01

    Full Text Available A traction control strategy for a four-wheel electric vehicle is proposed in this paper. The strategy is based on nonlinear observers which allows estimating the maximum force that can be transmitted to the road. Knowledge of the maximum force allows controlling the slip of the driving wheels, preventing the wheel’s slippage in low-grip surfaces. The proposed strategy also allows to avoid the undesired yaw moment in the vehicle which occurs when road conditions on either side of it are dierent. This improves the eciency and the control of the vehicle, avoiding possible losses of stability that can result in risks for its occupants. Both the proposed observer and the control strategy are designed based on a dynamic rotational model of the wheel and a brush force model. Simulation results are obtained based on a complete vehicle model on the Simulink/CarSim platform.

  17. [Therapeutic failure in scabies: An observational study].

    Science.gov (United States)

    De Sainte Marie, B; Mallet, S; Gaudy-Marqueste, C; Baumstarck, K; Bentaleb, N; Loundou, A; Hesse, S; Monestier, S; Grob, J-J; Richard, M-A

    2016-01-01

    Several sources suggest an escalation of scabies in France. To describe a population of patients continuing to present with scabies despite multiple treatments in order to identify factors associated with persistence of infection. A descriptive cross-sectional study in adults and children consulting for persistent scabies despite at least one previous treatment. A standardized questionnaire explored potential sources of treatment failure. Thirty-one patients were analyzed. Initial symptoms were noted to have started between two and 52 weeks earlier (mean: 19 weeks). The mean number of prior consultations with a general practitioner was 3.1 (0-10) and 1.7 with a dermatologist (0-7). The mean number of patients per household was 3.5 (1-9). At least one dose of oral ivermectin (maximum of 6 doses per household) was prescribed for 84 % of patients (29 % of whom were not fasted at the time). Further, 74 % of patients received at least one local application of esdepallethrin and piperonyl butoxide (maximum: 5 courses), four received benzyl benzoate and two received permethrin; however, 58 % did not reapply the substance after hand washing. All households bought the prescribed treatments despite the costs. Close contacts of patients were treated in 58 % of households. Decontamination of bedding and clothing was carried out properly in 90 % of households. Persistence of infection appears to be linked to: (1) insufficient treatment of close contacts; (2) absence of a second treatment between days 7 and 14; (3) insufficient efficacy of the available treatments, doubtless due to multiple factors (intrinsic resistance of Sarcoptes, failure to repeat treatment, poor explanation of methods for dosing and application, and oral intake of treatments). Access to non-reimbursed treatments was not identified as a problem and decontamination of bedding and clothing was correctly performed in most cases. Though certain fundamental aspects of scabies treatment must be better

  18. Observer Based Detection of Sensor Faults in Wind Turbines

    DEFF Research Database (Denmark)

    Odgaard, Peter Fogh; Stoustrup, Jakob; Nielsen, R.

    2009-01-01

    An observer based scheme is proposed to detect sensor faults in wind  turbines. In the example used for the proposed scheme the wind turbine  drive train is considered. A model of the drive train is used to  design the observer, and in this model the wind speed is an important  input, however......, if an unknown input observer the fault detection  scheme can be non dependent on the actual wind speed. The scheme  is validated on data from a more advanced and detailed simulation  model. The proposed scheme detects the sensor faults a few samples  after the beginning of the faults....

  19. Observer-Based Robust Control for Hydraulic Velocity Control System

    Directory of Open Access Journals (Sweden)

    Wei Shen

    2013-01-01

    Full Text Available This paper investigates the problems of robust stabilization and robust control for the secondary component speed control system with parameters uncertainty and load disturbance. The aim is to enhance the control performance of hydraulic system based on Common Pressure Rail (CPR. Firstly, a mathematical model is presented to describe the hydraulic control system. Then a novel observer is proposed, and an observed-based control strategy is designed such that the closed-loop system is asymptotically stable and satisfies the disturbance attenuation level. The condition for the existence of the developed controller can by efficiently solved by using the MATLAB software. Finally, simulation results are provided to demonstrate the effectiveness of the proposed method.

  20. Observer-Based Fuel Control Using Oxygen Measurement

    DEFF Research Database (Denmark)

    Andersen, Palle; Bendtsen, Jan Dimon; Mortensen, Jan Henrik

    is constructed and validated against data obtained at the plant. A Kalman filter based on measurements of combustion air flow led into the furnace and oxygen concentration in the flue gas is designed to estimate the actual coal flow. With this estimate, it becomes possible to close an inner loop around the coal......This report describes an attempt to improve the existing control af coal mills used at the Danish power plant Nordjyllandsværket Unit 3. The coal mills are not equipped with coal flow sensors; thus an observer-based approach is investigated. A nonlinear differential equation model of the boiler...

  1. HOW TO DESCRIBE THE RESULTS OF OBSERVATIONAL EPIDEMIOLOGICAL STUDIES

    Directory of Open Access Journals (Sweden)

    S. A. Shal'nova

    2016-01-01

    Full Text Available Principles and fundamentals of proper presentation of observational epidemiological study results are focused. Principles of observational study publication developed by expert epidemiologists (STROBE statement are explained in detail.

  2. The relationship between observer-based toxicity scoring and patient assessed symptom severity after treatment for head and neck cancer. A correlative cross sectional study of the DAHANCA toxicity scoring system and the EORTC quality of life questionnaires

    International Nuclear Information System (INIS)

    Jensen, Kenneth; Bonde Jensen, Anders; Grau, Cai

    2006-01-01

    Background and purpose: Morbidity is an important issue in cancer research. The observer-based toxicity scoring system used by DAHANCA (the Danish head and neck cancer study group) has proved itself sensitive to differences in toxicity in a large randomised study, but like other toxicity scoring systems it has not been formally validated. Conversely, the EORTC quality of life questionnaire (QLQ) has been validated as a tool for collecting information about the consequences of disease and treatment on the well being of cancer patients. The purpose of this study was to examine the relationship between the two methods of side effect recording. Patients and methods: One hundred and sixteen recurrence free patients with laryngeal (n=44), pharyngeal (n=34) and oral cavity (n=38) cancer attending follow-up after radiotherapy (n=83) or surgery (n=33) completed EORTC C30, the core questionnaire concerning general symptoms and function and EORTC H and N35 the head and neck specific questionnaire. The attending physicians in the follow-up clinic evaluated and recorded DAHANCA toxicity scores on the same patients. Results: The DAHANCA toxicity scoring system and the EORTC QLQ correlated with several clinical endpoints. The conceptually similar endpoints of the two methods correlated significantly. The objective endpoints of the DAHANCA scoring system were only correlated with quality of life endpoints to a very low degree. The DAHANCA toxicity scores had a low sensitivity (0.48-0.74) in detecting equivalent subjective complaints from the questionnaires and the observer-based scoring system severely underestimated patient complaints. A specific patient group where the DAHANCA score had a higher tendency to fail could not be detected. Conclusion: The DAHANCA toxicity score is an effective instrument in assessing objective treatment induced toxicity in head and neck cancer patients but insensitive and non-specific with regard to patient assessed subjective endpoints. This

  3. Using data mining techniques to characterize participation in observational studies.

    Science.gov (United States)

    Linden, Ariel; Yarnold, Paul R

    2016-12-01

    Data mining techniques are gaining in popularity among health researchers for an array of purposes, such as improving diagnostic accuracy, identifying high-risk patients and extracting concepts from unstructured data. In this paper, we describe how these techniques can be applied to another area in the health research domain: identifying characteristics of individuals who do and do not choose to participate in observational studies. In contrast to randomized studies where individuals have no control over their treatment assignment, participants in observational studies self-select into the treatment arm and therefore have the potential to differ in their characteristics from those who elect not to participate. These differences may explain part, or all, of the difference in the observed outcome, making it crucial to assess whether there is differential participation based on observed characteristics. As compared to traditional approaches to this assessment, data mining offers a more precise understanding of these differences. To describe and illustrate the application of data mining in this domain, we use data from a primary care-based medical home pilot programme and compare the performance of commonly used classification approaches - logistic regression, support vector machines, random forests and classification tree analysis (CTA) - in correctly classifying participants and non-participants. We find that CTA is substantially more accurate than the other models. Moreover, unlike the other models, CTA offers transparency in its computational approach, ease of interpretation via the decision rules produced and provides statistical results familiar to health researchers. Beyond their application to research, data mining techniques could help administrators to identify new candidates for participation who may most benefit from the intervention. © 2016 John Wiley & Sons, Ltd.

  4. Observational studies of X-ray binary systems

    International Nuclear Information System (INIS)

    Klis, M. van der.

    1983-01-01

    The subject of Chapter 1 is theoretical. The other chapters, Ch. 2 to 6, contain original observational data and efforts towards their interpretation. Of these, Ch. 3, 4 and 5 deal with massive X-ray binaries, Ch. 6 with low-mass systems and Ch. 2 with Cygnus X-3, which we have not yet been able to assign to any of these two classes. The X-ray observations described were made with the COS-B satellite. Work based on UV and optical observations is described in Ch. 5. The UV observations were made with the IUE satellite, the optical observations at several ground-based observatories. (Auth.)

  5. Kalman Based Finite State Controller for Partially Observable Domains

    Directory of Open Access Journals (Sweden)

    H. Levent Akin

    2008-11-01

    Full Text Available A real world environment is often partially observable by the agents either because of noisy sensors or incomplete perception. Moreover, it has continuous state space in nature, and agents must decide on an action for each point in internal continuous belief space. Consequently, it is convenient to model this type of decisionmaking problems as Partially Observable Markov Decision Processes (POMDPs with continuous observation and state space. Most of the POMDP methods whether approximate or exact assume that the underlying world dynamics or POMDP parameters such as transition and observation probabilities are known. However, for many real world environments it is very difficult if not impossible to obtain such information. We assume that only the internal dynamics of the agent, such as the actuator noise, interpretation of the sensor suite, are known. Using these internal dynamics, our algorithm, namely Kalman Based Finite State Controller (KBFSC, constructs an internal world model over the continuous belief space, represented by a finite state automaton. Constructed automaton nodes are points of the continuous belief space sharing a common best action and a common uncertainty level. KBFSC deals with continuous Gaussian-based POMDPs. It makes use of Kalman Filter for belief state estimation, which also is an efficient method to prune unvisited segments of the belief space and can foresee the reachable belief points approximately calculating the horizon N policy. KBFSC does not use an "explore and update" approach in the value calculation as TD-learning. Therefore KBFSC does not have an extensive exploration-exploitation phase. Using the MDP case reward and the internal dynamics of the agent, KBFSC can automatically construct the finite state automaton (FSA representing the approximate optimal policy without the need for discretization of the state and observation space. Moreover, the policy always converges for POMDP problems.

  6. Kalman Based Finite State Controller for Partially Observable Domains

    Directory of Open Access Journals (Sweden)

    Alp Sardag

    2006-12-01

    Full Text Available A real world environment is often partially observable by the agents either because of noisy sensors or incomplete perception. Moreover, it has continuous state space in nature, and agents must decide on an action for each point in internal continuous belief space. Consequently, it is convenient to model this type of decision-making problems as Partially Observable Markov Decision Processes (POMDPs with continuous observation and state space. Most of the POMDP methods whether approximate or exact assume that the underlying world dynamics or POMDP parameters such as transition and observation probabilities are known. However, for many real world environments it is very difficult if not impossible to obtain such information. We assume that only the internal dynamics of the agent, such as the actuator noise, interpretation of the sensor suite, are known. Using these internal dynamics, our algorithm, namely Kalman Based Finite State Controller (KBFSC, constructs an internal world model over the continuous belief space, represented by a finite state automaton. Constructed automaton nodes are points of the continuous belief space sharing a common best action and a common uncertainty level. KBFSC deals with continuous Gaussian-based POMDPs. It makes use of Kalman Filter for belief state estimation, which also is an efficient method to prune unvisited segments of the belief space and can foresee the reachable belief points approximately calculating the horizon N policy. KBFSC does not use an “explore and update” approach in the value calculation as TD-learning. Therefore KBFSC does not have an extensive exploration-exploitation phase. Using the MDP case reward and the internal dynamics of the agent, KBFSC can automatically construct the finite state automaton (FSA representing the approximate optimal policy without the need for discretization of the state and observation space. Moreover, the policy always converges for POMDP problems.

  7. Targeted Maximum Likelihood Estimation for Causal Inference in Observational Studies.

    Science.gov (United States)

    Schuler, Megan S; Rose, Sherri

    2017-01-01

    Estimation of causal effects using observational data continues to grow in popularity in the epidemiologic literature. While many applications of causal effect estimation use propensity score methods or G-computation, targeted maximum likelihood estimation (TMLE) is a well-established alternative method with desirable statistical properties. TMLE is a doubly robust maximum-likelihood-based approach that includes a secondary "targeting" step that optimizes the bias-variance tradeoff for the target parameter. Under standard causal assumptions, estimates can be interpreted as causal effects. Because TMLE has not been as widely implemented in epidemiologic research, we aim to provide an accessible presentation of TMLE for applied researchers. We give step-by-step instructions for using TMLE to estimate the average treatment effect in the context of an observational study. We discuss conceptual similarities and differences between TMLE and 2 common estimation approaches (G-computation and inverse probability weighting) and present findings on their relative performance using simulated data. Our simulation study compares methods under parametric regression misspecification; our results highlight TMLE's property of double robustness. Additionally, we discuss best practices for TMLE implementation, particularly the use of ensembled machine learning algorithms. Our simulation study demonstrates all methods using super learning, highlighting that incorporation of machine learning may outperform parametric regression in observational data settings. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Observational study of outpatients with schizophrenia in the Middle ...

    African Journals Online (AJOL)

    Observational study of outpatients with schizophrenia in the Middle East and Africa — 3- and 6-month efficacy and safety results. The Intercontinental Schizophrenia Outpatient Health Outcomes Study.

  9. Disturbance observer based hierarchical control of coaxial-rotor UAV.

    Science.gov (United States)

    Mokhtari, M Rida; Cherki, Brahim; Braham, Amal Choukchou

    2017-03-01

    This paper propose an hierarchical controller based on a new disturbance observer with finite time convergence (FTDO) to solve the path tracking of a small coaxial-rotor-typs Unmanned Aerial Vehicles (UAVs) despite of unknown aerodynamic efforts. The hierarchical control technique is used to separate the flight control problem into an inner loop that controls attitude and an outer loop that controls the thrust force acting on the vehicle. The new disturbance observer with finite time convergence is intergated to online estimate the unknown uncertainties and disturbances and to actively compensate them in finite time.The analysis further extends to the design of a control law that takes the disturbance estimation procedure into account. Numerical simulations are carried out to demonstrate the efficiency of the proposed control strategy. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

  10. OBSERVED AIR POLLUTION SPECIFICS OF THE VALLEY-BASED TOWNS

    Directory of Open Access Journals (Sweden)

    ZOLTÁN UTASI

    2012-03-01

    Full Text Available Observed air pollution specifics of the valley-based towns. There are 21 valley-based towns in the 100 most populated ones of Hungary. This topographical feature may be advantageous due to mezoscale circulation between the valley or basin, containing these settlements and the surrounding hills. On the other hand, the hills form a mechanical obstacle that may limit the vertical mixing of pollution. Final result of these counteracting features are analysed by comparing air pollution characteristics of these settlements with those in two control groups, also counting 21-21 non-valley towns of the country. Each group represents slightly over 1 million inhabitants. Nitrogen dioxide (NO2, sulphur-dioxide (SO2 concentrations and the total particulate matter below 10 µm (PM10 are considered. Annual mean, maxima and median values are analysed in 2007. For NO2 the valley-based towns are slightly cleaner, whereas for SO2 the situation is the opposite. The PM10 values do not indicate much difference between valley based and fully plain settlements. For explanation of these results, selected settlement and communal statistics are also compared. The paper is terminated by a sub-collection of similar valley-based towns in Central Europe.

  11. OBSERVATIONAL SELECTION EFFECTS WITH GROUND-BASED GRAVITATIONAL WAVE DETECTORS

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Hsin-Yu; Holz, Daniel E. [University of Chicago, Chicago, Illinois 60637 (United States); Essick, Reed; Vitale, Salvatore; Katsavounidis, Erik [LIGO, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139 (United States)

    2017-01-20

    Ground-based interferometers are not perfect all-sky instruments, and it is important to account for their behavior when considering the distribution of detected events. In particular, the LIGO detectors are most sensitive to sources above North America and the Indian Ocean, and as the Earth rotates, the sensitive regions are swept across the sky. However, because the detectors do not acquire data uniformly over time, there is a net bias on detectable sources’ right ascensions. Both LIGO detectors preferentially collect data during their local night; it is more than twice as likely to be local midnight than noon when both detectors are operating. We discuss these selection effects and how they impact LIGO’s observations and electromagnetic (EM) follow-up. Beyond galactic foregrounds associated with seasonal variations, we find that equatorial observatories can access over 80% of the localization probability, while mid-latitudes will access closer to 70%. Facilities located near the two LIGO sites can observe sources closer to their zenith than their analogs in the south, but the average observation will still be no closer than 44° from zenith. We also find that observatories in Africa or the South Atlantic will wait systematically longer before they can begin observing compared to the rest of the world; though, there is a preference for longitudes near the LIGOs. These effects, along with knowledge of the LIGO antenna pattern, can inform EM follow-up activities and optimization, including the possibility of directing observations even before gravitational-wave events occur.

  12. Learning to observe mathematical learning in lesson studies

    DEFF Research Database (Denmark)

    Rasmussen, Klaus; Østergaard, Camilla Hellsten; Foss, Kristian Kildemoes

    2016-01-01

    This poster deals with lesson study (LS) in pre-service teacher education. In particular how to prepare for, carry out, and reflect upon, observations of pupil learning. Observation is of crucial importance to the lesson study process, and here we present a study of observation features which ena...... enable or hinder fruitful lesson study. While substantial research has been carried out in the general field of bserving pupils’ learning processes and teachers’ pedagogical practice, little is known about this in the particular setting of lesson study.......This poster deals with lesson study (LS) in pre-service teacher education. In particular how to prepare for, carry out, and reflect upon, observations of pupil learning. Observation is of crucial importance to the lesson study process, and here we present a study of observation features which...

  13. Observer-based Coal Mill Control using Oxygen Measurements

    DEFF Research Database (Denmark)

    Andersen, Palle; Bendtsen, Jan Dimon; S., Tom

    2006-01-01

    This paper proposes a novel approach to coal flow estimation in pulverized coal mills, which utilizes measurements of oxygen content in the flue gas. Pulverized coal mills are typically not equipped with sensors that detect the amount of coal injected into the furnace. This makes control...... into the furnace and oxygen concentration in the flue gas is designed to estimate the actual coal flow injected into the furnace. With this estimate, it becomes possible to close an inner loop around the coal mill itself, thus giving a better disturbance rejection capability. The approach is validated against...... of the coal flow difficult, causing stability problems and limits the plant's load following capabilities. To alleviate this problem without having to rely on expensive flow measurement equipment, a novel observer-based approach is investigated. A Kalman filter based on measurements of combustion air flow led...

  14. Are general and strategic measures of organizational context and leadership associated with knowledge and attitudes toward evidence-based practices in public behavioral health settings? A cross-sectional observational study.

    Science.gov (United States)

    Powell, Byron J; Mandell, David S; Hadley, Trevor R; Rubin, Ronnie M; Evans, Arthur C; Hurford, Matthew O; Beidas, Rinad S

    2017-05-12

    Examining the role of modifiable barriers and facilitators is a necessary step toward developing effective implementation strategies. This study examines whether both general (organizational culture, organizational climate, and transformational leadership) and strategic (implementation climate and implementation leadership) organizational-level factors predict therapist-level determinants of implementation (knowledge of and attitudes toward evidence-based practices). Within the context of a system-wide effort to increase the use of evidence-based practices (EBPs) and recovery-oriented care, we conducted an observational, cross-sectional study of 19 child-serving agencies in the City of Philadelphia, including 23 sites, 130 therapists, 36 supervisors, and 22 executive administrators. Organizational variables included characteristics such as EBP initiative participation, program size, and proportion of independent contractor therapists; general factors such as organizational culture and climate (Organizational Social Context Measurement System) and transformational leadership (Multifactor Leadership Questionnaire); and strategic factors such as implementation climate (Implementation Climate Scale) and implementation leadership (Implementation Leadership Scale). Therapist-level variables included demographics, attitudes toward EBPs (Evidence-Based Practice Attitudes Scale), and knowledge of EBPs (Knowledge of Evidence-Based Services Questionnaire). We used linear mixed-effects regression models to estimate the associations between the predictor (organizational characteristics, general and strategic factors) and dependent (knowledge of and attitudes toward EBPs) variables. Several variables were associated with therapists' knowledge of EBPs. Clinicians in organizations with more proficient cultures or higher levels of transformational leadership (idealized influence) had greater knowledge of EBPs; conversely, clinicians in organizations with more resistant cultures

  15. Quality of oral anticoagulation with phenprocoumon in regular medical care and its potential for improvement in a telemedicine-based coagulation service--results from the prospective, multi-center, observational cohort study thrombEVAL.

    Science.gov (United States)

    Prochaska, Jürgen H; Göbel, Sebastian; Keller, Karsten; Coldewey, Meike; Ullmann, Alexander; Lamparter, Heidrun; Jünger, Claus; Al-Bayati, Zaid; Baer, Christina; Walter, Ulrich; Bickel, Christoph; ten Cate, Hugo; Münzel, Thomas; Wild, Philipp S

    2015-01-23

    The majority of studies on quality of oral anticoagulation (OAC) therapy with vitamin K-antagonists are performed with short-acting warfarin. Data on long-acting phenprocoumon, which is frequently used in Europe for OAC therapy and is considered to enable more stable therapy adjustment, are scarce. In this study, we aimed to assess quality of OAC therapy with phenprocoumon in regular medical care and to evaluate its potential for optimization in a telemedicine-based coagulation service. In the prospective observational cohort study program thrombEVAL we investigated 2,011 patients from regular medical care in a multi-center cohort study and 760 patients from a telemedicine-based coagulation service in a single-center cohort study. Data were obtained from self-reported data, computer-assisted personal interviews, and laboratory measurements according to standard operating procedures with detailed quality control. Time in therapeutic range (TTR) was calculated by linear interpolation method to assess quality of OAC therapy. Study monitoring was carried out by an independent institution. Overall, 15,377 treatment years and 48,955 international normalized ratio (INR) measurements were analyzed. Quality of anticoagulation, as measured by median TTR, was 66.3% (interquartile range (IQR) 47.8/81.9) in regular medical care and 75.5% (IQR 64.2/84.4) in the coagulation service (P service with TTR at 76.2% [(IQR 65.6/84.7); P = 0.001)]. Prospective follow-up of coagulation service patients with pretreatment in regular medical care showed an improvement of the TTR from 66.2% (IQR 49.0/83.6) to 74.5% (IQR 62.9/84.2; P service. Treatment in the coagulation service contributed to an optimization of the profile of time outside therapeutic range, a 2.2-fold increase of stabile INR adjustment and a significant decrease in TTR variability by 36% (P Quality of anticoagulation with phenprocoumon was comparably high in this real-world sample of regular medical care. Treatment in a

  16. Primary Trauma Triage Performed by Bystanders: An Observation Study.

    Science.gov (United States)

    Nordberg, Martin; Castrén, Maaret; Lindström, Veronica

    2016-08-01

    The aim of this study was to evaluate whether bystanders with no training in triage can correctly prioritize three injured patients by using a triage instrument. An observational study was conducted. Participants performed a primary triage on three paper-based patient cases and answered 11 questions during a public event in the center of Stockholm, Sweden. A total of 69 persons participated in the study. The success rate among all the participants for correct triage of the three patient cases was 52 percent. The female participants and younger participants (triage to a greater extent. The over-triage was 12.5 percent and under-triage was 6.3 percent. Participants with no prior knowledge of triage instruments may be capable of triaging injured patients with the help of an easy triage instrument. The over- and under-triage percentages were low, and this may indicate that the developed triage instrument is relatively easy to use. It may also indicate that bystanders can identify a severely injured patient. Nordberg M , Castrén M , Lindström V . Primary trauma triage performed by bystanders: an observation study. Prehosp Disaster Med. 2016;31(4):353-357.

  17. [Inferential evaluation of intimacy based on observation of interpersonal communication].

    Science.gov (United States)

    Kimura, Masanori

    2015-06-01

    How do people inferentially evaluate others' levels of intimacy with friends? We examined the inferential evaluation of intimacy based on the observation of interpersonal communication. In Experiment 1, participants (N = 41) responded to questions after observing conversations between friends. Results indicated that participants inferentially evaluated not only goodness of communication, but also intimacy between friends, using an expressivity heuristic approach. In Experiment 2, we investigated how inferential evaluation of intimacy was affected by prior information about relationships and by individual differences in face-to-face interactional ability. Participants (N = 64) were divided into prior- and no-prior-information groups and all performed the same task as in Experiment 1. Additionally, their interactional ability was assessed. In the prior-information group, individual differences had no effect on inferential evaluation of intimacy. On the other hand, in the no-prior-information group, face-to-face interactional ability partially influenced evaluations of intimacy. Finally, we discuss the fact that to understand one's social environment, it is important to observe others' interpersonal communications.

  18. Observing Tsunamis in the Ionosphere Using Ground Based GPS Measurements

    Science.gov (United States)

    Galvan, D. A.; Komjathy, A.; Song, Y. Tony; Stephens, P.; Hickey, M. P.; Foster, J.

    2011-01-01

    Ground-based Global Positioning System (GPS) measurements of ionospheric Total Electron Content (TEC) show variations consistent with atmospheric internal gravity waves caused by ocean tsunamis following recent seismic events, including the Tohoku tsunami of March 11, 2011. We observe fluctuations correlated in time, space, and wave properties with this tsunami in TEC estimates processed using JPL's Global Ionospheric Mapping Software. These TEC estimates were band-pass filtered to remove ionospheric TEC variations with periods outside the typical range of internal gravity waves caused by tsunamis. Observable variations in TEC appear correlated with the Tohoku tsunami near the epicenter, at Hawaii, and near the west coast of North America. Disturbance magnitudes are 1-10% of the background TEC value. Observations near the epicenter are compared to estimates of expected tsunami-driven TEC variations produced by Embry Riddle Aeronautical University's Spectral Full Wave Model, an atmosphere-ionosphere coupling model, and found to be in good agreement. The potential exists to apply these detection techniques to real-time GPS TEC data, providing estimates of tsunami speed and amplitude that may be useful for future early warning systems.

  19. Retrieval and analysis of atmospheric XCO2 using ground-based spectral observation.

    Science.gov (United States)

    Qin, Xiu-Chun; Lei, Li-Ping; Kawasaki, Masahiro; Masafumi, Ohashi; Takahiro, Kuroki; Zeng, Zhao-Cheng; Zhang, Bing

    2014-07-01

    Atmospheric CO2 column concentration (column-averaged dry air mole fractions of atmospheric carbon dioxide) data obtained by ground-based hyperspectral observation is an important source of data for the verification and improvement of the results of CO2 retrieval based on satellite hyperspectral observation. However, few studies have been conducted on atmospheric CO2 column concentration retrieval based on ground-based spectral hyperspectral observation in China. In the present study, we carried out the ground-based hyperspectral observation in Xilingol Grassland, Inner Mongolia of China by using an observation system which is consisted of an optical spectral analyzer, a sun tracker, and some other elements. The atmospheric CO2 column concentration was retrieved using the observed hyperspectral data. The effect of a wavelength shift of the observation spectra and the meteorological parameters on the retrieval precision of the atmospheric CO2 concentration was evaluated and analyzed. The results show that the mean value of atmospheric CO2 concentration was 390.9 microg x mL(-1) in the study area during the observing period from July to September. The shift of wavelength in the range between -0.012 and 0.042 nm will generally lead to 1 microg x mL(-1) deviation in the CO2 retrievals. This study also revealed that the spectral transmittance was sensitive to meteorological parameters in the wavelength range of 6 357-6 358, 6 360-6 361, and 6 363-6 364 cm(-1). By comparing the CO2 retrievals derived from the meteorological parameters observed in synchronous and non-synchronous time, respectively, with the spectral observation, it was showed that the concentration deviation caused by using the non-synchronously observed meteorological parameters is ranged from 0.11 to 4 microg x mL(-1). These results can be used as references for the further improvement of retrieving CO2 column concentration based on spectral observation.

  20. How safe do teenagers behave on Facebook? An observational study.

    Directory of Open Access Journals (Sweden)

    Ellen Vanderhoven

    Full Text Available The substantial use of social network sites by teenagers has raised concerns about privacy and security. Previous research about behavior on social network sites was mostly based on surveys and interviews. Observational research overcomes problems inherent to this research method, for example social desirability. However, existing observational research mostly focuses on public profiles of young adults. Therefore, the current observation-study includes 1050 public and non-public Facebook-profiles of teenagers (13-18 to investigate (1 what kind of information teenagers post on their profile, (2 to what extent they protect this information using privacy-settings and (3 how much risky information they have on their profile. It was found that young people mostly post pictures, interests and some basic personal information on their profile. Some of them manage their privacy-settings as such that this information is reserved for friends' eyes only, but a lot of information is accessible on the friends-of-friends' pages. Although general risk scores are rather low, more detailed analyses show that teenagers nevertheless post a significant amount of risky information. Moreover, older teenagers and girls post more (risky information while there are no differences in applying privacy settings. We found no differences in the Facebook behavior of teenagers enrolled in different education forms. Implications of these results are discussed.

  1. How safe do teenagers behave on Facebook? An observational study.

    Science.gov (United States)

    Vanderhoven, Ellen; Schellens, Tammy; Valcke, Martin; Raes, Annelies

    2014-01-01

    The substantial use of social network sites by teenagers has raised concerns about privacy and security. Previous research about behavior on social network sites was mostly based on surveys and interviews. Observational research overcomes problems inherent to this research method, for example social desirability. However, existing observational research mostly focuses on public profiles of young adults. Therefore, the current observation-study includes 1050 public and non-public Facebook-profiles of teenagers (13-18) to investigate (1) what kind of information teenagers post on their profile, (2) to what extent they protect this information using privacy-settings and (3) how much risky information they have on their profile. It was found that young people mostly post pictures, interests and some basic personal information on their profile. Some of them manage their privacy-settings as such that this information is reserved for friends' eyes only, but a lot of information is accessible on the friends-of-friends' pages. Although general risk scores are rather low, more detailed analyses show that teenagers nevertheless post a significant amount of risky information. Moreover, older teenagers and girls post more (risky) information while there are no differences in applying privacy settings. We found no differences in the Facebook behavior of teenagers enrolled in different education forms. Implications of these results are discussed.

  2. Monolayered copper based film. Experimental observation and theoretical investigation.

    Science.gov (United States)

    Sorokin, Pavel; Kano, Emi; Kvashnin, Dmitry; Chernozatonskii, Leonid; Sakai, Seiji; Hashimoto, Ayako; Takeguchi, Masaki

    Here we present the report of existence of novel two-dimensional phase of copper oxide studied by experimental and theoretical methods. Using in situ scanning transmission electron microscopy it was observed 2D CuO on graphene as well as in the graphene pore with principally different structure from the former reports Density functional theory allowed to elucidate the nature of the stability of observed CuO nanofilms. It was defined a critical role of the oxygen impurity atoms in the formation of stable 2D Cu cluster with unexpected orthogonal crystal lattice. It was found that the structure and stability of 2D Cu clusters strongly depends on the concentration and relative arrangement of oxygen impurities. Number of oxygen configurations was analyzed and the stable configuration was found corresponded well with experimental data. Additional to separated clusters, the periodic 2D CuO crystal was studied in details. Relative stability, features of elastic, electronic and magnetic properties were investigated. First-principles calculations explained the origin of the 2D phase formation and confirms the experimentally observed structures. P.B.S. acknowledges the fi\\x81nancial support of the Ministry of Education and Science of the Russian Federation in the framework of Increase Competitiveness Program of NUST ''MISiS'' No. 2-2015-033 and RFBR 16-32-60138 mol a dk.

  3. Automated Detection of Small Bodies by Space Based Observation

    Science.gov (United States)

    Bidstrup, P. R.; Grillmayer, G.; Andersen, A. C.; Haack, H.; Jorgensen, J. L.

    The number of known comets and asteroids is increasing every year. Up till now this number is including approximately 250,000 of the largest minor planets, as they are usually referred. These discoveries are due to the Earth-based observation which has intensified over the previous decades. Additionally larger telescopes and arrays of telescopes are being used for exploring our Solar System. It is believed that all near- Earth and Main-Belt asteroids of diameters above 10 to 30 km have been discovered, leaving these groups of objects as observationally complete. However, the cataloguing of smaller bodies is incomplete as only a very small fraction of the expected number has been discovered. It is estimated that approximately 1010 main belt asteroids in the size range 1 m to 1 km are too faint to be observed using Earth-based telescopes. In order to observe these small bodies, space-based search must be initiated to remove atmospheric disturbances and to minimize the distance to the asteroids and thereby minimising the requirement for long camera integration times. A new method of space-based detection of moving non-stellar objects is currently being developed utilising the Advanced Stellar Compass (ASC) built for spacecraft attitude determination by Ørsted, Danish Technical University. The ASC serves as a backbone technology in the project as it is capable of fully automated distinction of known and unknown celestial objects. By only processing objects of particular interest, i.e. moving objects, it will be possible to discover small bodies with a minimum of ground control, with the ultimate ambition of a fully automated space search probe. Currently, the ASC is being mounted on the Flying Laptop satellite of the Institute of Space Systems, Universität Stuttgart. It will, after a launch into a low Earth polar orbit in 2008, test the detection method with the ASC equipment that already had significant in-flight experience. A future use of the ASC based automated

  4. Impact of radiotherapy on implant-based prosthetic rehabilitation in patients with head and neck cancer: A prospective observational study on implant survival and quality of life-Preliminary results.

