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The brain-derived neurotrophic factor pathway, life stress, and chronic multi-site musculoskeletal pain.

Science.gov (United States)

Generaal, Ellen; Milaneschi, Yuri; Jansen, Rick; Elzinga, Bernet M; Dekker, Joost; Penninx, Brenda W J H

2016-01-01

Brain-derived neurotrophic factor (BDNF) disturbances and life stress, both independently and in interaction, have been hypothesized to induce chronic pain. We examined whether (a) the BDNF pathway (val(66)met genotype, gene expression, and serum levels), (b) early and recent life stress, and (c) their interaction are associated with the presence and severity of chronic multi-site musculoskeletal pain. Cross-sectional data are from 1646 subjects of the Netherlands Study of Depression and Anxiety. The presence and severity of chronic multi-site musculoskeletal pain were determined using the Chronic Pain Grade (CPG) questionnaire. The BDNF val(66)met polymorphism, BDNF gene expression, and BDNF serum levels were measured. Early life stress before the age of 16 was assessed by calculating a childhood trauma index using the Childhood Trauma Interview. Recent life stress was assessed as the number of recent adverse life events using the List of Threatening Events Questionnaire. Compared to val(66)val, BDNF met carriers more often had chronic pain, whereas no differences were found for BDNF gene expression and serum levels. Higher levels of early and recent stress were both associated with the presence and severity of chronic pain (p stress in the associations with chronic pain presence and severity. This study suggests that the BDNF gene marks vulnerability for chronic pain. Although life stress did not alter the impact of BDNF on chronic pain, it seems an independent factor in the onset and persistence of chronic pain. © The Author(s) 2016.
On multi-site damage identification using single-site training data

Science.gov (United States)

Barthorpe, R. J.; Manson, G.; Worden, K.

2017-11-01

This paper proposes a methodology for developing multi-site damage location systems for engineering structures that can be trained using single-site damaged state data only. The methodology involves training a sequence of binary classifiers based upon single-site damage data and combining the developed classifiers into a robust multi-class damage locator. In this way, the multi-site damage identification problem may be decomposed into a sequence of binary decisions. In this paper Support Vector Classifiers are adopted as the means of making these binary decisions. The proposed methodology represents an advancement on the state of the art in the field of multi-site damage identification which require either: (1) full damaged state data from single- and multi-site damage cases or (2) the development of a physics-based model to make multi-site model predictions. The potential benefit of the proposed methodology is that a significantly reduced number of recorded damage states may be required in order to train a multi-site damage locator without recourse to physics-based model predictions. In this paper it is first demonstrated that Support Vector Classification represents an appropriate approach to the multi-site damage location problem, with methods for combining binary classifiers discussed. Next, the proposed methodology is demonstrated and evaluated through application to a real engineering structure - a Piper Tomahawk trainer aircraft wing - with its performance compared to classifiers trained using the full damaged-state dataset.
Simulation-optimization framework for multi-site multi-season hybrid stochastic streamflow modeling

Science.gov (United States)

Srivastav, Roshan; Srinivasan, K.; Sudheer, K. P.

2016-11-01

A simulation-optimization (S-O) framework is developed for the hybrid stochastic modeling of multi-site multi-season streamflows. The multi-objective optimization model formulated is the driver and the multi-site, multi-season hybrid matched block bootstrap model (MHMABB) is the simulation engine within this framework. The multi-site multi-season simulation model is the extension of the existing single-site multi-season simulation model. A robust and efficient evolutionary search based technique, namely, non-dominated sorting based genetic algorithm (NSGA - II) is employed as the solution technique for the multi-objective optimization within the S-O framework. The objective functions employed are related to the preservation of the multi-site critical deficit run sum and the constraints introduced are concerned with the hybrid model parameter space, and the preservation of certain statistics (such as inter-annual dependence and/or skewness of aggregated annual flows). The efficacy of the proposed S-O framework is brought out through a case example from the Colorado River basin. The proposed multi-site multi-season model AMHMABB (whose parameters are obtained from the proposed S-O framework) preserves the temporal as well as the spatial statistics of the historical flows. Also, the other multi-site deficit run characteristics namely, the number of runs, the maximum run length, the mean run sum and the mean run length are well preserved by the AMHMABB model. Overall, the proposed AMHMABB model is able to show better streamflow modeling performance when compared with the simulation based SMHMABB model, plausibly due to the significant role played by: (i) the objective functions related to the preservation of multi-site critical deficit run sum; (ii) the huge hybrid model parameter space available for the evolutionary search and (iii) the constraint on the preservation of the inter-annual dependence. Split-sample validation results indicate that the AMHMABB model is
High prevalence of daily and multi-site pain

DEFF Research Database (Denmark)

Rathleff, Michael Skovdal; Roos, Ewa M.; Olesen, Jens Lykkegaard

2013-01-01

Daily pain and multi-site pain are both associated with reduction in work ability and health-related quality of life (HRQoL) among adults. However, no population-based studies have yet investigated the prevalence of daily and multi-site pain among adolescents and how these are associated...... with respondent characteristics. The purpose of this study was to investigate the prevalence of self-reported daily and multi-site pain among adolescents aged 12--19 years and associations of almost daily pain and multi-site pain with respondent characteristics (sex, age, body mass index (BMI), HRQoL and sports...
Multi-Sited Resilience

DEFF Research Database (Denmark)

Olwig, Mette Fog

2012-01-01

with natural disasters and climate change. In a globalized world, however, it is hard to discern what is “local” as global organizations play an increasingly visible and powerful role. This paper will argue that local understandings and practices of resilience cannot be disentangled from global understandings...... flooding in northern Ghana, this paper examines the mutual construction of “local” and “global” notions and practices of resilience through multi-sited processes. It is based on interviews and participant observation in multiple sites at the “local,” “regional” and “global” levels....
Shared worlds: multi-sited ethnography and nursing research.

Science.gov (United States)

Molloy, Luke; Walker, Kim; Lakeman, Richard

2017-03-22

Background Ethnography, originally developed for the study of supposedly small-scale societies, is now faced with an increasingly mobile, changing and globalised world. Cultural identities can exist without reference to a specific location and extend beyond regional and national boundaries. It is therefore no longer imperative that the sole object of the ethnographer's practice should be a geographically bounded site. Aim To present a critical methodological review of multi-sited ethnography. Discussion Understanding that it can no longer be taken with any certainty that location alone determines culture, multi-sited ethnography provides a method of contextualising multi-sited social phenomena. The method enables researchers to examine social phenomena that are simultaneously produced in different locations. It has been used to undertake cultural analysis of diverse areas such as organ trafficking, global organisations, technologies and anorexia. Conclusion The authors contend that multi-sited ethnography is particularly suited to nursing research as it provides researchers with an ethnographic method that is more relevant to the interconnected world of health and healthcare services. Implications for practice Multi-sited ethnography provides nurse researchers with an approach to cultural analysis in areas such as the social determinants of health, healthcare services and the effects of health policies across multiple locations.
Drupal 7 Multi Sites Configuration

CERN Document Server

Butcher, Matt

2012-01-01

Follow the creation of a multi-site instance with Drupal. The practical examples and accompanying screenshots will help you to get multiple Drupal sites set up in no time. This book is for Drupal site builders. It is assumed that readers are familiar with Drupal already, with a basic grasp of its concepts and components. System administration concepts, such as configuring Apache, MySQL, and Vagrant are covered but no previous knowledge of these tools is required.
A Gateway MultiSite recombination cloning toolkit.

Directory of Open Access Journals (Sweden)

Lena K Petersen

Full Text Available The generation of DNA constructs is often a rate-limiting step in conducting biological experiments. Recombination cloning of single DNA fragments using the Gateway system provided an advance over traditional restriction enzyme cloning due to increases in efficiency and reliability. Here we introduce a series of entry clones and a destination vector for use in two, three, and four fragment Gateway MultiSite recombination cloning whose advantages include increased flexibility and versatility. In contrast to Gateway single-fragment cloning approaches where variations are typically incorporated into model system-specific destination vectors, our Gateway MultiSite cloning strategy incorporates variations in easily generated entry clones that are model system-independent. In particular, we present entry clones containing insertions of GAL4, QF, UAS, QUAS, eGFP, and mCherry, among others, and demonstrate their in vivo functionality in Drosophila by using them to generate expression clones including GAL4 and QF drivers for various trp ion channel family members, UAS and QUAS excitatory and inhibitory light-gated ion channels, and QUAS red and green fluorescent synaptic vesicle markers. We thus establish a starter toolkit of modular Gateway MultiSite entry clones potentially adaptable to any model system. An inventory of entry clones and destination vectors for Gateway MultiSite cloning has also been established (www.gatewaymultisite.org.
Comparing clinical attachment level and pocket depth for predicting periodontal disease progression in healthy sites of patients with chronic periodontitis using multi-state Markov models.

Science.gov (United States)

Mdala, Ibrahimu; Olsen, Ingar; Haffajee, Anne D; Socransky, Sigmund S; Thoresen, Magne; de Blasio, Birgitte Freiesleben

2014-09-01

To understand degeneration of healthy sites and identify factors associated with disease progression in patients with chronic periodontitis. Data on healthy sites from 163 American and Swedish subjects were analysed using two-three-state (health, gingivitis, chronic periodontitis) Markov models based on bleeding on probing (BOP), and either clinical attachment level (CAL) + BOP or pocket depth (PD) + BOP. In 2 years, 10% (CAL + BOP) and 3% (PD + BOP) of healthy sites developed chronic periodontitis. On average, healthy sites remained healthy for 32 months before transiting in both models. Most transitions (87-97%) from health were to the gingivitis state. The expected duration of the gingivitis lesion was 4-5 months and sites recovered with a high probability (96-98%). Disease severity as measured by number of sites with CAL/PD > 4 mm at baseline and smoking, were associated with fast progression from health to chronic periodontitis within 6 months as were gingival redness in the PD + BOP model only. With age, the rate of disease progression to gingivitis decreased. Transition probabilities for gingivitis and chronic periodontitis were higher with CAL + BOP than with PD + BOP. Smoking and disease severity were significant predictors for fast progression. © 2014 The Authors. Journal of Clinical Periodontology Published by John Wiley & Sons Ltd.
Comparing clinical attachment level and pocket depth for predicting periodontal disease progression in healthy sites of patients with chronic periodontitis using multi-state Markov models

Science.gov (United States)

Mdala, Ibrahimu; Olsen, Ingar; Haffajee, Anne D; Socransky, Sigmund S; Thoresen, Magne; de Blasio, Birgitte Freiesleben

2014-01-01

Aim To understand degeneration of healthy sites and identify factors associated with disease progression in patients with chronic periodontitis. Material and Methods Data on healthy sites from 163 American and Swedish subjects were analysed using two-three-state (health, gingivitis, chronic periodontitis) Markov models based on bleeding on probing (BOP), and either clinical attachment level (CAL) + BOP or pocket depth (PD) + BOP. Results In 2 years, 10% (CAL + BOP) and 3% (PD + BOP) of healthy sites developed chronic periodontitis. On average, healthy sites remained healthy for 32 months before transiting in both models. Most transitions (87–97%) from health were to the gingivitis state. The expected duration of the gingivitis lesion was 4–5 months and sites recovered with a high probability (96–98%). Disease severity as measured by number of sites with CAL/PD > 4 mm at baseline and smoking, were associated with fast progression from health to chronic periodontitis within 6 months as were gingival redness in the PD + BOP model only. With age, the rate of disease progression to gingivitis decreased. Conclusion Transition probabilities for gingivitis and chronic periodontitis were higher with CAL + BOP than with PD + BOP. Smoking and disease severity were significant predictors for fast progression. PMID:24888705
Management of Decommissioning on a Multi-Facility Site

International Nuclear Information System (INIS)

Laraia, Michele; McIntyre, Peter; Visagie, Abrie

2008-01-01

The management of the decommissioning of multi-facility sites may be inadequate or inappropriate if based on approaches and strategies developed for sites consisting of only a single facility. The varied nature of activities undertaken, their interfaces and their interdependencies are likely to complicate the management of decommissioning. These issues can be exacerbated where some facilities are entering the decommissioning phase while others are still operational or even new facilities are being built. Multi-facility sites are not uncommon worldwide but perhaps insufficient attention has been paid to optimizing the overall site decommissioning in the context of the entire life cycle of facilities. Decommissioning management arrangements need to be established taking a view across the whole site. A site-wide decommissioning management system is required. This should include a project evaluation and approval process and specific arrangements to manage identified interfaces and interdependencies. A group should be created to manage decommissioning across the site, ensuring adequate and consistent practices in accordance with the management system. Decommissioning management should be aimed at the entire life cycle of facilities. In the case of multi facility sites, the process becomes more complex and decommissioning management arrangements need to be established with a view to the whole site. A site decommissioning management system, a group that is responsible for decommissioning on site, a site project evaluation and approval process and specific arrangements to manage the identified interfaces are key areas of a site decommissioning management structure that need to be addressed to ensure adequate and consistent decommissioning practices. A decommissioning strategy based on single facilities in a sequential manner is deemed inadequate
Holistic approach to multi-unit site risk assessment: Status and Issues

Energy Technology Data Exchange (ETDEWEB)

Kim, Inn Seock; Jang, Mi Suk; Kim, Seoung Rae [Nuclear Engineering Service and Solution Company (NESS), Daejeon Business Agency, Daejeon (Korea, Republic of)

2017-03-15

The events at the Fukushima Daiichi Nuclear Power Station in March 2011 point out, among other matters, that concurrent accidents at multiple units of a site can occur in reality. Although site risk has been deterministically considered to some extent in nuclear power plant siting and design, potential occurrence of multi-unit accident sequences at a site was not investigated in sufficient detail thus far in the nuclear power community. Therefore, there is considerable worldwide interest and research effort directed toward multi-unit site risk assessment, especially in the countries with high-density nuclear-power-plant sites such as Korea. As the technique of probabilistic safety assessment (PSA) has been successfully applied to evaluate the risk associated with operation of nuclear power plants in the past several decades, the PSA having primarily focused on single-unit risks is now being extended to the multi-unit PSA. In this paper we first characterize the site risk with explicit consideration of the risk associated with spent fuel pools as well as the reactor risks. The status of multi-unit risk assessment is discussed next, followed by a description of the emerging issues relevant to the multi-unit risk evaluation from a practical standpoint.
Holistic approach to multi-unit site risk assessment: Status and Issues

International Nuclear Information System (INIS)

Kim, Inn Seock; Jang, Mi Suk; Kim, Seoung Rae

2017-01-01

The events at the Fukushima Daiichi Nuclear Power Station in March 2011 point out, among other matters, that concurrent accidents at multiple units of a site can occur in reality. Although site risk has been deterministically considered to some extent in nuclear power plant siting and design, potential occurrence of multi-unit accident sequences at a site was not investigated in sufficient detail thus far in the nuclear power community. Therefore, there is considerable worldwide interest and research effort directed toward multi-unit site risk assessment, especially in the countries with high-density nuclear-power-plant sites such as Korea. As the technique of probabilistic safety assessment (PSA) has been successfully applied to evaluate the risk associated with operation of nuclear power plants in the past several decades, the PSA having primarily focused on single-unit risks is now being extended to the multi-unit PSA. In this paper we first characterize the site risk with explicit consideration of the risk associated with spent fuel pools as well as the reactor risks. The status of multi-unit risk assessment is discussed next, followed by a description of the emerging issues relevant to the multi-unit risk evaluation from a practical standpoint
Brain white matter changes associated with urological chronic pelvic pain syndrome: Multi-site neuroimaging from a MAPP case-control study

Science.gov (United States)

Huang, Lejian; Kutch, Jason J.; Ellingson, Benjamin M.; Martucci, Katherine T.; Harris, Richard E.; Clauw, Daniel J.; Mackey, Sean; Mayer, Emeran A.; Schaeffer, Anthony J.; Apkarian, A. Vania; Farmer, Melissa A.

2016-01-01

Clinical phenotyping of urological chronic pelvic pain syndromes (UCPPS) in men and women has focused on end-organ abnormalities to identify putative clinical subtypes. Initial evidence of abnormal brain function and structure in male pelvic pain has necessitated large-scale, multi-site investigations into potential UCPPS brain biomarkers. We present the first evidence of regional white matter (axonal) abnormalities in men and women with UCPPS, compared to positive (irritable bowel syndrome, IBS) and healthy controls. Epidemiological and neuroimaging data was collected from participants with UCPPS (n=52), IBS (n=39), and healthy, sex- and age-matched controls (n=61). White matter microstructure, measured as fractional anisotropy (FA), was examined with diffusion tensor imaging (DTI). Group differences in regional FA positively correlated with pain severity, including segments of the right corticospinal tract and right anterior thalamic radiation. Increased corticospinal FA was specific and sensitive to UCPPS, positively correlated with pain severity, and reflected sensory (not affective) features of pain. Reduced anterior thalamic radiation FA distinguished IBS from UCPPS patients and controls, suggesting greater microstructural divergence from normal tract organization. Findings confirm that regional white matter abnormalities characterize UCPPS and can distinguish between visceral diagnoses, suggesting that regional axonal microstructure is either altered with ongoing pain or predisposes its development. PMID:27842046
Multi-Site Clinical Assessment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (MCAM): Design and Implementation of a Prospective/Retrospective Rolling Cohort Study.

Science.gov (United States)

Unger, Elizabeth R; Lin, Jin-Mann S; Tian, Hao; Natelson, Benjamin H; Lange, Gudrun; Vu, Diana; Blate, Michelle; Klimas, Nancy G; Balbin, Elizabeth G; Bateman, Lucinda; Allen, Ali; Lapp, Charles W; Springs, Wendy; Kogelnik, Andreas M; Phan, Catrina C; Danver, Joan; Podell, Richard N; Fitzpatrick, Trisha; Peterson, Daniel L; Gottschalk, C Gunnar; Rajeevan, Mangalathu S

2017-04-15

In the Multi-Site Clinical Assessment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (MCAM), we relied on expert clinician diagnoses to enroll patients from 7 specialty clinics in the United States in order to perform a systematic collection of data on measures of myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS). Healthy persons and those with other illnesses that share some features with ME/CFS were enrolled in comparison groups. The major objectives were to: 1) use standardized questionnaires to measure illness domains of ME/CFS and to evaluate patient heterogeneity overall and between clinics; 2) describe the course of illness, identify the measures that best correlate with meaningful clinical differences, and assess the performances of questionnaires as patient/person-reported outcome measures; 3) describe prescribed medications, orders for laboratory and other tests, and management tools used by expert clinicians to care for persons with ME/CFS; 4) collect biospecimens for future hypothesis testing and for evaluation of morning cortisol profiles; and 5) identify measures that best distinguish persons with ME/CFS from those in the comparison groups and detect subgroups of persons with ME/CFS who may have different underlying causes. Enrollment began in 2012 and is planned to continue in multiple stages through 2017. We present the MCAM methods in detail, along with an initial description of the 471 patients with ME/CFS who were enrolled in stage 1. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Robust, highly customizable, and economical multi-channel electrode for chronic multi-unit recording in behaving animals.

Science.gov (United States)

Tateyama, Yukina; Oyama, Kei; Shiraishi, Masaru; Iijima, Toshio; Tsutsui, Ken-Ichiro

2017-12-01

Multi-unit recording has been one of the most widely used techniques to investigate the correlation between multiple neuronal activities and behavior. However, a common problem of currently used multi-channel electrodes is their physical weakness. In this study, we developed a novel multi-channel electrode with sufficient physical strength to penetrate a thickened dura mater. This electrode consists of low-cost materials and is easily fabricated, and it enables recording without removing dura mater, thereby reducing the risk of inflammation, infection, or brain herniation. The low-cost multi-channel electrode developed in this study would be a useful tool for chronic recording in behaving animals. Copyright © 2017. Published by Elsevier B.V.
Multi-Sited Comparison of "Doing Regulation"

DEFF Research Database (Denmark)

Sørensen, Estrid

2008-01-01

tertium comparationis. Artiklen foreslåt en multi-sited sammenligning, som ikke tager udgangspunkt i tertium comparationis, men derimod identificerer dette som sit resultat. Artiklen redegør for udviklingen af denne metode gennem en undersøgelse af medieregulering med henblik på børnebeskyttelse....
Prioritizing ecological restoration among sites in multi-stressor landscapes.

Science.gov (United States)

Neeson, Thomas M; Smith, Sigrid D P; Allan, J David; McIntyre, Peter B

2016-09-01

Most ecosystems are impacted by multiple local and long-distance stressors, many of which interact in complex ways. We present a framework for prioritizing ecological restoration efforts among sites in multi-stressor landscapes. Using a simple model, we show that both the economic and sociopolitical costs of restoration will typically be lower at sites with a relatively small number of severe problems than at sites with numerous lesser problems. Based on these results, we propose using cumulative stress and evenness of stressor impact as complementary indices that together reflect key challenges of restoring a site to improved condition. To illustrate this approach, we analyze stressor evenness across the world's rivers and the Laurentian Great Lakes. This exploration reveals that evenness and cumulative stress are decoupled, enabling selection of sites where remediating a modest number of high-intensity stressors could substantially reduce cumulative stress. Just as species richness and species evenness are fundamental axes of biological diversity, we argue that cumulative stress and stressor evenness constitute fundamental axes for identifying restoration opportunities in multi-stressor landscapes. Our results highlight opportunities to boost restoration efficiency through strategic use of multi-stressor datasets to identify sites that maximize ecological response per stressor remediated. This prioritization framework can also be expanded to account for the feasibility of remediation and the expected societal benefits of restoration projects. © 2016 by the Ecological Society of America.
Multi-Sited Global Ethnography and Travel: Gendered Journeys in Three Registers

Science.gov (United States)

Epstein, Debbie; Fahey, Johannah; Kenway, Jane

2013-01-01

This paper joins a barely begun conversation about multi-sited and global ethnography in educational research; a conversation that is likely to intensify along with growing interest in the links between education, globalisation, internationalisation and transnationalism. Drawing on an ongoing multi-sited global ethnography of elite schools and…
Design of a multi-site multi-state clinical trial of home monitoring of chronic disease in the community in Australia.

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Celler, Branko G; Sparks, Ross; Nepal, Surya; Alem, Leila; Varnfield, Marlien; Li, Jane; Jang-Jaccard, Julian; McBride, Simon J; Jayasena, Rajiv

2014-12-15

Telehealth services based on at-home monitoring of vital signs and the administration of clinical questionnaires are being increasingly used to manage chronic disease in the community, but few statistically robust studies are available in Australia to evaluate a wide range of health and socio-economic outcomes. The objectives of this study are to use robust statistical methods to research the impact of at home telemonitoring on health care outcomes, acceptability of telemonitoring to patients, carers and clinicians and to identify workplace cultural factors and capacity for organisational change management that will impact on large scale national deployment of telehealth services. Additionally, to develop advanced modelling and data analytics tools to risk stratify patients on a daily basis to automatically identify exacerbations of their chronic conditions. A clinical trial is proposed at five locations in five states and territories along the Eastern Seaboard of Australia. Each site will have 25 Test patients and 50 case matched control patients. All participants will be selected based on clinical criteria of at least two hospitalisations in the previous year or four or more admissions over the last five years for a range of one or more chronic conditions. Control patients are matched according to age, sex, major diagnosis and their Socio-Economic Indexes for Areas (SEIFA). The Trial Design is an Intervention control study based on the Before-After-Control-Impact (BACI) design. Our preliminary data indicates that most outcome variables before and after the intervention are not stationary, and accordingly we model this behaviour using linear mixed-effects (lme) models which can flexibly model within-group correlation often present in longitudinal data with repeated measures. We expect reduced incidence of unscheduled hospitalisation as well as improvement in the management of chronically ill patients, leading to better and more cost effective care. Advanced data

Safety assessment of multi-unit NPP sites subject to external events

International Nuclear Information System (INIS)

Samaddar, Sujit; Hibino, Kenta; Coman, Ovidiu

2014-01-01

This paper presents a framework for conducting a probabilistic safety assessment of multi-unit sites against external events. The treatment of multiple hazard on a unit, interaction between units, implementation of severe accident measures, human reliability, environmental conditions, metric of risk for both reactor and non-reactor sources, integration of risk and responses and many such important factors need to be addressed within the context of this framework. The framework facilitates the establishment of a comprehensive methodology that can be applied internationally to the peer review of safety assessment of multi-unit sites under the impact of multiple external hazards. In summary, it can be said that the site safety assessment for a multi-unit site will be quite complex and need to start with individual unit risk assessments, these need to be combined considering the interactions between units and their responses, and the fragilities of the installations established considering the combined demands from all interactions. Using newly established risk metric the risk can then be integrated for the overall site. Fig. 2 shows schematically such a proposal. Much work has to done and the IAEA has established a working group that is systematically establishing the structure and process to incorporate the many issues that are a part of a multi-unit site safety assessment. (authors)
Chronic Neck Pain Assessment using Multi-Frequency Bioimpedance

DEFF Research Database (Denmark)

Fener, Dilay Kesgin; Bartels, Else Marie; Elbrønd, Vibeke Sødring

2016-01-01

Scope: Chronic neck pain (CNP) is a disabling condition where the cause is often unknown, making treatment difficult. Muscle involvement is suspected in most cases, and assessment of muscle condition and changes following treatment may be possible with multi-frequency bioimpedance (mfBIA). Our aim...... involvement in chronic neck pain patients. AtlasBalans treatment did not show any clear indication as being an efficient form of treatment to relieve muscle tension in CNP patients....... was to test mfBIA as an assessment method of possible involvement of the neck, back and other related muscles in two CNP patients, prior to and following physiotherapy treatment with AtlasBalans. Methods: mfBIA measurements were carried out pre-treatment on m. sternocleidomastoideus, m. trapezius, upper back...
Multi-site and multi-depth near-infrared spectroscopy in a model of simulated (central) hypovolemia: Lower body negative pressure

NARCIS (Netherlands)

S.A. Bartels (Sebastiaan); R. Bezemer (Rick); F.J.W. Wallis de Vries (Floris); D.M.J. Milstein (Dan); A.A.P. Lima (Alexandre ); T.G.V. Cherpanath (Thomas); A.H. van den Meiracker (Anton); J. van Bommel (Jasper); M. Heger (Michal); J.M. Karemaker (John); C. Ince (Can)

2011-01-01

textabstractPurpose: To test the hypothesis that the sensitivity of near-infrared spectroscopy (NIRS) in reflecting the degree of (compensated) hypovolemia would be affected by the application site and probing depth. We simultaneously applied multi-site (thenar and forearm) and multi-depth (15-2.5
Multi-Sited Ethnography and the Field of Educational Research

Science.gov (United States)

Pierides, Dean

2010-01-01

This paper responds to the challenge of how educational research might be practised in a contemporary world that is no longer necessarily organised by nearness and unity. Focusing on ethnography, it argues for what a multi-sited imaginary contributes to research in the field of education. By giving prominence to the notion of multi-sited…
Risk analysis of NPP in multi-unit site for configuration of AAC power source

International Nuclear Information System (INIS)

Kim, Myung Ki

2000-01-01

Because of the difficulties in finding new sites for nuclear power plants, more units are being added to the existing sites. In these multi-unit sites, appropriate countermeasures should be established to cope with the potential station blackout (SBO) accident. Currently, installation of additional diesel generator (DG) is considered to ensure an alternative AC power source, but it has not been decided yet how many DGs should be installed in a multi-unit site. In this paper, risk informed decision making method, which evaluates reliability of electrical system, core damage frequency, and site average core damage frequency, is introduced to draw up the suitable number of DG in multi-unit site. The analysis results show that installing two DGs lowered the site average core damage frequency by 1.4% compared to one DG in six unit site. In the light of risk-informed decisions in regulatory guide 1.174, there is no difference of safety between two alternatives. It is concluded that one emergency diesel generator sufficiently guarantees safety against station blackout of nuclear power plants in multi-unit site. (author)
Chronic gastritis in China: a national multi-center survey.

Science.gov (United States)

Du, Yiqi; Bai, Yu; Xie, Pei; Fang, Jingyuan; Wang, Xiaozhong; Hou, Xiaohua; Tian, Dean; Wang, Chengdang; Liu, Yandi; Sha, Weihong; Wang, Bangmao; Li, Yanqing; Zhang, Guoliang; Li, Yan; Shi, Ruihua; Xu, Jianming; Li, Youming; Huang, Minghe; Han, Shengxi; Liu, Jie; Ren, Xu; Xie, Pengyan; Wang, Zhangliu; Cui, Lihong; Sheng, Jianqiu; Luo, Hesheng; Wang, Zhaohui; Zhao, Xiaoyan; Dai, Ning; Nie, Yuqiang; Zou, Yiyou; Xia, Bing; Fan, Zhining; Chen, Zhitan; Lin, Sanren; Li, Zhao-Shen

2014-02-07

Chronic gastritis is one of the most common findings at upper endoscopy in the general population, and chronic atrophic gastritis is epidemiologically associated with the occurrence of gastric cancer. However, the current status of diagnosis and treatment of chronic gastritis in China is unclear. A multi-center national study was performed; all patients who underwent diagnostic upper endoscopy for evaluation of gastrointestinal symptoms from 33 centers were enrolled. Data including sex, age, symptoms and endoscopic findings were prospectively recorded. Totally 8892 patients were included. At endoscopy, 4389, 3760 and 1573 patients were diagnosed to have superficial gastritis, erosive gastritis, and atrophic gastritis, respectively. After pathologic examination, it is found that atrophic gastritis, intestinal metaplasia and dysplasia were prevalent, which accounted for 25.8%, 23.6% and 7.3% of this patient population. Endoscopic features were useful for predicting pathologic atrophy (PLR = 4.78), but it was not useful for predicting erosive gastritis. Mucosal-protective agents and PPI were most commonly used medications for chronic gastritis. The present study suggests non-atrophic gastritis is the most common endoscopic finding in Chinese patients with upper GI symptoms. Precancerous lesions, including atrophy, intestinal metaplasia and dysplasia are prevalent in Chinese patients with chronic gastritis, and endoscopic features are useful for predicting pathologic atrophy.
Work-related determinants of multi-site musculoskeletal pain among employees in the health care sector.

Science.gov (United States)

Neupane, Subas; Nygård, Clas-Håkan; Oakman, Jodi

2016-06-16

Work-related musculoskeletal pain is a major occupational problem. Those with pain in multiple sites usually report worse health outcomes than those with pain in one site. This study explored prevalence and associated predictors of multi-site pain in health care sector employees. Survey responses from 1348 health care sector employees across three organisations (37% response rate) collected data on job satisfaction, work life balance, psychosocial and physical hazards, general health and work ability. Musculoskeletal discomfort was measured across 5 body regions with pain in ≥ 2 sites defined as multi-site pain. Generalized linear models were used to identify relationships between work-related factors and multi-site pain. Over 52% of the employees reported pain in multiple body sites and 19% reported pain in one site. Poor work life balance (PRR = 2.33, 95% CI = 1.06-5.14). physical (PRR = 7.58, 95% CI = 4.89-11.77) and psychosocial (PRR = 1.59, 95% CI = 1.00-2.57) hazard variables were related to multi-site pain (after controlling for age, gender, health and work ability. Older employees and females were more likely to report multi-site pain. Effective risk management of work related multi-site pain must include identification and control of psychosocial and physical hazards.
Chronic neural probe for simultaneous recording of single-unit, multi-unit, and local field potential activity from multiple brain sites

Science.gov (United States)

Pothof, F.; Bonini, L.; Lanzilotto, M.; Livi, A.; Fogassi, L.; Orban, G. A.; Paul, O.; Ruther, P.

2016-08-01

Objective. Drug resistant focal epilepsy can be treated by resecting the epileptic focus requiring a precise focus localisation using stereoelectroencephalography (SEEG) probes. As commercial SEEG probes offer only a limited spatial resolution, probes of higher channel count and design freedom enabling the incorporation of macro and microelectrodes would help increasing spatial resolution and thus open new perspectives for investigating mechanisms underlying focal epilepsy and its treatment. This work describes a new fabrication process for SEEG probes with materials and dimensions similar to clinical probes enabling recording single neuron activity at high spatial resolution. Approach. Polyimide is used as a biocompatible flexible substrate into which platinum electrodes and leads are integrated with a minimal feature size of 5 μm. The polyimide foils are rolled into the cylindrical probe shape at a diameter of 0.8 mm. The resulting probe features match those of clinically approved devices. Tests in saline solution confirmed the probe stability and functionality. Probes were implanted into the brain of one monkey (Macaca mulatta), trained to perform different motor tasks. Suitable configurations including up to 128 electrode sites allow the recording of task-related neuronal signals. Main results. Probes with 32 and 64 electrode sites were implanted in the posterior parietal cortex. Local field potentials and multi-unit activity were recorded as early as one hour after implantation. Stable single-unit activity was achieved for up to 26 days after implantation of a 64-channel probe. All recorded signals showed modulation during task execution. Significance. With the novel probes it is possible to record stable biologically relevant data over a time span exceeding the usual time needed for epileptic focus localisation in human patients. This is the first time that single units are recorded along cylindrical polyimide probes chronically implanted 22 mm deep into the
Electronic Cigarette Marketing Online: a Multi-Site, Multi-Product Comparison.

Science.gov (United States)

Chu, Kar-Hai; Sidhu, Anupreet K; Valente, Thomas W

2015-01-01

Electronic cigarette awareness and use has been increasing rapidly. E-cigarette brands have utilized social networking sites to promote their products, as the growth of the e-cigarette industry has paralleled that of Web 2.0. These online platforms are cost-effective and have unique technological features and user demographics that can be attractive for selective marketing. The popularity of multiple sites also poses a risk of exposure to social networks where e-cigarette brands might not have a presence. To examine the marketing strategies of leading e-cigarette brands on multiple social networking sites, and to identify how affordances of the digital media are used to their advantage. Secondary analyses include determining if any brands are benefitting from site demographics, and exploring cross-site diffusion of marketing content through multi-site users. We collected data from two e-cigarette brands from four social networking sites over approximately 2.5 years. Content analysis is used to search for themes, population targeting, marketing strategies, and cross-site spread of messages. Twitter appeared to be the most frequently used social networking site for interacting directly with product users. Facebook supported informational broadcasts, such as announcements regarding political legislation. E-cigarette brands also differed in their approaches to their users, from informal conversations to direct product marketing. E-cigarette makers use different strategies to market their product and engage their users. There was no evidence of direct targeting of vulnerable populations, but the affordances of the different sites are exploited to best broadcast context-specific messages. We developed a viable method to study cross-site diffusion, although additional refinement is needed to account for how different types of digital media are used.
Chronic gastritis in China: a national multi-center survey

Science.gov (United States)

2014-01-01

Background Chronic gastritis is one of the most common findings at upper endoscopy in the general population, and chronic atrophic gastritis is epidemiologically associated with the occurrence of gastric cancer. However, the current status of diagnosis and treatment of chronic gastritis in China is unclear. Methods A multi-center national study was performed; all patients who underwent diagnostic upper endoscopy for evaluation of gastrointestinal symptoms from 33 centers were enrolled. Data including sex, age, symptoms and endoscopic findings were prospectively recorded. Results Totally 8892 patients were included. At endoscopy, 4389, 3760 and 1573 patients were diagnosed to have superficial gastritis, erosive gastritis, and atrophic gastritis, respectively. After pathologic examination, it is found that atrophic gastritis, intestinal metaplasia and dysplasia were prevalent, which accounted for 25.8%, 23.6% and 7.3% of this patient population. Endoscopic features were useful for predicting pathologic atrophy (PLR = 4.78), but it was not useful for predicting erosive gastritis. Mucosal-protective agents and PPI were most commonly used medications for chronic gastritis. Conclusions The present study suggests non-atrophic gastritis is the most common endoscopic finding in Chinese patients with upper GI symptoms. Precancerous lesions, including atrophy, intestinal metaplasia and dysplasia are prevalent in Chinese patients with chronic gastritis, and endoscopic features are useful for predicting pathologic atrophy. PMID:24502423
Tools and Methods for Risk Management in Multi-Site Engineering Projects

Science.gov (United States)

Zhou, Mingwei; Nemes, Laszlo; Reidsema, Carl; Ahmed, Ammar; Kayis, Berman

In today's highly global business environment, engineering and manufacturing projects often involve two or more geographically dispersed units or departments, research centers or companies. This paper attempts to identify the requirements for risk management in a multi-site engineering project environment, and presents a review of the state-of-the-art tools and methods that can be used to manage risks in multi-site engineering projects. This leads to the development of a risk management roadmap, which will underpin the design and implementation of an intelligent risk mapping system.
Efficient multi-site two-photon functional imaging of neuronal circuits.

Science.gov (United States)

Castanares, Michael Lawrence; Gautam, Vini; Drury, Jack; Bachor, Hans; Daria, Vincent R

2016-12-01

Two-photon imaging using high-speed multi-channel detectors is a promising approach for optical recording of cellular membrane dynamics at multiple sites. A main bottleneck of this technique is the limited number of photons captured within a short exposure time (~1ms). Here, we implement temporal gating to improve the two-photon fluorescence yield from holographically projected multiple foci whilst maintaining a biologically safe incident average power. We observed up to 6x improvement in the signal-to-noise ratio (SNR) in Fluorescein and cultured hippocampal neurons showing evoked calcium transients. With improved SNR, we could pave the way to achieving multi-site optical recording of fluorogenic probes with response times in the order of ~1ms.
HOSPITAL SITE SELECTION USING TWO-STAGE FUZZY MULTI-CRITERIA DECISION MAKING PROCESS

Directory of Open Access Journals (Sweden)

Ali Soltani

2011-06-01

Full Text Available Site selection for sitting of urban activities/facilities is one of the crucial policy-related decisions taken by urban planners and policy makers. The process of site selection is inherently complicated. A careless site imposes exorbitant costs on city budget and damages the environment inevitably. Nowadays, multi-attributes decision making approaches are suggested to use to improve precision of decision making and reduce surplus side effects. Two well-known techniques, analytical hierarchal process and analytical network process are among multi-criteria decision making systems which can easily be consistent with both quantitative and qualitative criteria. These are also developed to be fuzzy analytical hierarchal process and fuzzy analytical network process systems which are capable of accommodating inherent uncertainty and vagueness in multi-criteria decision-making. This paper reports the process and results of a hospital site selection within the Region 5 of Shiraz metropolitan area, Iran using integrated fuzzy analytical network process systems with Geographic Information System (GIS. The weights of the alternatives were calculated using fuzzy analytical network process. Then a sensitivity analysis was conducted to measure the elasticity of a decision in regards to different criteria. This study contributes to planning practice by suggesting a more comprehensive decision making tool for site selection.
HOSPITAL SITE SELECTION USING TWO-STAGE FUZZY MULTI-CRITERIA DECISION MAKING PROCESS

Directory of Open Access Journals (Sweden)

Ali Soltani

2011-01-01

Full Text Available Site selection for sitting of urban activities/facilities is one of the crucial policy-related decisions taken by urban planners and policy makers. The process of site selection is inherently complicated. A careless site imposes exorbitant costs on city budget and damages the environment inevitably. Nowadays, multi-attributes decision making approaches are suggested to use to improve precision of decision making and reduce surplus side effects. Two well-known techniques, analytical hierarchal process and analytical network process are among multi-criteria decision making systems which can easily be consistent with both quantitative and qualitative criteria. These are also developed to be fuzzy analytical hierarchal process and fuzzy analytical network process systems which are capable of accommodating inherent uncertainty and vagueness in multi-criteria decision-making. This paper reports the process and results of a hospital site selection within the Region 5 of Shiraz metropolitan area, Iran using integrated fuzzy analytical network process systems with Geographic Information System (GIS. The weights of the alternatives were calculated using fuzzy analytical network process. Then a sensitivity analysis was conducted to measure the elasticity of a decision in regards to different criteria. This study contributes to planning practice by suggesting a more comprehensive decision making tool for site selection.
Network cyberinfrastructure as a shared platform to support multi-site research

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Multi-site research across the Long-term Agroecosystem Research (LTAR) network requires access to data and information. We present some existing examples where you can get data from across the network and summarize the rich inventory of measurements taken across LTAR sites. But data management suppo...
Hydrological modeling using a multi-site stochastic weather generator

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Weather data is usually required at several locations over a large watershed, especially when using distributed models for hydrological simulations. In many applications, spatially correlated weather data can be provided by a multi-site stochastic weather generator which considers the spatial correl...
Exploring the feasibility of multi-site flow cytometric processing of gut associated lymphoid tissue with centralized data analysis for multi-site clinical trials.

Directory of Open Access Journals (Sweden)

Ian McGowan

Full Text Available The purpose of this study was to determine whether the development of a standardized approach to the collection of intestinal tissue from healthy volunteers, isolation of gut associated lymphoid tissue mucosal mononuclear cells (MMC, and characterization of mucosal T cell phenotypes by flow cytometry was sufficient to minimize differences in the normative ranges of flow parameters generated at two trial sites. Forty healthy male study participants were enrolled in Pittsburgh and Los Angeles. MMC were isolated from rectal biopsies using the same biopsy acquisition and enzymatic digestion protocols. As an additional comparator, peripheral blood mononuclear cells (PBMC were collected from the study participants. For quality control, cryopreserved PBMC from a single donor were supplied to both sites from a central repository (qPBMC. Using a jointly optimized standard operating procedure, cells were isolated from tissue and blood and stained with monoclonal antibodies targeted to T cell phenotypic markers. Site-specific flow data were analyzed by an independent center which analyzed all data from both sites. Ranges for frequencies for overall CD4+ and CD8+ T cells, derived from the qPBMC samples, were equivalent at both UCLA and MWRI. However, there were significant differences across sites for the majority of T cell activation and memory subsets in qPBMC as well as PBMC and MMC. Standardized protocols to collect, stain, and analyze MMC and PBMC, including centralized analysis, can reduce but not exclude variability in reporting flow data within multi-site studies. Based on these data, centralized processing, flow cytometry, and analysis of samples may provide more robust data across multi-site studies. Centralized processing requires either shipping of fresh samples or cryopreservation and the decision to perform centralized versus site processing needs to take into account the drawbacks and restrictions associated with each method.
Exploring the feasibility of multi-site flow cytometric processing of gut associated lymphoid tissue with centralized data analysis for multi-site clinical trials.

Science.gov (United States)

McGowan, Ian; Anton, Peter A; Elliott, Julie; Cranston, Ross D; Duffill, Kathryn; Althouse, Andrew D; Hawkins, Kevin L; De Rosa, Stephen C

2015-01-01

The purpose of this study was to determine whether the development of a standardized approach to the collection of intestinal tissue from healthy volunteers, isolation of gut associated lymphoid tissue mucosal mononuclear cells (MMC), and characterization of mucosal T cell phenotypes by flow cytometry was sufficient to minimize differences in the normative ranges of flow parameters generated at two trial sites. Forty healthy male study participants were enrolled in Pittsburgh and Los Angeles. MMC were isolated from rectal biopsies using the same biopsy acquisition and enzymatic digestion protocols. As an additional comparator, peripheral blood mononuclear cells (PBMC) were collected from the study participants. For quality control, cryopreserved PBMC from a single donor were supplied to both sites from a central repository (qPBMC). Using a jointly optimized standard operating procedure, cells were isolated from tissue and blood and stained with monoclonal antibodies targeted to T cell phenotypic markers. Site-specific flow data were analyzed by an independent center which analyzed all data from both sites. Ranges for frequencies for overall CD4+ and CD8+ T cells, derived from the qPBMC samples, were equivalent at both UCLA and MWRI. However, there were significant differences across sites for the majority of T cell activation and memory subsets in qPBMC as well as PBMC and MMC. Standardized protocols to collect, stain, and analyze MMC and PBMC, including centralized analysis, can reduce but not exclude variability in reporting flow data within multi-site studies. Based on these data, centralized processing, flow cytometry, and analysis of samples may provide more robust data across multi-site studies. Centralized processing requires either shipping of fresh samples or cryopreservation and the decision to perform centralized versus site processing needs to take into account the drawbacks and restrictions associated with each method.
Ethics Review for a Multi-Site Project Involving Tribal Nations in the Northern Plains.

Science.gov (United States)

Angal, Jyoti; Petersen, Julie M; Tobacco, Deborah; Elliott, Amy J

2016-04-01

Increasingly, Tribal Nations are forming ethics review panels, which function separately from institutional review boards (IRBs). The emergence of strong community representation coincides with a widespread effort supported by the U.S. Department of Health & Human Services and other federal agencies to establish a single IRB for all multi-site research. This article underscores the value of a tribal ethics review board and describes the tribal oversight for the Safe Passage Study-a multi-site, community-based project in the Northern Plains. Our experience demonstrates the benefits of tribal ethics review and makes a strong argument for including tribal oversight in future regulatory guidance for multi-site, community-based research. © The Author(s) 2016.
Analytic hierarchy process-based approach for selecting a Pareto-optimal solution of a multi-objective, multi-site supply-chain planning problem

Science.gov (United States)

Ayadi, Omar; Felfel, Houssem; Masmoudi, Faouzi

2017-07-01

The current manufacturing environment has changed from traditional single-plant to multi-site supply chain where multiple plants are serving customer demands. In this article, a tactical multi-objective, multi-period, multi-product, multi-site supply-chain planning problem is proposed. A corresponding optimization model aiming to simultaneously minimize the total cost, maximize product quality and maximize the customer satisfaction demand level is developed. The proposed solution approach yields to a front of Pareto-optimal solutions that represents the trade-offs among the different objectives. Subsequently, the analytic hierarchy process method is applied to select the best Pareto-optimal solution according to the preferences of the decision maker. The robustness of the solutions and the proposed approach are discussed based on a sensitivity analysis and an application to a real case from the textile and apparel industry.

Multi-site musculoskeletal pain in Swedish police: associations with discomfort from wearing mandatory equipment and prolonged sitting.

Science.gov (United States)

Larsen, Louise Bæk; Andersson, Elisabeth Elgmark; Tranberg, Roy; Ramstrand, Nerrolyn

2018-05-01

Musculoskeletal disorders are considered as a major issue affecting the health and well-being of active duty police. Discomfort from wearing mandatory equipment and sitting for long periods of time in fleet vehicles are workload factors linked to musculoskeletal disorders in police. This study aims to determine the prevalence of multi-site musculoskeletal pain among Swedish police and to explore the possible association to discomfort experience when wearing mandatory equipment and sitting for long periods in fleet vehicles. In this cross-sectional study responses from 4185 police were collected through a self-administered online survey including questions about physical work environment, mandatory equipment and musculoskeletal pain. Multi-site pain was determined through summing pain sites from four body regions. Binomial logistic regression was performed to explore the association between multi-site musculoskeletal pain: (1) discomfort from wearing mandatory equipment and (2) sitting for long periods in fleet vehicles. The prevalence of multi-site musculoskeletal pain at least 1 day per week within the previous 3 months was 41.3%. A statistically significant association between discomfort from wearing mandatory equipment and multi-site musculoskeletal pain was found; duty belt [OR 5.42 (95% CI 4.56-6.43)] as well as body armour [OR 2.69 (95% CI 2.11-3.42)]. Sitting for long periods in fleet vehicles was not significantly associated to multi-site musculoskeletal pain. Multi-site musculoskeletal pain is a considerable problem among Swedish police and modifying mandatory equipment to decrease discomfort is suggested as a potential means of decreasing the musculoskeletal pain experienced by many police officers.
Factors contributing to intervention fidelity in a multi-site chronic disease self-management program.

Science.gov (United States)

Perrin, Karen M; Burke, Somer Goad; O'Connor, Danielle; Walby, Gary; Shippey, Claire; Pitt, Seraphine; McDermott, Robert J; Forthofer, Melinda S

2006-10-26

Disease self-management programs have been a popular approach to reducing morbidity and mortality from chronic disease. Replicating an evidence-based disease management program successfully requires practitioners to ensure fidelity to the original program design. The Florida Health Literacy Study (FHLS) was conducted to investigate the implementation impact of the Pfizer, Inc. Diabetes Mellitus and Hypertension Disease Self-Management Program based on health literacy principles in 14 community health centers in Florida. The intervention components discussed include health educator recruitment and training, patient recruitment, class sessions, utilization of program materials, translation of program manuals, patient retention and follow-up, and technical assistance. This report describes challenges associated with achieving a balance between adaptation for cultural relevance and fidelity when implementing the health education program across clinic sites. This balance was necessary to achieve effectiveness of the disease self-management program. The FHLS program was implemented with a high degree of fidelity to the original design and used original program materials. Adaptations identified as advantageous to program participation are discussed, such as implementing alternate methods for recruiting patients and developing staff incentives for participation. Effective program implementation depends on the talent, skill and willing participation of clinic staff. Program adaptations that conserve staff time and resources and recognize their contribution can increase program effectiveness without jeopardizing its fidelity.
Factors contributing to intervention fidelity in a multi-site chronic disease self-management program

Directory of Open Access Journals (Sweden)

Pitt Seraphine

2006-10-01

Full Text Available Abstract Background and objectives Disease self-management programs have been a popular approach to reducing morbidity and mortality from chronic disease. Replicating an evidence-based disease management program successfully requires practitioners to ensure fidelity to the original program design. Methods The Florida Health Literacy Study (FHLS was conducted to investigate the implementation impact of the Pfizer, Inc. Diabetes Mellitus and Hypertension Disease Self-Management Program based on health literacy principles in 14 community health centers in Florida. The intervention components discussed include health educator recruitment and training, patient recruitment, class sessions, utilization of program materials, translation of program manuals, patient retention and follow-up, and technical assistance. Results This report describes challenges associated with achieving a balance between adaptation for cultural relevance and fidelity when implementing the health education program across clinic sites. This balance was necessary to achieve effectiveness of the disease self-management program. The FHLS program was implemented with a high degree of fidelity to the original design and used original program materials. Adaptations identified as advantageous to program participation are discussed, such as implementing alternate methods for recruiting patients and developing staff incentives for participation. Conclusion Effective program implementation depends on the talent, skill and willing participation of clinic staff. Program adaptations that conserve staff time and resources and recognize their contribution can increase program effectiveness without jeopardizing its fidelity.
Psychosocial stress and multi-site musculoskeletal pain: a cross-sectional survey of patient care workers.

Science.gov (United States)

Sembajwe, Grace; Tveito, Torill Helene; Hopcia, Karen; Kenwood, Christopher; O'Day, Elizabeth Tucker; Stoddard, Anne M; Dennerlein, Jack T; Hashimoto, Dean; Sorensen, Glorian

2013-03-01

The aim of this study was to assess the relationship between psychosocial factors at work and multi-site musculoskeletal pain among patient care workers. In a survey of 1,572 workers from two hospitals, occupational psychosocial factors and health outcomes of workers with single and multi-site pain were evaluated using items from the Job Content Questionnaire that was designed to measure psychological demands, decision latitude, and social support. An adapted Nordic Questionnaire provided data on the musculoskeletal pain outcome. Covariates included body mass index, age, gender, and occupation. The analyses revealed statistically significant associations between psychosocial demands and multi-site musculoskeletal pain among patient care associates, nurses, and administrative personnel, both men and women. Supervisor support played a significant role for nurses and women. These results remained statistically significant after adjusting for covariates. These results highlight the associations between workplace psychosocial strain and multi-site musculoskeletal pain, setting the stage for future longitudinal explorations. Copyright 2013, SLACK Incorporated.
Multi-Destination and Multi-Purpose Trip Effects in the Analysis of the Demand for Trips to a Remote Recreational Site

Science.gov (United States)

Martínez-Espiñeira, Roberto; Amoako-Tuffour, Joe

2009-06-01

One of the basic assumptions of the travel cost method for recreational demand analysis is that the travel cost is always incurred for a single purpose recreational trip. Several studies have skirted around the issue with simplifying assumptions and dropping observations considered as nonconventional holiday-makers or as nontraditional visitors from the sample. The effect of such simplifications on the benefit estimates remains conjectural. Given the remoteness of notable recreational parks, multi-destination or multi-purpose trips are not uncommon. This article examines the consequences of allocating travel costs to a recreational site when some trips were taken for purposes other than recreation and/or included visits to other recreational sites. Using a multi-purpose weighting approach on data from Gros Morne National Park, Canada, we conclude that a proper correction for multi-destination or multi-purpose trip is more of what is needed to avoid potential biases in the estimated effects of the price (travel-cost) variable and of the income variable in the trip generation equation.
Progress in centralised ethics review processes: Implications for multi-site health evaluations.

Science.gov (United States)

Prosser, Brenton; Davey, Rachel; Gibson, Diane

2015-04-01

Increasingly, public sector programmes respond to complex social problems that intersect specific fields and individual disciplines. Such responses result in multi-site initiatives that can span nations, jurisdictions, sectors and organisations. The rigorous evaluation of public sector programmes is now a baseline expectation. For evaluations of large and complex multi-site programme initiatives, the processes of ethics review can present a significant challenge. However in recent years, there have been new developments in centralised ethics review processes in many nations. This paper provides the case study of an evaluation of a national, inter-jurisdictional, cross-sector, aged care health initiative and its encounters with Australian centralised ethics review processes. Specifically, the paper considers progress against the key themes of a previous five-year, five nation study (Fitzgerald and Phillips, 2006), which found that centralised ethics review processes would save time, money and effort, as well as contribute to more equitable workloads for researchers and evaluators. The paper concludes with insights for those charged with refining centralised ethics review processes, as well as recommendations for future evaluators of complex multi-site programme initiatives. Copyright © 2015 Elsevier Ltd. All rights reserved.
Using linear integer programming for multi-site land-use allocation

NARCIS (Netherlands)

Aerts, J.C.J.H.; Eisinger, E.; Heuvelink, G.B.M.; Stewart, Th.J.

2003-01-01

Research in the area of spatial decision support (SDS) and resource allocation has recently generated increased attention for integrating optimization techniques with GIS. In this paper we address the use of spatial optimization techniques for solving multi-site land-use allocation (MLUA) problems,
Multi-site Study of Diffusion Metric Variability: Characterizing the Effects of Site, Vendor, Field Strength, and Echo Time using the Histogram Distance

Science.gov (United States)

Helmer, K. G.; Chou, M-C.; Preciado, R. I.; Gimi, B.; Rollins, N. K.; Song, A.; Turner, J.; Mori, S.

2016-01-01

MRI-based multi-site trials now routinely include some form of diffusion-weighted imaging (DWI) in their protocol. These studies can include data originating from scanners built by different vendors, each with their own set of unique protocol restrictions, including restrictions on the number of available gradient directions, whether an externally-generated list of gradient directions can be used, and restrictions on the echo time (TE). One challenge of multi-site studies is to create a common imaging protocol that will result in a reliable and accurate set of diffusion metrics. The present study describes the effect of site, scanner vendor, field strength, and TE on two common metrics: the first moment of the diffusion tensor field (mean diffusivity, MD), and the fractional anisotropy (FA). We have shown in earlier work that ROI metrics and the mean of MD and FA histograms are not sufficiently sensitive for use in site characterization. Here we use the distance between whole brain histograms of FA and MD to investigate within- and between-site effects. We concluded that the variability of DTI metrics due to site, vendor, field strength, and echo time could influence the results in multi-center trials and that histogram distance is sensitive metrics for each of these variables. PMID:27350723
Multi-site Study of Diffusion Metric Variability: Characterizing the Effects of Site, Vendor, Field Strength, and Echo Time using the Histogram Distance.

Science.gov (United States)

Helmer, K G; Chou, M-C; Preciado, R I; Gimi, B; Rollins, N K; Song, A; Turner, J; Mori, S

2016-02-27

MRI-based multi-site trials now routinely include some form of diffusion-weighted imaging (DWI) in their protocol. These studies can include data originating from scanners built by different vendors, each with their own set of unique protocol restrictions, including restrictions on the number of available gradient directions, whether an externally-generated list of gradient directions can be used, and restrictions on the echo time (TE). One challenge of multi-site studies is to create a common imaging protocol that will result in a reliable and accurate set of diffusion metrics. The present study describes the effect of site, scanner vendor, field strength, and TE on two common metrics: the first moment of the diffusion tensor field (mean diffusivity, MD), and the fractional anisotropy (FA). We have shown in earlier work that ROI metrics and the mean of MD and FA histograms are not sufficiently sensitive for use in site characterization. Here we use the distance between whole brain histograms of FA and MD to investigate within- and between-site effects. We concluded that the variability of DTI metrics due to site, vendor, field strength, and echo time could influence the results in multi-center trials and that histogram distance is sensitive metrics for each of these variables.
Multi-site solar power forecasting using gradient boosted regression trees

DEFF Research Database (Denmark)

Persson, Caroline Stougård; Bacher, Peder; Shiga, Takahiro

2017-01-01

The challenges to optimally utilize weather dependent renewable energy sources call for powerful tools for forecasting. This paper presents a non-parametric machine learning approach used for multi-site prediction of solar power generation on a forecast horizon of one to six hours. Historical pow...
Work characteristics predict the development of multi-site musculoskeletal pain

NARCIS (Netherlands)

Oakman, J.; Wind, A. de; Heuvel, S.G. van den; Beek, A.J. van der

2017-01-01

Purpose. Musculoskeletal pain in more than one body region is common and a barrier to sustaining employment. We aimed to examine whether work characteristics predict the development of multi-site pain (MSP), and to determine differences in work-related predictors between age groups. Methods. This
Robust multi-site MR data processing: iterative optimization of bias correction, tissue classification, and registration.

Science.gov (United States)

Young Kim, Eun; Johnson, Hans J

2013-01-01

A robust multi-modal tool, for automated registration, bias correction, and tissue classification, has been implemented for large-scale heterogeneous multi-site longitudinal MR data analysis. This work focused on improving the an iterative optimization framework between bias-correction, registration, and tissue classification inspired from previous work. The primary contributions are robustness improvements from incorporation of following four elements: (1) utilize multi-modal and repeated scans, (2) incorporate high-deformable registration, (3) use extended set of tissue definitions, and (4) use of multi-modal aware intensity-context priors. The benefits of these enhancements were investigated by a series of experiments with both simulated brain data set (BrainWeb) and by applying to highly-heterogeneous data from a 32 site imaging study with quality assessments through the expert visual inspection. The implementation of this tool is tailored for, but not limited to, large-scale data processing with great data variation with a flexible interface. In this paper, we describe enhancements to a joint registration, bias correction, and the tissue classification, that improve the generalizability and robustness for processing multi-modal longitudinal MR scans collected at multi-sites. The tool was evaluated by using both simulated and simulated and human subject MRI images. With these enhancements, the results showed improved robustness for large-scale heterogeneous MRI processing.
Chronic idiopathic thrombocytopenic purpura (ITP): site of platelet sequestration and results of splenectomy

International Nuclear Information System (INIS)

Gugliotta, L.; Guarini, A.; Motta, M.R.; Bachetti, G.; Tura, S.; Isacchi, G.; Ciccone, F.; Lattarini, C.; Mazzucconi, M.G.; Mandelli, F.; Baccarani, M.