    Science.gov (United States)

    Ettl, Tobias; Weindler, Janet; Gosau, Martin; Müller, Steffen; Hautmann, Matthias; Zeman, Florian; Koller, Michael; Papavasileiou, Dimitrios; Bürgers, Ralf; Driemel, Oliver; Schneider, Isabel; Klingelhöffer, Christoph; Meier, Johannes; Wahlmann, Ulrich; Reichert, Torsten E

    2016-09-01

    To study implant-based prosthetic rehabilitation of head and neck cancer patients with focus on implant survival and quality of life. The prospective observational study presents preliminary results of 29 edentulous head neck cancer patients (20 patients after radiotherapy) with 165 OsseoSpeed implants. Implant success after 1-year follow-up was evaluated by means of the Albrektsson criteria. Quality of life was analysed with the EORTC QLQ-C30, QLQ-H&N35, and OHIP 14 questionnaires. The overall implant survival rate after 1 year was 95.2% (157/165). Implant success measured by the Albrektsson criteria showed a lower success rate of 86.7% (143/165), mainly because of peri-implant marginal bone loss with a mean of 0.8 mm after 1 year. Xerostomia (p = 0.008), implant insertion within the radiation target volume (p = 0.09), implantation in transplanted bone (p = 0.05), and smoking (p = 0.041) were the main reasons for implant failure, followed by D4 bone quality, maxillary implant site, and insufficient primary stability. Speaking, swallowing, eating, as well as social integration and individual self-confidence had considerably improved 1 year after denture placement compared to before treatment. Implant-based prosthetic rehabilitation of head and neck cancer patients is possible at a calculable risk and significantly improves patients' quality of life. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  5. Verifying Embedded Systems using Component-based Runtime Observers

    DEFF Research Database (Denmark)

    Guan, Wei; Marian, Nicolae; Angelov, Christo K.

    Formal verification methods, such as exhaustive model checking, are often infeasible because of high computational complexity. Runtime observers (monitors) provide an alternative, light-weight verification method, which offers a non-exhaustive yet feasible approach to monitoring system behavior...... is a reconfigurable component processing a data structure, representing the state transition diagram of a non-deterministic state machine, i.e. a Buchi automaton derived from a system property specified in Linear Temporal Logic (LTL). Observer components have been implemented using design models and design patterns...... specified properties via simulation. The presented method has been experimentally validated in an industrial case study---a control system for a safety-critical medical ventilator unit....

  6. Concatenation of observed grasp phases with observer's distal movements: a behavioural and TMS study.

    Directory of Open Access Journals (Sweden)

    Elisa De Stefani

    Full Text Available The present study aimed at determining how actions executed by two conspecifics can be coordinated with each other, or more specifically, how the observation of different phases of a reaching-grasping action is temporary related to the execution of a movement of the observer. Participants observed postures of initial finger opening, maximal finger aperture, and final finger closing of grasp after observation of an initial hand posture. Then, they opened or closed their right thumb and index finger (experiments 1, 2 and 3. Response times decreased, whereas acceleration and velocity of actual finger movements increased when observing the two late phases of grasp. In addition, the results ruled out the possibility that this effect was due to salience of the visual stimulus when the hand was close to the target and confirmed an effect of even hand postures in addition to hand apparent motion due to the succession of initial hand posture and grasp phase. In experiments 4 and 5, the observation of grasp phases modulated even foot movements and pronunciation of syllables. Finally, in experiment 6, transcranial magnetic stimulation applied to primary motor cortex 300 ms post-stimulus induced an increase in hand motor evoked potentials of opponens pollicis muscle when observing the two late phases of grasp. These data suggest that the observation of grasp phases induced simulation which was stronger during observation of finger closing. This produced shorter response times, greater acceleration and velocity of the successive movement. In general, our data suggest best concatenation between two movements (one observed and the other executed when the observed (and simulated movement was to be accomplished. The mechanism joining the observation of a conspecific's action with our own movement may be precursor of social functions. It may be at the basis for interactions between conspecifics, and related to communication between individuals.

  7. Concatenation of observed grasp phases with observer's distal movements: a behavioural and TMS study.

    Science.gov (United States)

    De Stefani, Elisa; Innocenti, Alessandro; De Marco, Doriana; Gentilucci, Maurizio

    2013-01-01

    The present study aimed at determining how actions executed by two conspecifics can be coordinated with each other, or more specifically, how the observation of different phases of a reaching-grasping action is temporary related to the execution of a movement of the observer. Participants observed postures of initial finger opening, maximal finger aperture, and final finger closing of grasp after observation of an initial hand posture. Then, they opened or closed their right thumb and index finger (experiments 1, 2 and 3). Response times decreased, whereas acceleration and velocity of actual finger movements increased when observing the two late phases of grasp. In addition, the results ruled out the possibility that this effect was due to salience of the visual stimulus when the hand was close to the target and confirmed an effect of even hand postures in addition to hand apparent motion due to the succession of initial hand posture and grasp phase. In experiments 4 and 5, the observation of grasp phases modulated even foot movements and pronunciation of syllables. Finally, in experiment 6, transcranial magnetic stimulation applied to primary motor cortex 300 ms post-stimulus induced an increase in hand motor evoked potentials of opponens pollicis muscle when observing the two late phases of grasp. These data suggest that the observation of grasp phases induced simulation which was stronger during observation of finger closing. This produced shorter response times, greater acceleration and velocity of the successive movement. In general, our data suggest best concatenation between two movements (one observed and the other executed) when the observed (and simulated) movement was to be accomplished. The mechanism joining the observation of a conspecific's action with our own movement may be precursor of social functions. It may be at the basis for interactions between conspecifics, and related to communication between individuals.

  8. Reservoirs for Comets: Compositional Differences Based on Infrared Observations

    Science.gov (United States)

    Disanti, Michael A.; Mumma, Michael J.

    Tracing measured compositions of comets to their origins continues to be of keen interest to cometary scientists and to dynamical modelers of Solar System formation and evolution. This requires building a taxonomy of comets from both present-day dynamical reservoirs: the Kuiper Belt (hereafter KB), sampled through observation of ecliptic comets (primarily Jupiter Family comets, or JFCs), and the Oort cloud (OC), represented observationally by the long-period comets and by Halley Family comets (HFCs). Because of their short orbital periods, JFCs are subjected to more frequent exposure to solar radiation compared with OC comets. The recent apparitions of the JFCs 9P/Tempel 1 and 73P/Schwassmann-Wachmann 3 permitted detailed observations of material issuing from below their surfaces—these comets added significantly to the compositional database on this dynamical class, which is under-represented in studies of cometary parent volatiles. This chapter reviews the latest techniques developed for analysis of high-resolution spectral observations from ˜2-5 μm, and compares measured abundances of native ices among comets. While no clear compositional delineation can be drawn along dynamical lines, interesting comparisons can be made. The sub-surface composition of comet 9P, as revealed by the Deep Impact ejecta, was similar to the majority of OC comets studied. Meanwhile, 73P was depleted in all native ices except HCN, similar to the disintegrated OC comet C/1999 S4 (LINEAR). These results suggest that 73P may have formed in the inner giant planets' region while 9P formed farther out or, alternatively, that both JFCs formed farther from the Sun but with 73P forming later in time.

  9. A conceptual framework for evaluating data suitability for observational studies.

    Science.gov (United States)

    Shang, Ning; Weng, Chunhua; Hripcsak, George

    2017-09-08

    To contribute a conceptual framework for evaluating data suitability to satisfy the research needs of observational studies. Suitability considerations were derived from a systematic literature review on researchers' common data needs in observational studies and a scoping review on frequent clinical database design considerations, and were harmonized to construct a suitability conceptual framework using a bottom-up approach. The relationships among the suitability categories are explored from the perspective of 4 facets of data: intrinsic, contextual, representational, and accessible. A web-based national survey of domain experts was conducted to validate the framework. Data suitability for observational studies hinges on the following key categories: Explicitness of Policy and Data Governance, Relevance, Availability of Descriptive Metadata and Provenance Documentation, Usability, and Quality. We describe 16 measures and 33 sub-measures. The survey uncovered the relevance of all categories, with a 5-point Likert importance score of 3.9 ± 1.0 for Explicitness of Policy and Data Governance, 4.1 ± 1.0 for Relevance, 3.9 ± 0.9 for Availability of Descriptive Metadata and Provenance Documentation, 4.2 ± 1.0 for Usability, and 4.0 ± 0.9 for Quality. The suitability framework evaluates a clinical data source's fitness for research use. Its construction reflects both researchers' points of view and data custodians' design features. The feedback from domain experts rated Usability, Relevance, and Quality categories as the most important considerations. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  10. A new permutation-based method for assessing agreement between two observers making replicated binary readings.

    Science.gov (United States)

    Pan, Yi; Haber, Michael; Barnhart, Huiman X

    2011-04-15

    A new coefficient for assessing agreement between two observers using a permutation-based method is introduced in this article. When observations are binary, this coefficient compares the observed disagreement (probability of discordance) between the observers with its expected value under the hypothesis of individual equivalence. This hypothesis states that for each subject, the conditional distributions of the readings of the two observers are identical, and therefore from a statistical viewpoint it does not matter which observer makes the reading on this subject. Let K and L denote the numbers of replicated observations that are available from observers X and Y, respectively, on a given subject. Then the expected disagreement under individual equivalence for a subject is based on the (K + L) choosing K possible assignments of X's and Y's to the K + L observations made on this subject. Simple methods for the estimation of the new coefficient and its standard error are derived. The new coefficient is compared with kappa and the coefficient of individual agreement, which is based on comparing the inter and intra observer disagreements. Simulation studies confirm the validity of the estimated coefficient and its standard error. Data from a study involving the evaluation of mammograms by 10 radiologists are used to illustrate this new approach to the evaluation of observer agreement. Copyright © 2010 John Wiley & Sons, Ltd.

  11. Capacitance Online Estimation Based on Adaptive Model Observer

    Directory of Open Access Journals (Sweden)

    Cen Zhaohui

    2016-01-01

    Full Text Available As a basic component in electrical and electronic devices, capacitors are very popular in electrical circuits. Conventional capacitors such as electrotype capacitors are easy to degradation, aging and fatigue due to long‐time running and outer damages such as mechanical and electrical stresses. In this paper, a novel online capacitance measurement/estimation approach is proposed. Firstly, an Adaptive Model Observer (AMO is designed based on the capacitor's circuit equations. Secondly, the AMO’s stability and convergence are analysed and discussed. Finally, Capacitors with different capacitance and different initial voltages in a buck converter topology are tested and validated. Simulation results demonstrate the effectiveness and superiority of our proposed approach.

  12. An Observational Study of Entrainment Rate in Deep Convection

    Directory of Open Access Journals (Sweden)

    Xiaohao Guo

    2015-09-01

    Full Text Available This study estimates entrainment rate and investigates its relationships with cloud properties in 156 deep convective clouds based on in-situ aircraft observations during the TOGA-COARE (Tropical Ocean Global Atmosphere Coupled Ocean Atmosphere Response Experiment field campaign over the western Pacific. To the authors’ knowledge, this is the first study on the probability density function of entrainment rate, the relationships between entrainment rate and cloud microphysics, and the effects of dry air sources on the calculated entrainment rate in deep convection from an observational perspective. Results show that the probability density function of entrainment rate can be well fitted by lognormal, gamma or Weibull distribution, with coefficients of determination being 0.82, 0.85 and 0.80, respectively. Entrainment tends to reduce temperature, water vapor content and moist static energy in cloud due to evaporative cooling and dilution. Inspection of the relationships between entrainment rate and microphysical properties reveals a negative correlation between volume-mean radius and entrainment rate, suggesting the potential dominance of homogeneous mechanism in the clouds examined. In addition, entrainment rate and environmental water vapor content show similar tendencies of variation with the distance of the assumed environmental air to the cloud edges. Their variation tendencies are non-monotonic due to the relatively short distance between adjacent clouds.

  13. An Observed Voting System Based On Biometric Technique

    Directory of Open Access Journals (Sweden)

    B. Devikiruba

    2015-08-01

    Full Text Available ABSTRACT This article describes a computational framework which can run almost on every computer connected to an IP based network to study biometric techniques. This paper discusses with a system protecting confidential information puts strong security demands on the identification. Biometry provides us with a user-friendly method for this identification and is becoming a competitor for current identification mechanisms. The experimentation section focuses on biometric verification specifically based on fingerprints. This article should be read as a warning to those thinking of using methods of identification without first examine the technical opportunities for compromising mechanisms and the associated legal consequences. The development is based on the java language that easily improves software packages that is useful to test new control techniques.

  14. A structured, group-based diabetes self-management education (DSME) programme for people, families and whanau with type 2 diabetes (T2DM) in New Zealand: an observational study.

    Science.gov (United States)

    Krebs, J D; Parry-Strong, A; Gamble, E; McBain, L; Bingham, L J; Dutton, E S; Tapu-Ta'ala, S; Howells, J; Metekingi, H; Smith, R B W; Coppell, K J

    2013-07-01

    Group-based diabetes self-management education (DSME) programmes have been shown to be effective. A programme tailored for the unique social and ethnic environment of New Zealand (NZ) was developed using concepts from internationally developed programmes. To assess the effectiveness of a 6 week New Zealand specific DSME programme. In this observational study people with type 2 diabetes (aged 18-80 years) from diverse cultural backgrounds were recruited from primary care. Seventeen groups of six education sessions were run. Clinical data were collected from primary care at baseline, 3, 6 and 9 months. Participants also completed a self-administered questionnaire on diabetes knowledge, and self-management behaviours. 107 participants, mean age 56.7±11.3 years and mean duration of diabetes 7.5±7 years (NZ European (44%), Maori (24%), Pacific (16%) and Indian (16%)), were enrolled. Confidence in self-managing diabetes, regular examination of feet, physical activity levels and smoking rates all improved. Glycaemic control improved between baseline and 6 months (HbA1C 64.9±20.0 mmol/mol to 59.9±13.9 mmol/mol (p<0.05) (baseline 8.07%±1.80, 6 months 7.62%±1.25)), but was no different to baseline at 9 months. Systolic BP reduced from 131.9±16.4 to 127.4±18.2 mmHg (p<0.05) at 6 months, but increased to baseline levels by 9 months. Diastolic BP, triglycerides and urine microalbumin:creatinine ratio were significantly reduced at 3, 6 and 9 months. A group-based DSME programme designed specifically for the NZ population was effective at improving aspects of diabetes care at 6 months. The attenuation of these improvements after 6 months suggests a refresher course at that time may be beneficial. Copyright © 2013. Published by Elsevier Ltd.

  15. Influence of treatment with alendronate on the speed of sound, an ultrasound parameter, of the calcaneus in postmenopausal Japanese women with osteoporosis: a clinical practice-based observational study

    Directory of Open Access Journals (Sweden)

    Iwamoto J

    2012-06-01

    Full Text Available Jun Iwamoto,1 Tetsuya Takada,2 Yoshihiro Sato,3 Hideo Matsumoto11Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, 2Department of Internal Medicine, Hiyoshi Medical Clinic, Kanagawa, 3Department of Neurology, Mitate Hospital, Fukuoka, JapanPurpose: The influence of alendronate (ALN treatment on the quantitative ultrasound parameters of the calcaneus remains to be established in Japanese patients. The aim of the present clinical practice-based observational study was to examine the influence of ALN treatment for 1 year on the speed of sound (SOS of the calcaneus and bone turnover markers in postmenopausal Japanese women with osteoporosis.Patients and methods: Forty-five postmenopausal Japanese women with osteoporosis who had received treatment with ALN for more than 1 year were enrolled in the study. The SOS and bone turnover markers were monitored over 1 year of ALN treatment.Results: The urinary levels of cross-linked N-terminal telopeptides of type I collagen and serum levels of alkaline phosphatase decreased significantly from the baseline values (–44.9% at 3 months and –22.2% at 12 months, respectively. The SOS increased modestly, but significantly, from the baseline value (0.6% at both 6 and 12 months. The percentage decrease in the urinary levels of cross-linked N-terminal telopeptides of type I collagen at 3 months was significantly correlated with the percentage increase in the SOS only at 6 months (correlation coefficient, 0.299.Conclusion: The present study confirmed that ALN treatment suppressed bone turnover, producing a clinically significant increase in the SOS of the calcaneus in postmenopausal Japanese women with osteoporosis.Keywords: postmenopausal osteoporosis, quantitative ultrasound (QUS, SOS, bone turnover, biochemical markers

  16. Observer Based Fault Detection and Moisture Estimating in Coal Mill

    DEFF Research Database (Denmark)

    Odgaard, Peter Fogh; Mataji, Babak

    2008-01-01

    In this paper an observer-based method for detecting faults and estimating moisture content in the coal in coal mills is presented. Handling of faults and operation under special conditions, such as high moisture content in the coal, are of growing importance due to the increasing...... requirements to the general performance of power plants. Detection  of faults and moisture content estimation are consequently of high interest in the handling of the problems caused by faults and moisture content. The coal flow out of the mill is the obvious variable to monitor, when detecting non-intended drops in the coal...... flow out of the coal mill. However, this variable is not measurable. Another estimated variable is the moisture content, which is only "measurable" during steady-state operations of the coal mill. Instead, this paper suggests a method where these unknown variables are estimated based on a simple energy...

  17. Multisatellite and ground-based observations of transient ULF waves

    International Nuclear Information System (INIS)

    Potemra, T.A.; Zanetti, L.J.; Takahashi, K.; Erlandson, R.E.; Luehr, H.; Marklund, G.T.; Block, L.P.; Blomberg, L.G.; Lepping, R.P.

    1989-01-01

    A unique alignment of the Active Magnetospheric Particle Tracer Explorers (AMPTE) CCE and Viking satellites with respect to the EISCAT Magnetometer Cross has provided an opportunity to study transient ULF pulsations associated with variations in solar wind plasma density observed by the IMP 8 satellite. These observations were acquired during a relatively quiet period on April 24, 1986, during the Polar Region and Outer Magnetosphere International Study (PROMIS) period. An isolated 4-mHz (4-min period) pulsation was detected on the ground which was associated with transverse magnetic field oscillations observed by Viking at a ∼ 2-R E altitude above the auroral zone and by CCE at ∼ 8-R E in the equatorial plane on nearly the same flux tube. CCE detected a compressional oscillation in the magnetic field with twice the period (∼ 10 min) of the transverse waves, and with a waveform nearly identical to an isolated oscillation in the solar wind plasma density measured by IMP 8. The authors conclude that the isolated 10-min oscillation in solar wind plasma density produced magnetic field compression oscillations inside the magnetosphere at the same frequency which also enhanced resonant oscillations at approximately twice the frequency that were already present. The ground magnetic field variations are due to ionospheric Hall currents driven by the electric field of the standing Alfven waves. The time delay between surface and satellite data acquired at different local times supports the conclusion that the periodic solar wind density variation excites a tailward traveling large-scale magnetosphere wave train which excites local field line resonant oscillations. They conclude that these transient magnetic field variations are not associated with magnetic field reconnection or flux transfer events

  18. Observational studies and the difficult quest for causality

    DEFF Research Database (Denmark)

    Lipsitch, Marc; Jha, Ayan; Simonsen, Lone

    2016-01-01

    design: cohort, case-control and ecological studies. Studies of influenza VE, especially in seniors, are an excellent demonstration of the challenges of detecting and reducing such bias, and so we use influenza VE as a running example. We take a fresh look at the time-trend studies often dismissed...... more robust observational study designs, challenges lie ahead for evaluating best practices for achieving robust unbiased results from observational studies. This is critical for evaluation of national and global vaccine programme effectiveness....... be answered once the vaccine is in use, from observational studies. However, such studies are inherently at risk for bias. Using a causal framework and illustrating with examples, we review newer approaches to detecting and avoiding confounding and selection bias in three major classes of observational study...

  19. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE)

    DEFF Research Database (Denmark)

    Vandenbroucke, Jan P; von Elm, Erik; Altman, Douglas G

    2014-01-01

    Much medical research is observational. The reporting of observational studies is often of insufficient quality. Poor reporting hampers the assessment of the strengths and weaknesses of a study and the generalisability of its results. Taking into account empirical evidence and theoretical...... considerations, a group of methodologists, researchers, and editors developed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations to improve the quality of reporting of observational studies. The STROBE Statement consists of a checklist of 22 items, which relate...... to the title, abstract, introduction, methods, results and discussion sections of articles. Eighteen items are common to cohort studies, case-control studies and cross-sectional studies and four are specific to each of the three study designs. The STROBE Statement provides guidance to authors about how...

  20. MultiWaveLink: An interactive data base for the coordination of multiwavelength and multifacility observations

    Science.gov (United States)

    Cordova, F. A.

    1993-01-01

    MultiWaveLink is an interactive, computerized data base that was developed to facilitate a multi-wavelength approach to studying astrophysical sources. It can be used to access information about multiwavelenth resources (observers, telescopes, data bases and analysis facilities) or to organize observing campaigns that require either many telescopes operating in different spectral regimes or a network of similar telescopes circumspanning the Earth.

  1. Explaining the effects of a multifaceted intervention to improve inpatient care in rural Kenyan hospitals--interpretation based on retrospective examination of data from participant observation, quantitative and qualitative studies.

    Science.gov (United States)

    English, Mike; Nzinga, Jacinta; Mbindyo, Patrick; Ayieko, Philip; Irimu, Grace; Mbaabu, Lairumbi

    2011-12-02

    We have reported the results of a cluster randomized trial of rural Kenyan hospitals evaluating the effects of an intervention to introduce care based on best-practice guidelines. In parallel work we described the context of the study, explored the process and perceptions of the intervention, and undertook a discrete study on health worker motivation because this was felt likely to be an important contributor to poor performance in Kenyan public sector hospitals. Here, we use data from these multiple studies and insights gained from being participants in and observers of the intervention process to provide our explanation of how intervention effects were achieved as part of an effort to better understand implementation in low-income hospital settings. Initial hypotheses were generated to explain the variation in intervention effects across place, time, and effect measure (indicator) based on our understanding of theory and informed by our implementation experience and participant observations. All data sources available for hospitals considered as cases for study were then examined to determine if hypotheses were supported, rejected, or required modification. Data included transcriptions of interviews and group discussions, field notes and that from the detailed longitudinal quantitative investigation. Potentially useful explanatory themes were identified, discussed by the implementing and research team, revised, and merged as part of an iterative process aimed at building more generic explanatory theory. At the end of this process, findings were mapped against a recently reported comprehensive framework for implementation research. A normative re-educative intervention approach evolved that sought to reset norms and values concerning good practice and promote 'grass-roots' participation to improve delivery of correct care. Maximal effects were achieved when this strategy and external support supervision helped create a soft-contract with senior managers clarifying

  2. Explaining the effects of a multifaceted intervention to improve inpatient care in rural Kenyan hospitals -- interpretation based on retrospective examination of data from participant observation, quantitative and qualitative studies

    Directory of Open Access Journals (Sweden)

    English Mike

    2011-12-01

    Full Text Available Abstract Background We have reported the results of a cluster randomized trial of rural Kenyan hospitals evaluating the effects of an intervention to introduce care based on best-practice guidelines. In parallel work we described the context of the study, explored the process and perceptions of the intervention, and undertook a discrete study on health worker motivation because this was felt likely to be an important contributor to poor performance in Kenyan public sector hospitals. Here, we use data from these multiple studies and insights gained from being participants in and observers of the intervention process to provide our explanation of how intervention effects were achieved as part of an effort to better understand implementation in low-income hospital settings. Methods Initial hypotheses were generated to explain the variation in intervention effects across place, time, and effect measure (indicator based on our understanding of theory and informed by our implementation experience and participant observations. All data sources available for hospitals considered as cases for study were then examined to determine if hypotheses were supported, rejected, or required modification. Data included transcriptions of interviews and group discussions, field notes and that from the detailed longitudinal quantitative investigation. Potentially useful explanatory themes were identified, discussed by the implementing and research team, revised, and merged as part of an iterative process aimed at building more generic explanatory theory. At the end of this process, findings were mapped against a recently reported comprehensive framework for implementation research. Results A normative re-educative intervention approach evolved that sought to reset norms and values concerning good practice and promote 'grass-roots' participation to improve delivery of correct care. Maximal effects were achieved when this strategy and external support supervision helped

  3. Grid-based platform for training in Earth Observation

    Science.gov (United States)

    Petcu, Dana; Zaharie, Daniela; Panica, Silviu; Frincu, Marc; Neagul, Marian; Gorgan, Dorian; Stefanut, Teodor

    2010-05-01

    GiSHEO platform [1] providing on-demand services for training and high education in Earth Observation is developed, in the frame of an ESA funded project through its PECS programme, to respond to the needs of powerful education resources in remote sensing field. It intends to be a Grid-based platform of which potential for experimentation and extensibility are the key benefits compared with a desktop software solution. Near-real time applications requiring simultaneous multiple short-time-response data-intensive tasks, as in the case of a short time training event, are the ones that are proved to be ideal for this platform. The platform is based on Globus Toolkit 4 facilities for security and process management, and on the clusters of four academic institutions involved in the project. The authorization uses a VOMS service. The main public services are the followings: the EO processing services (represented through special WSRF-type services); the workflow service exposing a particular workflow engine; the data indexing and discovery service for accessing the data management mechanisms; the processing services, a collection allowing easy access to the processing platform. The WSRF-type services for basic satellite image processing are reusing free image processing tools, OpenCV and GDAL. New algorithms and workflows were develop to tackle with challenging problems like detecting the underground remains of old fortifications, walls or houses. More details can be found in [2]. Composed services can be specified through workflows and are easy to be deployed. The workflow engine, OSyRIS (Orchestration System using a Rule based Inference Solution), is based on DROOLS, and a new rule-based workflow language, SILK (SImple Language for worKflow), has been built. Workflow creation in SILK can be done with or without a visual designing tools. The basics of SILK are the tasks and relations (rules) between them. It is similar with the SCUFL language, but not relying on XML in

  4. Alfven Waves Underlying Ionospheric Destabilization: Ground-Based Observations

    Science.gov (United States)

    Hirsch, Michael

    During geomagnetic storms, terawatts of power in the million mile-per-hour solar wind pierce the Earth's magnetosphere. Geomagnetic storms and substorms create transverse magnetic waves known as Alfven waves. In the auroral acceleration region, Alfven waves accelerate electrons up to one-tenth the speed of light via wave-particle interactions. These inertial Alfven wave (IAW) accelerated electrons are imbued with sub-100 meter structure perpendicular to geomagnetic field B. The IAW electric field parallel to B accelerates electrons up to about 10 keV along B. The IAW dispersion relation quantifies the precipitating electron striation observed with high-speed cameras as spatiotemporally dynamic fine structured aurora. A network of tightly synchronized tomographic auroral observatories using model based iterative reconstruction (MBIR) techniques were developed in this dissertation. The TRANSCAR electron penetration model creates a basis set of monoenergetic electron beam eigenprofiles of auroral volume emission rate for the given location and ionospheric conditions. Each eigenprofile consists of nearly 200 broadband line spectra modulated by atmospheric attenuation, bandstop filter and imager quantum efficiency. The L-BFGS-B minimization routine combined with sub-pixel registered electron multiplying CCD video stream at order 10 ms cadence yields estimates of electron differential number flux at the top of the ionosphere. Our automatic data curation algorithm reduces one terabyte/camera/day into accurate MBIR-processed estimates of IAW-driven electron precipitation microstructure. This computer vision structured auroral discrimination algorithm was developed using a multiscale dual-camera system observing a 175 km and 14 km swath of sky simultaneously. This collective behavior algorithm exploits the "swarm" behavior of aurora, detectable even as video SNR approaches zero. A modified version of the algorithm is applied to topside ionospheric radar at Mars and

  5. Observed Score Equating Using Discrete and Passage-Based Anchor Items

    Science.gov (United States)

    Zu, Jiyun; Liu, Jinghua

    2010-01-01

    Equating of tests composed of both discrete and passage-based multiple choice items using the nonequivalent groups with anchor test design is popular in practice. In this study, we compared the effect of discrete and passage-based anchor items on observed score equating via simulation. Results suggested that an anchor with a larger proportion of…

  6. Case Study Observational Research: A Framework for Conducting Case Study Research Where Observation Data Are the Focus.

    Science.gov (United States)

    Morgan, Sonya J; Pullon, Susan R H; Macdonald, Lindsay M; McKinlay, Eileen M; Gray, Ben V

    2017-06-01

    Case study research is a comprehensive method that incorporates multiple sources of data to provide detailed accounts of complex research phenomena in real-life contexts. However, current models of case study research do not particularly distinguish the unique contribution observation data can make. Observation methods have the potential to reach beyond other methods that rely largely or solely on self-report. This article describes the distinctive characteristics of case study observational research, a modified form of Yin's 2014 model of case study research the authors used in a study exploring interprofessional collaboration in primary care. In this approach, observation data are positioned as the central component of the research design. Case study observational research offers a promising approach for researchers in a wide range of health care settings seeking more complete understandings of complex topics, where contextual influences are of primary concern. Future research is needed to refine and evaluate the approach.

  7. Diffusion of Bevacizumab Across Oncology Practices: An Observational Study.

    Science.gov (United States)

    Keating, Nancy L; Huskamp, Haiden A; Schrag, Deborah; McWilliams, John M; McNeil, Barbara J; Landon, Bruce E; Chernew, Michael E; Normand, Sharon-Lise T

    2018-01-01

    Technological advances can improve care and outcomes but are a primary driver of health care spending growth. Understanding diffusion and use of new oncology therapies is important, given substantial increases in prices and spending on such treatments. Examine diffusion of bevacizumab, a novel (in 2004) and high-priced biologic cancer therapy, among US oncology practices during 2005-2012 and assess variation in use across practices. Population-based observational study. A total of 2329 US practices providing cancer chemotherapy. Random 20% sample of 236,304 Medicare fee-for-service beneficiaries aged above 65 years in 2004-2012 undergoing infused chemotherapy for cancer. Diffusion of bevacizumab (cumulative time to first use and 10% use) in practices, variation in use across practices overall and by higher versus lower-value use. We used hierarchical models with practice random effects to estimate the between-practice variation in the probability of receiving bevacizumab and to identify factors associated with use. We observed relatively rapid diffusion of bevacizumab, particularly in independent practices and larger versus smaller practices. We observed substantial variation in use; the adjusted odds ratio (95% confidence interval) of bevacizumab use was 2.90 higher (2.73-3.08) for practices 1 SD above versus one standard deviation below the mean. Variation was less for higher-value [odds ratio=2.72 (2.56-2.89)] than lower-value uses [odds ratio=3.61 (3.21-4.06)]. Use of bevacizumab varied widely across oncology practices, particularly for lower-value indications. These findings suggest that interventions targeted to practices have potential for decreasing low-value use of high-cost cancer therapies.

  8. Observer-Based and Regression Model-Based Detection of Emerging Faults in Coal Mills

    DEFF Research Database (Denmark)

    Odgaard, Peter Fogh; Lin, Bao; Jørgensen, Sten Bay

    2006-01-01

    In order to improve the reliability of power plants it is important to detect fault as fast as possible. Doing this it is interesting to find the most efficient method. Since modeling of large scale systems is time consuming it is interesting to compare a model-based method with data driven ones....... In this paper three different fault detection approaches are compared using a example of a coal mill, where a fault emerges. The compared methods are based on: an optimal unknown input observer, static and dynamic regression model-based detections. The conclusion on the comparison is that observer-based scheme...... detects the fault 13 samples earlier than the dynamic regression model-based method, and that the static regression based method is not usable due to generation of far too many false detections....

  9. Distributed estimation based on observations prediction in wireless sensor networks

    KAUST Repository

    Bouchoucha, Taha

    2015-03-19

    We consider wireless sensor networks (WSNs) used for distributed estimation of unknown parameters. Due to the limited bandwidth, sensor nodes quantize their noisy observations before transmission to a fusion center (FC) for the estimation process. In this letter, the correlation between observations is exploited to reduce the mean-square error (MSE) of the distributed estimation. Specifically, sensor nodes generate local predictions of their observations and then transmit the quantized prediction errors (innovations) to the FC rather than the quantized observations. The analytic and numerical results show that transmitting the innovations rather than the observations mitigates the effect of quantization noise and hence reduces the MSE. © 2015 IEEE.

  10. The EULAR Study Group for Registers and Observational Drug Studies

    DEFF Research Database (Denmark)

    Kearsley-Fleet, Lianne; Závada, Jakub; Hetland, Merete Lund

    2015-01-01

    OBJECTIVE: Under the auspices of the European League Against Rheumatism (EULAR), a study group of investigators representing European biologic DMARD (bDMARD) registers was convened. The purpose of this initial assessment was to collect and compare a cross section of patient characteristics...

  11. On sensitivity value of pair-matched observational studies

    OpenAIRE

    Zhao, Qingyuan

    2017-01-01

    An observational study may be biased for estimating causal effects by failing to control for unmeasured confounders. This paper proposes a new quantity called the "sensitivity value", which is defined as the minimum strength of unmeasured confounders needed to change the qualitative conclusions of a naive analysis assuming no unmeasured confounder. We establish the asymptotic normality of the sensitivity value in pair-matched observational studies. The theoretical results are then used to app...

  12. A novel earth observation based ecological indicator for cyanobacterial blooms

    Science.gov (United States)

    Anttila, Saku; Fleming-Lehtinen, Vivi; Attila, Jenni; Junttila, Sofia; Alasalmi, Hanna; Hällfors, Heidi; Kervinen, Mikko; Koponen, Sampsa

    2018-02-01

    Cyanobacteria form spectacular mass occurrences almost annually in the Baltic Sea. These harmful algal blooms are the most visible consequences of marine eutrophication, driven by a surplus of nutrients from anthropogenic sources and internal processes of the ecosystem. We present a novel Cyanobacterial Bloom Indicator (CyaBI) targeted for the ecosystem assessment of eutrophication in marine areas. The method measures the current cyanobacterial bloom situation (an average condition of recent 5 years) and compares this to the estimated target level for 'good environmental status' (GES). The current status is derived with an index combining indicative bloom event variables. As such we used seasonal information from the duration, volume and severity of algal blooms derived from earth observation (EO) data. The target level for GES was set by using a remote sensing based data set named Fraction with Cyanobacterial Accumulations (FCA; Kahru & Elmgren, 2014) covering years 1979-2014. Here a shift-detection algorithm for time series was applied to detect time-periods in the FCA data where the level of blooms remained low several consecutive years. The average conditions from these time periods were transformed into respective CyaBI target values to represent target level for GES. The indicator is shown to pass the three critical factors set for marine indicator development, namely it measures the current status accurately, the target setting can be scientifically proven and it can be connected to the ecosystem management goal. An advantage of the CyaBI method is that it's not restricted to the data used in the development work, but can be complemented, or fully applied, by using different types of data sources providing information on cyanobacterial accumulations.

  13. Synchronization of chaotic systems based on PI observer design

    Energy Technology Data Exchange (ETDEWEB)

    Hua Changchun [Institute of Electrical Engineering, Yanshan University, Qinhuangdao 066004 (China)]. E-mail: cch@ysu.edu.cn; Guan Xinping [Institute of Electrical Engineering, Yanshan University, Qinhuangdao 066004 (China)]. E-mail: xpguan@ysu.edu.cn

    2005-01-24

    Synchronization problem of chaotic systems via observer method is investigated. In contrast to the results of the literatures, we consider the case that there exist noise disturbances in the output. Under this condition, it is not ideal to employ the classic observer to solve the synchronization problem. The proportional integral observer is proposed, which can render the error system stable with the noise in the output. Simulations on synchronizing Chua chaotic systems are done to verify the effectiveness of the main results.

  14. CEOS contributions to informing energy management and policy decision making using space-based Earth observations

    International Nuclear Information System (INIS)

    Eckman, Richard S.; Stackhouse, Paul W.

    2012-01-01

    Earth observations are playing an increasingly significant role in informing decision making in the energy sector. In renewable energy applications, space-based observations now routinely augment sparse ground-based observations used as input for renewable energy resource assessment applications. As one of the nine Group on Earth Observations (GEO) societal benefit areas, the enhancement of management and policy decision making in the energy sector is receiving attention in activities conducted by the Committee on Earth Observation Satellites (CEOS). CEOS has become the “space arm” for the implementation of the Global Earth Observation System of Systems (GEOSS) vision. It is directly supporting the space-based, near-term tasks articulated in the GEO three-year work plan. This paper describes a coordinated program of demonstration projects conducted by CEOS member agencies and partners to utilize Earth observations to enhance energy management end-user decision support systems. We discuss the importance of engagement with stakeholders and understanding their decision support needs in successfully increasing the uptake of Earth observation products for societal benefit. Several case studies are presented, demonstrating the importance of providing data sets in formats and units familiar and immediately usable by decision makers. These projects show the utility of Earth observations to enhance renewable energy resource assessment in the developing world, forecast space weather impacts on the power grid, and improve energy efficiency in the built environment.

  15. Enhanced Research Opportunity to Study the Atmospheric Forcing by High-Energy Particle Precipitation at High Latitudes: Emerging New Satellite Data and the new Ground-Based Observations in Northern Scandinavia, including the EISCAT_3D Incoherent Scatter Facility.

    Science.gov (United States)

    Turunen, E. S.; Ulich, T.; Kero, A.; Tero, R.; Verronen, P. T.; Norberg, J.; Miyoshi, Y.; Oyama, S. I.; Saito, S.; Hosokawa, K.; Ogawa, Y.

    2017-12-01

    Recent observational and model results on the particle precipitation as source of atmospheric variability challenge us to implement better and continuously monitoring observational infrastructure for middle and upper atmospheric research. An example is the effect of high-energy electron precipitation during pulsating aurora on mesospheric ozone, the concentration of which may be reduced by several tens of percent, similarily as during some solar proton events, which are known to occur more rarely than pulsating aurora. So far the Assessment Reports by the Intergovernmental Panel on Climate Change did not include explicitely the particle forcing of middle and upper atmosphere in their climate model scenarios. This will appear for the first time in the upcoming climate simulations. We review recent results related to atmospheric forcing by particle precipitation via effects on chemical composition. We also show the research potential of new ground-based radio measurement techniques, such as spectral riometry and incoherent scatter by new phased-array radars, such as EISCAT_3D, which will be a volumetric, 3- dimensionally imaging radar, distributed in Norway, Sweden, and Finland. It is expected to be operational from 2020 onwards, surpassing all the current IS radars of the world in technology. It will be able to produce continuous information of ionospheric plasma parameters in a volume, including 3D-vector plasma velocities. For the first time we will be able to map the 3D electric currents in ionosphere, as well as we will have continuous vector wind measurements in mesosphere. The geographical area covered by the EISCAT_3D measurements can be expanded by suitably selected other continuous observations, such as optical and satellite tomography networks. A new 100 Hz all-sky camera network was recently installed in Northern Scandinavia in order to support the Japanese Arase satellite mission. In near future the ground-based measurement network will also include new

  16. Re-evaluation of the definition of remission on the 17-item Hamilton Depression Rating Scale based on recovery in health-related quality of life in an observational post-marketing study.

    Science.gov (United States)

    Sawamura, Jitsuki; Ishigooka, Jun; Nishimura, Katsuji

    2018-01-16

    Although a score of less than 7 for the 17-item Hamilton Depression Rating Scale (HAM-D17) has been widely adopted to define remission of depression, a full recovery from depression is closely related to the patient's quality of life as well. Accordingly, we re-evaluated this definition of remission using HAM-D17 in comparison with the corresponding score for health-related quality of life (HRQOL) measured by the SF-36. Using the data for depressive patients reported by GlaxoSmithKline K.K. (Study No. BRL29060A/863) in a post-marketing observational study of paroxetine, with a sample size of n = 722, multivariate logistic regression was performed with the HAM-D17 score as a dependent variable and with each of the eight domain scores of HRQOL (from the SF-36) transformed into a binominal form according to the national standard value for Japan. Then, area under curve of receiver operating characteristic analyses were conducted. Based on the obtained results, a multivariate analysis was performed using the HAM-D17 score in a binomial form with HAM-D17 as a dependent variable and with each of the eight HRQOL domain scores (SF-36) as binominalized independent variables. A cutoff value for the HAM-D17 score of 5 provided the maximum ROC-AUC at "0.864." The significantly associated scores of the eight HRQOL domains (SF-36) were identified for the HAM-D17 cutoff values of ≥5 and ≤4. The scores for physical functioning (odds ratio, 0.473), bodily pain (0.557), vitality (0.379), social functioning (0.540), role-emotion (0.265), and mental health (0.467) had a significant negative association with the HAM-D17 score (p < 0.05), and HRQOL domain scores for HAM-D17 ≥ 5 were significantly lower compared with those for HAM-D17 ≤ 4. A cutoff value for HAM-D17 of less than or equal to 4 was the best candidate for indicating remission of depression when the recovery of HRQOL is considered. Restoration of social function and performance should be considered

  17. An Observation-based Assessment of Instrument Requirements for a Future Precipitation Process Observing System

    Science.gov (United States)

    Nelson, E.; L'Ecuyer, T. S.; Wood, N.; Smalley, M.; Kulie, M.; Hahn, W.

    2017-12-01

    Global models exhibit substantial biases in the frequency, intensity, duration, and spatial scales of precipitation systems. Much of this uncertainty stems from an inadequate representation of the processes by which water is cycled between the surface and atmosphere and, in particular, those that govern the formation and maintenance of cloud systems and their propensity to form the precipitation. Progress toward improving precipitation process models requires observing systems capable of quantifying the coupling between the ice content, vertical mass fluxes, and precipitation yield of precipitating cloud systems. Spaceborne multi-frequency, Doppler radar offers a unique opportunity to address this need but the effectiveness of such a mission is heavily dependent on its ability to actually observe the processes of interest in the widest possible range of systems. Planning for a next generation precipitation process observing system should, therefore, start with a fundamental evaluation of the trade-offs between sensitivity, resolution, sampling, cost, and the overall potential scientific yield of the mission. Here we provide an initial assessment of the scientific and economic trade-space by evaluating hypothetical spaceborne multi-frequency radars using a combination of current real-world and model-derived synthetic observations. Specifically, we alter the field of view, vertical resolution, and sensitivity of a hypothetical Ka- and W-band radar system and propagate those changes through precipitation detection and intensity retrievals. The results suggest that sampling biases introduced by reducing sensitivity disproportionately affect the light rainfall and frozen precipitation regimes that are critical for warm cloud feedbacks and ice sheet mass balance, respectively. Coarser spatial resolution observations introduce regime-dependent biases in both precipitation occurrence and intensity that depend on cloud regime, with even the sign of the bias varying within a

  18. Acceptance of a reusable self-injection device for recombinant human growth hormone: final data from a questionnaire-based, cross-sectional, international, multicenter, observational study in pediatric patients

    Directory of Open Access Journals (Sweden)

    Schnabel D

    2016-09-01

    Full Text Available Dirk Schnabel,1 Carl-Joachim Partsch,2 Muriel Houang,3 Sarah Ehtisham,4 Helen Johnstone,5 Markus Zabransky,6 Wieland Kiess7 1Pediatric Endocrinology, Center for Chronic Sick Children, Otto-Heubner-Centrum für Kinder- und Jugendmedizin, Charite, University Medicine, Berlin, Germany; 2Endokrinologikum Hamburg, Hamburg, Germany; 3Explorations Fonctionnelles Endocriniennes, Hôpital Armand Trousseau, Paris, France; 4Mediclinic City Hospital, Dubai Healthcare City, Dubai, United Arab Emirates; 5The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK; 6Sandoz International GmbH, Holzkirchen, 7Department of Women and Child Health, Hospital for Children and Adolescents, University Hospitals, University of Leipzig, Leipzig, Germany Background: A questionnaire-based survey was conducted to assess attitudes toward a reusable self-injection system (SurePal™ among pediatric patients with growth disturbances who were prescribed treatment with Omnitrope® within routine clinical practice.Methods: This was a multicenter, observational study, incorporated into the noninterventional PAtients TReated with Omnitrope® (PATRO Children study. Included subjects, or their caregivers, completed a questionnaire on the following five main areas: attractiveness of SurePal™, training received, using the device, the low drug wastage system, and experience versus other devices used previously (pretreated patients. Responses were based on a 5-point scale, with 2 being the best possible outcome and −2 the worst possible outcome.Results: In total, 550 patients were included in this study (338 from France, 169 from Germany, and 43 from the UK. The mean age ± standard deviation of participants was 10.8±3.5 years; the majority (57% were male and growth hormone treatment naïve (88%. Almost half (49.8% of children prepared their SurePal™ for injection themselves and 45.5% performed injections themselves. As patients progressed into their teens, the majority

  19. Direct Observation vs. Video-Based Assessment in Flexible Cystoscopy

    DEFF Research Database (Denmark)

    Dagnaes-Hansen, Julia; Mahmood, Oria; Bube, Sarah

    2018-01-01

    observer and subsequently by 2 blinded video-raters on a global rating scale (GRS) for cystoscopy. Both intrarater and interrater reliability were explored. Furthermore, direct observer bias was explored by a paired samples t-test. RESULTS: Intrarater reliability calculated by Pearson's r was 0...

  20. Disturbance Observer Based Control of Multirotor Helicopters Based on a Universal Model with Unstructured Uncertainties

    Directory of Open Access Journals (Sweden)

    Ye Xie

    2015-01-01

    Full Text Available To handle different perspectives of unstructured uncertainties, two robust control techniques on the basis of a universal model are studied in this paper. Rather than building a model only applicable to a specific small-scale multirotor helicopter (MHeli, the paper proposes a modeling technique to develop a universal model-framework. Particularly, it is straightforward to apply the universal model to a certain MHeli because the contribution and allocation matrix is proposed in the model-framework. Based on the model uncertainties, the load perturbation of the rotor is the primary focus due to its indispensable importance in the tracking performance. In contrast to the common methods, it is proposed to take this unstructured uncertainty in that external disturbance and designs disturbance observer (DOB. In addition, a class of lead-compensator is specifically designed as for compensating phase lag induced by DOB. Compared with H∞ loop-shaping, greater robust tracking performance on rejecting load perturbation could be achieved as a tradeoff between robust stability and tracking performance which is successfully avoided with DOB-based control strategy.

  1. Issues of reporting in observational studies in veterinary medicine.

    Science.gov (United States)

    Sargeant, Jan M; O'Connor, Annette M

    2014-02-15

    Observational studies are common in veterinary medicine; the results may be used to inform decision-making, future research, or as inputs to systematic reviews or risk assessment. To be of use, the results must be published, all of the outcomes that were assessed must be included in the publication, and the research (methods and results) must be reported in sufficient detail that the reader can evaluate the internal and external validity. In human healthcare, concerns about the completeness of reporting - and evidence that poor reporting is associated with study results - have led to the creation of reporting guidelines; these include the STROBE statement for observational studies. There is evidence from a limited body of research that there also are reporting inadequacies in veterinary observational studies. There are differences between human and veterinary observational studies that might be relevant to recommendations for reporting. Such differences include: the use of observational studies in animal populations for simultaneously estimating disease frequency and risk-factor identification; the distinction between the animal owners who consent to participate and the animals that are the study subjects; and the complexity of organizational levels inherent in animal research (in particular, for studies in livestock species). In veterinary medicine, it is common to have clustering within outcomes (due to animal grouping) and clustering of predictor variables. We argue that there is a compelling need for the scientific community involved in veterinary observational studies to use the STROBE statement, use an amended version of STROBE, or to develop and use reporting guidelines that are specific to veterinary medicine to improve reporting of these studies. Copyright © 2013 Elsevier B.V. All rights reserved.

  2. Cauchy problem for Laplace equation: An observer based approach

    KAUST Repository

    Majeed, Muhammad Usman

    2013-10-01

    A method to solve Cauchy Problem for Laplace equation using state observers is proposed. It is known that this problem is ill-posed. The domain under consideration is simple lipschitz in 2 with a hole. The idea is to recover the solution over whole domain from the observations on outer boundary. Proposed approach adapts one of the space variables as a time variable. The observer developed to solve Cauchy problem for the Laplace\\'s equation is compuationally robust and accurate. © 2013 IEEE.

  3. Can citizen-based observations be assimilated in hydrological models to improve flood prediction?

    Science.gov (United States)

    Mazzoleni, Maurizio; Alfonso, Leonardo; Solomatine, Dimitri P.

    2015-04-01

    In the recent years, the continued technological improvement has stimulated the spread of low-cost sensors that can be used to measure hydrological variables by citizens in a more spatially distributed way than classic static physical sensors. However, such measurements have the main characteristics to have irregular arrival time and variable uncertainty. This study presents a Kalman filter based method to integrate citizen-based observations into hydrological models in order to improve flood prediction. The methodology is applied in the Brue catchment, South West of England. In order to estimate the response of the catchment to a given flood event, a lumped conceptual hydrological model is implemented. The measured precipitation values are used as perfect forecast input in the hydrological model. Synthetic streamflow values are used in this study due to the fact that citizen-based observations coming at irregular time steps are not available. The results of this study pointed out how increasing the number of uncertain citizen-based observations within two model time steps can improve the model accuracy leading to a better flood forecast. Therefore, observations uncertainty influences the model accuracy more than the irregular moments in which the streamflow observations are assimilated into the hydrological model. This study is part of the FP7 European Project WeSenseIt Citizen Water Observatory (http://wesenseit.eu/).

  4. SABRE observations of Pi2 pulsations: case studies

    Directory of Open Access Journals (Sweden)

    E. G. Bradshaw

    1997-01-01

    Full Text Available The characteristics of substorm-associated Pi2 pulsations observed by the SABRE coherent radar system during three separate case studies are presented. The SABRE field of view is well positioned to observe the differences between the auroral zone pulsation signature and that observed at mid-latitudes. During the first case study the SABRE field of view is initially in the eastward electrojet, equatorward and to the west of the substorm-enhanced electrojet current. As the interval progresses, the western, upward field-aligned current of the substorm current wedge moves westward across the longitudes of the radar field of view. The westward motion of the wedge is apparent in the spatial and temporal signatures of the associated Pi2 pulsation spectra and polarisation sense. During the second case study, the complex field-aligned and ionospheric currents associated with the pulsation generation region move equatorward into the SABRE field of view and then poleward out of it again after the third pulsation in the series. The spectral content of the four pulsations during the interval indicate different auroral zone and mid-latitude signatures. The final case study is from a period of low magnetic activity when SABRE observes a Pi2 pulsation signature from regions equatorward of the enhanced substorm currents. There is an apparent mode change between the signature observed by SABRE in the ionosphere and that on the ground by magnetometers at latitudes slightly equatorward of the radar field of view. The observations are discussed in terms of published theories of the generation mechanisms for this type of pulsation. Different signatures are observed by SABRE depending on the level of magnetic activity and the position of the SABRE field of view relative to the pulsation generation region. A twin source model for Pi2 pulsation generation provides the clearest explanation of the signatures observed.

  5. The valuable contribution of observational studies to nephrology

    NARCIS (Netherlands)

    Jager, K. J.; Stel, V. S.; Wanner, C.; Zoccali, C.; Dekker, F. W.

    2007-01-01

    In studies on the effects of therapy (or other interventions), the randomized controlled trial (RCT) is an almost unbeatable standard in clinical research. The value of RCTs leaves unabated the valuable contributions of observational studies to medicine. This paper discusses some limitations of RCTs

  6. Necrotizing soft tissue infections - a multicentre, prospective observational study (INFECT)

    NARCIS (Netherlands)

    Madsen, M.B.; Skrede, S.; Bruun, T.; Arnell, P.; Rosén, A.; Nekludov, M.; Karlsson, Y.; Bergey, F.; Saccenti, E.; Martins dos Santos, V.A.P.; Perner, A.; Norrby-Teglund, A.; Hyldegaard, O.

    2018-01-01

    Background: The INFECT project aims to advance our understanding of the pathophysiological mechanisms in necrotizing soft tissue infections (NSTIs). The INFECT observational study is part of the INFECT project with the aim of studying the clinical profile of patients with NSTIs and correlating

  7. An Application of Chaotic Chua's System for Secure Chaotic Communication Based on Sliding Mode observer

    Science.gov (United States)

    Kemih, K.; Halimi, M.; Ghanes, M.; Zhang, G.

    2011-12-01

    In this paper, we study the design and implementation of analog secure communication systems via synchronized chaotic Chua's circuit with sliding mode observer. For this, we adopt an approach based on an inclusion of the message in the transmitter and in the receiver; we use a sliding mode observer with un-known input in order to recover the information. Finally, an analog electronic circuit with Multisim software is designed to physically realize the complete system (transmitter-receiver).

  8. Event-based internet biosurveillance: relation to epidemiological observation.

    Science.gov (United States)

    Nelson, Noele P; Yang, Li; Reilly, Aimee R; Hardin, Jessica E; Hartley, David M

    2012-06-18

    The World Health Organization (WHO) collects and publishes surveillance data and statistics for select diseases, but traditional methods of gathering such data are time and labor intensive. Event-based biosurveillance, which utilizes a variety of Internet sources, complements traditional surveillance. In this study we assess the reliability of Internet biosurveillance and evaluate disease-specific alert criteria against epidemiological data. We reviewed and compared WHO epidemiological data and Argus biosurveillance system data for pandemic (H1N1) 2009 (April 2009 - January 2010) from 8 regions and 122 countries to: identify reliable alert criteria among 15 Argus-defined categories; determine the degree of data correlation for disease progression; and assess timeliness of Internet information. Argus generated a total of 1,580 unique alerts; 5 alert categories generated statistically significant (p Internet information. Disease-specific alert criteria provide situational awareness and may serve as proxy indicators to event progression and escalation in lieu of traditional surveillance data; alerts may identify early-warning indicators to another pandemic, preparing the public health community for disease events.

  9. Event-based internet biosurveillance: relation to epidemiological observation

    Directory of Open Access Journals (Sweden)

    Nelson Noele P

    2012-06-01

    Full Text Available Abstract Background The World Health Organization (WHO collects and publishes surveillance data and statistics for select diseases, but traditional methods of gathering such data are time and labor intensive. Event-based biosurveillance, which utilizes a variety of Internet sources, complements traditional surveillance. In this study we assess the reliability of Internet biosurveillance and evaluate disease-specific alert criteria against epidemiological data. Methods We reviewed and compared WHO epidemiological data and Argus biosurveillance system data for pandemic (H1N1 2009 (April 2009 – January 2010 from 8 regions and 122 countries to: identify reliable alert criteria among 15 Argus-defined categories; determine the degree of data correlation for disease progression; and assess timeliness of Internet information. Results Argus generated a total of 1,580 unique alerts; 5 alert categories generated statistically significant (p  Conclusion Confirmed pandemic (H1N1 2009 cases collected by Argus and WHO methods returned consistent results and confirmed the reliability and timeliness of Internet information. Disease-specific alert criteria provide situational awareness and may serve as proxy indicators to event progression and escalation in lieu of traditional surveillance data; alerts may identify early-warning indicators to another pandemic, preparing the public health community for disease events.

  10. Global GNSS processing based on the raw observation approach

    Science.gov (United States)

    Strasser, Sebastian; Zehentner, Norbert; Mayer-Gürr, Torsten

    2017-04-01

    Many global navigation satellite system (GNSS) applications, e.g. Precise Point Positioning (PPP), require high-quality GNSS products, such as precise GNSS satellite orbits and clocks. These products are routinely determined by analysis centers of the International GNSS Service (IGS). The current processing methods of the analysis centers make use of the ionosphere-free linear combination to reduce the ionospheric influence. Some of the analysis centers also form observation differences, in general double-differences, to eliminate several additional error sources. The raw observation approach is a new GNSS processing approach that was developed at Graz University of Technology for kinematic orbit determination of low Earth orbit (LEO) satellites and subsequently adapted to global GNSS processing in general. This new approach offers some benefits compared to well-established approaches, such as a straightforward incorporation of new observables due to the avoidance of observation differences and linear combinations. This becomes especially important in view of the changing GNSS landscape with two new systems, the European system Galileo and the Chinese system BeiDou, currently in deployment. GNSS products generated at Graz University of Technology using the raw observation approach currently comprise precise GNSS satellite orbits and clocks, station positions and clocks, code and phase biases, and Earth rotation parameters. To evaluate the new approach, products generated using the Global Positioning System (GPS) constellation and observations from the global IGS station network are compared to those of the IGS analysis centers. The comparisons show that the products generated at Graz University of Technology are on a similar level of quality to the products determined by the IGS analysis centers. This confirms that the raw observation approach is applicable to global GNSS processing. Some areas requiring further work have been identified, enabling future

  11. Active Bleeding after Cardiac Surgery: A Prospective Observational Multicenter Study.

    Science.gov (United States)

    Colson, Pascal H; Gaudard, Philippe; Fellahi, Jean-Luc; Bertet, Héléna; Faucanie, Marie; Amour, Julien; Blanloeil, Yvonnick; Lanquetot, Hervé; Ouattara, Alexandre; Picot, Marie Christine

    2016-01-01

    To estimate the incidence of active bleeding after cardiac surgery (AB) based on a definition directly related on blood flow from chest drainage; to describe the AB characteristics and its management; to identify factors of postoperative complications. AB was defined as a blood loss > 1.5 ml/kg/h for 6 consecutive hours within the first 24 hours or in case of reoperation for hemostasis during the first 12 postoperative hours. The definition was applied in a prospective longitudinal observational study involving 29 French centers; all adult patients undergoing cardiac surgery with cardiopulmonary bypass were included over a 3-month period. Perioperative data (including blood product administration) were collected. To study possible variation in clinical practice among centers, patients were classified into two groups according to the AB incidence of the center compared to the overall incidence: "Low incidence" if incidence is lower and "High incidence" if incidence is equal or greater than overall incidence. Logistic regression analysis was used to identify risk factors of postoperative complications. Among 4,904 patients, 129 experienced AB (2.6%), among them 52 reoperation. Postoperative bleeding loss was 1,000 [820;1,375] ml and 1,680 [1,280;2,300] ml at 6 and 24 hours respectively. Incidence of AB varied between centers (0 to 16%) but was independent of in-centre cardiac surgical experience. Comparisons between groups according to AB incidence showed differences in postoperative management. Body surface area, preoperative creatinine, emergency surgery, postoperative acidosis and red blood cell transfusion were risk factors of postoperative complication. A blood loss > 1.5 ml/kg/h for 6 consecutive hours within the first 24 hours or early reoperation for hemostasis seems a relevant definition of AB. This definition, independent of transfusion, adjusted to body weight, may assess real time bleeding occurring early after surgery.

  12. External Validation of the HERNIAscore: An Observational Study.

    Science.gov (United States)

    Cherla, Deepa V; Moses, Maya L; Mueck, Krislynn M; Hannon, Craig; Ko, Tien C; Kao, Lillian S; Liang, Mike K

    2017-09-01

    The HERNIAscore is a ventral incisional hernia (VIH) risk assessment tool that uses only preoperative variables and predictable intraoperative variables. The aim of this study was to validate and modify, if needed, the HERNIAscore in an external dataset. This was a retrospective observational study of all patients undergoing resection for gastrointestinal malignancy from 2011 through 2015 at a safety-net hospital. The primary end point was clinical postoperative VIH. Patients were stratified into low-risk, medium-risk, and high-risk groups based on HERNIAscore. A revised HERNIAscore was calculated with the addition of earlier abdominal operation as a categorical variable. Cox regression of incisional hernia with stratification by risk class was performed. Incidence rates of clinical VIH formation within each risk class were also calculated. Two hundred and forty-seven patents were enrolled. On Cox regression, in addition to the 3 variables of the HERNIAscore (BMI, COPD, and incision length), earlier abdominal operation was also predictive of VIH. The revised HERNIAscore demonstrated improved predictive accuracy for clinical VIH. Although the original HERNIAscore effectively stratified the risk of an incisional radiographic VIH developing, the revised HERNIAscore provided a statistically significant stratification for both clinical and radiographic VIHs in this patient cohort. We have externally validated and improved the HERNIAscore. The revised HERNIAscore uses BMI, incision length, COPD, and earlier abdominal operation to predict risk of postoperative incisional hernia. Future research should assess methods to prevent incisional hernias in moderate-to-high risk patients. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Active Bleeding after Cardiac Surgery: A Prospective Observational Multicenter Study.

    Directory of Open Access Journals (Sweden)

    Pascal H Colson

    Full Text Available To estimate the incidence of active bleeding after cardiac surgery (AB based on a definition directly related on blood flow from chest drainage; to describe the AB characteristics and its management; to identify factors of postoperative complications.AB was defined as a blood loss > 1.5 ml/kg/h for 6 consecutive hours within the first 24 hours or in case of reoperation for hemostasis during the first 12 postoperative hours. The definition was applied in a prospective longitudinal observational study involving 29 French centers; all adult patients undergoing cardiac surgery with cardiopulmonary bypass were included over a 3-month period. Perioperative data (including blood product administration were collected. To study possible variation in clinical practice among centers, patients were classified into two groups according to the AB incidence of the center compared to the overall incidence: "Low incidence" if incidence is lower and "High incidence" if incidence is equal or greater than overall incidence. Logistic regression analysis was used to identify risk factors of postoperative complications.Among 4,904 patients, 129 experienced AB (2.6%, among them 52 reoperation. Postoperative bleeding loss was 1,000 [820;1,375] ml and 1,680 [1,280;2,300] ml at 6 and 24 hours respectively. Incidence of AB varied between centers (0 to 16% but was independent of in-centre cardiac surgical experience. Comparisons between groups according to AB incidence showed differences in postoperative management. Body surface area, preoperative creatinine, emergency surgery, postoperative acidosis and red blood cell transfusion were risk factors of postoperative complication.A blood loss > 1.5 ml/kg/h for 6 consecutive hours within the first 24 hours or early reoperation for hemostasis seems a relevant definition of AB. This definition, independent of transfusion, adjusted to body weight, may assess real time bleeding occurring early after surgery.

  14. Simulation of global solar radiation based on cloud observations

    Energy Technology Data Exchange (ETDEWEB)

    Ehnberg, Jimmy S.G.; Bollen, Math H.J. [Chalmers Univ. of Technology, Dept. of Electric Power Engineering, Goeteborg (Sweden)

    2005-02-01

    A stochastic model for simulating global solar radiation on a horizontal surface has been developed for use in power systems reliability calculations. The importance of an appropriate model for global solar radiation has increased with the increased use of photovoltaic power generation. The global solar radiation shows not only regular yearly and daily variations but also a random behaviour. The yearly and daily variations can be described in a deterministic way while the random behaviour has a high correlation with the state of the atmosphere. The astronomic effects can easily be described mathematically with only some minor simplifications but the atmospheric effects are more complicated to describe. The transmissivity of solar radiation in the atmosphere depends on various factors, e.g. humidity, air pressure and cloud type. By using cloud observations as input for the simulations, the local meteorological conditions can be accounted for. The model is usable for any geographical location if cloud observations are available at the location or at locations with similar climatological conditions. This is especially useful for development countries where long-term solar radiation measurement can be hard to obtain. Cloud observations can be performed without any expensive equipment and have been a standard parameter for many years throughout the world. Standard observations are done according to the Oktas-scale. It is the interval between observations that sets the resolution of the simulation: the observations are normally only every hour or every third hour. The model can easily be combined with cloud coverage simulations, has been proposed, for a more general model. For some calculations higher resolution may be needed. This can be obtained by including a stochastic model for the short-term. (Author)

  15. Assessing the quality of reporting of observational studies in cancer.

    Science.gov (United States)

    Papathanasiou, Afroditi A; Zintzaras, Elias

    2010-01-01

    The vast majority of epidemiological studies in cancer are observational. However, inadequate reporting of the published observational studies (OS) may restrict the generalizability and credibility of study results. The aim of this study was to evaluate the reporting quality of OS concerning cancer. PubMed was searched for systematic reviews (SRs) of OS involving cancer published from January 2008 through February 2009. The citations provided in the SRs were evaluated for their reporting quality according to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement, a checklist of items that are considered essential for good reporting of OS. The evaluation was focused on 25 methodological items/sub-items. The effect of journals' ranking in quality of reporting was also evaluated. The search identified 244 eligible OS included in seven SRs. Nine items/sub-items were reported by more than 90% of studies and 16 items/sub-items were reported by more than 70%. Some essential methodological aspects of OS (such as matching, absolute risks, missing data and flow diagram) were underreported. Significant differences were found among the seven SRs in the majority of the items. High and lower ranked journals were different only in reporting of results estimates and precision. The quality of reporting in OS in cancer was considered satisfactory, although certain items were underreported. Further improvement of reporting may enhance the validity of observational research.

  16. Variance-based uncertainty relation for incompatible observers

    Science.gov (United States)

    Zheng, Xiao; Zhang, Guo-Feng

    2017-07-01

    Based on mixedness definition as M=1-{tr}( {ρ 2}) , we obtain a new variance-based uncertainty equality along with an inequality for Hermitian operators of a single-qubit system. The obtained uncertainty equality can be used as a measure of the system mixedness. A qubit system with feedback control is also exploited to demonstrate the new uncertainty.

  17. Observations of the Geometry of Horizon-Based Optical Navigation

    Science.gov (United States)

    Christian, John; Robinson, Shane

    2016-01-01

    NASA's Orion Project has sparked a renewed interest in horizon-based optical navigation(OPNAV) techniques for spacecraft in the Earth-Moon system. Some approaches have begun to explore the geometry of horizon-based OPNAV and exploit the fact that it is a conic section problem. Therefore, the present paper focuses more deeply on understanding and leveraging the various geometric interpretations of horizon-based OPNAV. These results provide valuable insight into the fundamental workings of OPNAV solution methods, their convergence properties, and associated estimate covariance. Most importantly, the geometry and transformations uncovered in this paper lead to a simple and non-iterative solution to the generic horizon-based OPNAV problem. This represents a significant theoretical advancement over existing methods. Thus, we find that a clear understanding of geometric relationships is central to the prudent design, use, and operation of horizon-based OPNAV techniques.

  18. Underwater navigation using diffusion-based trajectory observers

    DEFF Research Database (Denmark)

    Jouffroy, Jerome; Opderbecke, Jan

    2007-01-01

    the consideration of important practical problems such as different information update rates, outages, and outliers in a very simple framework. Results of contraction theory are used to prove that the observers are convergent, i.e., stable in the incremental sense. Simulation and experimental results are presented...

  19. Novel Earth Observation Based on Quantum Optics and Relativity

    Science.gov (United States)

    Mueller, J.; Flury, J.