1981-01-01

51 Cr-platelet kinetics study was performed in 197 patients with chronic ITP after corticosteroid therapy had failed to induce a long lasting remission. The incidence of splenic, spleno-hepatic, hepatic and diffuse platelet sequestration site was 58%, 17%, 6% and 19%, respectively. Splenic and spleno-hepatic sequestration sites were more frequent in patients less than 30 years old and in patients with a platelet count lower than 50 x 10 9 /l. 111 patients were splenectomized shortly after the study. Normalization of the platelet count was obtained more frequently in patients with splenic and spleno-hepatic sequestration than in the others. Labelled platelet sequestration site was the best predictor of the outcome of splenectomy. Platelet kinetics is a non-invasive investigation that should be performed early after the diagnosis of chronic ITP in all patients eligible for splenectomy. (author)
Multi site Kinetic Modeling of 13C Metabolic MR Using [1-13C]Pyruvate

International Nuclear Information System (INIS)

Damian, P.A.G.; Sperl, J.I.; Janich, M.A.; Wiesinger, F.; Schulte, R.F.; Menzel, M.I.; Damian, P.A.G.; Damian, P.A.G.; Haase, A.; Janich, M.A.; Schwaiger, M.; Janich, M.A.; Khegai, O.; Glaser, S.J.

2014-01-01

Hyperpolarized 13 C imaging allows real-time in vivo measurements of metabolite levels. Quantification of metabolite conversion between [1- 13 C]pyruvate and downstream metabolites [1- 13 C]alanine, [1- 13 C]lactate, and [ 13 C] bicarbonate can be achieved through kinetic modeling. Since pyruvate interacts dynamically and simultaneously with its downstream metabolites, the purpose of this work is the determination of parameter values through a multi site, dynamic model involving possible biochemical pathways present in MR spectroscopy. Kinetic modeling parameters were determined by fitting the multi site model to time-domain dynamic metabolite data. The results for different pyruvate doses were compared with those of different two-site models to evaluate the hypothesis that for identical data the uncertainty of a model and the signal-to-noise ratio determine the sensitivity in detecting small physiological differences in the target metabolism. In comparison to the two-site exchange models, the multi site model yielded metabolic conversion rates with smaller bias and smaller standard deviation, as demonstrated in simulations with different signal-to-noise ratio. Pyruvate dose effects observed previously were confirmed and quantified through metabolic conversion rate values. Parameter interdependency allowed an accurate quantification and can therefore be useful for monitoring metabolic activity in different tissues
Multi-trace elements level in drinking water and the prevalence of multi-chronic arsenical poisoning in residents in the west area of Iran

International Nuclear Information System (INIS)

Barati, A.H.; Maleki, A.; Alasvand, M.

2010-01-01

First, we determined the levels of 8 trace elements (As, Se, Hg, Cd, Ag, Mn, Cr and Pb) in 530 village drinking water sources by graphite furnace or flame atomic absorption spectroscopy method, in Kurdistan Province in the west of Iran. The results showed that the level of As, Cd and Se in 28 village drinking water sources exceeded WHO or National Standard limits. The levels of concentration of arsenic in drinking water ranged from 42 to 1500 μg/L. Then in a cross-sectional survey, 587 people from 211 households were chosen for clinical examinations of multi-chronic arsenical poisoning including pigment disorders, keratosis of palms and soles, Mee's line in fingers and nails and the gangrene as a systemic manifestation. Of 587 participants, 180 (30.7%) participants were affected by representing the type of chronic arsenical poisoning. The prevalence of Mee's line, keratosis, and pigment disorders were 86.1%, 77.2% and 67.8% respectively. Therefore, the prevalence of Mee's line between inhabitants was higher than the other disorders. The results show a strong linear relationship between arsenic exposure and occurrence of multi-chronic arsenical poisoning (R 2 = 0.76). The association between age for more than 40 years and gender for more than 60 years with chronic arsenical poisoning is significant (p < 0.05). Also, there is a relationship between subjects who were affected with disorders and duration of living in the village. Except for gangrene disorder, the odds ratio of prevalence of other disorders with arsenic exposure level in drinking water show a highly significant relationship between arsenic content and the risk of chronic disorders (p < 0.01). These results confirm the need to further study trace elements in drinking waters, food products and other samples in this area and the relationship to other chronic diseases arising out of arsenicosis.
Stability and selectivity of a chronic, multi-contact cuff electrode for sensory stimulation in human amputees.

Science.gov (United States)

Tan, Daniel W; Schiefer, Matthew A; Keith, Michael W; Anderson, J Robert; Tyler, Dustin J

2015-04-01

Stability and selectivity are important when restoring long-term, functional sensory feedback in individuals with limb-loss. Our objective is to demonstrate a chronic, clinical neural stimulation system for providing selective sensory response in two upper-limb amputees. Multi-contact cuff electrodes were implanted in the median, ulnar, and radial nerves of the upper-limb. Nerve stimulation produced a selective sensory response on 19 of 20 contacts and 16 of 16 contacts in subjects 1 and 2, respectively. Stimulation elicited multiple, distinct percept areas on the phantom and residual limb. Consistent threshold, impedance, and percept areas have demonstrated that the neural interface is stable for the duration of this on-going, chronic study. We have achieved selective nerve response from multi-contact cuff electrodes by demonstrating characteristic percept areas and thresholds for each contact. Selective sensory response remains consistent in two upper-limb amputees for 1 and 2 years, the longest multi-contact sensory feedback system to date. Our approach demonstrates selectivity and stability can be achieved through an extraneural interface, which can provide sensory feedback to amputees.
Reading Profiles in Multi-Site Data With Missingness.

Science.gov (United States)

Eckert, Mark A; Vaden, Kenneth I; Gebregziabher, Mulugeta

2018-01-01

Children with reading disability exhibit varied deficits in reading and cognitive abilities that contribute to their reading comprehension problems. Some children exhibit primary deficits in phonological processing, while others can exhibit deficits in oral language and executive functions that affect comprehension. This behavioral heterogeneity is problematic when missing data prevent the characterization of different reading profiles, which often occurs in retrospective data sharing initiatives without coordinated data collection. Here we show that reading profiles can be reliably identified based on Random Forest classification of incomplete behavioral datasets, after the missForest method is used to multiply impute missing values. Results from simulation analyses showed that reading profiles could be accurately classified across degrees of missingness (e.g., ∼5% classification error for 30% missingness across the sample). The application of missForest to a real multi-site dataset with missingness ( n = 924) showed that reading disability profiles significantly and consistently differed in reading and cognitive abilities for cases with and without missing data. The results of validation analyses indicated that the reading profiles (cases with and without missing data) exhibited significant differences for an independent set of behavioral variables that were not used to classify reading profiles. Together, the results show how multiple imputation can be applied to the classification of cases with missing data and can increase the integrity of results from multi-site open access datasets.
Reading Profiles in Multi-Site Data With Missingness

Directory of Open Access Journals (Sweden)

Mark A. Eckert

2018-05-01

Full Text Available Children with reading disability exhibit varied deficits in reading and cognitive abilities that contribute to their reading comprehension problems. Some children exhibit primary deficits in phonological processing, while others can exhibit deficits in oral language and executive functions that affect comprehension. This behavioral heterogeneity is problematic when missing data prevent the characterization of different reading profiles, which often occurs in retrospective data sharing initiatives without coordinated data collection. Here we show that reading profiles can be reliably identified based on Random Forest classification of incomplete behavioral datasets, after the missForest method is used to multiply impute missing values. Results from simulation analyses showed that reading profiles could be accurately classified across degrees of missingness (e.g., ∼5% classification error for 30% missingness across the sample. The application of missForest to a real multi-site dataset with missingness (n = 924 showed that reading disability profiles significantly and consistently differed in reading and cognitive abilities for cases with and without missing data. The results of validation analyses indicated that the reading profiles (cases with and without missing data exhibited significant differences for an independent set of behavioral variables that were not used to classify reading profiles. Together, the results show how multiple imputation can be applied to the classification of cases with missing data and can increase the integrity of results from multi-site open access datasets.
OPTIMIZING MAINTENANCE PROCESSES ON CUSTOMER SITE IN A DECENTRALIZED ORGANIZATION BASED ON MULTI-SITE TEAMS

Directory of Open Access Journals (Sweden)

Jorge Moutinho

2015-03-01

Full Text Available This lecture focuses on the complexity to manage and optimize maintenance processes, operations and service tasks to equipments and systems installed at customer sites. Different locations, access and working environment may compromise any standardization of setup's and operations. Multi-site teams based on geographic strategic locations, adds complexity to trainning, communication, supervising and monitoring processes. Logistics and information systems assume relevant rolls to consolidate global performance. Beside efficiency, effectiveness productivity and flexibility, field teams need skills on autonomy responsibility and proactivity. This lecture also explores the needed adaptation of most part of available literature, normally based on production sites, as also of Lean- Kaizen principles to the fact that services can not be stocked, quality is normally more difficult to measure and customer is normally present when and where service is produced.
Multi-site pain and working conditions as predictors of work ability in a 4-year follow-up among food industry employees.

Science.gov (United States)

Neupane, S; Virtanen, P; Leino-Arjas, P; Miranda, H; Siukola, A; Nygård, C-H

2013-03-01

We investigated the separate and joint effects of multi-site musculoskeletal pain and physical and psychosocial exposures at work on future work ability. A survey was conducted among employees of a Finnish food industry company in 2005 (n = 1201) and a follow-up survey in 2009 (n = 734). Information on self-assessed work ability (current work ability on a scale from 0 to 10; 7 = poor work ability), multi-site musculoskeletal pain (pain in at least two anatomical areas of four), leisure-time physical activity, body mass index and physical and psychosocial exposures was obtained by questionnaire. The separate and joint effects of multi-site pain and work exposures on work ability at follow-up, among subjects with good work ability at baseline, were assessed by logistic regression, and p-values for the interaction derived. Compared with subjects with neither multi-site pain nor adverse work exposure, multi-site pain at baseline increased the risk of poor work ability at follow-up, allowing for age, gender, occupational class, body mass index and leisure-time physical activity. The separate effects of the work exposures on work ability were somewhat smaller than those of multi-site pain. Multi-site pain had an interactive effect with work environment and awkward postures, such that no association of multi-site pain with poor work ability was seen when work environment was poor or awkward postures present. The decline in work ability connected with multi-site pain was not increased by exposure to adverse physical or psychosocial factors at work. © 2012 European Federation of International Association for the Study of Pain Chapters.

The opportunities and challenges of multi-site evaluations: lessons from the jail diversion and trauma recovery national cross-site evaluation.

Science.gov (United States)

Stainbrook, Kristin; Penney, Darby; Elwyn, Laura

2015-06-01

Multi-site evaluations, particularly of federally funded service programs, pose a special set of challenges for program evaluation. Not only are there contextual differences related to project location, there are often relatively few programmatic requirements, which results in variations in program models, target populations and services. The Jail Diversion and Trauma Recovery-Priority to Veterans (JDTR) National Cross-Site Evaluation was tasked with conducting a multi-site evaluation of thirteen grantee programs that varied along multiple domains. This article describes the use of a mixed methods evaluation design to understand the jail diversion programs and client outcomes for veterans with trauma, mental health and/or substance use problems. We discuss the challenges encountered in evaluating diverse programs, the benefits of the evaluation in the face of these challenges, and offer lessons learned for other evaluators undertaking this type of evaluation. Copyright © 2015 Elsevier Ltd. All rights reserved.
A method of risk assessment for a multi-plant site

International Nuclear Information System (INIS)

White, R.F.

1983-06-01

A model is presented which can be used in conjunction with probabilistic risk assessment to estimate whether a site on which there are several plants (reactors or chemical plants containing radioactive materials) meets whatever risk acceptance criteria or numerical risk guidelines are applied at the time of the assessment in relation to various groups of people and for various sources of risk. The application of the multi-plant site model to the direct and inverse methods of risk assessment is described. A method is proposed by which the potential hazard rating associated with a given plant can be quantified so that an appropriate allocation can be made when assessing the risks associated with each of the plants on a site. (author)
Bidirectional and Multi-User Telerehabilitation System: Clinical Effect on Balance, Functional Activity, and Satisfaction in Patients with Chronic Stroke Living in Long-Term Care Facilities

Directory of Open Access Journals (Sweden)

Kwan-Hwa Lin

2014-07-01

Full Text Available Background: The application of internet technology for telerehabilitation in patients with stroke has developed rapidly. Objective: The current study aimed to evaluate the effect of a bidirectional and multi-user telerehabilitation system on balance and satisfaction in patients with chronic stroke living in long-term care facilities (LTCFs. Method: This pilot study used a multi-site, blocked randomization design. Twenty-four participants from three LTCFs were recruited, and the participants were randomly assigned into the telerehabilitation (Tele and conventional therapy (Conv groups within each LTCF. Tele group received telerehabilitation but the Conv group received conventional therapy with two persons in each group for three sessions per week and for four weeks. The outcome measures included Berg Balance Scale (BBS, Barthel Index (BI, and the telerehabilitation satisfaction of the participants. Setting: A telerehabilitation system included “therapist end” in a laboratory, and the “client end” in LTCFs. The conventional therapy was conducted in LTCFs. Results: Training programs conducted for both the Tele and Conv groups showed significant effects within groups on the participant BBS as well as the total and self-care scores of BI. No significant difference between groups could be demonstrated. The satisfaction of participants between the Tele and the Conv groups also did not show significant difference. Conclusions: This pilot study indicated that the multi-user telerehabilitation program is feasible for improving the balance and functional activity similar to conventional therapy in patients with chronic stroke living in LTCFs.
Peat humification and climate change: a multi-site comparison from mires in south-east Alaska

Directory of Open Access Journals (Sweden)

R.J. Payne

2008-11-01

Full Text Available Peatland records of Holocene palaeoclimate have been widely used in Europe. Their potential in western North America remains largely unexploited despite an abundance of candidate sites. Peat humification analysis is a widely used technique for palaeoclimatic inference from peatlands. This study attempts to demonstrate a climatic role in determining peat humification by comparing low-resolution peat humification records from five mires in south-east Alaska. Humification was determined by alkali extraction and colorimetry and records dated by radiocarbon and tephrochronology. Testate amoebae analysis was carried out across a major humification-inferred wet shift in three of the sites. The humification results show variability down the length of the cores but there is only limited agreement between records from different sites. Many general trends in the data appear to be out of phase and periods of proxy 'complacency' are shown. This study does not provide strong evidence for climatic forcing of humification in these sites. Methodological issues including possible problems with the age-depth models and the role of a peat-forming plant species signal in the humification data are discussed. The results support previous studies in suggesting the value of employing a multi-proxy, multi-site, and possibly multi-core approach in peat-based palaeoclimatology.
A Multi-Modal Digital Game-Based Learning Environment for Hospitalized Children with Chronic Illnesses.

Science.gov (United States)

Chin, Jui-Chih; Tsuei, Mengping

2014-01-01

The aim of this study was to explore the digital game-based learning for children with chronic illnesses in the hospital settings. The design-based research and qualitative methods were applied. Three eight-year-old children with leukemia participated in this study. In the first phase, the multi-user game-based learning system was developed and…
Development of policies for Natura 2000 sites: a multi-criteria approach to support decision makers.

Science.gov (United States)

Cortina, Carla; Boggia, Antonio

2014-08-01

The aim of this study is to present a methodology to support decision makers in the choice of Natura 2000 sites needing an appropriate management plan to ensure a sustainable socio-economic development. In order to promote sustainable development in the Natura 2000 sites compatible with nature preservation, conservation measures or management plans are necessary. The main issue is to decide when only conservation measures can be applied and when the sites need an appropriate management plan. We present a case study for the Italian Region of Umbria. The methodology is based on a multi-criteria approach to identify the biodiversity index (BI), and on the development of a human activities index (HAI). By crossing the two indexes for each site on a Cartesian plane, four groups of sites were identified. Each group corresponds to a specific need for an appropriate management plan. Sites in the first group with a high level both of biodiversity and human activities have the most urgent need of an appropriate management plan to ensure sustainable development. The proposed methodology and analysis is replicable in other regions or countries by using the data available for each site in the Natura 2000 standard data form. A multi-criteria analysis is especially suitable for supporting decision makers when they deal with a multidimensional decision process. We found the multi-criteria approach particularly sound in this case, due to the concept of biodiversity itself, which is complex and multidimensional, and to the high number of alternatives (Natura 2000 sites) to be assessed. Copyright © 2014 Elsevier Ltd. All rights reserved.
Chronic swelling from entrapment of acrylic resin in a surgical extraction site

OpenAIRE

Weiting Ho; Pin-Chuang Lai; John D Walters

2010-01-01

When acrylic resin is inadvertently embedded in oral tissue, it can result in a pronounced chronic inflammatory response. This report describes a case in which temporary crown and bridge resin was forced into a surgical extraction site after the two adjacent teeth were prepared for a bridge immediately following extraction of a maxillary premolar. The patient experienced swelling at the extraction site over a ten month period despite treatment with antibiotics and anti-inflammatory drugs. Aft...
Mass discharge estimation from contaminated sites: Multi-model solutions for assessment of conceptual uncertainty

DEFF Research Database (Denmark)

Thomsen, Nanna Isbak; Troldborg, Mads; McKnight, Ursula S.

2012-01-01

site. The different conceptual models consider different source characterizations and hydrogeological descriptions. The idea is to include a set of essentially different conceptual models where each model is believed to be realistic representation of the given site, based on the current level...... the appropriate management option. The uncertainty of mass discharge estimates depends greatly on the extent of the site characterization. A good approach for uncertainty estimation will be flexible with respect to the investigation level, and account for both parameter and conceptual model uncertainty. We...... propose a method for quantifying the uncertainty of dynamic mass discharge estimates from contaminant point sources on the local scale. The method considers both parameter and conceptual uncertainty through a multi-model approach. The multi-model approach evaluates multiple conceptual models for the same...
Multi-trace elements level in drinking water and the prevalence of multi-chronic arsenical poisoning in residents in the west area of Iran

Energy Technology Data Exchange (ETDEWEB)

Barati, A.H., E-mail: ah_barati@yahoo.com [Department of Medical Physics, Faculty of Medicine, Kurdistan University of Medical Sciences, P.O.Box-66135-756, Pasdaran Street, Sanandaj (Iran, Islamic Republic of); Maleki, A. [Department of Environmental Health, Faculty of Health Sciences, Kurdistan University of Medical Sciences, Sanandaj (Iran, Islamic Republic of); Alasvand, M. [Department of Medical Physiology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj (Iran, Islamic Republic of)

2010-03-01

First, we determined the levels of 8 trace elements (As, Se, Hg, Cd, Ag, Mn, Cr and Pb) in 530 village drinking water sources by graphite furnace or flame atomic absorption spectroscopy method, in Kurdistan Province in the west of Iran. The results showed that the level of As, Cd and Se in 28 village drinking water sources exceeded WHO or National Standard limits. The levels of concentration of arsenic in drinking water ranged from 42 to 1500 {mu}g/L. Then in a cross-sectional survey, 587 people from 211 households were chosen for clinical examinations of multi-chronic arsenical poisoning including pigment disorders, keratosis of palms and soles, Mee's line in fingers and nails and the gangrene as a systemic manifestation. Of 587 participants, 180 (30.7%) participants were affected by representing the type of chronic arsenical poisoning. The prevalence of Mee's line, keratosis, and pigment disorders were 86.1%, 77.2% and 67.8% respectively. Therefore, the prevalence of Mee's line between inhabitants was higher than the other disorders. The results show a strong linear relationship between arsenic exposure and occurrence of multi-chronic arsenical poisoning (R{sup 2} = 0.76). The association between age for more than 40 years and gender for more than 60 years with chronic arsenical poisoning is significant (p < 0.05). Also, there is a relationship between subjects who were affected with disorders and duration of living in the village. Except for gangrene disorder, the odds ratio of prevalence of other disorders with arsenic exposure level in drinking water show a highly significant relationship between arsenic content and the risk of chronic disorders (p < 0.01). These results confirm the need to further study trace elements in drinking waters, food products and other samples in this area and the relationship to other chronic diseases arising out of arsenicosis.
Follow the link: Digital Tracings of a Multi-Sited Space of Research

DEFF Research Database (Denmark)

Munk, Anders Kristian

The paper discusses the use of digital methods as an alternative way of generating what George Marcus calls 'posited logics of association' for use in multi-sited fieldwork. I draw on cases from an ongoing research project on the new nordic food movement and its on- and off-line assemblages. I do...... doing so I demonstrate how methods which are native to the digital domain - such as the link or the like as a valuation metric - may be re-appropriated as strategies in more ethnographic styles of work.......The paper discusses the use of digital methods as an alternative way of generating what George Marcus calls 'posited logics of association' for use in multi-sited fieldwork. I draw on cases from an ongoing research project on the new nordic food movement and its on- and off-line assemblages. I...
Mass discharge estimation from contaminated sites: Multi-model solutions for assessment of conceptual uncertainty

Science.gov (United States)

Thomsen, N. I.; Troldborg, M.; McKnight, U. S.; Binning, P. J.; Bjerg, P. L.

2012-04-01

Mass discharge estimates are increasingly being used in the management of contaminated sites. Such estimates have proven useful for supporting decisions related to the prioritization of contaminated sites in a groundwater catchment. Potential management options can be categorised as follows: (1) leave as is, (2) clean up, or (3) further investigation needed. However, mass discharge estimates are often very uncertain, which may hamper the management decisions. If option 1 is incorrectly chosen soil and water quality will decrease, threatening or destroying drinking water resources. The risk of choosing option 2 is to spend money on remediating a site that does not pose a problem. Choosing option 3 will often be safest, but may not be the optimal economic solution. Quantification of the uncertainty in mass discharge estimates can therefore greatly improve the foundation for selecting the appropriate management option. The uncertainty of mass discharge estimates depends greatly on the extent of the site characterization. A good approach for uncertainty estimation will be flexible with respect to the investigation level, and account for both parameter and conceptual model uncertainty. We propose a method for quantifying the uncertainty of dynamic mass discharge estimates from contaminant point sources on the local scale. The method considers both parameter and conceptual uncertainty through a multi-model approach. The multi-model approach evaluates multiple conceptual models for the same site. The different conceptual models consider different source characterizations and hydrogeological descriptions. The idea is to include a set of essentially different conceptual models where each model is believed to be realistic representation of the given site, based on the current level of information. Parameter uncertainty is quantified using Monte Carlo simulations. For each conceptual model we calculate a transient mass discharge estimate with uncertainty bounds resulting from
A comparison of single- and multi-site calibration and validation: a case study of SWAT in the Miyun Reservoir watershed, China

Science.gov (United States)

Bai, Jianwen; Shen, Zhenyao; Yan, Tiezhu

2017-09-01

An essential task in evaluating global water resource and pollution problems is to obtain the optimum set of parameters in hydrological models through calibration and validation. For a large-scale watershed, single-site calibration and validation may ignore spatial heterogeneity and may not meet the needs of the entire watershed. The goal of this study is to apply a multi-site calibration and validation of the Soil andWater Assessment Tool (SWAT), using the observed flow data at three monitoring sites within the Baihe watershed of the Miyun Reservoir watershed, China. Our results indicate that the multi-site calibration parameter values are more reasonable than those obtained from single-site calibrations. These results are mainly due to significant differences in the topographic factors over the large-scale area, human activities and climate variability. The multi-site method involves the division of the large watershed into smaller watersheds, and applying the calibrated parameters of the multi-site calibration to the entire watershed. It was anticipated that this case study could provide experience of multi-site calibration in a large-scale basin, and provide a good foundation for the simulation of other pollutants in followup work in the Miyun Reservoir watershed and other similar large areas.
Implementation of a novel synchronous multi-site all day high-fidelity simulation.

Science.gov (United States)

Abraham, Paul; Verdonk, Franck; Buleon, Clement; Tesniere, Antoine; Lilot, Marc

2018-01-01

Integration of simulation in educational curricula for anesthesia and intensive care residents is a hot topic. There is a great interest for simulation centers to share their experiences through multi-site synchronous simulation sessions. The present study results from an experience conducted at three sites in France (Paris, Lyon, and Caen), which involved 16 instructors and 25 residents facing the same scenario across 1 day. Synchronous simulations were performed at each site with local and shared debriefing via teleconference. This innovative approach to simulation was found to be feasible, although certain difficulties were encountered with connectivity.
Multi-site study of diffusion metric variability: effects of site, vendor, field strength, and echo time on regions-of-interest and histogram-bin analyses.

Science.gov (United States)

Helmer, K G; Chou, M-C; Preciado, R I; Gimi, B; Rollins, N K; Song, A; Turner, J; Mori, S

2016-02-27

It is now common for magnetic-resonance-imaging (MRI) based multi-site trials to include diffusion-weighted imaging (DWI) as part of the protocol. It is also common for these sites to possess MR scanners of different manufacturers, different software and hardware, and different software licenses. These differences mean that scanners may not be able to acquire data with the same number of gradient amplitude values and number of available gradient directions. Variability can also occur in achievable b-values and minimum echo times. The challenge of a multi-site study then, is to create a common protocol by understanding and then minimizing the effects of scanner variability and identifying reliable and accurate diffusion metrics. This study describes the effect of site, scanner vendor, field strength, and TE on two diffusion metrics: the first moment of the diffusion tensor field (mean diffusivity, MD), and the fractional anisotropy (FA) using two common analyses (region-of-interest and mean-bin value of whole brain histograms). The goal of the study was to identify sources of variability in diffusion-sensitized imaging and their influence on commonly reported metrics. The results demonstrate that the site, vendor, field strength, and echo time all contribute to variability in FA and MD, though to different extent. We conclude that characterization of the variability of DTI metrics due to site, vendor, field strength, and echo time is a worthwhile step in the construction of multi-center trials.
[Effects of a Multi-disciplinary Approached, Empowerment Theory Based Self-management Intervention in Older Adults with Chronic Illness].

Science.gov (United States)

Park, Chorong; Song, Misoon; Cho, Belong; Lim, Jaeyoung; Song, Wook; Chang, Heekyung; Park, Yeon-Hwan

2015-04-01

The purpose of this study was to develop a multi-disciplinary self-management intervention based on empowerment theory and to evaluate the effectiveness of the intervention for older adults with chronic illness. A randomized controlled trial design was used with 43 Korean older adults with chronic illness (Experimental group=22, Control group=21). The intervention consisted of two phases: (1) 8-week multi-disciplinary, team guided, group-based health education, exercise session, and individual empowerment counseling, (2) 16-week self-help group activities including weekly exercise and group discussion to maintain acquired self-management skills and problem-solving skills. Baseline, 8-week, and 24-week assessments measured health empowerment, exercise self-efficacy, physical activity, and physical function. Health empowerment, physical activity, and physical function in the experimental group increased significantly compared to the control group over time. Exercise self-efficacy significantly increased in experimental group over time but there was no significant difference between the two groups. The self-management program based on empowerment theory improved health empowerment, physical activity, and physical function in older adults. The study finding suggests that a health empowerment strategy may be an effective approach for older adults with multiple chronic illnesses in terms of achieving a sense of control over their chronic illness and actively engaging self-management.
Dual and multi-stimuli responsive polymeric nanoparticles for programmed site-specific drug delivery.

Science.gov (United States)

Cheng, Ru; Meng, Fenghua; Deng, Chao; Klok, Harm-Anton; Zhong, Zhiyuan

2013-05-01

In the past decades, polymeric nanoparticles have emerged as a most promising and viable technology platform for targeted and controlled drug delivery. As vehicles, ideal nanoparticles are obliged to possess high drug loading levels, deliver drug to the specific pathological site and/or target cells without drug leakage on the way, while rapidly unload drug at the site of action. To this end, various "intelligent" polymeric nanoparticles that release drugs in response to an internal or external stimulus such as pH, redox, temperature, magnetic and light have been actively pursued. These stimuli-responsive nanoparticles have demonstrated, though to varying degrees, improved in vitro and/or in vivo drug release profiles. In an effort to further improve drug release performances, novel dual and multi-stimuli responsive polymeric nanoparticles that respond to a combination of two or more signals such as pH/temperature, pH/redox, pH/magnetic field, temperature/reduction, double pH, pH and diols, temperature/magnetic field, temperature/enzyme, temperature/pH/redox, temperature/pH/magnetic, pH/redox/magnetic, temperature/redox/guest molecules, and temperature/pH/guest molecules have recently been developed. Notably, these combined responses take place either simultaneously at the pathological site or in a sequential manner from nanoparticle preparation, nanoparticle transporting pathways, to cellular compartments. These dual and multi-stimuli responsive polymeric nanoparticles have shown unprecedented control over drug delivery and release leading to superior in vitro and/or in vivo anti-cancer efficacy. With programmed site-specific drug delivery feature, dual and multi-stimuli responsive nanoparticulate drug formulations have tremendous potential for targeted cancer therapy. In this review paper, we highlight the recent exciting developments in dual and multi-stimuli responsive polymeric nanoparticles for precision drug delivery applications, with a particular focus
Stochastic generation of multi-site daily precipitation focusing on extreme events

Directory of Open Access Journals (Sweden)

G. Evin

2018-01-01

Full Text Available Many multi-site stochastic models have been proposed for the generation of daily precipitation, but they generally focus on the reproduction of low to high precipitation amounts at the stations concerned. This paper proposes significant extensions to the multi-site daily precipitation model introduced by Wilks, with the aim of reproducing the statistical features of extremely rare events (in terms of frequency and magnitude at different temporal and spatial scales. In particular, the first extended version integrates heavy-tailed distributions, spatial tail dependence, and temporal dependence in order to obtain a robust and appropriate representation of the most extreme precipitation fields. A second version enhances the first version using a disaggregation method. The performance of these models is compared at different temporal and spatial scales on a large region covering approximately half of Switzerland. While daily extremes are adequately reproduced at the stations by all models, including the benchmark Wilks version, extreme precipitation amounts at larger temporal scales (e.g., 3-day amounts are clearly underestimated when temporal dependence is ignored.
A multi-site study on medical school selection, performance, motivation and engagement

NARCIS (Netherlands)

Wouters, A.; Croiset, G.; Schripsema, N. R.; Cohen-Schotanus, J.; Spaai, G. W. G.; Hulsman, R. L.; Kusurkar, R. A.

Medical schools seek ways to improve their admissions strategies, since the available methods prove to be suboptimal for selecting the best and most motivated students. In this multi-site cross-sectional questionnaire study, we examined the value of (different) selection procedures compared to a
Orthogonal use of a human tRNA synthetase active site to achieve multi-functionality

Science.gov (United States)

Zhou, Quansheng; Kapoor, Mili; Guo, Min; Belani, Rajesh; Xu, Xiaoling; Kiosses, William B.; Hanan, Melanie; Park, Chulho; Armour, Eva; Do, Minh-Ha; Nangle, Leslie A.; Schimmel, Paul; Yang, Xiang-Lei

2011-01-01

Protein multi-functionality is an emerging explanation for the complexity of higher organisms. In this regard, while aminoacyl tRNA synthetases catalyze amino acid activation for protein synthesis, some also act in pathways for inflammation, angiogenesis, and apoptosis. How multiple functions evolved and their relationship to the active site is not clear. Here structural modeling analysis, mutagenesis, and cell-based functional studies show that the potent angiostatic, natural fragment of human TrpRS associates via Trp side chains that protrude from the cognate cellular receptor VE-cadherin. Modeling indicates that (I prefer the way it was because the conclusion was reached not only by modeling, but more so by experimental studies.)VE-cadherin Trp side chains fit into the Trp-specific active site of the synthetase. Thus, specific side chains of the receptor mimic (?) amino acid substrates and expand the functionality of the active site of the synthetase. We propose that orthogonal use of the same active site may be a general way to develop multi-functionality of human tRNA synthetases and other proteins. PMID:20010843
Multi-site calibration, validation, and sensitivity analysis of the MIKE SHE Model for a large watershed in northern China

Directory of Open Access Journals (Sweden)

S. Wang

2012-12-01

Full Text Available Model calibration is essential for hydrologic modeling of large watersheds in a heterogeneous mountain environment. Little guidance is available for model calibration protocols for distributed models that aim at capturing the spatial variability of hydrologic processes. This study used the physically-based distributed hydrologic model, MIKE SHE, to contrast a lumped calibration protocol that used streamflow measured at one single watershed outlet to a multi-site calibration method which employed streamflow measurements at three stations within the large Chaohe River basin in northern China. Simulation results showed that the single-site calibrated model was able to sufficiently simulate the hydrographs for two of the three stations (Nash-Sutcliffe coefficient of 0.65–0.75, and correlation coefficient 0.81–0.87 during the testing period, but the model performed poorly for the third station (Nash-Sutcliffe coefficient only 0.44. Sensitivity analysis suggested that streamflow of upstream area of the watershed was dominated by slow groundwater, whilst streamflow of middle- and down- stream areas by relatively quick interflow. Therefore, a multi-site calibration protocol was deemed necessary. Due to the potential errors and uncertainties with respect to the representation of spatial variability, performance measures from the multi-site calibration protocol slightly decreased for two of the three stations, whereas it was improved greatly for the third station. We concluded that multi-site calibration protocol reached a compromise in term of model performance for the three stations, reasonably representing the hydrographs of all three stations with Nash-Sutcliffe coefficient ranging from 0.59–072. The multi-site calibration protocol applied in the analysis generally has advantages to the single site calibration protocol.

Quantification of source impact to PM using three-dimensional weighted factor model analysis on multi-site data

Science.gov (United States)

Shi, Guoliang; Peng, Xing; Huangfu, Yanqi; Wang, Wei; Xu, Jiao; Tian, Yingze; Feng, Yinchang; Ivey, Cesunica E.; Russell, Armistead G.

2017-07-01

Source apportionment technologies are used to understand the impacts of important sources of particulate matter (PM) air quality, and are widely used for both scientific studies and air quality management. Generally, receptor models apportion speciated PM data from a single sampling site. With the development of large scale monitoring networks, PM speciation are observed at multiple sites in an urban area. For these situations, the models should account for three factors, or dimensions, of the PM, including the chemical species concentrations, sampling periods and sampling site information, suggesting the potential power of a three-dimensional source apportionment approach. However, the principle of three-dimensional Parallel Factor Analysis (Ordinary PARAFAC) model does not always work well in real environmental situations for multi-site receptor datasets. In this work, a new three-way receptor model, called "multi-site three way factor analysis" model is proposed to deal with the multi-site receptor datasets. Synthetic datasets were developed and introduced into the new model to test its performance. Average absolute error (AAE, between estimated and true contributions) for extracted sources were all less than 50%. Additionally, three-dimensional ambient datasets from a Chinese mega-city, Chengdu, were analyzed using this new model to assess the application. Four factors are extracted by the multi-site WFA3 model: secondary source have the highest contributions (64.73 and 56.24 μg/m3), followed by vehicular exhaust (30.13 and 33.60 μg/m3), crustal dust (26.12 and 29.99 μg/m3) and coal combustion (10.73 and 14.83 μg/m3). The model was also compared to PMF, with general agreement, though PMF suggested a lower crustal contribution.
Multi-Site Diagnostic Classification of Schizophrenia Using Discriminant Deep Learning with Functional Connectivity MRI

Directory of Open Access Journals (Sweden)

Ling-Li Zeng

2018-04-01

Full Text Available Background: A lack of a sufficiently large sample at single sites causes poor generalizability in automatic diagnosis classification of heterogeneous psychiatric disorders such as schizophrenia based on brain imaging scans. Advanced deep learning methods may be capable of learning subtle hidden patterns from high dimensional imaging data, overcome potential site-related variation, and achieve reproducible cross-site classification. However, deep learning-based cross-site transfer classification, despite less imaging site-specificity and more generalizability of diagnostic models, has not been investigated in schizophrenia. Methods: A large multi-site functional MRI sample (n = 734, including 357 schizophrenic patients from seven imaging resources was collected, and a deep discriminant autoencoder network, aimed at learning imaging site-shared functional connectivity features, was developed to discriminate schizophrenic individuals from healthy controls. Findings: Accuracies of approximately 85·0% and 81·0% were obtained in multi-site pooling classification and leave-site-out transfer classification, respectively. The learned functional connectivity features revealed dysregulation of the cortical-striatal-cerebellar circuit in schizophrenia, and the most discriminating functional connections were primarily located within and across the default, salience, and control networks. Interpretation: The findings imply that dysfunctional integration of the cortical-striatal-cerebellar circuit across the default, salience, and control networks may play an important role in the “disconnectivity” model underlying the pathophysiology of schizophrenia. The proposed discriminant deep learning method may be capable of learning reliable connectome patterns and help in understanding the pathophysiology and achieving accurate prediction of schizophrenia across multiple independent imaging sites. Keywords: Schizophrenia, Deep learning, Connectome, f
Multi-Site Diagnostic Classification of Schizophrenia Using Discriminant Deep Learning with Functional Connectivity MRI.

Science.gov (United States)

Zeng, Ling-Li; Wang, Huaning; Hu, Panpan; Yang, Bo; Pu, Weidan; Shen, Hui; Chen, Xingui; Liu, Zhening; Yin, Hong; Tan, Qingrong; Wang, Kai; Hu, Dewen

2018-04-01

A lack of a sufficiently large sample at single sites causes poor generalizability in automatic diagnosis classification of heterogeneous psychiatric disorders such as schizophrenia based on brain imaging scans. Advanced deep learning methods may be capable of learning subtle hidden patterns from high dimensional imaging data, overcome potential site-related variation, and achieve reproducible cross-site classification. However, deep learning-based cross-site transfer classification, despite less imaging site-specificity and more generalizability of diagnostic models, has not been investigated in schizophrenia. A large multi-site functional MRI sample (n = 734, including 357 schizophrenic patients from seven imaging resources) was collected, and a deep discriminant autoencoder network, aimed at learning imaging site-shared functional connectivity features, was developed to discriminate schizophrenic individuals from healthy controls. Accuracies of approximately 85·0% and 81·0% were obtained in multi-site pooling classification and leave-site-out transfer classification, respectively. The learned functional connectivity features revealed dysregulation of the cortical-striatal-cerebellar circuit in schizophrenia, and the most discriminating functional connections were primarily located within and across the default, salience, and control networks. The findings imply that dysfunctional integration of the cortical-striatal-cerebellar circuit across the default, salience, and control networks may play an important role in the "disconnectivity" model underlying the pathophysiology of schizophrenia. The proposed discriminant deep learning method may be capable of learning reliable connectome patterns and help in understanding the pathophysiology and achieving accurate prediction of schizophrenia across multiple independent imaging sites. Copyright © 2018 German Center for Neurodegenerative Diseases (DZNE). Published by Elsevier B.V. All rights reserved.
Effect of Multi-layer Compression Bandage Systems on Leg Ulcers Associated with Chronic Venous Insufficiency

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Hüseyin Kuplay

2013-03-01

Full Text Available Introduction: Venous leg ulcer is a major health problem in terms of high prevalence and high cost for treatment. Multi-layer compression bandage systems for venous leg ulcers are supposed to be the gold standard for the treatment of venous ulcers. The aim of the current study is to investigate the effectiveness of multi-layer compression bandage systems for the treatment of venous leg ulcers.Patients and Methods: Nineteen consecutive patients diagnosed to have leg ulcers were evaluated and four patients were excluded from the study due to the peripheral arterial disease. Fifteen patients, enrolled in the study, were classified according to CEAP classification and belonged to the same class. Betaven® multi-layer compression bandage was applied to patients. Patients were followed-up in terms of wound healing and reduction in wound diameter.Results: Twelve male and three female patients underwent multi-layer bandage system. Mean age of patients was 38.2 ± 4.2 years. Ulcer size was measured planimetrically and baseline ulcer size was 4-10 cm². The location of ulcer was on medial malloelus in seven patients, lateral malleolus in three patients, anterior surface of the leg in four patients and lateral side of the leg in one patient. Patients had chronic venous insuuficiency for a mean of 5.1 ± 2.1 years. CEAP classifications were C6, Ep, As2,3-p18, Pr2,3, 18. Each bandage was changed five days after application along with wound care. Mean duration of treatment was 6 ± 2 weeks. Complete healing of the venous ulcers occurred in all patients except for one. This patient was referred to plastic surgery clinic for reconstruction.Conclusion: Multi-layer compression bandage system is an effective method of treatment for venous leg ulcers associated with chronic venous insufficiency by reducing venous return and increasing intertitial tissue pressure. This effect occurred in the shortrun as well as with a low cost and prevented loss of labor.
A Basal Area Increment-Based Approach of Site Productivity Evaluation for Multi-Aged and Mixed Forests

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Liyong Fu

2017-04-01

Full Text Available Accurate estimates of forest site productivity are essential for environmental planning and forest management. In this study, we developed a new productivity index, hereafter termed basal area potential productivity index (BAPP, to estimate site productivity for irregular and complex forests characterized by multi-aged, multi-species, and multi-layer stands. We presented the biological relevance of BAPP with its computational details. We also compared BAPP against basal area realized productivity (BARP in order to verify the practicability and reliability of BAPP. Time-series data of the national forest inventory on 1912 permanent sample plots that were located in two main forest types and consisted of oak-dominated mixed forests and other broadleaf forests in northeast China were used to demonstrate the application of BAPP. The results showed that the value of BAPP for each sample plot was larger than or equal to the corresponding BARP value for each forest type. For appropriately managed stands with relatively better site conditions, the values of both BARP and BAPP were almost identical. The values of the difference between BAPP and BARP could therefore be used to effectively assess forest site productivity. Meanwhile, BAPP also provides much reliable and valuable information that can aid decision-making in forest management.
Relationship between educational and occupational levels, and Chronic Kidney Disease in a multi-ethnic sample- The HELIUS study

NARCIS (Netherlands)

Adjei, David N.; Stronks, Karien; Adu, Dwomoa; Snijder, Marieke B.; Modesti, Pietro A.; Peters, Ron J. G.; Vogt, Liffert; Agyemang, Charles

2017-01-01

Ethnic minority groups in high-income countries are disproportionately affected by Chronic Kidney Disease (CKD) for reasons that are unclear. We assessed the association of educational and occupational levels with CKD in a multi-ethnic population. Furthermore, we assessed to what extent ethnic
Multi-criteria analysis for the detection of the most critical European UNESCO Heritage sites

Science.gov (United States)

Valagussa, Andrea; Frattini, Paolo; Berta, Nadia; Spizzichino, Daniele; Leoni, Gabriele; Margottini, Claudio; Battista Crosta, Giovanni

2017-04-01

A GIS-based multi-criteria analysis has been implemented to identify and to rank the most critical UNESCO Heritage sites at the European scale in the context of PROTHEGO JPI-Project. Two multi-criteria methods have been tested and applied to more than 300 European UNESCO Sites. First, the Analytic Hierarchy Procedure (AHP) was applied to the data of the UNESCO Periodic Report, in relation to 13 natural hazards that have affected or can potentially affect the Heritage sites. According to these reports, 22% of sites are without any documented hazard and 70% of the sites have at least one hazard affecting the site. The most important hazards on the European country are: fire (wildfire), storm, flooding, earthquake and erosion. For each UNESCO site, the potential risk was calculated as a weighed sum of the hazards that affect the site. The weighs of the 13 hazards were obtained by AHP procedure, which is a technique for multi-attribute decision making that enables the decomposition of a problem into hierarchy, based on the opinion of different experts about the dominance of risks. The weights are obtained by rescaling between 0 and 1 the eigenvectors relative to the maximum eigenvalue for the matrix of the coefficients. The internal coherence of the expert's attributions is defined through the calculation of the consistency ratio (Saaty, 1990). The result of the AHP method consists in a map of the UNESCO sites ranked according to the potential risk, where the site most at risk results to be the Geirangerfjord and Nærøyfjord in Norway. However, the quality of these results lies in the reliability of the Period Reports, which are produced by different experts with unknown level of scientific background. To test the reliability of these results, a comparison of the information of the periodic reports with available high-quality datasets (earthquake, volcano and landslide) at the Italian scale has been performed. Sites properly classified by the Period Reports range from
Chronic dihydroergotoxine treatment affects the number of dopamine recognition sites in rat striatum

Energy Technology Data Exchange (ETDEWEB)

Battaini, F.; Govoni, S.; Rius, R.A.; Spano, P.F.; Trabucchi, M.

1984-06-01

Ergot derivatives have been proposed to have ameliorative effects in various pathological conditions where dopaminergic transmission is believed to be impaired, namely Parkinson's disease, amenorrhea-galactorrhea syndrome, and in the treatment of behavioural disturbances of the elderly. To get more insight into a possible involvement of a direct action of ergot derivatives on dopamine receptors we studied the effect of acute and chronic dihydroergotoxine (DHT) treatment on 3H-Spiroperidol and 3H-N-Propylnorapomorphine (3H-NPA) binding to rat striatal membrane preparations. The results are in favor of an interaction of ergot derivatives with dopamine recognition sites both after acute and chronic treatment.
Chronic dihydroergotoxine treatment affects the number of dopamine recognition sites in rat striatum

Energy Technology Data Exchange (ETDEWEB)

Battaini, F; Govoni, S; Rius, R A; Spano, P F; Trabucchi, M

1984-06-01

Ergot derivatives have been proposed to have ameliorative effects in various pathological conditions where dopaminergic transmission is believed to be impaired, namely Parkinson's disease, amenorrhea-galactorrhea syndrome, and in the treatment of behavioural disturbances of the elderly. To get more insight into a possible involvement of a direct action of ergot derivatives on dopamine receptors we studied the effect of acute and chronic dihydroergotoxine (DHT) treatment on 3H-Spiroperidol and 3H-N-Propylnorapomorphine (3H-NPA) binding to rat striatal membrane preparations. The results are in favor of an interaction of ergot derivatives with dopamine recognition sites both after acute and chronic treatment.
Housing Retention in Single-Site Housing First for Chronically Homeless Individuals With Severe Alcohol Problems

Science.gov (United States)

Malone, Daniel K.; Clifasefi, Seema L.

2013-01-01

Objectives. We studied housing retention and its predictors in the single-site Housing First model. Methods. Participants (n = 111) were chronically homeless people with severe alcohol problems who lived in a single-site Housing First program and participated in a larger nonrandomized controlled trial (2005–2008) conducted in Seattle, Washington. At baseline, participants responded to self-report questionnaires assessing demographic, illness burden, alcohol and other drug use, and psychiatric variables. Housing status was recorded over 2 years. Results. Participants were interested in housing, although a sizable minority did not believe they would be able to maintain abstinence-based housing. Only 23% of participants returned to homelessness during the 2-year follow-up. Commonly cited risk factors—alcohol and other drug use, illness burden, psychiatric symptoms, and homelessness history—did not predict resumed homelessness. Active drinkers were more likely to stay in this housing project than nondrinkers. Conclusions. We found that single-site Housing First programming fills a gap in housing options for chronically homeless people with severe alcohol problems. PMID:24148063
Spatial Layout of Multi-Environment Test Sites: A Case Study of Maize in Jilin Province

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Zuliang Zhao

2018-05-01

Full Text Available Variety regional tests based on multiple environments play a critical role in understanding the high yield and adaptability of new crop varieties. However, the current approach mainly depends on experience from breeding experts and is difficulty to promote because of inconsistency between testing and actual situation. We propose a spatial layout method based on the existing systematic regional test network. First, the method of spatial clustering was used to cluster the planting environment. Then, we used spatial stratified sampling to determine the minimum number of test sites in each type of environment. Finally, combined with the factors such as the convenience of transportation and the planting area, we used spatial balance sampling to generate the layout of multi-environment test sites. We present a case study for maize in Jilin Province and show the utility of the method with an accuracy of about 94.5%. The experimental results showed that 66.7% of sites are located in the same county and the unbalanced layout of original sites is improved. Furthermore, we conclude that the set of operational technical ideas for carrying out the layout of multi-environment test sites based on crop varieties in this paper can be applied to future research.
CLIP-seq analysis of multi-mapped reads discovers novel functional RNA regulatory sites in the human transcriptome.

Science.gov (United States)

Zhang, Zijun; Xing, Yi

2017-09-19

Crosslinking or RNA immunoprecipitation followed by sequencing (CLIP-seq or RIP-seq) allows transcriptome-wide discovery of RNA regulatory sites. As CLIP-seq/RIP-seq reads are short, existing computational tools focus on uniquely mapped reads, while reads mapped to multiple loci are discarded. We present CLAM (CLIP-seq Analysis of Multi-mapped reads). CLAM uses an expectation-maximization algorithm to assign multi-mapped reads and calls peaks combining uniquely and multi-mapped reads. To demonstrate the utility of CLAM, we applied it to a wide range of public CLIP-seq/RIP-seq datasets involving numerous splicing factors, microRNAs and m6A RNA methylation. CLAM recovered a large number of novel RNA regulatory sites inaccessible by uniquely mapped reads. The functional significance of these sites was demonstrated by consensus motif patterns and association with alternative splicing (splicing factors), transcript abundance (AGO2) and mRNA half-life (m6A). CLAM provides a useful tool to discover novel protein-RNA interactions and RNA modification sites from CLIP-seq and RIP-seq data, and reveals the significant contribution of repetitive elements to the RNA regulatory landscape of the human transcriptome. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.
Multi-criteria assessment tool for sustainability appraisal of remediation alternatives for a contaminated site

DEFF Research Database (Denmark)

Søndergaard, Gitte Lemming; Binning, Philip John; Bondgård, Morten

2017-01-01

Purpose: In order to improve and support decision-making for the selection of remedial techniques for contaminated sites, a multi-criteria assessment (MCA) method has been developed. The MCA framework is structured in a decision process actively involving stakeholders, and compares...
A Qualitative Multi-Site Case Study: Examining Principals' Leadership Styles and School Performance

Science.gov (United States)

Preyear, Loukisha

2015-01-01

The purpose of this qualitative multi-site case study was to explore the impact of principals' leadership styles on student academic achievement in a high-poverty low-performing school district in Louisiana. A total of 17 participants, principals and teachers, from this school district were used in this study. Data source triangulation of…
Multi-Site Calibration of Linear Reservoir Based Geomorphologic Rainfall-Runoff Models

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Bahram Saeidifarzad

2014-09-01

Full Text Available Multi-site optimization of two adapted event-based geomorphologic rainfall-runoff models was presented using Non-dominated Sorting Genetic Algorithm (NSGA-II method for the South Fork Eel River watershed, California. The first model was developed based on Unequal Cascade of Reservoirs (UECR and the second model was presented as a modified version of Geomorphological Unit Hydrograph based on Nash’s model (GUHN. Two calibration strategies were considered as semi-lumped and semi-distributed for imposing (or unimposing the geomorphology relations in the models. The results of models were compared with Nash’s model. Obtained results using the observed data of two stations in the multi-site optimization framework showed reasonable efficiency values in both the calibration and the verification steps. The outcomes also showed that semi-distributed calibration of the modified GUHN model slightly outperformed other models in both upstream and downstream stations during calibration. Both calibration strategies for the developed UECR model during the verification phase showed slightly better performance in the downstream station, but in the upstream station, the modified GUHN model in the semi-lumped strategy slightly outperformed the other models. The semi-lumped calibration strategy could lead to logical lag time parameters related to the basin geomorphology and may be more suitable for data-based statistical analyses of the rainfall-runoff process.
A site-specific and multi-element isotopic approach to origin inference of sugars in foods and beverages

International Nuclear Information System (INIS)

Martin, M.L.; Martin, G.J.; Guillou, C.

1991-01-01

A strategy is presented for the characterization of sugars according to their botanical origin. The samples fermented in standardized conditions can be described in the multi-dimensional space of the overall carbon isotope ratio of ethanol measured by isotope ratio mass spectrometry (IRMS) and of the specific hydrogen isotope parameters of the methyl and methylene sites derived from nuclear magnetic resonance investigation of site-specific natural isotope fractionation (SNIF-NMR method). In the comparison of natural juices, the deuterium and oxygen-18 parameters of water extracted from the juice and from the end fermentation medium also contain information on the origin of the product. The isotopic effects of the concentration processes leading to concentrated juices, musts and syrups can be estimated and taken into account in interpreting the data. The classification power of this multi-element and multi-site approach is illustrated by discriminant analyses involving selected isotopic variables associated with pineapple, apple and barley sugars, compared to beet and cane sugars which are common sources of enrichment. The ability of the method to detect adulteration by exogenous sugars is improved when environmental conditions can be taken into account. (authors)
A novel biometric signature: multi-site, remote (> 100 m) photo-plethysmography using ambient light

NARCIS (Netherlands)

Verkruijsse, W.; Bodlaender, M.P.

2010-01-01

We propose a novel biometric signature based on the principle of multi-site remote photo-plethysmography (remote PPG). This signature can be measured using video cameras. Traditional PPG uses a contact sensor to measure slight skin color changes that occur with every heartbeat. Recently we have
Coastal flooding as a parameter in multi-criteria analysis for industrial site selection

Science.gov (United States)

Christina, C.; Memos, C.; Diakoulaki, D.

2014-12-01

Natural hazards can trigger major industrial accidents, which apart from affecting industrial installations may cause a series of accidents with serious impacts on human health and the environment far beyond the site boundary. Such accidents, also called Na-Tech (natural - technical) accidents, deserve particular attention since they can cause release of hazardous substances possibly resulting in severe environmental pollution, explosions and/or fires. There are different kinds of natural events or, in general terms, of natural causes of industrial accidents, such as landslides, hurricanes, high winds, tsunamis, lightning, cold/hot temperature, floods, heavy rains etc that have caused accidents. The scope of this paper is to examine the coastal flooding as a parameter in causing an industrial accident, such as the nuclear disaster in Fukushima, Japan, and the critical role of this parameter in industrial site selection. Land use planning is a complex procedure that requires multi-criteria decision analysis involving economic, environmental and social parameters. In this context the parameter of a natural hazard occurrence, such as coastal flooding, for industrial site selection should be set by the decision makers. In this paper it is evaluated the influence that has in the outcome of a multi-criteria decision analysis for industrial spatial planning the parameter of an accident risk triggered by coastal flooding. The latter is analyzed in the context of both sea-and-inland induced flooding.
Use of the Multi-Agency Radiological Laboratory Analytical Protocols Manual (MARLAP) for site cleanup activities

International Nuclear Information System (INIS)

Griggs, J.

1999-01-01

MARLAP is being developed as a multi-agency guidance manual for project managers and radioanalytical laboratories. The document uses a performance based approach and will provide guidance and a framework to assure that laboratory radioanalytical data meets the specific project or program needs and requirements. MARLAP supports a wide range of data collection activities including site characterization and compliance demonstration activities. Current participants include: US Environmental Protection Agency (EPA), US Department of Energy (DOE), US Nuclear Regulatory Commission (NRC), US Department of Defense (DoD), US National Institutes of Standards and Technology (NIST), US Geologic Survey (USGS), US Food and Drug Administration (FDA), Commonwealth of Kentucky, and the State of California. MARLAP is the radioanalytical laboratory counterpart to the Multi-Agency Radiological Survey and Site Investigation Manual (MARSSIM). MARLAP is currently in a preliminary draft stage. (author)
Biological stress systems, adverse life events and the onset of chronic multi-site musculoskeletal pain: a six-year cohort study

NARCIS (Netherlands)

Generaal, E.; Vogelzangs, N.; MacFarlane, G.J.; Geenen, R.|info:eu-repo/dai/nl/087017571; Smit, J.H.; de Geus, E.J.C.N.; Penninx, B.W.J.H.; Dekker, J.

2016-01-01

Objectives Dysregulated biological stress systems and adverse life events, independently and in interaction, have been hypothesised to initiate chronic pain. We examine whether (1) function of biological stress systems, (2) adverse life events, and (3) their combination predict the onset of chronic

Chance-constrained multi-objective optimization of groundwater remediation design at DNAPLs-contaminated sites using a multi-algorithm genetically adaptive method

Science.gov (United States)

Ouyang, Qi; Lu, Wenxi; Hou, Zeyu; Zhang, Yu; Li, Shuai; Luo, Jiannan

2017-05-01

In this paper, a multi-algorithm genetically adaptive multi-objective (AMALGAM) method is proposed as a multi-objective optimization solver. It was implemented in the multi-objective optimization of a groundwater remediation design at sites contaminated by dense non-aqueous phase liquids. In this study, there were two objectives: minimization of the total remediation cost, and minimization of the remediation time. A non-dominated sorting genetic algorithm II (NSGA-II) was adopted to compare with the proposed method. For efficiency, the time-consuming surfactant-enhanced aquifer remediation simulation model was replaced by a surrogate model constructed by a multi-gene genetic programming (MGGP) technique. Similarly, two other surrogate modeling methods-support vector regression (SVR) and Kriging (KRG)-were employed to make comparisons with MGGP. In addition, the surrogate-modeling uncertainty was incorporated in the optimization model by chance-constrained programming (CCP). The results showed that, for the problem considered in this study, (1) the solutions obtained by AMALGAM incurred less remediation cost and required less time than those of NSGA-II, indicating that AMALGAM outperformed NSGA-II. It was additionally shown that (2) the MGGP surrogate model was more accurate than SVR and KRG; and (3) the remediation cost and time increased with the confidence level, which can enable decision makers to make a suitable choice by considering the given budget, remediation time, and reliability.
A Development of Domestic Food Chain Model Data for Chronic Effect Estimation of Off-site Consequence Analysis

Energy Technology Data Exchange (ETDEWEB)

Han, Seok-Jung; KEUM, Dong-Kwon; Jang, Seung-Cheol [KAERI, Daejeon (Korea, Republic of)

2015-05-15

The FCM includes complex transport phenomena of radiation materials on a biokinetic system of contaminated environments. An estimation of chronic health effects is a key part of the level 3 PSA (Probabilistic Safety Assessment), which depends on the FCM estimation from contaminated foods ingestion. A cultural ingestion habit of a local region and agricultural productions are different to the general features over worldwide scale or case by case. This is a reason to develop a domestic FCM data for the level 3 PSA. However, a generation of the specific FCM data is a complex process and under a large degree of uncertainty due to inherent biokinetic models. As a preliminary study, the present study focuses on an infrastructure development to generation of a specific FCM data. During this process, the features of FCM data to generate a domestic FCM data were investigated. Based on the insights obtained from this process, a specific domestic FCM data was developed. The present study was developed a domestic FCM data to estimate the chronic health effects of off-site consequence analysis. From this study, an insight was obtained, that a domestic FCM data is roughly 20 times higher than the MACCS2 defaults data. Based on this observation, it is clear that the specific chronic health effects of a domestic plant site should be considered in the off-site consequence analysis.
A Development of Domestic Food Chain Model Data for Chronic Effect Estimation of Off-site Consequence Analysis

International Nuclear Information System (INIS)

Han, Seok-Jung; KEUM, Dong-Kwon; Jang, Seung-Cheol

2015-01-01

The FCM includes complex transport phenomena of radiation materials on a biokinetic system of contaminated environments. An estimation of chronic health effects is a key part of the level 3 PSA (Probabilistic Safety Assessment), which depends on the FCM estimation from contaminated foods ingestion. A cultural ingestion habit of a local region and agricultural productions are different to the general features over worldwide scale or case by case. This is a reason to develop a domestic FCM data for the level 3 PSA. However, a generation of the specific FCM data is a complex process and under a large degree of uncertainty due to inherent biokinetic models. As a preliminary study, the present study focuses on an infrastructure development to generation of a specific FCM data. During this process, the features of FCM data to generate a domestic FCM data were investigated. Based on the insights obtained from this process, a specific domestic FCM data was developed. The present study was developed a domestic FCM data to estimate the chronic health effects of off-site consequence analysis. From this study, an insight was obtained, that a domestic FCM data is roughly 20 times higher than the MACCS2 defaults data. Based on this observation, it is clear that the specific chronic health effects of a domestic plant site should be considered in the off-site consequence analysis
A study of changes in stomach wall at sites other than the ulcer in chronic duodenal ulcer patients.

Science.gov (United States)

Mishra, Jagmohan; Panigrahi, Souvagya

2011-08-01

It is known that at least 90% of duodenal ulcers are caused by infection with the bacterium Helicobacter pylori. Eradicating this organism usually results in complete resolution of the disease (Rosengren, Br J Gen Pract 46(409):491-492, 1996). To study the different changes if any in stomach wall at sites other than the ulcer in chronic duodenal ulcer patients by upper Gastro-Intenstinal Endoscopy followed by histopathological examination of different parts of stomach. This study was a retrospective study conducted in the Department of General surgery, V.S.S. Medical College, Burla, Sambalpur, odisha during the period of June 2007 to May 2009. Subjects were patients with chronic duodenal ulcer who underwent endoscopic examination, gastric biopsy and rapid urease test. Chronic gastritis of antrum, followed by erythematous pangastritis was the prominent feature both in endoscopy and histopathological examination. The Inflammatory change affected the mucosa and submucosa of the stomach wall. The prevalence rate of Helicobacter pylori was 84%, the antrum being the most common affected part (84%) followed by gastric fundus (41%). Chronic superficial atrophic gastritis of antrum, followed by pangastritis is the most common pathological abnormality in stomach wall in CDU cases. Gastric antrum is the most common site for H. pylori colonization followed by fundus. Presence of H. pylori in stomach wall is associated with active on chronic gastritis.
Chronic swelling from entrapment of acrylic resin in a surgical extraction site

Directory of Open Access Journals (Sweden)

Weiting Ho

2010-01-01

Full Text Available When acrylic resin is inadvertently embedded in oral tissue, it can result in a pronounced chronic inflammatory response. This report describes a case in which temporary crown and bridge resin was forced into a surgical extraction site after the two adjacent teeth were prepared for a bridge immediately following extraction of a maxillary premolar. The patient experienced swelling at the extraction site over a ten month period despite treatment with antibiotics and anti-inflammatory drugs. After detection and removal of the foreign body, the symptoms resolved. The episode contributed to periodontal bone loss around an adjacent tooth. While morbidity of this nature is rare, this case reinforces the need to investigate persistent signs of inflammation and account for dental materials that are lost during the course of treatment.
Integrative invasion science: model systems, multi-site studies, focused meta-analysis, and invasion syndromes

Czech Academy of Sciences Publication Activity Database

Kueffer, C.; Pyšek, Petr; Richardson, D. M.

2013-01-01

Roč. 200, č. 3 (2013), s. 615-633 ISSN 1469-8137 R&D Projects: GA ČR(CZ) GAP504/11/1028; GA ČR GA206/09/0563 Institutional support: RVO:67985939 Keywords : model systems * invasion syndromes * multi-site studies Subject RIV: EF - Botanics Impact factor: 6.545, year: 2013
Efficacy and safety of novel multi-lumen catheter for chronic total occlusions: from preclinical study to first-in-man experience.

Science.gov (United States)

Mitsutake, Yoshiaki; Ebner, Adrian; Yeung, Alan C; Taber, Mark D; Davidson, Charles J; Ikeno, Fumiaki

2015-02-15

To report our initial animal and human experience with a new multi-lumen catheter called MultiCross™ (Roxwood Medical, Inc.) in a porcine coronary model and patients with a chronic total occlusion (CTO). Preclinical safety study was done in the coronary vasculature of a porcine model. In a clinical setting, patients with a CTO of a coronary artery (n = 5) were enrolled. After an initial unsuccessful attempt using a conventional guidewire, operators could use the MultiCross system. The primary efficacy endpoint was successful recanalization (technical success) and the primary safety endpoint was serious adverse events through 30 days post-procedure. The MultiCross catheter was used for all patients after failure of the initial attempt with a guidewire. Successful recanalization was achieved in all CTOs attempted (100%). No patients reported any adverse events at 30 days post-procedure. In this first-in-man experience, the MultiCross catheter has the potential to enhance crossing of CTOs. © 2014 Wiley Periodicals, Inc.
A Multi-Data Source and Multi-Sensor Approach for the 3D Reconstruction and Web Visualization of a Complex Archaelogical Site: The Case Study of “Tolmo De Minateda”

Directory of Open Access Journals (Sweden)

Jose Alberto Torres-Martínez

2016-06-01

Full Text Available The complexity of archaeological sites hinders creation of an integral model using the current Geomatic techniques (i.e., aerial, close-range photogrammetry and terrestrial laser scanner individually. A multi-sensor approach is therefore proposed as the optimal solution to provide a 3D reconstruction and visualization of these complex sites. Sensor registration represents a riveting milestone when automation is required and when aerial and terrestrial datasets must be integrated. To this end, several problems must be solved: coordinate system definition, geo-referencing, co-registration of point clouds, geometric and radiometric homogeneity, etc. The proposed multi-data source and multi-sensor approach is applied to the study case of the “Tolmo de Minateda” archaeological site. A total extension of 9 ha is reconstructed, with an adapted level of detail, by an ultralight aerial platform (paratrike, an unmanned aerial vehicle, a terrestrial laser scanner and terrestrial photogrammetry. Finally, a mobile device (e.g., tablet or smartphone has been used to integrate, optimize and visualize all this information, providing added value to archaeologists and heritage managers who want to use an efficient tool for their works at the site, and even for non-expert users who just want to know more about the archaeological settlement.
Chance-constrained multi-objective optimization of groundwater remediation design at DNAPLs-contaminated sites using a multi-algorithm genetically adaptive method.

Science.gov (United States)

Ouyang, Qi; Lu, Wenxi; Hou, Zeyu; Zhang, Yu; Li, Shuai; Luo, Jiannan

2017-05-01

In this paper, a multi-algorithm genetically adaptive multi-objective (AMALGAM) method is proposed as a multi-objective optimization solver. It was implemented in the multi-objective optimization of a groundwater remediation design at sites contaminated by dense non-aqueous phase liquids. In this study, there were two objectives: minimization of the total remediation cost, and minimization of the remediation time. A non-dominated sorting genetic algorithm II (NSGA-II) was adopted to compare with the proposed method. For efficiency, the time-consuming surfactant-enhanced aquifer remediation simulation model was replaced by a surrogate model constructed by a multi-gene genetic programming (MGGP) technique. Similarly, two other surrogate modeling methods-support vector regression (SVR) and Kriging (KRG)-were employed to make comparisons with MGGP. In addition, the surrogate-modeling uncertainty was incorporated in the optimization model by chance-constrained programming (CCP). The results showed that, for the problem considered in this study, (1) the solutions obtained by AMALGAM incurred less remediation cost and required less time than those of NSGA-II, indicating that AMALGAM outperformed NSGA-II. It was additionally shown that (2) the MGGP surrogate model was more accurate than SVR and KRG; and (3) the remediation cost and time increased with the confidence level, which can enable decision makers to make a suitable choice by considering the given budget, remediation time, and reliability. Copyright © 2017 Elsevier B.V. All rights reserved.
A Multi-Site Campaign to Measure Solar-Like Oscillations in Procyon. II. Mode Frequencies

DEFF Research Database (Denmark)

Bedding, Timothy R.; Kjeldsen, Hans; Campante, Tiago L.

2010-01-01

We have analyzed data from a multi-site campaign to observe oscillations in the F5 star Procyon. The data consist of high-precision velocities that we obtained over more than three weeks with 11 telescopes. A new method for adjusting the data weights allows us to suppress the sidelobes in the p...
Clinical relevance of the breakpoint sites within the M-BCR in 50 patients from Argentina with chronic myeloid leukemia.

Science.gov (United States)

Giere, I A; Larripa, I B

1996-08-01

Fifty patients from Argentina with chronic myeloid leukemia (CML) were studied in order to characterize the breakpoint site within the major breakpoint cluster region (M-BCR) and its relationship with the duration of the chronic phase (CP). The DNA digestion with the restriction enzymes: Bgl II, BAM HI and Hind III and hybridization with the 1.2Kb Hind III-Bgl II bcr probe showed that 56% of cases had the breakpoint in 5'M-bcr region and the remaining 44% in 3'M-bcr region. The duration of chronic phase from diagnosis to the onset of the blast crisis (BC) was correlated with the location of the breakpoint within the M-bcr and no statistical differences were observed between the 5' and the 3' groups. These data indicate that the breakpoint site within the bcr gene is not a prognostic indicator of the duration of CP of the disease.
PG 1605+072 in Wet XCov22: Support for the Multi Site Spectroscopic Telescope

Directory of Open Access Journals (Sweden)

Schuh S. L.

2003-03-01

Full Text Available The Multi-site spectroscopic telescope is a virtual instrument and the name of a collaboration that opens up a new observational window by combining continuous observations of spectroscopic variations and simultaneous photometric monitoring. This constitutes an enormous observational effort, but in return promises to finally provide access to a mode identification for and an asteroseismological analysis of the pulsating sdB star PG 1605+072. Multi-Site Spectroscopic Telescope observations for this object have been secured during a large coordinated campaign in May and June of the year 2002. The frequency resolution and coverage of the photometric time series has been noticeably enhanced by a significant contribution from the Whole Earth Telescope, which was used to observe PG 1605+072 as an alternate target during the WET XCov22 campaign, also conducted in May 2002. This paper briefly outlines the motivation for the MSST project and tries to give a first assessment of the overall quality of the data obtained, with a focus on the Whole Earth Telescope observations.
Bias and Bias Correction in Multi-Site Instrumental Variables Analysis of Heterogeneous Mediator Effects

Science.gov (United States)

Reardon, Sean F.; Unlu, Faith; Zhu, Pei; Bloom, Howard

2013-01-01

We explore the use of instrumental variables (IV) analysis with a multi-site randomized trial to estimate the effect of a mediating variable on an outcome in cases where it can be assumed that the observed mediator is the only mechanism linking treatment assignment to outcomes, as assumption known in the instrumental variables literature as the…
Biological stress systems, adverse life events and the improvement of chronic multi-site musculoskeletal pain across a 6-year follow-up

NARCIS (Netherlands)

Generaal, E.; Vogelzangs, N.; Macfarlane, G.J.; Geenen, R.; Smit, J.H.; de Geus, E.J.C.N.; Dekker, J.; Penninx, B.W.J.H.

Dysfunction of biological stress systems and adverse life events, independently and in interaction, have been hypothesized to predict chronic pain persistence. Conversely, these factors may hamper the improvement of chronic pain. Longitudinal evidence is currently lacking. We examined whether: 1)
Self-adaptive tensor network states with multi-site correlators

Science.gov (United States)

Kovyrshin, Arseny; Reiher, Markus

2017-12-01

We introduce the concept of self-adaptive tensor network states (SATNSs) based on multi-site correlators. The SATNS ansatz gradually extends its variational space incorporating the most important next-order correlators into the ansatz for the wave function. The selection of these correlators is guided by entanglement-entropy measures from quantum information theory. By sequentially introducing variational parameters and adjusting them to the system under study, the SATNS ansatz achieves keeping their number significantly smaller than the total number of full-configuration interaction parameters. The SATNS ansatz is studied for manganocene in its lowest-energy sextet and doublet states; the latter of which is known to be difficult to describe. It is shown that the SATNS parametrization solves the convergence issues found for previous correlator-based tensor network states.
Multisite, multimodal neuroimaging of chronic urological pelvic pain: Methodology of the MAPP Research Network

Directory of Open Access Journals (Sweden)

Jeffry R. Alger

2016-01-01

Full Text Available The Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP Research Network is an ongoing multi-center collaborative research group established to conduct integrated studies in participants with urologic chronic pelvic pain syndrome (UCPPS. The goal of these investigations is to provide new insights into the etiology, natural history, clinical, demographic and behavioral characteristics, search for new and evaluate candidate biomarkers, systematically test for contributions of infectious agents to symptoms, and conduct animal studies to understand underlying mechanisms for UCPPS. Study participants were enrolled in a one-year observational study and evaluated through a multisite, collaborative neuroimaging study to evaluate the association between UCPPS and brain structure and function. 3D T1-weighted structural images, resting-state fMRI, and high angular resolution diffusion MRI were acquired in five participating MAPP Network sites using 8 separate MRI hardware and software configurations. We describe the neuroimaging methods and procedures used to scan participants, the challenges encountered in obtaining data from multiple sites with different equipment/software, and our efforts to minimize site-to-site variation.
Fixed-site high-frequency transcutaneous electrical nerve stimulation for treatment of chronic low back and lower extremity pain

OpenAIRE

Gozani, Shai

2016-01-01

Shai N Gozani NeuroMetrix, Inc., Waltham, MA, USA Objective: The objective of this study was to determine if fixed-site high-frequency transcutaneous electrical nerve stimulation (FS-TENS) is effective in treating chronic low back and lower extremity pain. Background: Transcutaneous electrical nerve stimulation is widely used for treatment of chronic pain. General-purpose transcutaneous electrical nerve stimulation devices are designed for stimulation anywhere on the body and often cannot be ...
Settings for Physical Activity – Developing a Site-specific Physical Activity Behavior Model based on Multi-level Intervention Studies

DEFF Research Database (Denmark)

Troelsen, Jens; Klinker, Charlotte Demant; Breum, Lars

Settings for Physical Activity – Developing a Site-specific Physical Activity Behavior Model based on Multi-level Intervention Studies Introduction: Ecological models of health behavior have potential as theoretical framework to comprehend the multiple levels of factors influencing physical...... to be taken into consideration. A theoretical implication of this finding is to develop a site-specific physical activity behavior model adding a layered structure to the ecological model representing the determinants related to the specific site. Support: This study was supported by TrygFonden, Realdania...... activity (PA). The potential is shown by the fact that there has been a dramatic increase in application of ecological models in research and practice. One proposed core principle is that an ecological model is most powerful if the model is behavior-specific. However, based on multi-level interventions...
Analysis of Multi-Criteria Evaluation Method of Landfill Site Selection for Municipal Solid Waste Management

Science.gov (United States)

Mohammed, Habiba Ibrahim; Majid, Zulkepli; Yusof, Norhakim Bin; Bello Yamusa, Yamusa

2018-03-01

Landfilling remains the most common systematic technique of solid waste disposal in most of the developed and developing countries. Finding a suitable site for landfill is a very challenging task. Landfill site selection process aims to provide suitable areas that will protect the environment and public health from pollution and hazards. Therefore, various factors such as environmental, physical, socio-economic, and geological criteria must be considered before siting any landfill. This makes the site selection process vigorous and tedious because it involves the processing of large amount of spatial data, rules and regulations from different agencies and also policy from decision makers. This allows the incorporation of conflicting objectives and decision maker preferences into spatial decision models. This paper particularly analyzes the multi-criteria evaluation (MCE) method of landfill site selection for solid waste management by means of literature reviews and surveys. The study will help the decision makers and waste management authorities to choose the most effective method when considering landfill site selection.
Analysis of Multi-Criteria Evaluation Method of Landfill Site Selection for Municipal Solid Waste Management

Directory of Open Access Journals (Sweden)

Ibrahim Mohammed Habiba

2018-01-01

Full Text Available Landfilling remains the most common systematic technique of solid waste disposal in most of the developed and developing countries. Finding a suitable site for landfill is a very challenging task. Landfill site selection process aims to provide suitable areas that will protect the environment and public health from pollution and hazards. Therefore, various factors such as environmental, physical, socio-economic, and geological criteria must be considered before siting any landfill. This makes the site selection process vigorous and tedious because it involves the processing of large amount of spatial data, rules and regulations from different agencies and also policy from decision makers. This allows the incorporation of conflicting objectives and decision maker preferences into spatial decision models. This paper particularly analyzes the multi-criteria evaluation (MCE method of landfill site selection for solid waste management by means of literature reviews and surveys. The study will help the decision makers and waste management authorities to choose the most effective method when considering landfill site selection.

Robust site security using smart seismic array technology and multi-sensor data fusion

Science.gov (United States)

Hellickson, Dean; Richards, Paul; Reynolds, Zane; Keener, Joshua

2010-04-01

Traditional site security systems are susceptible to high individual sensor nuisance alarm rates that reduce the overall system effectiveness. Visual assessment of intrusions can be intensive and manually difficult as cameras are slewed by the system to non intrusion areas or as operators respond to nuisance alarms. Very little system intrusion performance data are available other than discrete sensor alarm indications that provide no real value. This paper discusses the system architecture, integration and display of a multi-sensor data fused system for wide area surveillance, local site intrusion detection and intrusion classification. The incorporation of a novel seismic array of smart sensors using FK Beamforming processing that greatly enhances the overall system detection and classification performance of the system is discussed. Recent test data demonstrates the performance of the seismic array within several different installations and its ability to classify and track moving targets at significant standoff distances with exceptional immunity to background clutter and noise. Multi-sensor data fusion is applied across a suite of complimentary sensors eliminating almost all nuisance alarms while integrating within a geographical information system to feed a visual-fusion display of the area being secured. Real-time sensor detection and intrusion classification data is presented within a visual-fusion display providing greatly enhanced situational awareness, system performance information and real-time assessment of intrusions and situations of interest with limited security operator involvement. This approach scales from a small local perimeter to very large geographical area and can be used across multiple sites controlled at a single command and control station.
Multi-component assessment of chronic obstructive pulmonary disease : an evaluation of the ADO and DOSE indices and the global obstructive lung disease categories in international primary care data sets

NARCIS (Netherlands)

Jones, Rupert C.; Price, David; Chavannes, Niels H.; Lee, Amanda J.; Hyland, Michael E.; Stallberg, Bjorn; Lisspers, Karin; Sundh, Josefin; van der Molen, Thys; Tsiligianni, Ioanna

2016-01-01

Suitable tools for assessing the severity of chronic obstructive pulmonary disease (COPD) include multi-component indices and the global initiative for chronic obstructive lung disease (GOLD) categories. The aim of this study was to evaluate the dyspnoea, obstruction, smoking, exacerbation (DOSE)
Distortions in Distributions of Impact Estimates in Multi-Site Trials: The Central Limit Theorem Is Not Your Friend

Science.gov (United States)

May, Henry

2014-01-01

Interest in variation in program impacts--How big is it? What might explain it?--has inspired recent work on the analysis of data from multi-site experiments. One critical aspect of this problem involves the use of random or fixed effect estimates to visualize the distribution of impact estimates across a sample of sites. Unfortunately, unless the…
SNL-NUMO collaborative : development of a deterministic site characterization tool using multi-model ranking and inference.

Energy Technology Data Exchange (ETDEWEB)

Grace, Matthew; Lowry, Thomas Stephen; Arnold, Bill Walter; James, Scott Carlton; Gray, Genetha Anne; Ahlmann, Michael

2008-08-01

Uncertainty in site characterization arises from a lack of data and knowledge about a site and includes uncertainty in the boundary conditions, uncertainty in the characteristics, location, and behavior of major features within an investigation area (e.g., major faults as barriers or conduits), uncertainty in the geologic structure, as well as differences in numerical implementation (e.g., 2-D versus 3-D, finite difference versus finite element, grid resolution, deterministic versus stochastic, etc.). Since the true condition at a site can never be known, selection of the best conceptual model is very difficult. In addition, limiting the understanding to a single conceptualization too early in the process, or before data can support that conceptualization, may lead to confidence in a characterization that is unwarranted as well as to data collection efforts and field investigations that are misdirected and/or redundant. Using a series of numerical modeling experiments, this project examined the application and use of information criteria within the site characterization process. The numerical experiments are based on models of varying complexity that were developed to represent one of two synthetically developed groundwater sites; (1) a fully hypothetical site that represented a complex, multi-layer, multi-faulted site, and (2) a site that was based on the Horonobe site in northern Japan. Each of the synthetic sites were modeled in detail to provide increasingly informative 'field' data over successive iterations to the representing numerical models. The representing numerical models were calibrated to the synthetic site data and then ranked and compared using several different information criteria approaches. Results show, that for the early phases of site characterization, low-parameterized models ranked highest while more complex models generally ranked lowest. In addition, predictive capabilities were also better with the low-parameterized models. For
Deficient prepulse inhibition in schizophrenia detected by the multi-site COGS.

Science.gov (United States)

Swerdlow, Neal R; Light, Gregory A; Sprock, Joyce; Calkins, Monica E; Green, Michael F; Greenwood, Tiffany A; Gur, Raquel E; Gur, Ruben C; Lazzeroni, Laura C; Nuechterlein, Keith H; Radant, Allen D; Ray, Amrita; Seidman, Larry J; Siever, Larry J; Silverman, Jeremy M; Stone, William S; Sugar, Catherine A; Tsuang, Debby W; Tsuang, Ming T; Turetsky, Bruce I; Braff, David L

2014-02-01

Startle inhibition by weak prepulses (PPI) is studied to understand the biology of information processing in schizophrenia patients and healthy comparison subjects (HCS). The Consortium on the Genetics of Schizophrenia (COGS) identified associations between PPI and single nucleotide polymorphisms in schizophrenia probands and unaffected relatives, and linkage analyses extended evidence for the genetics of PPI deficits in schizophrenia in the COGS-1 family study. These findings are being extended in a 5-site "COGS-2" study of 1800 patients and 1200 unrelated HCS to facilitate genetic analyses. We describe a planned interim analysis of COGS-2 PPI data. Eyeblink startle was measured in carefully screened HCS and schizophrenia patients (n=1402). Planned analyses of PPI (60 ms intervals) assessed effects of diagnosis, sex and test site, PPI-modifying effects of medications and smoking, and relationships between PPI and neurocognitive measures. 884 subjects met strict inclusion criteria. ANOVA of PPI revealed significant effects of diagnosis (p=0.0005) and sex (pschizophrenia PPI differences were greatest among patients not taking 2nd generation antipsychotics, and were independent of smoking status. Modest but significant relationships were detected between PPI and performance in specific neurocognitive measures. The COGS-2 multi-site study detects schizophrenia-related PPI deficits reported in single-site studies, including patterns related to diagnosis, prepulse interval, sex, medication and other neurocognitive measures. Site differences were detected and explored. The target COGS-2 schizophrenia "endophenotype" of reduced PPI should prove valuable for identifying and confirming schizophrenia risk genes in future analyses. Copyright © 2013 Elsevier B.V. All rights reserved.
a Framework for Low-Cost Multi-Platform VR and AR Site Experiences

Science.gov (United States)

Wallgrün, J. O.; Huang, J.; Zhao, J.; Masrur, A.; Oprean, D.; Klippel, A.

2017-11-01

Low-cost consumer-level immersive solutions have the potential to revolutionize education and research in many fields by providing virtual experiences of sites that are either inaccessible, too dangerous, or too expensive to visit, or by augmenting in-situ experiences using augmented and mixed reality methods. We present our approach for creating low-cost multi-platform virtual and augmented reality site experiences of real world places for education and research purposes, making extensive use of Structure-from-Motion methods as well as 360° photography and videography. We discuss several example projects, for the Mayan City of Cahal Pech, Iceland's Thrihnukar volcano, the Santa Marta informal settlement in Rio, and for the Penn State Campus, and we propose a framework for creating and maintaining such applications by combining declarative content specification methods with a central linked-data based spatio-temporal information system.
Multi-site laser Doppler flowmetry for assessing collateral flow in experimental ischemic stroke: Validation of outcome prediction with acute MRI.

Science.gov (United States)

Cuccione, Elisa; Versace, Alessandro; Cho, Tae-Hee; Carone, Davide; Berner, Lise-Prune; Ong, Elodie; Rousseau, David; Cai, Ruiyao; Monza, Laura; Ferrarese, Carlo; Sganzerla, Erik P; Berthezène, Yves; Nighoghossian, Norbert; Wiart, Marlène; Beretta, Simone; Chauveau, Fabien

2017-06-01

High variability in infarct size is common in experimental stroke models and affects statistical power and validity of neuroprotection trials. The aim of this study was to explore cerebral collateral flow as a stratification factor for the prediction of ischemic outcome. Transient intraluminal occlusion of the middle cerebral artery was induced for 90 min in 18 Wistar rats. Cerebral collateral flow was assessed intra-procedurally using multi-site laser Doppler flowmetry monitoring in both the lateral middle cerebral artery territory and the borderzone territory between middle cerebral artery and anterior cerebral artery. Multi-modal magnetic resonance imaging was used to assess acute ischemic lesion (diffusion-weighted imaging, DWI), acute perfusion deficit (time-to-peak, TTP), and final ischemic lesion at 24 h. Infarct volumes and typology at 24 h (large hemispheric versus basal ganglia infarcts) were predicted by both intra-ischemic collateral perfusion and acute DWI lesion volume. Collateral flow assessed by multi-site laser Doppler flowmetry correlated with the corresponding acute perfusion deficit using TTP maps. Multi-site laser Doppler flowmetry monitoring was able to predict ischemic outcome and perfusion deficit in good agreement with acute MRI. Our results support the additional value of cerebral collateral flow monitoring for outcome prediction in experimental ischemic stroke, especially when acute MRI facilities are not available.
A MultiSite GatewayTM vector set for the functional analysis of genes in the model Saccharomyces cerevisiae

Directory of Open Access Journals (Sweden)

Nagels Durand Astrid

2012-09-01

Full Text Available Abstract Background Recombinatorial cloning using the GatewayTM technology has been the method of choice for high-throughput omics projects, resulting in the availability of entire ORFeomes in GatewayTM compatible vectors. The MultiSite GatewayTM system allows combining multiple genetic fragments such as promoter, ORF and epitope tag in one single reaction. To date, this technology has not been accessible in the yeast Saccharomyces cerevisiae, one of the most widely used experimental systems in molecular biology, due to the lack of appropriate destination vectors. Results Here, we present a set of three-fragment MultiSite GatewayTM destination vectors that have been developed for gene expression in S. cerevisiae and that allow the assembly of any promoter, open reading frame, epitope tag arrangement in combination with any of four auxotrophic markers and three distinct replication mechanisms. As an example of its applicability, we used yeast three-hybrid to provide evidence for the assembly of a ternary complex of plant proteins involved in jasmonate signalling and consisting of the JAZ, NINJA and TOPLESS proteins. Conclusion Our vectors make MultiSite GatewayTM cloning accessible in S. cerevisiae and implement a fast and versatile cloning method for the high-throughput functional analysis of (heterologous proteins in one of the most widely used model organisms for molecular biology research.
Multi-method Near-surface Geophysical Surveys for Site Response and Earthquake Damage Assessments at School Sites in Washington, USA

Science.gov (United States)

Cakir, R.; Walsh, T. J.; Norman, D. K.

2017-12-01

We, Washington Geological Survey (WGS), have been performing multi-method near surface geophysical surveys to help assess potential earthquake damage at public schools in Washington. We have been conducting active and passive seismic surveys, and estimating Shear-wave velocity (Vs) profiles, then determining the NEHRP soil classifications based on Vs30m values at school sites in Washington. The survey methods we have used: 1D and 2D MASW and MAM, P- and S-wave refraction, horizontal-to-vertical spectral ratio (H/V), and 2ST-SPAC to measure Vs and Vp at shallow (0-70m) and greater depths at the sites. We have also run Ground Penetrating Radar (GPR) surveys at the sites to check possible horizontal subsurface variations along and between the seismic survey lines and the actual locations of the school buildings. The seismic survey results were then used to calculate Vs30m for determining the NEHRP soil classifications at school sites, thus soil amplification effects on the ground motions. Resulting shear-wave velocity profiles generated from these studies can also be used for site response and liquefaction potential studies, as well as for improvement efforts of the national Vs30m database, essential information for ShakeMap and ground motion modeling efforts in Washington and Pacific Northwest. To estimate casualties, nonstructural, and structural losses caused by the potential earthquakes in the region, we used these seismic site characterization results associated with structural engineering evaluations based on ASCE41 or FEMA 154 (Rapid Visual Screening) as inputs in FEMA Hazus-Advanced Engineering Building Module (AEBM) analysis. Compelling example surveys will be presented for the school sites in western and eastern Washington.
Case Study of Multi-Unit Risk: Multi-Unit Station Black-Out

Energy Technology Data Exchange (ETDEWEB)

Oh, Kyemin; Jang, Seung-cheol [KAERI, Daejeon (Korea, Republic of); Heo, Gyunyoung [Kyung Hee University, Yongin (Korea, Republic of)

2015-05-15

After Fukushima Daiichi Accident, importance and public concern for Multi-Unit Risk (MUR) or Probabilistic Safety Assessment (PSA) have been increased. Most of nuclear power plant sites in the world have more than two units. These sites have been facing the problems of MUR or accident such as Fukushima. In case of South Korea, there are generally more than four units on the same site and even more than ten units are also expected. In other words, sites in South Korea also have been facing same problems. Considering number of units on the same site, potential of these problems may be larger than other countries. The purpose of this paper is to perform case study based on another paper submitted in the conference. MUR is depended on various site features such as design, shared systems/structures, layout, environmental condition, and so on. Considering various dependencies, we assessed Multi-Unit Station Black-out (MSBO) accident based on Hanul Unit 3 and 4 model. In this paper, case study for multi-unit risk or PSA had been performed. Our result was incomplete to assess total multi-unit risk because of two challenging issues. First, economic impact had not been evaluated to estimate multi-unit risk. Second, large uncertainties were included in our result because of various assumptions. These issues must be resolved in the future.
Case Study of Multi-Unit Risk: Multi-Unit Station Black-Out

International Nuclear Information System (INIS)

Oh, Kyemin; Jang, Seung-cheol; Heo, Gyunyoung

2015-01-01

After Fukushima Daiichi Accident, importance and public concern for Multi-Unit Risk (MUR) or Probabilistic Safety Assessment (PSA) have been increased. Most of nuclear power plant sites in the world have more than two units. These sites have been facing the problems of MUR or accident such as Fukushima. In case of South Korea, there are generally more than four units on the same site and even more than ten units are also expected. In other words, sites in South Korea also have been facing same problems. Considering number of units on the same site, potential of these problems may be larger than other countries. The purpose of this paper is to perform case study based on another paper submitted in the conference. MUR is depended on various site features such as design, shared systems/structures, layout, environmental condition, and so on. Considering various dependencies, we assessed Multi-Unit Station Black-out (MSBO) accident based on Hanul Unit 3 and 4 model. In this paper, case study for multi-unit risk or PSA had been performed. Our result was incomplete to assess total multi-unit risk because of two challenging issues. First, economic impact had not been evaluated to estimate multi-unit risk. Second, large uncertainties were included in our result because of various assumptions. These issues must be resolved in the future
A FRAMEWORK FOR LOW-COST MULTI-PLATFORM VR AND AR SITE EXPERIENCES

Directory of Open Access Journals (Sweden)

J. O. Wallgrün

2017-11-01

Full Text Available Low-cost consumer-level immersive solutions have the potential to revolutionize education and research in many fields by providing virtual experiences of sites that are either inaccessible, too dangerous, or too expensive to visit, or by augmenting in-situ experiences using augmented and mixed reality methods. We present our approach for creating low-cost multi-platform virtual and augmented reality site experiences of real world places for education and research purposes, making extensive use of Structure-from-Motion methods as well as 360° photography and videography. We discuss several example projects, for the Mayan City of Cahal Pech, Iceland’s Thrihnukar volcano, the Santa Marta informal settlement in Rio, and for the Penn State Campus, and we propose a framework for creating and maintaining such applications by combining declarative content specification methods with a central linked-data based spatio-temporal information system.
Quantification by qPCR of Pathobionts in Chronic Periodontitis: Development of Predictive Models of Disease Severity at Site-Specific Level

OpenAIRE

Tomás, Inmaculada; Regueira-Iglesias, Alba; López, Maria; Arias-Bujanda, Nora; Novoa, Lourdes; Balsa-Castro, Carlos; Tomás, Maria

2017-01-01

Currently, there is little evidence available on the development of predictive models for the diagnosis or prognosis of chronic periodontitis based on the qPCR quantification of subgingival pathobionts. Our objectives were to: (1) analyze and internally validate pathobiont-based models that could be used to distinguish different periodontal conditions at site-specific level within the same patient with chronic periodontitis; (2) develop nomograms derived from predictive models. Subgingival pl...
Multi-Site Project Management A Program for Reducing the Cost of Technology Deployment at Department of Energy Sites

International Nuclear Information System (INIS)

Davis, N.R.; Selden, E.R.; Little, D.B.; Coleman, M.C.; Bennett, J.T.

2009-01-01

Retrieval and processing of High Level Waste (HLW) stored in Department of Energy (DOE) waste tanks is performed to support closure of the tanks as required by site specific regulatory agreements. Currently, there are four sites in the DOE Complex that have HLW tanks and must process and disposition HLW. As such, there is an opportunity to achieve an economy of scale and reduce duplication of efforts. Two or more sites typically have similar technology development and deployment needs. Technology development is already executed at the national level. As the technology is matured, the next step is to commission a design/build project. Typically each site performs this separately due to differences in waste type, tank design, site specific considerations such as proximity to the water table or to the site boundary. The focus of the individual sites tends to be on the differences between sites versus on the similarities thus there is an opportunity to minimize the cost for similar deployments. A team of engineers and project management professionals from the Savannah River Site has evaluated technology needs at the four HLW sites and determined that there is an economy of scale that can be achieved by specific technology deployments in the area of waste retrieval, waste pretreatment and waste disposition. As an example, the Waste on Wheels tank retrieval system (presented in the 2006 Waste Management Symposium) was designed and fabricated in portable modules that could be installed in HLW tanks at Hanford, Savannah River or Idaho. This same concept could be used for modular in-tank cesium removal process and equipment, tank cleaning mechanical equipment, and chemical tank cleaning process and equipment. The purpose of this paper is to present a multi-site project management approach that will reduce deployment costs and be consistent with DOE Order 413.3 project management principles. The approach will describe how projects can be managed by a lead site with
Video Game Rehabilitation for Outpatient Stroke (VIGoROUS): protocol for a multi-center comparative effectiveness trial of in-home gamified constraint-induced movement therapy for rehabilitation of chronic upper extremity hemiparesis.

Science.gov (United States)

Gauthier, Lynne V; Kane, Chelsea; Borstad, Alexandra; Strahl, Nancy; Uswatte, Gitendra; Taub, Edward; Morris, David; Hall, Alli; Arakelian, Melissa; Mark, Victor

2017-06-08

Constraint-Induced Movement therapy (CI therapy) is shown to reduce disability, increase use of the more affected arm/hand, and promote brain plasticity for individuals with upper extremity hemiparesis post-stroke. Randomized controlled trials consistently demonstrate that CI therapy is superior to other rehabilitation paradigms, yet it is available to only a small minority of the estimated 1.2 million chronic stroke survivors with upper extremity disability. The current study aims to establish the comparative effectiveness of a novel, patient-centered approach to rehabilitation utilizing newly developed, inexpensive, and commercially available gaming technology to disseminate CI therapy to underserved individuals. Video game delivery of CI therapy will be compared against traditional clinic-based CI therapy and standard upper extremity rehabilitation. Additionally, individual factors that differentially influence response to one treatment versus another will be examined. This protocol outlines a multi-site, randomized controlled trial with parallel group design. Two hundred twenty four adults with chronic hemiparesis post-stroke will be recruited at four sites. Participants are randomized to one of four study groups: (1) traditional clinic-based CI therapy, (2) therapist-as-consultant video game CI therapy, (3) therapist-as-consultant video game CI therapy with additional therapist contact via telerehabilitation/video consultation, and (4) standard upper extremity rehabilitation. After 6-month follow-up, individuals assigned to the standard upper extremity rehabilitation condition crossover to stand-alone video game CI therapy preceded by a therapist consultation. All interventions are delivered over a period of three weeks. Primary outcome measures include motor improvement as measured by the Wolf Motor Function Test (WMFT), quality of arm use for daily activities as measured by Motor Activity Log (MAL), and quality of life as measured by the Quality of Life in
Identifying factors related to family management during the coping process of families with childhood chronic conditions: a multi-site study.

Science.gov (United States)

Zhang, Ying; Wei, Min; Shen, Nanping; Zhang, Yaqing

2015-01-01

This study was designed to determine the key predictors for each aspect of family management of families with children who have chronic conditions in China. The participants included 399 caregivers whose children have chronic illnesses. We used the following instruments: Child Behavior Checklist; Feetham Family Functioning Survey; and Family Management Measures. The final modes of the hierarchical regression explained 29-48% of the variance in aspects of family management. More family support should be provided for those with low family income, children with renal and genetic disorders and rheumatic diseases and those living in rural areas. Child and family functioning affects family management. Copyright © 2015 Elsevier Inc. All rights reserved.
Projection of Climate Change Based on Multi-Site Statistical Downscaling over Gilan area, Iran

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Vesta Afzali

2017-01-01

Full Text Available Introduction: The phenomenon of climate change and its consequences is a familiar topic which is associated with natural disasters such as, flooding, hurricane, drought that cause water crisis and irreparable damages. Studying this phenomenon is a serious warning regarding the earth’s weather change for a long period of time. Materials and Methods: In order to understand and survey the impacts of climate change on water resources, Global Circulation Models, GCMs, are used; their main role is analyzing the current climate and projecting the future climate. Climate change scenarios developing from GCMs are the initial source of information to estimate plausible future climate. For transforming coarse resolution outputs of the GCMs into finer resolutions influenced by local variables, there is a need for reliable downscaling techniques in order to analyze climate changes in a region. The classical statistical methods run the model and generate the future climate just with considering the time variable. Multi-site daily rainfall and temperature time series are the primary inputs in most hydrological analyses such as rainfall-runoff modeling. Water resource management is directly influenced by the spatial and temporal variation of rainfall and temperature. Therefore, spatial-temporal modeling of daily rainfall or temperature including climate change effects is required for sustainable planning of water resources. Results and Discussion: For the first time, in this study by ASD model (Automated regression-based Statistical Downscaling tool developed by M. Hessami et al., multi-site downscaling of temperature and precipitation was done with CGCM3.1A2 outputs and two synoptic stations (Rasht and Bandar Anzali simultaneously by considering the correlations of multiple sites. The model can process conditionally on the occurrence of precipitation or unconditionally for temperature. Hence, the modeling of daily precipitation involves two steps: one step
Landfill Site Selection by AHP Based Multi-criteria Decision Making Tool: A Case Study in Kolkata, India

Science.gov (United States)

Majumdar, Ankush; Hazra, Tumpa; Dutta, Amit

2017-09-01

This work presents a Multi-criteria Decision Making (MCDM) tool to select a landfill site from three candidate sites proposed for Kolkata Municipal Corporation (KMC) area that complies with accessibility, receptor, environment, public acceptability, geological and economic criteria. Analytical Hierarchy Process has been used to solve the MCDM problem. Suitability of the three sites (viz. Natagachi, Gangajoara and Kharamba) as landfills as proposed by KMC has been checked by Landfill Site Sensitivity Index (LSSI) as well as Economic Viability Index (EVI). Land area availability for disposing huge quantity of Municipal Solid Waste for the design period has been checked. Analysis of the studied sites show that they are moderately suitable for landfill facility construction as both LSSI and EVI scores lay between 300 and 750. The proposed approach represents an effective MCDM tool for siting sanitary landfill in growing metropolitan cities of developing countries like India.
A Novel Approach to Site Selection: Collaborative Multi-Criteria Decision Making through Geo-Social Network (Case Study: Public Parking

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Zeinab Neisani Samani

2018-03-01

Full Text Available There are many potential factors that are involved in the decision making process of site selection, which makes it a challenging issue. This paper addresses the collaborative decision making concept through a geo-social network to predict site selection for public parking in Tehran, Iran. The presented approach utilized the analytic hierarchy process (AHP as a multi-criteria decision method (MCDM for weighting the criteria, which was completed in two stages; once by 50 experts, and then by three different levels of users, including 50 experts, 25 urban managers, and 150 pubic citizens, with respect to the case study area. The fuzzy majority method aggregates the archived results of AHP to determine the preferred locations that are suitable for public parking. The proposed method was implemented using a telegram bot platform. Two main advantages of the collaborative decision making scenario for public urban site selection are the fair distribution of the selected locations and the high satisfaction of users, which increased from 65% to 85%. This study presents an application for site selection based on multi-criteria decision making in a geo-social network context.
FDG PET/CT for therapeutic response monitoring in multi-site non-respiratory tuberculosis

International Nuclear Information System (INIS)

Geng Tian; Yong Xiao; Bin Chen; Jun Xia; Hong Guan; Qunyi Deng

2010-01-01

Background: Tuberculosis (TB) can produce positive signals during 18 F-fluorodeoxyglucose positron emission/computed tomography (FDG PET/CT) scanning. Until now, there has been no better method than clinical assessment to evaluate the therapeutic response of non-respiratory TB (NRTB). Purpose: To retrospectively assess the ability of FDG PET/CT to evaluate the response to anti-TB treatment in patients with NRTB. Material and Methods: Three patients with multi-site NRTB underwent repeat PET/CT scans during anti-TB treatment. Changes in maximal standard uptake value (SUVmax) of the TB lesions on PET/CT images were analyzed between two scans. Initial PET/CT scans were performed before the start of anti-TB treatment, and later scans were performed after completion of the treatment. Results: Patient 1, a 63-year-old female, and patient 2, a 50-year-old male, were diagnosed as multi-site NRTB by biopsy. Patient 3, a 37-year-old male was diagnosed clinically. These patients demonstrated multiple FDG-avid lesions in whole body on initial PET/CT images. The highest SUVmax of patient 1, 2, and 3 were 13.6, 17.7, and 13.9 separately. After completion of the treatment, all positive signals of patient 1, 2, and 3 decreased to undetectable value on repeated PET/CT scans with intervals of 318 days, 258 days, and 182 days separately. Conclusion: FDG PET/CT scan may be useful for monitoring responses to anti-TB treatment in patients with NRTB

Multi-Sensor Observations of Earthquake Related Atmospheric Signals over Major Geohazard Validation Sites

Science.gov (United States)

Ouzounov, D.; Pulinets, S.; Davindenko, D.; Hattori, K.; Kafatos, M.; Taylor, P.

2012-01-01

We are conducting a scientific validation study involving multi-sensor observations in our investigation of phenomena preceding major earthquakes. Our approach is based on a systematic analysis of several atmospheric and environmental parameters, which we found, are associated with the earthquakes, namely: thermal infrared radiation, outgoing long-wavelength radiation, ionospheric electron density, and atmospheric temperature and humidity. For first time we applied this approach to selected GEOSS sites prone to earthquakes or volcanoes. This provides a new opportunity to cross validate our results with the dense networks of in-situ and space measurements. We investigated two different seismic aspects, first the sites with recent large earthquakes, viz.- Tohoku-oki (M9, 2011, Japan) and Emilia region (M5.9, 2012,N. Italy). Our retrospective analysis of satellite data has shown the presence of anomalies in the atmosphere. Second, we did a retrospective analysis to check the re-occurrence of similar anomalous behavior in atmosphere/ionosphere over three regions with distinct geological settings and high seismicity: Taiwan, Japan and Kamchatka, which include 40 major earthquakes (M>5.9) for the period of 2005-2009. We found anomalous behavior before all of these events with no false negatives; false positives were less then 10%. Our initial results suggest that multi-instrument space-borne and ground observations show a systematic appearance of atmospheric anomalies near the epicentral area that could be explained by a coupling between the observed physical parameters and earthquake preparation processes.
Metaproteomics and metabolomics analyses of chronically petroleum-polluted sites reveal the importance of general anaerobic processes uncoupled with degradation.

Science.gov (United States)

Bargiela, Rafael; Herbst, Florian-Alexander; Martínez-Martínez, Mónica; Seifert, Jana; Rojo, David; Cappello, Simone; Genovese, María; Crisafi, Francesca; Denaro, Renata; Chernikova, Tatyana N; Barbas, Coral; von Bergen, Martin; Yakimov, Michail M; Ferrer, Manuel; Golyshin, Peter N

2015-10-01

Crude oil is one of the most important natural assets for humankind, yet it is a major environmental pollutant, notably in marine environments. One of the largest crude oil polluted areas in the word is the semi-enclosed Mediterranean Sea, in which the metabolic potential of indigenous microbial populations towards the large-scale chronic pollution is yet to be defined, particularly in anaerobic and micro-aerophilic sites. Here, we provide an insight into the microbial metabolism in sediments from three chronically polluted marine sites along the coastline of Italy: the Priolo oil terminal/refinery site (near Siracuse, Sicily), harbour of Messina (Sicily) and shipwreck of MT Haven (near Genoa). Using shotgun metaproteomics and community metabolomics approaches, the presence of 651 microbial proteins and 4776 metabolite mass features have been detected in these three environments, revealing a high metabolic heterogeneity between the investigated sites. The proteomes displayed the prevalence of anaerobic metabolisms that were not directly related with petroleum biodegradation, indicating that in the absence of oxygen, biodegradation is significantly suppressed. This suppression was also suggested by examining the metabolome patterns. The proteome analysis further highlighted the metabolic coupling between methylotrophs and sulphate reducers in oxygen-depleted petroleum-polluted sediments. © 2015 The Authors. PROTEOMICS published by Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.
Metaproteomics and metabolomics analyses of chronically petroleum‐polluted sites reveal the importance of general anaerobic processes uncoupled with degradation

Science.gov (United States)

Bargiela, Rafael; Herbst, Florian‐Alexander; Martínez‐Martínez, Mónica; Seifert, Jana; Rojo, David; Cappello, Simone; Genovese, María; Crisafi, Francesca; Denaro, Renata; Chernikova, Tatyana N.; Barbas, Coral; von Bergen, Martin; Yakimov, Michail M.; Golyshin, Peter N.

2015-01-01

Crude oil is one of the most important natural assets for humankind, yet it is a major environmental pollutant, notably in marine environments. One of the largest crude oil polluted areas in the word is the semi‐enclosed Mediterranean Sea, in which the metabolic potential of indigenous microbial populations towards the large‐scale chronic pollution is yet to be defined, particularly in anaerobic and micro‐aerophilic sites. Here, we provide an insight into the microbial metabolism in sediments from three chronically polluted marine sites along the coastline of Italy: the Priolo oil terminal/refinery site (near Siracuse, Sicily), harbour of Messina (Sicily) and shipwreck of MT Haven (near Genoa). Using shotgun metaproteomics and community metabolomics approaches, the presence of 651 microbial proteins and 4776 metabolite mass features have been detected in these three environments, revealing a high metabolic heterogeneity between the investigated sites. The proteomes displayed the prevalence of anaerobic metabolisms that were not directly related with petroleum biodegradation, indicating that in the absence of oxygen, biodegradation is significantly suppressed. This suppression was also suggested by examining the metabolome patterns. The proteome analysis further highlighted the metabolic coupling between methylotrophs and sulphate reducers in oxygen‐depleted petroleum‐polluted sediments. PMID:26201687
Study of multi-generational effects of a chronic exposure to ionizing radiations at a model organism: the nematode Caenorhabditis elegans

International Nuclear Information System (INIS)

Buisset-Goussen, Adeline

2014-01-01

The environmental risk assessment of chronic exposure to ionizing radiation (natural and ubiquitous phenomenon enhanced by human activities) has become a major concern. Few studies relating to chronic exposure over several generations - essential knowledge to better understand the disruption caused by ionizing radiation and its possible consequences on the population - exist. In addition, it has become necessary to understand the mechanisms of disturbances related to ionizing radiation at the molecular and cellular level. Without this mechanistic understanding, it is difficult to extrapolate the effects observed between the different levels of biological organization and between different species. The aim of this PhD was to study the multi-generational effects of chronic gamma radiation in an integrated manner (to the life history traits from the subcellular mechanisms) in a model organism, the nematode Caenorhabditis elegans. A two-step strategy was implemented. First, studying the effects of chronic gamma radiation on the life history traits of C. elegans was performed. The objective of this experiment was to test the hypothesis of an increase of the sensitivity according generations. For that, three generations have been exposed to different dose rates. In parallel, two generations have been placed in 'control' environment after parental exposure to test a possible transmission of maternal effects. The second part of this thesis aimed to characterize the different subcellular mechanisms that could explain the observed effects on the life history traits after multi-generational exposure. The results showed that (i) the cumulative number of larvae was the most sensitive endpoint to gamma radiation, (ii) an increase in radiosensitivity was observed over three exposed generations and (iii) the effects of the parental generation were transmitted to the non-exposed generations. An increase in apoptosis, a reduction in the stock of sperm, and to a lesser
Real-Time Multi-Directional Equipment Site

Data.gov (United States)

Federal Laboratory Consortium — As part of the George E. Brown, Jr. Network for Earthquake Engineering Simulation (NEES) Program, Lehigh University has established the Real-Time Multi-Directional...
"Less Clicking, More Watching": Results from the User-Centered Design of a Multi-Institutional Web Site for Art and Culture.

Science.gov (United States)

Vergo, John; Karat, Clare-Marie; Karat, John; Pinhanez, Claudio; Arora, Renee; Cofino, Thomas; Riecken, Doug; Podlaseck, Mark

This paper summarizes a 10-month long research project conducted at the IBM T.J. Watson Research Center aimed at developing the design concept of a multi-institutional art and culture web site. The work followed a user-centered design (UCD) approach, where interaction with prototypes and feedback from potential users of the web site were sought…
A Stochastic Programming Approach for a Multi-Site Supply Chain Planning in Textile and Apparel Industry under Demand Uncertainty

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Houssem Felfel

2015-11-01

Full Text Available In this study, a new stochastic model is proposed to deal with a multi-product, multi-period, multi-stage, multi-site production and transportation supply chain planning problem under demand uncertainty. A two-stage stochastic linear programming approach is used to maximize the expected profit. Decisions such as the production amount, the inventory level of finished and semi-finished product, the amount of backorder and the quantity of products to be transported between upstream and downstream plants in each period are considered. The robustness of production supply chain plan is then evaluated using statistical and risk measures. A case study from a real textile and apparel industry is shown in order to compare the performances of the proposed stochastic programming model and the deterministic model.
Chronic fatigue syndrome and impaired peripheral pulse characteristics on orthostasis–a new potential diagnostic biomarker

International Nuclear Information System (INIS)

Allen, John; Murray, Alan; Di Maria, Costanzo; Newton, Julia L

2012-01-01

Autonomic nervous system dysfunction is frequently reported in chronic fatigue syndrome (CFS) with orthostatic intolerance, a common symptom that can be objectively assessed. The frequent finding of autonomic dysfunction and symptoms on standing has the potential to provide a diagnostic biomarker in chronic fatigue. In this study we explored the clinical value of non-invasive optical multi-site photoplethysmography (PPG) technology to assess cardiovascular responses to standing. Multi-site PPG pulses were collected from tissue pads of the ears, fingers and toes of 14 patients with CFS and 14 age-matched sedentary subjects using a measurement protocol of a 10 min baseline (subject supine) followed by 3 min of tilting on a tilt table (head-up to 70°). Percentage change in pulse timing (pulse transit time, PTTf) and pulse amplitude (AMP) at each site were calculated using beat-to-beat pulse wave analysis. A significant reduction in the overall pulse timing response to controlled standing was found for the CFS group (using summed absolute percentage change in PTTf for ear, finger and toe sites, median change of 26% for CFS and 37% for control with p = 0.002). There were no significant differences between subject groups for the AMP measure at any site. Changes in AMP with tilt were, however, weakly significantly and negatively correlated with fatigue severity (p < 0.05). Receiver operating characteristic (ROC) analysis of timing measures produced an area under the curve of 0.81. Experimental linear discriminant classification analysis comparing both timing and amplitude measures produced an overall diagnostic accuracy of 82%. Pulse wave abnormalities have been observed in CFS and represent a potential objective measure to help differentiate between CFS patients and healthy controls. (paper)
Downscaling atmospheric patterns to multi-site precipitation amounts in southern Scandinavia

DEFF Research Database (Denmark)

Gelati, Emiliano; Christensen, O.B.; Rasmussen, P.F.

2010-01-01

A non-homogeneous hidden Markov model (NHMM) is applied for downscaling atmospheric synoptic patterns to winter multi-site daily precipitation amounts. The implemented NHMM assumes precipitation to be conditional on a hidden weather state that follows a Markov chain, whose transition probabilities...... depend on current atmospheric information. The gridded atmospheric fields are summarized through the singular value decomposition (SVD) technique. SVD is applied to geopotential height and relative humidity at several pressure levels, to identify their principal spatial patterns co...... products of bivariate distributions. Conditional on the weather state, precipitation amounts are modelled separately at each gauge as independent gamma-distributed random variables. This modelling approach is applied to 51 precipitation gauges in Denmark and southern Sweden for the period 1981...
Electric properties and carrier multiplication in breakdown sites in multi-crystalline silicon solar cells

Energy Technology Data Exchange (ETDEWEB)

Schneemann, Matthias; Carius, Reinhard; Rau, Uwe [IEK5-Photovoltaics, Forschungszentrum Jülich, Jülich 52425 (Germany); Kirchartz, Thomas, E-mail: t.kirchartz@fz-juelich.de [IEK5-Photovoltaics, Forschungszentrum Jülich, Jülich 52425 (Germany); Faculty of Engineering and CENIDE, University of Duisburg-Essen, Carl-Benz-Str. 199, Duisburg 47057 (Germany)

2015-05-28

This paper studies the effective electrical size and carrier multiplication of breakdown sites in multi-crystalline silicon solar cells. The local series resistance limits the current of each breakdown site and is thereby linearizing the current-voltage characteristic. This fact allows the estimation of the effective electrical diameters to be as low as 100 nm. Using a laser beam induced current (LBIC) measurement with a high spatial resolution, we find carrier multiplication factors on the order of 30 (Zener-type breakdown) and 100 (avalanche breakdown) as new lower limits. Hence, we prove that also the so-called Zener-type breakdown is followed by avalanche multiplication. We explain that previous measurements of the carrier multiplication using thermography yield results higher than unity, only if the spatial defect density is high enough, and the illumination intensity is lower than what was used for the LBIC method. The individual series resistances of the breakdown sites limit the current through these breakdown sites. Therefore, the measured multiplication factors depend on the applied voltage as well as on the injected photocurrent. Both dependencies are successfully simulated using a series-resistance-limited diode model.
Risk of chronic anxiety in implantable defibrillator patients

DEFF Research Database (Denmark)

Pedersen, Susanne S.; den Broek, Krista C van; Theuns, Dominic A M J

2011-01-01

Little is known about the prevalence of chronic anxiety in patients with an implantable cardioverter defibrillator (ICD). In a multi-center, prospective study, we examined 1) the prevalence of chronic anxiety (i.e., patients anxious at implantation and 12 months), and 2) predictors of chronic...... anxiety....
Economic and Environmental Evaluation of a Brick Delivery System Based on Multi-Trip Vehicle Loader Routing Problem for Small Construction Sites

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Heungjo An

2018-05-01

Full Text Available While large construction sites have on-site loaders to handle heavy and large packages of bricks, small brick manufacturers employ a truck-mounted loader or sometimes deploy a loader truck to accompany normal brick delivery trucks to small construction sites lacking on-site loaders. It may be very challenging for small contractors to manage a sustainable delivery system that is both cost-effective and environmentally friendly. To address this issue, this paper proposes to solve a multi-trip vehicle loader routing problem by uniquely planning routes and schedules of several types of vehicles considering their synchronized operations at customer sites and multi trips. This paper also evaluates the sustainability of the developed model from both economic and environmental perspectives. Case studies based on small construction sites in the Middle East demonstrate applications of the proposed model to make the most economical plans for delivering bricks. Compared to the single-trip vehicle loader routing problem, the proposed model reduces, on average, 18.7% of the total delivery cost while increasing CO2 emission negligibly. The economic benefit is mainly achieved by reducing the required number of vehicles. Brick plant managers can use the proposed mathematical model to plan the most cost-effective delivery schedules sustainably while minimizing negative environmental effects.
Inter-Site Consistency at a Multi-Site Psychiatry Clerkship

Science.gov (United States)

Shultes von Schlageter, Margo; Park, EunMi; Tucker, Phebe

2006-01-01

Objective: This study examines the effects of clinical site assignment within a multiple-site psychiatry clerkship program on the convergent outcome of the National Board of Medical Examiners (NBME) subject examination. Method: NBME scores, controlled for baseline pre-clerkship knowledge base as measured by second year human behavior scores, were…
Webinar Training: an acceptable, feasible and effective approach for multi-site medical record abstraction: the BOWII experience

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St Charles Meaghan

2011-10-01

Full Text Available Abstract Background Abstractor training is a key element in creating valid and reliable data collection procedures. The choice between in-person vs. remote or simultaneous vs. sequential abstractor training has considerable consequences for time and resource utilization. We conducted a web-based (webinar abstractor training session to standardize training across six individual Cancer Research Network (CRN sites for a study of breast cancer treatment effects in older women (BOWII. The goals of this manuscript are to describe the training session, its participants and participants' evaluation of webinar technology for abstraction training. Findings A webinar was held for all six sites with the primary purpose of simultaneously training staff and ensuring consistent abstraction across sites. The training session involved sequential review of over 600 data elements outlined in the coding manual in conjunction with the display of data entry fields in the study's electronic data collection system. Post-training evaluation was conducted via Survey Monkey©. Inter-rater reliability measures for abstractors within each site were conducted three months after the commencement of data collection. Ten of the 16 people who participated in the training completed the online survey. Almost all (90% of the 10 trainees had previous medical record abstraction experience and nearly two-thirds reported over 10 years of experience. Half of the respondents had previously participated in a webinar, among which three had participated in a webinar for training purposes. All rated the knowledge and information delivered through the webinar as useful and reported it adequately prepared them for data collection. Moreover, all participants would recommend this platform for multi-site abstraction training. Consistent with participant-reported training effectiveness, results of data collection inter-rater agreement within sites ranged from 89 to 98%, with a weighted average of
The effect of simulation courseware on critical thinking in undergraduate nursing students: multi-site pre-post study.