    2016-12-01

    Recent developments in fundamental physics (in theory as well as in technology) provide novel capabilities for geodetic applications such as refined observations of the Earth's gravity field. We will focus on two new concepts: one applies atomic interferometry for (satellite) gravimetry, the other uses clock measurements for observing potential differences at Earth surface. In the first case, gravity anomalies are determined by observing free-falling atoms (quantum gravimetry), such technique can also be applied for future gradiometric measurements in space. In the second case according to Einstein's theory of general relativity, frequency comparisons of highly precise optical clocks give access to differences of the gravity potential - even over long distances (relativistic geodesy). Also laser interferometry between test masses in space with nanometer accuracy belongs to these novel concepts. For the latter, technology developed for gravitational wave detection and successfully tested in the LISA/pathfinder mission is being prepared for geodetic measurements. Those concepts are recently elaborated in close cooperation between physicists and geodesists at the University of Hannover under the umbrella of the Collaborative Research Center SFB 1128 "Relativistic geodesy and gravimetry with quantum sensors (geo-Q)". We will give a few examples where geodesy will potentially benefit from these novel developments and show future perspectives. The direct determination of physical heights and the connection of distant tide gauges are just two examples. We will also illustrate the application of the new methods for Earth observation, where local and global mass variations can be observed with unforeseen accuracy and resolution, benefitting a wide range of geosciences.

  20. [The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting of observational studies].

    Science.gov (United States)

    von Elm, E; Altman, D G; Egger, M; Pocock, S J; Gøtzsche, P C; Vandenbroucke, J P

    2008-06-01

    Much of biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalizability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. Eighteen items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies.

  1. Contribution of infrared observations to the study of supernovae remnants

    International Nuclear Information System (INIS)

    Douvion, Thomas

    2000-01-01

    This research thesis addresses the study of dust in young supernovae remnants observed in middle infrared, mainly by means of the ISOCAM instrument installed on the ISO satellite. The author first presents the supernovae physics and the studied young remnants, describes dusts and the main sites of formation and destruction, and outlines the difficulties and benefits of observations performed in the middle infrared. Then, the author reports acquired evidences related to the formation of dusts in supernovae, and the search for a millimetre emission by cold dust contained in regions which are not yet excited by the shock, in order to better assess the overall quantities created by supernovae. He reports the use of observations of dust and neon in Cassiopeia A to perform a diagnosis on the mixture of elements during the supernovae explosion [fr

  2. Using video-based observation research methods in primary care health encounters to evaluate complex interactions.

    Science.gov (United States)

    Asan, Onur; Montague, Enid

    2014-01-01

    The purpose of this paper is to describe the use of video-based observation research methods in primary care environment and highlight important methodological considerations and provide practical guidance for primary care and human factors researchers conducting video studies to understand patient-clinician interaction in primary care settings. We reviewed studies in the literature which used video methods in health care research, and we also used our own experience based on the video studies we conducted in primary care settings. This paper highlighted the benefits of using video techniques, such as multi-channel recording and video coding, and compared "unmanned" video recording with the traditional observation method in primary care research. We proposed a list that can be followed step by step to conduct an effective video study in a primary care setting for a given problem. This paper also described obstacles, researchers should anticipate when using video recording methods in future studies. With the new technological improvements, video-based observation research is becoming a promising method in primary care and HFE research. Video recording has been under-utilised as a data collection tool because of confidentiality and privacy issues. However, it has many benefits as opposed to traditional observations, and recent studies using video recording methods have introduced new research areas and approaches.

  3. Observer-based Fault Detection and Isolation for Nonlinear Systems

    DEFF Research Database (Denmark)

    Lootsma, T.F.

    systems. It consists of four different contributions. First, it presents a review of the idea and the theory behind the geometric approach for FDI. Starting from the original solution for linear systems up to the latest results for input-affine systems the theory and solutions are described....... Then the geometric approach is applied to a nonlinear ship propulsion system benchmark. The calculations and application results are presented in detail to give an illustrative example. The obtained subsystems are considered for the design of nonlinear observers in order to obtain FDI. Additionally, an adaptive...... for the observers designed for the ship propulsion system. Furthermore, it stresses the importance of the time-variant character of the linearization along a trajectory. It leads to a different stability analysis than for linearization at one operation point. Finally, the preliminary concept of (actuator) fault...

  4. Using Copulas in Data Mining Based on the Observational Calculus

    Czech Academy of Sciences Publication Activity Database

    Holeňa, Martin; Bajer, L.; Ščavnický, M.

    2015-01-01

    Roč. 27, č. 10 (2015), s. 2851-2864 ISSN 1041-4347 R&D Projects: GA ČR GA13-17187S Grant - others:SLU(CZ) SGS/21/2014 Institutional support: RVO:67985807 Keywords : data mining * observational calculus * general ized quantifiers * joint probability distribution * copulas * hierarchical Archimedean copulas Subject RIV: IN - Informatics, Computer Science Impact factor: 2.476, year: 2015

  5. DMD-based programmable wide field spectrograph for Earth observation

    Science.gov (United States)

    Zamkotsian, Frédéric; Lanzoni, Patrick; Liotard, Arnaud; Viard, Thierry; Costes, Vincent; Hébert, Philippe-Jean

    2015-03-01

    In Earth Observation, Universe Observation and Planet Exploration, scientific return could be optimized in future missions using MOEMS devices. In Earth Observation, we propose an innovative reconfigurable instrument, a programmable wide-field spectrograph where both the FOV and the spectrum could be tailored thanks to a 2D micromirror array (MMA). For a linear 1D field of view (FOV), the principle is to use a MMA to select the wavelengths by acting on intensity. This component is placed in the focal plane of a first grating. On the MMA surface, the spatial dimension is along one side of the device and for each spatial point, its spectrum is displayed along the perpendicular direction: each spatial and spectral feature of the 1D FOV is then fully adjustable dynamically and/or programmable. A second stage with an identical grating recomposes the beam after wavelengths selection, leading to an output tailored 1D image. A mock-up has been designed, fabricated and tested. The micromirror array is the largest DMD in 2048 x 1080 mirrors format, with a pitch of 13.68μm. A synthetic linear FOV is generated and typical images have been recorded o at the output focal plane of the instrument. By tailoring the DMD, we could modify successfully each pixel of the input image: for example, it is possible to remove bright objects or, for each spatial pixel, modify the spectral signature. The very promising results obtained on the mock-up of the programmable wide-field spectrograph reveal the efficiency of this new instrument concept for Earth Observation.

  6. general paralysis in a tropical country. study of 43 observations

    African Journals Online (AJOL)

    GENERAL PARALYSIS IN A TROPICAL COUNTRY. STUDY OF 43 OBSERVATIONS. Amara Cisse, Yves Morel, Abass Fodé Cisse, Naby Camara, Bangaly Cisse, Morifode Doukoure, Ibrahima Sory Souare, Mariam Barry, Siaka Camara, Sele Kourouma, Mohamed Mmah Diaby, L Dasilva, Amara Sylla, Hasmiou Dia ...

  7. An observational study on the relationship between plasma vitamin ...

    African Journals Online (AJOL)

    Methods. In a prospective, observational study of 25 adult septic shock patients, serial blood samples were analysed for vitamin C, thiobarbituric acid-reactive substances (TBARS) (a biomarker of oxidative stress), and soluble vascular cell adhesion molecule-1 (sVCAM-1) and E-selectin. (markers of endothelial dysfunction).

  8. Serum YKL-40 and gestational diabetes - an observational cohort study

    DEFF Research Database (Denmark)

    Gybel-Brask, Dorte; Johansen, Julia S; Christiansen, Ib J

    2016-01-01

    To examine serum YKL-40 in women developing gestational diabetes mellitus (GDM). In the present large observational cohort study of 1179 pregnant women, we determined serum YKL-40 four times during pregnancy (at gestational age 12, 20, 25, and 32 weeks). Pregnancy outcome was obtained from medical...

  9. An observational study of defensible space in the neighbourhood park

    Science.gov (United States)

    Marzukhi, M. A.; Afiq, M. A.; Zaki, S. Ahmad; Ling, O. H. L.

    2018-02-01

    The planning of neighborhood park is important to provide space for interaction, leisure, and recreation among residents in any neighbourhood area. However, on an almost daily basis, newspapers report inappropriate incidents such as snatch theft, robbery and street attack that occurred in the neighborhood park. These cases reflect the significance of physical planning and design of neighborhood park that directly affect the safety and comfort of the users. Thus, this study attempts to engage with the defensible space concept in ensuring the security elements be applied in the planning of the recreational area. This study adopts a qualitative method form of research that is retrofitted to an observational study. The observational study is significant for revealing the condition of a neighbourhood park in the ‘real-world,’ in which direct observation is conducted on Taman Tasik Puchong Perdana. The observer focused on four elements or variables of defensible space concept including the provision of facilities in the neighborhood park, territoriality, surveillance, image and milieu. The findings revealed that the planning of Taman Tasik Puchong Perdana does not deliberate the defensible space elements, which may contribute to the crime activities in the park. In these circumstances, the planning of neighbourhood park needs to include proposals for the implementation of defensible space in response to the challenges underpinned by crime problems. Besides, the awareness among the residents needs to be emphasized with the support from local authorities and other organizations to manage and sustain the safety environment in the neighborhood park.

  10. Results of Joint Observations of Jupiter's Atmosphere by Juno and a Network of Earth-Based Observing Stations

    Science.gov (United States)

    Orton, Glenn; Momary, Thomas; Bolton, Scott; Levin, Steven; Hansen, Candice; Janssen, Michael; Adriani, Alberto; Gladstone, G. Randall; Bagenal, Fran; Ingersoll, Andrew

    2017-04-01

    The Juno mission has promoted and coordinated a network of Earth-based observations, including both Earth-proximal and ground-based facilities, to extend and enhance observations made by the Juno mission. The spectral region and timeline of all of these observations are summarized in the web site: https://www.missionjuno.swri.edu/planned-observations. Among the earliest of these were observation of Jovian auroral phenomena at X-ray, ultraviolet and infrared wavelengths and measurements of Jovian synchrotron radiation from the Earth simultaneously with the measurement of properties of the upstream solar wind. Other observations of significance to the magnetosphere measured the mass loading from Io by tracking its observed volcanic activity and the opacity of its torus. Observations of Jupiter's neutral atmosphere included observations of reflected sunlight from the near-ultraviolet through the near-infrared and thermal emission from 5 μm through the radio region. The point of these measurements is to relate properties of the deep atmosphere that are the focus of Juno's mission to the state of the "weather layer" at much higher atmospheric levels. These observations cover spectral regions not included in Juno's instrumentation, provide spatial context for Juno's often spatially limited coverage of Jupiter, and they describe the evolution of atmospheric features in time that are measured only once by Juno. We will summarize the results of measurements during the approach phase of the mission that characterized the state of the atmosphere, as well as observations made by Juno and the supporting campaign during Juno's perijoves 1 (2016 August 27), 3 (2016 December 11), 4 (2017 February 2) and possibly "early" results from 5 (2017 March 27). Besides a global network of professional astronomers, the Juno mission also benefited from the enlistment of a network of dedicated amateur astronomers who provided a quasi-continuous picture of the evolution of features observed by

  11. Observing position and movements in hydrotherapy: a pilot study.

    Science.gov (United States)

    Stark, Mary Ann; Rudell, Barb; Haus, George

    2008-01-01

    To observe and describe the positions and movements women choose while immersed in water during the first stage of labor. Descriptive, observational pilot study. A rural community hospital that provided hydrotherapy in labor. Women (N = 7) who intended to use hydrotherapy in labor were recruited prenatally from a midwife-managed practice. For 15 minutes of each hour during the first stage of labor, position and movements of the participants were observed and recorded on a laptop computer. The observational tool was developed for this study from a review of the literature and interviews with nursing experts; 435 observations were recorded. Women were free to choose when and how long to use hydrotherapy and had no restriction on their positions and movements. Only 3 of the 7 participants labored in the tub. Women demonstrated a greater range of positions and movements in the tub than in bed, both throughout labor and during late first-stage labor (7-10 cm of dilatation). Women had more contractions and made more rhythmic movements while in the tub than in bed. Hydrotherapy may encourage upright positions and movements that facilitate labor progress and coping, helping women avoid unnecessary interventions.

  12. Demonstrating the value of community-based ('citizen science') observations for catchment modelling and characterisation

    Science.gov (United States)

    Starkey, Eleanor; Parkin, Geoff; Birkinshaw, Stephen; Large, Andy; Quinn, Paul; Gibson, Ceri

    2017-05-01

    Despite there being well-established meteorological and hydrometric monitoring networks in the UK, many smaller catchments remain ungauged. This leaves a challenge for characterisation, modelling, forecasting and management activities. Here we demonstrate the value of community-based ('citizen science') observations for modelling and understanding catchment response as a contribution to catchment science. The scheme implemented within the 42 km2 Haltwhistle Burn catchment, a tributary of the River Tyne in northeast England, has harvested and used quantitative and qualitative observations from the public in a novel way to effectively capture spatial and temporal river response. Community-based rainfall, river level and flood observations have been successfully collected and quality-checked, and used to build and run a physically-based, spatially-distributed catchment model, SHETRAN. Model performance using different combinations of observations is tested against traditionally-derived hydrographs. Our results show how the local network of community-based observations alongside traditional sources of hydro-information supports characterisation of catchment response more accurately than using traditional observations alone over both spatial and temporal scales. We demonstrate that these community-derived datasets are most valuable during local flash flood events, particularly towards peak discharge. This information is often missed or poorly represented by ground-based gauges, or significantly underestimated by rainfall radar, as this study clearly demonstrates. While community-based observations are less valuable during prolonged and widespread floods, or over longer hydrological periods of interest, they can still ground-truth existing traditional sources of catchment data to increase confidence during characterisation and management activities. Involvement of the public in data collection activities also encourages wider community engagement, and provides important

  13. Driving performance while using cell phones: an observational study.

    Science.gov (United States)

    Rosenbloom, Tova

    2006-01-01

    Through spontaneous driving observations, this study sought to examine the impact of using a hands-free cell phone while driving on speed and safe gap keeping behaviors. The study also examined the association between the measure of disturbance created by using a cell phone and the driver's awareness of the disturbance. Twenty-three male adults were observed while driving for an hour and a half each; drivers were unaware of being observed. During the session, each of the participants received a phone call, initiated by an associate of the observer. The experiment was divided into two periods during which the experimental parameters were monitored: 10 minutes during conversation on a cell phone and 10 minutes of non-conversation on a hands-free cell phone. After the experiment, the driver was questioned concerning the extent to which his/her driving was disturbed by the cell phone conversation. T-test for matched samples revealed that the gaps between the drivers' cars and those in front of them diminished when drivers were engaged in the cell phone conversations. Repeated measures ANOVA revealed that drivers that had short conversations did not change their speed, while drivers who were engaged in long (over 16 minutes) conversations drove faster. No effect of drivers' awareness toward cell phone-related disturbance on actual driving behavior monitored in the present study was found.

  14. Observer Based Sliding Mode Attitude Control: Theoretical and Experimental Results

    Directory of Open Access Journals (Sweden)

    U. Jørgensen

    2011-07-01

    Full Text Available In this paper we present the design of a sliding mode controller for attitude control of spacecraft actuated by three orthogonal reaction wheels. The equilibrium of the closed loop system is proved to be asymptotically stable in the sense of Lyapunov. Due to cases where spacecraft do not have angular velocity measurements, an estimator for the generalized velocity is derived and asymptotic stability is proven for the observer. The approach is tested on an experimental platform with a sphere shaped Autonomous Underwater Vehicle SATellite: AUVSAT, developed at the Norwegian University of Science and Technology.

  15. Observations on Experience and Flow in Movement-Based Interaction

    NARCIS (Netherlands)

    Nijholt, Antinus; Pasch, Marco; van Dijk, Elisabeth M.A.G.; Reidsma, Dennis; Heylen, Dirk K.J.; England, David

    2011-01-01

    Movement-based interfaces assume that their users move. Users have to perform exercises, they have to dance, they have to golf or football, or they want to train particular bodily skills. Many examples of those interfaces exist, sometimes asking for subtle interaction between user and interface and

  16. Context Matters: Systematic Observation of Place-Based Physical Activity

    Science.gov (United States)

    McKenzie, Thomas L.

    2016-01-01

    Physical activity is place-based, and being able to assess the number of people and their characteristics in specific locations is important both for public health surveillance and for practitioners in their design of physical activity spaces and programs. Although physical activity measurement has improved recently, many investigators avoid or…

  17. A Proxy Outcome Approach for Causal Effect in Observational Studies: A Simulation Study

    Directory of Open Access Journals (Sweden)

    Wenbin Liang

    2014-01-01

    Full Text Available Background. Known and unknown/unmeasured risk factors are the main sources of confounding effects in observational studies and can lead to false observations of elevated protective or hazardous effects. In this study, we investigate an alternative approach of analysis that is operated on field-specific knowledge rather than pure statistical assumptions. Method. The proposed approach introduces a proxy outcome into the estimation system. A proxy outcome possesses the following characteristics: (i the exposure of interest is not a cause for the proxy outcome; (ii causes of the proxy outcome and the study outcome are subsets of a collection of correlated variables. Based on these two conditions, the confounding-effect-driven association between the exposure and proxy outcome can then be measured and used as a proxy estimate for the effects of unknown/unmeasured confounders on the outcome of interest. Performance of this approach is tested by a simulation study, whereby 500 different scenarios are generated, with the causal factors of a proxy outcome and a study outcome being partly overlapped under low-to-moderate correlations. Results. The simulation results demonstrate that the conventional approach only led to a correct conclusion in 21% of the 500 scenarios, as compared to 72.2% for the alternative approach. Conclusion. The proposed method can be applied in observational studies in social science and health research that evaluates the health impact of behaviour and mental health problems.

  18. Stator Flux Observer for Induction Motor Based on Tracking Differentiator

    Directory of Open Access Journals (Sweden)

    Dafang Wang

    2013-01-01

    Full Text Available Voltage model is commonly used in direct torque control (DTC for flux observing of asynchronous motor. In order to improve low-speed and dynamic performance of the voltage model, a modified low-pass filter (LPF algorithm is proposed. Firstly, the tracking differentiator is brought in to modulate the measured stator current, which suppresses the measurement noise, and then amplitude and phase compensation is made towards the stator electromotive force (EMF, after which the stator flux is obtained through a low-pass filter. This method can eliminate the dynamic error of flux filtered by LPF and improve low-speed performance. Experimental results demonstrate effectiveness and improved dynamic performance of such method.

  19. Extended State Observer based control for coaxial-rotor UAV.

    Science.gov (United States)

    Rida Mokhtari, M; Choukchou Braham, Amal; Cherki, Brahim

    2016-03-01

    This paper considers the problem of controlling the position and the orientation of a Coaxial-Rotor Unmanned Aerial Vehicle -CRUAV- despite unknown aerodynamic efforts. A hierarchical flight controller is designed, allowing the trajectory tracking and the stabilization of the vehicle. The designed controller is build through a hierarchical approach yielding two control loops, an inner one to control the attitude and an outer one to control the translational trajectory of the rotorcraft. An Extended State Observer -ESO- is used to estimate the state and the unknown aerodynamic disturbances. The analysis further extends to the design of a control law that takes the disturbance estimation procedure into account. Numerical simulations are carried out to demonstrate the efficiency of the proposed control strategy. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

  20. Folic Acid Supplementation and Preterm Birth: Results from Observational Studies

    Directory of Open Access Journals (Sweden)

    Elena Mantovani

    2014-01-01

    Full Text Available Introduction. Folic acid (FA supplementation is recommended worldwide in the periconceptional period for the prevention of neural tube defects. Due to its involvement in a number of cellular processes, its role in other pregnancy outcomes such as miscarriage, recurrent miscarriage, low birth weight, preterm birth (PTB, preeclampsia, abruptio placentae, and stillbirth has been investigated. PTB is a leading cause of perinatal mortality and morbidity; therefore its association with FA supplementation is of major interest. The analysis of a small number of randomized clinical trials (RCTs has not found a beneficial role of FA in reducing the rate of PTBs. Aim of the Study. The aim of this review was to examine the results from recent observational studies about the effect of FA supplementation on PTB. Materials and Methods. We carried out a search on Medline and by manual search of the observational studies from 2009 onwards that analyzed the rate of PTB in patients who received supplementation with FA before and/or throughout pregnancy. Results. The results from recent observational studies suggest a slight reduction of PTBs that is not consistent with the results from RCTs. Further research is needed to better understand the role of FA supplementation before and during pregnancy in PTB.

  1. Detailed Study of the Internal Structure of a Red-giant Star Observed with Kepler

    DEFF Research Database (Denmark)

    Di Mauro, M. P.; Ventura, R.; Cardini, D.

    2012-01-01

    We study the internal structure and evolutionary state of KIC 4351319, a red-giant star observed with the Kepler satellite. The use of 25 individual oscillation frequencies, together with the accurate atmospheric data provided by ground-based spectroscopic observations, allowed us to estimate the...

  2. Detailed Study of the Internal Structure of a Red-giant Star Observed with Kepler

    NARCIS (Netherlands)

    Di Mauro, M.P.; Ventura, R.; Cardini, D.; Catanzaro, G.; Barban, C.; Bedding, T.R.; Christensen-Dalsgaard, J.; De Ridder, J.; Hekker, S.; Huber, D.; Kallinger, T.; Kinemuchi, K.; Kjeldsen, H.; Miglio, A.; Montalbán, J.; Mosser, B.; Mullally, F.; Stello, D.; Still, M.; Uytterhoeven, K.

    2012-01-01

    We study the internal structure and evolutionary state of KIC 4351319, a red-giant star observed with the Kepler satellite. The use of 25 individual oscillation frequencies, together with the accurate atmospheric data provided by ground-based spectroscopic observations, allowed us to estimate the

  3. An Observational Analysis of Coaching Behaviors for Career Development Event Teams: A Mixed Methods Study

    Science.gov (United States)

    Ball, Anna L.; Bowling, Amanda M.; Sharpless, Justin D.

    2016-01-01

    School Based Agricultural Education (SBAE) teachers can use coaching behaviors, along with their agricultural content knowledge to help their Career Development Event (CDE) teams succeed. This mixed methods, collective case study observed three SBAE teachers preparing multiple CDEs throughout the CDE season. The teachers observed had a previous…

  4. Effective population management practices in diabetes care - an observational study

    DEFF Research Database (Denmark)

    Frølich, Anne; Bellows, Jim; Nielsen, Bo Friis

    2010-01-01

    Of fifteen diabetes care management practices, our data indicate that high performance is most associated with provider alerts and more weakly associated with action plans and with guideline distribution and training. Lack of convergence in the literature on effective care management practices su...... suggests that factors contributing to high performance may be highly context-dependent or that the factors involved may be too numerous or their implementation too nuanced to be reliably identified in observational studies....

  5. Strategies GeoCape Intelligent Observation Studies @ GSFC

    Science.gov (United States)

    Cappelaere, Pat; Frye, Stu; Moe, Karen; Mandl, Dan; LeMoigne, Jacqueline; Flatley, Tom; Geist, Alessandro

    2015-01-01

    This presentation provides information a summary of the tradeoff studies conducted for GeoCape by the GSFC team in terms of how to optimize GeoCape observation efficiency. Tradeoffs include total ground scheduling with simple priorities, ground scheduling with cloud forecast, ground scheduling with sub-area forecast, onboard scheduling with onboard cloud detection and smart onboard scheduling and onboard image processing. The tradeoffs considered optimzing cost, downlink bandwidth and total number of images acquired.

  6. Analysis of subprotonospheric whistlers observed by DEMETER: A case study

    Science.gov (United States)

    Chum, Jaroslav; Santolik, Ondrej; Parrot, Michel

    2009-02-01

    Subprotonospheric (SP) whistlers consist of a series of low-dispersion components that result from repeated reflections between the base of the ionosphere and altitudes up to ~1000 km. We have used wave-normal angles and plasma characteristics measured by the DEMETER microsatellite as an input for a three-dimensional ray tracing technique. For several SP whistlers we have also succeeded in finding the causative lightning located at relatively large distances from the satellite footprint along the geomagnetic field line. We show that the reflections and formation of the SP whistlers take place owing to an oblique propagation, with respect to the magnetic field, in the waveguide formed by a profile of the increasing lower hybrid resonance frequency in the upper ionosphere and the base of the ionosphere. We have observed propagation across the magnetic meridian planes. We conclude that the individual components of the SP whistler propagate along different raypaths. The reflected components enter the ionosphere at relatively large distances from the satellite footprint and experience a spread of wave-normal angles during this entry. Depending on the initial wave-normal angle, these waves undergo a different number of reflections before reaching the satellite, thus arriving with different time delays. However, the first component observed of a SP whistler is formed by waves entering the ionosphere at relatively small distances from the satellite footprint and at relatively small wave-normal angles. These waves do not reflect above the satellite but propagate to the opposite hemisphere.

  7. Folic acid supplementation and preterm birth: results from observational studies.

    Science.gov (United States)

    Mantovani, Elena; Filippini, Francesca; Bortolus, Renata; Franchi, Massimo

    2014-01-01

    Folic acid (FA) supplementation is recommended worldwide in the periconceptional period for the prevention of neural tube defects. Due to its involvement in a number of cellular processes, its role in other pregnancy outcomes such as miscarriage, recurrent miscarriage, low birth weight, preterm birth (PTB), preeclampsia, abruptio placentae, and stillbirth has been investigated. PTB is a leading cause of perinatal mortality and morbidity; therefore its association with FA supplementation is of major interest. The analysis of a small number of randomized clinical trials (RCTs) has not found a beneficial role of FA in reducing the rate of PTBs. The aim of this review was to examine the results from recent observational studies about the effect of FA supplementation on PTB. We carried out a search on Medline and by manual search of the observational studies from 2009 onwards that analyzed the rate of PTB in patients who received supplementation with FA before and/or throughout pregnancy. The results from recent observational studies suggest a slight reduction of PTBs that is not consistent with the results from RCTs. Further research is needed to better understand the role of FA supplementation before and during pregnancy in PTB.

  8. Meditation Based Therapies—A Systematic Review and Some Critical Observations

    Directory of Open Access Journals (Sweden)

    Lone Overby Fjorback

    2012-01-01

    Full Text Available This article systematically reviews the evidence for Mindfulness-Based Stress Reduction (MBSR and Mindfulness-Based Cognitive Therapy (MBCT and analyses the conditions around their rising popularity. MBSR, MBCT and Mindfulness Meditation were used as key words. The inclusion criteria were randomized controlled trials using the standard MBSR/MBCT program with a minimum of 33 participants. Twenty four studies were included. MBSR improved mental health in ten studies compared to waitlist control or treatment as usual. Moreover, MBSR was as efficacious as active control group in four studies, and showed a tendency over active control in one study. MBCT reduced the risk of depressive relapse in all five included studies. Evidence supports that MBSR improves mental health and MBCT prevents depressive relapse. It is interesting to observe that meditation based therapy programs are rapidly enjoying popularity. We discuss the cultural and theoretical implications.

  9. Entamoeba histolytica: observations on metabolism based on thegenome sequence

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, Iain J.; Loftus, Brendan J.

    2005-07-01

    The sequencing of the genome of Entamoeba histolytica has allowed a reconstruction of its metabolic pathways, many of which are unusual for a eukaryote. Based on the genome sequence, it appears that amino acids may play a larger role than previously thought in energy metabolism, with roles in both ATP synthesis and NAD regeneration. Arginine decarboxylase may be involved in survival of E. histolytica during its passage through the stomach. The usual pyrimidine synthesis pathway is absent, but a partial pyrimidine degradation pathway could be part of a novel pyrimidine synthesis pathway. Ribonucleotide reductase was not found in the E. histolytica genome, but it was found in the close relatives Entamoeba invadens and Entamoeba moshkovskii, suggesting a recent loss from E. histolytica. The usual eukaryotic glucose transporters are not present, but members of a prokaryotic monosaccharide transporter family are present.

  10. Understanding NOx emission trends in China based on OMI observations

    Science.gov (United States)

    Wang, Y.; Ga, D.; Smeltzer, C. D.; Yi, R.; Liu, Z.

    2012-12-01

    We analyze OMI observations of NO2 columns over China from 2005 to 2010. Simulations using a regional 3-D chemical transport model (REAM) are used to derive the top-down anthropogenic NOx emissions. The Kendall method is then applied to derive the emission trend. The emission trend is affected by the economic slowdown in 2009. After removing the effect of one year abnormal data, the overall emission trend is 4.35±1.42% per year, which is slower than the linear-regression trend of 5.8-10.8% per year reported for previous years. We find large regional, seasonal, and urban-rural variations in emission trend. The annual emission trends of Northeast China, Central China Plain, Yangtze River Delta and Pearl River Delta are 44.98±1.39%, 5.24±1.63%, 3.31±1.02% and -4.02±1.87%, respectively. The annual emission trends of four megacities, Beijing, Shanghai, Guangzhou and Shenzhen are 0.7±0.27%, -0.75±0.31%, -4.08±1.21% and -6.22±2.85%,, considerably lower than the regional averages. These results appear to suggest that a number of factors, including migration of high-emission industries, vehicle emission regulations, emission control measures of thermal power plants, increased hydro-power usage, have reduced or reversed the increasing trend of NOx emissions in more economically developed megacities and southern coastal regions.

  11. A foundational observation method for studying design situations

    DEFF Research Database (Denmark)

    Cash, Philip; Hicks, Ben; Culley, Steve

    2015-01-01

    impact of individual studies is severely constrained. This paper begins to address this issue by introducing and developing a foundational method for observational design research to improve replicability, reuse, and overall comparability of empirical studies. A three-step foundational method is proposed...... that covers capture, coding, and analysis. The capture step defines overall and situational context as well as multiple capture streams, generating a broad data-set that can be examined from multiple perspectives. The coding step employs a multi-level approach that seeks to minimise workload while describing...

  12. Evidence-Based Novel Changes in Prevalence and Symptom Characteristics of Spleen Deficiency Syndrome in Persons of Varied Health Status and Different Ages: A Cross-Sectional Observational Study

    Directory of Open Access Journals (Sweden)

    Yin Zhang

    2014-01-01

    Full Text Available Deficiency of the organs is a vital pathophysiologic characteristic in the elderly. A core TCM aging theory is known as aging caused by spleen deficiency syndrome (SDS that can be found in ancient and modern literature. The key objectives of this study were to establish a full-scale trial to evaluate the prevalence, symptom severity, frequency, and distribution of SDS in different age groups as related to health status (healthy, subhealthy, and chronic disease to elucidate the role of spleen deficiency in the aging process and deterioration of health status. This cross-sectional observational study was conducted in 4 hospitals in China. 1390 participants aged 20–79 were interviewed by investigators who completed questionnaires recording prevalence, severity, and frequency of symptoms as well as other relevant information. The results revealed that prevalence and symptom characteristics of SDS showed regularities with increasing age and deteriorating health status. It supports the TCM concept that spleen deficiency is an important mechanism of aging, subhealth, and chronic diseases. Early recognition of the warning signs and symptoms of SDS may lead to intervention and even prevention strategies for subhealth and chronic diseases as well as promotion of healthy aging.

  13. Study of some defects observed in the hexagonal liquid crystals

    International Nuclear Information System (INIS)

    Oswald, Patrick

    1981-01-01

    A polarising microscopy study of the disclinations in an hexagonal discotic liquid crystal (hexa-pentoxy-triphenylene) allows us to confirm the theory of the developable domains and the existence of the disclinations as involute of the circle. The absence of the lines S = 1 leads us to propose a model of core in which the energetic instability of these lines is emphasized. The nature of the core is discussed: it is probably filled with hexagonal liquid crystal. Moreover the birefringence Δn is measured and a first estimate of the anchoring energies of the discotic both on the glass and in contact with the air is given. The Michelson interferometry study of the interaction between the disclinations and the free surface has allowed to observe a strong anisotropy of the interfacial tension. At last a study of the walls leads to a classification according to the matching angle and to a first estimate of the penetration distance λ. A similar study has been undertaken in an inverse middle liquid crystalline phase (Na dioctylsulfosuccinate). A strong dependence of the elastic constants with the water concentration is observed. The micellar → hexagonal transition is studied. (author) [fr

  14. Observations of radiographer communication: An exploratory study using Transactional Analysis

    International Nuclear Information System (INIS)

    Booth, Lisa A.; Manning, David J.

    2006-01-01

    Purpose: Communication in medical imaging is a neglected area of research, despite the necessity for good communication if optimum diagnostic images are to be achieved. Methods: The present study has investigated the styles of communication used in medical imaging, using an approach known as Transactional Analysis. This approach has been demonstrated previously as having reliability and validity, using observations and supporting interviews with medical imaging staff, along with inter-rater observations of radiographer-patient interactions. Results: The results indicate that Transactional Analysis can be used effectively for identifying and naming interaction events in diagnostic radiography, with diagnostic radiographers using five styles of communication. Conclusion: Radiographers tend to use Parental styles of communicating; these styles are commonly associated with a practitioner-centred approach to dealing with patients which often result in non-adherence

  15. Linking Indigenous Knowledge and Observed Climate Change Studies

    Science.gov (United States)

    Alexander, Chief Clarence; Bynum, Nora; Johnson, Liz; King, Ursula; Mustonen, Tero; Neofotis, Peter; Oettle, Noel; Rosenzweig, Cynthia; Sakakibara, Chie; Shadrin, Chief Vyacheslav; hide

    2010-01-01

    We present indigenous knowledge narratives and explore their connections to documented temperature and other climate changes and observed climate change impact studies. We then propose a framework for enhancing integration of these indigenous narratives of observed climate change with global assessments. Our aim is to contribute to the thoughtful and respectful integration of indigenous knowledge with scientific data and analysis, so that this rich body of knowledge can inform science, and so that indigenous and traditional peoples can use the tools and methods of science for the benefit of their communities if they choose to do so. Enhancing ways of understanding such connections are critical as the Intergovernmental Panel on Climate Change Fifth Assessment process gets underway.

  16. Supplementing Oscat winds with Saral Altika observations for cyclone studies

    Science.gov (United States)

    Niharika, K.; Usha Sundari, H. S. V.; Prasad, A. V. V.; Kumari, E. V. S. Sita; Dadhwal, V. K.; Ali, M. M.