Science.gov (United States)

Shin, Hyunsook; Ma, Hyunhee; Park, Jiyoung; Ji, Eun Sun; Kim, Dong Hee

2015-04-01

The use of simulations has been considered as opportunities for students to enhance their critical thinking (CT), but previous studies were limited because they did not provide in-depth information on the working dynamics of simulation or on the effects of the number of simulation exposures on CT. This study examined the effect of an integrated pediatric nursing simulation used in a nursing practicum on students' CT abilities and identified the effects of differing numbers of simulation exposures on CT in a multi-site environment. The study used a multi-site, pre-test, post-test design. A total of 237 nursing students at three universities enrolled in a pediatric practicum participated in this study from February to December 2013. All three schools used the same simulation courseware, including the same simulation scenarios, evaluation tools, and simulation equipment. The courseware incorporated high-fidelity simulators and standardized patients. Students at school A completed one simulation session, whereas students at schools B and C completed two and three simulation sessions, respectively. Yoon's Critical Thinking Disposition tool (2008) was used to measure students' CT abilities. The gains in students' CT scores varied according to their numbers of exposures to the simulation courseware. With a single exposure, there were no statistically significant gains in CT, whereas three exposures to the courseware produced significant gains in CT. In seven subcategories of critical thinking, three exposures to the simulation courseware produced CT gains in the prudence and intellectual eagerness subcategories, and the overall simulation experience produced CT gains in the prudence, systematicity, healthy skepticism, and intellectual eagerness subcategories. Simulation courseware may produce positive learning outcomes for prudence in nursing education. In addition, the findings from the multi-site comparative study may contribute to greater understanding of how patient
Multi-criteria ranking and receptor modelling of airborne fine particles at three sites in the Pearl River Delta region of China.

Science.gov (United States)

Friend, Adrian J; Ayoko, Godwin A; Guo, Hai

2011-01-15

The multi-criteria decision making methods, Preference Ranking Organization METHods for Enrichment Evaluation (PROMETHEE) and Graphical Analysis for Interactive Assistance (GAIA), and the two-way Positive Matrix Factorization (PMF) receptor model were applied to airborne fine particle compositional data collected at three sites in Hong Kong during two monitoring campaigns held from November 2000 to October 2001 and November 2004 to October 2005. PROMETHEE/GAIA indicated that the three sites were worse during the later monitoring campaign, and that the order of the air quality at the sites during each campaign was: rural site>urban site>roadside site. The PMF analysis on the other hand, identified 6 common sources at all of the sites (diesel vehicle, fresh sea salt, secondary sulphate, soil, aged sea salt and oil combustion) which accounted for approximately 68.8±8.7% of the fine particle mass at the sites. In addition, road dust, gasoline vehicle, biomass burning, secondary nitrate, and metal processing were identified at some of the sites. Secondary sulphate was found to be the highest contributor to the fine particle mass at the rural and urban sites with vehicle emission as a high contributor to the roadside site. The PMF results are broadly similar to those obtained in a previous analysis by PCA/APCS. However, the PMF analysis resolved more factors at each site than the PCA/APCS. In addition, the study demonstrated that combined results from multi-criteria decision making analysis and receptor modelling can provide more detailed information that can be used to formulate the scientific basis for mitigating air pollution in the region. Copyright © 2010 Elsevier B.V. All rights reserved.
Fixed-site high-frequency transcutaneous electrical nerve stimulation for treatment of chronic low back and lower extremity pain

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Gozani SN

2016-06-01

Full Text Available Shai N Gozani NeuroMetrix, Inc., Waltham, MA, USA Objective: The objective of this study was to determine if fixed-site high-frequency transcutaneous electrical nerve stimulation (FS-TENS is effective in treating chronic low back and lower extremity pain. Background: Transcutaneous electrical nerve stimulation is widely used for treatment of chronic pain. General-purpose transcutaneous electrical nerve stimulation devices are designed for stimulation anywhere on the body and often cannot be used while the user is active or sleeping. FS-TENS devices are designed for placement at a pre-determined location, which enables development of a wearable device for use over extended time periods. Methods: Study participants with chronic low back and/or lower extremity pain self-administered an FS-TENS device for 60 days. Baseline, 30-, and 60-day follow-up data were obtained through an online questionnaire. The primary outcome measure was the patient global impression of change. Pain intensity and interference were assessed using the Brief Pain Inventory. Changes in use of concomitant pain medications were evaluated with a single-item global self-rating. Results: One hundred and thirty participants were enrolled, with 88 completing the 60-day follow-up questionnaire. Most participants (73.9% were 50 years of age or older. At baseline, low back pain was identified by 85.3%, lower extremity pain by 71.6%, and upper extremity pain by 62.5%. Participants reported widespread pain, at baseline, with a mean of 3.4 (standard deviation 1.1 pain sites. At the 60-day follow-up, 80.7% of participants reported that their chronic pain had improved and they were classified as responders. Baseline characteristics did not differentiate non-responders from responders. There were numerical trends toward reduced pain interference with walking ability and sleep, and greater pain relief in responders. There was a large difference in use of concomitant pain medications, with 80
Effectiveness of fixed-site high-frequency transcutaneous electrical nerve stimulation in chronic pain: a large-scale, observational study

Science.gov (United States)

Kong, Xuan; Gozani, Shai N

2018-01-01

Objective The objective of this study was to assess the effectiveness of fixed-site high-frequency transcutaneous electrical nerve stimulation (FS-TENS) in a real-world chronic pain sample. Background There is a need for nonpharmacological treatment options for chronic pain. FS-TENS improved multisite chronic pain in a previous interventional study. Large observational studies are needed to further characterize its effectiveness. Methods This retrospective observational cohort study examined changes in chronic pain measures following 60 days of FS-TENS use. The study data were obtained from FS-TENS users who uploaded their device utilization and clinical data to an online database. The primary outcome measures were changes in pain intensity and pain interference with sleep, activity, and mood on an 11-point numerical rating scale. Dose–response associations were evaluated by stratifying subjects into low (≤30 days), intermediate (31–56 days), and high (≥57 days) utilization subgroups. FS-TENS effectiveness was quantified by baseline to follow-up group differences and a responder analysis (≥30% improvement in pain intensity or ≥2-point improvement in pain interference domains). Results Utilization and clinical data were collected from 11,900 people using FS-TENS for chronic pain, with 713 device users meeting the inclusion and exclusion criteria. Study subjects were generally older, overweight adults. Subjects reported multisite pain with a mean of 4.8 (standard deviation [SD] 2.5) pain sites. A total of 97.2% of subjects identified low back and/or lower extremity pain, and 72.9% of subjects reported upper body pain. All pain measures exhibited statistically significant group differences from baseline to 60-day follow-up. The largest changes were pain interference with activity (−0.99±2.69 points) and mood (−1.02±2.78 points). A total of 48.7% of subjects exhibited a clinically meaningful reduction in pain interference with activity or mood. This
Effectiveness of fixed-site high-frequency transcutaneous electrical nerve stimulation in chronic pain: a large-scale, observational study

Directory of Open Access Journals (Sweden)

Kong X

2018-04-01

Full Text Available Xuan Kong, Shai N Gozani NeuroMetrix, Inc., Waltham, MA, USA Objective: The objective of this study was to assess the effectiveness of fixed-site high-frequency transcutaneous electrical nerve stimulation (FS-TENS in a real-world chronic pain sample. Background: There is a need for nonpharmacological treatment options for chronic pain. FS-TENS improved multisite chronic pain in a previous interventional study. Large observational studies are needed to further characterize its effectiveness. Methods: This retrospective observational cohort study examined changes in chronic pain measures following 60 days of FS-TENS use. The study data were obtained from FS-TENS users who uploaded their device utilization and clinical data to an online database. The primary outcome measures were changes in pain intensity and pain interference with sleep, activity, and mood on an 11-point numerical rating scale. Dose–response associations were evaluated by stratifying subjects into low (≤30 days, intermediate (31–56 days, and high (≥57 days utilization subgroups. FS-TENS effectiveness was quantified by baseline to follow-up group differences and a responder analysis (≥30% improvement in pain intensity or ≥2-point improvement in pain interference domains. Results: Utilization and clinical data were collected from 11,900 people using FS-TENS for chronic pain, with 713 device users meeting the inclusion and exclusion criteria. Study subjects were generally older, overweight adults. Subjects reported multisite pain with a mean of 4.8 (standard deviation [SD] 2.5 pain sites. A total of 97.2% of subjects identified low back and/or lower extremity pain, and 72.9% of subjects reported upper body pain. All pain measures exhibited statistically significant group differences from baseline to 60-day follow-up. The largest changes were pain interference with activity (−0.99±2.69 points and mood (−1.02±2.78 points. A total of 48.7% of subjects exhibited a
Oak Forest Responses to Episodic-Seasonal-Drought, Chronic Multi-year Precipitation Change and Acute Drought Manipulations in a Region With Deep Soils and High Precipitation

Science.gov (United States)

Hanson, Paul J.; Wullschleger, Stan D.; Todd, Donald E.; Auge, Robert M.; Froberg, Mats; Johnson, Dale W.

2010-05-01

Implications of episodic-seasonal drought (extremely dry late summers), chronic multi-year precipitation manipulations (±33 percent over 12 years) and acute drought (-100 percent over 3 years) were evaluated for the response of vegetation and biogeochemical cycles for an upland-oak forest. The Quercus-Acer forest is located in eastern Tennessee on deep acidic soils with mean annual temperatures of 14.2 °C and abundant precipitation (1352 mm y-1). The multi-year observations and chronic manipulations were conducted from 1993 through 2005 using understory throughfall collection troughs and redistribution gutters and pipes. Acute manipulations of dominant canopy trees (Quercus prinus; Liriodendron tulipifera) were conducted from 2003 through 2005 using full understory tents. Regional and severe late-summer droughts were produced reduced stand water use and photosynthetic carbon gain as expected. Likewise, seedlings and saplings exhibited reduced survival and cumulative growth reductions. Conversely, multi-year chronic increases or decreases in precipitation and associated soil water deficits did not reduce large tree basal area growth for the tree species present. The resilience of canopy trees to chronic-change was the result of a disconnect between carbon allocation to tree growth (an early-season phenomenon) and late-season drought occurrence. Acute precipitation exclusion from the largest canopy trees also produced limited physiological responses and minimal cumulative growth reductions. Lateral root water sources were removed through trenching and could not explain the lack of response to extreme soil drying. Therefore, deep rooting the primary mechanism for large-tree resilience to severe drought. Extensive trench-based assessments of rooting depth suggested that ‘deep' water supplies were being obtained from limited numbers of deep fine roots. Observations of carbon stocks in organic horizons demonstrated accumulation with precipitation reductions and

Fixed-site high-frequency transcutaneous electrical nerve stimulation for treatment of chronic low back and lower extremity pain.

Science.gov (United States)

Gozani, Shai N

2016-01-01

The objective of this study was to determine if fixed-site high-frequency transcutaneous electrical nerve stimulation (FS-TENS) is effective in treating chronic low back and lower extremity pain. Transcutaneous electrical nerve stimulation is widely used for treatment of chronic pain. General-purpose transcutaneous electrical nerve stimulation devices are designed for stimulation anywhere on the body and often cannot be used while the user is active or sleeping. FS-TENS devices are designed for placement at a pre-determined location, which enables development of a wearable device for use over extended time periods. Study participants with chronic low back and/or lower extremity pain self-administered an FS-TENS device for 60 days. Baseline, 30-, and 60-day follow-up data were obtained through an online questionnaire. The primary outcome measure was the patient global impression of change. Pain intensity and interference were assessed using the Brief Pain Inventory. Changes in use of concomitant pain medications were evaluated with a single-item global self-rating. One hundred and thirty participants were enrolled, with 88 completing the 60-day follow-up questionnaire. Most participants (73.9%) were 50 years of age or older. At baseline, low back pain was identified by 85.3%, lower extremity pain by 71.6%, and upper extremity pain by 62.5%. Participants reported widespread pain, at baseline, with a mean of 3.4 (standard deviation 1.1) pain sites. At the 60-day follow-up, 80.7% of participants reported that their chronic pain had improved and they were classified as responders. Baseline characteristics did not differentiate non-responders from responders. There were numerical trends toward reduced pain interference with walking ability and sleep, and greater pain relief in responders. There was a large difference in use of concomitant pain medications, with 80.3% of responders reporting a reduction compared to 11.8% of non-responders. FS-TENS is a safe and effective
RELATIONSHIPS BETWEEN INITIAL PROBING DEPTH AND CHANGES IN THE CLINICAL PARAMETERS FOLLOWING NON-SURGICAL PERIODONTAL TREATMENT IN CHRONIC PERIODONTITIS

Directory of Open Access Journals (Sweden)

Süleyman Emre MESELİ

2017-10-01

Full Text Available Purpose: The aim of this study was to evaluate the relationship between initial probing depth (IPD and changes in clinical parameters following non-surgical periodontal treatment (NPT in chronic periodontitis patients. Subjects and Methods: A total of 1672 periodontal pockets having 3mm≤IPD≤9mm of depth in 15 chronic periodontitis patients were included. NPT consisting of oral hygiene instructions, scaling and root planing was applied in two sessions. Probing depth (PD, clinical attachment level, gingival recessions (GR were measured before and eight weeks after treatment. Pocket sites were grouped according to their IPD and root number as single- or multi-rooted teeth. Results: Other than the sites having 3 mm IPD, PD reduction and GR increase were significant in all groups (p<0.001. Attachment gains (AG were significant in all single-rooted teeth (p<0.001 again except those having IPD=3mm. However, AG was significant in multi-rooted teeth having only 7mm≤IPD≤9mm (p<0.05. Positive correlations were observed between IPD and PD reduction, GR increase and AG in single-rooted teeth (p<0.001. Furthermore, positive correlations were found between IPD and PD reduction and GR increase in multi-rooted teeth (p<0.001, but there was no correlation between IPD and AG. Conclusion: NPT may lead to positive association between IPD and PD reduction as well as GR increase, which is independent from tooth root anatomy.
Chronic in vivo stability assessment of carbon fiber microelectrode arrays

Science.gov (United States)

Patel, Paras R.; Zhang, Huanan; Robbins, Matthew T.; Nofar, Justin B.; Marshall, Shaun P.; Kobylarek, Michael J.; Kozai, Takashi D. Y.; Kotov, Nicholas A.; Chestek, Cynthia A.

2016-12-01

Objective. Individual carbon fiber microelectrodes can record unit activity in both acute and semi-chronic (∼1 month) implants. Additionally, new methods have been developed to insert a 16 channel array of carbon fiber microelectrodes. Before assessing the in vivo long-term viability of these arrays, accelerated soak tests were carried out to determine the most stable site coating material. Next, a multi-animal, multi-month, chronic implantation study was carried out with carbon fiber microelectrode arrays and silicon electrodes. Approach. Carbon fibers were first functionalized with one of two different formulations of PEDOT and subjected to accelerated aging in a heated water bath. After determining the best PEDOT formula to use, carbon fiber arrays were chronically implanted in rat motor cortex. Some rodents were also implanted with a single silicon electrode, while others received both. At the end of the study a subset of animals were perfused and the brain tissue sliced. Tissue sections were stained for astrocytes, microglia, and neurons. The local reactive responses were assessed using qualitative and quantitative methods. Main results. Electrophysiology recordings showed the carbon fibers detecting unit activity for at least 3 months with average amplitudes of ∼200 μV. Histology analysis showed the carbon fiber arrays with a minimal to non-existent glial scarring response with no adverse effects on neuronal density. Silicon electrodes showed large glial scarring that impacted neuronal counts. Significance. This study has validated the use of carbon fiber microelectrode arrays as a chronic neural recording technology. These electrodes have demonstrated the ability to detect single units with high amplitude over 3 months, and show the potential to record for even longer periods. In addition, the minimal reactive response should hold stable indefinitely, as any response by the immune system may reach a steady state after 12 weeks.
Can multi-criteria analysis models support the site selection for a repository for heat-generating waste?

International Nuclear Information System (INIS)

Gutberlet, Daniela

2015-01-01

The decision for or against a potential site for a nuclear waste repository is highly complex and requires decision-makers to consider multiple assessment criteria. The complexity of each site and its characteristics, and the differing opinions among members of the public and advocacy groups mean t hat conflicts of interest are likely to arise. In this paper, the author suggests that multi-criteria analysis models could be used to provide methodological support during the selection process. The models can map these types of decision situations and suggest coherent solutions with relatively little formal effort. They allow users to compare different opt ions simultaneously and ensure that t heir decision-making Is conscious rather than arbitrary.
Igs expressed by chronic lymphocytic leukemia B cells show limited binding-site structure variability.

Science.gov (United States)

Marcatili, Paolo; Ghiotto, Fabio; Tenca, Claudya; Chailyan, Anna; Mazzarello, Andrea N; Yan, Xiao-Jie; Colombo, Monica; Albesiano, Emilia; Bagnara, Davide; Cutrona, Giovanna; Morabito, Fortunato; Bruno, Silvia; Ferrarini, Manlio; Chiorazzi, Nicholas; Tramontano, Anna; Fais, Franco

2013-06-01

Ag selection has been suggested to play a role in chronic lymphocytic leukemia (CLL) pathogenesis, but no large-scale analysis has been performed so far on the structure of the Ag-binding sites (ABSs) of leukemic cell Igs. We sequenced both H and L chain V(D)J rearrangements from 366 CLL patients and modeled their three-dimensional structures. The resulting ABS structures were clustered into a small number of discrete sets, each containing ABSs with similar shapes and physicochemical properties. This structural classification correlates well with other known prognostic factors such as Ig mutation status and recurrent (stereotyped) receptors, but it shows a better prognostic value, at least in the case of one structural cluster for which clinical data were available. These findings suggest, for the first time, to our knowledge, on the basis of a structural analysis of the Ab-binding sites, that selection by a finite quota of antigenic structures operates on most CLL cases, whether mutated or unmutated.
Performace Of Multi-Probe Corrosion Monitoring Systems At The Hanford Site

International Nuclear Information System (INIS)

Carothers, K.D.; Boomer, K.D.; Anda, V.S.; Dahl, M.M.; Edgemon, G.L.

2010-01-01

Between 2007 and 2009, several different multi-probe corrosion monitoring systems were designed and installed in high-level nuclear waste tanks at the U.S. Department of Energy's Hanford Site in WaShington State. The probe systems are being monitored to ensure waste tanks operate in regions that minimize localized corrosion (i.e., pitting) and stress corrosion cracking. The corrosion monitoring systems have been installed in wastes with different chemistry types. An ongoing effort during the same time period has generated non-radioactive simulants that are tested in the laboratory to establish baseline corrosion monitoring system performance and characterize data to allow interpretation of readings from the multiple corrosion monitoring systems. Data collection from these monitoring systems has reached the point where the results allow comparison with the laboratory testing. This paper presents analytical results from the corrosion monitoring system development program.
A risk assessment method for multi-site damage

Science.gov (United States)

Millwater, Harry Russell, Jr.

This research focused on developing probabilistic methods suitable for computing small probabilities of failure, e.g., 10sp{-6}, of structures subject to multi-site damage (MSD). MSD is defined as the simultaneous development of fatigue cracks at multiple sites in the same structural element such that the fatigue cracks may coalesce to form one large crack. MSD is modeled as an array of collinear cracks with random initial crack lengths with the centers of the initial cracks spaced uniformly apart. The data used was chosen to be representative of aluminum structures. The structure is considered failed whenever any two adjacent cracks link up. A fatigue computer model is developed that can accurately and efficiently grow a collinear array of arbitrary length cracks from initial size until failure. An algorithm is developed to compute the stress intensity factors of all cracks considering all interaction effects. The probability of failure of two to 100 cracks is studied. Lower bounds on the probability of failure are developed based upon the probability of the largest crack exceeding a critical crack size. The critical crack size is based on the initial crack size that will grow across the ligament when the neighboring crack has zero length. The probability is evaluated using extreme value theory. An upper bound is based on the probability of the maximum sum of initial cracks being greater than a critical crack size. A weakest link sampling approach is developed that can accurately and efficiently compute small probabilities of failure. This methodology is based on predicting the weakest link, i.e., the two cracks to link up first, for a realization of initial crack sizes, and computing the cycles-to-failure using these two cracks. Criteria to determine the weakest link are discussed. Probability results using the weakest link sampling method are compared to Monte Carlo-based benchmark results. The results indicate that very small probabilities can be computed
Prevalence of drug use during sex amongst MSM in Europe: Results from a multi-site bio-behavioural survey.

Science.gov (United States)

Rosińska, Magdalena; Gios, Lorenzo; Nöstlinger, Christiana; Vanden Berghe, Wim; Marcus, Ulrich; Schink, Susanne; Sherriff, Nigel; Jones, Anna-Marie; Folch, Cinta; Dias, Sonia; Velicko, Inga; Mirandola, Massimo

2018-05-01

Substance use has been consistently reported to be more prevalent amongst Men who have Sex with Men (MSM) compared to the general population. Substance use, in particular polydrug use, has been found to be influenced by social and contextual factors and to increase the risk of unprotected intercourse among MSM. The objective of this analysis was to investigate the prevalence and predictors of drug use during a sexual encounter and to identify specific prevention needs. A multi-site bio-behavioural cross-sectional survey was implemented in 13 European cities, targeting MSM and using Time-Location Sampling and Respondent-Driven Sampling methods Multivariable multi-level logistic random-intercept model (random effect of study site) was estimated to identify factors associated with the use of alcohol, cannabis, party drugs, sexual performance enhancement drugs and chemsex drugs. Overall, 1261 (30.0%) participants reported drug use, and 436 of 3706 (11.8%) reported the use of two or more drugs during their last sexual encounter. By drug class, 966 (23.0%) reported using sexual performance enhancement drugs, 353 (8.4%) - party drugs, and 142 (3.4%) the use of chemsex drugs. Respondents who reported drug use were more frequently diagnosed with HIV (10.5% vs. 3.9%) before and with other STIs during the 12 months prior to the study (16.7% vs. 9.2%). The use of all the analysed substances was significantly associated with sexual encounter with more than one partner. Substance and polydrug use during sexual encounters occurred amongst sampled MSM across Europe although varying greatly between study sites. Different local social norms within MSM communities may be important contextual drivers of drug use, highlighting the need for innovative and multi-faceted prevention measures to reduce HIV/STI risk in the context of drug use. Copyright © 2018 Elsevier B.V. All rights reserved.
Taxonomy of the burden of treatment: a multi-country web-based qualitative study of patients with chronic conditions.

Science.gov (United States)

Tran, Viet-Thi; Barnes, Caroline; Montori, Victor M; Falissard, Bruno; Ravaud, Philippe

2015-05-14

Management strategies for patients with chronic conditions are becoming increasingly complex, which may result in a burden of treatment for patients. To develop a Minimally Disruptive Medicine designed to reduce the burden of treatment, clinicians need to understand which healthcare tasks and aggravating factors may be responsible for this burden. The objective of the present study was to describe and classify the components of the burden of treatment for patients with chronic conditions from the patient's perspective. We performed a multi-country qualitative study using an online survey and a purposive sampling strategy to select English-, French-, and Spanish-speaking participants with different chronic conditions. Participants were recruited by physicians, patients' associations, advertisement on social media, and 'snowballing'. The answers were analyzed by i) manual content analysis with a grounded theory approach, coded by two researchers, and ii) automatic textual analysis by Reinert's method. Between 2013 and 2014, 1,053 participants from 34 different countries completed the online survey using 408,625 words. Results from both analyses were synthesized in a taxonomy of the burden of treatment, which described i) the tasks imposed on patients by their diseases and by their healthcare system (e.g., medication management, lifestyle changes, follow-up, etc.); ii) the structural (e.g., access to healthcare resources, coordination between care providers), personal, situational, and financial factors that aggravated the burden of treatment; and iii) patient-reported consequences of the burden (e.g., poor adherence to treatments, financial burden, impact on professional, family, and social life, etc.). Our findings may not be applicable to patients with chronic conditions who differ from those who responded to our survey. Our taxonomy of the burden of treatment, provided by patients with chronic conditions from different countries and settings, supports the
Amount of platelet-bound IgG in chronic autoimmune thrombocytopenic purpura (ITP): absence of significant influence on platelet survival and destruction-site

International Nuclear Information System (INIS)

Leners, N.; Ferrant, A.; Beckers, C.

1982-01-01

The amount of platelet-bound IgG, as measured with a direct Coombs radioactive antiglobulin test, could not be correlated with either platelet survival or the site of platelet destruction in 22 patients with chronic ITP. The amount of platelet-bound IgG may not be an index of severity in this disease, nor does it offer an indication on the site of destruction of platelets
Monitoring of active layer dynamics at a permafrost site on Svalbard using multi-channel ground-penetrating radar

Directory of Open Access Journals (Sweden)

S. Westermann

2010-11-01

Full Text Available Multi-channel ground-penetrating radar is used to investigate the late-summer evolution of the thaw depth and the average soil water content of the thawed active layer at a high-arctic continuous permafrost site on Svalbard, Norway. Between mid of August and mid of September 2008, five surveys have been conducted in gravelly soil over transect lengths of 130 and 175 m each. The maximum thaw depths range from 1.6 m to 2.0 m, so that they are among the deepest thaw depths recorded in sediments on Svalbard so far. The thaw depths increase by approximately 0.2 m between mid of August and beginning of September and subsequently remain constant until mid of September. The thaw rates are approximately constant over the entire length of the transects within the measurement accuracy of about 5 to 10 cm. The average volumetric soil water content of the thawed soil varies between 0.18 and 0.27 along the investigated transects. While the measurements do not show significant changes in soil water content over the first four weeks of the study, strong precipitation causes an increase in average soil water content of up to 0.04 during the last week. These values are in good agreement with evapotranspiration and precipitation rates measured in the vicinity of the the study site. While we cannot provide conclusive reasons for the detected spatial variability of the thaw depth at the study site, our measurements show that thaw depth and average soil water content are not directly correlated.

The study demonstrates the potential of multi-channel ground-penetrating radar for mapping thaw depth in permafrost areas. The novel non-invasive technique is particularly useful when the thaw depth exceeds 1.5 m, so that it is hardly accessible by manual probing. In addition, multi-channel ground-penetrating radar holds potential for mapping the latent heat content of the active layer and for estimating weekly to monthly averages of the ground heat flux during the
Fixed-site high-frequency transcutaneous electrical nerve stimulation for treatment of chronic low back and lower extremity pain

Science.gov (United States)

Gozani, Shai N

2016-01-01

Objective The objective of this study was to determine if fixed-site high-frequency transcutaneous electrical nerve stimulation (FS-TENS) is effective in treating chronic low back and lower extremity pain. Background Transcutaneous electrical nerve stimulation is widely used for treatment of chronic pain. General-purpose transcutaneous electrical nerve stimulation devices are designed for stimulation anywhere on the body and often cannot be used while the user is active or sleeping. FS-TENS devices are designed for placement at a pre-determined location, which enables development of a wearable device for use over extended time periods. Methods Study participants with chronic low back and/or lower extremity pain self-administered an FS-TENS device for 60 days. Baseline, 30-, and 60-day follow-up data were obtained through an online questionnaire. The primary outcome measure was the patient global impression of change. Pain intensity and interference were assessed using the Brief Pain Inventory. Changes in use of concomitant pain medications were evaluated with a single-item global self-rating. Results One hundred and thirty participants were enrolled, with 88 completing the 60-day follow-up questionnaire. Most participants (73.9%) were 50 years of age or older. At baseline, low back pain was identified by 85.3%, lower extremity pain by 71.6%, and upper extremity pain by 62.5%. Participants reported widespread pain, at baseline, with a mean of 3.4 (standard deviation 1.1) pain sites. At the 60-day follow-up, 80.7% of participants reported that their chronic pain had improved and they were classified as responders. Baseline characteristics did not differentiate non-responders from responders. There were numerical trends toward reduced pain interference with walking ability and sleep, and greater pain relief in responders. There was a large difference in use of concomitant pain medications, with 80.3% of responders reporting a reduction compared to 11.8% of non
Sensitivity of the Modified Children's Yale-Brown Obsessive Compulsive Scale to Detect Change: Results from Two Multi-Site Trials

Science.gov (United States)

Scahill, Lawrence; Sukhodolsky, Denis G.; Anderberg, Emily; Dimitropoulos, Anastasia; Dziura, James; Aman, Michael G.; McCracken, James; Tierney, Elaine; Hallett, Victoria; Katz, Karol; Vitiello, Benedetto; McDougle, Christopher

2016-01-01

Repetitive behavior is a core feature of autism spectrum disorder. We used 8-week data from two federally funded, multi-site, randomized trials with risperidone conducted by the Research Units on Pediatric Psychopharmacology Autism Network to evaluate the sensitivity of the Children's Yale-Brown Obsessive Compulsive Scale modified for autism…
Multi-Site Quality Assurance Project Plan for Wisconsin Public Service Corporation, Peoples Gas Light and Coke Company, and North Shore Gas

Science.gov (United States)

This Multi-Site QAPP presents the organization, data quality objectives (DQOs), a set of anticipated activities, sample analysis, data handling and specific Quality Assurance/Quality Control (QA/QC) procedures associated with Studies done in EPA Region 5
A multi-site resting state fMRI study on the amplitude of low frequency fluctuations in schizophrenia

Directory of Open Access Journals (Sweden)

Jessica A Turner

2013-08-01

Full Text Available Background. This multi-site study compares resting state fMRI amplitude of low frequency fluctuations (ALFF and fractional ALFF (fALFF between patients with schizophrenia (SZ and healthy controls (HC. Methods. Eyes-closed resting fMRI scans (5:38 minutes; n=306, 146 SZ were collected from 6 Siemens 3T scanners and one GE 3T scanner. Imaging data were pre-processed using an SPM pipeline. Power in the low frequency band (0.01 to 0.08 Hz was calculated both for the original pre-processed data as well as for the pre-processed data after regressing out the six rigid-body motion parameters, mean white matter and CSF signals. Both original and regressed ALFF and fALFF measures were modeled with site, diagnosis, age, and diagnosis × age interactions. Results. Regressing out motion and non-gray matter signals significantly decreased fALFF throughout the brain as well as ALFF in the cortical edge, but significantly increased ALFF in subcortical regions. Regression had little effect on site, age, and diagnosis effects on ALFF, other than to reduce diagnosis effects in subcortical regions. There were significant effects of site across the brain in all the analyses, largely due to vendor differences. HC showed greater ALFF in the occipital, posterior parietal, and superior temporal lobe, while SZ showed smaller clusters of greater ALFF in the frontal and temporal/insular regions as well as in the caudate, putamen, and hippocampus. HC showed greater fALFF compared with SZ in all regions, though subcortical differences were only significant for original fALFF. Conclusions. SZ show greater eyes-closed resting state low frequency power in frontal cortex, and less power in posterior lobes than do HC; fALFF, however, is lower in SZ than HC throughout the cortex. These effects are robust to multi-site variability. Regressing out physiological noise signals significantly affects both total and fractional ALFF measures, but does not affect the pattern of case
A new spatial multi-criteria decision support tool for site selection for implementation of managed aquifer recharge.

Science.gov (United States)

Rahman, M Azizur; Rusteberg, Bernd; Gogu, R C; Lobo Ferreira, J P; Sauter, Martin

2012-05-30

This study reports the development of a new spatial multi-criteria decision analysis (SMCDA) software tool for selecting suitable sites for Managed Aquifer Recharge (MAR) systems. The new SMCDA software tool functions based on the combination of existing multi-criteria evaluation methods with modern decision analysis techniques. More specifically, non-compensatory screening, criteria standardization and weighting, and Analytical Hierarchy Process (AHP) have been combined with Weighted Linear Combination (WLC) and Ordered Weighted Averaging (OWA). This SMCDA tool may be implemented with a wide range of decision maker's preferences. The tool's user-friendly interface helps guide the decision maker through the sequential steps for site selection, those steps namely being constraint mapping, criteria hierarchy, criteria standardization and weighting, and criteria overlay. The tool offers some predetermined default criteria and standard methods to increase the trade-off between ease-of-use and efficiency. Integrated into ArcGIS, the tool has the advantage of using GIS tools for spatial analysis, and herein data may be processed and displayed. The tool is non-site specific, adaptive, and comprehensive, and may be applied to any type of site-selection problem. For demonstrating the robustness of the new tool, a case study was planned and executed at Algarve Region, Portugal. The efficiency of the SMCDA tool in the decision making process for selecting suitable sites for MAR was also demonstrated. Specific aspects of the tool such as built-in default criteria, explicit decision steps, and flexibility in choosing different options were key features, which benefited the study. The new SMCDA tool can be augmented by groundwater flow and transport modeling so as to achieve a more comprehensive approach to the selection process for the best locations of the MAR infiltration basins, as well as the locations of recovery wells and areas of groundwater protection. The new spatial
Occurrence of acute febrile dermatitis at the site of chronic radiodermatitis of 25 years duration

International Nuclear Information System (INIS)

Aoshima, Toshiyuki; Furukawa, Ikuko; Furukawa, Hiroo

1994-01-01

The patient was a 72-year-old female who underwent radiation therapy following surgical treatment for an ovarian tumor in 1963. Radiation therapy resulted in chronic radiodermatitis which has persisted since then. Twenty-five years after radiation therapy, painful indurative erythema appeared on her leoins (the site of irradiation) accompanied by fever. Histologically, acanthosis, edema and capillary dilatation in the upper dermis, amorphous collagen fibers and scarcity of vasculature in the deep dermis were observed. We found no mitosis but did observe swollen keratinocytes in the epidermal layer. The patient did not respond to antibiotics; however, the administration of oral steroids gradually alleviated the fever and local symptoms. Steroids could not be completely discontinued; she was given low-dose steroids for maintenance of remission. We speculated that the acute inflammatory reaction which was superimposed on the patient's chronic radiodermatitis constituted the earliest signs of malignant transformation. Intermittent bloody stools due to radiation colitis had been present since 3 years before, but after administration of steroids, melena was no longer seen. (author)
Occurrence of acute febrile dermatitis at the site of chronic radiodermatitis of 25 years duration

Energy Technology Data Exchange (ETDEWEB)

Aoshima, Toshiyuki; Furukawa, Ikuko; Furukawa, Hiroo (Otsu Red Cross Hospital, Shiga (Japan))

1994-02-01

The patient was a 72-year-old female who underwent radiation therapy following surgical treatment for an ovarian tumor in 1963. Radiation therapy resulted in chronic radiodermatitis which has persisted since then. Twenty-five years after radiation therapy, painful indurative erythema appeared on her leoins (the site of irradiation) accompanied by fever. Histologically, acanthosis, edema and capillary dilatation in the upper dermis, amorphous collagen fibers and scarcity of vasculature in the deep dermis were observed. We found no mitosis but did observe swollen keratinocytes in the epidermal layer. The patient did not respond to antibiotics; however, the administration of oral steroids gradually alleviated the fever and local symptoms. Steroids could not be completely discontinued; she was given low-dose steroids for maintenance of remission. We speculated that the acute inflammatory reaction which was superimposed on the patient's chronic radiodermatitis constituted the earliest signs of malignant transformation. Intermittent bloody stools due to radiation colitis had been present since 3 years before, but after administration of steroids, melena was no longer seen. (author).
Site systems engineering fiscal year 1999 multi-year work plan (MYWP) update for WBS 1.8.2.2; TOPICAL

International Nuclear Information System (INIS)

GRYGIEL, M.L.

1998-01-01

Manage the Site Systems Engineering process to provide a traceable integrated requirements-driven, and technically defensible baseline. Through the Site Integration Group(SIG), Systems Engineering ensures integration of technical activities across all site projects. Systems Engineering's primary interfaces are with the RL Project Managers, the Project Direction Office and with the Project Major Subcontractors, as well as with the Site Planning organization. Systems Implementation: (1) Develops, maintains, and controls the site integrated technical baseline, ensures the Systems Engineering interfaces between projects are documented, and maintain the Site Environmental Management Specification. (2) Develops and uses dynamic simulation models for verification of the baseline and analysis of alternatives. (3) Performs and documents fictional and requirements analyses. (4) Works with projects, technology management, and the SIG to identify and resolve technical issues. (5) Supports technical baseline information for the planning and budgeting of the Accelerated Cleanup Plan, Multi-Year Work Plans, Project Baseline Summaries as well as performance measure reporting. (6) Works with projects to ensure the quality of data in the technical baseline. (7) Develops, maintains and implements the site configuration management system
Concept and methodology for evaluating core damage frequency considering failure correlation at multi units and sites and its application

Energy Technology Data Exchange (ETDEWEB)

Ebisawa, K.; Teragaki, T.; Nomura, S. [Former Incorporated Administrative Agency, Japan Nuclear Safety Organization (Japan); Abe, H., E-mail: Hiroshi_abe@nsr.go.jp [Former Incorporated Administrative Agency, Japan Nuclear Safety Organization (Japan); Shigemori, M.; Shimomoto, M. [Mizuho Information & Research Institute, 2-3, Kanda-Nishikicho, Chiyoda-ku, Tokyo (Japan)

2015-07-15

Highlights: • We develop a method to evaluate CDF considering failure correlation at multi units. • We develop a procedure to evaluate correlation coefficient between multi components. • We evaluate CDF at two different BWR units using correlation coefficients. • We confirm the validity of method and correlation coefficient through the evaluation. - Abstract: The Tohoku earthquake (Mw9.0) occurred on March 11, 2011 and caused a large tsunami. The Fukushima Daiichi Nuclear Power Plant with six units were overwhelmed by the tsunami and core damage occurred. Authors proposed the concept and method for evaluating core damage frequency (CDF) considering failure correlation at the multi units and sites. Based on the above method, one of authors developed the procedure for evaluating the failure correlation coefficient and response correlation coefficient between the multi components under the strong seismic motion. These method and failure correlation coefficients were applied to two different BWR units and their CDF was evaluated by seismic probabilistic risk assessment technology. Through this quantitative evaluation, the validity of the method and failure correlation coefficient was confirmed.

Concept and methodology for evaluating core damage frequency considering failure correlation at multi units and sites and its application

International Nuclear Information System (INIS)

Ebisawa, K.; Teragaki, T.; Nomura, S.; Abe, H.; Shigemori, M.; Shimomoto, M.

2015-01-01

Highlights: • We develop a method to evaluate CDF considering failure correlation at multi units. • We develop a procedure to evaluate correlation coefficient between multi components. • We evaluate CDF at two different BWR units using correlation coefficients. • We confirm the validity of method and correlation coefficient through the evaluation. - Abstract: The Tohoku earthquake (Mw9.0) occurred on March 11, 2011 and caused a large tsunami. The Fukushima Daiichi Nuclear Power Plant with six units were overwhelmed by the tsunami and core damage occurred. Authors proposed the concept and method for evaluating core damage frequency (CDF) considering failure correlation at the multi units and sites. Based on the above method, one of authors developed the procedure for evaluating the failure correlation coefficient and response correlation coefficient between the multi components under the strong seismic motion. These method and failure correlation coefficients were applied to two different BWR units and their CDF was evaluated by seismic probabilistic risk assessment technology. Through this quantitative evaluation, the validity of the method and failure correlation coefficient was confirmed
Igs Expressed by Chronic Lymphocytic Leukemia B Cells Show Limited Binding-Site Structure Variability

KAUST Repository

Marcatili, P.

2013-05-01

Ag selection has been suggested to play a role in chronic lymphocytic leukemia (CLL) pathogenesis, but no large-scale analysis has been performed so far on the structure of the Ag-binding sites (ABSs) of leukemic cell Igs. We sequenced both H and L chain V(D)J rearrangements from 366 CLL patients and modeled their three-dimensional structures. The resulting ABS structures were clustered into a small number of discrete sets, each containing ABSs with similar shapes and physicochemical properties. This structural classification correlates well with other known prognostic factors such as Ig mutation status and recurrent (stereotyped) receptors, but it shows a better prognostic value, at least in the case of one structural cluster for which clinical data were available. These findings suggest, for the first time, to our knowledge, on the basis of a structural analysis of the Ab-binding sites, that selection by a finite quota of antigenic structures operates on most CLL cases, whether mutated or unmutated. Copyright © 2013 by The American Association of Immunologists, Inc.
Igs Expressed by Chronic Lymphocytic Leukemia B Cells Show Limited Binding-Site Structure Variability

KAUST Repository

Marcatili, P.; Ghiotto, F.; Tenca, C.; Chailyan, A.; Mazzarello, A. N.; Yan, X.-J.; Colombo, M.; Albesiano, E.; Bagnara, D.; Cutrona, G.; Morabito, F.; Bruno, S.; Ferrarini, M.; Chiorazzi, N.; Tramontano, A.; Fais, F.

2013-01-01

Ag selection has been suggested to play a role in chronic lymphocytic leukemia (CLL) pathogenesis, but no large-scale analysis has been performed so far on the structure of the Ag-binding sites (ABSs) of leukemic cell Igs. We sequenced both H and L chain V(D)J rearrangements from 366 CLL patients and modeled their three-dimensional structures. The resulting ABS structures were clustered into a small number of discrete sets, each containing ABSs with similar shapes and physicochemical properties. This structural classification correlates well with other known prognostic factors such as Ig mutation status and recurrent (stereotyped) receptors, but it shows a better prognostic value, at least in the case of one structural cluster for which clinical data were available. These findings suggest, for the first time, to our knowledge, on the basis of a structural analysis of the Ab-binding sites, that selection by a finite quota of antigenic structures operates on most CLL cases, whether mutated or unmutated. Copyright © 2013 by The American Association of Immunologists, Inc.
Recurrent signature patterns in HIV-1 B clade envelope glycoproteins associated with either early or chronic infections.

Directory of Open Access Journals (Sweden)

S Gnanakaran

2011-09-01

Full Text Available Here we have identified HIV-1 B clade Envelope (Env amino acid signatures from early in infection that may be favored at transmission, as well as patterns of recurrent mutation in chronic infection that may reflect common pathways of immune evasion. To accomplish this, we compared thousands of sequences derived by single genome amplification from several hundred individuals that were sampled either early in infection or were chronically infected. Samples were divided at the outset into hypothesis-forming and validation sets, and we used phylogenetically corrected statistical strategies to identify signatures, systematically scanning all of Env. Signatures included single amino acids, glycosylation motifs, and multi-site patterns based on functional or structural groupings of amino acids. We identified signatures near the CCR5 co-receptor-binding region, near the CD4 binding site, and in the signal peptide and cytoplasmic domain, which may influence Env expression and processing. Two signatures patterns associated with transmission were particularly interesting. The first was the most statistically robust signature, located in position 12 in the signal peptide. The second was the loss of an N-linked glycosylation site at positions 413-415; the presence of this site has been recently found to be associated with escape from potent and broad neutralizing antibodies, consistent with enabling a common pathway for immune escape during chronic infection. Its recurrent loss in early infection suggests it may impact fitness at the time of transmission or during early viral expansion. The signature patterns we identified implicate Env expression levels in selection at viral transmission or in early expansion, and suggest that immune evasion patterns that recur in many individuals during chronic infection when antibodies are present can be selected against when the infection is being established prior to the adaptive immune response.
Evaluation of a multi-site program designed to strengthen relational bonds for siblings separated by foster care.

Science.gov (United States)

Waid, Jeffrey; Wojciak, Armeda Stevenson

2017-10-01

Sibling relationships in foster care settings have received increased attention in recent years. Despite growing evidence regarding the protective potential of sibling relationships for youth in care, some sibling groups continue to experience foster care related separation, and few programs exist to address the needs of these youth. This study describes and evaluates Camp To Belong, a multi-site program designed to provide short-term reunification to separated sibling groups through a week-long summer camp experience. Using a pre-test post-test survey design, this paper examines changes in youth ratings of sibling conflict and sibling support across camps located in six geographically distinct regions of the United States. The effects of youth age, number of prior camp exposures, and camp location were tested using multilevel modeling procedures. Findings suggest that participation in Camp To Belong may reduce sibling conflict, and improvements in sibling support are noted for youth who have had prior exposure to the camp's programming. Camp-level variance in the sibling support outcome highlight the complex nature of relationships for siblings separated by foster care, and suggest the need for additional research. Lessons learned from this multi-site evaluation and future directions are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.
Current Research Status of KHNP for Site Risk

Energy Technology Data Exchange (ETDEWEB)

Oh, Kyemin; Jeon, Ho-Jun; Bahng, Ki-In; Na, Jang-Hwan [KHNP CRI, Daejeon (Korea, Republic of)

2016-10-15

In Korea, by the geographical characteristics, many Nuclear Power Plants (NPPs) have been constructed and operated at a single site. This is above average level or number of plants per site in the world. For this reason, the public concerns for the safety of nuclear facilities increased after Fukushima Daiichi accident. As a result, comprehensive risk assessment and management for the site which have multi-unit NPPs were strongly asked. Currently, to solve it, many researches and projects has carried out by various Korean companies, research centers, and regulatory authorities. In this paper, R and D plans of KHNP for multi-unit risk were summarized. Firstly, the needs of multi-unit PSA were reviewed. R and D activities and plans of KHNP were summarized in the last part. In this paper, we summarized the R and D plans of KHNP for assessing the multi-unit risk. Currently, multi-unit risk or multi-unit PSA are important and practical issues in both nuclear industry and national energy policy. After Fukushima accident, several countries stopped the construction and the operation of NPPs, other countries which is maintaining the NPPs are being strongly asked to assess the risk for multi-unit NPPs at the same site. Because of Korean geographical characteristics, the number of NPPs which are above average level or number of plants per site in the world is being constructed and operated at a single site. The population density nearby each site is considered to be higher than that of other countries.
Current Research Status of KHNP for Site Risk

International Nuclear Information System (INIS)

Oh, Kyemin; Jeon, Ho-Jun; Bahng, Ki-In; Na, Jang-Hwan

2016-01-01

In Korea, by the geographical characteristics, many Nuclear Power Plants (NPPs) have been constructed and operated at a single site. This is above average level or number of plants per site in the world. For this reason, the public concerns for the safety of nuclear facilities increased after Fukushima Daiichi accident. As a result, comprehensive risk assessment and management for the site which have multi-unit NPPs were strongly asked. Currently, to solve it, many researches and projects has carried out by various Korean companies, research centers, and regulatory authorities. In this paper, R and D plans of KHNP for multi-unit risk were summarized. Firstly, the needs of multi-unit PSA were reviewed. R and D activities and plans of KHNP were summarized in the last part. In this paper, we summarized the R and D plans of KHNP for assessing the multi-unit risk. Currently, multi-unit risk or multi-unit PSA are important and practical issues in both nuclear industry and national energy policy. After Fukushima accident, several countries stopped the construction and the operation of NPPs, other countries which is maintaining the NPPs are being strongly asked to assess the risk for multi-unit NPPs at the same site. Because of Korean geographical characteristics, the number of NPPs which are above average level or number of plants per site in the world is being constructed and operated at a single site. The population density nearby each site is considered to be higher than that of other countries
Endovascular Revascularization of Chronically Thrombosed Arteriovenous Fistulas and Grafts for Hemodialysis: A Retrospective Study in 15 Patients With 18 Access Sites

International Nuclear Information System (INIS)

Weng Meijui; Chen, Matt Chiung-Yu; Chi Wenche; Liu Yichun; Liang, Huei-Lung; Pan, Huay-Ben

2011-01-01

The current study retrospectively evaluated whether endovascular revascularization of chronically thrombosed and long-discarded vascular access sites for hemodialysis was feasible. Technical and clinical success rates, postintervention primary and secondary patency rates, and complications were reported. During a 1-year period, we reviewed a total of 924 interventions performed for dysfunction and/or failed hemodialysis vascular access sites and permanent catheters in 881 patients. In patients whose vascular access-site problems were considered untreatable or were considered treatable with a high risk of failure and access-site abandonment, we attempted to revascularize (resurrect) the chronically occluded and long-discarded (mummy) vascular access sites. We attempted to resurrect a total of 18 mummy access sites (mean age 46.6 ± 38.7 months; range 5–144) in 15 patients (8 women and 7 men; mean age 66.2 ± 11.5 years; age range 50–85) and had an overall technical success rate of 77.8%. Resurrection failure occurred in 3 fistulas and in 1 straight graft. The clinical success rate was 100% at 2 months after resurrection. In the 14 resurrected vascular access sites, 6 balloon-assisted maturation procedures were required in 5 fistulas; after access-site maturation, a total of 22 interventions were performed to maintain access-site patency. The mean go-through time for successful resurrection procedures was 146.6 ± 34.3 min (range 74–193). Postmaturation primary patency rates were 71.4 ± 12.1% at 30 days, 57.1 ± 13.2% at 60 days, 28.6 ± 13.4% at 90 days, and 19 ± 11.8% at 180 days. Postmaturation secondary patency rates were 100% at 30, 60, and 90 days and 81.8 ± 11.6% at 180 days. There were 2 major complications consisting of massive venous ruptures in 2 mummy access sites during balloon dilation; in both cases, prolonged balloon inflation failed to achieve hemostasis, but percutaneous N-butyl cyanoacrylate glue seal-off was performed successfully
Quantitative multi-parameter mapping of R1, PD*, MT and R2* at 3T: a multi-center validation

Directory of Open Access Journals (Sweden)

Nikolaus eWeiskopf

2013-06-01

Full Text Available Multi-center studies using magnetic resonance imaging facilitate studying small effect sizes, global population variance and rare diseases. The reliability and sensitivity of these multi-center studies crucially depend on the comparability of the data generated at different sites and time points. The level of inter-site comparability is still controversial for conventional anatomical T1-weighted MRI data. Quantitative multi-parameter mapping (MPM was designed to provide MR parameter measures that are comparable across sites and time points, i.e., 1mm high-resolution maps of the longitudinal relaxation rate (R1=1/T1, effective proton density (PD*, magnetization transfer saturation (MT and effective transverse relaxation rate (R2*=1/T2*. MPM was validated at 3T for use in multi-center studies by scanning five volunteers at three different sites. We determined the inter-site bias, inter-site and intra-site coefficient of variation (CoV for typical morphometric measures (i.e., gray matter probability maps used in voxel-based morphometry and the four quantitative parameters. The inter-site bias and CoV were smaller than 3.1% and 8%, respectively, except for the inter-site CoV of R2* (< 20%. The gray matter probability maps based on the MT parameter maps had a 14% higher inter-site reproducibility than maps based on conventional T1-weighted images. The low inter-site bias and variance in the parameters and derived gray matter probability maps confirm the high comparability of the quantitative maps across sites and time points. The reliability, short acquisition time, high resolution and the detailed insights into the brain microstructure provided by MPM makes it an efficient tool for multi-center imaging studies.
Replication and Comparison of the Newly Proposed ADOS-2, Module 4 Algorithm in ASD without ID: A Multi-Site Study

Science.gov (United States)

Pugliese, Cara E.; Kenworthy, Lauren; Bal, Vanessa Hus; Wallace, Gregory L.; Yerys, Benjamin E.; Maddox, Brenna B.; White, Susan W.; Popal, Haroon; Armour, Anna Chelsea; Miller, Judith; Herrington, John D.; Schultz, Robert T.; Martin, Alex; Anthony, Laura Gutermuth

2015-01-01

Recent updates have been proposed to the Autism Diagnostic Observation Schedule-2 Module 4 diagnostic algorithm. This new algorithm, however, has not yet been validated in an independent sample without intellectual disability (ID). This multi-site study compared the original and revised algorithms in individuals with ASD without ID. The revised…
Multi-isotope (carbon and chlorine) analysis for fingerprinting and site characterization at a fractured bedrock aquifer contaminated by chlorinated ethenes

Energy Technology Data Exchange (ETDEWEB)

Palau, Jordi, E-mail: jordi.palau@unine.ch [Departament de Cristal.lografia, Mineralogia i Dipòsits Minerals, Facultat de Geologia, Universitat de Barcelona, Martí i Franquès, s/n 08028 Barcelona (Spain); Marchesi, Massimo [Departament de Cristal.lografia, Mineralogia i Dipòsits Minerals, Facultat de Geologia, Universitat de Barcelona, Martí i Franquès, s/n 08028 Barcelona (Spain); Department of Earth and Environmental Sciences, University of Waterloo, Waterloo, Ontario N2L 3G1 (Canada); Chambon, Julie C.C. [Department of Environmental Engineering, Technical University of Denmark, 2800 Lyngby (Denmark); Aravena, Ramon [Department of Earth and Environmental Sciences, University of Waterloo, Waterloo, Ontario N2L 3G1 (Canada); Canals, Àngels [Departament de Cristal.lografia, Mineralogia i Dipòsits Minerals, Facultat de Geologia, Universitat de Barcelona, Martí i Franquès, s/n 08028 Barcelona (Spain); Binning, Philip J.; Bjerg, Poul L. [Department of Environmental Engineering, Technical University of Denmark, 2800 Lyngby (Denmark); Otero, Neus; Soler, Albert [Departament de Cristal.lografia, Mineralogia i Dipòsits Minerals, Facultat de Geologia, Universitat de Barcelona, Martí i Franquès, s/n 08028 Barcelona (Spain)

2014-03-01

The use of compound specific multi-isotope approach (C and Cl) in the characterization of a chlorinated ethenes contaminated fractured aquifer allows the identification of several sources and contaminant plumes, as well as the occurrence of biodegradation and mixing processes. The study site is located in Spain with contamination resulting in groundwater concentrations of up to 50 mg/L of trichloroethene (TCE), the most abundant chlorinated ethene, and 7 mg/L of tetrachloroethene (PCE). The potential sources of contamination including abandoned barrels, an underground tank, and a disposal lagoon, showed a wide range in δ{sup 13}C values from − 15.6 to − 40.5‰ for TCE and from − 18.5 to − 32.4‰ for PCE, allowing the use of isotope fingerprinting for tracing of the origin and migration of these contaminants in the aquifer. In contrast, there is no difference between the δ{sup 37}Cl values for TCE in the contaminant sources, ranging from + 0.53 to + 0.66‰. Variations of δ{sup 37}Cl and δ{sup 13}C in the different contaminant plumes were used to investigate the role of biodegradation in groundwater. Moreover, the isotopic data were incorporated into a reactive transport model for determination of whether the isotope pattern observed downstream from the tank's source could be explained by the simultaneous effect of mixing and biodegradation. The results demonstrate that a multi-isotope approach is a valuable tool for characterization of complex sites such as fractured bedrock aquifer contaminated by multiple sources, providing important information which can be used by consultants and site managers to prioritize and design more successful remediation strategies. - Highlights: • Origin and fate of CAHs in groundwater by means of multi CSIA ({sup 13}C,{sup 35}Cl) survey • Innovative/new approach tested in a fractured bedrock site • Differentiation of distinct CAH sources • Biodegradation and source mixing recognition in the aquifer.
Multi-isotope (carbon and chlorine) analysis for fingerprinting and site characterization at a fractured bedrock aquifer contaminated by chlorinated ethenes

International Nuclear Information System (INIS)

Palau, Jordi; Marchesi, Massimo; Chambon, Julie C.C.; Aravena, Ramon; Canals, Àngels; Binning, Philip J.; Bjerg, Poul L.; Otero, Neus; Soler, Albert

2014-01-01

The use of compound specific multi-isotope approach (C and Cl) in the characterization of a chlorinated ethenes contaminated fractured aquifer allows the identification of several sources and contaminant plumes, as well as the occurrence of biodegradation and mixing processes. The study site is located in Spain with contamination resulting in groundwater concentrations of up to 50 mg/L of trichloroethene (TCE), the most abundant chlorinated ethene, and 7 mg/L of tetrachloroethene (PCE). The potential sources of contamination including abandoned barrels, an underground tank, and a disposal lagoon, showed a wide range in δ 13 C values from − 15.6 to − 40.5‰ for TCE and from − 18.5 to − 32.4‰ for PCE, allowing the use of isotope fingerprinting for tracing of the origin and migration of these contaminants in the aquifer. In contrast, there is no difference between the δ 37 Cl values for TCE in the contaminant sources, ranging from + 0.53 to + 0.66‰. Variations of δ 37 Cl and δ 13 C in the different contaminant plumes were used to investigate the role of biodegradation in groundwater. Moreover, the isotopic data were incorporated into a reactive transport model for determination of whether the isotope pattern observed downstream from the tank's source could be explained by the simultaneous effect of mixing and biodegradation. The results demonstrate that a multi-isotope approach is a valuable tool for characterization of complex sites such as fractured bedrock aquifer contaminated by multiple sources, providing important information which can be used by consultants and site managers to prioritize and design more successful remediation strategies. - Highlights: • Origin and fate of CAHs in groundwater by means of multi CSIA ( 13 C, 35 Cl) survey • Innovative/new approach tested in a fractured bedrock site • Differentiation of distinct CAH sources • Biodegradation and source mixing recognition in the aquifer
CS2164, a novel multi-target inhibitor against tumor angiogenesis, mitosis and chronic inflammation with anti-tumor potency.

Science.gov (United States)

Zhou, You; Shan, Song; Li, Zhi-Bin; Xin, Li-Jun; Pan, De-Si; Yang, Qian-Jiao; Liu, Ying-Ping; Yue, Xu-Peng; Liu, Xiao-Rong; Gao, Ji-Zhou; Zhang, Jin-Wen; Ning, Zhi-Qiang; Lu, Xian-Ping

2017-03-01

Although inhibitors targeting tumor angiogenic pathway have provided improvement for clinical treatment in patients with various solid tumors, the still very limited anti-cancer efficacy and acquired drug resistance demand new agents that may offer better clinical benefits. In the effort to find a small molecule potentially targeting several key pathways for tumor development, we designed, discovered and evaluated a novel multi-kinase inhibitor, CS2164. CS2164 inhibited the angiogenesis-related kinases (VEGFR2, VEGFR1, VEGFR3, PDGFRα and c-Kit), mitosis-related kinase Aurora B and chronic inflammation-related kinase CSF-1R in a high potency manner with the IC 50 at a single-digit nanomolar range. Consequently, CS2164 displayed anti-angiogenic activities through suppression of VEGFR/PDGFR phosphorylation, inhibition of ligand-dependent cell proliferation and capillary tube formation, and prevention of vasculature formation in tumor tissues. CS2164 also showed induction of G2/M cell cycle arrest and suppression of cell proliferation in tumor tissues through the inhibition of Aurora B-mediated H3 phosphorylation. Furthermore, CS2164 demonstrated the inhibitory effect on CSF-1R phosphorylation that led to the suppression of ligand-stimulated monocyte-to-macrophage differentiation and reduced CSF-1R + cells in tumor tissues. The in vivo animal efficacy studies revealed that CS2164 induced remarkable regression or complete inhibition of tumor growth at well-tolerated oral doses in several human tumor xenograft models. Collectively, these results indicate that CS2164 is a highly selective multi-kinase inhibitor with potent anti-tumor activities against tumor angiogenesis, mitosis and chronic inflammation, which may provide the rationale for further clinical assessment of CS2164 as a therapeutic agent in the treatment of cancer. © 2016 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.
Intra-operative multi-site stimulation: Expanding methodology for cortical brain mapping of language functions.

Science.gov (United States)

Gonen, Tal; Gazit, Tomer; Korn, Akiva; Kirschner, Adi; Perry, Daniella; Hendler, Talma; Ram, Zvi

2017-01-01

Direct cortical stimulation (DCS) is considered the gold-standard for functional cortical mapping during awake surgery for brain tumor resection. DCS is performed by stimulating one local cortical area at a time. We present a feasibility study using an intra-operative technique aimed at improving our ability to map brain functions which rely on activity in distributed cortical regions. Following standard DCS, Multi-Site Stimulation (MSS) was performed in 15 patients by applying simultaneous cortical stimulations at multiple locations. Language functioning was chosen as a case-cognitive domain due to its relatively well-known cortical organization. MSS, performed at sites that did not produce disruption when applied in a single stimulation point, revealed additional language dysfunction in 73% of the patients. Functional regions identified by this technique were presumed to be significant to language circuitry and were spared during surgery. No new neurological deficits were observed in any of the patients following surgery. Though the neuro-electrical effects of MSS need further investigation, this feasibility study may provide a first step towards sophistication of intra-operative cortical mapping.
Streamflow prediction using multi-site rainfall obtained from hydroclimatic teleconnection

Science.gov (United States)

Kashid, S. S.; Ghosh, Subimal; Maity, Rajib

2010-12-01

SummarySimultaneous variations in weather and climate over widely separated regions are commonly known as "hydroclimatic teleconnections". Rainfall and runoff patterns, over continents, are found to be significantly teleconnected, with large-scale circulation patterns, through such hydroclimatic teleconnections. Though such teleconnections exist in nature, it is very difficult to model them, due to their inherent complexity. Statistical techniques and Artificial Intelligence (AI) tools gain popularity in modeling hydroclimatic teleconnection, based on their ability, in capturing the complicated relationship between the predictors (e.g. sea surface temperatures) and predictand (e.g., rainfall). Genetic Programming is such an AI tool, which is capable of capturing nonlinear relationship, between predictor and predictand, due to its flexible functional structure. In the present study, gridded multi-site weekly rainfall is predicted from El Niño Southern Oscillation (ENSO) indices, Equatorial Indian Ocean Oscillation (EQUINOO) indices, Outgoing Longwave Radiation (OLR) and lag rainfall at grid points, over the catchment, using Genetic Programming. The predicted rainfall is further used in a Genetic Programming model to predict streamflows. The model is applied for weekly forecasting of streamflow in Mahanadi River, India, and satisfactory performance is observed.
A GIS-BASED MULTI-CRITERIA EVALUATION SYSTEM FOR SELECTION OF LANDFILL SITES: a case study from Abu Dhabi, United Arab Emirates

Directory of Open Access Journals (Sweden)

S. M. Issa

2012-07-01

Full Text Available Landfill sites receive 92% of total annual solid waste produced by municipalities in the emirate of Abu Dhabi. In this study, candidate sites for an appropriate landfill location for the Abu Dhabi municipal area are determined by integrating geographic information systems (GIS and multi-criteria evaluation (MCE analysis. To identify appropriate landfill sites, eight input map layers including proximity to urban areas, proximity to wells and water table depth, geology and topography, proximity to touristic and archeological sites, distance from roads network, distance from drainage networks, and land slope are used in constraint mapping. A final map was generated which identified potential areas showing suitability for the location of the landfill site. Results revealed that 30% of the study area was identified as highly suitable, 25% as suitable, and 45% as unsuitable. The selection of the final landfill site, however, requires further field research.
Key Determinant Derivations for Information Technology Disaster Recovery Site Selection by the Multi-Criterion Decision Making Method

Directory of Open Access Journals (Sweden)

Chia-Lee Yang

2015-05-01

Full Text Available Disaster recovery sites are an important mechanism in continuous IT system operations. Such mechanisms can sustain IT availability and reduce business losses during natural or human-made disasters. Concerning the cost and risk aspects, the IT disaster-recovery site selection problems are multi-criterion decision making (MCDM problems in nature. For such problems, the decision aspects include the availability of the service, recovery time requirements, service performance, and more. The importance and complexities of IT disaster recovery sites increases with advances in IT and the categories of possible disasters. The modern IT disaster recovery site selection process requires further investigation. However, very few researchers tried to study related issues during past years based on the authors’ extremely limited knowledge. Thus, this paper aims to derive the aspects and criteria for evaluating and selecting a modern IT disaster recovery site. A hybrid MCDM framework consisting of the Decision Making Trial and Evaluation Laboratory (DEMATEL and the Analytic Network Process (ANP will be proposed to construct the complex influence relations between aspects as well as criteria and further, derive weight associated with each aspect and criteria. The criteria with higher weight can be used for evaluating and selecting the most suitable IT disaster recovery sites. In the future, the proposed analytic framework can be used for evaluating and selecting a disaster recovery site for data centers by public institutes or private firms.
Localization of sclerotic-type chronic graft-vs-host disease to sites of skin injury: potential insight into the mechanism of isomorphic and isotopic responses.

Science.gov (United States)

Martires, Kathryn J; Baird, Kristin; Citrin, Deborah E; Hakim, Fran T; Pavletic, Steven Z; Cowen, Edward W

2011-09-01

The mechanisms responsible for the variable manifestations of chronic cutaneous graft-vs-host disease (cGVHD) are poorly understood. Localization of sclerotic-type chronic graft-vs-host disease to sites of skin injury (isomorphic and isotopic responses), a recognized phenomenon in morphea, suggests a potential common pathway between cGVHD and other sclerotic skin conditions. Four cases of sclerotic-type cGVHD developed at the site of disparate skin injuries (ionizing radiotherapy, repeated needle sticks, central catheter site, and varicella-zoster virus infection). We review the spectrum of previously reported cases of sclerotic and nonsclerotic cGVHD relating to external forces on the skin. Localization of sclerotic-type cGVHD may occur after many types of skin injury, including UV and ionizing radiotherapy, needle sticks, viral infection, and pressure or friction. Recognition of this phenomenon may be helpful for the early diagnosis of sclerotic disease. Recent insights into the immunological consequences of minor skin injury may provide important clues to the underlying pathogenesis of cGVHD-mediated skin disease.
No difference in incidence of port-site hernia and chronic pain after single-incision laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy

DEFF Research Database (Denmark)

Christoffersen, Mette W; Brandt, Erik; Oehlenschläger, Jacob

2015-01-01

and matched 1:2 with patients subjected to CLC using pre-defined criteria. Follow-up data were obtained from the Danish National Patient Registry, mailed patient questionnaires, and clinical examination. A port-site hernia was defined as a repair for a port-site hernia or clinical hernia located at one......BACKGROUND: Conventional laparoscopic cholecystectomy (CLC) is regarded as the gold standard for cholecystectomy. However, single-incision laparoscopic cholecystectomy (SLC) has been suggested to replace CLC. This study aimed at comparing long-term incidences of port-site hernia and chronic pain...... after SLC versus CLC. METHODS: We conducted a matched cohort study based on prospective data (Jan 1, 2009-June 1, 2011) from the Danish Cholecystectomy Database with perioperative information and clinical follow-up. Consecutive patients undergoing elective SLC during the study period were included...
Multi-scale habitat selection in highly territorial bird species: Exploring the contribution of nest, territory and landscape levels to site choice in breeding rallids (Aves: Rallidae)

Science.gov (United States)

Jedlikowski, Jan; Chibowski, Piotr; Karasek, Tomasz; Brambilla, Mattia

2016-05-01

Habitat selection often involves choices made at different spatial scales, but the underlying mechanisms are still poorly understood, and studies that investigate the relative importance of individual scales are rare. We investigated the effect of three spatial scales (landscape, territory, nest-site) on the occurrence pattern of little crake Zapornia parva and water rail Rallus aquaticus at 74 ponds in the Masurian Lakeland, Poland. Habitat structure, food abundance and water chemical parameters were measured at nests and random points within landscape plots (from 300-m to 50-m radius), territory (14-m) and nest-site plots (3-m). Regression analyses suggested that the most relevant scale was territory level, followed by landscape, and finally by nest-site for both species. Variation partitioning confirmed this pattern for water rail, but also highlighted the importance of nest-site (the level explaining the highest share of unique variation) for little crake. The most important variables determining the occurrence of both species were water body fragmentation (landscape), vegetation density (territory) and water depth (at territory level for little crake, and at nest-site level for water rail). Finally, for both species multi-scale models including factors from different levels were more parsimonious than single-scale ones, i.e. habitat selection was likely a multi-scale process. The importance of particular spatial scales seemed more related to life-history traits than to the extent of the scales considered. In the case of our study species, the territory level was highly important likely because both rallids have to obtain all the resources they need (nest site, food and mates) in relatively small areas, the multi-purpose territories they defend.

Discovering transcription factor binding sites in highly repetitive regions of genomes with multi-read analysis of ChIP-Seq data.

Science.gov (United States)

Chung, Dongjun; Kuan, Pei Fen; Li, Bo; Sanalkumar, Rajendran; Liang, Kun; Bresnick, Emery H; Dewey, Colin; Keleş, Sündüz

2011-07-01

Chromatin immunoprecipitation followed by high-throughput sequencing (ChIP-seq) is rapidly replacing chromatin immunoprecipitation combined with genome-wide tiling array analysis (ChIP-chip) as the preferred approach for mapping transcription-factor binding sites and chromatin modifications. The state of the art for analyzing ChIP-seq data relies on using only reads that map uniquely to a relevant reference genome (uni-reads). This can lead to the omission of up to 30% of alignable reads. We describe a general approach for utilizing reads that map to multiple locations on the reference genome (multi-reads). Our approach is based on allocating multi-reads as fractional counts using a weighted alignment scheme. Using human STAT1 and mouse GATA1 ChIP-seq datasets, we illustrate that incorporation of multi-reads significantly increases sequencing depths, leads to detection of novel peaks that are not otherwise identifiable with uni-reads, and improves detection of peaks in mappable regions. We investigate various genome-wide characteristics of peaks detected only by utilization of multi-reads via computational experiments. Overall, peaks from multi-read analysis have similar characteristics to peaks that are identified by uni-reads except that the majority of them reside in segmental duplications. We further validate a number of GATA1 multi-read only peaks by independent quantitative real-time ChIP analysis and identify novel target genes of GATA1. These computational and experimental results establish that multi-reads can be of critical importance for studying transcription factor binding in highly repetitive regions of genomes with ChIP-seq experiments.
Discovering transcription factor binding sites in highly repetitive regions of genomes with multi-read analysis of ChIP-Seq data.

Directory of Open Access Journals (Sweden)

Dongjun Chung

2011-07-01

Full Text Available Chromatin immunoprecipitation followed by high-throughput sequencing (ChIP-seq is rapidly replacing chromatin immunoprecipitation combined with genome-wide tiling array analysis (ChIP-chip as the preferred approach for mapping transcription-factor binding sites and chromatin modifications. The state of the art for analyzing ChIP-seq data relies on using only reads that map uniquely to a relevant reference genome (uni-reads. This can lead to the omission of up to 30% of alignable reads. We describe a general approach for utilizing reads that map to multiple locations on the reference genome (multi-reads. Our approach is based on allocating multi-reads as fractional counts using a weighted alignment scheme. Using human STAT1 and mouse GATA1 ChIP-seq datasets, we illustrate that incorporation of multi-reads significantly increases sequencing depths, leads to detection of novel peaks that are not otherwise identifiable with uni-reads, and improves detection of peaks in mappable regions. We investigate various genome-wide characteristics of peaks detected only by utilization of multi-reads via computational experiments. Overall, peaks from multi-read analysis have similar characteristics to peaks that are identified by uni-reads except that the majority of them reside in segmental duplications. We further validate a number of GATA1 multi-read only peaks by independent quantitative real-time ChIP analysis and identify novel target genes of GATA1. These computational and experimental results establish that multi-reads can be of critical importance for studying transcription factor binding in highly repetitive regions of genomes with ChIP-seq experiments.
A Study of Changes in Stomach Wall at Sites Other Than the Ulcer in Chronic Duodenal Ulcer Patients

OpenAIRE

Mishra, Jagmohan; Panigrahi, Souvagya

2011-01-01

It is known that at least 90% of duodenal ulcers are caused by infection with the bacterium Helicobacter pylori. Eradicating this organism usually results in complete resolution of the disease (Rosengren, Br J Gen Pract 46(409):491–492, 1996). To study the different changes if any in stomach wall at sites other than the ulcer in chronic duodenal ulcer patients by upper Gastro-Intenstinal Endoscopy followed by histopathological examination of different parts of stomach. This study was a retros...
Use of multi-objective air pollution monitoring sites and online air pollution monitoring system for total health risk assessment in Hyderabad, India.

Science.gov (United States)

Anjaneyulu, Y; Jayakumar, I; Hima Bindu, V; Sagareswar, G; Mukunda Rao, P V; Rambabu, N; Ramani, K V

2005-08-01

A consensus has been emerging among public health experts in developing countries that air pollution, even at current ambient levels, aggravates respiratory and cardiovascular diseases and leads to premature mortality. Recent studies have also presented well-founded theories concerning the biological mechanisms involved and the groups of people that are probably more susceptible to health effects caused or exacerbated by inhalation of ambient particulate matter (PM.). On the basis of prognostic studies carried out in Center for Environment, JNT University, Hyderabad "it has been estimated that in Hyderabad some 1,700 to 3,000 people per year die prematurely as a result of inhaling PM". These figures reflect only the effects of acute exposure to air pollution. If the long-term effects of chronic exposure are taken into account, 10,000-15,000 people a year could die prematurely in Hyderabad. This estimate of the chronic effects is based on other studies, which are not completely comparable with the Hyderabad situation. While the study designs and analyses in these other studies may indeed be different or irrelevant to Hyderabad, the fact they were carried out in other countries is irrelevant. Taking into account these considerations, a model for total health risk assessment for the city of Hyderabad, and its state of Andhra Pradesh in India has been developed using a multi-objective air pollution monitoring network and online and real time air pollution monitoring stations. For the model studies a number of potential monitoring sites were screened for general and site-specific criteria in a geographic information system (GIS) environment that may, on a local basis, affect the representativeness of the data collected. Local features that may affect either the chemical or meteorological parameters are evaluated to assure a minimum of interference. Finally, for monitoring air pollution, an online and real-time monitoring system was designed using advanced
3% Amuchina is as effective as the 50% concentration in the prevention of exit-site infection in children on chronic peritoneal dialysis.

Science.gov (United States)

Grosman, Mònica D; Mosquera, Vanesa M; Hernandez, Maria G; Agostini, Silvana; Adragna, Marta; Sojo, Ernesto T

2005-01-01

In a previous communication, we demonstrated that, in the prevention of exit-site infection (ESI) in children, the cleansing agent 50% Amuchina (electrolytic chloroxidizer. Amuchina SpA, Genoa, Italy) is more effective than 10% povidone iodine and as effective as 4% chlorhexidine, but with fewer adverse secondary effects. In the present study, we assessed, in an Argentine pediatric population, whether Amuchina 3% is as effective as Amuchina 50% in preventing ESI in children on chronic peritoneal dialysis. In an open-label, single-center prospective study, 27 children (mean age: 7.2 years; range: 1.7-17 years) used 3% Amuchina as a cleansing agent for the daily care of a healthy exit site. Of the 27 children, 14 were switched from 50% Amuchina to 3% Amuchina, and 13 were using the 3% Amuchina for the first time. The control group consisted of 18 patients who had previously used 50% Amuchina as a cleansing agent. We followed the recommendations of the International Society for Peritoneal Dialysis with regard to exit-site care, which include keeping the cleansing agent out of the sinus and rinsing the exit site with sterile water. Amuchina was used from the first post-implantation care of the exit site. No adverse secondary effects were seen with the use of Amuchina at either concentration. Patients using 3% Amuchina presented an ESI rate similar to that of patients using Amuchina 50%. The cost of 3% Amuchina was significantly lower than that of the 50% concentration, and it was even lower than the cost for 10% povidone iodine or 4% chlorhexidine. Although more research trials are needed to assess the efficacy of 3% Amuchina, we conclude that 3% Amuchina is the best and most cost-effective cleansing agent for the daily care of a healthy exit site in children on chronic peritoneal dialysis.
Gis-Based Solar and Wind Turbine Site Selection Using Multi-Criteria Analysis: Case Study Tehran, Iran

Science.gov (United States)

Sadeghi, M.; Karimi, M.

2017-09-01

Renewable energy has less negative impacts on environment than fossil fuels. Iran has many resources for renewable energy exploitation but because of their high price, it has not been developed. Site selection is an important step for utilizing large investments like solar farms and wind turbines. Multi-criteria evaluation methods are commonly used for site selection. The purpose of this paper is to determine suitable sites for solar farm and wind turbine using GIS and AHP in Tehran, in order to generate a distributed network to increase power network stability. The final land suitability index was grouped in four categories as "most suitable", "suitable", "moderate" and "low suitable". As a result 94.61% (789939.63 km2) is low suitable, 4.47% (37337.17 km2) is moderate, 0.59% (4964.22 km2) is suitable and 0.32% (2680.70 km2) is the most suitable for building wind turbine and for solar farm, 44.07% (8116.88 km2) is low suitable, 12.81% (2359.79 km2) is moderate, 35.10% (6464.29 km2) is suitable and 8.02% (1477.28 km2) is the most suitable.
GIS-BASED SOLAR AND WIND TURBINE SITE SELECTION USING MULTI-CRITERIA ANALYSIS: CASE STUDY TEHRAN, IRAN

Directory of Open Access Journals (Sweden)

M. Sadeghi

2017-09-01

Full Text Available Renewable energy has less negative impacts on environment than fossil fuels. Iran has many resources for renewable energy exploitation but because of their high price, it has not been developed. Site selection is an important step for utilizing large investments like solar farms and wind turbines. Multi-criteria evaluation methods are commonly used for site selection. The purpose of this paper is to determine suitable sites for solar farm and wind turbine using GIS and AHP in Tehran, in order to generate a distributed network to increase power network stability. The final land suitability index was grouped in four categories as “most suitable”, “suitable”, “moderate” and “low suitable”. As a result 94.61% (789939.63 km2 is low suitable, 4.47% (37337.17 km2 is moderate, 0.59% (4964.22 km2 is suitable and 0.32% (2680.70 km2 is the most suitable for building wind turbine and for solar farm, 44.07% (8116.88 km2 is low suitable, 12.81% (2359.79 km2 is moderate, 35.10% (6464.29 km2 is suitable and 8.02% (1477.28 km2 is the most suitable.
Multi-organ dysfunction in bodybuilding possibly caused by prolonged hypercalcemia due to multi-substance abuse

DEFF Research Database (Denmark)

Schäfer, Carolyn; Guldager, Helle Skov; Jørgensen, H L

2011-01-01

and chronic ulcers due to paraffin-oil injections in both upper arms one year before. Over the course of the next few hours, the patient developed signs of multi-organ dysfunction, including pancreatitis, hemorrhagic gastritis, nephropathy with temporary anuria, and respiratory insufficiency...
Application of the multi-element analysis by X-fluorescence and neutron activation to the characterization of an archaeological site

International Nuclear Information System (INIS)

Rossini, I.

1991-06-01

The first part of this thesis is about possible analysis methods (XRF, PIXE, INAA, laser fluorimetry, and ICP), applied to Uranium, Thorium and Rubidium assays in archaeological clays and potteries. The best results have been obtained with Neutron Activation technics. The second part is about the multi-element analysis of quarries and about the research by statistical treatment of correlations between the element concentrations and the sampling sites (excavations, quarries)
What is the benefit of driving a hydrological model with data from a multi-site weather generator compared to data from a simple delta change approach?"

Science.gov (United States)

Rössler, Ole; Keller, Denise; Fischer, Andreas

2016-04-01

. Recently, a multi-site weather generator was developed and tested for downscaling purposes over Switzerland. The weather generator is of type Richardson, that is run with spatially correlated random number streams to ensure spatial consistency. As a downside, multi-site weather generators are much more complex to develop, but they are a very promising alternative downscaling technique. A new multi-site-weather generator was developed for Switzerland in a previous study (Keller et al. 2014). In this study, we tested this new multi-site-weather generator against the "standard" delta change derived data in a hydrological impact assessment study that focused on runoff in the meso-scale catchment of the river Thur catchment. Two hydrological models of different complexity were run with the data sets under present (1980-2009) and under future conditions (2070-2099), assuming the SRES A1B emission2070-2100 scenario conditions. Eight meteorological stations were used to interpolate a meteorological field that served as input to calibrate and validate the two hydrological models against runoff. The downscaling intercomparison was done for We applied 10 GCM-RCM combinations simulations of the ENSEMBLES. In case of the weather generator, that allows for multiple synthetic realizations, we generated for which change factors for each station (delta change approach) were available and generated 25 realizations of multi-site weather. with each climate model projection. Results show that the delta change driven data constitutes only one appropriate representation compared to theof a bandwidth of runoff projections yielded by the multi-site weather generator data. Especially oOn average, differences between both the two approaches are small. Low and high runoff Runoff values to both extremes are however better reproduced with the weather generator driven data set. The stochastic representation of multiday rainfall events are considered as the main reason. Hence, tThere is a clear yet small
Integrating knowledge-based multi-criteria evaluation techniques with GIS for landfill site selection: A case study using AHP

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Fagbohun B.J.

2016-09-01

Full Text Available A major challenge in most growing urban areas of developing countries, without a pre-existing land use plan is the sustainable and efficient management of solid wastes. Siting a landfill is a complicated task because of several environmental regulations. This challenge gives birth to the need to develop efficient strategies for the selection of proper waste disposal sites in accordance with all existing environmental regulations. This paper presents a knowledge-based multi-criteria decision analysis using GIS for the selection of suitable landfill site in Ado-Ekiti, Nigeria. In order to identify suitable sites for landfill, seven factors - land use/cover, geology, river, soil, slope, lineament and roads - were taken into consideration. Each factor was classified and ranked based on prior knowledge about the area and existing guidelines. Weights for each factor were determined through pair-wise comparison using Saaty’s 9 point scale and AHP. The integration of factors according to their weights using weighted index overlay analysis revealed that 39.23 km2 within the area was suitable to site a landfill. The resulting suitable area was classified as high suitability covering 6.47 km2 (16.49%, moderate suitability 25.48 km2 (64.95% and low suitability 7.28 km2 (18.56% based on their overall weights.
Multi-centre retrospective analysis of clinical diagnosis and treatment for chronic cough

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Xiao-ming CHENG

2011-02-01

Full Text Available Objective To explore the clinical characteristics and the present status of diagnosis and treatment of chronic cough.Methods The clinical data of 238 in-patients and out-patients of Departments of Respiratory Diseases from 4 teaching hospitals of Chongqing Municipality were collected from Oct.2008 to Dec.2009,and their clinical characteristics,diagnosis and therapeutic effects were retrospectively analyzed.Results A total of 238 patients were enrolled,most of them complained of dry cough and night cough.Throat symptoms were most common,including itching or foreign body sensation,throat discomfort and gastro-oesophageal reflux.Congestion of pharynx and cobblestone like changes in posterior pharyngeal wall were the most common signs in patients with chronic cough.Among all the supplementary examinations,bronchial provocation test resulted in highest positive rate.Etiological diagnosis was done in a total of 254 case-times for diseases leading to chronic cough,among them upper airway cough syndrome(UACS was suspected in 115 case-times.cough variant asthma(CVA in 42 case-times,and cough due to gastroesophageal reflux(GERC in 53 case-times.After the specific treatment targeting UACS,CVA and GERC,in 152 case-times improvement was found after follow-up,including 56,27 and 21 case-times,respectively,with an effective rate of 68.4%(104/152.The final diagnosis for the other 44 case-times with chronic cough was chronic tonsillitis,chronic bronchitis,eosinophilic bronchitis and angiotensin converting enzyme inhibitor(ACEI induced cough.A definite diagnosis was finally made in 148 out of a total of 254 casses,with a diagnostic rate of 58.3%(148/254.Conclusion The final diagnostic rate in etiology of chronic cough is still poor nowadays in our country,and empirical treatment is still the main practice for chronic cough.
Selection of adequate site location during early stages of construction project management: A multi-criteria decision analysis approach

Science.gov (United States)

Marović, Ivan; Hanak, Tomaš

2017-10-01

In the management of construction projects special attention should be given to the planning as the most important phase of decision-making process. Quality decision-making based on adequate and comprehensive collaboration of all involved stakeholders is crucial in project’s early stages. Fundamental reasons for existence of this problem arise from: specific conditions of construction industry (final products are inseparable from the location i.e. location has a strong influence of building design and its structural characteristics as well as technology which will be used during construction), investors’ desires and attitudes, and influence of socioeconomic and environment aspects. Considering all mentioned reasons one can conclude that selection of adequate construction site location for future investment is complex, low structured and multi-criteria problem. To take into account all the dimensions, the proposed model for selection of adequate site location is devised. The model is based on AHP (for designing the decision-making hierarchy) and PROMETHEE (for pairwise comparison of investment locations) methods. As a result of mixing basis feature of both methods, operational synergies can be achieved in multi-criteria decision analysis. Such gives the decision-maker a sense of assurance, knowing that if the procedure proposed by the presented model has been followed, it will lead to a rational decision, carefully and systematically thought out.
Optimizing Travel Time to Outpatient Interventional Radiology Procedures in a Multi-Site Hospital System Using a Google Maps Application.

Science.gov (United States)

Mandel, Jacob E; Morel-Ovalle, Louis; Boas, Franz E; Ziv, Etay; Yarmohammadi, Hooman; Deipolyi, Amy; Mohabir, Heeralall R; Erinjeri, Joseph P

2018-02-20

The purpose of this study is to determine whether a custom Google Maps application can optimize site selection when scheduling outpatient interventional radiology (IR) procedures within a multi-site hospital system. The Google Maps for Business Application Programming Interface (API) was used to develop an internal web application that uses real-time traffic data to determine estimated travel time (ETT; minutes) and estimated travel distance (ETD; miles) from a patient's home to each a nearby IR facility in our hospital system. Hypothetical patient home addresses based on the 33 cities comprising our institution's catchment area were used to determine the optimal IR site for hypothetical patients traveling from each city based on real-time traffic conditions. For 10/33 (30%) cities, there was discordance between the optimal IR site based on ETT and the optimal IR site based on ETD at non-rush hour time or rush hour time. By choosing to travel to an IR site based on ETT rather than ETD, patients from discordant cities were predicted to save an average of 7.29 min during non-rush hour (p = 0.03), and 28.80 min during rush hour (p travel time when more than one location providing IR procedures is available within the same hospital system.
The comparison of exit-site care with normal saline and povidone-iodine in preventing exit-site infection and peritonitis in children on chronic peritoneal dialysis treatment

Directory of Open Access Journals (Sweden)

Onder Yavascan

2011-01-01

Full Text Available Peritonitis and catheter exit- site infections (ESI are important causes of hospitalization and catheter loss in patients undergoing chronic peritoneal dialysis (CPD. The frequency of infection can be reduced by scrupulous exit- site care with or without topical antiseptics. There are no studies showing any benefit in the use of povidone-iodine or normal saline for care of exit- sites in long- term CPD patients. In this study, we aimed to determine the potential effectiveness of the application of povidone-iodine or normal saline at the catheter exit- site in preventing ESI and peritonitis in children on CPD. A total of 98 patients treated with either povidone-iodine or normal saline were included in this study. Group I (34 patients used povidone-iodine and group II (64 patients simply cleansed the exit- site with normal saline (0.9% NaCl. Dressings were changed 2 to 3 times in a week. The total cumulative follow- up time was 3233 patient- months. ESIs occurred in 10 (29.4% of 34 patients using povidone-iodine and in 10 (15.6% of 64 patients using normal saline. The frequency of ESI was significantly high in group I (povidone-iodine patients. The mean rate of ESI was 1 episode/60.8 patient- months for group I versus 1 episode/144 patient- months for group II (P 0.05. In conclusion, exit- site care with normal saline is an effective strategy in reducing the incidence of ESI in children on CPD. It can thus significantly reduce morbidity, catheter loss, and the need to transfer patients on peritoneal dialysis to hemodialysis.
Enhancing evidence informed policymaking in complex health systems: lessons from multi-site collaborative approaches.

Science.gov (United States)

Langlois, Etienne V; Becerril Montekio, Victor; Young, Taryn; Song, Kayla; Alcalde-Rabanal, Jacqueline; Tran, Nhan

2016-03-17

There is an increasing interest worldwide to ensure evidence-informed health policymaking as a means to improve health systems performance. There is a need to engage policymakers in collaborative approaches to generate and use knowledge in real world settings. To address this gap, we implemented two interventions based on iterative exchanges between researchers and policymakers/implementers. This article aims to reflect on the implementation and impact of these multi-site evidence-to-policy approaches implemented in low-resource settings. The first approach was implemented in Mexico and Nicaragua and focused on implementation research facilitated by communities of practice (CoP) among maternal health stakeholders. We conducted a process evaluation of the CoPs and assessed the professionals' abilities to acquire, analyse, adapt and apply research. The second approach, called the Policy BUilding Demand for evidence in Decision making through Interaction and Enhancing Skills (Policy BUDDIES), was implemented in South Africa and Cameroon. The intervention put forth a 'buddying' process to enhance demand and use of systematic reviews by sub-national policymakers. The Policy BUDDIES initiative was assessed using a mixed-methods realist evaluation design. In Mexico, the implementation research supported by CoPs triggered monitoring by local health organizations of the quality of maternal healthcare programs. Health programme personnel involved in CoPs in Mexico and Nicaragua reported improved capacities to identify and use evidence in solving implementation problems. In South Africa, Policy BUDDIES informed a policy framework for medication adherence for chronic diseases, including both HIV and non-communicable diseases. Policymakers engaged in the buddying process reported an enhanced recognition of the value of research, and greater demand for policy-relevant knowledge. The collaborative evidence-to-policy approaches underline the importance of iterations and continuity
Harmonization of multi-site diffusion tensor imaging data.

Science.gov (United States)

Fortin, Jean-Philippe; Parker, Drew; Tunç, Birkan; Watanabe, Takanori; Elliott, Mark A; Ruparel, Kosha; Roalf, David R; Satterthwaite, Theodore D; Gur, Ruben C; Gur, Raquel E; Schultz, Robert T; Verma, Ragini; Shinohara, Russell T

2017-11-01

Diffusion tensor imaging (DTI) is a well-established magnetic resonance imaging (MRI) technique used for studying microstructural changes in the white matter. As with many other imaging modalities, DTI images suffer from technical between-scanner variation that hinders comparisons of images across imaging sites, scanners and over time. Using fractional anisotropy (FA) and mean diffusivity (MD) maps of 205 healthy participants acquired on two different scanners, we show that the DTI measurements are highly site-specific, highlighting the need of correcting for site effects before performing downstream statistical analyses. We first show evidence that combining DTI data from multiple sites, without harmonization, may be counter-productive and negatively impacts the inference. Then, we propose and compare several harmonization approaches for DTI data, and show that ComBat, a popular batch-effect correction tool used in genomics, performs best at modeling and removing the unwanted inter-site variability in FA and MD maps. Using age as a biological phenotype of interest, we show that ComBat both preserves biological variability and removes the unwanted variation introduced by site. Finally, we assess the different harmonization methods in the presence of different levels of confounding between site and age, in addition to test robustness to small sample size studies. Copyright © 2017 Elsevier Inc. All rights reserved.
Increasing STEM Exposure in K–5 Schools Through MakerSpace Use: A Multi-Site Early Success Case Study

OpenAIRE

Ortega, Veronica Inez

2017-01-01

Using Brinkerhoff’s success case methodology, this multi-site case study examined early models of MakerSpace implementation in K–5 schools in a single district. Specifically, this study examined the early use of MakerSpaces as well as the supports and barriers affecting teacher use of these spaces. The study also examined curricular connections and MakerSpace use as a conduit for purveying instruction in the soon-to-be-implemented Next Generation Science Standards. The findings of this stud...
Chronic kidney disease, cardiovascular disease and mortality: A prospective cohort study in a multi-ethnic Asian population.

Science.gov (United States)

Lim, Cynthia C; Teo, Boon Wee; Ong, Peng Guan; Cheung, Carol Y; Lim, Su Chi; Chow, Khuan Yew; Meng, Chan Choon; Lee, Jeannette; Tai, E Shyong; Wong, Tien Y; Sabanayagam, Charumathi

2015-08-01

Few studies have examined the impact of chronic kidney disease (CKD) on adverse cardiovascular outcomes and deaths in Asian populations. We evaluated the associations of CKD with cardiovascular disease (CVD) and all-cause mortality in a multi-ethnic Asian population. Prospective cohort study of 7098 individuals who participated in two independent population-based studies involving Malay adults (n = 3148) and a multi-ethnic cohort of Chinese, Malay and Indian adults (n = 3950). CKD was assessed from CKD-EPI estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR). Incident CVD (myocardial infarction, stroke and CVD mortality) and all-cause mortality were identified by linkage with national disease/death registries. Over a median follow-up of 4.3 years, 4.6% developed CVD and 6.1% died. Risks of both CVD and all-cause mortality increased with decreasing eGFR and increasing albuminuria (all p-trend <0.05). Adjusted hazard ratios (HR (95% confidence interval)) of CVD and all-cause mortality were: 1.54 (1.05-2.27) and 2.21 (1.67-2.92) comparing eGFR <45 vs ≥60; 2.81 (1.49-5.29) and 2.34 (1.28-4.28) comparing UACR ≥300 vs <30. The association between eGFR <60 and all-cause mortality was stronger among those with diabetes (p-interaction = 0.02). PAR of incident CVD was greater among those with UACR ≥300 (12.9%) and that of all-cause mortality greater among those with eGFR <45 (16.5%). In multi-ethnic Asian adults, lower eGFR and higher albuminuria were independently associated with incident CVD and all-cause mortality. These findings extend previously reported similar associations in Western populations to Asians and emphasize the need for early detection of CKD and intervention to prevent adverse outcomes. © The European Society of Cardiology 2014.
PS1-29: Resources to Facilitate Multi-site Collaboration: the PRIMER Research Toolkit

Science.gov (United States)

Greene, Sarah; Thompson, Ella; Baldwin, Laura-Mae; Neale, Anne Victoria; Dolor, Rowena

2010-01-01

Background and Aims: The national research enterprise has typically functioned in a decentralized fashion, resulting in duplicative or undocumented processes, impeding not only the pace of research, but diffusion of established best practices. To remedy this, many long-standing networks have begun capturing and documenting proven strategies to streamline and standardize various aspects of the research process. The project, “Partnership-driven Resources to IMprove and Enhance Research” (PRIMER), was funded through the Clinical and Translational Science Awards (CTSA) initiative to leverage the collective expertise from two networks: the HMO Research Network and Practice Based Research Networks (PBRNs). Each network has a shared goal of propagating research resources and best practices. Methods: We created and distributed an online survey to 92 CTSA and PBRN representatives in March, 2009 to define critical needs and existing resources that could inform a resource repository. The survey identified barriers and benefits to forming research partnerships, and assessed the perceived utility of various tools that could accelerate the research process. The study team identified, reviewed and organized tools based on the typical research trajectory from design to dissemination. Results: Fifty-five of 92 invitees (59%) completed the survey. Respondents rated the ability to conduct community-relevant research through true academic-community partnerships as the top-rated benefit of multi-site research, followed by the opportunity to accelerate translation of research into practice. The top two perceived barriers to multi-site research were ‘funding opportunities are not adequate (e.g., too few, not enough to support true collaborations), and ‘lack of research infrastructure to support [all] partners (e.g., no IT support, IRB, dedicated research staff). Respondents’ ratings of the utility of various tools and templates was used to guide development of an online

Multi-criteria analysis for site selection for the reuse of reclaimed water and biosolids

Directory of Open Access Journals (Sweden)

António Albuquerque

2015-01-01

Full Text Available Low pH soils with insufficient organic matter can benefit from the application of reclaimed water (RW and biosolids. The presence of nutrients also aids plant growth. This paper presents the results of two integrated research studies, both carried out in the Beira Interior Region (Covilhã, Portugal; one used RW for irrigation, the other applied paper mill sludge to agricultural land. In both cases, multiple criteria based on GIS tools were used for site selection. In the first study, the characteristics of RW analyzed over 2 years were found suitable for crop irrigation. The RW had moderate organic content, low electrical conductivity (CE, high nutrient content (N, P, and low concentrations of nitrate, metals and phytotoxic elements (Al, B, Cl and Na. The multi-criteria analysis was carried out taking into account environmental, technical and economic criteria and a suitable area of 30.5 ha was found for RW irrigation. In the second work, the paper mill sludge was considered suitable for application to agricultural land. Its concentrations of N, P and heavy metals did not a present risk for soil contamination and were suitable for soil improvement and crop production. A multi-criteria analysis based on similar criteria was conducted and a suitable area of 253 ha was found for sludge application.
A Fuzzy Multi-Criteria SWOT Analysis: An Application to Nuclear Power Plant Site Selection

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Mehmet Ekmekcioglu

2011-08-01

Full Text Available SWOT (Strengths, Weaknesses, Opportunities and Threats analysis is a commonly used and an important technique for analyzing internal and external environments in order to provide a systematic approach and support for a decision making. SWOT is criticized mostly for considering only qualitative examination of environmental factors, no priority for various factors and strategies, and no vagueness of the factors under fuzziness. In this paper, fuzzy TOPSIS (Technique for Order Preference by Similarity to Ideal Solution integrated with fuzzy AHP (Analytical Hierarchy Process is used to develop fuzzy multi-criteria SWOT analysis in order to overcome these shortcomings. Nuclear power plant site selection, which is a strategic and important issue for Turkeyrs energy policy making, is considered as an application case study that demonstrated the applicability of the developed fuzzy SWOT model.
Early and late surgical site infections in ear surgery.

Science.gov (United States)

Bastier, P L; Leroyer, C; Lashéras, A; Rogues, A-M; Darrouzet, V; Franco-Vidal, V

2016-04-01

A retroauricular approach is routinely used for treating chronic otitis media. The incidence of surgical site infections after ear surgery is around 10% in contaminated or dirty procedures. This observational prospective study describes surgical site infections after chronic otitis media surgery with the retroauricular approach and investigated their potential predictive factors. This observational prospective study included patients suffering from chronic otitis media and eligible for therapeutic surgery with a retroauricular approach. During follow-up, surgical site infections were defined as "early" if occurring within 30 days after surgery or as "late" if occurring thereafter. The data of 102 patients were analysed. Concerning early surgical site infections, four cases were diagnosed (3.9%) and a significant association was found with preoperative antibiotic therapy, wet ear at pre-operative examination, class III (contaminated) in the surgical wound classification, NNIS (National Nosocomial Infection Surveillance) index > 1, and oral post-operative antibiotic use. Seven late surgical site infections were diagnosed (7.1%) between 90 and 160 days after surgery and were significantly correlated to otorrhoea during the 6 months before surgery, surgery duration ≤60 minutes, canal wall down technique and use of fibrin glue. Surgical site infections after chronic otitis media surgery seem to be associated with factors related to the inflammatory state of the middle ear at the time of surgery in early infections and with chronic inflammation in late infections. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.
Replication and Comparison of the Newly Proposed ADOS-2, Module 4 Algorithm in ASD without ID: A Multi-site Study

OpenAIRE

Pugliese, Cara E.; Kenworthy, Lauren; Bal, Vanessa Hus; Wallace, Gregory L; Yerys, Benjamin E; Maddox, Brenna B.; White, Susan W.; Popal, Haroon; Armour, Anna Chelsea; Miller, Judith; Herrington, John D.; Schultz, Robert T.; Martin, Alex; Anthony, Laura Gutermuth

2015-01-01

Recent updates have been proposed to the Autism Diagnostic Observation Schedule-2 Module 4 diagnostic algorithm. This new algorithm, however, has not yet been validated in an independent sample without intellectual disability (ID). This multi-site study compared the original and revised algorithms in individuals with ASD without ID. The revised algorithm demonstrated increased sensitivity, but lower specificity in the overall sample. Estimates were highest for females, individuals with a verb...
Conducting a team-based multi-sited focused ethnography in primary care

Directory of Open Access Journals (Sweden)

A.P. Bikker

2017-09-01

Full Text Available Abstract Focused ethnography is an applied and pragmatic form of ethnography that explores a specific social phenomenon as it occurs in everyday life. Based on the literature a problem-focused research question is formulated before the data collection. The data generation process targets key informants and situations so that relevant results on the pre-defined topic can be obtained within a relatively short time-span. As part of a theory based evaluation of alternative forms of consultation (such as video, phone and email in primary care we used the focused ethnographic method in a multisite study in general practice across the UK. To date there is a gap in the literature on using focused ethnography in healthcare research. The aim of the paper is to build on the various methodological approaches in health services research by presenting the challenges and benefits we encountered whilst conducing a focused ethnography in British primary care. Our considerations are clustered under three headings: constructing a shared understanding, dividing the tasks within the team, and the functioning of the focused ethnographers within the broader multi-disciplinary team. As a result of using this approach we experienced several advantages, like the ability to collect focused data in several settings simultaneously within in a short time-span. Also, the sharing of experiences and interpretations between the researchers contributed to a more holistic understanding of the research topic. However, mechanisms need to be in place to facilitate and synthesise the observations, guide the analysis, and to ensure that all researchers feel engaged. Reflection, trust and flexibility among the team members were crucial to successfully adopt a team focused ethnographic approach. When used for policy focussed applied healthcare research a team-based multi-sited focused ethnography can uncover practices and understandings that would not be apparent through surveys or
Conducting a team-based multi-sited focused ethnography in primary care.

Science.gov (United States)

Bikker, A P; Atherton, H; Brant, H; Porqueddu, T; Campbell, J L; Gibson, A; McKinstry, B; Salisbury, C; Ziebland, S

2017-09-12

Focused ethnography is an applied and pragmatic form of ethnography that explores a specific social phenomenon as it occurs in everyday life. Based on the literature a problem-focused research question is formulated before the data collection. The data generation process targets key informants and situations so that relevant results on the pre-defined topic can be obtained within a relatively short time-span. As part of a theory based evaluation of alternative forms of consultation (such as video, phone and email) in primary care we used the focused ethnographic method in a multisite study in general practice across the UK. To date there is a gap in the literature on using focused ethnography in healthcare research.The aim of the paper is to build on the various methodological approaches in health services research by presenting the challenges and benefits we encountered whilst conducing a focused ethnography in British primary care. Our considerations are clustered under three headings: constructing a shared understanding, dividing the tasks within the team, and the functioning of the focused ethnographers within the broader multi-disciplinary team.As a result of using this approach we experienced several advantages, like the ability to collect focused data in several settings simultaneously within in a short time-span. Also, the sharing of experiences and interpretations between the researchers contributed to a more holistic understanding of the research topic. However, mechanisms need to be in place to facilitate and synthesise the observations, guide the analysis, and to ensure that all researchers feel engaged. Reflection, trust and flexibility among the team members were crucial to successfully adopt a team focused ethnographic approach. When used for policy focussed applied healthcare research a team-based multi-sited focused ethnography can uncover practices and understandings that would not be apparent through surveys or interviews alone. If conducted with
SPICODYN: A Toolbox for the Analysis of Neuronal Network Dynamics and Connectivity from Multi-Site Spike Signal Recordings.

Science.gov (United States)

Pastore, Vito Paolo; Godjoski, Aleksandar; Martinoia, Sergio; Massobrio, Paolo

2018-01-01

We implemented an automated and efficient open-source software for the analysis of multi-site neuronal spike signals. The software package, named SPICODYN, has been developed as a standalone windows GUI application, using C# programming language with Microsoft Visual Studio based on .NET framework 4.5 development environment. Accepted input data formats are HDF5, level 5 MAT and text files, containing recorded or generated time series spike signals data. SPICODYN processes such electrophysiological signals focusing on: spiking and bursting dynamics and functional-effective connectivity analysis. In particular, for inferring network connectivity, a new implementation of the transfer entropy method is presented dealing with multiple time delays (temporal extension) and with multiple binary patterns (high order extension). SPICODYN is specifically tailored to process data coming from different Multi-Electrode Arrays setups, guarantying, in those specific cases, automated processing. The optimized implementation of the Delayed Transfer Entropy and the High-Order Transfer Entropy algorithms, allows performing accurate and rapid analysis on multiple spike trains from thousands of electrodes.
CMS readiness for multi-core workload scheduling

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Perez-Calero Yzquierdo, A.; Balcas, J.; Hernandez, J.; Aftab Khan, F.; Letts, J.; Mason, D.; Verguilov, V.

2017-10-01

In the present run of the LHC, CMS data reconstruction and simulation algorithms benefit greatly from being executed as multiple threads running on several processor cores. The complexity of the Run 2 events requires parallelization of the code to reduce the memory-per- core footprint constraining serial execution programs, thus optimizing the exploitation of present multi-core processor architectures. The allocation of computing resources for multi-core tasks, however, becomes a complex problem in itself. The CMS workload submission infrastructure employs multi-slot partitionable pilots, built on HTCondor and GlideinWMS native features, to enable scheduling of single and multi-core jobs simultaneously. This provides a solution for the scheduling problem in a uniform way across grid sites running a diversity of gateways to compute resources and batch system technologies. This paper presents this strategy and the tools on which it has been implemented. The experience of managing multi-core resources at the Tier-0 and Tier-1 sites during 2015, along with the deployment phase to Tier-2 sites during early 2016 is reported. The process of performance monitoring and optimization to achieve efficient and flexible use of the resources is also described.
CMS Readiness for Multi-Core Workload Scheduling

Energy Technology Data Exchange (ETDEWEB)

Perez-Calero Yzquierdo, A. [Madrid, CIEMAT; Balcas, J. [Caltech; Hernandez, J. [Madrid, CIEMAT; Aftab Khan, F. [NCP, Islamabad; Letts, J. [UC, San Diego; Mason, D. [Fermilab; Verguilov, V. [CLMI, Sofia

2017-11-22

In the present run of the LHC, CMS data reconstruction and simulation algorithms benefit greatly from being executed as multiple threads running on several processor cores. The complexity of the Run 2 events requires parallelization of the code to reduce the memory-per- core footprint constraining serial execution programs, thus optimizing the exploitation of present multi-core processor architectures. The allocation of computing resources for multi-core tasks, however, becomes a complex problem in itself. The CMS workload submission infrastructure employs multi-slot partitionable pilots, built on HTCondor and GlideinWMS native features, to enable scheduling of single and multi-core jobs simultaneously. This provides a solution for the scheduling problem in a uniform way across grid sites running a diversity of gateways to compute resources and batch system technologies. This paper presents this strategy and the tools on which it has been implemented. The experience of managing multi-core resources at the Tier-0 and Tier-1 sites during 2015, along with the deployment phase to Tier-2 sites during early 2016 is reported. The process of performance monitoring and optimization to achieve efficient and flexible use of the resources is also described.
Ensuring treatment fidelity in a multi-site behavioral intervention study: implementing NIH Behavior Change Consortium recommendations in the SMART trial.

Science.gov (United States)

Robb, Sheri L; Burns, Debra S; Docherty, Sharron L; Haase, Joan E

2011-11-01

The Stories and Music for Adolescent/Young Adult Resilience during Transplant (SMART) study (R01NR008583; U10CA098543; U10CA095861) is an ongoing multi-site Children's Oncology Group randomized clinical trial testing the efficacy of a therapeutic music video intervention for adolescents/young adults (11-24 years of age) with cancer undergoing stem cell transplant. Treatment fidelity strategies from our trial are consistent with the National Institutes of Health (NIH) Behavior Change Consortium Treatment Fidelity Workgroup (BCC) recommendations and provide a successful working model for treatment fidelity implementation in a large, multi-site behavioral intervention study. In this paper, we summarize 20 specific treatment fidelity strategies used in the SMART trial and how these strategies correspond with NIH BCC recommendations in five specific areas: (1) study design, (2) training providers, (3) delivery of treatment, (4) receipt of treatment, and (5) enactment of treatment skills. Increased use and reporting of treatment fidelity procedures is essential in advancing the reliability and validity of behavioral intervention research. The SMART trial provides a strong model for the application of fidelity strategies to improve scientific findings and addresses the absence of published literature, illustrating the application of BCC recommendations in behavioral intervention studies. Copyright © 2010 John Wiley & Sons, Ltd.
Use of Multi-Objective Air Pollution Monitoring Sites and Online Air Pollution Monitoring System for Total Health Risk Assessment in Hyderabad, India

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K. V. Ramani

2005-08-01

Full Text Available A consensus has been emerging among public health experts in developing countries that air pollution, even at current ambient levels, aggravates respiratory and cardiovascular diseases and leads to premature mortality. Recent studies have also presented well-founded theories concerning the biological mechanisms involved and the groups of people that are probably more susceptible to health effects caused or exacerbated by inhalation of ambient particulate matter (PM.. On the basis of prognostic studies carried out in Center for Environment, JNT University, Hyderabad Ã¢Â€Âœit has been estimated that in Hyderabad some 1,700 to 3,000 people per year die prematurely as a result of inhaling PMÃ¢Â€Â. These figures reflect only the effects of acute exposure to air pollution. If the long-term effects of chronic exposure are taken into account, 10,000Ã¢Â€Â“15,000 people a year could die prematurely in Hyderabad. This estimate of the chronic effects is based on other studies, which are not completely comparable with the Hyderabad situation. While the study designs and analyses in these other studies may indeed be different or irrelevant to Hyderabad, the fact they were carried out in other countries is irrelevant. Taking into account these considerations, a model for total health risk assessment for the city of Hyderabad, and its state of Andhra Pradesh in India has been developed using a multi-objective air pollution monitoring network and online and real time air pollution monitoring stations. For the model studies a number of potential monitoring sites were screened for general and site-specific criteria in a geographic information system (GIS environment that may, on a local basis, affect the representativeness of the data collected. Local features that may affect either the chemical or meteorological parameters are evaluated to assure a minimum of interference. Finally, for monitoring air pollution, an online and real
A Graphic Overlay Method for Selection of Osteotomy Site in Chronic Radial Head Dislocation: An Evaluation of 3D-printed Bone Models.

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Kim, Hui Taek; Ahn, Tae Young; Jang, Jae Hoon; Kim, Kang Hee; Lee, Sung Jae; Jung, Duk Young

2017-03-01

Three-dimensional (3D) computed tomography imaging is now being used to generate 3D models for planning orthopaedic surgery, but the process remains time consuming and expensive. For chronic radial head dislocation, we have designed a graphic overlay approach that employs selected 3D computer images and widely available software to simplify the process of osteotomy site selection. We studied 5 patients (2 traumatic and 3 congenital) with unilateral radial head dislocation. These patients were treated with surgery based on traditional radiographs, but they also had full sets of 3D CT imaging done both before and after their surgery: these 3D CT images form the basis for this study. From the 3D CT images, each patient generated 3 sets of 3D-printed bone models: 2 copies of the preoperative condition, and 1 copy of the postoperative condition. One set of the preoperative models was then actually osteotomized and fixed in the manner suggested by our graphic technique. Arcs of rotation of the 3 sets of 3D-printed bone models were then compared. Arcs of rotation of the 3 groups of bone models were significantly different, with the models osteotomized accordingly to our graphic technique having the widest arcs. For chronic radial head dislocation, our graphic overlay approach simplifies the selection of the osteotomy site(s). Three-dimensional-printed bone models suggest that this approach could improve range of motion of the forearm in actual surgical practice. Level IV-therapeutic study.
Ecological restoration of Central European mining sites: a summary of a multi-site analysis

Energy Technology Data Exchange (ETDEWEB)

Prach, K.; Rehounkova, K.; Rehounek, J.; Konvalinkova, P. [University of South Bohemia, Ceske Budejovice (Czech Republic)

2011-07-01

Sites disturbed by mining were surveyed in the Czech Republic, central Europe. The sites included spoil heaps from coal mining, sand and gravel pits, extracted peatlands and stone quarries. The following main conclusions emerged: I) potential for spontaneous succession to be used in restoration projects is between 95 and 100% of the total area disturbed; ii) mining sites, if mining is properly designed and then the sites are left to spontaneous succession, often act as refugia for endangered and retreating organisms, and may contribute substantially to local biodiversity.
Efficacy and safety of acupuncture for chronic pain caused by gonarthrosis: A study protocol of an ongoing multi-centre randomised controlled clinical trial [ISRCTN27450856

Directory of Open Access Journals (Sweden)

Krämer Jürgen

2004-03-01

Full Text Available Abstract Background Controlled clinical trials produced contradictory results with respect to a specific analgesic effect of acupuncture. There is a lack of large multi-centre acupuncture trials. The German Acupuncture Trial represents the largest multi-centre study of acupuncture in the treatment of chronic pain caused by gonarthrosis up to now. Methods 900 patients will be randomised to three treatment arms. One group receives verum acupuncture, the second sham acupuncture, and the third conservative standard therapy. The trial protocol is described with eligibility criteria, detailed information on the treatment definition, blinding, endpoints, safety evaluation, statistical methods, sample size determination, monitoring, legal aspects, and the current status of the trial. Discussion A critical discussion is given regarding the considerations about standardisation of the acupuncture treatment, the choice of the control group, and the blinding of patients and observers.
A multi-technique phytoremediation approach to purify metals contaminated soil from e-waste recycling site.

Science.gov (United States)

Luo, Jie; Cai, Limei; Qi, Shihua; Wu, Jian; Sophie Gu, Xiaowen

2017-12-15

Multiple techniques for soil decontamination were combined to enhance the phytoremediation efficiency of Eucalyptus globulese and alleviate the corresponding environmental risks. The approach constituted of chelating agent using, electrokinetic remediation, plant hormone foliar application and phytoremediation was designed to remediate multi-metal contaminated soils from a notorious e-waste recycling town. The decontamination ability of E. globulese increased from 1.35, 58.47 and 119.18 mg per plant for Cd, Pb and Cu in planting controls to 7.57, 198.68 and 174.34 mg per plant in individual EDTA treatments, respectively, but simultaneously, 0.9-11.5 times more metals leached from chelator treatments relative to controls. Low (2 V) and moderate (4 V) voltage electric fields provoked the growth of the species while high voltage (10 V) had an opposite effect and metal concentrations of the plants elevated with the increment of voltage. Volumes of the leachate decreased from 1224 to 134 mL with voltage increasing from 0 to 10 V due to electroosmosis and electrolysis. Comparing with individual phytoremediation, foliar cytokinin treatments produced 56% more biomass and intercepted 2.5 times more leachate attributed to the enhanced transpiration rate. The synergistic combination of the individuals resulted in the most biomass production and metal accumulation of the species under the stress condition relative to other methods. Time required for the multi-technique approach to decontaminate Cd, Pb and Cu from soil was 2.1-10.4 times less than individual chelator addition, electric field application or plant hormone utilization. It's especially important that nearly no leachate (60 mL in total) was collected from the multi-technique system. This approach is a suitable method to remediate metal polluted site considering its decontamination efficiency and associated environmental negligible risk. Copyright © 2017 Elsevier Ltd. All rights reserved.
Completion Report for Multi-Site Incentive MRT 2779 Implement ASC Tripod Initiative by 30SEP08

Energy Technology Data Exchange (ETDEWEB)

East, D; Cerutti, J; Noe, J; Cupps, K; Loncaric, J; Sturtevant, J

2008-09-22

This report provides documentation and evidence for the completion of the deployment of the Tripod common operating system (TripodOS, also known as and generally referred to below as TOSS). Background documents for TOSS are provided in Appendices A and B, including the initial TOSS proposal accepted by ASC HQ and Executives in July 2007 and a Governance Model defined by a Tri-Lab working group in September 2007. Appendix C contains a document that clarifies the intent and requirements for the completion criteria associated with MRT 2779. The deployment of TOSS is a Multi-Site Incentive from the ASC FY08-09 Implementation Plan due at the end of Quarter 4 in FY08.
Siting of Carsharing Stations Based on Spatial Multi-Criteria Evaluation: A Case Study of Shanghai EVCARD

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Wenxiang Li

2017-01-01

Full Text Available Carsharing is one of the effective ways to relieve the problems of traffic jams, parking difficulties, and air pollution. In recent years, the numbers of carsharing services and their members have remarkably increased around the world. The project of electric carsharing in Shanghai, called EVCARD, has also developed rapidly with very large demand and supply. Aiming to determine the optimal locations of future stations of the EVCARD, this research employs a novel method combining the analytic hierarchy process (AHP and geographical information system (GIS with big data. Potential users, potential travel demand, potential travel purposes, and distance from existing stations are selected as the decision criteria. A siting decision system is established, consisting of 15 evaluation indicators which are calculated from multi-source data on mobile phones, taxi trajectory, point of interests (POI, and the EVCARD operation. The method of the AHP is used to determine the indicator weights, and the “Spatial Analyst” tool of ArcGIS is adopted to generate the indicator values for every 1 km × 1 km decision unit. Finally, synthetic scores are calculated to evaluate the candidate sites of EVCARD stations. The results of the case study verify the effectiveness of the proposed method, which can provide a more scientific and feasible method for carsharing operators to site stations, avoiding aimless and random decisions.
Deep learning architectures for multi-label classification of intelligent health risk prediction.

Science.gov (United States)

Maxwell, Andrew; Li, Runzhi; Yang, Bei; Weng, Heng; Ou, Aihua; Hong, Huixiao; Zhou, Zhaoxian; Gong, Ping; Zhang, Chaoyang

2017-12-28

Multi-label classification of data remains to be a challenging problem. Because of the complexity of the data, it is sometimes difficult to infer information about classes that are not mutually exclusive. For medical data, patients could have symptoms of multiple different diseases at the same time and it is important to develop tools that help to identify problems early. Intelligent health risk prediction models built with deep learning architectures offer a powerful tool for physicians to identify patterns in patient data that indicate risks associated with certain types of chronic diseases. Physical examination records of 110,300 anonymous patients were used to predict diabetes, hypertension, fatty liver, a combination of these three chronic diseases, and the absence of disease (8 classes in total). The dataset was split into training (90%) and testing (10%) sub-datasets. Ten-fold cross validation was used to evaluate prediction accuracy with metrics such as precision, recall, and F-score. Deep Learning (DL) architectures were compared with standard and state-of-the-art multi-label classification methods. Preliminary results suggest that Deep Neural Networks (DNN), a DL architecture, when applied to multi-label classification of chronic diseases, produced accuracy that was comparable to that of common methods such as Support Vector Machines. We have implemented DNNs to handle both problem transformation and algorithm adaption type multi-label methods and compare both to see which is preferable. Deep Learning architectures have the potential of inferring more information about the patterns of physical examination data than common classification methods. The advanced techniques of Deep Learning can be used to identify the significance of different features from physical examination data as well as to learn the contributions of each feature that impact a patient's risk for chronic diseases. However, accurate prediction of chronic disease risks remains a challenging
Work characteristics predict the development of multi-site musculoskeletal pain.