    2014-11-01

    Accurate prediction of life cycle of cyclone is very critical to the disaster management practices. Since the cyclones originate over the oceans where in situ observations are limited, we have to resort to the remote sensing techniques. Both optical and microwave sensors help studying the cyclones. While scatterometer provide wind vectors, altimeters can give only wind speed. In this paper we present how altimeter measurements can supplement the scatterometer observations in determining the radius of maximum winds (RMW). Sustained maximum winds, indicator for the intensity of the cyclone, are within the eye wall of a cyclone at a distance of RMW. This parameter is also useful in predicting right time of the storm surge. In this paper we used the wind speed estimations from AltiKa, an altimeter operating at Ka band.

  17. The influence of aerosol particle number and hygroscopicity on the evolution of convective cloud systems and their precipitation: A numerical study based on the COPS observations on 12 August 2007

    Science.gov (United States)

    Planche, Céline; Wobrock, Wolfram; Flossmann, Andrea I.; Tridon, Frédéric; Van Baelen, Joël; Pointin, Yves; Hagen, Martin

    2010-10-01

    The 3D cloud model DESCAM-3D with bin resolved microphysics for ice, water and aerosol particles is used to study the role of particles on the evolution of summertime mid-level convective clouds and the subsequent precipitation during the COPS field campaign which occurred at mid-latitude near the French/German border in summer 2007. Using a 3D grid resolution of 250 m, DESCAM-3D, is able to simulate well the dynamical, cloud and precipitation features of the convective cloud system observed during the afternoon of the 12th August. This mid-level convective system was dominated by warm-phase microphysics. The simulated convective system led to a 1.5 h long lasting precipitation event in agreement with the radar observations. The results of the fine numerical scale compare well with the high resolved radar reflectivities of the LaMP X-band radar and the DLR-Poldirad radar. The prediction of the liquid hydrometeor spectra allows a detailed calculation of the cloud radar reflectivity. In order to better understand the role of aerosol particles on cloud evolution and precipitation formation, several sensitivity studies were performed by modifying aerosol number concentration as well as their physico-chemical properties. Drastic changes in the aerosol solubility lead to a variation in precipitation on the order of 10% for the same convective case. In contrast, changes in the aerosol number concentrations can lead to a variation in total precipitation of up to 30%. Hence, the role of changes in aerosol number concentrations is more important than changes in particle solubility for this case of continental mid-level convection at mid-latitude. A subsequent analysis of the in-cloud microphysics revealed that in-cloud properties are modified significantly in all scenarios. Key parameter is the supersaturation whose magnitude influences both cloud microphysics (cloud droplet and rain drop formation) as well as cloud thermodynamics and cloud dynamics. Furthermore

  18. Task-based model/human observer evaluation of SPIHT wavelet compression with human visual system-based quantization.

    Science.gov (United States)

    Zhang, Yani; Pham, Binh T; Eckstein, Miguel P

    2005-03-01

    The set partitioning in hierarchical trees (SPIHT) wavelet image compression algorithm with the human visual system (HVS) quantization matrix was investigated using x-ray coronary angiograms. We tested whether the HVS quantization matrix for the SPIHT wavelet compression improved computer model/human observer performance in a detection task with variable signals compared to performance with the default quantization matrix. We also tested the hypothesis of whether evaluating the rank order of the two quantization matrices (HVS versus default) based on performance of computer model observers in a signal known exactly but variable task (SKEV) generalized to model/human performance in the more clinically realistic signal known statistically task (SKS). Nine hundred test images were created using real x-ray coronary angiograms as backgrounds and simulated arteries with filling defects (signals). The task for the model and human observer was to detect which one of the four computer simulated arterial segments contained the signal, four alternative-forced-choice (4 AFC). We obtained performance for four model observers (nonprewhitening matched filter with an eye filter, Hotelling, Channelized Hotelling, and Laguerre Gauss Hotelling model observers) for both the SKEV and SKS tasks with images compressed with and without the HVS quantization matrix. A psychophysical study measured performance from three human observers for the same conditions and tasks as the model observers. Performance for all four model observers improved with the use of the HVS quantization scheme. Improvements ranged from 5% (at compression ratio 7:1) to 50% (at compression ratio 30:1) for both the SKEV and SKS tasks. Human observer performance improvement averaged across observers ranged from 6% (at compression ratio 7:1) to 35% (at compression ratio 30:1) for the SKEV task and from 2% (at compression ratio 7:1) to 38% (at compression ratio 30:1) for the SKS task. Addition of internal noise to the

  19. A Kalman Filter for SINS Self-Alignment Based on Vector Observation.

    Science.gov (United States)

    Xu, Xiang; Xu, Xiaosu; Zhang, Tao; Li, Yao; Tong, Jinwu

    2017-01-29

    In this paper, a self-alignment method for strapdown inertial navigation systems based on the q -method is studied. In addition, an improved method based on integrating gravitational apparent motion to form apparent velocity is designed, which can reduce the random noises of the observation vectors. For further analysis, a novel self-alignment method using a Kalman filter based on adaptive filter technology is proposed, which transforms the self-alignment procedure into an attitude estimation using the observation vectors. In the proposed method, a linear psuedo-measurement equation is adopted by employing the transfer method between the quaternion and the observation vectors. Analysis and simulation indicate that the accuracy of the self-alignment is improved. Meanwhile, to improve the convergence rate of the proposed method, a new method based on parameter recognition and a reconstruction algorithm for apparent gravitation is devised, which can reduce the influence of the random noises of the observation vectors. Simulations and turntable tests are carried out, and the results indicate that the proposed method can acquire sound alignment results with lower standard variances, and can obtain higher alignment accuracy and a faster convergence rate.

  20. Complex state variable- and disturbance observer-based current controllers for AC drives

    DEFF Research Database (Denmark)

    Dal, Mehmet; Teodorescu, Remus; Blaabjerg, Frede

    2013-01-01

    , extracted by a disturbance observer and then injected into the current controller. In this study, a revised version of a disturbance observer-based controller and a well known complex variable model-based design with a single set of complex pole are compared in terms of design aspects and performance......In vector-controlled AC drives, the design of current controller is usually based on a machine model defined in synchronous frame coordinate, where the drive performance may be degraded by both the variation of the machine parameters and the cross-coupling between the d- and q-axes components...... of the stator current. In order to improve the current control performance an alternative current control strategy was proposed previously aiming to avoid the undesired cross-coupling and non-linearities between the state variables. These effects are assumed as disturbances arisen in the closed-loop path...

  1. Age estimation in forensic anthropology: quantification of observer error in phase versus component-based methods.

    Science.gov (United States)

    Shirley, Natalie R; Ramirez Montes, Paula Andrea

    2015-01-01

    The purpose of this study was to assess observer error in phase versus component-based scoring systems used to develop age estimation methods in forensic anthropology. A method preferred by forensic anthropologists in the AAFS was selected for this evaluation (the Suchey-Brooks method for the pubic symphysis). The Suchey-Brooks descriptions were used to develop a corresponding component-based scoring system for comparison. Several commonly used reliability statistics (kappa, weighted kappa, and the intraclass correlation coefficient) were calculated to assess observer agreement between two observers and to evaluate the efficacy of each of these statistics for this study. The linear weighted kappa was determined to be the most suitable measure of observer agreement. The results show that a component-based system offers the possibility for more objective scoring than a phase system as long as the coding possibilities for each trait do not exceed three states of expression, each with as little overlap as possible. © 2014 American Academy of Forensic Sciences.

  2. A NANOFLARE-BASED CELLULAR AUTOMATON MODEL AND THE OBSERVED PROPERTIES OF THE CORONAL PLASMA

    Energy Technology Data Exchange (ETDEWEB)

    Fuentes, Marcelo López [Instituto de Astronomía y Física del Espacio, CONICET-UBA, CC. 67, Suc. 28, 1428 Buenos Aires (Argentina); Klimchuk, James A., E-mail: lopezf@iafe.uba.ar [NASA Goddard Space Flight Center, Code 671, Greenbelt, MD 20771 (United States)

    2016-09-10

    We use the cellular automaton model described in López Fuentes and Klimchuk to study the evolution of coronal loop plasmas. The model, based on the idea of a critical misalignment angle in tangled magnetic fields, produces nanoflares of varying frequency with respect to the plasma cooling time. We compare the results of the model with active region (AR) observations obtained with the Hinode /XRT and SDO /AIA instruments. The comparison is based on the statistical properties of synthetic and observed loop light curves. Our results show that the model reproduces the main observational characteristics of the evolution of the plasma in AR coronal loops. The typical intensity fluctuations have amplitudes of 10%–15% both for the model and the observations. The sign of the skewness of the intensity distributions indicates the presence of cooling plasma in the loops. We also study the emission measure (EM) distribution predicted by the model and obtain slopes in log(EM) versus log(T) between 2.7 and 4.3, in agreement with published observational values.

  3. A Nanoflare-Based Cellular Automaton Model and the Observed Properties of the Coronal Plasma

    Science.gov (United States)

    Lopez-Fuentes, Marcelo; Klimchuk, James Andrew

    2016-01-01

    We use the cellular automaton model described in Lopez Fuentes and Klimchuk to study the evolution of coronal loop plasmas. The model, based on the idea of a critical misalignment angle in tangled magnetic fields, produces nanoflares of varying frequency with respect to the plasma cooling time. We compare the results of the model with active region (AR) observations obtained with the Hinode/XRT and SDOAIA instruments. The comparison is based on the statistical properties of synthetic and observed loop light curves. Our results show that the model reproduces the main observational characteristics of the evolution of the plasma in AR coronal loops. The typical intensity fluctuations have amplitudes of 10 percent - 15 percent both for the model and the observations. The sign of the skewness of the intensity distributions indicates the presence of cooling plasma in the loops. We also study the emission measure (EM) distribution predicted by the model and obtain slopes in log(EM) versus log(T) between 2.7 and 4.3, in agreement with published observational values.

  4. Decreased systolic blood pressure is associated with increased risk of all-cause mortality in patients with type 2 diabetes and renal impairment: A nationwide longitudinal observational study of 27,732 patients based on the Swedish National Diabetes Register.

    Science.gov (United States)

    Svensson, Maria K; Afghahi, Henri; Franzen, Stefan; Björk, Staffan; Gudbjörnsdottir, Soffia; Svensson, Ann-Marie; Eliasson, Björn

    2017-05-01

    Previous studies have shown a U-shaped relationship between systolic blood pressure and risk of all-cause of mortality in patients with type 2 diabetes and renal impairment. To evaluate the associations between time-updated systolic blood pressure and time-updated change in systolic blood pressure during the follow-up period and risk of all-cause mortality in patients with type 2 diabetes and renal impairment. A total of 27,732 patients with type 2 diabetes and renal impairment in the Swedish National Diabetes Register were followed for 4.7 years. Time-dependent Cox models were used to estimate risk of all-cause mortality. Time-updated mean systolic blood pressure is the average of the baseline and the reported post-baseline systolic blood pressures. A time-updated systolic blood pressure blood pressure > 10 mmHg between the last two observations was associated with higher risk of all-cause mortality (-10 to -25 mmHg; hazard ratio: 1.24, 95% confidence interval: 1.17-1.32). Both low systolic blood pressure and a decrease in systolic blood pressure during the follow-up are associated with a higher risk of all-cause mortality in patients with type 2 diabetes and renal impairment.

  5. Adaptive observer-based control for a class of chaotic systems

    Energy Technology Data Exchange (ETDEWEB)

    Hua Changchun E-mail: cch@ysu.edu.cn; Guan Xinping; Li Xiaoli; Shi Peng

    2004-10-01

    In this note, the problem of control for a class of chaotic systems is studied. Only partial information of the systems states is known. First, an adaptive observer is designed to ensure the corresponding error system asymptotically stable. Then, based on the states obtained by the above observer, a nonlinear state feedback controller is constructed for the chaotic system, which, according to the input to state stable (ISS) principal, guarantees the closed-loop chaotic system is asymptotically stable. A numerical example is included to show the effectiveness of the proposed techniques.

  6. An observational study of post-asymptotic-giant-branch stars

    Science.gov (United States)

    Sahin, T.

    2008-05-01

    In this thesis, we present an LTE model atmosphere analyses of a group of early B-type postasymptotic giant branch (pAGB) stars. With initial masses ≤ 9M⊙, post-AGB stars form an important group of evolved stars and provide a unique opportunity to study stellar evolution almost on a human time-scale. Post-AGB stars have spectral types ranging from K to B and luminosities between 103 and 104L⊙. These objects ended their asymptotic giant branch (AGB) evolution phase with a period of strong mass loss (10-7 - 10-4M⊙ yr-1) and have been evolving from cooler to hotter temperatures at almost constant luminosity on a timescale of ˜ 104yr. B-type pAGB stars span a wide range in effective temperature (10 000 - 30 000K). Their expected surface gravities (log g ) and effective temperatures ( Teff ) coincide with those of B stars evolving from the main sequence. Therefore systematic observational analyses are required to distinguish these two groups. Furthermore, p! ost-AGB stars may be divided into four distinct groups based on their chemical composition. In this thesis, groups I and II represent post-AGB stars which are very metal deficient with C/O ≈ 1 and metal poor with C/OTIGER. These spectra were analyzed using model atmospheres and synthetic spectra computed with the Armagh LTE stellar atmospheres software. The semiautomated spectral fitting package SFIT was used to measure the stellar surface parameters and composition. The results show that Teff of the programme stars are in the range 15 000 - 25 000 K and log g are in the range 2.5 - 3.0. In addition to being metal-poor stars, they show mostly C/O<1. Several of our programme stars, namely HD119608, LSS4331, LSS5112, and LB3116 confirm this. The majority of hot post-AGB stars can be identified with the group II, metal-poor and C-deficient post-AGB stars. The model atmosphere parameters, LTE element abundances and estimated distance obtained here support the idea that programme stars are in true post

  7. Detection of Cardiovascular Anomalies: An Observer-Based Approach

    KAUST Repository

    Ledezma, Fernando

    2012-07-01

    In this thesis, a methodology for the detection of anomalies in the cardiovascular system is presented. The cardiovascular system is one of the most fascinating and complex physiological systems. Nowadays, cardiovascular diseases constitute one of the most important causes of mortality in the world. For instance, an estimate of 17.3 million people died in 2008 from cardiovascular diseases. Therefore, many studies have been devoted to modeling the cardiovascular system in order to better understand its behavior and find new reliable diagnosis techniques. The lumped parameter model of the cardiovascular system proposed in [1] is restructured using a hybrid systems approach in order to include a discrete input vector that represents the influence of the mitral and aortic valves in the different phases of the cardiac cycle. Parting from this model, a Taylor expansion around the nominal values of a vector of parameters is conducted. This expansion serves as the foundation for a component fault detection process to detect changes in the physiological parameters of the cardiovascular system which could be associated with cardiovascular anomalies such as atherosclerosis, aneurysm, high blood pressure, etc. An Extended Kalman Filter is used in order to achieve a joint estimation of the state vector and the changes in the considered parameters. Finally, a bank of filters is, as in [2], used in order to detect the appearance of heart valve diseases, particularly stenosis and regurgitation. The first numerical results obtained are presented.

  8. Observer-Based Fault Estimation and Accomodation for Dynamic Systems

    CERN Document Server

    Zhang, Ke; Shi, Peng

    2013-01-01

    Due to the increasing security and reliability demand of actual industrial process control systems, the study on fault diagnosis and fault tolerant control of dynamic systems has received considerable attention. Fault accommodation (FA) is one of effective methods that can be used to enhance system stability and reliability, so it has been widely and in-depth investigated and become a hot topic in recent years. Fault detection is used to monitor whether a fault occurs, which is the first step in FA. On the basis of fault detection, fault estimation (FE) is utilized to determine online the magnitude of the fault, which is a very important step because the additional controller is designed using the fault estimate. Compared with fault detection, the design difficulties of FE would increase a lot, so research on FE and accommodation is very challenging. Although there have been advancements reported on FE and accommodation for dynamic systems, the common methods at the present stage have design difficulties, whi...

  9. A statistical study of giant molecular clouds traced by 13CO, C18O, CS, and CH3OH in the disk of NGC 1068 based on ALMA observations

    Science.gov (United States)

    Tosaki, Tomoka; Kohno, Kotaro; Harada, Nanase; Tanaka, Kunihiko; Egusa, Fumi; Izumi, Takuma; Takano, Shuro; Nakajima, Taku; Taniguchi, Akio; Tamura, Yoichi

    2017-04-01

    We present 1{^''.}4 (98 pc) resolution ALMA observations of 13CO(J = 1-0), C18O(J = 1-0), CS(J = 2-1), and CH3OH(JK = 2K-1K) molecular rotational lines in the central 1΄ (4.2 kpc) diameter region of NGC 1068 to study the physical and chemical properties of giant molecular clouds (GMCs) and to test whether these GMC-scale properties are linked to the larger-scale galactic environment. Using the derived 13CO cube, we have identified 187 high-significance (>8 σ) GMCs by employing the CLUMPFIND algorithm. The molecular gas masses of GMCs (M_^{13CO}), derived from the 13CO data, range from 1.8 × 104 M⊙ to 4.2 × 107 M⊙. A mass function of GMCs in NGC 1068 has been obtained for the first time at ∼100 pc resolution. We find the slope of the mass function γ = -1.25 ± 0.07 for a mass range of M_^{13CO} ≥ 105 M⊙. This is shallower than the GMCs in the disk regions of the Milky Way, M 51, and NGC 300. Further, we find that the high mass cut-off of the GMC mass function occurs at M_^{13CO} ˜ 6 × 107 M⊙, which is an order of magnitude larger than that in the nuclear bar region of M 51, indicating that the more massive clouds dominate the mass budget in NGC 1068. The observed C18O(J = 1-0)/13CO(J = 1-0) intensity ratios are found to be fairly uniform (0.27 ± 0.05) among the identified GMCs. In contrast, the CH3OH(JK = 2K-1K)/13CO(J = 1-0) ratios exhibit striking spatial variation across the disk, with the smallest values around the bar-end (<0.03), and larger ratios along the spiral arms (∼0.1-0.2). We find that GMCs with detectable methanol emission tend to have systematically larger velocity widths than those without methanol emission, suggesting that (relatively weak) shocks are responsible for the enhancement of the CH3OH/13CO ratios of GMCs in the disk of NGC 1068.

  10. [The reporting of observational studies: analysis using the STROBE statement].

    Science.gov (United States)

    Galera Llorca, Jordi; Lahoz Grillo, Raquel; Roig Loscertales, Francesc

    2011-12-01

    Deficiencies detected in biomedical studies publication different Guidelines to improve. The objective of the study is to assess the communication of observational studies of Cardiovascular and Metabolism therapeutic area (CVM) published in 6 Spanish journals in 2009 using the STROBE statement. Cross-sectional analysis of articles related to CVM therapeutic area, published during 2009 in 6 Spanish journals applying the 34 items of the STROBE statement. Descriptive analysis of the results for qualitative variables was performed using a frequency analysis. Quantitative variables were analyzed by sample estimates and dispersion. A comparative analysis of journals was performed using ANOVA with a statistical significance of pSTROBE recommendations. The Methods and Results sections showed more deficiencies.

  11. Necrotizing soft tissue infections - a multicentre, prospective observational study (INFECT)

    DEFF Research Database (Denmark)

    Madsen, M. B.; Skrede, S.; Bruun, T.

    2018-01-01

    Indicator for Necrotizing Fasciitis (LRINEC) score and 90-day mortality; 90-day mortality in patients with and without acute kidney injury (AKI) and LRINEC score of six and above or below six; and association between affected body part at arrival and microbiological findings. Exploratory outcomes include......Background: The INFECT project aims to advance our understanding of the pathophysiological mechanisms in necrotizing soft tissue infections (NSTIs). The INFECT observational study is part of the INFECT project with the aim of studying the clinical profile of patients with NSTIs and correlating...... univariate analyses of baseline characteristics associations with 90-day mortality. The statistical analyses will be conducted in accordance with the predefined statistical analysis plan. Conclusion: Necrotizing soft tissue infections result in severe morbidity and mortality. The INFECT study...

  12. Palliative care team visits. Qualitative study through participant observation

    Science.gov (United States)

    Bueno Pernias, Maria José; Hueso Montoro, César; Guardia Mancilla, Plácido; Montoya Juárez, Rafael; García Caro, Maria Paz

    2016-01-01

    Objectives: To describe the clinical encounters that occur when a palliative care team provides patient care and the features that influence these encounters and indicate whether they are favorable or unfavorable depending on the expectations and feelings of the various participants. Methods: A qualitative case study conducted via participant observation. A total of 12 observations of the meetings of palliative care teams with patients and families in different settings (home, hospital and consultation room) were performed. The visits were follow-up or first visits, either scheduled or on demand. Content analysis of the observation was performed. Results: The analysis showed the normal follow-up activity of the palliative care unit that was focused on controlling symptoms, sharing information and providing advice on therapeutic regimens and care. The environment appeared to condition the patients' expressions and the type of patient relationship. Favorable clinical encounter conditions included kindness and gratitude. Unfavorable conditions were deterioration caused by approaching death, unrealistic family objectives and limited resources. Conclusion: Home visits from basic palliative care teams play an important role in patient and family well-being. The visits seem to focus on controlling symptoms and are conditioned by available resources. PMID:27226663

  13. Motorcycle helmet use in Southern China: an observational study.

    Science.gov (United States)

    Li, Gong-Li; Li, Li-Ping; Cai, Qi-En

    2008-06-01

    In China, despite national motorcycle helmet legislation and the known safety benefits of helmets, helmet use remains low. The aim of this study was to determine the rate of motorcycle helmet use and attitudes towards helmet use among drivers and passengers in two cities in Southern China to provide baseline data and scientific evidence for the formulation of an intervention aimed at strengthening road safety law enforcement. Observational sites were randomly selected from three road types (national roads, main streets, and subordinate streets). Observations were conducted during six specified time periods and uniform checklists were used to record helmet use. Motorcycle riders were randomly selected from service stations, elementary schools, and supermarket car parks to participate in a face-to-face interview to ascertain attitudes. Overall, the rate of correct helmet use among drivers was higher in Chaozhou (34.6%) than in Shantou (30.2%; P helmet use was higher among drivers in main streets, during daytime hours, and during weekdays (P helmet knowledge of motorcycle drivers was high with most reporting that helmets prevent or reduce head injury (Shantou: 78.2%; Chaozhou 70.6%). Although level of awareness of the benefits of helmets was high, observed helmet usage was low. These results suggest that there is a need to implement new interventions to increase helmet use.

  14. A Statistical Study of Interplanetary Type II Bursts: STEREO Observations

    Science.gov (United States)

    Krupar, V.; Eastwood, J. P.; Magdalenic, J.; Gopalswamy, N.; Kruparova, O.; Szabo, A.

    2017-12-01

    Coronal mass ejections (CMEs) are the primary cause of the most severe and disruptive space weather events such as solar energetic particle (SEP) events and geomagnetic storms at Earth. Interplanetary type II bursts are generated via the plasma emission mechanism by energetic electrons accelerated at CME-driven shock waves and hence identify CMEs that potentially cause space weather impact. As CMEs propagate outward from the Sun, radio emissions are generated at progressively at lower frequencies corresponding to a decreasing ambient solar wind plasma density. We have performed a statistical study of 153 interplanetary type II bursts observed by the two STEREO spacecraft between March 2008 and August 2014. These events have been correlated with manually-identified CMEs contained in the Heliospheric Cataloguing, Analysis and Techniques Service (HELCATS) catalogue. Our results confirm that faster CMEs are more likely to produce interplanetary type II radio bursts. We have compared observed frequency drifts with white-light observations to estimate angular deviations of type II burst propagation directions from radial. We have found that interplanetary type II bursts preferably arise from CME flanks. Finally, we discuss a visibility of radio emissions in relation to the CME propagation direction.

  15. Nursing praxis, compassionate caring and interpersonal relations: an observational study.

    Science.gov (United States)

    Fry, Margaret; MacGregor, Casimir; Ruperto, Kate; Jarrett, Kate; Wheeler, Janet; Fong, Jacqueline; Fetchet, Wendy

    2013-05-01

    The Clinical Initiative Nurse (CIN) is a role that requires experienced emergency nurses to assess, initiate diagnostic tests, treat and manage a range of patient conditions. The CIN role is focused on the waiting room and to 'communicate the wait', initiate diagnostics or treatment and follow-up for waiting room patients. We aim to explore what emergency nurses' do in their extended practice role in observable everyday life in the emergency department (ED). The paper argues that compassionate caring is a core nursing skill that supports CIN interpersonal relations, despite the role's highly clinical nature. Sixteen non-participant observations were undertaken in three EDs in New South Wales, Australia. Nurses were eligible for inclusion if they had two years of emergency experience and had worked in the CIN role for more than one year. All CIN's that were observed were highly experienced with a minimum three year ED experience. The CIN observations revealed how compassionate caring was utilised by CIN's to quickly build a therapeutic relationship with patients and colleagues, and helped to facilitate core communication and interpersonal skills. While the CIN role was viewed as extended practice, the role relied heavily on compassionate care to support interpersonal relationships and to actualise extended practice care. The study supports the contribution made by emergency nurses and demonstrates how compassionate caring is central to nursing praxis. This paper also demonstrates that the CIN role utilises a complex mix between advanced clinical skills and compassion that supports interpersonal and therapeutic relationships. Further research is needed to understand how compassionate care can be optimised within nursing praxis and the duty of care between nurses and patients, nurses and other health care professionals so that future healthcare goals can be realised. Copyright © 2013 College of Emergency Nursing Australasia Ltd. All rights reserved.

  16. Recent changes in stratospheric aerosol budget from ground-based and satellite observations

    Science.gov (United States)

    Khaykin, Sergey; Godin-Beekmann, Sophie; Keckhut, Philippe; Hauchecorne, Alain; Portafaix, Thierry; Begue, Nelson; Vernier, Jean-Paul; DeLand, Matthew; Bhartia, Pawan K.; Leblanc, Thierry

    2017-04-01

    Stratospheric aerosol budget plays an important role in climate variability and ozone chemistry. Observations of stratospheric aerosol by ground-based lidars represent a particular value as they ensure the continuity and coherence of stratospheric aerosol record. Ground-based lidars remain indispensable for complementing and validating satellite instruments and for filling gaps between satellite missions. On the other hand, geophysical interpretation of local observations is complicated without the knowledge of global distribution of stratospheric aerosol, which calls for a combined analysis of ground-based and space-borne observations. The present study aims at characterizing global and regional variability of stratospheric aerosol over the last 5 years using various sets of observations. We use the data provided by three lidars operated within NDACC (Network for Detection of Atmospheric Composition Change) at Haute-Provence, (44° N), Mauna Loa (21° N) and Maido (21° S) sites together with quasi-global-coverage aerosol measurements by CALIOP and OMPS satellite instruments. The local and space-borne measurements are shown to be in good agreement allowing for their synergetic use. Since the late 2012 stratospheric aerosol remained at background levels throughout the globe. Eruptions of Kelud volcano at 4° S in February 2014 and Calbuco volcano at 41° S in April 2015 resulted in a remarkable enhancement of stratospheric AOD at a wide latitude range. We explore meridional dispersion and lifetime of volcanic plumes in consideration of global atmospheric circulation. A focus is made on the poleward transport of volcanic aerosol and its detection at the mid-latitude Haute-Provence observatory. We show that the moderate eruptions in the Southern hemisphere leave a measurable imprint on the Northern mid-latitude aerosol loading. Having identified the volcanically-perturbed periods from local and global observations we examine the evolution of non-volcanic (background

  17. From feedback- to response-based performance monitoring in active and observational learning.

    Science.gov (United States)

    Bellebaum, Christian; Colosio, Marco

    2014-09-01

    Humans can adapt their behavior by learning from the consequences of their own actions or by observing others. Gradual active learning of action-outcome contingencies is accompanied by a shift from feedback- to response-based performance monitoring. This shift is reflected by complementary learning-related changes of two ACC-driven ERP components, the feedback-related negativity (FRN) and the error-related negativity (ERN), which have both been suggested to signal events "worse than expected," that is, a negative prediction error. Although recent research has identified comparable components for observed behavior and outcomes (observational ERN and FRN), it is as yet unknown, whether these components are similarly modulated by prediction errors and thus also reflect behavioral adaptation. In this study, two groups of 15 participants learned action-outcome contingencies either actively or by observation. In active learners, FRN amplitude for negative feedback decreased and ERN amplitude in response to erroneous actions increased with learning, whereas observational ERN and FRN in observational learners did not exhibit learning-related changes. Learning performance, assessed in test trials without feedback, was comparable between groups, as was the ERN following actively performed errors during test trials. In summary, the results show that action-outcome associations can be learned similarly well actively and by observation. The mechanisms involved appear to differ, with the FRN in active learning reflecting the integration of information about own actions and the accompanying outcomes.

  18. A Conceptual List of Indicators for Urban Planning and Management Based on Earth Observation

    OpenAIRE

    Chrysoulakis, Nektarios; Feigenwinter, Christian; Triantakonstantis, Dimitrios; Penyevskiy Igor,; Tal, Abraham; Parlow, Eberhard; Fleishman, Guy; Düzgün, Sebnem; Esch, Thomas; Marconcini, Mattia

    2014-01-01

    Sustainable development is a key component in urban studies. Earth Observation (EO) can play a valuable role in sustainable urban development and planning, since it represents a powerful data source with the potential to provide a number of relevant urban sustainability indicators. To this end, in this paper we propose a conceptual list of EO-based indicators capable of supporting urban planning and management. Three cities with different typologies, namely Basel, Switzerland; Tel Aviv, Israe...

  19. Safety Hazards During Intrahospital Transport: A Prospective Observational Study.

    Science.gov (United States)

    Bergman, Lina M; Pettersson, Monica E; Chaboyer, Wendy P; Carlström, Eric D; Ringdal, Mona L

    2017-10-01

    To identify, classify, and describe safety hazards during the process of intrahospital transport of critically ill patients. A prospective observational study. Data from participant observations of the intrahospital transport process were collected over a period of 3 months. The study was undertaken at two ICUs in one university hospital. Critically ill patients transported within the hospital by critical care nurses, unlicensed nurses, and physicians. None. Content analysis was performed using deductive and inductive approaches. We detected a total of 365 safety hazards (median, 7; interquartile range, 4-10) during 51 intrahospital transports of critically ill patients, 80% of whom were mechanically ventilated. The majority of detected safety hazards were assessed as increasing the risk of harm, compromising patient safety (n = 204). Using the System Engineering Initiative for Patient Safety, we identified safety hazards related to the work system, as follows: team (n = 61), tasks (n = 83), tools and technologies (n = 124), environment (n = 48), and organization (n = 49). Inductive analysis provided an in-depth description of those safety hazards, contributing factors, and process-related outcomes. Findings suggest that intrahospital transport is a hazardous process for critically ill patients. We have identified several factors that may contribute to transport-related adverse events, which will provide the opportunity for the redesign of systems to enhance patient safety.

  20. Technological aspects of hospital communication challenges: an observational study.

    Science.gov (United States)

    Popovici, Ilinca; Morita, Plinio P; Doran, Diane; Lapinsky, Stephen; Morra, Dante; Shier, Ashleigh; Wu, Robert; Cafazzo, Joseph A

    2015-06-01

    To gain insights into how technological communication tools impact effective communication among clinicians, which is critical for patient safety. This multi-site observational study analyzes inter-clinician communication and interaction with information technology, with a focus on the critical process of patient transfer from the Emergency Department to General Internal Medicine. Mount Sinai Hospital, Sunnybrook Health Sciences Centre and Toronto General Hospital. At least five ED and general internal medicine nurses and physicians directly involved in patient transfers were observed on separate occasions at each institution. N/A. N/A. The study provides insight into clinician workflow, evaluates current hospital communication systems and identifies key issues affecting communication: interruptions, issues with numeric pagers, lack of integrated communication tools, lack of awareness of consultation status, inefficiencies related to the paper chart, unintuitive user interfaces, mixed use of electronic and paper systems and lack of up-to-date contact information. It also identifies design trade-offs to be negotiated: synchronous communication vs. reducing interruptions, notification of patient status vs. reducing interruptions and speed vs. quality of handovers. The issues listed should be considered in the design of new technology for hospital communications. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  1. Assessment of health-related quality of life and psychological well-being of children and adolescents with obesity enrolled in a New Zealand community-based intervention programme: an observational study.

    Science.gov (United States)

    Anderson, Yvonne C; Wynter, Lisa E; Treves, Katharine F; Grant, Cameron C; Stewart, Joanna M; Cave, Tami L; Wouldes, Trecia A; Derraik, José G B; Cutfield, Wayne S; Hofman, Paul L

    2017-08-09

    To describe health-related quality of life (HRQOL) and psychological well-being of children and adolescents at enrolment in a multidisciplinary community-based obesity programme and to determine association with ethnicity. This programme targeted indigenous people and those from most deprived households. Further, this cohort was compared with other populations/normative data. This study examines baseline demographic data of an unblinded randomised controlled clinical trial. Participants (recruited from January 2012-August 2014) resided in Taranaki, New Zealand, and for this study we only included those with a body mass index (BMI) ≥98th percentile (obese). HRQOL and psychological well-being were assessed using the Pediatric Quality of Life Inventory (PedsQL V.4.0 TM ) (parent and child reports), and Achenbach's Child Behavior Checklist (CBCL)/Youth Self Report (YSR). Assessments were undertaken for 233 participants (45% Māori, 45% New Zealand European, 10% other ethnicities, 52% female, 30% from the most deprived household quintile), mean age 10.6 years. The mean BMI SD score (SDS) was 3.12 (range 2.01-5.34). Total PedsQL generic scaled score (parent) was lower (mean=63.4, SD 14.0) than an age-matched group of Australian children without obesity from the Health of Young Victorians study (mean=83.1, SD 12.5). In multivariable models, child and parental generic scaled scores decreased in older children (β=-0.70 and p=0.031, β=-0.64 and p=0.047, respectively). Behavioural difficulties (CBCL/YSR total score) were reported in 43.5% of participants, with the rate of emotional/behavioural difficulties six times higher than reported norms (pchildren and adolescents with obesity had a low HRQOL, and a concerning level of psychological difficulties, irrespective of ethnicity. Obesity itself rather than ethnicity or deprivation appeared to contribute to lower HRQOL scores. This study highlights the importance of psychologist involvement in obesity intervention

  2. Magnetotail magnetic flux monitoring based on simultaneous solar wind and magnetotail observations

    Science.gov (United States)

    Shukhtina, M. A.; Gordeev, E. I.; Sergeev, V. A.; Tsyganenko, N. A.; Clausen, L. B. N.; Milan, S. E.