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Oakman, Jodi; de Wind, Astrid; van den Heuvel, Swenne G; van der Beek, Allard J

2017-10-01

Musculoskeletal pain in more than one body region is common and a barrier to sustaining employment. We aimed to examine whether work characteristics predict the development of multi-site pain (MSP), and to determine differences in work-related predictors between age groups. This study is based on 5136 employees from the Study on Transitions in Employment, Ability and Motivation (STREAM) who reported no MSP at baseline. Measures included physical, emotional, mental, and psychological job demands, social support and autonomy. Predictors of MSP were studied by logistic regression analyses. Univariate and multivariate analyses with age stratification (45-49, 50-54, 55-59, and 60-64 years) were done to explore differences between age groups. All work characteristics with the exception of autonomy were predictive of the development of MSP, with odds ratios varying from 1.21 (95% CI 1.04-1.40) for mental job demands to 1.63 (95% CI 1.43-1.86) for physical job demands. No clear pattern of age-related differences in the predictors of MSP emerged, with the exception of social support, which was predictive of MSP developing in all age groups except for the age group 60-64 years. Adverse physical and psychosocial work characteristics are associated with MSP. Organisations need to comprehensively assess work environments to ensure that all relevant workplace hazards, physical and psychosocial, are identified and then controlled for across all age groups.
How school climate relates to chronic absence: A multi-level latent profile analysis.

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Van Eck, Kathryn; Johnson, Stacy R; Bettencourt, Amie; Johnson, Sarah Lindstrom

2017-04-01

Chronic absence is a significant problem in schools. School climate may play an important role in influencing chronic absence rates among schools, yet little research has evaluated how school climate constructs relate to chronic absence. Using multilevel latent profile analysis, we evaluated how profiles of student perceptions of school climate at both the student and school level differentiated school-level rates of chronic absence. Participants included 25,776 middle and high school students from 106 schools who completed a district administered school climate survey. Students attended schools in a large urban school district where 89% of 6th through 12th grade students were African-American and 61% were eligible for the federally subsidized school meals program. Three student-level profiles of perceptions of school climate emerged that corresponded to "positive," "moderate," and "negative" climate. Two predominant patterns regarding the distribution of these profiles within schools emerged that corresponded to the two school-level profiles of "marginal climate" and "climate challenged" schools. Students reporting "moderate" and "negative" climate in their schools were more likely to attend schools with higher chronic absence rates than students reporting that their school had "positive" climate. Likewise, "climate challenged" schools had significantly higher chronic absence rates than "marginal climate" schools. These results suggest that school climate shares an important relation with chronic absence among adolescent students attending urban schools. Implications for prevention and intervention programs are discussed. Copyright © 2016 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

A new multi-gas constrained model of trace gas non-homogeneous transport in firn: evaluation and behaviour at eleven polar sites

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E. Witrant

2012-12-01

Full Text Available Insoluble trace gases are trapped in polar ice at the firn-ice transition, at approximately 50 to 100 m below the surface, depending primarily on the site temperature and snow accumulation. Models of trace gas transport in polar firn are used to relate firn air and ice core records of trace gases to their atmospheric history. We propose a new model based on the following contributions. First, the firn air transport model is revised in a poromechanics framework with emphasis on the non-homogeneous properties and the treatment of gravitational settling. We then derive a nonlinear least square multi-gas optimisation scheme to calculate the effective firn diffusivity (automatic diffusivity tuning. The improvements gained by the multi-gas approach are investigated (up to ten gases for a single site are included in the optimisation process. We apply the model to four Arctic (Devon Island, NEEM, North GRIP, Summit and seven Antarctic (DE08, Berkner Island, Siple Dome, Dronning Maud Land, South Pole, Dome C, Vostok sites and calculate their respective depth-dependent diffusivity profiles. Among these different sites, a relationship is inferred between the snow accumulation rate and an increasing thickness of the lock-in zone defined from the isotopic composition of molecular nitrogen in firn air (denoted δ¹⁵N. It is associated with a reduced diffusivity value and an increased ratio of advective to diffusive flux in deep firn, which is particularly important at high accumulation rate sites. This has implications for the understanding of δ¹⁵N of N₂ records in ice cores, in relation with past variations of the snow accumulation rate. As the snow accumulation rate is clearly a primary control on the thickness of the lock-in zone, our new approach that allows for the estimation of the lock-in zone width as a function of accumulation may lead to a better constraint on the age difference between the ice and entrapped gases.
[Multiple chronic conditions and morbidity burden: challenges and considerations for an organizational strategy].

Science.gov (United States)

Balicer, Ran; Bitterman, Haim; Shadmi, Efrat

2012-07-01

Technological advances combined with the aging of the population bring about an increasingly growing number of patients with chronic conditions and multi-morbidity. Multi-morbidity, the co-occurrence of chronic and/or non-chronic conditions in an individual, is the norm among elderly patients, and is becoming increasingly common among younger adults. The Israeli health system, like other systems worldwide, is faced with the challenges posed by the increase in complex multi-morbidity, in an era of growing fiscal constraints, a situation that can induce financial and organizational crises. To effectively cope with such circumstances, a paradigm shift is needed. Health systems need to focus on overall morbidity burden and multi-morbidity (rather than the prevailing one disease at a time approach) and on better care integration. The Israeli health system entails many of the essential elements for addressing the challenges of integrated care, including universal health coverage and advanced health information technology systems. Yet, like other health systems, there is a need for care management support mechanisms that are more effectively tailored to meet the needs of the highly multimorbid patients. This review outlines the organizational approach required to better align care for the main customers of health care in the 21st century: patients with multi-morbidity. We focus on four domains: assessment of morbidity burden according to measures that account for the interaction and synergism amongst conditions; integration across the care continuum; enhancement of primary care and self-management support approaches; and provision of uniquely tailored care management solutions for the highest risk multi-morbid patients.
Advances in multi-unit nuclear power plant probabilistic risk assessment

International Nuclear Information System (INIS)

Modarres, Mohammad; Zhou, Taotao; Massoud, Mahmoud

2017-01-01

The Fukushima Dai-ichi accident highlighted the importance of risks from multiple nuclear reactor unit accidents at a site. As a result, there has been considerable interest in Multi-Unit Probabilistic Risk Assessment (MUPRA) in the past few years. For considerations in nuclear safety, the MUPRA estimates measures of risk and identifies contributors to risk representing the entire site rather than the individual units in the site. In doing so, possible unit-to-unit interactions and dependencies should be modeled and accounted for in the MUPRA. In order to effectively account for these risks, six main commonality classifications—initiating events, shared connections, identical components, proximity dependencies, human dependencies, and organizational dependencies—may be used. This paper examines advances in MUPRA, offers formal definitions of multi-unit site risk measures and proposes quantitative approaches and data to account for unit-to-unit dependencies. Finally, a parametric approach for the multi-unit dependencies has been discussed and a simple example illustrates application of the proposed methodology. - Highlights: • This paper will discuss the technical aspects of an integrated MUPRA, including consideration of dependencies and assessment of the multi-unit dependency data and models for quantifying such dependencies. • The paper also provides discussions on formal definitions and metrics for multi-unit site risks. • The parametric methods are used to address multi-unit dependency situations. • A conceptual two-unit logic example is used to demonstrate the application of proposed methodology.
RNF4 interacts with multiSUMOylated ETV4.

Science.gov (United States)

Aguilar-Martinez, Elisa; Guo, Baoqiang; Sharrocks, Andrew D

2016-01-01

Protein SUMOylation represents an important regulatory event that changes the activities of numerous proteins. Recent evidence demonstrates that polySUMO chains can act as a trigger to direct the ubiquitin ligase RNF4 to substrates to cause their turnover through the ubiquitin pathway. RNF4 uses multiple SUMO interaction motifs (SIMs) to bind to these chains. However, in addition to polySUMO chains, a multimeric binding surface created by the simultaneous SUMOylation of multiple residues on a protein or complex could also provide a platform for the recruitment of multi-SIM proteins like RNF4. Here we demonstrate that multiSUMOylated ETV4 can bind to RNF4 and that a unique combination of SIMs is required for RNF4 to interact with this multiSUMOylated platform. Thus RNF4 can bind to proteins that are either polySUMOylated through a single site or multiSUMOylated on several sites and raises the possibility that such multiSIM-multiSUMO interactions might be more widespread.
The surface chemistry of divalent metal carbonate minerals; a critical assessment of surface charge and potential data using the charge distribution multi-site ion complexation model

NARCIS (Netherlands)

Wolthers, M.; Charlet, L.; Van Cappellen, P.

2008-01-01

The Charge Distribution MUltiSite Ion Complexation or CD–MUSIC modeling approach is used to describe the chemical structure of carbonate mineralaqueous solution interfaces. The new model extends existing surface complexation models of carbonate minerals, by including atomic scale information on
The carbon balance of European croplands: a Trans-European, cross-site, multi model simulation study

Science.gov (United States)

Wattenbach, Martin; Sus, Oliver; Vuichard, Nicolas; Lehuger, Simon; Leip, Adrian; Gottschalk, Pia; Smith, Pete

2010-05-01

Croplands cover approximately 45% of Europe and play a significant role in the overall carbon budget of the continent. However, the estimation of the regional carbon balance is still uncertain. Here, we present a multi-site model comparison for four cropland ecosystem models namely the DNDC, ORCHIDEE-STICS, CERES-EGC and SPA model. We compare the accuracy of the models in predicting net ecosystem exchange (NEE), gross primary production (GPP), ecosystem respiration (Reco) as well as actual evapo-transpiration (ETa) for winter wheat (Triticum aestivum L.), winter barley (Hordeum vulgare L.) and maize (Zea mays L.) derived from eddy covariance measurements on five sites of the CarboEurope IP network. The models are all able to simulate mean daily GPP. The simulation results for mean daily ETa and Reco are, however, less accurate. The resulting simulation of daily NEE is adequate beside some cases where models fail due to a lack in phase and amplitude alignment. ORCHIDEE-STICS and the SPA demonstrate the best performance, nevertheless, they are not able to simulate full crop rotations under consideration of multiple management. CERES-EGC and especially DNDC although exhibiting a lower level of model accuracy are able to simulate such conditions resulting in more accurate annual cumulative NEE.
A geographic information system and multi criteria analysis method for site selection of spent nuclear fuel disposal

International Nuclear Information System (INIS)

Martins, Vivian Borges

2009-01-01

This thesis aims to develop a site selection methodology for the construction of final repository for the spent nuclear fuel disposal, by using geographic information systems (GIS) and multi-criteria decision analysis. Decision making processes of this kind are often complex, given the great number of space parameters to consider and also the typically conflicting opinions of the diverse stake holders. By using GIS, data from different space parameters can be quickly and reliably stored, treated and analyzed. Multi-criteria techniques allow for the incorporation of different stake holders' opinions. These tools, when jointly used, allow for the decision process to be more transparent, quick and reliable. The method developed was applied to the particular case of the state of Rio de Janeiro. Weights obtained from an expert panel and also by using the Hierarchical Analysis Method and cartographic data were combined in the GIS. The application showed that it is possible not only to select and classify areas as to their aptness for the proposed objective, but also to exclude those clearly inadequate areas, thus optimizing the selection process by reducing the search space and consequently minimizing costs and the time spent in the search. (author)
Multi-slice spiral CT perfusion imaging of chronic obstructive pulmonary disease

International Nuclear Information System (INIS)

Shao Yanhui; Qian Nong; Xue Yuejun; Dao Yinhong

2008-01-01

Objective: To evaluate the diagnostic value of multi-slice spiral CT (MSCT) perfusion imaging in chronic obstructive pulmonary disease (COPD). Methods: Twenty COPD patients and 20 volunteers underwent 8-row detector spiral CT (MSCT) perfusion imaging using cine scan mode with 5 mm slice thickness, 0.5 s rotation time and a total scan time of 45 s with 5 s intervals. 60 ml contrast agent (300 nag I/ml) were administered at a rate of 4 ml/s from the forearm superficial vein. The imaging data were transferred to a workstation. A time-density curve and pseudo-color map were generated automatically with GE CT perfusion 3 software, the blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability surface (PS) were measured. Results: Time-density curve was flatter and the peak of the curve was obviously lower in COPD patients than the volunteers. The BF, BV, PS in COPD patients was (24.77±11.49) ml·min -1 ·100 g -1 , (2.48±1.02) ml/100 g and (2.75±1.13) ml· min -1 ·100 g -1 respectively. In volunteers was (290.14±107.59) ml·min -1 ·100 g -1 , (16.51 ± 5.98) ml/100 g, (8.80±3.03) ml·min -1 ·100 g -1 respectively. The MTT in COPD patients and volunteers was (10.58±4.85) s and (4.50±1.71)s respectively. The BF, BV and PS in COPD patients was lower than the volunteers, the MTY was higher (P<0.01). Conclusion: MSCT perfusion imaging is helpful for the diagnosis of COPD. (authors)
Health Literacy Training for Public Health Nurses in Fukushima: A Multi-site Program Evaluation.

Science.gov (United States)

Goto, Aya; Lai, Alden Yuanhong; Rudd, Rima E

2015-09-01

Public health nurses (PHNs) are community residents' access points to health information and services in Japan. After the Fukushima nuclear accident, they were challenged to communicate radiation-related health information to best meet community needs. We previously developed and evaluated the outcome of a single-site health literacy training program to augment PHNs' ability to improve community residents' access to written health information. This paper presents an evaluation of an identical training program using data combined from multiple sites, and further included proximal and distal evaluations to document the impact of health literacy training in a post-disaster setting. A total of 64 participants, primarily experienced PHNs, attended one of three multi-session health literacy workshops conducted in multiple sites across Fukushima. Quantitative and qualitative data on PHNs' training satisfaction, self-evaluation of achievements regarding training goals, and application of learned skills were collected and analyzed. Each workshop consisted of two 2-hour sessions introducing health literacy and assessment tools and developing skills to improve written materials, followed by a one-month follow-up assessment on PHNs' application of the gained skills in the field. Post-training evaluations on the appropriateness and usefulness of the workshop were highly positive. At the end of the one-month follow-up, 45% of participants had gained confidence in assessing and revising written materials and had applied the skills they had gained to develop and communicate health information in various settings and modes. This increase in confidence was associated with further application of the learned skills at the municipal level. However, participants reported difficulties in explaining risks, and the need to learn more about plain language to be able to paraphrase professional terms. This paper highlighs the positive outcomes of health literacy training among PHNs. Practical
Bacterial Contribution in Chronicity of Wounds.

Science.gov (United States)

Rahim, Kashif; Saleha, Shamim; Zhu, Xudong; Huo, Liang; Basit, Abdul; Franco, Octavio Luiz

2017-04-01

A wound is damage of a tissue usually caused by laceration of a membrane, generally the skin. Wound healing is accomplished in three stages in healthy individuals, including inflammatory, proliferative, and remodeling stages. Healing of wounds normally starts from the inflammatory phase and ends up in the remodeling phase, but chronic wounds remain in an inflammatory stage and do not show progression due to some specific reasons. Chronic wounds are classified in different categories, such as diabetic foot ulcer (DFU), venous leg ulcers (VLU) and pressure ulcer (PU), surgical site infection (SSI), abscess, or trauma ulcers. Globally, the incidence rate of DFU is 1-4 % and prevalence rate is 5.3-10.5 %. However, colonization of pathogenic bacteria at the wound site is associated with wound chronicity. Most chronic wounds contain more than one bacterial species and produce a synergetic effect that results in previously non-virulent bacterial species becoming virulent and causing damage to the host. While investigating bacterial diversity in chronic wounds, Staphylococcus, Pseudomonas, Peptoniphilus, Enterobacter, Stenotrophomonas, Finegoldia, and Serratia were found most frequently in chronic wounds. Recently, it has been observed that bacteria in chronic wounds develop biofilms that contribute to a delay in healing. In a mature biofilm, bacteria grow slowly due to deficiency of nutrients that results in the resistance of bacteria to antibiotics. The present review reflects the reasons why acute wounds become chronic. Interesting findings include the bacterial load, which forms biofilms and shows high-level resistance toward antibiotics, which is a threat to human health in general and particularly to some patients who have acute wounds.
[Clinical retrospective control study of single-port laparoendoscopic and multi-port laparoscopic ovarian cystectomy].

Science.gov (United States)

Liu, X; Wen, M K; Liu, H Y; Sun, D W; Lang, J H; Fan, Q B; Shi, H H

2017-10-25

Objective: To investigate clinical outcomes of laparoendoscopic single-site ovarian cystectomy compared with traditional multi-port laparoscopic ovarian cystectomy. Methods: Data of 81 patients with ovarian cystectomy from January 2016 to May 2017, the single-site group ( n= 40) and the multi-port group ( n= 41) in Peking Union Medical College Hospital were retrospectively collected. The outcomes of single-site and multi-port groups were analyzed and compared, including: postoperative fever, operation time, blood loss, hemoglobin change, surgical complications, postoperative pain score, postoperative analgesic requirements, body image scale and cosmetic score, length of hospital stay, postoperative total cost. Results: No complication was found in two groups. No difference was found in postoperative fever, blood loss, hemoglobin change, postoperative pain score, length of hospital stay, and total cost between the two groups (all P> 0.05). Operation time was (50±20) minutes in single-site group, and (40±15) minutes in multi-port group; postoperative analgesic requirements was 28%(11/40) in single-site group, and 7%(4/41) in multi-port group; cosmetic score was 22.6±2.6 in single-site group, and 17.3±2.6 in multi-port group; body image scale was 5.7±1.2 in single-site group, and 6.2±1.2 in multi-port group; these four clinical parameters were statistical differences (all P< 0.05). Conculsion: Laparoendoscopic single-site ovarian cystectomy is feasible and safe, although it could't relieve the postoperative pian, it do offer a higher cosmetic satisfaction.
Importance of the multi-modules study in PSA; Importancia del estudio de multi-modulos en APS

Energy Technology Data Exchange (ETDEWEB)

Gonzalez R, V. J.; Nelson E, P. F., E-mail: judith_gonzalez_rodriguez@outlook.es [UNAM, Facultad de Ingenieria, Departamento de Sistemas Energeticos, Paseo Cuauhnahuac 8532, 62550 Jiutepec, Morelos (Mexico)

2015-09-15

The current approach that has taken the Probabilistic Safety Analysis (PSA) consists of doing all the APS analysis including the existence of multi-units in the nuclear power plants (NPP), this new approach seeks to analyze the risk of site, evaluating all reactors together. The main reasons for this trend are: the accident occurred on March 2011 in Fukushima Daiichi in Japan, with serious consequences in more than one reactor of the NPP and the current planning and construction of new Small Modular Reactors, which host more than one module on the same NPP and are connected to a single control room. This study analyzes how to model the risk of a multi-module NPP. In 2013, the ASME/ANS standard for advanced reactors that are not light-water reactors was published, in which the requirements to realize a PSA including multi-units or modules are shown; however, does not describe the methodology to do that. This article presents a methodology to calculate the risk of the site in a PBMR plant with two modules. This methodology consists of two models of trees of different events, one that evaluates to a single PBMR module and another that evaluates the two modules together. Both models are responsible to show their differences and compare results to finally demonstrate the need for new methodologies for risk analysis site in multi-modules and units. (Author)
Multi-dimensionality of chronic pain of the oral cavity and face

Science.gov (United States)

2013-01-01

Orofacial pain in its broadest definition can affect up to 7% of the population. Its diagnosis and initial management falls between dentists and doctors and in the secondary care sector among pain physicians, headache neurologists and oral physicians. Chronic facial pain is a long term condition and like all other chronic pain is associated with numerous co-morbidities and treatment outcomes are often related to the presenting co-morbidities such as depression, anxiety, catastrophising and presence of other chronic pain which must be addressed as part of management . The majority of orofacial pain is continuous so a history of episodic pain narrows down the differentials. There are specific oral conditions that rarely present extra orally such as atypical odontalgia and burning mouth syndrome whereas others will present in both areas. Musculoskeletal pain related to the muscles of mastication is very common and may also be associated with disc problems. Trigeminal neuralgia and the rarer glossopharyngeal neuralgia are specific diagnosis with defined care pathways. Other trigeminal neuropathic pain which can be associated with neuropathy is caused most frequently by trauma but secondary causes such as malignancy, infection and auto-immune causes need to be considered. Management is along the lines of other neuropathic pain using accepted pharmacotherapy with psychological support. If no other diagnostic criteria are fulfilled than a diagnosis of chronic or persistent idiopathic facial pain is made and often a combination of antidepressants and cognitive behaviour therapy is effective. Facial pain patients should be managed by a multidisciplinary team. PMID:23617409
Disease management projects and the Chronic Care Model in action: baseline qualitative research

Science.gov (United States)

2012-01-01

Background Disease management programs, especially those based on the Chronic Care Model (CCM), are increasingly common in the Netherlands. While disease management programs have been well-researched quantitatively and economically, less qualitative research has been done. The overall aim of the study is to explore how disease management programs are implemented within primary care settings in the Netherlands; this paper focuses on the early development and implementation stages of five disease management programs in the primary care setting, based on interviews with project leadership teams. Methods Eleven semi-structured interviews were conducted at the five selected sites with sixteen professionals interviewed; all project directors and managers were interviewed. The interviews focused on each project’s chosen chronic illness (diabetes, eating disorders, COPD, multi-morbidity, CVRM) and project plan, barriers to development and implementation, the project leaders’ action and reactions, as well as their roles and responsibilities, and disease management strategies. Analysis was inductive and interpretive, based on the content of the interviews. After analysis, the results of this research on disease management programs and the Chronic Care Model are viewed from a traveling technology framework. Results This analysis uncovered four themes that can be mapped to disease management and the Chronic Care Model: (1) changing the health care system, (2) patient-centered care, (3) technological systems and barriers, and (4) integrating projects into the larger system. Project leaders discussed the paths, both direct and indirect, for transforming the health care system to one that addresses chronic illness. Patient-centered care was highlighted as needed and a paradigm shift for many. Challenges with technological systems were pervasive. Project leaders managed the expenses of a traveling technology, including the social, financial, and administration involved
Disease management projects and the Chronic Care Model in action: baseline qualitative research.

Science.gov (United States)

Walters, Bethany Hipple; Adams, Samantha A; Nieboer, Anna P; Bal, Roland

2012-05-11

Disease management programs, especially those based on the Chronic Care Model (CCM), are increasingly common in The Netherlands. While disease management programs have been well-researched quantitatively and economically, less qualitative research has been done. The overall aim of the study is to explore how disease management programs are implemented within primary care settings in The Netherlands; this paper focuses on the early development and implementation stages of five disease management programs in the primary care setting, based on interviews with project leadership teams. Eleven semi-structured interviews were conducted at the five selected sites with sixteen professionals interviewed; all project directors and managers were interviewed. The interviews focused on each project's chosen chronic illness (diabetes, eating disorders, COPD, multi-morbidity, CVRM) and project plan, barriers to development and implementation, the project leaders' action and reactions, as well as their roles and responsibilities, and disease management strategies. Analysis was inductive and interpretive, based on the content of the interviews. After analysis, the results of this research on disease management programs and the Chronic Care Model are viewed from a traveling technology framework. This analysis uncovered four themes that can be mapped to disease management and the Chronic Care Model: (1) changing the health care system, (2) patient-centered care, (3) technological systems and barriers, and (4) integrating projects into the larger system. Project leaders discussed the paths, both direct and indirect, for transforming the health care system to one that addresses chronic illness. Patient-centered care was highlighted as needed and a paradigm shift for many. Challenges with technological systems were pervasive. Project leaders managed the expenses of a traveling technology, including the social, financial, and administration involved. At the sites, project leaders served
Progression from Chronic Atrophic Gastritis to Gastric Cancer; Tangle, Toggle, Tackle with Korea Red Ginseng

Science.gov (United States)

Kim, Yoon Jae; Chung, Jun Won; Lee, So Jung; Choi, Ki Seok; Kim, Ju Hyun; Hahm, Ki Baik

2010-01-01

Key molecular players that link inflammation to carcinogenesis are prostaglandins, cytokines, nuclear factor-κB (NF-κB), chemokines, angiogenic growth factors, and free radicals, all of which lead to increased mutations and altered functions of important enzymes and proteins, for example, activation of oncogenic products and/or inhibition of tumor suppressor proteins, in inflamed tissues, thus contributing to multi-stage carcinogenesis process. Interpreted reversely, the identification of the molecular mechanisms by which chronic inflammation increases cancer risk or optimal intervention of targeted drugs or agents during the inflammation-associated carcinogenic process could be a necessary basis for developing new strategy of cancer prevention at many sites. In this review, we discuss the possibilities for cancer prevention by controlling inflammation process in Helicobacter pylori (H. pylori)-associated inflamed stomach with Korea red ginseng. Korea red ginseng is a good example of a natural herb that has ubiquitous properties that are conductive to stop inflammatory carcinogenesis that is un wanted outcome of H. pylori infection, rendering rejuvenation of chronic atrophic gastritis. PMID:20490314
The Fermilab Advanced Computer Program multi-array processor system (ACPMAPS): A site oriented supercomputer for theoretical physics

International Nuclear Information System (INIS)

Nash, T.; Areti, H.; Atac, R.

1988-08-01

The ACP Multi-Array Processor System (ACPMAPS) is a highly cost effective, local memory parallel computer designed for floating point intensive grid based problems. The processing nodes of the system are single board array processors based on the FORTRAN and C programmable Weitek XL chip set. The nodes are connected by a network of very high bandwidth 16 port crossbar switches. The architecture is designed to achieve the highest possible cost effectiveness while maintaining a high level of programmability. The primary application of the machine at Fermilab will be lattice gauge theory. The hardware is supported by a transparent site oriented software system called CANOPY which shields theorist users from the underlying node structure. 4 refs., 2 figs
A multi-state, multi-site, multi-sector healthcare improvement model: implementing evidence for practice.

Science.gov (United States)

Edward, Karen-Leigh; Walker, Kim; Duff, Jed

2017-10-01

Healthcare is complex and we know that evidence takes nearly 20 years to find its way into clinical practice. The slow process of translating research points to the need for effective translational research models to ensure patient care quality and safety are not compromised by such an epistemic failure. Our model to achieve reasonably rapid and enduring improvements to clinical care draws on that developed and promulgated by the Institute for Healthcare Improvement in the United States of America model as well as that developed by the Johns Hopkins Quality and Safety Group known as the Translating Research into Practice implementation model. The core principle of our hybrid model was to engage those most likely to be affected by the changes being introduced through a series of face-to-face and web-enabled meetings that act both as drivers of information but also as a means of engaging all stakeholders across the healthcare system involved in the change towards their pre-established goals. The model was piloted on the focused topic of the management of inadvertent perioperative hypothermia across nine hospitals within Australia (four sites in Victoria, three sites in New South Wales and two sites in Queensland). Improvement in management of hypothermia in these patients was achieved and sustained over time. Our model aims to engage the hearts and minds of healthcare clinicians, and others in order to empower them to make the necessary improvements to enhance patient care quality and safety. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
A Phase 3 Placebo-Controlled, Double Blind, Multi-Site Trial of the alpha-2-adrenergic Agonist, Lofexidine, for Opioid Withdrawal

Science.gov (United States)

Yu, Elmer; Miotto, Karen; Akerele, Evaristo; Montgomery, Ann; Elkashef, Ahmed; Walsh, Robert; Montoya, Ivan; Fischman, Marian W.; Collins, Joseph; McSherry, Frances; Boardman, Kathy; Davies, David K.; O’Brien, Charles P.; Ling, Walter; Kleber, Herbert; Herman, Barbara H.

2008-01-01

Context Lofexidine is an alpha-2-A noradrenergic receptor agonist that is approved in the United Kingdom for the treatment of opioid withdrawal symptoms. Lofexidine has been reported to have more significant effects on decreasing opioid withdrawal symptoms with less hypotension than clonidine. Objective To demonstrate that lofexidine is well tolerated and effective in the alleviation of observationally-defined opioid withdrawal symptoms in opioid dependent individuals undergoing medically supervised opioid detoxification as compared to placebo. Design An inpatient, Phase 3, placebo-controlled, double blind, randomized multi-site trial with three phases: (1) Opioid Agonist Stabilization Phase (days 1–3), (2) Detoxification/Medication or Placebo Phase (days 4–8), and (3) Post Detoxification/Medication Phase (days 9–11). Subjects Sixty-eight opioid dependent subjects were enrolled at three sites with 35 randomized to lofexidine and 33 to placebo. Main Outcome Measure Modified Himmelsbach Opiate Withdrawal Scale (MHOWS) on study day 5 (2nd opioid detoxification treatment day). Results Due to significant findings, the study was terminated early. On the study day 5 MHOWS, subjects treated with lofexidine had significantly lower scores (equating to fewer/less severe withdrawal symptoms) than placebo subjects (Least squares means 19.5 ± 2.1 versus 30.9 ± 2.7; p=0.0019). Lofexidine subjects had significantly better retention in treatment than placebo subjects (38.2% versus 15.2%; Log rank test p=0.01). Conclusions Lofexidine is well tolerated and more efficacious than placebo for reducing opioid withdrawal symptoms in inpatients undergoing medically supervised opioid detoxification. Trial Registration trial registry name A Phase 3 Placebo-Controlled, Double-Blind Multi-Site Trial of Lofexidine for Opiate Withdrawal, registration number NCT00032942, URL for the registry http://clinicaltrials.gov/ct/show/NCT00032942?order=4. PMID:18508207
Integrated risk assessment for multi-unit NPP sites—A comparison

International Nuclear Information System (INIS)

Kumar, C. Senthil; Hassija, Varun; Velusamy, K.; Balasubramaniyan, V.

2015-01-01

Highlights: • Framework for integrated risk assessment for multi-unit NPP sites. • Categorization of external and internal events. • Modelling of key issues: mission time, cliff-edge, common cause failures, etc. • Safety goals for multi-unit NPP sites. • Comparison of site core damage frequency in one, two, three and four unit sites. - Abstract: Most of the nuclear power producing sites in the world houses multiple units. Such sites are faced with hazards generated from external events: earthquake, tsunami, flood, etc. and can threaten the safety of nuclear power plants. Further, risk from a multiple unit site and its impact on the public and environment was evident during the Fukushima nuclear disaster in March 2011. It is therefore important to evolve a methodology to systematically assess the risk from multi-unit site. For a single unit site, probabilistic risk assessment technique identifies the potential accident scenarios, their consequences, and estimates the core damage frequency that arise due to internal and external hazards. This challenging task becomes even more complex for a multiple unit site, especially when the external hazards that has the potential to generate one or more correlated hazards or a combination of non-correlated hazards are to be modelled. This paper presents an approach to evaluate risk for multiple NPP sites and also compare the risk for sites housing single, double and multiple nuclear plants.

Integrated risk assessment for multi-unit NPP sites—A comparison

Energy Technology Data Exchange (ETDEWEB)

Kumar, C. Senthil, E-mail: cskumar@igcar.gov.in [AERB-Safety Research Institute, Kalpakkam (India); Hassija, Varun; Velusamy, K. [Reactor Design Group, Indira Gandhi Centre for Atomic Research, Kalpakkam (India); Balasubramaniyan, V. [AERB-Safety Research Institute, Kalpakkam (India)

2015-11-15

Highlights: • Framework for integrated risk assessment for multi-unit NPP sites. • Categorization of external and internal events. • Modelling of key issues: mission time, cliff-edge, common cause failures, etc. • Safety goals for multi-unit NPP sites. • Comparison of site core damage frequency in one, two, three and four unit sites. - Abstract: Most of the nuclear power producing sites in the world houses multiple units. Such sites are faced with hazards generated from external events: earthquake, tsunami, flood, etc. and can threaten the safety of nuclear power plants. Further, risk from a multiple unit site and its impact on the public and environment was evident during the Fukushima nuclear disaster in March 2011. It is therefore important to evolve a methodology to systematically assess the risk from multi-unit site. For a single unit site, probabilistic risk assessment technique identifies the potential accident scenarios, their consequences, and estimates the core damage frequency that arise due to internal and external hazards. This challenging task becomes even more complex for a multiple unit site, especially when the external hazards that has the potential to generate one or more correlated hazards or a combination of non-correlated hazards are to be modelled. This paper presents an approach to evaluate risk for multiple NPP sites and also compare the risk for sites housing single, double and multiple nuclear plants.
Decision aiding techniques for site remediation

Energy Technology Data Exchange (ETDEWEB)

Van de Walle, B

1996-09-18

Decision making problems in the nuclear domain are known for their complexity since they usually involve a wide range of technical, social, and political considerations. Site restoration is a typical example of a complex nuclear decision problem, and more and more decision makers realize that they need new tools to assist in the decision making process. This paper reports on multi-criteria decision analysis, a powerful tool for handling complex decisions involving multiple criteria. The motivation to use multi-criteria decision analysis in the domain of site restoration is illustrated. New developments and challenges in this field are addressed.
Decision aiding techniques for site remediation

International Nuclear Information System (INIS)

Van de Walle, B.

1996-01-01

Decision making problems in the nuclear domain are known for their complexity since they usually involve a wide range of technical, social, and political considerations. Site restoration is a typical example of a complex nuclear decision problem, and more and more decision makers realize that they need new tools to assist in the decision making process. This paper reports on multi-criteria decision analysis, a powerful tool for handling complex decisions involving multiple criteria. The motivation to use multi-criteria decision analysis in the domain of site restoration is illustrated. New developments and challenges in this field are addressed
Multi-criteria GIS-based siting of an incineration plant for municipal solid waste.

Science.gov (United States)

Tavares, Gilberto; Zsigraiová, Zdena; Semiao, Viriato

2011-01-01

Siting a municipal solid waste (MSW) incineration plant requires a comprehensive evaluation to identify the best available location(s) that can simultaneously meet the requirements of regulations and minimise economic, environmental, health, and social costs. A spatial multi-criteria evaluation methodology is presented to assess land suitability for a plant siting and applied to Santiago Island of Cape Verde. It combines the analytical hierarchy process (AHP) to estimate the selected evaluation criteria weights with Geographic Information Systems (GIS) for spatial data analysis that avoids the subjectivity of the judgements of decision makers in establishing the influences between some criteria or clusters of criteria. An innovative feature of the method lies in incorporating the environmental impact assessment of the plant operation as a criterion in the decision-making process itself rather than as an a posteriori assessment. Moreover, a two-scale approach is considered. At a global scale an initial screening identifies inter-municipal zones satisfying the decisive requirements (socio-economic, technical and environmental issues, with weights respectively, of 48%, 41% and 11%). A detailed suitability ranking inside the previously identified zones is then performed at a local scale in two phases and includes environmental assessment of the plant operation. Those zones are ranked by combining the non-environmental feasibility of Phase 1 (with a weight of 75%) with the environmental assessment of the plant operation impact of Phase 2 (with a weight of 25%). The reliability and robustness of the presented methodology as a decision supporting tool is assessed through a sensitivity analysis. The results proved the system effectiveness in the ranking process. Copyright © 2011 Elsevier Ltd. All rights reserved.
Acute-on-chronic Liver Failure.

Science.gov (United States)

Sarin, Shiv Kumar; Choudhury, Ashok

2016-12-01

Acute-on-chronic liver failure (ACLF) is a distinct entity that differs from acute liver failure and decompensated cirrhosis in timing, presence of treatable acute precipitant, and course of disease, with a potential for self-recovery. The core concept is acute deterioration of existing liver function in a patient of chronic liver disease with or without cirrhosis in response to an acute insult. The insult should be a hepatic one and presentation in the form of liver failure (jaundice, encephalopathy, coagulopathy, ascites) with or without extrahepatic organ failure in a defined time frame. ACLF is characterized by a state of deregulated inflammation. Initial cytokine burst presenting as SIRS, progression to CARS and associated immunoparalysis leads to sepsis and multi-organ failure. Early identification of the acute insult and mitigation of the same, use of nucleoside analogue in HBV-ACLF, steroid in severe alcoholic hepatitis, steroid in severe autoimmune hepatitis and/or bridging therapy lead to recovery, with a 90-day transplant-free survival rate of up to 50 %. First-week presentation is crucial concerning SIRS/sepsis, development, multiorgan failure and consideration of transplant. A protocol-based multi-disciplinary approach including critical care hepatology, early liver transplant before multi-organ involvement, or priority for organ allocation may improve the outcome. Presentation with extrahepatic organ involvement or inclusion of sepsis as an acute insult in definition restricts the therapy, i.e., liver transplant or bridging therapy, and needs serious consideration. Augmentation of regeneration, cell-based therapy, immunotherapy, and gut microbiota modulation are the emerging areas and need further research.
Integrating physically based simulators with Event Detection Systems: Multi-site detection approach.

Science.gov (United States)

Housh, Mashor; Ohar, Ziv

2017-03-01

The Fault Detection (FD) Problem in control theory concerns of monitoring a system to identify when a fault has occurred. Two approaches can be distinguished for the FD: Signal processing based FD and Model-based FD. The former concerns of developing algorithms to directly infer faults from sensors' readings, while the latter uses a simulation model of the real-system to analyze the discrepancy between sensors' readings and expected values from the simulation model. Most contamination Event Detection Systems (EDSs) for water distribution systems have followed the signal processing based FD, which relies on analyzing the signals from monitoring stations independently of each other, rather than evaluating all stations simultaneously within an integrated network. In this study, we show that a model-based EDS which utilizes a physically based water quality and hydraulics simulation models, can outperform the signal processing based EDS. We also show that the model-based EDS can facilitate the development of a Multi-Site EDS (MSEDS), which analyzes the data from all the monitoring stations simultaneously within an integrated network. The advantage of the joint analysis in the MSEDS is expressed by increased detection accuracy (higher true positive alarms and fewer false alarms) and shorter detection time. Copyright © 2016 Elsevier Ltd. All rights reserved.
Dietary Protein Intake in a Multi-ethnic Asian Population of Healthy Participants and Chronic Kidney Disease Patients.

Science.gov (United States)

Teo, Boon Wee; Toh, Qi Chun; Xu, Hui; Yang, Adonsia Y T; Lin, Tingxuan; Li, Jialiang; Lee, Evan J C

2015-04-01

Clinical practice guidelines recommend different levels of dietary protein intake in predialysis chronic kidney disease (CKD) patients. It is unknown how effectively these recommendations perform in a multi-ethnic Asian population, with varied cultural beliefs and diets. We assess the profi le of protein intake in a multi-ethnic Asian population, comparing healthy participants and CKD patients. We analysed the 24-hour urine collections of the Asian Kidney Disease Study (AKDS) and the Singapore Kidney Function Study (SKFS) to estimate total protein intake (TPI; g/day). We calculated ideal body weight (IDW; kg): 22.99 × height2 (m). Standard statistical tests were applied where appropriate, and linear regression was used to assess associations of continuous variables with protein intake. There were 232 CKD patients and 103 healthy participants with 35.5% diabetics. The mean TPI in healthy participants was 58.89 ± 18.42 and the mean TPI in CKD patients was 53.64 ± 19.39. By US National Kidney Foundation (NKF) guidelines, 29/232 (12.5%) of CKD patients with measured glomerular filtration rate (GFR) patients had TPI-IDW >0.75g/kg/ day. By American Dietetic Association (ADA) guidelines, 34.7% (44/127) of CKD patients with GFR patients with GFR protein intake of between 0.3 to 0.5 g/kg/day. A total of 21.9% (25/114) of diabetic CKD patients had protein intake between 0.8 to 0.9 g/kg/day. On average, the protein intake of most CKD patients exceeds the recommendations of guidelines. Diabetic CKD patients should aim to have higher protein intakes.
Compartmental HBV evolution and replication in liver and extrahepatic sites after nucleos/tide analogue therapy in chronic hepatitis B carriers.

Science.gov (United States)

Gao, Shan; Duan, Zhong-Ping; Chen, Yu; van der Meer, Frank; Lee, Samuel S; Osiowy, Carla; van Marle, Guido; Coffin, Carla S

2017-09-01

Hepatitis B virus (HBV) variants are associated with nucleos/tide analogue (NA) response and liver disease but it is unknown whether NA influences extrahepatic HBV persistence. To investigate HBV replication and genetic evolution in hepatic and extrahepatic sites of chronic hepatitis B (CHB) before and after NA therapy. A total of 13 paired plasma, peripheral blood mononuclear cells (PBMC), were collected from chronic HBV carriers at baseline and after a median 53 weeks NA therapy as well as liver biopsy (N=7 baseline, N=5 follow-up). HBV covalently closed circular DNA (cccDNA) and messenger (m) RNA in liver and PBMC were analyzed. HBV polymerase (P)/surface (S), basal core promoter (BCP)/pre-core (PC)/C gene clonal sequencing was done in plasma, peripheral blood mononuclear cells (PBMC), and liver. Compare to baseline, at ∼53 weeks follow-up, there was no significant change in HBV cccDNA levels in liver (0.2-0.08 copies/hepatocyte, p>0.05) or in PBMC 0.003-0.02 copies/PBMC, p>0.05), and HBV mRNA remained detectable in both sites. At baseline, BCP variants were higher in PBMC vs. liver and plasma. After therapy, drug resistant (DR) and immune escape (IE) variants increased in liver but IE and PC variants were more frequent in PBMC. HBV P/S diversity was significantly higher in PBMC compared to plasma. Continuous HBV replication occurs in liver and PBMC and shows compartmentalized evolution under selective pressure of potent NA therapy. Copyright © 2017 Elsevier B.V. All rights reserved.
Genetic Risk for Alcoholic Chronic Pancreatitis

Directory of Open Access Journals (Sweden)

Flair José Carrilho

2011-06-01

Full Text Available In recent years many studies have examined the genetic predisposition to pancreatic diseases. Pancreatic disease of an alcoholic etiology was determined to be a multi-factorial disease, where environmental factors interact with the genetic profile of the individual. In this review we discuss the main results from studies examining the frequency of genetic mutations in alcoholic chronic pancreatitis.
Urban Conservation Policies and Plans for a World Heritage Site Case: Antique Pergamon City and its Multi-Layered Cultural Landscape

Science.gov (United States)

Tunçer, Mehmet

2017-10-01

Izmir’s Pergamon (Bergama) Antique City and Its Multi-Layered Cultural Landscape entered the UNESCO World Heritage List with the participation of 21 countries in the 38th World Heritage Committee Meeting held in Doha, Qatar’s capital in between 15 - 25 June 2014. Bergama became the 999th WORLD HERITAGE. Bergama, which has been in operation since 2010, has entered the list as a Multi-layered Cultural Landscape Area. The main purpose of this paper will explain and summarize of urban and archaeological conservation efforts for Pergamon since 1992 to 2014. In the paper also aimed to give the conservation policies of public administrations which mainly central /Ministry of Culture and Tourism, Ministry of Environment/ and local /Bergama Municipality, Gen. Directorate of Vakiflar. Turkey is one of the 10 original member states to establish UNESCO. 9 cities in Turkey are included in the UNESCO List of World Heritage Sites. Further, 23 sites have been nominated and are included in the tentative list. The activities aimed to include the district of Bergama in the UNESCO World Heritage List are ongoing in the years 2009-2014. All the efforts have been made carry this unique antique city to the UNESCO Heritage List at 2014. As an Urban Conservation Planner, I had a change of preparing the FIRST Conservation Aimed Plans and urban designs for Urban and Archaeological Sites of Pergamon together with my team, in the years between 1992-94. We prepared conservation aimed plans for all of the areas of Acropolis, Middle City and Ottoman period urban conservation areas. Urban and archaeological sites of Pergamon the ancient city today, which is over two thousand years old, where scientists, archaeologists, architects, art historians, urban planners, sculptors and similar arts and culture, men talk about admiration, write about and write praises, face to face some deterioration and destruction. As a conservation planner working on Pergamon since 1992, I’ will concentrate the
Setting strategy for system change: using concept mapping to prioritise national action for chronic disease prevention.

Science.gov (United States)

Wutzke, Sonia; Roberts, Nick; Willis, Cameron; Best, Allan; Wilson, Andrew; Trochim, William

2017-08-08

Chronic diseases are a serious and urgent problem, requiring at-scale, multi-component, multi-stakeholder action and cooperation. Despite numerous national frameworks and agenda-setting documents to coordinate prevention efforts, Australia, like many countries internationally, is yet to substantively impact the burden from chronic disease. Improved evidence on effective strategies for the prevention of chronic disease is required. This research sought to articulate a priority set of important and feasible action domains to inform future discussion and debate regarding priority areas for chronic disease prevention policy and strategy. Using concept mapping, a mixed-methods approach to making use of the best available tacit knowledge of recognised, diverse and well-experienced actors, and national actions to improve the prevention of chronic disease in Australia were identified and then mapped. Participants (ranging from 58 to 78 in the various stages of the research) included a national sample of academics, policymakers and practitioners. Data collection involved the generation and sorting of statements by participants. A series of visual representations of the data were then developed. A total of 95 statements were distilled into 12 clusters for action, namely Inter-Sectoral Partnerships; Systems Perspective/Action; Governance; Roles and Responsibilities; Evidence, Feedback and Learning; Funding and Incentive; Creating Demand; Primary Prevention; Social Determinants and Equity; Healthy Environments; Food and Nutrition; and Regulation and Policy. Specific areas for more immediate national action included refocusing the health system to prevention over cure, raising the profile of public health with health decision-makers, funding policy- and practice-relevant research, improving communication about prevention, learning from both global best-practice and domestic successes and failures, increasing the focus on primary prevention, and developing a long-term prevention
Simple-MSSM: a simple and efficient method for simultaneous multi-site saturation mutagenesis.

Science.gov (United States)

Cheng, Feng; Xu, Jian-Miao; Xiang, Chao; Liu, Zhi-Qiang; Zhao, Li-Qing; Zheng, Yu-Guo

2017-04-01

To develop a practically simple and robust multi-site saturation mutagenesis (MSSM) method that enables simultaneously recombination of amino acid positions for focused mutant library generation. A general restriction enzyme-free and ligase-free MSSM method (Simple-MSSM) based on prolonged overlap extension PCR (POE-PCR) and Simple Cloning techniques. As a proof of principle of Simple-MSSM, the gene of eGFP (enhanced green fluorescent protein) was used as a template gene for simultaneous mutagenesis of five codons. Forty-eight randomly selected clones were sequenced. Sequencing revealed that all the 48 clones showed at least one mutant codon (mutation efficiency = 100%), and 46 out of the 48 clones had mutations at all the five codons. The obtained diversities at these five codons are 27, 24, 26, 26 and 22, respectively, which correspond to 84, 75, 81, 81, 69% of the theoretical diversity offered by NNK-degeneration (32 codons; NNK, K = T or G). The enzyme-free Simple-MSSM method can simultaneously and efficiently saturate five codons within one day, and therefore avoid missing interactions between residues in interacting amino acid networks.
A criticism of applications with multi-criteria decision analysis that are used for the site selection for the disposal of municipal solid wastes

International Nuclear Information System (INIS)

Kemal Korucu, M.; Erdagi, Bora

2012-01-01

Highlights: ► The existing structure of the multi-criteria decision analysis for site selection is criticized. ► Fundamental problematic points based on the critics are defined. ► Some modifications are suggested in order to provide solutions to these problematical points. ► A new structure for the decision making mechanism is proposed. ► The feasibility of the new method is subjected to an evaluation process. - Abstract: The main aim of this study is to criticize the process of selecting the most appropriate site for the disposal of municipal solid wastes which is one of the problematic issues of waste management operations. These kinds of problems are pathological symptoms of existing problematical human–nature relationship which is related to the syndrome called ecological crisis. In this regard, solving the site selection problem, which is just a small part of a larger entity, for the good of ecological rationality and social justice is only possible by founding a new and extensive type of human–nature relationship. In this study, as a problematic point regarding the discussions on ecological problems, the existing structure of the applications using multi-criteria decision analysis in the process of site selection with three main criteria is criticized. Based on this critique, fundamental problematic points (to which applications are insufficient to find solutions) will be defined. Later, some modifications will be suggested in order to provide solutions to these problematical points. Finally, the criticism addressed to the structure of the method with three main criteria and the feasibility of the new method with four main criteria is subjected to an evaluation process. As a result, it is emphasized that the new structure with four main criteria may be effective in solution of the fundamental problematic points.
A criticism of applications with multi-criteria decision analysis that are used for the site selection for the disposal of municipal solid wastes

Energy Technology Data Exchange (ETDEWEB)

Kemal Korucu, M., E-mail: kemal.korucu@kocaeli.edu.tr [University of Kocaeli, Department of Environmental Engineering, 41380 Kocaeli (Turkey); Erdagi, Bora [University of Kocaeli, Department of Philosophy, 41380 Kocaeli (Turkey)

2012-12-15

Highlights: Black-Right-Pointing-Pointer The existing structure of the multi-criteria decision analysis for site selection is criticized. Black-Right-Pointing-Pointer Fundamental problematic points based on the critics are defined. Black-Right-Pointing-Pointer Some modifications are suggested in order to provide solutions to these problematical points. Black-Right-Pointing-Pointer A new structure for the decision making mechanism is proposed. Black-Right-Pointing-Pointer The feasibility of the new method is subjected to an evaluation process. - Abstract: The main aim of this study is to criticize the process of selecting the most appropriate site for the disposal of municipal solid wastes which is one of the problematic issues of waste management operations. These kinds of problems are pathological symptoms of existing problematical human-nature relationship which is related to the syndrome called ecological crisis. In this regard, solving the site selection problem, which is just a small part of a larger entity, for the good of ecological rationality and social justice is only possible by founding a new and extensive type of human-nature relationship. In this study, as a problematic point regarding the discussions on ecological problems, the existing structure of the applications using multi-criteria decision analysis in the process of site selection with three main criteria is criticized. Based on this critique, fundamental problematic points (to which applications are insufficient to find solutions) will be defined. Later, some modifications will be suggested in order to provide solutions to these problematical points. Finally, the criticism addressed to the structure of the method with three main criteria and the feasibility of the new method with four main criteria is subjected to an evaluation process. As a result, it is emphasized that the new structure with four main criteria may be effective in solution of the fundamental problematic points.
Comparison of Multi-Tensor Diffusion Models' Performance for White Matter Integrity Estimation in Chronic Stroke

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Olena G. Filatova

2018-04-01

Full Text Available Better insight into white matter (WM alterations after stroke onset could help to understand the underlying recovery mechanisms and improve future interventions. MR diffusion imaging enables to assess such changes. Our goal was to investigate the relation of WM diffusion characteristics derived from diffusion models of increasing complexity with the motor function of the upper limb. Moreover, we aimed to evaluate the variation of such characteristics across different WM structures of chronic stroke patients in comparison to healthy subjects. Subjects were scanned with a two b-value diffusion-weighted MRI protocol to exploit multiple diffusion models: single tensor, single tensor with isotropic compartment, bi-tensor model, bi-tensor with isotropic compartment. From each model we derived the mean tract fractional anisotropy (FA, mean (MD, radial (RD and axial (AD diffusivities outside the lesion site based on a WM tracts atlas. Asymmetry of these measures was correlated with the Fugl-Meyer upper extremity assessment (FMA score and compared between patient and control groups. Eighteen chronic stroke patients and eight age-matched healthy individuals participated in the study. Significant correlation of the outcome measures with the clinical scores of stroke recovery was found. The lowest correlation of the corticospinal tract FAasymmetry and FMA was with the single tensor model (r = −0.3, p = 0.2 whereas the other models reported results in the range of r = −0.79 ÷ −0.81 and p = 4E-5 ÷ 8E-5. The corticospinal tract and superior longitudinal fasciculus showed most alterations in our patient group relative to controls. Multiple compartment models yielded superior correlation of the diffusion measures and FMA compared to the single tensor model.
HPV Vaccine Effective at Multiple Anatomic Sites

Science.gov (United States)

A new study from NCI researchers finds that the HPV vaccine protects young women from infection with high-risk HPV types at the three primary anatomic sites where persistent HPV infections can cause cancer. The multi-site protection also was observed at l
GIS-based multi-criteria site selection for zebra mussel cultivation: Addressing end-of-pipe remediation of a eutrophic coastal lagoon ecosystem.

Science.gov (United States)

Bagdanavičiūtė, Ingrida; Umgiesser, Georg; Vaičiūtė, Diana; Bresciani, Mariano; Kozlov, Igor; Zaiko, Anastasija

2018-04-11

Farming of shellfish and seaweeds is a tested tool for mitigating eutrophication consequences in coastal environments, however as many other marine economic activities it should be a subject of marine spatial planning for designating suitable sites. The present study proposes site selection framework for provisional zebra mussel farming in a eutrophic lagoon ecosystem, aimed primarily at remediation purposes. GIS-based multi-criteria approach was applied, combining data from empirical maps, numerical models and remote sensing to estimate suitability parameters. Site selection and prioritisation of suitable areas considered 15 environmental and socio-economic criteria, which contributed to 4 optimisation models (settlement, growth and survival of mussels, environmental and socio-economic) and 3 predefined scenarios representing provisional goals of mussel cultivation: spat production, biomass production and bioremediation. The relative importance of each criterion was assessed utilizing the Analytical Hierarchy Process. Site suitability index was calculated and the final result of the site selection analysis was summarized for 3 scenarios and overall suitability map. Four suitability classes (unsuitable, least, moderately and most suitable) were applied, and 3 most suitable zones for provisional zebra mussel cultivation with 12 candidate sites were selected accordingly. The integrated approach presented in this study can be adjusted for designating zebra mussel farming sites in other estuarine lagoon ecosystems, or cultivation of other mussel species for bioremediation purposes. The analytical framework and the workflow designed in this study are also adoptable for addressing other aquaculture-related spatial planning issues. Copyright © 2018 Elsevier B.V. All rights reserved.
Controlling engineering project changes for multi-unit, multi-site standardized nuclear power plants

International Nuclear Information System (INIS)

Randall, E.; Boddeker, G.; McGugin, H.; Strother, E.; Waggoner, G.

1978-01-01

Multibillioin dollar multiple nuclear power plant projects have numerous potential sources of engineering changes. The majority of these are internally generated changes, client generated changes, and changes from construction, procurement, other engineering organizations, and regulatory organizations. For multiunit, multisite projects, the use of a standardized design is cost effective. Engineering changes can then be controlled for a single standardized design, and the unit or site unique changes can be treated as deviations. Once an effective change procedure is established for change control of the standardized design, the same procedures can be used for control of unit or site unique changes
Development and Usability Evaluation of an Art and Narrative-Based Knowledge Translation Tool for Parents With a Child With Pediatric Chronic Pain: Multi-Method Study.

Science.gov (United States)

Reid, Kathy; Hartling, Lisa; Ali, Samina; Le, Anne; Norris, Allison; Scott, Shannon D

2017-12-14

Chronic pain in childhood is increasingly being recognized as a significant clinical problem for children and their families. Previous research has identified that families want information about the causes of their child's chronic pain, treatment options, and effective strategies to help their child cope with the pain. Unfortunately, parents have reported that finding this information can be challenging. The aim of this study was to actively work together with children attending a pediatric chronic pain clinic and their parents to develop, refine, and evaluate the usability of an art and narrative-based electronic book (e-book) for pediatric chronic pain. A multiphase, multi-method research design employing patient engagement techniques was used to develop, refine, and evaluate the usability of an art and narrative based e-book for pediatric chronic pain management to facilitate knowledge translation for parents with a child with chronic pain. The multiple phases included the following: (1) qualitative interviews to compile parents' narratives using qualitative interviews; (2) qualitative data analysis; (3) development of an e-book prototype; (4) expert clinician feedback; (5) parent usability evaluation, knowledge change, and confidence in knowledge responses using an electronic survey; (6) e-book refinement; and (7) dissemination of the e-book. A 48-page e-book was developed to characterize the experiences of a family living with a child with chronic pain. The e-book was a composite narrative of the parent interviews and encompassed descriptions of the effects the condition has on each member of the family. This was merged with the best available research evidence on the day-to-day management of pediatric chronic pain. The e-book was vetted for clinical accuracy by expert pediatric pain clinicians. All parents that participated in the usability evaluation (N=14) agreed or strongly agreed the content of the e-book was easy to understand and stated that they would
Use of multi-frequency, multi-polarization, multi-angle airborne radars for class discrimination in a southern temperature forest

Science.gov (United States)

Mehta, N. C.

1984-01-01

The utility of radar scatterometers for discrimination and characterization of natural vegetation was investigated. Backscatter measurements were acquired with airborne multi-frequency, multi-polarization, multi-angle radar scatterometers over a test site in a southern temperate forest. Separability between ground cover classes was studied using a two-class separability measure. Very good separability is achieved between most classes. Longer wavelength is useful in separating trees from non-tree classes, while shorter wavelength and cross polarization are helpful for discrimination among tree classes. Using the maximum likelihood classifier, 50% overall classification accuracy is achieved using a single, short-wavelength scatterometer channel. Addition of multiple incidence angles and another radar band improves classification accuracy by 20% and 50%, respectively, over the single channel accuracy. Incorporation of a third radar band seems redundant for vegetation classification. Vertical transmit polarization is critically important for all classes.

Chronic activation of the low affinity site of β1-adrenoceptors stimulates haemodynamics but exacerbates pressure-overload cardiac remodelling

Science.gov (United States)

Kiriazis, Helen; Tugiono, Niquita; Xu, Qi; Gao, Xiao-Ming; Jennings, Nicole L; Ming, Ziqui; Su, Yidan; Klenowski, Paul; Summers, Roger J; Kaumann, Alberto; Molenaar, Peter; Du, Xiao-Jun

2013-01-01

BACKGROUND AND PURPOSE The β1-adrenoceptor has at least two binding sites, high and low affinity sites (β1H and β1L, respectively), which mediate cardiostimulation. While β1H-adrenoceptor can be blocked by all clinically used β-blockers, β1L-adrenoceptor is relatively resistant to blockade. Thus, chronic β1L-adrenoceptor activation may mediate persistent cardiostimulation, despite the concurrent blockade of β1H-adrenoceptors. Hence, it is important to determine the potential significance of β1L-adrenoceptors in vivo, particularly in pathological situations. EXPERIMENTAL APPROACH C57Bl/6 male mice were used. Chronic (4 or 8 weeks) β1L-adrenoceptor activation was achieved by treatment, via osmotic mini pumps, with (-)-CGP12177 (10 mg·kg−1·day−1). Cardiac function was assessed by echocardiography and micromanometry. KEY RESULTS (-)-CGP12177 treatment of healthy mice increased heart rate and left ventricular (LV) contractility. (-)-CGP12177 treatment of mice subjected to transverse aorta constriction (TAC), during weeks 4–8 or 4–12 after TAC, led to a positive inotropic effect and exacerbated fibrogenic signalling while cardiac hypertrophy tended to be more severe. (-)-CGP12177 treatment of mice with TAC also exacerbated the myocardial expression of hypertrophic, fibrogenic and inflammatory genes compared to untreated TAC mice. Washout of (-)-CGP12177 revealed a more pronounced cardiac dysfunction after 12 weeks of TAC. CONCLUSIONS AND IMPLICATIONS β1L-adrenoceptor activation provides functional support to the heart, in both normal and pathological (pressure overload) situations. Sustained β1L-adrenoceptor activation in the diseased heart exacerbates LV remodelling and therefore may promote disease progression from compensatory hypertrophy to heart failure. PMID:23750586
Coping with chronic lower back pain: designing and testing the online tool ONESELF

OpenAIRE

Schulz, Peter J.; Rubinelli, Sara; Caiata Zufferey, Maria; Hartung, Uwe

2011-01-01

A website was designed in order to help patients with chronic lower back pain (cLBP) to cope with their condition, relying on the concept of health literacy. A sample of 748 chronic or potentially chronic LBP patients were asked to regularly visit the site for a period of 12 months. The intervention was evaluated quantitatively (both preuse and postuse surveys, logfiles) and qualitatively. Users appear to have taken less painkillers than before in the period they accessed the site. Most use...
Multi-proxy studies in palaeolimnology

OpenAIRE

Birks, Hilary H.; Birks, Harry John Betteley

2006-01-01

Multi-proxy studies are becoming increasingly common in palaeolimnology. Eight basic requirements and challenges for a multi-proxy study are outlined in this essay – definition of research questions, leadership, site selection and coring, data storage, chronology, presentation of results, numerical tools, and data interpretation. The nature of proxy data is discussed in terms of physical proxies and biotic proxies. Loss-on-ignition changes and the use of transfer functions are reviewed as exa...
Chronic Actinic Dermatitis

Directory of Open Access Journals (Sweden)

Bengü Çevirgen Cemil

2017-06-01

Full Text Available Chronic actinic dermatitis (CAD is characterized by persistent eczema-like lesions, mainly on sun-exposed sites, induced by ultraviolet B, sometimes ultraviolet A, and occasionally visible light. CAD is a rare photodermatitis. It is often associated with contact allergens including airborne allergens such as fragrances, plant antigens and topical medications. A 62 year old farmer is applied with eczematous lesions restricted to sun-exposed areas. Clinical findings and histopathologic features were consistent with the diagnosis of chronic actinic dermatitis. The patient also had contact allergy to multiple allergens. We present this case to emphasize the significance of patch test on CAD treatment and the success of topical tacrolimus and azathioprine.
The multi-level impact of chronic intermittent hypoxia on central auditory processing.

Science.gov (United States)

Wong, Eddie; Yang, Bin; Du, Lida; Ho, Wai Hong; Lau, Condon; Ke, Ya; Chan, Ying Shing; Yung, Wing Ho; Wu, Ed X

2017-08-01

During hypoxia, the tissues do not obtain adequate oxygen. Chronic hypoxia can lead to many health problems. A relatively common cause of chronic hypoxia is sleep apnea. Sleep apnea is a sleep breathing disorder that affects 3-7% of the population. During sleep, the patient's breathing starts and stops. This can lead to hypertension, attention deficits, and hearing disorders. In this study, we apply an established chronic intermittent hypoxemia (CIH) model of sleep apnea to study its impact on auditory processing. Adult rats were reared for seven days during sleeping hours in a gas chamber with oxygen level cycled between 10% and 21% (normal atmosphere) every 90s. During awake hours, the subjects were housed in standard conditions with normal atmosphere. CIH treatment significantly reduces arterial oxygen partial pressure and oxygen saturation during sleeping hours (relative to controls). After treatment, subjects underwent functional magnetic resonance imaging (fMRI) with broadband sound stimulation. Responses are observed in major auditory centers in all subjects, including the auditory cortex (AC) and auditory midbrain. fMRI signals from the AC are statistically significantly increased after CIH by 0.13% in the contralateral hemisphere and 0.10% in the ipsilateral hemisphere. In contrast, signals from the lateral lemniscus of the midbrain are significantly reduced by 0.39%. Signals from the neighboring inferior colliculus of the midbrain are relatively unaffected. Chronic hypoxia affects multiple levels of the auditory system and these changes are likely related to hearing disorders associated with sleep apnea. Copyright © 2017 Elsevier Inc. All rights reserved.
Using the Multi-Criteria AHP for the Optimal Selection of Site Location and Wastewater Collection System The Case Study of Varzeghan

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Hassan talebi

2015-11-01

Full Text Available This study investigates the use of multi-criteria decision making in waste management and selection of the site location and proper wastewater collection and processing system in Varzeqan Town. Moreover, the effect of the decision-making method employed on ranking the final alternatives will be evaluated. Different factors are involved in the selection of wastewater treatment construction sites. These factors, in turn, not only depend on the special location and time the decision is made but also have their own weights in the final decision. In this study, the environmental conditions in the study area are initially investigated to select one site from among five different alternatives proposed for the construction of the facility using the AHP method. Also, the AHP method is used to evaluate and select the suitable collection and treatment method from among the four non-conventional options including Septic Tank Effluent Gravity, Septic Tank Effluent Pressure, Vacuum Sewerage System, and Simplified Sewerage for this region based on the special geographical and geotechnical conditions. The results indicate that the barren lands between Varzeghan Town and Dizaj Safar Ali Village are the best site for constructing the treatment facility and that the simplified sewarge system is the best collection system for the region.
Vacuum-assisted closure versus closure without vacuum assistance for preventing surgical site infections and infections of chronic wounds: a meta-analysis of randomized controlled trials.

Science.gov (United States)

Tansarli, Giannoula S; Vardakas, Konstantinos Z; Stratoulias, Constantinos; Peppas, George; Kapaskelis, Anastasios; Falagas, Matthew E

2014-08-01

We sought to examine whether vacuum-assisted closure (VAC) is associated with fewer surgical site infections (SSIs) or infections of chronic wounds than other management procedures for surgical wounds. The PubMed and Scopus databases were searched systematically. Randomized controlled trials (RCTs) comparing the development of SSIs or infections of chronic wounds between patients treated with VAC for acute or chronic wounds and those whose wounds were treated without VAC were considered eligible for inclusion in the study. Eight RCTs met the inclusion criteria for the study. Four of the studies included chronic or diabetic lower extremity wounds and four included fractures. In three of four studies reporting on fractures, the wounds were not closed post-operatively, whereas in one study primary closure of the wound was performed. With regard to wounds left open after the stabilization of fractures, patients whose wounds were treated with VAC developed fewer SSIs than those whose wounds were treated without VAC ([367 patients (196 with VAC; 171 without VAC) relative risk [RR], 0.47; 95% CI 0.28-0.81]). On the contrary, no difference in the development of SSIs occurred among patients with chronic or diabetic lower-extremity wounds treated with VAC and those whose wounds were treated without VAC ([638 patients (320 with VAC; 318 without VAC) RR 1.67; 95% CI: 0.71-3.94]). The available evidence suggests that the development of infections in wounds treated with VAC depends on the type of wound being treated.
Introduction of shared electronic records: multi-site case study using diffusion of innovation theory.

Science.gov (United States)

Greenhalgh, Trisha; Stramer, Katja; Bratan, Tanja; Byrne, Emma; Mohammad, Yara; Russell, Jill

2008-10-23

To explore the introduction of a centrally stored, shared electronic patient record (the summary care record (SCR)) in England and draw wider lessons about the implementation of large scale information technology projects in health care. Multi-site, mixed method case study applying utilisation focused evaluation. Four early adopter sites for the SCR in England-three in urban areas of relative socioeconomic deprivation and the fourth in a relatively affluent rural area. Data sources and analysis Data included 250 staff interviews, 1500 hours of ethnographic observation, interviews and focus groups with 170 patients and carers, 2500 pages of correspondence and documentary evidence, and incorporation of relevant surveys and statistics produced by others. These were analysed by using a thematic approach drawing on (and extending) a theoretical model of complex change developed in a previous systematic review. Main findings The mixed fortunes of the SCR programme in its first year were largely explained by eight interacting influences. The first was the SCR's material properties (especially technical immaturity and lack of interoperability) and attributes (especially the extent to which potential adopters believed the benefits outweighed the risks). The second was adopters' concerns (especially about workload and the ethicality of sharing "confidential" information on an implied consent model). The third influence was interpersonal influence (for example, opinion leaders, champions, facilitators), and the fourth was organisational antecedents for innovation (for example past experience with information technology projects, leadership and management capacity, effective data capture systems, slack resources). The fifth was organisational readiness for the SCR (for example, innovation-system fit, tension for change, power balances between supporters and opponents, baseline data quality). The sixth was the implementation process (including the nature of the change model and
The Use of Importance Measures for Quantification of Multi-unit Risk

Energy Technology Data Exchange (ETDEWEB)

Jang, Seung-Cheol; Lim, Ho-Gon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2015-10-15

In this paper, we focus on the quantification of the multi-unit accident sequences frequencies, i.e., conditional core damage probability (CCDP) for a MUI from the SUR model. The paper proposes a method for the estimation of the r-units CCDP considered the interunit dependency, using importance measures. Note that the 1{sup st} and 2{sup nd} terms in the left hand side of the equation have different units of risk measure, i.e., reactor operating year and site operating year, respectively. The total risk of multi-unit reactor accidents concurred by the independent accident sequences each single-unit (the 1{sup st} term in the right-hand side of the Equation 1) can approximate the sum of n single-unit risk conservatively. It corresponds to the traditional multi-unit risk profile concept having used since post-PSA era. Simultaneously, the Equation 1 represent that multi-unit risk within a site with n units has been underestimated as much as the amount of the 2{sup nd} term (MUR by multi-unit initiators), which consists of three parts: 1) the frequency estimation of a MUI, , 2) the quantification of the multi-unit accident sequences frequencies for a MUI, , and 3) the multi-unit consequence analysis for a MUI. The paper proposes a method for the estimation of the r-units CCDP considered the inter-unit dependency, using importance measures. It can facilitate the treatment of the inter-unit dependencies in the multi-unit risk model and can give more comprehensive and more practicable technical platform for estimating multi-unit site risk.
The Use of Importance Measures for Quantification of Multi-unit Risk

International Nuclear Information System (INIS)

Jang, Seung-Cheol; Lim, Ho-Gon

2015-01-01

In this paper, we focus on the quantification of the multi-unit accident sequences frequencies, i.e., conditional core damage probability (CCDP) for a MUI from the SUR model. The paper proposes a method for the estimation of the r-units CCDP considered the interunit dependency, using importance measures. Note that the 1 st and 2 nd terms in the left hand side of the equation have different units of risk measure, i.e., reactor operating year and site operating year, respectively. The total risk of multi-unit reactor accidents concurred by the independent accident sequences each single-unit (the 1 st term in the right-hand side of the Equation 1) can approximate the sum of n single-unit risk conservatively. It corresponds to the traditional multi-unit risk profile concept having used since post-PSA era. Simultaneously, the Equation 1 represent that multi-unit risk within a site with n units has been underestimated as much as the amount of the 2 nd term (MUR by multi-unit initiators), which consists of three parts: 1) the frequency estimation of a MUI, , 2) the quantification of the multi-unit accident sequences frequencies for a MUI, , and 3) the multi-unit consequence analysis for a MUI. The paper proposes a method for the estimation of the r-units CCDP considered the inter-unit dependency, using importance measures. It can facilitate the treatment of the inter-unit dependencies in the multi-unit risk model and can give more comprehensive and more practicable technical platform for estimating multi-unit site risk
A primary care, multi-disciplinary disease management program for opioid-treated patients with chronic non-cancer pain and a high burden of psychiatric comorbidity

Directory of Open Access Journals (Sweden)

Malone Robert M

2005-01-01

Full Text Available Abstract Background Chronic non-cancer pain is a common problem that is often accompanied by psychiatric comorbidity and disability. The effectiveness of a multi-disciplinary pain management program was tested in a 3 month before and after trial. Methods Providers in an academic general medicine clinic referred patients with chronic non-cancer pain for participation in a program that combined the skills of internists, clinical pharmacists, and a psychiatrist. Patients were either receiving opioids or being considered for opioid therapy. The intervention consisted of structured clinical assessments, monthly follow-up, pain contracts, medication titration, and psychiatric consultation. Pain, mood, and function were assessed at baseline and 3 months using the Brief Pain Inventory (BPI, the Center for Epidemiological Studies-Depression Scale scale (CESD and the Pain Disability Index (PDI. Patients were monitored for substance misuse. Results Eighty-five patients were enrolled. Mean age was 51 years, 60% were male, 78% were Caucasian, and 93% were receiving opioids. Baseline average pain was 6.5 on an 11 point scale. The average CESD score was 24.0, and the mean PDI score was 47.0. Sixty-three patients (73% completed 3 month follow-up. Fifteen withdrew from the program after identification of substance misuse. Among those completing 3 month follow-up, the average pain score improved to 5.5 (p = 0.003. The mean PDI score improved to 39.3 (p Conclusions A primary care disease management program improved pain, depression, and disability scores over three months in a cohort of opioid-treated patients with chronic non-cancer pain. Substance misuse and depression were common, and many patients who had substance misuse identified left the program when they were no longer prescribed opioids. Effective care of patients with chronic pain should include rigorous assessment and treatment of these comorbid disorders and intensive efforts to insure follow up.
Comparison of Subgingival and Peri-implant Microbiome in Chronic Periodontitis.

Science.gov (United States)

Zhang, Qian; Qin, Xue Yan; Jiang, Wei Peng; Zheng, Hui; Xu, Xin Li; Chen, Feng

2015-09-01

To analyse the microbia composition of 10 healthy dental implants and 10 chronic periodontitis patients. Subgingival plaque and peri-implant biofilm were sampled at the first molar site before and after implant restoration. The analysis was conducted by 454-prosequencing of bacterial V1 to V3 regions of 16S rDNA. Chronic periodontitis subjects showed greater bacterial diversity compared with implant subjects. The relative abundance of sixteen genera and twelve species differed significantly between implant and chronic periodontitis subjects. The genera Catonella, Desulfovibrio, Mogibacterium, Peptostreptococcus and Propionibacterium were present in higher abundance in chronic periodontitis subjects, while implant subjects had higher proportions of Brevundimonas and Pseudomonas species. Our results demonstrate that implant restoration changes the oral microbiota. The analysis suggests that periodontal bacteria can remain for a prolonged period of time at non-dental sites, from where they can colonise the peri-implant.
GIS and Multi Criteria Decision Method Based Approach of Identifying Appropriate Landfill Sites for the City Of Chittagong

Directory of Open Access Journals (Sweden)

M. Ali Ashraf

2015-02-01

Full Text Available Urban solid waste management is a serious environmental issue confronting the cities in developing countries like Bangladesh. Apathy towards the problem, inadequacy of field level information and data, and resource constraints may be blamed for the dismal situation of solid waste management often visible in our cities. The most common problems associated with the absence of sustainable solid waste management practice include diseases transmission, odour nuisance, atmospheric and water pollution, visual blight, fire hazards and economic losses. In the three major cities of Bangladesh, Dhaka, Chittagong & Khulna, per capita production of solid waste is around 0.4kg /capita / day, but only a fraction of this waste is carried to the final disposal site. A recent study on Municipal Solid Waste Management found that waste generated in Chittagong was 0.352kg/cap/day. Considering per capita generation of solid waste as 0.352kg to 0.4kg per capita per day, for a population of 25, 92,459 distributed within the 41 wards of the city (BBS, 2011, total solid waste generated in Chittagong will be around 913 tons to 1037 tons per day in 2012. Currently, Chittagong City Corporation (CCC has only two dumping yards: one at Ananda Bazar, Halishahar at the mid western part of the city and the other at Arefin Nagar, Pahartali at the northern tip of the city. None of these sites are sanitary landfill. Considering the city area of 168 sq. kms, only two dumping sites are not sufficient to cater to the requirement of the city. Long distances between the collection points and the disposal site are responsible for inefficient utilization of the CCC trucks and the resulting increase in the haulage time that eventually increases the costs of collection and disposal. This study utilized Geographic Information System (GIS and Multi-Criteria Decision Method (MCDM for the identification and selection of appropriate landfill sites within the city of Chittagong. Thirteen sites
Influenza and Pneumonia Vaccination Rates and Factors Affecting Vaccination among Patients with Chronic Obstructive Pulmonary Disease

OpenAIRE

Aka Akt?rk, ?lk?; G?rek Dilekta?l?, Asl?; ?eng?l, Aysun; Musaffa Salep?i, Banu; Oktay, Nuray; D?ger, Mustafa; Ar?k Ta?y?kan, Hale; Durmu? Ko?ak, Nagihan

2017-01-01

Background: Influenza and pneumococcal vaccinations are recommended in chronic obstructive pulmonary disease patients to decrease associated risks at all stages. Although the prevalence of chronic obstructive pulmonary disease is high in our country, as previously reported, vaccination rates are low. Aims: To assess the vaccination rates of chronic obstructive pulmonary disease patients and factors that may affect these. Study Design: Multi-centre cross-sectional study. Methods: Patients admi...
Regulatory analysis for the resolution of Generic Issue 130: Essential service water system failures at multi-unit sites

International Nuclear Information System (INIS)

Leung, V.; Basdekas, D.; Mazetis, G.

1991-06-01

The essential service water system (ESWS) is required to provide cooling in nuclear power plants during normal operation and accident conditions. The ESWS typically supports component cooling water heat exchangers, containment spray heat exchangers, high-pressure injection pump oil coolers, emergency diesel generators, and auxiliary building ventilation coolers. Failure of the ESWS function could lead to severe consequences. This report presents the regulatory analysis for GI-130, ''Essential Service Water System Failures at Multi-Unit Sites.'' The risk reduction estimates, cost/benefit analyses, and other insights gained during this effort have shown that implementation of the recommendations will significantly reduce risk and that these improvements are warranted in accordance with the backfit rule, 10 CFR 50.109(a)(3). 19 refs., 16 tabs
Design and Baseline Findings of a Multi-site Non-randomized Evaluation of the Effect of a Health Programme on Microfinance Clients in India

OpenAIRE

Saha, Somen

2013-01-01

Microfinance is the provision of financial services for the poor. Health program through microfinance has the potential to address several access barriers to health. We report the design and baseline findings of a multi-site non-randomized evaluation of the effect of a health program on the members of two microfinance organizations from Karnataka and Gujarat states of India. Villages identified for roll-out of health services with microfinance were pair-matched with microfinance only villages...
[3H]muscimol binding sites increased in autopsied brains of chronic schizophrenics

International Nuclear Information System (INIS)

Hanada, S.; Mita, T.; Nishino, N.; Tanaka, C.

1987-01-01

[ 3 H]muscimol binding and glutamic acid decarboxylase (GAD) activity in the prefrontal cortex and caudate nucleus of autopsied brains from 19 chronic schizophrenics and 17 control subjects were investigated. In the schizophrenics, saturation analysis with varying concentrations of [ 3 H]muscimol revealed an increase in the number GABA/sub A/ receptors, but there was no significant difference in the affinity. In addition, the enhancement of [ 3 H]muscimol binding by diazepam was significantly greater in schizophrenics than in controls. GAD activity did not differ between controls and schizophrenics. The possibility that GABAergic mechanisms might play a role in case of chronic schizophrenia should be given further attention
Proteomics portrait of archival lesions of chronic pancreatitis.

Directory of Open Access Journals (Sweden)

Sheng Pan

Full Text Available Chronic pancreatitis is a chronic inflammatory disorder of the pancreas. The etiology is multi-fold, but all lead to progressive scarring and loss of pancreatic function. Early diagnosis is difficult; and the understanding of the molecular events that underlie this progressive disease is limited. In this study, we investigated differential proteins associated with mild and severe chronic pancreatitis in comparison with normal pancreas and pancreatic cancer. Paraffin-embedded formalin-fixed tissues from five well-characterized specimens each of normal pancreas (NL, mild chronic pancreatitis (MCP, severe chronic pancreatitis (SCP and pancreatic ductal adenocarcinoma (PDAC were subjected to proteomic analysis using a "label-free" comparative approach. Our results show that the numbers of differential proteins increase substantially with the disease severity, from mild to severe chronic pancreatitis, while the number of dysregulated proteins is highest in pancreatic adenocarcinoma. Important functional groups and biological processes associated with chronic pancreatitis and cancer include acinar cell secretory proteins, pancreatic fibrosis/stellate cell activation, glycoproteins, and inflammatory proteins. Three differential proteins were selected for verification by immunohistochemistry, including collagen 14A1, lumican and versican. Further canonical pathway analysis revealed that acute phase response signal, prothrombin activation pathway, and pancreatic fibrosis/pancreatic stellate cell activation pathway were the most significant pathways involved in chronic pancreatitis, while pathways relating to metabolism were the most significant pathways in pancreatic adenocarcinoma. Our study reveals a group of differentially expressed proteins and the related pathways that may shed light on the pathogenesis of chronic pancreatitis and the common molecular events associated with chronic pancreatitis and pancreatic adenocarcinoma.
Defense strategies for cloud computing multi-site server infrastructures

Energy Technology Data Exchange (ETDEWEB)

Rao, Nageswara S. [ORNL; Ma, Chris Y. T. [Hang Seng Management College, Hon Kong; He, Fei [Texas A& M University, Kingsville, TX, USA

2018-01-01

We consider cloud computing server infrastructures for big data applications, which consist of multiple server sites connected over a wide-area network. The sites house a number of servers, network elements and local-area connections, and the wide-area network plays a critical, asymmetric role of providing vital connectivity between them. We model this infrastructure as a system of systems, wherein the sites and wide-area network are represented by their cyber and physical components. These components can be disabled by cyber and physical attacks, and also can be protected against them using component reinforcements. The effects of attacks propagate within the systems, and also beyond them via the wide-area network.We characterize these effects using correlations at two levels using: (a) aggregate failure correlation function that specifies the infrastructure failure probability given the failure of an individual site or network, and (b) first-order differential conditions on system survival probabilities that characterize the component-level correlations within individual systems. We formulate a game between an attacker and a provider using utility functions composed of survival probability and cost terms. At Nash Equilibrium, we derive expressions for the expected capacity of the infrastructure given by the number of operational servers connected to the network for sum-form, product-form and composite utility functions.
Multi-channel ground-penetrating radar to explore spatial variations in thaw depth and moisture content in the active layer of a permafrost site

Directory of Open Access Journals (Sweden)

U. Wollschläger

2010-08-01

Full Text Available Multi-channel ground-penetrating radar (GPR was applied at a permafrost site on the Tibetan Plateau to investigate the influence of surface properties and soil texture on the late-summer thaw depth and average soil moisture content of the active layer. Measurements were conducted on an approximately 85 × 60 m² sized area with surface and soil textural properties that ranged from medium to coarse textured bare soil to finer textured, sparsely vegetated areas covered with fine, wind blown sand, and it included the bed of a gravel road. The survey allowed a clear differentiation of the various units. It showed (i a shallow thaw depth and low average soil moisture content below the sand-covered, vegetated area, (ii an intermediate thaw depth and high average soil moisture content along the gravel road, and (iii an intermediate to deep thaw depth and low to intermediate average soil moisture content in the bare soil terrain. From our measurements, we found hypotheses for the permafrost processes at this site leading to the observed late-summer thaw depth and soil moisture conditions. The study clearly indicates the complicated interactions between surface and subsurface state variables and processes in this environment. Multi-channel GPR is an operational technology to efficiently study such a system at scales varying from a few meters to a few kilometers.

Optimal Procedure for siting of Nuclear Power Plant

International Nuclear Information System (INIS)

Aziuddin, Khairiah Binti; Park, Seo Yeon; Roh, Myung Sub

2013-01-01

This study discusses on a simulation approach for sensitivity analysis of the weights of multi-criteria decision models. The simulation procedures can also be used to aid the actual decision process, particularly when the task is to select a subset of superior alternatives. This study is to identify the criteria or parameters which are sensitive to the weighting factor that can affect the results in the decision making process to determine the optimal site for nuclear power plant (NPP) site. To perform this study, we adhere to IAEA NS-R-3 and DS 433. The siting process for nuclear installation consists of site survey and site selection stages. The siting process generally consists of an investigation of a large region to select one or more candidate sites by surveying the sites. After comparing the ROI, two candidate sites are compared for final determination, which are Wolsong and Kori site. Some assumptions are taken into consideration due to limitations and constraints throughout performing this study. Sensitivity analysis of multi criteria decision models is performed in this study to determine the optimal site in the site selection stage. Logical Decisions software will be employed as a tool to perform this analysis. Logical Decisions software helps to formulate the preferences and then rank the alternatives. It provides clarification of the rankings and hence aids the decision makers on evaluating the alternatives, and finally draw a conclusion on the selection of the optimal site
Optimal Procedure for siting of Nuclear Power Plant

Energy Technology Data Exchange (ETDEWEB)

Aziuddin, Khairiah Binti; Park, Seo Yeon; Roh, Myung Sub [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

2013-10-15

This study discusses on a simulation approach for sensitivity analysis of the weights of multi-criteria decision models. The simulation procedures can also be used to aid the actual decision process, particularly when the task is to select a subset of superior alternatives. This study is to identify the criteria or parameters which are sensitive to the weighting factor that can affect the results in the decision making process to determine the optimal site for nuclear power plant (NPP) site. To perform this study, we adhere to IAEA NS-R-3 and DS 433. The siting process for nuclear installation consists of site survey and site selection stages. The siting process generally consists of an investigation of a large region to select one or more candidate sites by surveying the sites. After comparing the ROI, two candidate sites are compared for final determination, which are Wolsong and Kori site. Some assumptions are taken into consideration due to limitations and constraints throughout performing this study. Sensitivity analysis of multi criteria decision models is performed in this study to determine the optimal site in the site selection stage. Logical Decisions software will be employed as a tool to perform this analysis. Logical Decisions software helps to formulate the preferences and then rank the alternatives. It provides clarification of the rankings and hence aids the decision makers on evaluating the alternatives, and finally draw a conclusion on the selection of the optimal site.
Importance of the multi-modules study in PSA

International Nuclear Information System (INIS)

Gonzalez R, V. J.; Nelson E, P. F.

2015-09-01

The current approach that has taken the Probabilistic Safety Analysis (PSA) consists of doing all the APS analysis including the existence of multi-units in the nuclear power plants (NPP), this new approach seeks to analyze the risk of site, evaluating all reactors together. The main reasons for this trend are: the accident occurred on March 2011 in Fukushima Daiichi in Japan, with serious consequences in more than one reactor of the NPP and the current planning and construction of new Small Modular Reactors, which host more than one module on the same NPP and are connected to a single control room. This study analyzes how to model the risk of a multi-module NPP. In 2013, the ASME/ANS standard for advanced reactors that are not light-water reactors was published, in which the requirements to realize a PSA including multi-units or modules are shown; however, does not describe the methodology to do that. This article presents a methodology to calculate the risk of the site in a PBMR plant with two modules. This methodology consists of two models of trees of different events, one that evaluates to a single PBMR module and another that evaluates the two modules together. Both models are responsible to show their differences and compare results to finally demonstrate the need for new methodologies for risk analysis site in multi-modules and units. (Author)
Determination of optimum "multi-channel surface wave method" field parameters.

Science.gov (United States)

2012-12-01

Multi-channel surface wave methods (especially the multi-channel analyses of surface wave method; MASW) are routinely used to : determine the shear-wave velocity of the subsurface to depths of 100 feet for site classification purposes. Users are awar...
Single-site neural tube closure in human embryos revisited.

Science.gov (United States)

de Bakker, Bernadette S; Driessen, Stan; Boukens, Bastiaan J D; van den Hoff, Maurice J B; Oostra, Roelof-Jan

2017-10-01

Since the multi-site closure theory was first proposed in 1991 as explanation for the preferential localizations of neural tube defects, the closure of the neural tube has been debated. Although the multi-site closure theory is much cited in clinical literature, single-site closure is most apparent in literature concerning embryology. Inspired by Victor Hamburgers (1900-2001) statement that "our real teacher has been and still is the embryo, who is, incidentally, the only teacher who is always right", we decided to critically review both theories of neural tube closure. To verify the theories of closure, we studied serial histological sections of 10 mouse embryos between 8.5 and 9.5 days of gestation and 18 human embryos of the Carnegie collection between Carnegie stage 9 (19-21 days) and 13 (28-32 days). Neural tube closure was histologically defined by the neuroepithelial remodeling of the two adjoining neural fold tips in the midline. We did not observe multiple fusion sites in neither mouse nor human embryos. A meta-analysis of case reports on neural tube defects showed that defects can occur at any level of the neural axis. Our data indicate that the human neural tube fuses at a single site and, therefore, we propose to reinstate the single-site closure theory for neural tube closure. We showed that neural tube defects are not restricted to a specific location, thereby refuting the reasoning underlying the multi-site closure theory. Clin. Anat. 30:988-999, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.
Acute and chronic myocardial infarction in a pig model: Utility of multi-slice cardiac computed tomography in assessing myocardial viability and infarct parameters

International Nuclear Information System (INIS)

Qu Xinkai; Fang Weiyi; Ye Jianding; Koh, Angela S.; Xu Yingjia; Guan Shaofeng; Li Ruogu; Shen Yan

2012-01-01

Objectives: The aim of this study was to determine the feasibility of multi-slice computed tomography (MSCT) biphasic imaging in assessing myocardial viability and infarct parameters in both acutely and chronically infarcted pig models. Materials and methods: Seven pigs underwent ligation of the distal left anterior descending artery. Imaging was performed on the day of infarction and 3 months post-infarct, with contrast infusion followed by MSCT scan acquisition at different time-points. Left ventricular ejection fractions (LVEFs) were obtained by left ventriculography (LVG) after 3 months. Infarcted locations found using MSCT were compared with those obtained using SPECT. Infarcted areas were also analysed histopathologically and compared with the findings from MSCT. Results: Chronic phase images had perfusion defects with lower CT values relative to normal myocardium (43 ± 10 HU vs. 156 ± 13 HU, p = 0.001) on the early images but no residual defects on delayed images. However, we found hyperenhancing regions on delayed images (244 ± 20 HU vs. 121 ± 25 HU, p = 0.001), and good correlation between MSCT- and LVG-derived LVEFs (60.56 ± 7.56%). The areas identified by MSCT corresponded to the location of 201 Tl SPECT-/pathologic staining-derived regions in all models. Infarct size was in good agreement with MSCT and pathological analyses of chronic phase models. Conclusions: Necrotic myocardium in different stages after infarction could be qualitatively and quantitatively assessed using MSCT biphasic imaging, as could the status of microcirculation formation. MSCT-measured LVEFs matched well with other modalities, and hence MSCT is a useful tool in assessing post-infarct cardiac function.
ICA-based artifact removal diminishes scan site differences in multi-center resting-state fMRI.

Directory of Open Access Journals (Sweden)

Rogier Alexander Feis

2015-10-01

Full Text Available Resting-state fMRI (R-fMRI has shown considerable promise in providing potential biomarkers for diagnosis, prognosis and drug response across a range of diseases. Incorporating R-fMRI into multi-center studies is becoming increasingly popular, imposing technical challenges on data acquisition and analysis, as fMRI data is particularly sensitive to structured noise resulting from hardware, software and environmental differences. Here, we investigated whether a novel clean up tool for structured noise was capable of reducing center-related R-fMRI differences between healthy subjects.We analyzed 3 Tesla R-fMRI data from 72 subjects, half of whom were scanned with eyes closed in a Philips Achieva system in The Netherlands, and half of whom were scanned with eyes open in a Siemens Trio system in the UK. After pre-statistical processing and individual Independent Component Analysis (ICA, FMRIB’s ICA-based X-noiseifier (FIX was used to remove noise components from the data. GICA and dual regression were run and non-parametric statistics were used to compare spatial maps between groups before and after applying FIX.Large significant differences were found in all resting-state networks between study sites before using FIX, most of which were reduced to non-significant after applying FIX. The between-center difference in the medial/primary visual network, presumably reflecting a between-center difference in protocol, remained statistically different.FIX helps facilitate multi-center R-fMRI research by diminishing structured noise from R-fMRI data. In doing so, it improves combination of existing data from different centers in new settings and comparison of rare diseases and risk genes for which adequate sample size remains a challenge.
Ethnic differences in the association between depression and chronic pain: cross sectional results from UK Biobank.

Science.gov (United States)

Nicholl, Barbara I; Smith, Daniel J; Cullen, Breda; Mackay, Daniel; Evans, Jonathan; Anderson, Jana; Lyall, Donald M; Fawns-Ritchie, Chloe; McIntosh, Andrew M; Deary, Ian J; Pell, Jill P; Mair, Frances S

2015-10-06

Comorbid chronic pain and depression is a challenging dyad of conditions to manage in primary care and reporting has shown to vary by ethnic group. Whether the relationship between depression and chronic pain varies by ethnicity is unclear. This study aims to explore chronic pain and depression reporting across ethnic groups and examine whether this association differs, independently of potential confounding factors. Cross-sectional study of UK Biobank participants with complete data on chronic pain and probable lifetime history of depression, who reported their ethnic group as White, Asian/Asian British or Black/Black British. Chronic pain classification: present if participants had ≥ 1 site of body pain (up to seven sites or "pain all over the body" could be selected) that lasted ≥ 3 months; extent of chronic pain categories: 0, 1, 2-3, 4-7 sites or pain all over the body. Probable depression classification: an algorithm of low mood, anhedonia and help-seeking behaviour. Relationship between depression and presence/extent of chronic pain assessed using logistic/multinomial regression models (odds ratio (OR); relative risk ratio (RRR), 95 % confidence intervals), adjusted for sociodemographic, lifestyle, and morbidity factors; and a final adjustment for current depressive symptoms. The number of participants eligible for inclusion was 144,139: 35,703 (94 %) White, 4539 (3 %) Asian, and 3897 (3 %) Black. Chronic pain was less (40.5 %, 45.8 %, 45.0 %, respectively) and depression more (22.1 %, 12.9 %, 13.8 %, respectively) commonly reported in White participants than Asian and Black participants. Statistically significant associations between depression and presence/extent of chronic pain persisted following adjustment for potential confounding variables; this relationship was strongest for Black participants (presence of chronic pain: OR 1.86 (1.52, 2.27); RRR 1 site 1.49 (1.16, 1.91), 2-3 sites 1.98 (1.53, 2.56), 4-7 sites 3.23 (2.09, 4.99), pain all
Imaging in chronic obstructive pulmonary disease.

Science.gov (United States)

Shaker, Saher B; Dirksen, Asger; Bach, Karen S; Mortensen, Jann

2007-06-01

Chronic obstructive pulmonary disease (COPD) is divided into pulmonary emphysema and chronic bronchitis (CB). Emphysema is defined patho-anatomically as "permanent enlargement of airspaces distal to the terminal bronchiole, accompanied by the destruction of their walls, and without obvious fibrosis" (1). These lesions are readily identified and quantitated using computed tomography (CT), whereas the accompanying hyperinflation is best detected on plain chest X-ray, especially in advanced disease. The diagnosis of CB is clinical and relies on the presence of productive cough for 3 months in 2 or more successive years. The pathological changes of mucosal inflammation and bronchial wall thickening have been more difficult to identify with available imaging techniques. However, recent studies using Multi-detector row CT (MDCT) reported more reproducible assessment of air wall thickening.
Mass-forming chronic pancreatitis : CT and ERCP features

Energy Technology Data Exchange (ETDEWEB)

Jung, Dong Jin; Ha, Hyun Kwon; Lee, Yong Suk; Lee, Jin Hwa; Kim, Pyo Nyun; Lee, Moon Gyu; Auh, Yong Ho [Asan Medical Center, Ulsan Univ. College of Medicine, Ulsan (Korea, Republic of)

1999-11-01

To describe the CT and ERCP findings of mass-forming chronic pancreatitis. CT and ERCP features were assessed in 13 patients suffering from mass-forming chronic pancreatitis. Diagnosis was on the basis of surgery (n=5), percutaneous needle biopsy (n=3), and clinical follow-up (n=5). Contrast-enhanced CT was available for all patients : five underwent dynamic study and ERCP was performed in 12. On CT and ERCP, both groups were evaluated with regard to the presence and degree of pancreatic ductal dilatation (greater or less than 50 % of total gland width), double duct sign, enhancement pattern, pancreatic parenchymal calcification (site and distribution pattern), mass identification, the direction of infiltration, pancreatic parenchymal atrophy, configuration at the site of obstruction in the pancreatic and common bile duct, lymphadenopathy, vascular encasement, and vascular engorgement or increased collateral vessels in the peripancreatic space. Seven of 13 patients had suffered chronic alcoholism. Serum CA19-9 levels were normal in all patients except one. Common CT and ERCP findings of mass-forming chronic pancreatitis included pancreatic duct dilatation (92.3%), double duct sign (69.2%), inhomogeneous enhancement of the mass (69.2%), and the presence of calcification (61.5%). Patterns of pancreatic duct dilation were irregular in five patients (38.4%) and smooth in three (23.1%). In all patients, duct dilatation was less than 50% of total gland width. Enhancement patterns of the pancreatic mass were inhomogeneous (69.2%), a nonenhancing low attenuation mass (15.3%), and homogeneous enhancement (15.3%). Configuration at the site of obstruction in the pancreatic duct was abrupt termination in two patients (15.4%) and smooth termination in two (15.4%). The common bile duct teminated abruptly in three patients (23.1%), and in four (30.8%) smooth narrowing was abserved. Common findings of mass-forming chronic pancreatitis were duct dilatation of less than 50% of total
Mass-forming chronic pancreatitis : CT and ERCP features

International Nuclear Information System (INIS)

Jung, Dong Jin; Ha, Hyun Kwon; Lee, Yong Suk; Lee, Jin Hwa; Kim, Pyo Nyun; Lee, Moon Gyu; Auh, Yong Ho

1999-01-01

To describe the CT and ERCP findings of mass-forming chronic pancreatitis. CT and ERCP features were assessed in 13 patients suffering from mass-forming chronic pancreatitis. Diagnosis was on the basis of surgery (n=5), percutaneous needle biopsy (n=3), and clinical follow-up (n=5). Contrast-enhanced CT was available for all patients : five underwent dynamic study and ERCP was performed in 12. On CT and ERCP, both groups were evaluated with regard to the presence and degree of pancreatic ductal dilatation (greater or less than 50 % of total gland width), double duct sign, enhancement pattern, pancreatic parenchymal calcification (site and distribution pattern), mass identification, the direction of infiltration, pancreatic parenchymal atrophy, configuration at the site of obstruction in the pancreatic and common bile duct, lymphadenopathy, vascular encasement, and vascular engorgement or increased collateral vessels in the peripancreatic space. Seven of 13 patients had suffered chronic alcoholism. Serum CA19-9 levels were normal in all patients except one. Common CT and ERCP findings of mass-forming chronic pancreatitis included pancreatic duct dilatation (92.3%), double duct sign (69.2%), inhomogeneous enhancement of the mass (69.2%), and the presence of calcification (61.5%). Patterns of pancreatic duct dilation were irregular in five patients (38.4%) and smooth in three (23.1%). In all patients, duct dilatation was less than 50% of total gland width. Enhancement patterns of the pancreatic mass were inhomogeneous (69.2%), a nonenhancing low attenuation mass (15.3%), and homogeneous enhancement (15.3%). Configuration at the site of obstruction in the pancreatic duct was abrupt termination in two patients (15.4%) and smooth termination in two (15.4%). The common bile duct teminated abruptly in three patients (23.1%), and in four (30.8%) smooth narrowing was abserved. Common findings of mass-forming chronic pancreatitis were duct dilatation of less than 50% of total
[Chronic pancreatitis: which is the role of 320-row CT for the staging?].

Science.gov (United States)

Stabile Ianora, Amato Antonio; Rubini, Giuseppe; Lorusso, Filomenamila; Ambriola, Angela; Rella, Leonarda; Di Crescenzo, Vincenzo; Moschetta, Marco

2013-01-01

The purpose of this study was to evaluate the diagnostic potential of multi-planar and volumetric reconstructions obtained from isotropic data by using 16-slice computed tomography (CT) in the diagnosis and staging of chronic pancreatitis. In a group of 42 patients CT images were evaluated searching for alterations in morphology and structure of the pancreas, alterations of the Wirsung duct, dilatation of the bile ducts, fluid collections, and vascular involvement of the digestive tract. The disease was then staged in mild, moderate and severe and correlated with the clinical staging. CT allowed the recognition of chronic pancreatitis in all cases. The staging was correct in 25/42 patients, with an accuracy rate of 59.5%. In the staging of moderate and severe forms, CT correlation with clinical and laboratory data was valid, but in mild forms it appeared less significant. Multi-detector CT is accurate in the recognition of moderate, advanced forms of chronic pancreatitis and in the identification of its complications, while it is poorly correlated with the clinical staging in mild forms of the disease.
Fatty Acid-Mediated Inhibition of Metal Binding to the Multi-Metal Site on Serum Albumin: Implications for Cardiovascular Disease.

Science.gov (United States)

Blindauer, Claudia A; Khazaipoul, Siavash; Yu, Ruitao; Stewart, Alan J

2016-01-01

Human serum albumin (HSA) is the major protein in blood plasma and is responsible for circulatory transport of a range of small molecules including fatty acids, metal ions and drugs. We previously identified the major plasma Zn2+ transport site on HSA and revealed that fatty-acid binding (at a distinct site called the FA2 site) and Zn2+ binding are interdependent via an allosteric mechanism. Since binding affinities of long-chain fatty acids exceed those of plasma Zn2+, this means that under certain circumstances the binding of fatty acid molecules to HSA is likely to diminish HSA Zn2+-binding, and hence affects the control of circulatory and cellular Zn2+ dynamics. This relationship between circulatory fatty acid and Zn2+ dynamics is likely to have important physiological and pathological implications, especially since it has been recognised that Zn2+ acts as a signalling agent in many cell types. Fatty acid levels in the blood are dynamic, but most importantly, chronic elevation of plasma fatty acid levels is associated with some metabolic disorders and disease states - including myocardial infarction and other cardiovascular diseases. In this article, we briefly review the metal-binding properties of albumin and highlight the importance of their interplay with fatty acid binding. We also consider the impact of this dynamic link upon levels and speciation of plasma Zn2+, its effect upon cellular Zn2+ homeostasis and its relevance to cardiovascular and circulatory processes in health and disease.
Changes in symptoms during urologic chronic pelvic pain syndrome symptom flares: findings from one site of the MAPP Research Network.

Science.gov (United States)

Sutcliffe, Siobhan; Colditz, Graham A; Pakpahan, Ratna; Bradley, Catherine S; Goodman, Melody S; Andriole, Gerald L; Lai, H Henry

2015-02-01

To provide the first description and quantification of symptom changes during interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome symptom exacerbations ("flares"). Participants at one site of the Trans-Multidisciplinary Approaches to the study of chronic Pelvic Pain Epidemiology and Phenotyping Study completed two 10-day diaries over the 1-year study follow-up period, one at baseline and one during their first flare (if not at baseline). On each day of the diary, participants reported whether they were currently experiencing a flare, defined as "symptoms that are much worse than usual" for at least 1 day, and their levels of urination-related pain, pelvic pain, urgency, and frequency on a scale of 0-10. Linear mixed models were used to calculate mean changes in symptoms between non-flare and flare days from the same participant. Eighteen of 27 women and 9 of 29 men reported at least one flare during follow-up, for a total of 281 non-flare and 210 flare days. Of these participants, 44.4% reported one flare, 29.6% reported two flares, and 25.9% reported ≥ 3 flares over the combined 20-day diary observation period, with reported flares ranging in duration from 1 day to >2 weeks. During these flares, each of the main symptoms worsened significantly by a mean of at least two points and total symptoms worsened by a mean of 11 points for both sexes (all P ≤ 0.01). Flares are common and correspond to a global worsening of urologic and pelvic pain symptoms. © 2013 Wiley Periodicals, Inc.
Relationships between Premonitory Urge and Anxiety in Youth with Chronic Tic Disorders.

Science.gov (United States)

Rozenman, Michelle; Johnson, Olivia E; Chang, Susanna W; Woods, Douglas W; Walkup, John T; Wilhelm, Sabine; Peterson, Alan; Scahill, Lawrence; Piacentini, John

2015-07-01

Tourette's Disorder and other chronic tic disorders are common neurodevelopmental conditions. One characteristic of tic disorders is the premonitory urge, an aversive or unpleasant sensory phenomenon that may precede tics. Initial examination of premonitory urge in pediatric tic disorders suggests that awareness and experience of sensations preceding tics may be related to anxiety and OCD. However, it may be possible that specific anxiety-related symptoms, such as anxious physiologic arousal, are particularly relevant to the experience of premonitory urge. The current study examines relationships between tic-related premonitory urge and anxiety-related symptom clusters in treatment-seeking youths with a primary diagnoses of Tourette's or other chronic tic disorder. The sample consisted of 124 youth, ages 9 to 17, who participated in the multi-site Comprehensive Behavioral Intervention for Tics randomized controlled trial (CBIT; Piacentini et al., 2010). Specific anxiety-related subtypes, including generalized worry, separation, social, and panic/somatic symptoms, as well as severity of obsessions and compulsions, were assessed as potential correlates of premonitory urge. Findings indicated that age, global tic-related impairment, and specific panic/somatic symptoms accounted for a substantial proportion of variance in youth report of premonitory urge. These findings provide information about the characteristics of premonitory urge in pediatric tic disorders, and have implications for the treatment of pediatric tic syndromes.
Transcutaneous electrical nerve stimulation (TENS) for chronic low-back pain.

Science.gov (United States)

Khadilkar, A; Milne, S; Brosseau, L; Robinson, V; Saginur, M; Shea, B; Tugwell, P; Wells, G

2005-07-20

-planned subgroup analyses, intended to examine the impact of different stimulation parameters, sites of TENS application, treatment durations and baseline patient characteristics were not possible due to the small number of included trials. There is inconsistent evidence to support the use of TENS as a single treatment in the management of chronic LBP. Larger, multi-center, randomized controlled trials are needed to better assess the true effectiveness of TENS. Special attention should be given to the risks and benefits of long-term use, which more appropriately addresses the realities of managing chronic low-back pain.
The radiological study of areas gastricae in chronic gastritis

International Nuclear Information System (INIS)

Baik, D. I.; Jaun, W. K.; Lee, S. W.; Han, C. Y.

1980-01-01

A chronic gastritis is common and clinically significant, but specific findings were rarely described in UGIS. And the authors attempted to clarify the area gastrica of the stomach related to the chronic gastritis. The authors reviewed 'Areae gastricae' micromucosal patterns of stomach, retrospectively with double contrast barium meal study in 16 cases, histologically proven cases of chronic gastritis by endoscopic biopsy from January 1, 1980 to June 30, 1980. Here the commonest site of chronic gastritis is evident in 12 cases in pyloric gland area, and a sixe of area gastrica shows above 2.5mm in longest diameter with combinding morphology, regular to irregular, 3 to 1 and coarse barium accumulations of intervening sulci. The chronic gastritis could be suggested with this better technique of UGIS
A stable isotope approach for source apportionment of chlorinated ethene plumes at a complex multi-contamination events urban site

Science.gov (United States)

Nijenhuis, Ivonne; Schmidt, Marie; Pellegatti, Eleonora; Paramatti, Enrico; Richnow, Hans Hermann; Gargini, Alessandro

2013-10-01

The stable carbon isotope composition of chlorinated aliphatic compounds such as chlorinated methanes, ethanes and ethenes was examined as an intrinsic fingerprint for apportionment of sources. A complex field site located in Ferrara (Italy), with more than 50 years history of use of chlorinated aliphatic compounds, was investigated in order to assess contamination sources. Several contamination plumes were found in a complex alluvial sandy multi-aquifer system close to the river Po; sources are represented by uncontained former industrial and municipal dump sites as well as by spills at industrial areas. The carbon stable isotope signature allowed distinguishing 2 major sources of contaminants. One source of chlorinated aliphatic contaminants was strongly depleted in 13C (-40‰ which is commonly observed in recent production of chlorinated solvents. The degradation processes in the plumes could be traced interpreting the isotope enrichment and depletion of parent and daughter compounds, respectively. We demonstrate that, under specific production conditions, namely when highly chlorinated ethenes are produced as by-product during chloromethanes production, 13C depleted fingerprinting of contaminants can be obtained and this can be used to track sources and address the responsible party of the pollution in urban areas.
Financial Management of a Large Multi-site Randomized Clinical Trial

Science.gov (United States)

Sheffet, Alice J.; Flaxman, Linda; Tom, MeeLee; Hughes, Susan E.; Longbottom, Mary E.; Howard, Virginia J.; Marler, John R.; Brott, Thomas G.

2014-01-01

Background The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) received five years’ funding ($21,112,866) from the National Institutes of Health to compare carotid stenting to surgery for stroke prevention in 2,500 randomized participants at 40 sites. Aims Herein we evaluate the change in the CREST budget from a fixed to variable-cost model and recommend strategies for the financial management of large-scale clinical trials. Methods Projections of the original grant’s fixed-cost model were compared to the actual costs of the revised variable-cost model. The original grant’s fixed-cost budget included salaries, fringe benefits, and other direct and indirect costs. For the variable-cost model, the costs were actual payments to the clinical sites and core centers based upon actual trial enrollment. We compared annual direct and indirect costs and per-patient cost for both the fixed and variable models. Differences between clinical site and core center expenditures were also calculated. Results Using a variable-cost budget for clinical sites, funding was extended by no-cost extension from five to eight years. Randomizing sites tripled from 34 to 109. Of the 2,500 targeted sample size, 138 (5.5%) were randomized during the first five years and 1,387 (55.5%) during the no-cost extension. The actual per-patient costs of the variable model were 9% ($13,845) of the projected per-patient costs ($152,992) of the fixed model. Conclusions Performance-based budgets conserve funding, promote compliance, and allow for additional sites at modest additional cost. Costs of large-scale clinical trials can thus be reduced through effective management without compromising scientific integrity. PMID:24661748
Rent Sharing in Multi-Site Hog Production

OpenAIRE

Brian P. Cozzarin; Randall E. Westgren

2000-01-01

A firm-level model of three-site hog production is used compare a franchise organizational structure to a three-firm alliance. The results of the simulations imply that the franchise system is better equipped to mitigate underproduction in the nursery and finishing units, the nursery and finishing units lose relatively more profit than they otherwise would in an alliance. The pig-space guatantee does little to offset the financial risk for the nursery and finishing units when underproduction ...

Eosinophilic Chronic Rhinosinusitis in Japan

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Junichi Ishitoya

Full Text Available ABSTRACT: Chronic rhinosinusitis is a heterogeneous disease. In Europe and the United States, it has recently been divided into two subgroups: chronic rhinosinusitis with nasal polyps (CRSwNP and chronic rhinosinusitis without nasal polyps (CRSsNP. The majority of CRSwNP cases have a strong tendency to recur after surgery and show eosinophil-dominant inflammation. However, this definition has proved difficult to apply in Japan and East Asia, because more than half of the CRSwNP cases do not exhibit eosinophil-dominant inflammation in these areas of the world. In Japan in the 1990s, refractory CRSwNP to the standard treatment was focused on in clinical studies and the term ''eosinophilic chronic rhinosinusitis'' (ECRS was introduced to identify this subgroup of chronic rhinosinusitis in 2001.ECRS is different from non-ECRS in terms of many clinical features: symptom appearance, occurrence site of nasal polyps, CT scan findings, the histology of nasal polyps, blood examination findings, clinical course after surgery, and co-morbid asthma, etc. In this review, we describe these clinical features and mention how to make a clinical diagnosis of ECRS as well as how to treat it. Finally, we discuss the pathophysiology of ECRS. The concept of ECRS in Japan would be applicable for CRSwNP in other countries including Europe and the United States. KEY WORDS: chronic rhinosinusitis, clinical feature, diagnosis, eosinophilic chronic rhinosinusitis, eosinophils
Childhood violence and adult chronic pain among indigenous Sami and non-Sami populations in Norway: a SAMINOR 2 questionnaire study

Directory of Open Access Journals (Sweden)

Astrid M. A. Eriksen

2016-10-01

Full Text Available Background: Internationally, studies have shown that childhood violence is associated with chronic pain in adulthood. However, to date, this relationship has not been examined in any indigenous population. Objective: The main objectives of this study were to investigate the association between childhood violence and reported chronic pain, number of pain sites and the intensity of pain in adulthood in indigenous Sami and non-Sami adults, and to explore ethnic differences. Design: The study is based on the SAMINOR 2 questionnaire study, a larger population-based, cross-sectional survey on health and living conditions in multiethnic areas with both Sami and non-Sami populations in Mid- and Northern Norway. Our study includes a total of 11,130 adult participants: 2,167 Sami respondents (19.5% and 8,963 non-Sami respondents (80.5%. Chronic pain was estimated by reported pain located in various parts of the body. Childhood violence was measured by reported exposure of emotional, physical and/or sexual violence. Results: Childhood violence was associated with adult chronic pain in several pain sites of the body regardless of ethnicity and gender. Childhood violence was also associated with increased number of chronic pain sites and higher pain intensity compared to those not exposed to childhood violence. However, among Sami men, this association was only significant for pain located in chest, hips/legs and back, and non-significant for increased number of chronic pain sites (adjusted model, and higher pain intensity. Conclusion: Respondents exposed to childhood violence reported more chronic pain in several parts of the body, increased number of chronic pain sites and more intense pain in adulthood than respondents reporting no childhood violence. However, among Sami men, this association was weaker and also not significant for increased number of chronic pain sites and higher pain intensity.
Changes in cell-type composition in digestive gland of slugs and its influence in biomarkers following transplantation between a relatively unpolluted and a chronically metal-polluted site

International Nuclear Information System (INIS)

Zaldibar, B.; Cancio, I.; Soto, M.; Marigomez, I.

2008-01-01

Changes in cell-type composition (CCTC) is a general phenomenon that takes place in the digestive gland epithelium of stressed molluscs. The aim of the present work was to determine whether CCTC is a reversible process in the digestive gland of sentinel slugs chronically exposed to metal pollution and how CCTC affects metal accumulation parameters and different cell and tissue biomarkers of exposure and effect. Slugs (Arion ater) from an abandoned zinc mine were transferred to a relatively unpolluted site and the other way around for 3, 10 and 28 d. The volume density of black silver deposits (Vv BSD ) after autometallography, and metallothionein (MT) levels were used as biomarkers of exposure to metals and CCTC and lysosomal responses were selected as effect biomarkers. Results indicated that slugs were sensitive to recent metal pollution; however, slugs chronically exposed to metals presented some characteristic features and were less responsive to pollution cessation without signs of CCTC reversal. - Cell and tissue-level biomarkers in slugs after recent and chronic metal pollution
Globalisation, Mergers and "Inadvertent Multi-Campus Universities": Reflections from Wales

Science.gov (United States)

Zeeman, Nadine; Benneworth, Paul

2017-01-01

Multi-site universities face the challenge of integrating campuses that may have different profiles and orientations arising from place-specific attachments. Multi-campus universities created via mergers seeking to ensure long-term financial sustainability, and increasing their attractiveness to students, create a tension in campuses' purposes. We…
Antibody-mediated delivery of interleukin 4 to the neo-vasculature reduces chronic skin inflammation

OpenAIRE

Hemmerle Teresa; Zgraggen Silvana; Matasci Mattia; Halin Cornelia; Detmar Michael; Neri Dario

2014-01-01

BACKGROUND: The antibody mediated delivery of cytokines (quot;immunocytokinesquot;) to sites of pathological angiogenesis represents an attractive strategy for the development of innovative biopharmaceuticals capable of modulating the activity of the immune system in cancer and in chronic inflammatory conditions. OBJECTIVE: Recombinant IL4 has previously been shown to be therapeutically active in patients with psoriasis. The antibody mediated delivery of this cytokine to sites of chronic skin...
a Web-Based Interactive Tool for Multi-Resolution 3d Models of a Maya Archaeological Site

Science.gov (United States)

Agugiaro, G.; Remondino, F.; Girardi, G.; von Schwerin, J.; Richards-Rissetto, H.; De Amicis, R.

2011-09-01

Continuous technological advances in surveying, computing and digital-content delivery are strongly contributing to a change in the way Cultural Heritage is "perceived": new tools and methodologies for documentation, reconstruction and research are being created to assist not only scholars, but also to reach more potential users (e.g. students and tourists) willing to access more detailed information about art history and archaeology. 3D computer-simulated models, sometimes set in virtual landscapes, offer for example the chance to explore possible hypothetical reconstructions, while on-line GIS resources can help interactive analyses of relationships and change over space and time. While for some research purposes a traditional 2D approach may suffice, this is not the case for more complex analyses concerning spatial and temporal features of architecture, like for example the relationship of architecture and landscape, visibility studies etc. The project aims therefore at creating a tool, called "QueryArch3D" tool, which enables the web-based visualisation and queries of an interactive, multi-resolution 3D model in the framework of Cultural Heritage. More specifically, a complete Maya archaeological site, located in Copan (Honduras), has been chosen as case study to test and demonstrate the platform's capabilities. Much of the site has been surveyed and modelled at different levels of detail (LoD) and the geometric model has been semantically segmented and integrated with attribute data gathered from several external data sources. The paper describes the characteristics of the research work, along with its implementation issues and the initial results of the developed prototype.
The radiological study of areas gastricae in chronic gastritis

Energy Technology Data Exchange (ETDEWEB)

Baik, D. I.; Jaun, W. K.; Lee, S. W.; Han, C. Y. [Inje Medical College Paik Hospital (Korea, Republic of)

1980-12-15

A chronic gastritis is common and clinically significant, but specific findings were rarely described in UGIS. And the authors attempted to clarify the area gastrica of the stomach related to the chronic gastritis. The authors reviewed 'Areae gastricae' micromucosal patterns of stomach, retrospectively with double contrast barium meal study in 16 cases, histologically proven cases of chronic gastritis by endoscopic biopsy from January 1, 1980 to June 30, 1980. Here the commonest site of chronic gastritis is evident in 12 cases in pyloric gland area, and a sixe of area gastrica shows above 2.5mm in longest diameter with combinding morphology, regular to irregular, 3 to 1 and coarse barium accumulations of intervening sulci. The chronic gastritis could be suggested with this better technique of UGIS.
Understanding differences between caregivers and non-caregivers in completer rates of Chronic Disease Self-Management Program.