    2016-09-01

    The magnetotail magnetic flux (MTF) is an important global variable to describe the magnetospheric state and dynamics. Existing methods of MTF estimation on the basis of the polar cap area, inferred from observations of global auroras and field-aligned currents, do not allow benchmarking due to the absence of a gauge for comparison; besides, they rarely allow a systematic nearly real time MTF monitoring. We describe three modifications (F0, F1, and F2) of the method to calculate the MTF, based on simultaneous spacecraft observations in the magnetotail and in the solar wind, suitable for real-time MTF monitoring. The MTF dependence on the solar wind parameters and the observed tail lobe magnetic field is derived from the pressure balance conditions. An essential part of this study is the calibration of our approximate method against global 3-D MHD simulations and the empirical T14 magnetospheric field model. The calibration procedure provides all variables required to evaluate F0, F1, and F2 quantities and, at the same time, computes the reference MTF value through any tail cross section. It allowed us to extend the method to be used in the near tail, investigate its errors, and define the applicability domain. The method was applied to Cluster and THEMIS measurements and compared with methods of polar cap area calculation based on IMAGE and AMPERE observations. We also discuss possible applications and some recent results based on the proposed method.

  3. Assessing the completeness of reporting of observational studies in Colombian Journal of Anesthesiology. Cross sectional study

    NARCIS (Netherlands)

    Bravo-Peña, M. (Mary); Barona-Fong, L. (Luis); Campo-López, J. (Julio); Arroyave, Y. (Yeni); J.A. Calvache (Jose Andres)

    2017-01-01

    textabstractIntroduction The STROBE statement (Strengthening the Reporting of Observational Studies in Epidemiology), consisting of 22 points, was published in 2007 with the aim of improving the reporting of observational research. Objective To determine the completeness of reporting of

  4. Analyzing the uncertainty of ensemble-based gridded observations in land surface simulations and drought assessment

    Science.gov (United States)

    Ahmadalipour, Ali; Moradkhani, Hamid

    2017-12-01

    Hydrologic modeling is one of the primary tools utilized for drought monitoring and drought early warning systems. Several sources of uncertainty in hydrologic modeling have been addressed in the literature. However, few studies have assessed the uncertainty of gridded observation datasets from a drought monitoring perspective. This study provides a hydrologic modeling oriented analysis of the gridded observation data uncertainties over the Pacific Northwest (PNW) and its implications on drought assessment. We utilized a recently developed 100-member ensemble-based observed forcing data to simulate hydrologic fluxes at 1/8° spatial resolution using Variable Infiltration Capacity (VIC) model, and compared the results with a deterministic observation. Meteorological and hydrological droughts are studied at multiple timescales over the basin, and seasonal long-term trends and variations of drought extent is investigated for each case. Results reveal large uncertainty of observed datasets at monthly timescale, with systematic differences for temperature records, mainly due to different lapse rates. The uncertainty eventuates in large disparities of drought characteristics. In general, an increasing trend is found for winter drought extent across the PNW. Furthermore, a ∼3% decrease per decade is detected for snow water equivalent (SWE) over the PNW, with the region being more susceptible to SWE variations of the northern Rockies than the western Cascades. The agricultural areas of southern Idaho demonstrate decreasing trend of natural soil moisture as a result of precipitation decline, which implies higher appeal for anthropogenic water storage and irrigation systems.

  5. Foot Length, Chest Circumference, and Mid Upper Arm Circumference Are Good Predictors of Low Birth Weight and Prematurity in Ethnic Minority Newborns in Vietnam: A Hospital-Based Observational Study.

    Science.gov (United States)

    Thi, Hai Nguyen; Khanh, Dung Khu Thi; Thu, Ha Le Thi; Thomas, Emma G; Lee, Katherine J; Russell, Fiona M

    2015-01-01

    The evaluation of tools to accurately identify low birth weight (LBW) and/or premature newborns in resource-limited countries is a research priority. We explored the use of foot length, chest circumference, and mid-upper arm circumference (MUAC) measured within 24 h as diagnostic tools for identifying newborns who are LBW, premature, or both; and compared measurements taken at birth with those taken at five days of age. An observational study was undertaken in Hoa Binh Province General Hospital, Vietnam, in ethnic minority newborns. Birth weight, foot length, chest circumference, and MUAC were measured within 24 h of birth and in a subset of 200, were repeated on day five of life. Gestational age was estimated using the New Ballard Score. Receiver Operating Characteristic curves and optimal cut-points (the point with the highest sensitivity and specificity where the sensitivity was at least 0.8) were calculated, for predicting prematurity, LBW, and both. Measurements within 24 h and at five days of life were compared. 485 newborns were recruited. Chest circumference and MUAC measured within 24 h of birth were found to be highly predictive of LBW (both yielding area under the curve [AUC] of 0.98, 95% confidence interval [CI] 0.96-0.99), and performed marginally better than foot length (AUC 0.94, 95%CI 0.92-0.96). The optimal cut-points for measurements within 24 h of birth were ≤ 7.4 cm for foot length; ≤ 30.4 cm for chest circumference; and ≤ 9.0 cm for MUAC. There was statistical evidence that anthropometric measurements taken within 24 h of birth were higher than measurements on day five (p<0.02 for all anthropometric measurements) but the magnitude of these differences was small (at most 2mm). All measurements taken within 24 h of birth were good predictors of LBW, prematurity and both. Differences in measurements taken within 24 h and on day five were not clinically relevant. Further research will ensure that the application of these measures is reliable

  6. Foot Length, Chest Circumference, and Mid Upper Arm Circumference Are Good Predictors of Low Birth Weight and Prematurity in Ethnic Minority Newborns in Vietnam: A Hospital-Based Observational Study.

    Directory of Open Access Journals (Sweden)

    Hai Nguyen Thi

    Full Text Available The evaluation of tools to accurately identify low birth weight (LBW and/or premature newborns in resource-limited countries is a research priority. We explored the use of foot length, chest circumference, and mid-upper arm circumference (MUAC measured within 24 h as diagnostic tools for identifying newborns who are LBW, premature, or both; and compared measurements taken at birth with those taken at five days of age.An observational study was undertaken in Hoa Binh Province General Hospital, Vietnam, in ethnic minority newborns. Birth weight, foot length, chest circumference, and MUAC were measured within 24 h of birth and in a subset of 200, were repeated on day five of life. Gestational age was estimated using the New Ballard Score. Receiver Operating Characteristic curves and optimal cut-points (the point with the highest sensitivity and specificity where the sensitivity was at least 0.8 were calculated, for predicting prematurity, LBW, and both. Measurements within 24 h and at five days of life were compared.485 newborns were recruited. Chest circumference and MUAC measured within 24 h of birth were found to be highly predictive of LBW (both yielding area under the curve [AUC] of 0.98, 95% confidence interval [CI] 0.96-0.99, and performed marginally better than foot length (AUC 0.94, 95%CI 0.92-0.96. The optimal cut-points for measurements within 24 h of birth were ≤ 7.4 cm for foot length; ≤ 30.4 cm for chest circumference; and ≤ 9.0 cm for MUAC. There was statistical evidence that anthropometric measurements taken within 24 h of birth were higher than measurements on day five (p<0.02 for all anthropometric measurements but the magnitude of these differences was small (at most 2mm.All measurements taken within 24 h of birth were good predictors of LBW, prematurity and both. Differences in measurements taken within 24 h and on day five were not clinically relevant. Further research will ensure that the application of these measures is

  7. Yogurt and Diabetes: Overview of Recent Observational Studies.

    Science.gov (United States)

    Salas-Salvadó, Jordi; Guasch-Ferré, Marta; Díaz-López, Andrés; Babio, Nancy

    2017-07-01

    The effects of dairy consumption on the prevention of type 2 diabetes remain controversial and depend on the dairy subtype. Yogurt intake has received special attention because its association with health benefits is more consistent than that of other types of dairy products. In the present article, we review those observational studies that evaluated the association between yogurt consumption and type 2 diabetes. We also discuss the possible mechanisms involved in these associations. We found that 13 prospective studies evaluated the association between yogurt intake and type 2 diabetes, most of which showed an inverse association between the frequency of yogurt consumption and the risk of diabetes. In addition to the scientific evidence accumulated from individual prospective studies, several meta-analyses have shown that yogurt consumption has a potential role in diabetes prevention. The most recent analysis shows a 14% lower risk of type 2 diabetes when yogurt consumption was 80-125 g/d compared with no yogurt consumption. The intake of fermented dairy products, especially yogurt, has been inversely associated with variables of glucose metabolism. Yogurt may have probiotic effects that could modulate glucose metabolism. We conclude that yogurt consumption, in the context of a healthy dietary pattern, may reduce the risk of type 2 diabetes in healthy and older adults at high cardiovascular risk. Large-scale intervention studies and randomized clinical trials are warranted to determine if yogurt consumption has beneficial effects on insulin sensitivity and reduces the risk of type 2 diabetes. © 2017 American Society for Nutrition.

  8. An observational study of foot lifts asymmetry during obstacle avoidance

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    Ujjawal Singh Tomar

    2012-01-01

    Full Text Available Background: Specific information regarding obstacle-clearance strategies used by community-dwelling young and elderly is scant in the literature, and physical barriers encountered in real-life situations have not been used in most of the studies. Aim: The aim of this study is to determine foot lift asymmetry during obstacle avoidance in young and elderly subjects. Settings and Design: This was an observational study. Materials and Methods: Thirty elderly and 30 young individuals were taken for the study. All the subjects were evaluated using different scales and foot lift asymmetry was measured on a walkway using three obstacles of different heights. Results: The mean and standard deviation (SD value of the asymmetric index of the young was 3.25±0.28 and the mean and SD value of the asymmetric index of the elderly was 3.53±0.47. The asymmetric index of the elderly population was found to be higher than that of the younger population. Conclusion: The asymmetric index of the elderly population was found to be higher than that of the younger population, though it is not clinically significant.

  9. Mucocutaneous manifestations of acquired hypoparathyroidism: An observational study

    Directory of Open Access Journals (Sweden)

    Somenath Sarkar

    2012-01-01

    Full Text Available Hypoparathyroidism is a disorder of calcium and phosphorus metabolism due to decreased secretion of parathyroid hormone. Hypoparathyroidism can be hereditary and acquired. Acquired hypoparathyroidism usually occurs following neck surgery (thyroid surgery or parathyroid surgery. Along with systemic manifestations, hypoparathyroidism produces some skin manifestations. Lack of study regarding mucocutaneous manifestations of acquired hypoparathyroidism prompted us to undertake this study. To evaluate the mucocutaneous manifestations of acquired hypoparathyroidism. An observational study done in a tertiary care hospital of Kolkata by comprehensive history taking, through clinical examination and relevant laboratory investigations. Twenty-one patients were included in the study. The commonest form of acquired hypoparathyroidism was neck surgery (thyroidectomy and parathyroidectomy operation. Mucocutaneous manifestations were present in 76.19% of patients. The most frequent mucocutaneous manifestation was found in the hairs like the loss of axillary hair (61.9%, loss of pubic hair (52.38%, coarsening of body hair (47.62%, and alopecia areata (9.52%. The nail changes noted were brittle and ridged nail, followed by onycholysis, onychosezia, and onychomedesis. The most common skin features were xerotic skin in 11 patients (52.38%, followed by pellagra-like skin pigmentation, pustular psoriasis and acne form eruption, bullous impetigo, etc. Mucosa was normal in all the cases excepting the one which showed oral candidiasis.

  10. Critical Observation on Methodologies of Select Doctoral Research Studies

    Directory of Open Access Journals (Sweden)

    Dr Indrajit Goswami

    2014-12-01

    Full Text Available The present article aims to critically observe and interpret the methodological deficiencies as found in randomly selected 14 doctoral theses submitted to two different universities in India. Despite their serious deviation from the expected methodological standards, all those theses were accepted and approved by the universities and scholars concerned conferred with PhD degrees. Undoubtedly, those theses kept in the reference sections at the respective university libraries would potentially misguide and mislead the future researchers. Some of the common technical deficiencies, as have been noticed, include (1 absence of careful thoughts in framing research titles, (ii biased method of data collection, (ii absence of logical explanation in favour of sample size and sample selection process, (iii designing and execution of instrument for data collection, (iv theory formulation in terms of framing of objectives, hypotheses and operational definitions etc. The article attempts to present the critical observations on case-to-case basis so that their conceptual, instrumental and procedural deficiencies and deviations are easily understood by the academicians, researchers and students. The content of this article is divided in to three broad sections. The first section deals with an introduction to quantitative and qualitative research methods and their advantages and limitations. The next section deals with the review of the selected theses followed by conclusion and suggested remedial measures. The objective of this article is purely academic and its scope is limited to enhancement of quality of future research studies in the domains and related fields.

  11. A study of GPS ionospheric scintillations observed at Guilin

    Science.gov (United States)

    Zou, Yuhua; Wang, Dongli

    2009-12-01

    The occurrence of strong ionospheric scintillations with S4>=0.2 was studied using global positioning system (GPS) measurements at Guilin (25.29°N, 110.33°E; geomagnetic: 15.04°N, 181.98°E), a station located near the northern crest of equatorial anomaly in China. The results are presented for data collected from January 2007 to December 2008. The results show that amplitude scintillations occurred only during the first five months of the considered years. Nighttime amplitude scintillations, observed mainly in the south of Guilin, always occurred with phase scintillations, total electron content (TEC) depletions, and Rate Of change of TEC (ROT) fluctuations. However, TEC depletions and ROT fluctuations were weak during daytime amplitude scintillations, and daytime amplitude scintillations usually occurred in most of the azimuth directions. GPS scintillation/TEC observations recorded at Guilin and signal-to-noise-ratio measurements obtained from GPS-COSMIC radio occultation indicate that nighttime and daytime scintillations are very likely caused by ionospheric F region irregularities and sporadic E, respectively.

  12. Ensemble-sensitivity Analysis Based Observation Targeting for Mesoscale Convection Forecasts and Factors Influencing Observation-Impact Prediction

    Science.gov (United States)

    Hill, A.; Weiss, C.; Ancell, B. C.

    2017-12-01

    The basic premise of observation targeting is that additional observations, when gathered and assimilated with a numerical weather prediction (NWP) model, will produce a more accurate forecast related to a specific phenomenon. Ensemble-sensitivity analysis (ESA; Ancell and Hakim 2007; Torn and Hakim 2008) is a tool capable of accurately estimating the proper location of targeted observations in areas that have initial model uncertainty and large error growth, as well as predicting the reduction of forecast variance due to the assimilated observation. ESA relates an ensemble of NWP model forecasts, specifically an ensemble of scalar forecast metrics, linearly to earlier model states. A thorough investigation is presented to determine how different factors of the forecast process are impacting our ability to successfully target new observations for mesoscale convection forecasts. Our primary goals for this work are to determine: (1) If targeted observations hold more positive impact over non-targeted (i.e. randomly chosen) observations; (2) If there are lead-time constraints to targeting for convection; (3) How inflation, localization, and the assimilation filter influence impact prediction and realized results; (4) If there exist differences between targeted observations at the surface versus aloft; and (5) how physics errors and nonlinearity may augment observation impacts.Ten cases of dryline-initiated convection between 2011 to 2013 are simulated within a simplified OSSE framework and presented here. Ensemble simulations are produced from a cycling system that utilizes the Weather Research and Forecasting (WRF) model v3.8.1 within the Data Assimilation Research Testbed (DART). A "truth" (nature) simulation is produced by supplying a 3-km WRF run with GFS analyses and integrating the model forward 90 hours, from the beginning of ensemble initialization through the end of the forecast. Target locations for surface and radiosonde observations are computed 6, 12, and

  13. An observational study towards a newer classification in child psychiatry

    Directory of Open Access Journals (Sweden)

    Shyamanta Das

    2017-01-01

    Full Text Available Background: The first manifestations of majority of mental disorders are seen in childhood and adolescence. They result in burden in this age group as well. Materials and methods: A different way of classifying psychiatric disorders in children and adolescents categorise them into emotional, disruptive, and developmental disorders. We carried out an observational study to validate such an approach towards diagnosis. Results: Sample was almost equally divided in the two age groups as well as between the sexes. The distribution of emotional, disruptive, and developmental disorders in the younger and older age groups were 4:3:2 and 5:0:1 respectively. The same for boys and girls were 4:2:1 and 4:1:2 respectively. Comorbidity was same within group and across groups. Conclusion: A simplified diagnostic approach in child psychiatry has the potential of bridging the gap among the different ‘gatekeepers’ toward psychiatric service utilisation.

  14. Nursing diagnoses in patients with chronic venous ulcer: observational study

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    Glycia de Almeida Nogueira

    2015-06-01

    Full Text Available This study aimed to analyze nursing diagnoses in people with chronic venous ulcer. An observational, descriptive, quantitative research conducted in an ambulatory specialized in wound treatment, with a non-probabilistic sample of 20 patients.  Data collection was performed in an institutional form denominated Assessment Protocol for Clients with Tissue Lesions. Diagnoses were established by consensus among four researchers with experience in nursing diagnoses and wound treatments. From data analysis, 16 diagnoses were identified, with 100% of participants presenting: Impaired tissue integrity, Ineffective peripheral tissue perfusion, Risk of infection, Impaired physical mobility and Ineffective health self-control. These diagnoses are found in Safety/Protection, Activity/Rest and Health promotion domains, which from the clinical practice stand point should be priority focuses in nursing intervention and assessment.

  15. [Assessment of Urinary Incontinence in Pregnancy and Postpartum: Observational Study].

    Science.gov (United States)

    Rocha, Juliana; Brandão, Pedro; Melo, Anabela; Torres, Silvia; Mota, Lurdes; Costa, Fernanda

    2017-08-31

    The urinary incontinence can affect up to 50% of women at some stage of their lives, particularly during pregnancy and postpartum. This study was designed in order to identify and assess the prevalence and risk factors for urinary incontinence during the third trimester of pregnancy and three months postpartum. Observational and cross-sectional study. The population of the study was composed of 268 women who delivered and were admitted to the Centro Hospitalar Tâmega e Sousa in the years 2013 and 2014, and who agreed to participate in this study. Postpartum women were asked to fill out a questionnaire adapted from the International Consultation on Incontinence Questionnaire - Short Form, for urinary incontinence research in the third trimester of pregnancy. Three months after delivery, they were contacted by telephone and asked to answer the same questions about the urinary incontinence postpartum. Of the 268 women interviewed, 31 were excluded from the study, taking into account the defined inclusion and exclusion criteria. In total (n = 237), 51.89% of women included in the study, reported the occurrence of urinary incontinence during pregnancy. The prevalence of urinary incontinence in pregnancy by parity (primiparous versus multiparous) was statistically significant (p = 0.006). At postpartum (n = 237), 28.69% of women with urinary incontinence had vaginal delivery and 5.91% of women underwent cesarean delivery (p = 0.001). In these group of women with postpartum urinary incontinence (n = 82), 31.69% have had urinary incontinence only in the postpartum and 68.31% of women have had symptoms during pregnancy (p urinary incontinence in pregnancy and the respective decrease in postpartum. Multiparity and occurrence of urinary incontinence in pregnancy appear as potential risk factors in the emergence of the urinary incontinence.

  16. Observational attachment theory-based parenting measures predict children's attachment narratives independently from social learning theory-based measures.

    Science.gov (United States)

    Matias, Carla; O'Connor, Thomas G; Futh, Annabel; Scott, Stephen

    2014-01-01

    Conceptually and methodologically distinct models exist for assessing quality of parent-child relationships, but few studies contrast competing models or assess their overlap in predicting developmental outcomes. Using observational methodology, the current study examined the distinctiveness of attachment theory-based and social learning theory-based measures of parenting in predicting two key measures of child adjustment: security of attachment narratives and social acceptance in peer nominations. A total of 113 5-6-year-old children from ethnically diverse families participated. Parent-child relationships were rated using standard paradigms. Measures derived from attachment theory included sensitive responding and mutuality; measures derived from social learning theory included positive attending, directives, and criticism. Child outcomes were independently-rated attachment narrative representations and peer nominations. Results indicated that Attachment theory-based and Social Learning theory-based measures were modestly correlated; nonetheless, parent-child mutuality predicted secure child attachment narratives independently of social learning theory-based measures; in contrast, criticism predicted peer-nominated fighting independently of attachment theory-based measures. In young children, there is some evidence that attachment theory-based measures may be particularly predictive of attachment narratives; however, no single model of measuring parent-child relationships is likely to best predict multiple developmental outcomes. Assessment in research and applied settings may benefit from integration of different theoretical and methodological paradigms.

  17. Obesity in adolescents with chronic fatigue syndrome: an observational study.

    Science.gov (United States)

    Norris, T; Hawton, K; Hamilton-Shield, J; Crawley, E

    2017-01-01

    Identify the prevalence of obesity in patients with chronic fatigue syndrome (CFS) compared with healthy adolescents, and those identified with CFS in a population cohort. Cross-sectional analysis of multiple imputed data. Data from UK paediatric CFS/myalgic encephalomyelitis (CFS/ME) services compared with data collected at two time points in the Avon Longitudinal Study of Parents and Children (ALSPAC). 1685 adolescents who attended a CFS/ME specialist service between 2004 and 2014 and 13 978 adolescents aged approximately 13 years and 16 years participating in the ALSPAC study. Body mass index (BMI) (kg/m 2 ), sex-specific and age-specific BMI Z-scores (relative to the International Obesity Task Force cut-offs) and prevalence of obesity (%). Adolescents who had attended specialist CFS/ME services had a higher prevalence of obesity (age 13 years: 9.28%; age 16 years: 16.43%) compared with both adolescents classified as CFS/ME in ALSPAC (age 13 years: 3.72%; age 16 years: 5.46%) and those non-CFS in ALSPAC (age 13 years: 4.18%; age 16 years: 4.46%). The increased odds of obesity in those who attended specialist services (relative to non-CFS in ALSPAC) was apparent at both 13 years (OR: 2.31 (1.54 to 3.48)) and 16 years, with a greater likelihood observed at 16 years (OR: 4.07 (2.04 to 8.11)). We observed an increased prevalence of obesity in adolescents who were affected severely enough to be referred to a specialist CFS/ME service. Further longitudinal research is required in order to identify the temporal relationship between the two conditions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  18. Splenic lesions observed in 71 splenectomized dogs: a retrospective study

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    Elisângela Olegário da Silva

    2016-10-01

    Full Text Available The spleen of dogs is frequently affected by disorders that vary from local and systemic origin. The difficulty in associating clinical and gross findings contributes for the choice of total splenectomy as the main treatment, leading to an impairment of the immune and hematopoietic functions. The aim of this study was to evaluate the pathological findings in the spleen of splenectomized dogs during 2008 to 2014 at a Veterinary Teaching Hospital. From the 71 cases analyzed, 97% (69/71 of the dogs were submitted to total splenectomy and 3% (2/71 to partial splenectomy. In 45 (63.4% of these cases, the histopathological diagnosis was non-neoplastic alterations; only 36.6% (26/71 had a splenic neoplasia. The main non-neoplastic lesions observed were nodular hyperplasia 24.4% (11/45, infarction 22.3% (10/45, and hematoma 20% (9/45. The most frequent tumors were hemangiosarcoma 50% (13/26, histiocytic sarcoma 23% (6/26, and lymphoma 11.5% (3/26. The clinical methods used to diagnose splenic lesions were ultrasonography 88% (63/71, radiography 2.8% (2/71 and exploratory laparotomy 4.2% (3/71. In 4.2% (3/71 the spleen changes were observed during the therapeutic ovariohysterectomy. The results of the present study showed a prevalence of benign disorders in the spleen of splenectomized dogs associated with a high incidence of total splenectomy performed, indicating a difficulty in recognizing the different lesions that can affect the spleen by the veterinarian medical.

  19. Observational Study of Solar Magnetic Active Phenomena Hongqi ...

    Indian Academy of Sciences (India)

    1991-06-09

    Jun 9, 1991 ... active region NOAA 6580-6619-6659 observed at Huairou Solar Observing Station of. National Astronomical Observatories of China in 1991 (Ai & Hu ... The white arrows mark the observed transverse field and the black arrows show the transverse components inferred from the calculation of magnetic ...

  20. Observational study of sleep disturbances in advanced cancer.

    Science.gov (United States)

    Davies, Andrew Neil; Patel, Shuchita D; Gregory, Amanda; Lee, Bernadette

    2017-12-01

    To determine the prevalence of nightmares, sleep terrors and vivid dreams in patients with advanced cancer (and the factors associated with them in this group of patients). The study was a multicentre, prospective observational study. Participants were patients with locally advanced/metastatic cancer, who were under the care of a specialist palliative care team. Data were collected on demographics, cancer diagnosis, cancer treatment, current medication, performance status, sleep quality (Pittsburgh Sleep Quality Index), dreams and nightmares, and physical and psychological symptoms (Memorial Symptom Assessment Scale-Short Form). 174 patients completed the study. Sleep quality was poor in 70.5% participants and was worse in younger patients and in inpatients (hospital, hospice). 18% of patients reported nightmares, 8% sleep terrors and 34% vivid dreams. Nightmares were associated with poor sleep quality and greater sleep disturbance; nightmares were also associated with greater physical and psychological burden. Nightmares (and vivid dreams) were not associated with the use of opioid analgesics. Nightmares do not seem to be especially common in patients with advanced cancer, and when they do occur, there is often an association with sleep disturbance, and/or physical and psychological burden. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Improvements in Patient Acceptance by Hospitals Following the Introduction of a Smartphone App for the Emergency Medical Service System: A Population-Based Before-and-After Observational Study in Osaka City, Japan.

    Science.gov (United States)

    Katayama, Yusuke; Kitamura, Tetsuhisa; Kiyohara, Kosuke; Iwami, Taku; Kawamura, Takashi; Izawa, Junichi; Gibo, Koichiro; Komukai, Sho; Hayashida, Sumito; Kiguchi, Takeyuki; Ohnishi, Mitsuo; Ogura, Hiroshi; Shimazu, Takeshi

    2017-09-11

    Recently, the number of ambulance dispatches has been increasing in Japan, and it is therefore difficult for hospitals to accept emergency patients smoothly and appropriately because of the limited hospital capacity. To facilitate the process of requesting patient transport and hospital acceptance, an emergency information system using information technology (IT) has been built and introduced in various communities. However, its effectiveness has not been thoroughly revealed. We introduced a smartphone app system in 2013 that enables emergency medical service (EMS) personnel to share information among themselves regarding on-scene ambulances and the hospital situation. The aim of this study was to assess the effects of introducing this smartphone app on the EMS system in Osaka City, Japan. This retrospective study analyzed the population-based ambulance records of Osaka Municipal Fire Department. The study period was 6 years, from January 1, 2010 to December 31, 2015. We enrolled emergency patients for whom on-scene EMS personnel conducted hospital selection. The main endpoint was the difficulty experienced in gaining hospital acceptance at the scene. The definition of difficulty was making ≥5 phone calls by EMS personnel at the scene to hospitals until a decision to transport was determined. The smartphone app was introduced in January 2013, and we compared the patients treated from 2010 to 2012 (control group) with those treated from 2013 to 2015 (smartphone app group) using an interrupted time-series analysis to assess the effects of introducing this smartphone app. A total of 600,526 emergency patients for whom EMS personnel selected hospitals were eligible for our analysis. There were 300,131 emergency patients in the control group (50.00%, 300,313/600,526) from 2010 to 2012 and 300,395 emergency patients in the smartphone app group (50.00%, 300,395/600,526) from 2013 to 2015. The rate of difficulty in hospital acceptance was 14.19% (42,585/300,131) in the

  2. Observational studies using propensity score analysis underestimated the effect sizes in critical care medicine.

    Science.gov (United States)

    Zhang, Zhongheng; Ni, Hongying; Xu, Xiao

    2014-08-01

    Propensity score (PS) analysis has been increasingly used in critical care medicine; however, its validation has not been systematically investigated. The present study aimed to compare effect sizes in PS-based observational studies vs. randomized controlled trials (RCTs) (or meta-analysis of RCTs). Critical care observational studies using PS were systematically searched in PubMed from inception to April 2013. Identified PS-based studies were matched to one or more RCTs in terms of population, intervention, comparison, and outcome. The effect sizes of experimental treatments were compared for PS-based studies vs. RCTs (or meta-analysis of RCTs) with sign test. Furthermore, ratio of odds ratio (ROR) was calculated from the interaction term of treatment × study type in a logistic regression model. A ROR analysis of RCTs) were more likely to report beneficial effect for the experimental treatment than PS-based studies. The result remained unchanged in sensitivity analysis and meta-regression. In critical care literature, PS-based observational study is likely to report less beneficial effect of experimental treatment compared with RCTs (or meta-analysis of RCTs). Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Observing Participating Observation—A Re-description Based on Systems Theory

    Directory of Open Access Journals (Sweden)

    Tina Bering Keiding

    2010-09-01

    Full Text Available Current methodology concerning participating observation in general leaves the act of observation unobserved. Approaching participating observation from systems theory offers fundamental new insights into the topic. Observation is always participation. There is no way to escape becoming a participant and, as such, co-producer of the observed phenomenon. There is no such thing as a neutral or objective description. As observation deals with differences and process meaning, all descriptions are re-constructions and interpretations of the observed. Hence, the idea of neutral descriptions as well as the idea of the naïve observer becomes a void. Not recognizing and observing oneself as observer and co-producer of empirical data simply leaves the process of observation as the major unobserved absorber of contingency in data production based on participating observation. URN: urn:nbn:de:0114-fqs1003119

  4. Testing Gravitational Physics with Space-based Gravitational-wave Observations

    Science.gov (United States)

    Baker, John G.

    2011-01-01

    Gravitational wave observations provide exceptional and unique opportunities for precision tests of gravitational physics, as predicted by general relativity (GR). Space-based gravitational wave measurements, with high signal-to-noise ratios and large numbers of observed events may provide the best-suited gravitational-wave observations for testing GR with unprecedented precision. These observations will be especially useful in testing the properties of gravitational waves and strong-field aspects of the theory which are less relevant in other observations. We review the proposed GR test based on observations of massive black hole mergers, extreme mass ratio inspirals, and galactic binary systems.

  5. Feedback in formative OSCEs: comparison between direct observation and video-based formats

    Directory of Open Access Journals (Sweden)

    Noëlle Junod Perron

    2016-11-01

    Full Text Available Introduction: Medical students at the Faculty of Medicine, University of Geneva, Switzerland, have the opportunity to practice clinical skills with simulated patients during formative sessions in preparation for clerkships. These sessions are given in two formats: 1 direct observation of an encounter followed by verbal feedback (direct feedback and 2 subsequent review of the videotaped encounter by both student and supervisor (video-based feedback. The aim of the study was to evaluate whether content and process of feedback differed between both formats. Methods: In 2013, all second- and third-year medical students and clinical supervisors involved in formative sessions were asked to take part in the study. A sample of audiotaped feedback sessions involving supervisors who gave feedback in both formats were analyzed (content and process of the feedback using a 21-item feedback scale. Results: Forty-eight audiotaped feedback sessions involving 12 supervisors were analyzed (2 direct and 2 video-based sessions per supervisor. When adjusted for the length of feedback, there were significant differences in terms of content and process between both formats; the number of communication skills and clinical reasoning items addressed were higher in the video-based format (11.29 vs. 7.71, p=0.002 and 3.71 vs. 2.04, p=0.010, respectively. Supervisors engaged students more actively during the video-based sessions than during direct feedback sessions (self-assessment: 4.00 vs. 3.17, p=0.007; active problem-solving: 3.92 vs. 3.42, p=0.009. Students made similar observations and tended to consider that the video feedback was more useful for improving some clinical skills. Conclusion: Video-based feedback facilitates discussion of clinical reasoning, communication, and professionalism issues while at the same time actively engaging students. Different time and conceptual frameworks may explain observed differences. The choice of feedback format should depend on

  6. Satellite Observation Systems for Polar Climate Change Studies

    Science.gov (United States)

    Comiso, Josefino C.

    2012-01-01

    The key observational tools for detecting large scale changes of various parameters in the polar regions have been satellite sensors. The sensors include passive and active satellite systems in the visible, infrared and microwave frequencies. The monitoring started with Tiros and Nimbus research satellites series in the 1970s but during the period, not much data was stored digitally because of limitations and cost of the needed storage systems. Continuous global data came about starting with the launch of ocean color, passive microwave, and thermal infrared sensors on board Nimbus-7 and Synthetic Aperture Radar, Radar Altimeter and Scatterometer on board SeaSat satellite both launched in 1978. The Nimbus-7 lasted longer than expected and provided about 9 years of useful data while SeaSat quit working after 3 months but provided very useful data that became the baseline for follow-up systems with similar capabilities. Over the years, many new sensors were launched, some from Japan Aeronautics and Space Agency (JAXA), some from the European Space Agency (ESA) and more recently, from RuSSia, China, Korea, Canada and India. For polar studies, among the most useful sensors has been the passive microwave sensor which provides day/night and almost all weather observation of the surface. The sensor provide sea surface temperature, precipitation, wind, water vapor and sea ice concentration data that have been very useful in monitoring the climate of the region. More than 30 years of such data are now available, starting with the Scanning Multichannel Microwave Radiometer (SMMR) on board the Nimbus-7, the Special Scanning Microwave/Imager (SSM/I) on board a Defense Meteorological Satellite Program (DMSP) and the Advanced Microwave Scanning Radiometer on board the EOS/ Aqua satellite. The techniques that have been developed to derive geophysical parameters from data provided by these and other sensors and associated instrumental and algorithm errors and validation techniques

  7. Ions, isotopes, and metal cyanides: Observational and laboratory studies

    Science.gov (United States)

    Savage, Chandra Shannon

    2004-11-01

    Chemistry in the interstellar medium is very different from the processes which take place in terrestrial settings. Environments such as circumstellar envelopes, molecular clouds, and comets contain diverse and complex chemical networks. The low temperatures (10 50 K) and densities (1 10 6 cm-3) allow normally unstable molecules to exist in significant quantities. At these temperatures, the rotational energy levels of molecules are populated, and thus these species can be detected by millimeter-wave radio astronomy. The detection and quantification of interstellar molecules, including metal cyanides and molecular ions, is the basis of this dissertation work. While conducting observations of CN and 13CN to determine the 12C/13C ratio throughout the Galaxy, it was found that the ratios in photon- dominated regions (PDRs) were much higher than those in nearby molecular clouds. This can be explained by isotope-selective photodissociation, in which the 12CN molecules are self-shielded. However, the chemistry in these regions is poorly understood, and other processes may be occurring. In order to understand one of the chemical networks present in PDRs, observations of HCO+, HOC +, and CO+ were made toward several of these sources. Previous studies indicated that the HCO+/HOC+ ratio was much lower in PDRs, due to the presence of CO+. The new observations indicate that there is a strong correlation between CO + and HOC+ abundances, which suggests that other molecular ions which have not been detected in molecular clouds may be present in PDRs. There is a significant obstacle to the detection of new interstellar molecular ions, however. The laboratory spectra are virtually unknown for many of these species, due to their inherent instability. Thus, techniques which can selectively detect ionic spectra must be utilized. One such method is velocity modulation, which incorporates an AC electrical discharge to produce and detect ions. Previously, velocity modulation spectroscopy

  8. OGLE-2015-BLG-0196: GROUND-BASED GRAVITATIONAL MICROLENS PARALLAX CONFIRMED BY SPACE-BASED OBSERVATION

    Energy Technology Data Exchange (ETDEWEB)

    Han, C. [Department of Physics, Chungbuk National University, Cheongju 361-763 (Korea, Republic of); Udalski, A.; Szymański, M. K.; Soszyński, I.; Skowron, J.; Mróz, P.; Poleski, R.; Pietrukowicz, P.; Kozłowski, S.; Ulaczyk, K.; Pawlak, M. [Warsaw University Observatory, Al. Ujazdowskie 4, 00-478 Warszawa (Poland); Gould, A.; Zhu, Wei; Fausnaugh, M.; Gaudi, B. S. [Department of Astronomy, Ohio State University, 140 W. 18th Ave., Columbus, OH 43210 (United States); Yee, J. C. [Harvard-Smithsonian Center for Astrophysics, 60 Garden St., Cambridge, MA 02138 (United States); Beichman, C. [NASA Exoplanet Science Institute, MS 100-22, California Institute of Technology, Pasadena, CA 91125 (United States); Novati, S. Calchi [Dipartimento di Fisica “E. R. Caianiello,” Uńiversitá di Salerno, Via Giovanni Paolo II, I-84084 Fisciano (Italy); Carey, S. [Spitzer Science Center, MS 220-6, California Institute of Technology, Pasadena, CA (United States); Bryden, C. [Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Dr., Pasadena, CA 91109 (United States); Collaboration: OGLE Collaboration; Spitzer Microlensing Team; and others

    2017-01-01

    In this paper, we present an analysis of the binary gravitational microlensing event OGLE-2015-BLG-0196. The event lasted for almost a year, and the light curve exhibited significant deviations from the lensing model based on the rectilinear lens-source relative motion, enabling us to measure the microlens parallax. The ground-based microlens parallax is confirmed by the data obtained from space-based microlens observations using the Spitzer telescope. By additionally measuring the angular Einstein radius from the analysis of the resolved caustic crossing, the physical parameters of the lens are determined up to the twofold degeneracy, u {sub 0} < 0 and u {sub 0} > 0, solutions caused by the well-known “ecliptic” degeneracy. It is found that the binary lens is composed of two M dwarf stars with similar masses, M {sub 1} = 0.38 ± 0.04 M {sub ⊙} (0.50 ± 0.05 M {sub ⊙}) and M {sub 2} = 0.38 ± 0.04 M {sub ⊙} (0.55 ± 0.06 M {sub ⊙}), and the distance to the lens is D {sub L} = 2.77 ± 0.23 kpc (3.30 ± 0.29 kpc). Here the physical parameters outside and inside the parentheses are for the u {sub 0} < 0 and u {sub 0} > 0 solutions, respectively.

  9. Oral implications of the vegan diet: observational study.

    Science.gov (United States)

    Laffranchi, L; Zotti, F; Bonetti, S; Dalessandri, D; Fontana, P

    2010-01-01

    The aim of this study was to investigate oral changes in subjects who have assumed a vegan diet for a long time (at least 18 months), that is to say, a diet completely lacking in meat and animal derivatives. A sample of 15 subjects was analyzed, all from northern Italy and aged 24 to 60 year, composed of 11 men and 4 women who had been following a vegan diet for a minimum of 18 months to a maximum of 20 years. In parallel with the study sample, a control group (15 subjects) with the same criteria of age, sex, and place of origin all following an omnivorous diet was chosen. The sample answered a questionnaire that investigated their eating habits, the frequency with which they eat meals, the main foodstuffs assumed, oral hygiene habits, and any painful symptomatology of the teeth or more general problems in the oral cavity. The sample was then subject to objective examination in which the saliva pH was measured and the teeth were checked for demineralization of the enamel, white spots, and caries (using KaVo DIAGNOdent) with particular attention being paid to the localization of these lesions, and lastly, sounding was carried out to detect any osseous defects and periodontal pockets. The study revealed greater incidence of demineralization and white spots in the vegan subjects compared to the omnivorous ones localized at the neck of the teeth and on the vestibular surfaces of dental elements (with the exception of the lower anterior group). The saliva pH, more acid in the omnivorous patients, ranged between four and six. Changes in oral conditions in both groups of subjects were observed. In order to research into the cause-effect relationship of the vegan diet on the oral cavity effectively, the sample needs to be studied for a longer period of time and the results re-evaluated.

  10. A Mirror Therapy-Based Action Observation Protocol to Improve Motor Learning After Stroke.

    Science.gov (United States)

    Harmsen, Wouter J; Bussmann, Johannes B J; Selles, Ruud W; Hurkmans, Henri L P; Ribbers, Gerard M

    2015-07-01

    Mirror therapy is a priming technique to improve motor function of the affected arm after stroke. To investigate whether a mirror therapy-based action observation (AO) protocol contributes to motor learning of the affected arm after stroke. A total of 37 participants in the chronic stage after stroke were randomly allocated to the AO or control observation (CO) group. Participants were instructed to perform an upper-arm reaching task as fast and as fluently as possible. All participants trained the upper-arm reaching task with their affected arm alternated with either AO or CO. Participants in the AO group observed mirrored video tapes of reaching movements performed by their unaffected arm, whereas participants in the CO group observed static photographs of landscapes. The experimental condition effect was investigated by evaluating the primary outcome measure: movement time (in seconds) of the reaching movement, measured by accelerometry. Movement time decreased significantly in both groups: 18.3% in the AO and 9.1% in the CO group. Decrease in movement time was significantly more in the AO compared with the CO group (mean difference = 0.14 s; 95% confidence interval = 0.02, 0.26; P = .026). The present study showed that a mirror therapy-based AO protocol contributes to motor learning after stroke. © The Author(s) 2014.

  11. Evaluation of Xerostomia in Different Psychological Disorders: An Observational Study.

    Science.gov (United States)

    Veerabhadrappa, Suresh Kandagal; Chandrappa, Pramod Redder; Patil, Snehal; Roodmal, Seema Yadav; Kumarswamy, Akshay; Chappi, Mounesh Kumar

    2016-09-01

    Psychiatric diseases like anxiety, depression, schizophrenia and bipolar disorders are increasing at an alarming rate. These diseases can affect the quantity and quality of saliva leading to multiple oral diseases. Although many researchers have evaluated xerostomia in general population, its prevalence is not been assessed in patients suffering from different psychological disorders. To investigate the prevalence of xerostomia and to assess the correlation between xerostomia and dryness of lip and mucosa in different psychological disorders. A cross-sectional observational study was conducted over a period of six months in Department of Psychiatry and Department of Oral Medicine. Patients with anxiety, depression, schizophrenia and bipolar disorder, as diagnosed by an experienced psychiatrist, were given a questionnaire to evaluate the xerostomia. Patients with symptoms of xerostomia were subjected to oral examination by a skilled oral diagnostician to check for dryness of lips and mucosa. One hundred patients from each group of psychiatric diseases were included in the study using a consecutive sampling technique. An equal number of healthy individuals reporting to oral medicine department for routine oral screening were included as control group after initial psychiatric evaluation. In this study statistically significant increase in the xerostomia in psychiatric patients was recorded when compared to the control group (pXerostomia was significantly higher in anxiety patients (51%) followed by depression (47%), bipolar disorder (41%), schizophrenia (39%) and control group (27%). The majority of the psychiatric patients had 'moderate' to 'severe' xerostomia whereas the control group had 'mild' xerostomia. Xerostomia was significantly higher in younger age group (18-49 years) than in older age group and females patients had higher xerostomia than male patients. Psychiatric patients had significantly more dryness of lip and mucosa than healthy controls. A moderate

  12. Estimation of Skin to Subarachnoid Space Depth: An Observational Study.

    Science.gov (United States)

    Hazarika, Rajib; Choudhury, Dipika; Nath, Sangeeta; Parua, Samit

    2016-10-01

    In a patient, the skin to Subarachnoid Space Depth (SSD) varies considerably at different levels of the spinal cord. It also varies from patient to patient at the same vertebral level as per age, sex and Body Mass Index (BMI). Estimation of the skin to SSD reduces complications related to spinal anaesthesia. To measure the skin to SSD in the Indian population and to find a formula for predicting this depth. Three hundred adult patients belonging to American Society of Anaesthesiologist class I and II, undergoing surgery using spinal anaesthesia in various surgical specialities of Gauhati Medical College were selected by systemic sampling for this prospective, observational study. Patients were divided into three groups: Group M containing male patients, Group F containing non-pregnant female patients, and Group PF containing pregnant female's patients. SSD was measured after performing lumbar puncture. The relationship between SSD and patient characteristics were studied, correlated and statistical analysis was used to find a formula for predicting the skin to SSD. Statistical analysis was done using Statistical Package for Social Sciences (SPSS 21.0, Chicago, IL, USA). One-way ANOVA with post-hoc(Bonferroni correction factor) analysis was applied to compare the three groups. Multivariate analysis was done for the covariates followed by a multivariate regression analysis to evaluate the covariates influencing SSD for each group separately. Mean SSD was 4.37±0.31cm in the overall population. SSD in adult males was 4.49±0.19cm which was significantly longer than that observed in female's 4.18±0.39cm which was comparable with SSD in parturient 4.43±0.19 cm. The formula for predicting the skin to SSD in the male population was 1.718+0.077×BMI+0.632×Height, in nonpregnant female population was 1.828+0.077×BMI+0.018×Height+0.007×Age and 0.748+0.209×BMI+4.703×Height-0.054×weight in parturient females, respectively. Skin to SSD correlated with the BMI in all

  13. Southeast Atmosphere Studies: learning from model-observation syntheses

    Science.gov (United States)

    Mao, Jingqiu; Carlton, Annmarie; Cohen, Ronald C.; Brune, William H.; Brown, Steven S.; Wolfe, Glenn M.; Jimenez, Jose L.; Pye, Havala O. T.; Ng, Nga Lee; Xu, Lu; McNeill, V. Faye; Tsigaridis, Kostas; McDonald, Brian C.; Warneke, Carsten; Guenther, Alex; Alvarado, Matthew J.; de Gouw, Joost; Mickley, Loretta J.; Leibensperger, Eric M.; Mathur, Rohit; Nolte, Christopher G.; Portmann, Robert W.; Unger, Nadine; Tosca, Mika; Horowitz, Larry W.

    2018-02-01

    Concentrations of atmospheric trace species in the United States have changed dramatically over the past several decades in response to pollution control strategies, shifts in domestic energy policy and economics, and economic development (and resulting emission changes) elsewhere in the world. Reliable projections of the future atmosphere require models to not only accurately describe current atmospheric concentrations, but to do so by representing chemical, physical and biological processes with conceptual and quantitative fidelity. Only through incorporation of the processes controlling emissions and chemical mechanisms that represent the key transformations among reactive molecules can models reliably project the impacts of future policy, energy and climate scenarios. Efforts to properly identify and implement the fundamental and controlling mechanisms in atmospheric models benefit from intensive observation periods, during which collocated measurements of diverse, speciated chemicals in both the gas and condensed phases are obtained. The Southeast Atmosphere Studies (SAS, including SENEX, SOAS, NOMADSS and SEAC4RS) conducted during the summer of 2013 provided an unprecedented opportunity for the atmospheric modeling community to come together to evaluate, diagnose and improve the representation of fundamental climate and air quality processes in models of varying temporal and spatial scales.This paper is aimed at discussing progress in evaluating, diagnosing and improving air quality and climate modeling using comparisons to SAS observations as a guide to thinking about improvements to mechanisms and parameterizations in models. The effort focused primarily on model representation of fundamental atmospheric processes that are essential to the formation of ozone, secondary organic aerosol (SOA) and other trace species in the troposphere, with the ultimate goal of understanding the radiative impacts of these species in the southeast and elsewhere. Here we

  14. Study of Rayleigh-Love coupling from Spatial Gradient Observation

    Science.gov (United States)

    Lin, C. J.; Hosseini, K.; Donner, S.; Vernon, F.; Wassermann, J. M.; Igel, H.

    2017-12-01

    We present a new method to study Rayleigh-Love coupling. Instead of using seismograms solely, where ground motion is recorded as function of time, we incorporate with rotation and strain, also called spatial gradient where ground is represented as function of distance. Seismic rotation and strain are intrinsic different observable wavefield so are helpful to indentify wave type and wave propagation. A Mw 7.5 earthquake on 29 March 2015 occurred in Kokopo, Papua New Guinea recorded by a dense seismic array at PFO, California are used to obtaint seismic spatial gradient. We firstly estimate time series of azimuthal direction and phase velocity of SH wave and Rayleigh wave by analyzing collocated seismograms and rotations. This result also compares with frequency wavenumber methods using a nearby ANZA seismic array. We find the direction of Rayleigh wave fits well with great-circle back azimuth during wave propagation, while the direction of Love wave deviates from that, especially when main energy of Rayleigh wave arrives. From the analysis of cross-correlation between areal strain and vertical rotation, it reveals that high coherence, either positive or negative, happens at the same time when Love wave deparate from great-circle path. We also find the observed azimuth of Love wave and polarized particle motion of Rayleigh wave fits well with the fast direction of Rayleigh wave, for the period of 50 secs. We conclude the cause of deviated azimuth of Love wave is due to Rayleigh-Love coupling, as surface wave propagates through the area with anisotropic structure.

  15. [Pregnancy-Associated Breast Cancer: An analytical observational study].

    Science.gov (United States)

    Baulies, Sonia; Cusidó, Maite; Tresserra, Francisco; Rodríguez, Ignacio; Ubeda, Belén; Ara, Carmen; Fábregas, Rafael

    2014-03-04

    Pregnancy-associated breast cancer is defined as breast cancer diagnosed during pregnancy and up to one year postpartum. A retrospective, analytical, observational study comparing 56 cases of breast cancer and pregnancy (PABC) diagnosed 1976-2008 with 73 patients with breast cancer not associated with pregnancy (non-PABC) was performed. Demographic data, prognostic factors, treatment and survival were reviewed and compared. The prevalence of PABC in our center is 8.3/10,000. The highest frequency (62%) appeared during the postpartum period. The stages are higher in PABC, being 31.3% advanced (EIII and EIV) in PABC versus 13.3% in non-PABC (P < .05). Regarding prognostic factors, 27.3% in PABC had a tumoral grade 3 versus 15.8% of non-PABC. Among women with PABC, 33.3% had negative estrogen receptors, 48.7% negative progesterone receptors and 34.5% positive Her2Neu compared with 22.2, 24.1 and 31%, respectively of non-PABC patients. Finally, positive lymph nodes were found in 52.8% of PABC, versus 33.8% non-PABC (P < .05). Overall and disease-free survival rate at 5 years for PABC was 63.7 and 74.2%, respectively. The poorer survival observed is possibly due to the presence of adverse prognostic features such as lymph node metastases, negative hormone receptors, tumoral grade iii, as well as a delay in diagnosis with a higher rate of advanced stages. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  16. Southeast Atmosphere Studies: learning from model-observation syntheses

    Directory of Open Access Journals (Sweden)

    J. Mao

    2018-02-01

    Full Text Available Concentrations of atmospheric trace species in the United States have changed dramatically over the past several decades in response to pollution control strategies, shifts in domestic energy policy and economics, and economic development (and resulting emission changes elsewhere in the world. Reliable projections of the future atmosphere require models to not only accurately describe current atmospheric concentrations, but to do so by representing chemical, physical and biological processes with conceptual and quantitative fidelity. Only through incorporation of the processes controlling emissions and chemical mechanisms that represent the key transformations among reactive molecules can models reliably project the impacts of future policy, energy and climate scenarios. Efforts to properly identify and implement the fundamental and controlling mechanisms in atmospheric models benefit from intensive observation periods, during which collocated measurements of diverse, speciated chemicals in both the gas and condensed phases are obtained. The Southeast Atmosphere Studies (SAS, including SENEX, SOAS, NOMADSS and SEAC4RS conducted during the summer of 2013 provided an unprecedented opportunity for the atmospheric modeling community to come together to evaluate, diagnose and improve the representation of fundamental climate and air quality processes in models of varying temporal and spatial scales.This paper is aimed at discussing progress in evaluating, diagnosing and improving air quality and climate modeling using comparisons to SAS observations as a guide to thinking about improvements to mechanisms and parameterizations in models. The effort focused primarily on model representation of fundamental atmospheric processes that are essential to the formation of ozone, secondary organic aerosol (SOA and other trace species in the troposphere, with the ultimate goal of understanding the radiative impacts of these species in the southeast and

  17. Treatment of Crohn's disease with cannabis: an observational study.

    Science.gov (United States)

    Naftali, Timna; Lev, Lihi Bar; Yablecovitch, Doron; Yablekovitz, Doron; Half, Elisabeth; Konikoff, Fred M

    2011-08-01

    The marijuana plant cannabis is known to have therapeutic effects, including improvement of inflammatory processes. However, no report of patients using cannabis for Crohn's disease (CD) was ever published. To describe the effects of cannabis use in patients suffering from CD. In this retrospective observational study we examined disease activity, use of medication, need for surgery, and hospitalization before and after cannabis use in 30 patients (26 males) with CD. Disease activity was assessed by the Harvey Bradshaw index for Crohn's disease. Of the 30 patients 21 improved significantly after treatment with cannabis. The average Harvey Bradshaw index improved from 14 +/- 6.7 to 7 +/- 4.7 (P cannabis use, but only 2 required surgery during an average period of 3 years of cannabis use. This is the first report of cannabis use in Crohn's disease in humans. The results indicate that cannabis may have a positive effect on disease activity, as reflected by reduction in disease activity index and in the need for other drugs and surgery. Prospective placebo-controlled studies are warranted to fully evaluate the efficacy and side effects of cannabis in CD.

  18. Ali Observatory in Tibet: a unique northern site for future CMB ground-based observations

    Science.gov (United States)

    Su, Meng

    2015-08-01

    Ground-based CMB observations have been performed at the South Pole and the Atacama desert in Chile. However, a significant fraction of the sky can not be observed from just these two sites. For a full sky coverage from the ground in the future, a northern site for CMB observation, in particular CMB polarization, is required. Besides the long-thought site in Greenland, the high altitude Tibet plateau provides another opportunity. I will describe the Ali Observatory in Tibet, located at N32°19', E80°01', as a potential site for ground-based CMB observations. The new site is located on almost 5100m mountain, near Gar town, where is an excellent site for both infrared and submillimeter observations. Study with the long-term database of ground weather stations and archival satellite data has been performed. The site has enough relative height on the plateau and is accessible by car. The Shiquanhe town is 40 mins away by driving, and a recently opened airport with 40 mins driving, the site also has road excess, electricity, and optical fiber with fast internet. Preliminary measurement of the Precipitable Water Vapor is ~one quarter less than 0.5mm per year and the long term monitoring is under development. In addition, surrounding higher sites are also available and could be further developed if necessary. Ali provides unique northern sky coverage and together with the South Pole and the Atacama desert, future CMB observations will be able to cover the full sky from ground.

  19. Characterization of Jupiter's Atmosphere from Observation of Thermal Emission by Juno and Ground-Based Supporting Observations

    Science.gov (United States)

    Orton, G. S.; Momary, T.; Tabataba-Vakili, F.; Janssen, M. A.; Hansen, C. J.; Bolton, S. J.; Li, C.; Adriani, A.; Mura, A.; Grassi, D.; Fletcher, L. N.; Brown, S. T.; Fujiyoshi, T.; Greathouse, T. K.; Kasaba, Y.; Sato, T. M.; Stephens, A.; Donnelly, P.; Eichstädt, G.; Rogers, J.

    2017-12-01

    Ground-breaking measurements of thermal emission at very long wavelengths have been made by the Juno mission's Microwave Radiometer (MWR). We examine the relationship between these and other thermal emission measurements by the Jupiter Infrared Auroral Mapper (JIRAM) at 5 µm and ground-based supporting observations in the thermal infrared that cover the 5-25 µm range. The relevant ground-based observations of thermal emission are constituted from imaging and scanning spectroscopy obtained at the NASA Infrared Telescope Facility (IRTF), the Gemini North Telescope, the Subaru Telescope and the Very Large Telescope. A comparison of these results clarifies the physical properties responsible for the observed emissions, i.e. variability of the temperature field, the cloud field or the distribution of gaseous ammonia. Cross-references to the visible cloud field from Juno's JunoCam experiment and Earth-based images are also useful. This work continues an initial comparison by Orton et al. (2017, GRL 44, doi: 10.1002/2017GL073019) between MWR and JIRAM results, together with ancillary 5-µm IRTF imaging and with JunoCam and ground-based visible imaging. These showed a general agreement between MWR and JIRAM results for the 5-bar NH3 abundance in specific regions of low cloud opacity but only a partial correlation between MWR and 5-µm radiances emerging from the 0.5-5 bar levels of the atmosphere in general. Similar to the latter, there appears to be an inconsistent correlation between MWR channels sensitive to 0.5-10 bars and shorter-wavelength radiances in the "tails" of 5-µm hot spots , which may be the result of the greater sensitivity of the latter to particulate opacity that could depend on the evolution history of the particular features sampled. Of great importance is the interpretation of MWR radiances in terms of the variability of temperature vs. NH3 abundances in the 0.5-5 bar pressure range. This is particularly important to understand MWR results in

  20. Effectiveness of home-based directly observed treatment for tuberculosis in Kweneng West subdistrict, Botswana

    Directory of Open Access Journals (Sweden)

    Bob Mash

    2010-03-01

    Full Text Available Background: Tuberculosis (TB and HIV are major public health problems in Botswana. In the face of growing TB notification rates, a low cure rate, human resource constraints and poor accessibility to health facilities, Botswana Ministry of Health decided to offer home-based directly observed treatment (DOT using community volunteers.Objectives: The aim of this study was to assess the outcomes of home-based directly observed treatment (HB-DOT versus facility-based, directly observed treatment (FB-DOT in the Kweneng West subdistrict in Botswana and to explore the acceptability of HB-DOT among TB patients,community volunteers and health workers.Method: A quantitative, observational study using routinely collected TB data from 405 TB patientswas conducted and combined with 20 qualitative in-depth interviews.Results: The overall cure rate for smear-positive pulmonary TB patients was 78.5%. Treatmentoutcomes were not statistically different between FB-DOT and HB-DOT. Contact tracing was significantly better in FB-DOT patients. Interviews revealed advantages and disadvantages for both FB and HB options and that flexibility in the choice or mix of options was important. A number of suggestions were made by the interviewees to improve the HB-DOT programme.Conclusion: HB-DOT is at least as good as FB-DOT in terms of the treatment outcomes, but attention must be given to contact tracing. HB-DOT offers some patients the flexibility they need to adhere to TB treatment and community volunteers may be strengthened by ongoing training and support from health workers, financial incentives and provision of basic equipment.

  1. The Application of Observational Practice and Educational Networking in Simulation-Based and Distributed Medical Education Contexts.

    Science.gov (United States)

    Welsher, Arthur; Rojas, David; Khan, Zain; VanderBeek, Laura; Kapralos, Bill; Grierson, Lawrence E M

    2018-02-01

    Research has revealed that individuals can improve technical skill performance by viewing demonstrations modeled by either expert or novice performers. These findings support the development of video-based observational practice communities that augment simulation-based skill education and connect geographically distributed learners. This study explores the experimental replicability of the observational learning effect when demonstrations are sampled from a community of distributed learners and serves as a context for understanding learner experiences within this type of training protocol. Participants from 3 distributed medical campuses engaged in a simulation-based learning study of the elliptical excision in which they completed a video-recorded performance before being assigned to 1 of 3 groups for a 2-week observational practice intervention. One group observed expert demonstrations, another observed novice demonstrations, and the third observed a combination of both. Participants returned for posttesting immediately and 1 month after the intervention. Participants also engaged in interviews regarding their perceptions of the usability and relevance of video-based observational practice to clinical education. Checklist (P simulation-based skill learning in a group of geographically distributed trainees. These findings support the use of Internet-mediated observational learning communities in distributed and simulation-based medical education contexts.

  2. Relationship between soft stratum thickness and predominant frequency of ground based on microtremor observation data

    Science.gov (United States)

    Chia, Kenny; Lau, Tze Liang

    2017-07-01

    Despite categorized as low seismicity group, until being affected by distant earthquake ground motion from Sumatra and the recent 2015 Sabah Earthquake, Malaysia has come to realize that seismic hazard in the country is real and has the potential to threaten the public safety and welfare. The major concern in this paper is to study the effect of local site condition, where it could amplify the magnitude of ground vibration at sites. The aim for this study is to correlate the thickness of soft stratum with the predominant frequency of soil. Single point microtremor measurements were carried out at 24 selected points where the site investigation reports are available. Predominant period and frequency at each site are determined by Nakamura's method. The predominant period varies from 0.22 s to 0.98 s. Generally, the predominant period increases when getting closer to the shoreline which has thicker sediments. As far as the thickness of the soft stratum could influence the amplification of seismic wave, the advancement of micotremor observation to predict the thickness of soft stratum (h) from predominant frequency (fr) is of the concern. Thus an empirical relationship h =54.917 fr-1.314 is developed based on the microtremor observation data. The empirical relationship will be benefited in the prediction of thickness of soft stratum based on microtremor observation for seismic design with minimal cost compared to conventional boring method.

  3. Space-based pseudo-fixed latitude observation mode based on the characteristics of geosynchronous orbit belt

    Science.gov (United States)

    Hu, Yun-peng; Chen, Lei; Huang, Jian-yu

    2017-08-01

    The US Lincoln Laboratory proved that space-based visible (SBV) observation is efficient to observe space objects, especially Geosynchronous Orbit (GEO) objects. After that, SBV observation plays an important role in the space surveillance. In this paper, a novel space-based observation mode is designed to observe all the GEO objects in a relatively short time. A low earth orbit (LEO) satellite, especially a dawn-dusk sun-synchronous orbit satellite, is useful for space-based observation. Thus, the observation mode for GEO objects is based on a dawn-dusk sun-synchronous orbit satellite. It is found that the Pinch Point (PP) regions proposed by the US Lincoln Laboratory are spreading based on the analysis of the evolution principles of GEO objects. As the PP regions becoming more and more widely in the future, many strategies based on it may not be efficient any more. Hence, the key point of the space-based observation strategy design for GEO objects should be emphasized on the whole GEO belt as far as possible. The pseudo-fixed latitude observation mode is proposed in this paper based on the characteristics of GEO belt. Unlike classical space-based observation modes, pseudo-fixed latitude observation mode makes use of the one-dimensional attitude adjustment of the observation satellite. The pseudo-fixed latitude observation mode is more reliable and simple in engineering, compared with the gazing observation mode which needs to adjust the attitude from the two dimensions. It includes two types of attitude adjustment, i.e. daily and continuous attitude adjustment. Therefore, the pseudo-fixed latitude observation mode has two characteristics. In a day, the latitude of the observation region is fixed and the scanning region is about a rectangle, while the latitude of the observation region centre changes each day in a long term based on a daily strategy. The capabilities of a pseudo-fixed latitude observation instrument with a 98° dawn-dusk sun-synchronous orbit are

  4. Observational study of drug-drug interactions in oncological inpatients

    Directory of Open Access Journals (Sweden)

    María Sacramento Díaz-Carrasco

    2018-01-01

    Full Text Available Objective: To determine the prevalence of potential clinically relevant drug- drug interactions in adult oncological inpatients, as well as to describe the most frequent interactions. A standard database was used. Method: An observational, transversal, and descriptive study including patients admitted to the Oncology Service of a reference hospital. All prescriptions were collected twice a week during a month. They were analysed using Lexicomp® database, recording all interactions classified with a level of risk: C, D or X. Results: A total of 1 850 drug-drug interactions were detected in 218 treatments. The prevalence of treatments with at least one clinically relevant interaction was 95%, being 94.5% for those at level C and 26.1% for levels D and X. The drugs most commonly involved in the interactions detected were opioid analgesics, antipsychotics (butyrophenones, benzodiazepines, pyrazolones, glucocorticoids and heparins, whereas interactions with antineoplastics were minimal, highlighting those related to paclitaxel and between metamizole and various antineoplastics. Conclusions: The prevalence of clinically relevant drug-drug interactions rate was very high, highlighting the high risk percentage of them related to level of risk X. Due to the frequency of onset and potential severity, highlighted the concomitant use of central nervous system depressants drugs with risk of respiratory depression, the risk of onset of anticholinergic symptoms when combining morphine or haloperidol with butylscopolamine, ipratropium bromide or dexchlorpheniramine and the multiple interactions involving metamizole.

  5. Young adult smoking in peer groups: an experimental observational study.

    Science.gov (United States)

    Harakeh, Zeena; Vollebergh, Wilma A M

    2013-03-01

    The aim of this experimental observational study is to examine whether, in a group setting (same-sex triads), passive peer influence (imitation) in the context of homogeneous and heterogeneous (contradictory) behavior of peer models affects young adults' smoking behavior. An experiment was conducted among 48 daily-smoking college and university students aged 17-25. Participants had to complete a 30-min music task with two same-sex confederates. We tested the following three conditions: (a) neither of the confederates is smoking, (b) one confederate is smoking and the other is not, and (c) both confederates are smoking. The primary outcome tested was the total number of cigarettes smoked during the task. Students in the condition with two smoking peer models and in the condition with one smoking peer model and one nonsmoking peer model smoked significantly more cigarettes than those in the condition with two nonsmoking peer models. However, results for the condition with two smoking peer models did not differ significantly from the condition with one smoking peer model and one nonsmoking peer model. Our findings show that in a group setting, the impact of the homogeneity of smoking peers on young adults' smoking behavior is not greater than the impact of the heterogeneity of smoking and nonsmoking peers. This would suggest that the smoking peer in the group has a greater impact on the daily-smoking young adult, thus reducing or even eliminating the protective effect of the nonsmoking peer model.

  6. iPad use during ward rounds: an observational study.

    Science.gov (United States)

    Lehnbom, Elin C; Adams, Kristian; Day, Richard O; Westbrook, Johanna I; Baysari, Melissa T

    2014-01-01

    Much clinical information is computerised and doctors' use of mobile devices such as iPad tablets to access this information is expanding rapidly. This study investigated the use of iPads during ward rounds and their usefulness in providing access to information during ward rounds. Ten teams of doctors at a large teaching hospital were given iPads for ten weeks and were observed on ward rounds for 77.3 hours as they interacted with 525 patients. Use of iPads and other information technology devices to access clinical information was recorded. The majority of clinical information was accessed using iPads (56.2%), followed by computers-on-wheels (35.8%), stationary PCs (7.9%) and smartphones (0.1%). Despite having read-only access on iPads, doctors were generally happy using iPads on ward rounds. These findings provide evidence of the value of iPads as a tool to access information at the point of care.

  7. Sensitivity of dose-finding studies to observation errors.

    Science.gov (United States)

    Zohar, Sarah; O'Quigley, John

    2009-11-01

    The purpose of Phase I designs is to estimate the MTD (maximum tolerated dose, in practice a dose with some given acceptable rate of toxicity) while, at the same time, minimizing the number of patients treated at doses too far removed from the MTD. Our purpose here is to investigate the sensitivity of conclusions from dose-finding designs to recording or observation errors. Certain toxicities may go undetected and, conversely, certain non-toxicities may be incorrectly recorded as dose-limiting toxicities. Recording inaccuracies would be expected to have an influence on final and within trial recommendations and, in this paper, we study in greater depth this question. We focus, in particular on three designs used currently; the standard '3+3' design, the grouped up-and-down design [M. Gezmu, N. Flournoy, Group up-and-down designs for dose finding. Journal of Statistical Planning and Inference 2006; 136 (6): 1749-1764.] and the continual reassessment method (CRM, [J. O'Quigley, M. Pepe, L. Fisher, Continual reassessment method: a practical design for phase 1 clinical trials in cancer. Biometrics 1990; 46 (1): 33-48.]). A non-toxicity incorrectly recorded as a toxicity (error of first kind) has a greater influence in general than the converse (error of second kind). These results are illustrated via figures which suggest that the standard '3+3' design in particular is sensitive to errors of the second kind. Such errors can have a very important impact on drug development in that, if carried through to the Phase 2 and Phase 3 studies, we can significantly increase the probability of failure to detect efficacy as a result of having delivered an inadequate dose.

  8. [The aggression in SPDC: an observational study. Preliminary data].

    Science.gov (United States)

    Minutolo, Giuseppe; Cannavò, Dario; Petralia, Antonino; Gandolfo, Liliana; Palermo, Filippo; Aguglia, Eugenio

    2010-01-01

    In the different psychiatric disorders the aggression often leads to uncontrolled events, taking aspects of impulsiveness and irrationality. Our research proposes the assessment of socio-demographic and clinical characteristics of patients with a psychiatric disorder, who presented an aggressive event. The observational study was conducted on a sample of 50 patients (34 men and 16 women), hospitalized following the manifestation of an aggressive event. For each patient was provided an assessment of socio-demographic and clinical variables and a psychometric investigation through: the OAS, for the analysis of aggressive episodes; the BDHI, for the hostile behavior and attitudes; the BIS-11, for the impulsiveness and the BPRS for the psychopathological aspects. Among the socio-demographic features investigated, the highest correlation with aggressive behavior was related to the concomitant substance abuse, type of admission to psychiatric hospital and the male gender. The OAS has shown a greater propensity to directed-aggression in males with schizophrenia, and self-directed in females with major depression. The BPRS has shown a positive correlation between hetero-directed aggressive behavior and positive symptomatology, and between the self-directed and depression, risk of suicide, feelings of guilt and somatic concerns. The BDHI has indicated greater suspicion in women's group. The hypothesis that aggression is otherwise related to specific socio-demographic and clinical characteristics was confirmed by our study. The data suggest that early identification and assessment of potential risk factors involved in the genesis of aggressive episodes would allow the clinician to implement a better strategy for prevention and intervention.

  9. Self-Localization and Stream Field Based Partially Observable Moving Object Tracking

    Directory of Open Access Journals (Sweden)

    Kuo-Shih Tseng

    2009-01-01

    Full Text Available Self-localization and object tracking are key technologies for human-robot interactions. Most previous tracking algorithms focus on how to correctly estimate the position, velocity, and acceleration of a moving object based on the prior state and sensor information. What has been rarely studied so far is how a robot can successfully track the partially observable moving object with laser range finders if there is no preanalysis of object trajectories. In this case, traditional tracking algorithms may lead to the divergent estimation. Therefore, this paper presents a novel laser range finder based partially observable moving object tracking and self-localization algorithm for interactive robot applications. Dissimilar to the previous work, we adopt a stream field-based motion model and combine it with the Rao-Blackwellised particle filter (RBPF to predict the object goal directly. This algorithm can keep predicting the object position by inferring the interactive force between the object goal and environmental features when the moving object is unobservable. Our experimental results show that the robot with the proposed algorithm can localize itself and track the frequently occluded object. Compared with the traditional Kalman filter and particle filter-based algorithms, the proposed one significantly improves the tracking accuracy.

  10. Ventilation strategies in burn intensive care: A retrospective observational study

    Directory of Open Access Journals (Sweden)

    Stefano Palazzo

    2014-01-01

    Full Text Available Consensus regarding optimal burns intensive care (BICU patient management is lacking. This study aimed to assess whether ventilation strategies, cardiovascular support and sedation in BICU patients have changed over time, and whether this affects outcome. A retrospective observational study comparing two 12-patient BICU cohorts (2005/06 and 2010/11 was undertaken. Demographic and admission characteristics, ventilation parameters, sedation, fluid resuscitation, cardiovascular support and outcome (length of stay, mortality data were collected from patient notes. Data was analysed using T-tests, Fisher's exact and Mann-Whitney U tests. In our study cohort groups were equivalent in demographic and admission parameters. There were equal ventilator-free days in the two cohorts 10 ± 12.7 vs. 13.3 ± 12.2 ventilator free days; P = 0.447. The 2005/06 cohort were mechanically ventilated more often than in 2010/11 cohort (568 ventilator days/1000 patient BICU days vs. 206 ventilator days/1000 patient BICU days; P = 0.001. The 2005/06 cohort were ventilated less commonly in tracheostomy group/endotracheal tube spontaneous (17.8% vs. 26%; P = 0.001 and volume-controlled modes (34.4% vs. 40.8%; P = 0.001. Patients in 2010/11 cohort were more heavily sedated (P = 0.001 with more long-acting sedative drug use (P = 0.001 than the 2005/06 cohort, fluid administration was equivalent. Patient outcome did not vary. Inhalational injury patients were ventilated in volume-controlled (44.5% vs. 28.1%; P = 0.001 and pressure-controlled modes (18.2% vs. 9.5%; P = 0.001 more frequently than those without. Outcome did not vary. This study showed there has been shift away from mechanical ventilation, with increased use of tracheostomy/tracheal tube airway spontaneous ventilation. Inhalation injury patients require more ventilatory support though patient outcomes do not differ. Prospective trials are required to establish which strategies confer benefit.

  11. Fatal poisonings in Oslo: a one-year observational study

    Directory of Open Access Journals (Sweden)

    Heyerdahl Fridtjof

    2010-06-01

    Full Text Available Abstract Background Acute poisonings are common and are treated at different levels of the health care system. Since most fatal poisonings occur outside hospital, these must be included when studying characteristics of such deaths. The pattern of toxic agents differs between fatal and non-fatal poisonings. By including all poisoning episodes, cause-fatality rates can be calculated. Methods Fatal and non-fatal acute poisonings in subjects aged ≥16 years in Oslo (428 198 inhabitants were included consecutively in an observational multi-centre study including the ambulance services, the Oslo Emergency Ward (outpatient clinic, and hospitals, as well as medico-legal autopsies from 1st April 2003 to 31st March 2004. Characteristics of fatal poisonings were examined, and a comparison of toxic agents was made between fatal and non-fatal acute poisoning. Results In Oslo, during the one-year period studied, 103 subjects aged ≥16 years died of acute poisoning. The annual mortality rate was 24 per 100 000. The male-female ratio was 2:1, and the mean age was 44 years (range 19-86 years. In 92 cases (89%, death occurred outside hospital. The main toxic agents were opiates or opioids (65% of cases, followed by ethanol (9%, tricyclic anti-depressants (TCAs (4%, benzodiazepines (4%, and zopiclone (4%. Seventy-one (69% were evaluated as accidental deaths and 32 (31% as suicides. In 70% of all cases, and in 34% of suicides, the deceased was classified as drug or alcohol dependent. When compared with the 2981 non-fatal acute poisonings registered during the study period, the case fatality rate was 3% (95% C.I., 0.03-0.04. Methanol, TCAs, and antihistamines had the highest case fatality rates; 33% (95% C.I., 0.008-0.91, 14% (95% C.I., 0.04-0.33, and 10% (95% C.I., 0.02-0.27, respectively. Conclusions Three per cent of all acute poisonings were fatal, and nine out of ten deaths by acute poisonings occurred outside hospital. Two-thirds were evaluated as accidental

  12. Modified release paracetamol overdose: a prospective observational study (ATOM-3).

    Science.gov (United States)

    Chiew, Angela L; Isbister, Geoffrey K; Page, Colin B; Kirby, Katharine A; Chan, Betty S H; Buckley, Nicholas A

    2018-02-16

    Modified-release (MR) paracetamol is available in many countries as 665 mg tablets of which 69% is MR and 31% is immediate release. There are concerns that MR paracetamol overdose has higher rates of liver injury despite standard treatment algorithms. The objective of this study was to describe the clinical characteristics and outcomes of acute MR paracetamol overdose. Prospective observational study, recruiting patients from January 2013 to June 2017, from five clinical toxicology units and calls to two Poisons Information Centres in Australia. Included were patients >14 years who ingested ≥10 g or 200 mg/kg (whichever is less) of MR paracetamol. Data collected included demographics, ingestion history, pathology results, treatments, and outcomes including hepatotoxicity (ALT >1000 U/L). In total, 116 patients were recruited, 85(73%) were female. The median dose ingested was 32 g (IQR: 20-49 g) and median time to presentation was 3 h (IQR: 2-9 h). 78(67%) had an initial paracetamol concentration above the nomogram line (150 mg/L at 4 h). A further 12(10%) crossed the nomogram after repeat paracetamol measurements, of which five crossed after two non-toxic levels 4 h apart. Six had a double paracetamol peak, in three occurring >24 h post-ingestion. 113(97%) received acetylcysteine of which 67 received prolonged treatment beyond the standard 21 h. This was because of an elevated paracetamol concentration at the completion of acetylcysteine in 39 (median paracetamol concentration 25 mg/L, IQR: 16-62 mg/L). 21 (18%) developed hepatotoxicity, including six treated within 8 h of ingestion. Activated charcoal and double doses of acetylcysteine did not significantly decrease the risk of hepatotoxicity. Drug regulatory authorities are considering restrictions on MR paracetamol preparations. Following an acute MR paracetamol overdose, this study found that many patients had a persistently elevated paracetamol concentrations, many required

  13. Fatal poisonings in Oslo: a one-year observational study.

    Science.gov (United States)

    Bjornaas, Mari A; Teige, Brita; Hovda, Knut E; Ekeberg, Oivind; Heyerdahl, Fridtjof; Jacobsen, Dag

    2010-06-06

    Acute poisonings are common and are treated at different levels of the health care system. Since most fatal poisonings occur outside hospital, these must be included when studying characteristics of such deaths. The pattern of toxic agents differs between fatal and non-fatal poisonings. By including all poisoning episodes, cause-fatality rates can be calculated. Fatal and non-fatal acute poisonings in subjects aged > or =16 years in Oslo (428 198 inhabitants) were included consecutively in an observational multi-centre study including the ambulance services, the Oslo Emergency Ward (outpatient clinic), and hospitals, as well as medico-legal autopsies from 1st April 2003 to 31st March 2004. Characteristics of fatal poisonings were examined, and a comparison of toxic agents was made between fatal and non-fatal acute poisoning. In Oslo, during the one-year period studied, 103 subjects aged > or =16 years died of acute poisoning. The annual mortality rate was 24 per 100 000. The male-female ratio was 2:1, and the mean age was 44 years (range 19-86 years). In 92 cases (89%), death occurred outside hospital. The main toxic agents were opiates or opioids (65% of cases), followed by ethanol (9%), tricyclic anti-depressants (TCAs) (4%), benzodiazepines (4%), and zopiclone (4%). Seventy-one (69%) were evaluated as accidental deaths and 32 (31%) as suicides. In 70% of all cases, and in 34% of suicides, the deceased was classified as drug or alcohol dependent. When compared with the 2981 non-fatal acute poisonings registered during the study period, the case fatality rate was 3% (95% C.I., 0.03-0.04). Methanol, TCAs, and antihistamines had the highest case fatality rates; 33% (95% C.I., 0.008-0.91), 14% (95% C.I., 0.04-0.33), and 10% (95% C.I., 0.02-0.27), respectively. Three per cent of all acute poisonings were fatal, and nine out of ten deaths by acute poisonings occurred outside hospital. Two-thirds were evaluated as accidental deaths. Although case fatality rates were

  14. Conveying Clinical Reasoning Based on Visual Observation via Eye-Movement Modelling Examples

    Science.gov (United States)

    Jarodzka, Halszka; Balslev, Thomas; Holmqvist, Kenneth; Nystrom, Marcus; Scheiter, Katharina; Gerjets, Peter; Eika, Berit

    2012-01-01

    Complex perceptual tasks, like clinical reasoning based on visual observations of patients, require not only conceptual knowledge about diagnostic classes but also the skills to visually search for symptoms and interpret these observations. However, medical education so far has focused very little on how visual observation skills can be…

  15. Accounting for correlated observations in an age-based state-space stock assessment model

    DEFF Research Database (Denmark)

    Berg, Casper Willestofte; Nielsen, Anders

    2016-01-01

    Fish stock assessment models often relyon size- or age-specific observations that are assumed to be statistically independent of each other. In reality, these observations are not raw observations, but rather they are estimates from a catch-standardization model or similar summary statistics based...

  16. Effects of an Augmented Reality-Based Educational Game on Students' Learning Achievements and Attitudes in Real-World Observations

    Science.gov (United States)

    Hwang, Gwo-Jen; Wu, Po-Han; Chen, Chi-Chang; Tu, Nien-Ting

    2016-01-01

    Augmented reality (AR) has been recognized as a potential technology to help students link what they are observing in the real world to their prior knowledge. One of the most challenging issues of AR-based learning is the provision of effective strategy to help students focus on what they need to observe in the field. In this study, a competitive…

  17. [OBSERVANT II: OBservational Study of Effectiveness of transcatheter aortic valve implantation with new geneRation deVices for severe Aortic steNosis Treatment. Study protocol].

    Science.gov (United States)

    Seccareccia, Fulvia; Tarantini, Giuseppe; Bedogni, Francesco; Berti, Sergio; Santoro, Gennaro; Tamburino, Corrado; Ussia, Gian Paolo; Barbanti, Marco; Baiocchi, Massimo; Ranucci, Marco; D'Errigo, Paola; Rosato, Stefano; Musumeci, Giuseppe

    2017-06-01

    The rapid spread of transcatheter aortic valve implantation (TAVI) for the treatment of severe symptomatic aortic stenosis in the last decade in Italy has led to a gradually increasing use of TAVI procedures also in patients potentially eligible for aortic valve replacement (AVR). For this subset of patients, the OBSERVANT study (2011-2012) evaluated the short- and medium term outcome of TAVI vs AVR, at least for the first generations of TAVI devices, but failed to gather information on all the technological innovations occurred in recent years. The launch of a phase II of the study will allow to recruit a new series of TAVI, with different risk profiles compared with the historical OBSERVANT TAVI cohort, in order to assess whether and how much the use of new-generation devices mitigate the differences in outcomes recorded in the OBSERVANT study. OBSERVANT II is an observational multicenter, prospective, cohort study collecting data on patients with severe symptomatic aortic stenosis undergoing TAVI in Italian hospitals since December 15, 2016, for at least 12 months. For each patient, data on demographic characteristics, health status, type of intervention and presence of comorbidities will be collected. Mortality and incidence of in-hospital major adverse cardiac and cerebrovascular events (MACCE) within 36 months of intervention will be the primary adverse outcome. Secondary outcomes will include 30-day mortality and the incidence of MACCE at 12 and 24 months. The statistical hypotheses were formulated considering the results from the OBSERVANT study. Testing these hypotheses will require the recruitment of at least 823 new TAVI. The risk/propensity-adjustment techniques will be used to comparatively evaluate the effectiveness of TAVI vs AVR. Safety and efficacy profiles of the new-generation TAVI prosthesis; comparative effectiveness of the new TAVI prosthesis as compared to TAVI procedures of the OBSERVANT historical cohort; comparative effectiveness of the

  18. Observing power blackouts from space - A disaster related study

    Science.gov (United States)

    Aubrecht, C.; Elvidge, C. D.; Ziskin, D.; Baugh, K. E.; Tuttle, B.; Erwin, E.; Kerle, N.

    2009-04-01

    In case of emergency disaster managers worldwide require immediate information on affected areas and estimations of the number of affected people. Natural disasters such as earthquakes, hurricanes, tornados, wind and ice storms often involve failures in the electrical power generation system and grid. Near real time identification of power blackouts gives a first impression of the area affected by the event (Elvidge et al. 2007), which can subsequently be linked to population estimations. Power blackouts disrupt societal activities and compound the difficulties associated with search and rescue, clean up, and the provision of food and other supplies following a disastrous event. Locations and spatial extents of power blackouts are key considerations in planning and execution of the primary disaster missions of emergency management organizations. To date only one satellite data source has been used successfully for the detection of power blackouts. Operated by NOAA's National Geophysical Data Center (NGDC) the U.S. Air Force Defense Meteorological Satellite Program (DMSP) Operational Linescan System (OLS) offers a unique capability to observe lights present at the Earth's surface at night. Including a pair of visible and thermal spectral bands and originally designed to detect moonlit clouds, this sensor enables mapping of lights from cities and towns, gas flares and offshore platforms, fires, and heavily lit fishing boats. The low light imaging of the OLS is accomplished using a photomultiplier tube (PMT) which intensifies the visible band signal at night. With 14 orbits collected per day and a 3.000 km swath width, each OLS is capable of collecting a complete set of images of the Earth every 24 hours. NGDC runs the long-term archive for OLS data with the digital version extending back to 1992. OLS data is received by NGDC in near real time (1-2 hours from acquisition) and subscription based services for the near real time data are provided for users all over the

  19. Computational and human observer image quality evaluation of low dose, knowledge-based CT iterative reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Eck, Brendan L.; Fahmi, Rachid; Miao, Jun [Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106 (United States); Brown, Kevin M.; Zabic, Stanislav; Raihani, Nilgoun [Philips Healthcare, Cleveland, Ohio 44143 (United States); Wilson, David L., E-mail: dlw@case.edu [Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106 and Department of Radiology, Case Western Reserve University, Cleveland, Ohio 44106 (United States)

    2015-10-15

    Purpose: Aims in this study are to (1) develop a computational model observer which reliably tracks the detectability of human observers in low dose computed tomography (CT) images reconstructed with knowledge-based iterative reconstruction (IMR™, Philips Healthcare) and filtered back projection (FBP) across a range of independent variables, (2) use the model to evaluate detectability trends across reconstructions and make predictions of human observer detectability, and (3) perform human observer studies based on model predictions to demonstrate applications of the model in CT imaging. Methods: Detectability (d′) was evaluated in phantom studies across a range of conditions. Images were generated using a numerical CT simulator. Trained observers performed 4-alternative forced choice (4-AFC) experiments across dose (1.3, 2.7, 4.0 mGy), pin size (4, 6, 8 mm), contrast (0.3%, 0.5%, 1.0%), and reconstruction (FBP, IMR), at fixed display window. A five-channel Laguerre–Gauss channelized Hotelling observer (CHO) was developed with internal noise added to the decision variable and/or to channel outputs, creating six different internal noise models. Semianalytic internal noise computation was tested against Monte Carlo and used to accelerate internal noise parameter optimization. Model parameters were estimated from all experiments at once using maximum likelihood on the probability correct, P{sub C}. Akaike information criterion (AIC) was used to compare models of different orders. The best model was selected according to AIC and used to predict detectability in blended FBP-IMR images, analyze trends in IMR detectability improvements, and predict dose savings with IMR. Predicted dose savings were compared against 4-AFC study results using physical CT phantom images. Results: Detection in IMR was greater than FBP in all tested conditions. The CHO with internal noise proportional to channel output standard deviations, Model-k4, showed the best trade-off between fit

  20. Computational and human observer image quality evaluation of low dose, knowledge-based CT iterative reconstruction

    International Nuclear Information System (INIS)

    Eck, Brendan L.; Fahmi, Rachid; Miao, Jun; Brown, Kevin M.; Zabic, Stanislav; Raihani, Nilgoun; Wilson, David L.

    2015-01-01

    Purpose: Aims in this study are to (1) develop a computational model observer which reliably tracks the detectability of human observers in low dose computed tomography (CT) images reconstructed with knowledge-based iterative reconstruction (IMR™, Philips Healthcare) and filtered back projection (FBP) across a range of independent variables, (2) use the model to evaluate detectability trends across reconstructions and make predictions of human observer detectability, and (3) perform human observer studies based on model predictions to demonstrate applications of the model in CT imaging. Methods: Detectability (d′) was evaluated in phantom studies across a range of conditions. Images were generated using a numerical CT simulator. Trained observers performed 4-alternative forced choice (4-AFC) experiments across dose (1.3, 2.7, 4.0 mGy), pin size (4, 6, 8 mm), contrast (0.3%, 0.5%, 1.0%), and reconstruction (FBP, IMR), at fixed display window. A five-channel Laguerre–Gauss channelized Hotelling observer (CHO) was developed with internal noise added to the decision variable and/or to channel outputs, creating six different internal noise models. Semianalytic internal noise computation was tested against Monte Carlo and used to accelerate internal noise parameter optimization. Model parameters were estimated from all experiments at once using maximum likelihood on the probability correct, P C . Akaike information criterion (AIC) was used to compare models of different orders. The best model was selected according to AIC and used to predict detectability in blended FBP-IMR images, analyze trends in IMR detectability improvements, and predict dose savings with IMR. Predicted dose savings were compared against 4-AFC study results using physical CT phantom images. Results: Detection in IMR was greater than FBP in all tested conditions. The CHO with internal noise proportional to channel output standard deviations, Model-k4, showed the best trade-off between fit and

  1. Subtropical and Polar Cirrus Clouds Characterized by Ground-Based Lidars and CALIPSO/CALIOP Observations

    Directory of Open Access Journals (Sweden)

    Córdoba-Jabonero Carmen

    2016-01-01

    Full Text Available Cirrus clouds are product of weather processes, and then their occurrence and macrophysical/optical properties can vary significantly over different regions of the world. Lidars can provide height-resolved measurements with a relatively good both vertical and temporal resolutions, making them the most suitable instrumentation for high-cloud observations. The aim of this work is to show the potential of lidar observations on Cirrus clouds detection in combination with a recently proposed methodology to retrieve the Cirrus clouds macrophysical and optical features. In this sense, a few case studies of cirrus clouds observed at both subtropical and polar latitudes are examined and compared to CALIPSO/CALIOP observations. Lidar measurements are carried out in two stations: the Metropolitan city of Sao Paulo (MSP, Brazil, 23.3°S 46.4°W, located at subtropical latitudes, and the Belgrano II base (BEL, Argentina, 78ºS 35ºW in the Antarctic continent. Optical (COD-cloud optical depth and LR-Lidar Ratio and macrophysical (top/base heights and thickness properties of both the subtropical and polar cirrus clouds are reported. In general, subtropical Cirrus clouds present lower LR values and are found at higher altitudes than those detected at polar latitudes. In general, Cirrus clouds are detected at similar altitudes by CALIOP. However, a poor agreement is achieved in the LR retrieved between ground-based lidars and space-borne CALIOP measurements, likely due to the use of a fixed (or low-variable LR value in CALIOP inversion procedures.

  2. Some observations on phosphate based corrosion inhibitors in preventing carbon steel corrosion

    International Nuclear Information System (INIS)

    Anupkumar, B.; Satpathy, K.K.

    2000-01-01

    Among the various types of phosphonic acid based inhibitors assayed, namely HEDP, ATMP and a commercial corrosion inhibitor (code named Betz), it was found that Betz has the maximum amount of organic phosphate followed by HEDP and ATMP. The corrosion rate studies show that Betz gives the highest inhibition efficiency followed by HEDP and ATMP. This shows that organic phosphate plays a significant role in corrosion protection. However, it was observed that due to synergestic effect, HEDP in the presence of Zn 2+ gave a better corrosion protection than Betz. The results are discussed in the light of available literature. (author)

  3. Adaptive observer based synchronization of a class of uncertain chaotic systems

    International Nuclear Information System (INIS)

    Bowong, S.; Yamapi, R.

    2005-05-01

    This study addresses the adaptive synchronization of a class of uncertain chaotic systems in the drive-response framework. For a class of uncertain chaotic systems with unknown parameters and external disturbances, a robust adaptive observer based response system is constructed to synchronize the uncertain chaotic system. Lyapunov stability theory and Barbalat lemma ensure the global synchronization between the drive and response systems even if Lipschitz constants on function matrices and bounds on uncertainties are unknown. Numerical simulation of the Genesio-Tesi system verifies the effectiveness of the proposed method. (author)

  4. Advancing land surface model development with satellite-based Earth observations

    Science.gov (United States)

    Orth, Rene; Dutra, Emanuel; Trigo, Isabel F.; Balsamo, Gianpaolo

    2017-04-01

    The land surface forms an essential part of the climate system. It interacts with the atmosphere through the exchange of water and energy and hence influences weather and climate, as well as their predictability. Correspondingly, the land surface model (LSM) is an essential part of any weather forecasting system. LSMs rely on partly poorly constrained parameters, due to sparse land surface observations. With the use of newly available land surface temperature observations, we show in this study that novel satellite-derived datasets help to improve LSM configuration, and hence can contribute to improved weather predictability. We use the Hydrology Tiled ECMWF Scheme of Surface Exchanges over Land (HTESSEL) and validate it comprehensively against an array of Earth observation reference datasets, including the new land surface temperature product. This reveals satisfactory model performance in terms of hydrology, but poor performance in terms of land surface temperature. This is due to inconsistencies of process representations in the model as identified from an analysis of perturbed parameter simulations. We show that HTESSEL can be more robustly calibrated with multiple instead of single reference datasets as this mitigates the impact of the structural inconsistencies. Finally, performing coupled global weather forecasts we find that a more robust calibration of HTESSEL also contributes to improved weather forecast skills. In summary, new satellite-based Earth observations are shown to enhance the multi-dataset calibration of LSMs, thereby improving the representation of insufficiently captured processes, advancing weather predictability and understanding of climate system feedbacks. Orth, R., E. Dutra, I. F. Trigo, and G. Balsamo (2016): Advancing land surface model development with satellite-based Earth observations. Hydrol. Earth Syst. Sci. Discuss., doi:10.5194/hess-2016-628

  5. Southeast Atmosphere Studies: learning from model-observation syntheses

    Data.gov (United States)

    U.S. Environmental Protection Agency — Observed and modeled data shown in figure 2b-c. This dataset is associated with the following publication: Mao, J., A. Carlton, R. Cohen, W. Brune, S. Brown, G....

  6. The utility of observational studies in clinical decision making: lessons learned from statin trials.

    Science.gov (United States)

    Foody, JoAnne M; Mendys, Phillip M; Liu, Larry Z; Simpson, Ross J

    2010-05-01

    Contemporary clinical decision making is well supported by a wide variety of information sources, including clinical practice guidelines, position papers, and insights from randomized controlled trials (RCTs). Much of our fundamental understanding of cardiovascular risk factors is based on multiple observations from major epidemiologic studies, such as The Seven Country Studies and the US-based Framingham Heart Study. These studies provided the framework for the development of clinical practice guidelines, including the National Cholesterol Education Program Adult Treatment Panel series. The objective of this article is to highlight the value of observational studies as a complement to clinical trial data for clinical decision making in real-world practice. Although RCTs are still the benchmark for assessing clinical efficacy and safety of a specific therapeutic approach, they may be of limited utility to practitioners who must then adapt the lessons learned from the trial into the patient care environment. The use of well-structured observational studies can improve our understanding of the translation of clinical trials into clinical practice, as demonstrated here with the example of statins. Although such studies have their own limitations, improved techniques for design and analysis have reduced the impact of bias and confounders. The introduction of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines has provided more uniformity for such studies. When used together with RCTs, observational studies can enhance our understanding of effectiveness and utility in real-world clinical practice. In the examples of statin observational studies, the results suggest that relative effectiveness of different statins and potential impact of switching statins should be carefully considered in treating individual patients by practicing physicians.

  7. Pulp polyp - A periapical lesion: Radiographic observational study

    Directory of Open Access Journals (Sweden)

    Kandagal V Suresh

    2015-01-01

    Full Text Available Introduction: Pulp polyp (PP is a chronic hyperplastic condition resulting in formation of granulation tissue and proliferative mass. The radiographic appearance of PP has innumerable presentations. Diagnosing and treatment planning of periapical lesions, heavily relies on the radiographic changes surrounding the root structures. Objective: To evaluate different radiographic periapical changes in clinically detected PP patients. Materials and Methods: Patients reporting to Department of Oral Medicine and Radiology and who were clinically diagnosed with PP by an oral diagnostician were subjected to radiographic examination. Digital intraoral periapical radiographs of 50 patients with PP were taken. Various periapical changes in the digital radiographs were recorded by a skilled oral radiologist. The data obtained was subjected to statistical analysis using SPSS ver 17.0 and P-value was set at <0.05 as significant. Result: Periapical changes like periodontal space widening (PDLW, loss of lamina dura, periapical abscess, periapical granuloma, hypercementosis, condensing osteitis and root resorption were noted. Periodontal space widening was seen in all patients (100%, loss of lamina dura was noted in 72%, periapical rarefying osteitis in 56%, condensing osteitis in 8%, hypercementosis, periapical granuloma, and root resorption were seen in 4% of PP patients. Majority of PP were asymptomatic (66%. Pulp polyp was commonly seen in mandibular first molar followed by mandibular second molar and maxillary first molar. Statistically significant difference was noticed between periapical changes in PP patients (P value <0.0001. All PP patients showed definite periapical changes suggesting it to be a periapical lesion. Conclusion: Pulp polyp is confined to the pulpal portion of the tooth which, may or may not cause changes in periapical region. The results of the present study showed that majority of the PP patients were associated with definite periapical

  8. Multicentre observational study of the Gatekeeper for faecal incontinence.

    Science.gov (United States)

    Ratto, C; Buntzen, S; Aigner, F; Altomare, D F; Heydari, A; Donisi, L; Lundby, L; Parello, A

    2016-02-01

    A variety of therapeutic approaches are available for faecal incontinence. Implantation of Gatekeeper prostheses is a new promising option. The primary endpoint of this prospective observational multicentre study was to assess the clinical efficacy of Gatekeeper implantation in patients with faecal incontinence. Secondary endpoints included the assessment of patients' quality of life, and the feasibility and safety of implantation. Patients with faecal incontinence, with either intact sphincters or internal anal sphincter lesions extending for less than 60° of the anal circumference, were selected. Intersphincteric implantation of six prostheses was performed. At baseline, and 1, 3 and 12 months after implantation, the number of faecal incontinence episodes, Cleveland Clinic Faecal Incontinence, Vaizey and American Medical Systems, Faecal Incontinence Quality of Life Scale and Short Form 36 Health Survey scores were recorded. Endoanal ultrasonography was performed at baseline and follow-up. Fifty-four patients were implanted. After Gatekeeper implantation, incontinence to gas, liquid and solid stool improved significantly, soiling was reduced, and ability to defer defaecation enhanced. All faecal incontinence severity scores were significantly reduced, and patients' quality of life improved. At 12 months, 30 patients (56 per cent) showed at least 75 per cent improvement in all faecal incontinence parameters, and seven (13 per cent) became fully continent. In three patients a single prosthesis was extruded during surgery, but was replaced immediately. After implantation, prosthesis dislodgement occurred in three patients; no replacement was required. Anal implantation of the Gatekeeper in patients with faecal incontinence was effective and safe. Clinical benefits were sustained at 1-year follow-up. © 2015 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.

  9. Observer-Based Load Frequency Control for Island Microgrid with Photovoltaic Power

    Directory of Open Access Journals (Sweden)

    Chaoxu Mu

    2017-01-01

    Full Text Available As renewable energy is widely integrated into the power system, the stochastic and intermittent power generation from renewable energy may cause system frequency deviating from the prescribed level, especially for a microgrid. In this paper, the load frequency control (LFC of an island microgrid with photovoltaic (PV power and electric vehicles (EVs is investigated, where the EVs can be treated as distributed energy storages. Considering the disturbances from load change and PV power, an observer-based integral sliding mode (OISM controller is designed to regulate the frequency back to the prescribed value, where the neural network observer is used to online estimate the PV power. Simulation studies on a benchmark microgrid system are presented to illustrate the effectiveness of OISM controller, and comparative results also demonstrate that the proposed method has a superior performance for stabilizing the frequency over the PID control.

  10. Disturbance attenuation of nonlinear control systems using an observer-based fuzzy feedback linearization control

    International Nuclear Information System (INIS)

    Chen, C.-C.; Hsu, C.-H.; Chen, Y.-J.; Lin, Y.-F.

    2007-01-01

    The almost disturbance decoupling and trajectory tracking of nonlinear control systems using an observer-based fuzzy feedback linearization control (FLC) is developed. Because not all of the state variables of the nonlinear dynamic equations are available, a nonlinear state observer is employed to estimate the state variables. The feedback linearization control guarantees the almost disturbance decoupling performance and the uniform ultimate bounded stability of the tracking error system. Once the tracking errors are driven to touch the global final attractor with the desired radius, the fuzzy logic control is immediately applied via human expert's knowledge to improve the convergence rate. One example, which cannot be solved by the first paper on the almost disturbance decoupling problem, is proposed in this paper to exploit the fact that the tracking and the almost disturbance decoupling performances are easily achieved by our proposed approach. In order to demonstrate the practical applicability, the study has investigated a pendulum control system

  11. Sliding mode disturbance observer-based control of a twin rotor MIMO system.

    Science.gov (United States)

    Rashad, Ramy; El-Badawy, Ayman; Aboudonia, Ahmed

    2017-07-01

    This work proposes a robust tracking controller for a helicopter laboratory setup known as the twin rotor MIMO system (TRMS) using an integral sliding mode controller. To eliminate the discontinuity in the control signal, the controller is augmented by a sliding mode disturbance observer. The actuator dynamics is handled using a backstepping approach which is