Science.gov (United States)

Shi, J; McCallion, P; Ferretti, L A

2017-06-01

The Chronic Disease Self-Management Program (CDSMP) was developed to advance participants' self-care of chronic illness and may be offered to both individuals with chronic conditions and their caregivers. Previous studies of CDSMP have identified multiple resulting health benefits for participants as well as factors associated with participants' completion rates. This study investigated differences on these issues between caregiving and non-caregiving participants. Secondary analysis using regression analysis to predict the outcome. Baseline data were collected directly from adult (over 18 years) participants of CDSMP workshops in New York State from 2012 to 2015 (n = 2685). Multi-level logistic regression analysis was used to compare the difference on completion of workshops (attended four or more of sessions) and contributing factors with the independent variable of whether participants provided care/assistance to a family member or friends with long-term illness or disability. Additional individual-level variables controlled for in the model were age, gender, race/ethnicity, living arrangement, education, the number of chronic conditions and disabilities; as were workshop-level characteristics of class size, language used, workshop leader experience, location urbanity and delivery site type. Participants who provided care to family or friends were 28% more likely to complete the workshop compared with those who did not (odds ratio = 1.279, P < 0.05). Different factors influenced the completion of CDSMP workshop for caregivers and non-caregivers. People who provide care to others appeared to have stronger motivation to complete the workshops with greater benefits. Agencies offering CDSMP should encourage caregivers to attend. Copyright © 2017. Published by Elsevier Ltd.
Specific Clinical Profile and Risk Factors for Mortality in General Surgery Patients with Infections by Multi-Drug-Resistant Gram-Negative Bacteria.

Science.gov (United States)

Rubio-Perez, Ines; Martin-Perez, Elena; Domingo-García, Diego; Garcia-Olmo, Damian

2017-07-01

The incidence of gram-negative multi-drug-resistant (MDR) infections is increasing worldwide. This study sought to determine the incidence, clinical profiles, risk factors, and mortality of these infections in general surgery patients. All general surgery patients with a clinical infection by gram-negative MDR bacteria were studied prospectively for a period of five years (2007-2011). Clinical, surgical, and microbiologic parameters were recorded, with a focus on the identification of risk factors for MDR infection and mortality. Incidence of MDR infections increased (5.6% to 15.2%) during the study period; 106 patients were included, 69.8% presented nosocomial infections. Mean age was 65 ± 15 years, 61% male. Extended-spectrum β-lactamases (ESBL) Escherichia coli was the most frequent MDR bacteria. Surgical site infections and abscesses were the most common culture locations. The patients presented multiple pre-admission risk factors and invasive measures during hospitalization. Mortality was 15%, and related to older age (odds ratio [OR] 1.07), malnutrition (OR 13.5), chronic digestive conditions (OR 4.7), chronic obstructive pulmonary disease (OR 3.9), and surgical re-intervention (OR 9.2). Multi-drug resistant infections in the surgical population are increasing. The most common clinical profile is a 65-year-old male, with previous comorbidities, who has undergone a surgical intervention, intensive care unit (ICU) admission, and invasive procedures and who has acquired the MDR infection in the nosocomial setting.
Knowledge of practice: A multi-sited event ethnography of border security fairs in Europe and North America.

Science.gov (United States)

Baird, Theodore

2017-06-01

This article takes the reader inside four border security fairs in Europe and North America to examine the knowledge practices of border security professionals. Building on the border security as practice research agenda, the analysis focuses on the production, circulation, and consumption of scarce forms of knowledge. To explore situated knowledge of border security practices, I develop an approach to multi-sited event ethnography to observe and interpret knowledge that may be hard to access at the security fairs. The analysis focuses on mechanisms for disseminating and distributing scarce forms of knowledge, technological materializations of situated knowledge, expressions of transversal knowledge of security problems, how masculinities structure knowledge in gendered ways, and how unease is expressed through imagined futures in order to anticipate emergent solutions to proposed security problems. The article concludes by reflecting on the contradictions at play at fairs and how to address such contradictions through alternative knowledges and practices.
Multi-generation cadmium acclimation and tolerance in Daphnia magna Straus

International Nuclear Information System (INIS)

Muyssen, Brita T.A.; Janssen, Colin R.

2004-01-01

The cladoceran Daphnia magna was acclimated for seven generations to cadmium concentrations ranging from 0 (control) to 250 μg/l Cd (corresponding to a free ion activity of 4.60 nM Cd 2+ ). Acute and chronic cadmium tolerance as well as cadmium accumulation were monitored as a function of acclimation time. After two to three generations of acclimation to concentrations ranging from 0.23 to 1.11 nM Cd 2+ increases in acute tolerance were maximal (factor 7.2) and significant. Acclimation for seven generations to the same acclimation concentrations did result in an increased chronic cadmium tolerance (21 days EC 50 values increased). Organisms acclimated to 1.93 nM Cd 2+ were equally or more sensitive than non-acclimated daphnids in acute and chronic toxicity tests. Cadmium contents in D. magna increased significantly as a function of the acclimation concentration. Maximum body burdens of 236±30 μg Cd/g dry weight were measured in organisms exposed to 4.60 nM Cd 2+ , but detoxification mechanisms were only successful up to 82±20 μg Cd/g dry weight as this concentration did not cause major decreases in survival and reproduction in chronic toxicity tests. As the potential positive effect of acclimation on cadmium tolerance disappeared with successive acclimation generations and increasing acclimation concentrations, it is concluded that multi-generation acclimation studies are important for the evaluation of the long-term effects of environmental toxicants. - Multi-generation acclimation studies are important for evaluating long-term effects of aquatic pollutants
Secondary and tertiary hyperparathyroidism in chronic kidney disease

Directory of Open Access Journals (Sweden)

Lilit V. Egshatyan

2017-12-01

Full Text Available In the treatment of secondary hyperparathyroidism of end-stage chronic kidney disease, vitamin D receptor activation and allosteric modulators of the calcium-sensing receptor – inhibit glandular hyperplasia, reduce parathyroid hormone levels, impact on bone turnover and mineral density. But the use of calcimimetic and vitamin D analogs or mimetics did not reduce the need for parathyroidectomy for refractory hyperparathyroidism. The enlarged parathyroid gland and gland nodular transformation became refractory to medical therapy and patient need for parathyroidectomy. Tertiary hyperparathyroidism is a state of excessive secretion of parathyroid hormone after a long period of secondary hyperparathyroidism and renal transplantation. In this article, we present the case of a Caucasian male with chronic kidney disease (end-stage on chronic hemodialysis and after kidney transplantation and different forms of hyperparathyroidism (secondary and tertiary. Our case study shows that only a multi-interventional strategy is likely to be more effective treatment in cases of severe and refractory to medical therapy hyperparathyroidism.
Prefrontal rTMS for treating depression: location and intensity results from the OPT-TMS multi-site clinical trial.

Science.gov (United States)

Johnson, Kevin A; Baig, Mirza; Ramsey, Dave; Lisanby, Sarah H; Avery, David; McDonald, William M; Li, Xingbao; Bernhardt, Elisabeth R; Haynor, David R; Holtzheimer, Paul E; Sackeim, Harold A; George, Mark S; Nahas, Ziad

2013-03-01

Motor cortex localization and motor threshold determination often guide Transcranial Magnetic Stimulation (TMS) placement and intensity settings for non-motor brain stimulation. However, anatomic variability results in variability of placement and effective intensity. Post-study analysis of the OPT-TMS Study reviewed both the final positioning and the effective intensity of stimulation (accounting for relative prefrontal scalp-cortex distances). We acquired MRI scans of 185 patients in a multi-site trial of left prefrontal TMS for depression. Scans had marked motor sites (localized with TMS) and marked prefrontal sites (5 cm anterior of motor cortex by the "5 cm rule"). Based on a visual determination made before the first treatment, TMS therapy occurred either at the 5 cm location or was adjusted 1 cm forward. Stimulation intensity was 120% of resting motor threshold. The "5 cm rule" would have placed stimulation in premotor cortex for 9% of patients, which was reduced to 4% with adjustments. We did not find a statistically significant effect of positioning on remission, but no patients with premotor stimulation achieved remission (0/7). Effective stimulation ranged from 93 to 156% of motor threshold, and no seizures were induced across this range. Patients experienced remission with effective stimulation intensity ranging from 93 to 146% of motor threshold, and we did not find a significant effect of effective intensity on remission. Our data indicates that individualized positioning methods are useful to reduce variability in placement. Stimulation at 120% of motor threshold, unadjusted for scalp-cortex distances, appears safe for a broad range of patients. Copyright © 2013 Elsevier Inc. All rights reserved.
Optimal Siting of Charging Stations for Electric Vehicles Based on Fuzzy Delphi and Hybrid Multi-Criteria Decision Making Approaches from an Extended Sustainability Perspective

Directory of Open Access Journals (Sweden)

Huiru Zhao

2016-04-01

Full Text Available Optimal siting of electric vehicle charging stations (EVCSs is crucial to the sustainable development of electric vehicle systems. Considering the defects of previous heuristic optimization models in tackling subjective factors, this paper employs a multi-criteria decision-making (MCDM framework to address the issue of EVCS siting. The initial criteria for optimal EVCS siting are selected from extended sustainability theory, and the vital sub-criteria are further determined by using a fuzzy Delphi method (FDM, which consists of four pillars: economy, society, environment and technology perspectives. To tolerate vagueness and ambiguity of subjective factors and human judgment, a fuzzy Grey relation analysis (GRA-VIKOR method is employed to determine the optimal EVCS site, which also improves the conventional aggregating function of fuzzy Vlsekriterijumska Optimizacijia I Kompromisno Resenje (VIKOR. Moreover, to integrate the subjective opinions as well as objective information, experts’ ratings and Shannon entropy method are employed to determine combination weights. Then, the applicability of proposed framework is demonstrated by an empirical study of five EVCS site alternatives in Tianjin. The results show that A3 is selected as the optimal site for EVCS, and sub-criteria affiliated with environment obtain much more attentions than that of other sub-criteria. Moreover, sensitivity analysis indicates the selection results remains stable no matter how sub-criteria weights are changed, which verifies the robustness and effectiveness of proposed model and evaluation results. This study provides a comprehensive and effective method for optimal siting of EVCS and also innovates the weights determination and distance calculation for conventional fuzzy VIKOR.
Evaluating meteorological data from weather stations, and from satellites and global models for a multi-site epidemiological study.

Science.gov (United States)

Colston, Josh M; Ahmed, Tahmeed; Mahopo, Cloupas; Kang, Gagandeep; Kosek, Margaret; de Sousa Junior, Francisco; Shrestha, Prakash Sunder; Svensen, Erling; Turab, Ali; Zaitchik, Benjamin

2018-04-21

Longitudinal and time series analyses are needed to characterize the associations between hydrometeorological parameters and health outcomes. Earth Observation (EO) climate data products derived from satellites and global model-based reanalysis have the potential to be used as surrogates in situations and locations where weather-station based observations are inadequate or incomplete. However, these products often lack direct evaluation at specific sites of epidemiological interest. Standard evaluation metrics of correlation, agreement, bias and error were applied to a set of ten hydrometeorological variables extracted from two quasi-global, commonly used climate data products - the Global Land Data Assimilation System (GLDAS) and Climate Hazards Group InfraRed Precipitation with Stations (CHIRPS) - to evaluate their performance relative to weather-station derived estimates at the specific geographic locations of the eight sites in a multi-site cohort study. These metrics were calculated for both daily estimates and 7-day averages and for a rotavirus-peak-season subset. Then the variables from the two sources were each used as predictors in longitudinal regression models to test their association with rotavirus infection in the cohort after adjusting for covariates. The availability and completeness of station-based validation data varied depending on the variable and study site. The performance of the two gridded climate models varied considerably within the same location and for the same variable across locations, according to different evaluation criteria and for the peak-season compared to the full dataset in ways that showed no obvious pattern. They also differed in the statistical significance of their association with the rotavirus outcome. For some variables, the station-based records showed a strong association while the EO-derived estimates showed none, while for others, the opposite was true. Researchers wishing to utilize publicly available climate data
Multi-organ dysfunction in bodybuilding possibly caused by prolonged hypercalcemia due to multi-substance abuse: case report and review of literature.

Science.gov (United States)

Schäfer, C N; Guldager, H; Jørgensen, H L

2011-01-01

A 26-year-old male bodybuilder was admitted to the surgical department of a Danish community hospital for hematemesis. During the clinical interview, he revealed that he had recently finished a course of anabolic steroids and erythropoietin. The patient also had a previous history of infections and chronic ulcers due to paraffin-oil injections in both upper arms one year before. Over the course of the next few hours, the patient developed signs of multi-organ dysfunction, including pancreatitis, hemorrhagic gastritis, nephropathy with temporary anuria, and respiratory insufficiency, and was transferred to the ICU. After manometric monitoring on the patient's upper arms proved difficult, invasive blood pressure monitoring was used and revealed that the patient was in a state of hypertensive crisis. This case of multi-organ dysfunction was possibly caused by multi-substance-induced hypercalcemia. © Georg Thieme Verlag KG Stuttgart · New York.
Multi-segment foot kinematics and plantar fascia strain during treadmill and overground running

OpenAIRE

Sinclair, Jonathan Kenneth; Taylor, Paul John; Vincent, Hayley

2014-01-01

Although physiologically beneficial, running is known to be associated with a high incidence of chronic injuries. Excessive coronal and transverse plane motions of the foot segments and strain experienced by the plantar fascia are linked to the development of a number of chronic injuries. This study examined differences in multi-segment foot kinematics and plantar fascia strain during treadmill and overground running. Twelve male recreational runners ran at 4.0 m.s-1 in both treadmill and ove...
Homeopathy in chronic sinusitis: a prospective multi-centric observational study.

Science.gov (United States)

Nayak, Chaturbhuja; Singh, Vikram; Singh, V P; Oberai, Praveen; Roja, Varanasi; Shitanshu, Shashi Shekhar; Sinha, M N; Deewan, Deepti; Lakhera, B C; Ramteke, Sunil; Kaushik, Subhash; Sarkar, Sarabjit; Mandal, N R; Mohanan, P G; Singh, J R; Biswas, Sabyasachi; Mathew, Georgekutty

2012-04-01

The primary objective was to ascertain the therapeutic usefulness of homeopathic medicine in the management of chronic sinusitis (CS). Multicentre observational study at Institutes and Units of the Central Council for Research in Homoeopathy, India. Symptoms were assessed using the chronic sinusitis assessment score (CSAS). 17 pre-defined homeopathic medicines were shortlisted for prescription on the basis of repertorisation for the pathological symptoms of CS. Regimes and adjustment of regimes in the event of a change of symptoms were pre-defined. The follow-up period was for 6 months. Statistical analysis was done using SPSS version 16. 628 patients suffering from CS confirmed on X-ray were enrolled from eight Institutes and Units of the Central Council for Research in Homoeopathy. All 550 patients with at least one follow-up assessment were analyzed. There was a statistically significant reduction in CSAS (P = 0.0001, Friedman test) after 3 and 6 months of treatment. Radiological appearances also improved. A total of 13 out of 17 pre-defined medicines were prescribed in 550 patients, Sil. (55.2% of 210), Calc. (62.5% of 98), Lyc. (69% of 55), Phos. (66.7% of 45) and Kali iod. (65% of 40) were found to be most useful having marked improvement. 4/17 medicines were never prescribed. No complications were observed during treatment. Homeopathic treatment may be effective for CS patients. Controlled trials are required for further validation. Copyright © 2012 Elsevier Ltd. All rights reserved.
Port Site Infections After Laparoscopic Cholecystectomy

Directory of Open Access Journals (Sweden)

Mumtaz KH Al-Naser

2017-06-01

Full Text Available Background: Port site infection (PSI is an infrequent surgical site infection that complicates laparoscopic surgery but has a considerable influence in the overall outcome of laparoscopic cholecystectomy. The aim of this study was to evaluate factors that influence PSI after laparoscopic cholecystectomies and to analyze which of these factors can be modified to avoid PSI in a trail to achieve maximum laparoscopic advantages. Methods: A prospective descriptive qualitative study conducted on patients who underwent laparoscopic cholecystectomies. Swabs were taken for culture & sensitivity in all patients who developed PSI. Exploration under general anaesthesia, for patients, had deep surgical site infections and wound debridement was done, excisional biopsies had been taken for histopathological studies, and tissue samples for polymerase chain reaction for detection of mycobacterium tuberculosis was done. All patients were followed up for six months postoperatively. Factors as gender, site of infected port, type of microorganism, acute versus chronic cholecystitis, type of infection (superficial or deep infection and intraoperative spillage of stones, bile or pus were analyzed in our sample. Results: Port site infection rate was recorded in 40/889 procedures (4.5%, higher rates were observed in male patients 8/89 (8.9%, in acute cholecystitis 13/125 (10.4%, when spillage of bile, stones or pus occurred 24/80 (30%, and at epigastric port 32/40 (80%. Most of the PSI were superficial infections 77.5% with non-specific microorganism 34/40 (85%. Conclusion: There is a significant association of port site infection with spillage of bile, stones, or pus, with the port of gallbladder extraction and with acute cholecystitis. Especial consideration should be taken in chronic deep surgical site infection as mycobacterium tuberculosis could be the cause. Most of the PSIs are superficial and more common in males.
Multi-frac test series. Final report

Energy Technology Data Exchange (ETDEWEB)

Schmidt, R A; Warpinski, N R; Finley, S J; Shear, R C

1981-11-01

This paper describes a series of five full-scale tests performed to evaluate various multi-frac concepts. The tests were conducted at the Nevada Test Site in horizontal boreholes drilled in ash-fall tuff from a tunnel under 1300 ft of overburden.

Chronic obstructive pulmonary disease and cancer risk

DEFF Research Database (Denmark)

Kornum, Jette Brommann; Sværke, Claus; Thomsen, Reimar Wernich

2012-01-01

Little is known about the risk of cancer in patients with chronic obstructive pulmonary disease (COPD), including which cancer sites are most affected. We examined the short- and long-term risk of lung and extrapulmonary cancer in a nationwide cohort of COPD patients....
A multi-site study on medical school selection, performance, motivation and engagement.

Science.gov (United States)

Wouters, A; Croiset, G; Schripsema, N R; Cohen-Schotanus, J; Spaai, G W G; Hulsman, R L; Kusurkar, R A

2017-05-01

Medical schools seek ways to improve their admissions strategies, since the available methods prove to be suboptimal for selecting the best and most motivated students. In this multi-site cross-sectional questionnaire study, we examined the value of (different) selection procedures compared to a weighted lottery procedure, which includes direct admission based on top pre-university grade point averages (≥8 out of 10; top-pu-GPA). We also considered whether students had participated in selection, prior to being admitted through weighted lottery. Year-1 (pre-clinical) and Year-4 (clinical) students completed standard validated questionnaires measuring quality of motivation (Academic Self-regulation Questionnaire), strength of motivation (Strength of Motivation for Medical School-Revised) and engagement (Utrecht Work Engagement Scale-Student). Performance data comprised GPA and course credits in Year-1 and clerkship performance in Year-4. Regression analyses were performed. The response rate was 35% (387 Year-1 and 273 Year-4 students). Top-pu-GPA students outperformed selected students. Selected Year-1 students reported higher strength of motivation than top-pu-GPA students. Selected students did not outperform or show better quality of motivation and engagement than lottery-admitted students. Participation in selection was associated with higher engagement and better clerkship performance in Year-4. GPA, course credits and strength of motivation in Year-1 differed between students admitted through different selection procedures. Top-pu-GPA students perform best in the medical study. The few and small differences found raise questions about the added value of an extensive selection procedure compared to a weighted lottery procedure. Findings have to be interpreted with caution because of a low response rate and small group sizes.
Optimal site selection for sitting a solar park using multi-criteria decision analysis and geographical information systems

Science.gov (United States)

Georgiou, Andreas; Skarlatos, Dimitrios

2016-07-01

Among the renewable power sources, solar power is rapidly becoming popular because it is inexhaustible, clean, and dependable. It has also become more efficient since the power conversion efficiency of photovoltaic solar cells has increased. Following these trends, solar power will become more affordable in years to come and considerable investments are to be expected. Despite the size of solar plants, the sitting procedure is a crucial factor for their efficiency and financial viability. Many aspects influence such a decision: legal, environmental, technical, and financial to name a few. This paper describes a general integrated framework to evaluate land suitability for the optimal placement of photovoltaic solar power plants, which is based on a combination of a geographic information system (GIS), remote sensing techniques, and multi-criteria decision-making methods. An application of the proposed framework for the Limassol district in Cyprus is further illustrated. The combination of a GIS and multi-criteria methods produces an excellent analysis tool that creates an extensive database of spatial and non-spatial data, which will be used to simplify problems as well as solve and promote the use of multiple criteria. A set of environmental, economic, social, and technical constrains, based on recent Cypriot legislation, European's Union policies, and expert advice, identifies the potential sites for solar park installation. The pairwise comparison method in the context of the analytic hierarchy process (AHP) is applied to estimate the criteria weights in order to establish their relative importance in site evaluation. In addition, four different methods to combine information layers and check their sensitivity were used. The first considered all the criteria as being equally important and assigned them equal weight, whereas the others grouped the criteria and graded them according to their objective perceived importance. The overall suitability of the study
A novel flexible cuff-like microelectrode for dual purpose, acute and chronic electrical interfacing with the mouse cervical vagus nerve

Science.gov (United States)

Caravaca, A. S.; Tsaava, T.; Goldman, L.; Silverman, H.; Riggott, G.; Chavan, S. S.; Bouton, C.; Tracey, K. J.; Desimone, R.; Boyden, E. S.; Sohal, H. S.; Olofsson, P. S.

2017-12-01

Objective. Neural reflexes regulate immune responses and homeostasis. Advances in bioelectronic medicine indicate that electrical stimulation of the vagus nerve can be used to treat inflammatory disease, yet the understanding of neural signals that regulate inflammation is incomplete. Current interfaces with the vagus nerve do not permit effective chronic stimulation or recording in mouse models, which is vital to studying the molecular and neurophysiological mechanisms that control inflammation homeostasis in health and disease. We developed an implantable, dual purpose, multi-channel, flexible ‘microelectrode’ array, for recording and stimulation of the mouse vagus nerve. Approach. The array was microfabricated on an 8 µm layer of highly biocompatible parylene configured with 16 sites. The microelectrode was evaluated by studying the recording and stimulation performance. Mice were chronically implanted with devices for up to 12 weeks. Main results. Using the microelectrode in vivo, high fidelity signals were recorded during physiological challenges (e.g potassium chloride and interleukin-1β), and electrical stimulation of the vagus nerve produced the expected significant reduction of blood levels of tumor necrosis factor (TNF) in endotoxemia. Inflammatory cell infiltration at the microelectrode 12 weeks of implantation was limited according to radial distribution analysis of inflammatory cells. Significance. This novel device provides an important step towards a viable chronic interface for cervical vagus nerve stimulation and recording in mice.
SLAC site design aesthetics

International Nuclear Information System (INIS)

Hall, F.F.

1985-10-01

Stanford Linear Accelerator Center (SLAC) is a single mission laboratory dedicated to basic research in high energy particle physics. SLAC site also houses Stanford Synchrotron Radiation Laboratory (SSRL) which is a multi-mission laboratory for research using beams of ultraviolet light and low energy photons as emitted tangentially from SLAC colliding beam facilities. This paper discusses various aspects of SLAC site design aesthetics under the following headings: (1) imposed footprint of SLAC, (2) description of selected site, (3) use of earth cover for radiation and sight screens, (4) use of landscaping for cosmetic purposes, (5) use of exterior paint colors to soften SLAC impact on neighbors, (6) relocation of SLAC main entrance, (7) relocation of SLAC collider arcs and experimental hall, (8) parking lots and storage yards, and (9) land use zoning at SLAC
Technical know-how of site descriptive modeling for site characterization - 59089

International Nuclear Information System (INIS)

Saegusa, Hiromitsu; Onoe, Hironori; Doke, Ryosuke; Niizato, Tadafumi; Yasue, Ken-ichi

2012-01-01

The site descriptive model covering the current status of characteristics of geological environment and the site evolution model for estimation of the long-term evolution of site conditions are used to integrate multi-disciplinary investigation results. It is important to evaluate uncertainties in the models, to specify issues regarding the uncertainties and to prioritize the resolution of specified issues, for the planning of site characterization. There is a large quantity of technical know-how in the modeling process. It is important to record the technical know-how with transparency and traceability, since site characterization projects generally need long duration. The transfer of the technical know-how accumulated in the research and development (R and D) phase to the implementation phase is equally important. The aim of this study is to support the planning of initial surface-based site characterizations based on the technical know-how accumulated from the underground research laboratory projects. These projects are broad scientific studies of the deep geological environment and provide a technical basis for the geological disposal of high-level radioactive wastes. In this study, a comprehensive task flow from acquisition of existing data to planning of field investigations through the modeling has been specified. Specific task flow and decision-making process to perform the tasks have been specified. (authors)
Common acute and chronic musculoskeletal injuries among female ...

African Journals Online (AJOL)

The hip/lower back was the most prevalent anatomical site of chronic musculoskeletal injury. (p<0.001). The intrinsic ..... Musculoskeletal disorders among nursing personnel in Korea. Int J ... Marieb E. Human Anatomy and Physiology. 7th ed.
Open source electronic health records and chronic disease management.

Science.gov (United States)

Goldwater, Jason C; Kwon, Nancy J; Nathanson, Ashley; Muckle, Alison E; Brown, Alexa; Cornejo, Kerri

2014-02-01

To study and report on the use of open source electronic health records (EHR) to assist with chronic care management within safety net medical settings, such as community health centers (CHC). The study was conducted by NORC at the University of Chicago from April to September 2010. The NORC team undertook a comprehensive environmental scan, including a literature review, a dozen key informant interviews using a semistructured protocol, and a series of site visits to CHC that currently use an open source EHR. Two of the sites chosen by NORC were actively using an open source EHR to assist in the redesign of their care delivery system to support more effective chronic disease management. This included incorporating the chronic care model into an CHC and using the EHR to help facilitate its elements, such as care teams for patients, in addition to maintaining health records on indigent populations, such as tuberculosis status on homeless patients. The ability to modify the open-source EHR to adapt to the CHC environment and leverage the ecosystem of providers and users to assist in this process provided significant advantages in chronic care management. Improvements in diabetes management, controlled hypertension and increases in tuberculosis vaccinations were assisted through the use of these open source systems. The flexibility and adaptability of open source EHR demonstrated its utility and viability in the provision of necessary and needed chronic disease care among populations served by CHC.
RNF4 interacts with multiSUMOylated ETV4 [version 2; referees: 2 approved

Directory of Open Access Journals (Sweden)

Elisa Aguilar-Martinez

2017-02-01

Full Text Available Protein SUMOylation represents an important regulatory event that changes the activities of numerous proteins. Recent evidence demonstrates that polySUMO chains can act as a trigger to direct the ubiquitin ligase RNF4 to substrates to cause their turnover through the ubiquitin pathway. RNF4 uses multiple SUMO interaction motifs (SIMs to bind to these chains. However, in addition to polySUMO chains, a multimeric binding surface created by the simultaneous SUMOylation of multiple residues on a protein or complex could also provide a platform for the recruitment of multi-SIM proteins like RNF4. Here we demonstrate that multiSUMOylated ETV4 can bind to RNF4 and that a unique combination of SIMs is required for RNF4 to interact with this multiSUMOylated platform. Thus RNF4 can bind to proteins that are either polySUMOylated through a single site or multiSUMOylated on several sites and raises the possibility that such multiSIM-multiSUMO interactions might be more widespread.
Rationale and design of the Study of a Tele-pharmacy Intervention for Chronic diseases to Improve Treatment adherence (STIC2IT): A cluster randomized pragmatic trial

Science.gov (United States)

Choudhry, Niteesh K.; Isaac, Thomas; Lauffenburger, Julie C.; Gopalakrishnan, Chandrasekar; Khan, Nazleen F.; Lee, Marianne; Vachon, Amy; Iliadis, Tanya L.; Hollands, Whitney; Doheny, Scott; Elman, Sandra; Kraft, Jacqueline M.; Naseem, Samrah; Gagne, Joshua J.; Jackevicius, Cynthia A.; Fischer, Michael A.; Solomon, Daniel H.; Sequist, Thomas D.

2016-01-01

Background Approximately half of patients with chronic cardiometabolic conditions are non-adherent with their prescribed medications. Interventions to improve adherence have been only modestly effective because they often address single barriers to adherence, intervene at single points in time, or are imprecisely targeted to patients who may or may not need adherence assistance. Objective To evaluate the effect of a multi-component, behaviorally-tailored pharmacist-based intervention to improve adherence to medications for diabetes, hypertension, and hyperlipidemia. Trial design The STIC2IT (Study of a Tele-pharmacy Intervention for Chronic diseases To Improve Treatment adherence) trial is a cluster-randomized pragmatic trial testing the impact of a pharmacist-led multi-component intervention that uses behavioral interviewing, text messaging, mailed progress reports and video visits. Targeted patients are those who are non-adherent to glucose-lowering, anti-hypertensive, or statin medications and who also have evidence of poor disease control. The intervention is tailored to patients’ individual health barriers and their level of health activation. We cluster randomized 14 practice sites of a large multi-specialty group practice to receive either the pharmacist-based intervention or usual care. STIC2IT has enrolled 4,076 patients to be followed for 12 months after randomization. The trial’s primary outcome is medication adherence, assessed using pharmacy claims data. Secondary outcomes are disease control and healthcare resource utilization. Conclusion This trial will determine whether a technologically-enabled, behaviorally-targeted pharmacist-based intervention results in improved adherence and disease control. If effective, this strategy could be a scalable method of offering tailored adherence support to those with the greatest clinical need. PMID:27659887
Principles and strategies for monitoring data collection integrity in a multi-site randomized clinical trial of a behavioral intervention.

Science.gov (United States)

Phillips-Salimi, Celeste R; Donovan Stickler, Molly A; Stegenga, Kristin; Lee, Melissa; Haase, Joan E

2011-08-01

Although treatment fidelity strategies for enhancing the integrity of behavioral interventions have been well described, little has been written about monitoring data collection integrity. This article describes the principles and strategies developed to monitor data collection integrity of the "Stories and Music for Adolescent/Young Adult Resilience During Transplant" study (R01NR008583, U10CA098543, and U10CA095861)-a multi-site Children's Oncology Group randomized clinical trial of a music therapy intervention for adolescents and young adults undergoing stem cell transplant. The principles and strategies outlined in this article provide one model for development and evaluation of a data collection integrity monitoring plan for behavioral interventions that may be adapted by investigators and may be useful to funding agencies and grant application reviewers in evaluating proposals. Copyright © 2011 Wiley Periodicals, Inc.
Multi-donor Research Platform on Social Protection, Financial ...

International Development Research Centre (IDRC) Digital Library (Canada)

Multi-donor Research Platform on Social Protection, Financial Inclusion and ICTs ... been some experiments linking a financial inclusion component to CCT programs, ... Institution. Universidad de Chile. Pays d' institution. Chile. Site internet.
Prevalence and correlates of ENDS use among adults being treated for chronic lung disease

OpenAIRE

Meghan Moran; Shyam Biswal; Joanna Cohen; Robert Henderson; Janet Holbrook; Venkataramana Sidhaye; Robert Wise

2018-01-01

Background Chronic lung disease such as asthma or COPD may be exacerbated by electronic nicotine device (ENDS) use. Despite this, little is known about the extent to which adults with chronic lung disease use ENDS and what factors are associated with use. Methods We analyzed data from the second wave of the Population Assessment of Tobacco and Health (PATH) study. The PATH study recruited 28,362 U.S. adults over the age of 18 using a multi-stage randomized sampli...
Development of a chronic care ostomy self-management program.

Science.gov (United States)

Grant, Marcia; McCorkle, Ruth; Hornbrook, Mark C; Wendel, Christopher S; Krouse, Robert

2013-03-01

Each year a percentage of the 1.2 million men and women in the United States with a new diagnosis of colorectal cancer join the 700,000 people who have an ostomy. Education targeting the long-term, chronic care of this population is lacking. This report describes the development of a Chronic Care Ostomy Self-Management Program, which was informed by (1) evidence on published quality-of-life changes for cancer patients with ostomies, (2) educational suggestions from patients with ostomies, and (3) examination of the usual care of new ostomates to illustrate areas for continued educational emphases and areas for needed education and support. Using these materials, the Chronic Care Ostomy Self-Management Program was developed by a team of multi-disciplinary researchers accompanied by experienced ostomy nurses. Testing of the program is in process. Pilot study participants reported high satisfaction with the program syllabus, ostomy nurse leaders, and ostomate peer buddies.
Development of a Chronic Care Ostomy Self Management Program

Science.gov (United States)

Grant, Marcia; McCorkle, Ruth; Hornbrook, Mark C.; Wendel, Christopher S.; Krouse, Robert

2012-01-01

Each year a percentage of the 1.2 million men and women in the United States with a new diagnosis of colorectal cancer join the 700,000 people who have an ostomy. Education targeting the long term, chronic care of this population is lacking. This report describes the development of a Chronic Care Ostomy Self Management Program, which was informed by (1) evidence on published quality of life changes for cancer patients with ostomies, (2) educational suggestions from patients with ostomies, and (3) examination of the usual care of new ostomates to illustrate areas for continued educational emphases and areas for needed education and support. Using these materials, the Chronic Care Ostomy Self Management Program was developed by a team of multi-disciplinary researchers accompanied by experienced ostomy nurses. Testing of the program is in process. Pilot study participants reported high satisfaction with the program syllabus, ostomy nurse leaders, and ostomate peer buddies. PMID:23104143
Predicting protein-ATP binding sites from primary sequence through fusing bi-profile sampling of multi-view features

Directory of Open Access Journals (Sweden)

Zhang Ya-Nan

2012-05-01

Full Text Available Abstract Background Adenosine-5′-triphosphate (ATP is one of multifunctional nucleotides and plays an important role in cell biology as a coenzyme interacting with proteins. Revealing the binding sites between protein and ATP is significantly important to understand the functionality of the proteins and the mechanisms of protein-ATP complex. Results In this paper, we propose a novel framework for predicting the proteins’ functional residues, through which they can bind with ATP molecules. The new prediction protocol is achieved by combination of sequence evolutional information and bi-profile sampling of multi-view sequential features and the sequence derived structural features. The hypothesis for this strategy is single-view feature can only represent partial target’s knowledge and multiple sources of descriptors can be complementary. Conclusions Prediction performances evaluated by both 5-fold and leave-one-out jackknife cross-validation tests on two benchmark datasets consisting of 168 and 227 non-homologous ATP binding proteins respectively demonstrate the efficacy of the proposed protocol. Our experimental results also reveal that the residue structural characteristics of real protein-ATP binding sites are significant different from those normal ones, for example the binding residues do not show high solvent accessibility propensities, and the bindings prefer to occur at the conjoint points between different secondary structure segments. Furthermore, results also show that performance is affected by the imbalanced training datasets by testing multiple ratios between positive and negative samples in the experiments. Increasing the dataset scale is also demonstrated useful for improving the prediction performances.
Bacterial population and biodegradation potential in chronically crude oil-contaminated marine sediments are strongly linked to temperature

KAUST Repository

Bargiela, Rafael

2015-06-29

Two of the largest crude oil-polluted areas in the world are the semi-enclosed Mediterranean and Red Seas, but the effect of chronic pollution remains incompletely understood on a large scale. We compared the influence of environmental and geographical constraints and anthropogenic forces (hydrocarbon input) on bacterial communities in eight geographically separated oil-polluted sites along the coastlines of the Mediterranean and Red Seas. The differences in community compositions and their biodegradation potential were primarily associated (P < 0.05) with both temperature and chemical diversity. Furthermore, we observed a link between temperature and chemical and biological diversity that was stronger in chronically polluted sites than in pristine ones where accidental oil spills occurred. We propose that low temperature increases bacterial richness while decreasing catabolic diversity and that chronic pollution promotes catabolic diversification. Our results further suggest that the bacterial populations in chronically polluted sites may respond more promptly in degrading petroleum after accidental oil spills.
Bacterial population and biodegradation potential in chronically crude oil-contaminated marine sediments are strongly linked to temperature

KAUST Repository

Bargiela, Rafael; Mapelli, Francesca; Rojo, David; Chouaia, Bessem; Torné s, Jesú s; Borin, Sara; Richter, Michael; Del Pozo, Mercedes V.; Cappello, Simone; Gertler, Christoph; Genovese, Marí a; Denaro, Renata; Martí nez-Martí nez, Mó nica; Fodelianakis, Stilianos; Amer, Ranya A.; Bigazzi, David; Han, Xifang; Chen, Jianwei; Chernikova, Tatyana N.; Golyshina, Olga V.; Mahjoubi, Mouna; Jaouanil, Atef; Benzha, Fatima; Magagnini, Mirko; Hussein, Emad; Al-Horani, Fuad; Cherif, Ameur; Blaghen, Mohamed; Abdel-Fattah, Yasser R.; Kalogerakis, Nicolas; Barbas, Coral; Malkawi, Hanan I.; Golyshin, Peter N.; Yakimov, Michail M.; Daffonchio, Daniele; Ferrer, Manuel

2015-01-01

Two of the largest crude oil-polluted areas in the world are the semi-enclosed Mediterranean and Red Seas, but the effect of chronic pollution remains incompletely understood on a large scale. We compared the influence of environmental and geographical constraints and anthropogenic forces (hydrocarbon input) on bacterial communities in eight geographically separated oil-polluted sites along the coastlines of the Mediterranean and Red Seas. The differences in community compositions and their biodegradation potential were primarily associated (P < 0.05) with both temperature and chemical diversity. Furthermore, we observed a link between temperature and chemical and biological diversity that was stronger in chronically polluted sites than in pristine ones where accidental oil spills occurred. We propose that low temperature increases bacterial richness while decreasing catabolic diversity and that chronic pollution promotes catabolic diversification. Our results further suggest that the bacterial populations in chronically polluted sites may respond more promptly in degrading petroleum after accidental oil spills.
Emerging chronic non-communicable diseases in rural communities of Northern Ethiopia: evidence using population-based verbal autopsy method in Kilite Awlaelo surveillance site.

Science.gov (United States)

Weldearegawi, Berhe; Ashebir, Yemane; Gebeye, Ejigu; Gebregziabiher, Tesfay; Yohannes, Mekonnen; Mussa, Seid; Berhe, Haftu; Abebe, Zerihun

2013-12-01

In countries where most deaths are outside health institutions and medical certification of death is absent, verbal autopsy (VA) method is used to estimate population level causes of death. VA data were collected by trained lay interviewers for 409 deaths in the surveillance site. Two physicians independently assigned cause of death using the International Classification of Diseases manual. In general, infectious and parasitic diseases accounted for 35.9% of death, external causes 15.9%, diseases of the circulatory system 13.4% and perinatal causes 12.5% of total deaths. Mortalities attributed to maternal causes and malnutrition were low, 0.2 and 1.5%, respectively. Causes of death varied by age category. About 22.1, 12.6 and 8.4% of all deaths of under 5-year-old children were due to bacterial sepsis of the newborn, acute lower respiratory infections such as neonatal pneumonia and prematurity including respiratory distress, respectively. For 5-15-year-old children, accidental drowning and submersion, accounting for 34.4% of all deaths in this age category, and accidental fall, accounting for 18.8%, were leading causes of death. Among 15-49-year-old adults, HIV/AIDS (16.3%) and tuberculosis (12.8%) were commonest causes of death, whereas tuberculosis and cerebrovascular diseases were major killers of those aged 50 years and above. In the rural district, mortality due to chronic non-communicable diseases was very high. The observed magnitude of death from chronic non-communicable disease is unlikely to be unique to this district. Thus, formulation of chronic disease prevention and control strategies is recommended.
Estimating Cross-Site Impact Variation in the Presence of Heteroscedasticity

Science.gov (United States)

Bloom, Howard S.; Porter, Kristin E.; Weiss, Michael J.; Raudenbush, Stephen

2013-01-01

To date, evaluation research and policy analysis have focused mainly on average program impacts and paid little systematic attention to their variation. Recently, the growing number of multi-site randomized trials that are being planned and conducted make it increasingly feasible to study "cross-site" variation in impacts. Important…

Minimizing impacts of land use change on ecosystem services using multi-criteria heuristic analysis.

Science.gov (United States)

Keller, Arturo A; Fournier, Eric; Fox, Jessica

2015-06-01

Development of natural landscapes to support human activities impacts the capacity of the landscape to provide ecosystem services. Typically, several ecosystem services are impacted at a single development site and various footprint scenarios are possible, thus a multi-criteria analysis is needed. Restoration potential should also be considered for the area surrounding the permanent impact site. The primary objective of this research was to develop a heuristic approach to analyze multiple criteria (e.g. impacts to various ecosystem services) in a spatial configuration with many potential development sites. The approach was to: (1) quantify the magnitude of terrestrial ecosystem service (biodiversity, carbon sequestration, nutrient and sediment retention, and pollination) impacts associated with a suite of land use change scenarios using the InVEST model; (2) normalize results across categories of ecosystem services to allow cross-service comparison; (3) apply the multi-criteria heuristic algorithm to select sites with the least impact to ecosystem services, including a spatial criterion (separation between sites). As a case study, the multi-criteria impact minimization algorithm was applied to InVEST output to select 25 potential development sites out of 204 possible locations (selected by other criteria) within a 24,000 ha property. This study advanced a generally applicable spatial multi-criteria approach for 1) considering many land use footprint scenarios, 2) balancing impact decisions across a suite of ecosystem services, and 3) determining the restoration potential of ecosystem services after impacts. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Multi-targeted therapy for leprosy: insilico strategy to overcome multi drug resistance and to improve therapeutic efficacy.

Science.gov (United States)

Anusuya, Shanmugam; Natarajan, Jeyakumar

2012-12-01

Leprosy remains a major public health problem, since single and multi-drug resistance has been reported worldwide over the last two decades. In the present study, we report the novel multi-targeted therapy for leprosy to overcome multi drug resistance and to improve therapeutic efficacy. If multiple enzymes of an essential metabolic pathway of a bacterium were targeted, then the therapy would become more effective and can prevent the occurrence of drug resistance. The MurC, MurD, MurE and MurF enzymes of peptidoglycan biosynthetic pathway were selected for multi targeted therapy. The conserved or class specific active site residues important for function or stability were predicted using evolutionary trace analysis and site directed mutagenesis studies. Ten such residues which were present in at least any three of the four Mur enzymes (MurC, MurD, MurE and MurF) were identified. Among the ten residues G125, K126, T127 and G293 (numbered based on their position in MurC) were found to be conserved in all the four Mur enzymes of the entire bacterial kingdom. In addition K143, T144, T166, G168, H234 and Y329 (numbered based on their position in MurE) were significant in binding substrates and/co-factors needed for the functional events in any three of the Mur enzymes. These are the probable residues for designing newer anti-leprosy drugs in an attempt to reduce drug resistance. Copyright © 2012 Elsevier B.V. All rights reserved.
Site of iodination in hyperplastic thyroid glands deduced from autoradiographs

International Nuclear Information System (INIS)

Wollman, S.H.; Ekholm, R.

1981-01-01

We have tried to ascertain the site of iodination in the chronically stimulated, hyperplastic thyroid gland of rats. Rats were fed propylthiouracil in a commercial rat diet for 10 days. Then the diet was changed to a low iodine diet for 5 days. To label the gland, 10 mCi of 125I-iodide was injected into the left heart ventricle. Ten seconds later the animal was perfused through the left ventricle with a fixative solution containing a goitrogen to block further iodination, and stable iodide to help extract uncombined radioiodide. Electron microscopic autoradiographs prepared from the fixed thyroids show strong labeling over the lumen of the follicle and no consistent labeling of any other site or organelle. We conclude that the site of iodination in the chronically stimulated, hyperplastic thyroid is the follicular lumen, i.e. the same as that in the normal gland
Peer Influence on Ethnic-Racial Identity Development: A Multi-Site Investigation.

Science.gov (United States)

Santos, Carlos E; Kornienko, Olga; Rivas-Drake, Deborah

2017-05-01

The peer context features prominently in theory, and increasingly in empirical research, about ethnic-racial identity (ERI) development, but no studies have assessed peer influence on ERI using methods designed to properly assess peer influence. We examined peer influence on ERI centrality, private, and public regard using longitudinal social network analysis. Data were drawn from two sites: a predominantly Latina/o Southwestern (SW) school (N = 1034; Mage = 12.10) and a diverse Midwestern (MW) school (N = 513; Mage = 11.99). Findings showed that peers influenced each other's public regard over time at both sites. However, peer influence on centrality was evident in the SW site, whereas peer influence on private regard was evident in the MW site. Importantly, peer influence was evident after controlling for selection effects. Our integration of developmental, contextual, and social network perspectives offers a fruitful approach to explicate how ERI content may shift in early adolescence as a function of peer influence. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.
Chronic Spinal Injury Repair by Olfactory Bulb Ensheathing Glia and Feasibility for Autologous Therapy

Science.gov (United States)

Muñoz-Quiles, Cintia; Santos-Benito, Fernando F.; Llamusí, M. Beatriz; Ramón-Cueto, Almudena

2009-01-01

Olfactory bulb ensheathing glia (OB-OEG) promote repair of spinal cord injury (SCI) in rats after transplantation at acute or subacute (up to 45 days) stages. The most relevant clinical scenario in humans, however, is chronic SCI, in which no more major cellular or molecular changes occur at the injury site; this occurs after the third month in rodents. Whether adult OB-OEG grafts promote repair of severe chronic SCI has not been previously addressed. Rats with complete SCI that were transplanted with OB-OEG 4 months after injury exhibited progressive improvement in motor function and axonal regeneration from different brainstem nuclei across and beyond the SCI site. A positive correlation between motor outcome and axonal regeneration suggested a role for brainstem neurons in the recovery. Functional and histological outcomes did not differ at subacute or chronic stages. Thus, autologous transplantation is a feasible approach as there is time for patient stabilization and OEG preparation in human chronic SCI; the healing effects of OB-OEG on established injuries may offer new therapeutic opportunities for chronic SCI patients. PMID:19915486
Development and Application of SITES

International Nuclear Information System (INIS)

Park, Jo Wan; Yoon; Yoon, Jeong Hyoun; Kim, Chank Lak; Cho, Sung IL

2008-01-01

SITES (Site Information and Total Environmental Data Management System) has been developed for the purpose of systematically managing site characteristics and environmental data produced during the pre-operational, operational, and post-closure phases of a radioactive waste disposal facility. SITES is an integration system, which consists of 4 modules, to be available for maintenance of site characteristics data, for safety assessment, and for site/environment monitoring; site environmental data management module (SECURE), integrated safety assessment module (SAINT), site/environment monitoring module (SUDAL) and geological information module for geological data management (SITES-GIS). Each module has its database with the functions of browsing, storing, and reporting data and information. Data from SECURE and SUDAL are interconnected to be utilized as inputs to SAINT. SAINT has the functions that multi-user can access simultaneously via client-server system, and the safety assessment results can be managed with its embedded Quality Assurance feature. Comparison between assessment results and environmental monitoring data can be made and visualized in SUDAL and SITES-GIS. Also, SUDAL is designed that the periodic monitoring data and information could be opened to the public via internet homepage. SITES has applied to the Wolsong low- and intermediate-level radioactive waste disposal center in Korea, and is expected to enhance the function of site/environment monitoring in other nuclear-related facilities and also in industrial facilities handling hazardous materials.
Multi criteria analysis in environmental management: Selecting the best stormwater erosion and sediment control measure in Malaysian construction sites

Energy Technology Data Exchange (ETDEWEB)

Al-Hadu, Ibrahiem Abdul Razak; Sidek, Lariyah Mohd; Desa, Mohamed Nor Mohamed [Civil Engineering, Universiti Tenga Nasional, Kajang, Selangor (Malaysia); Basri, Noor Ezlin Ahmad [Civil and Structural Engineering, Universiti Kebangsaan Malyasia, Bangi, Selangor (Malaysia)

2011-07-01

Malaysia located in a tropical region which is interested with a heavy rainfall through the whole seasons of the year. Construction stages usually associated with soil disturbing due to land clearing and grading activities, this combined with the tropical climate in Malaysia, will generate an enormous amount of soil to be eroded and then deposited in the adjacent water bodies. There are many kinds of mitigation measures used so as to reduce the impact of erosion and sedimentation that are generated due to the stormwater in construction sites. This paper presents the application of Multi Criteria Analysis (MCA) tool in choosing the best stormwater control measure by depending on specified criteria and criterion weight. The results obtained from the application of MCA in stormwater pollution control have many benefits to the contractors, consultants and decision makers by making them able to select the best control measure for every stage of construction.
Environmental assessment for the reuse of TNX as a multi-purpose pilot plant campus at the Savannah River Site

International Nuclear Information System (INIS)

1998-07-01

The Department of Energy (DOE) prepared this environmental assessment (EA) to analyze the potential environmental and safety impacts of DOE planning to allow asset reuse of the TNX Area at the Savannah River Site (SRS) located near Aiken, South Carolina. The proposed action would include providing for a location for the Centers of Excellence at or adjacent to SRS and entering into a cooperative agreement with a non-profit management and operations (management firm) contractor to operate and market the TNX facilities and equipment. The area (formerly TNX) would be called a Multi-Purpose Pilot Plant Campus (MPPC) and would be used: (1) as location for technology research, development, demonstration, and commercial operations; (2) to establish partnerships with industry to develop applied technologies for commercialization; and (3) serve as administrative headquarters for Centers of Excellence in the program areas of soil remediation, radioecology, groundwater contamination, and municipal solid waste minimization
Repeated assessment of orthotopic glioma pO2 by multi-site EPR oximetry: A technique with the potential to guide therapeutic optimization by repeated measurements of oxygen

Science.gov (United States)

Khan, Nadeem; Mupparaju, Sriram; Hou, Huagang; Williams, Benjamin B.; Swartz, Harold

2011-01-01

Tumor hypoxia plays a vital role in therapeutic resistance. Consequently, measurements of tumor pO2 could be used to optimize the outcome of oxygen-dependent therapies, such as, chemoradiation. However, the potential optimizations are restricted by the lack of methods to repeatedly and quantitatively assess tumor pO2 during therapies, particularly in gliomas. We describe the procedures for repeated measurements of orthotopic glioma pO2 by multi-site electron paramagnetic resonance (EPR) oximetry. This oximetry approach provides simultaneous measurements of pO2 at more than one site in the glioma and contralateral cerebral tissue. The pO2 of intracerebral 9L, C6, F98 and U251 tumors, as well as contralateral brain, were measured repeatedly for five consecutive days. The 9L glioma was well oxygenated with pO2 of 27 - 36 mm Hg, while C6, F98 and U251 glioma were hypoxic with pO2 of 7 - 12 mm Hg. The potential of multi-site EPR oximetry to assess temporal changes in tissue pO2 was investigated in rats breathing 100% O2. A significant increase in F98 tumor and contralateral brain pO2 was observed on day 1 and day 2, however, glioma oxygenation declined on subsequent days. In conclusion, EPR oximetry provides the capability to repeatedly assess temporal changes in orthotopic glioma pO2. This information could be used to test and optimize the methods being developed to modulate tumor hypoxia. Furthermore, EPR oximetry could be potentially used to enhance the outcome of chemoradiation by scheduling treatments at times of increase in glioma pO2. PMID:22079559
Bacterial population and biodegradation potential in chronically crude oil-contaminated marine sediments are strongly linked to temperature.

Science.gov (United States)

Bargiela, Rafael; Mapelli, Francesca; Rojo, David; Chouaia, Bessem; Tornés, Jesús; Borin, Sara; Richter, Michael; Del Pozo, Mercedes V; Cappello, Simone; Gertler, Christoph; Genovese, María; Denaro, Renata; Martínez-Martínez, Mónica; Fodelianakis, Stilianos; Amer, Ranya A; Bigazzi, David; Han, Xifang; Chen, Jianwei; Chernikova, Tatyana N; Golyshina, Olga V; Mahjoubi, Mouna; Jaouanil, Atef; Benzha, Fatima; Magagnini, Mirko; Hussein, Emad; Al-Horani, Fuad; Cherif, Ameur; Blaghen, Mohamed; Abdel-Fattah, Yasser R; Kalogerakis, Nicolas; Barbas, Coral; Malkawi, Hanan I; Golyshin, Peter N; Yakimov, Michail M; Daffonchio, Daniele; Ferrer, Manuel

2015-06-29

Two of the largest crude oil-polluted areas in the world are the semi-enclosed Mediterranean and Red Seas, but the effect of chronic pollution remains incompletely understood on a large scale. We compared the influence of environmental and geographical constraints and anthropogenic forces (hydrocarbon input) on bacterial communities in eight geographically separated oil-polluted sites along the coastlines of the Mediterranean and Red Seas. The differences in community compositions and their biodegradation potential were primarily associated (P polluted sites than in pristine ones where accidental oil spills occurred. We propose that low temperature increases bacterial richness while decreasing catabolic diversity and that chronic pollution promotes catabolic diversification. Our results further suggest that the bacterial populations in chronically polluted sites may respond more promptly in degrading petroleum after accidental oil spills.
Architecture and Development of DCMP Web Site

Science.gov (United States)

Bariakhtar, Irina

2003-03-01

The multi-tier implementation of DCMP Web site is discussed. It is based upon newly developed PHP technology. The technology allows for creating dynamic content and scalable solutions for Web site capabilities. There are several aspects as to what type of information is to be on the site. First, it should serve the immediate needs of the researchers in the field, namely, conferences, journals, news, funds, etc. This is currently available on the site, but can be extended and improved if needed. Second, the site will reflect the connection between Condensed matter physics and the technological breakthroughs that drive the economy. Third, the site will carry an educational mission helping educate the general public, and on the other hand, help young people to start their careers in the field. The content of the DCMP Web site is under active development. It depends upon wide involvement of DCMP members.
Literature Survey on Technical Issues and Insights of Multi-Unit PSA

International Nuclear Information System (INIS)

Baek, Sejin; Park, Soyoung; Heo, Gyunyoung

2016-01-01

The need consider the risk impact in case of multi-unit in a single site increased after the accident at Fukushima Daiichi in March 2011. This means that we have to consider the single-unit initiators impacting the other units and the simultaneous accidents of the multi-unit on the same site. Particularly, this kind of technical concern is serious in case of the Republic of Korea where multi-units had to be located in high-density population area due to geographical features. The Nuclear Safety and Security Commission (NSSC) in the Republic of Korea has been trying to identify the state of the art of international and domestic regulations and techniques on multi-unit risk assessment and planning the road map for the safety researches. However, we have to say that finding a common accepted methodology along with safety criteria for multi-unit PSA was not an easy task up to now. This paper summarizes and analyzes related international and domestic journals' papers, conferences' papers and reports about the multi-unit PSA classifying categories with themes to understand the technical tendency of multi-unit PSA. In addition, some insights that were obtained from this classification have been arranged too. This paper investigated the technical trend of the multi-unit PSA as collecting of the international and domestic journals' papers, conferences papers and reports, and analyzing them. Upon the literature survey, a few statistics, technical issues, and insights were summarized. Both of the fundamental and practical researches need to find a globally accepted methodology to calculate and determine quantitative objectives for a multi-unit PSA. We want to expect that this paper can be shared to understand the current status of multi-unit PSA
Literature Survey on Technical Issues and Insights of Multi-Unit PSA

Energy Technology Data Exchange (ETDEWEB)

Baek, Sejin; Park, Soyoung; Heo, Gyunyoung [Kyung Hee Univ., Yongin (Korea, Republic of)

2016-10-15

The need consider the risk impact in case of multi-unit in a single site increased after the accident at Fukushima Daiichi in March 2011. This means that we have to consider the single-unit initiators impacting the other units and the simultaneous accidents of the multi-unit on the same site. Particularly, this kind of technical concern is serious in case of the Republic of Korea where multi-units had to be located in high-density population area due to geographical features. The Nuclear Safety and Security Commission (NSSC) in the Republic of Korea has been trying to identify the state of the art of international and domestic regulations and techniques on multi-unit risk assessment and planning the road map for the safety researches. However, we have to say that finding a common accepted methodology along with safety criteria for multi-unit PSA was not an easy task up to now. This paper summarizes and analyzes related international and domestic journals' papers, conferences' papers and reports about the multi-unit PSA classifying categories with themes to understand the technical tendency of multi-unit PSA. In addition, some insights that were obtained from this classification have been arranged too. This paper investigated the technical trend of the multi-unit PSA as collecting of the international and domestic journals' papers, conferences papers and reports, and analyzing them. Upon the literature survey, a few statistics, technical issues, and insights were summarized. Both of the fundamental and practical researches need to find a globally accepted methodology to calculate and determine quantitative objectives for a multi-unit PSA. We want to expect that this paper can be shared to understand the current status of multi-unit PSA.
Design of a Recommendation System for Adding Support in the Treatment of Chronic Patients.

Science.gov (United States)

Torkar, Simon; Benedik, Peter; Rajkovič, Uroš; Šušteršič, Olga; Rajkovič, Vladislav

2016-01-01

Rapid growth of chronic disease cases around the world is adding pressure on healthcare providers to ensure a structured patent follow-up during chronic disease management process. In response to the increasing demand for better chronic disease management and improved health care efficiency, nursing roles have been specialized or enhanced in the primary health care setting. Nurses become key players in chronic disease management process. Study describes a system to help nurses manage the care process of patient with chronic disease. It supports focusing nurse's attention on those resources/solutions that are likely to be most relevant to their particular situation/problem in nursing domain. System is based on multi-relational property graph representing a flexible modeling construct. Graph allows modeling a nursing ontology and the indices that partition domain into an efficient, searchable space where the solution to a problem is seen as abstractly defined traversals through its vertices and edges.
Multi-characteristic opsin enabled vision restoration

Science.gov (United States)

Wright, Weldon; Pradhan, Sanjay; Bhattacharya, Sulgana; Mahapatra, Vasu; Tripathy, Ashutosh; Gajjeraman, Sivakumar; Mohanty, Samarendra

2017-02-01

Photodegenerative retinal diseases such as retinitis pigmentosa (RP) and dry age related macular degeneration (dry- AMD) lead to loss of vision in millions of individuals. Currently, no surgical or medical treatment is available though optogenetic therapies are in clinical development. Here, we demonstrate vision restoration using Multi- Characteristics Opsin (MCO1) in animal models with photo-degenerated retina. MCO1 is reliably delivered to specific retinal cells via intravitreal injection of Adeno-Associated Virus, leading to significant improvement in visually guided behavior conducted using a radial-arm water maze. The time to reach platform significantly reduced after delivery of MCO1. Notably, the improvement in visually guided behavior was observed even at light intensity levels orders of magnitude lower than that required for Channelrhodopsin-2 opsin. Chronic light exposure study showed that chronic light exposure did not compromise viability of vMCO1-treated retina. Safe virus-mediated MCO1-delivery has potential for effective gene therapy of diverse retinal degenerations in patients.
EFFECTIVNESS OF TARGET ANTIMICROBIAL THERAPY OF SEVERE CHRONIC PERIODONTITIS PART I: REDUCTION OF GINGIVAL INFLAMATION AND ACTIVE PERIODONTAL DISEASE SITES

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Kamen Kotsilkov

2010-10-01

Full Text Available The correlation between recurrent bleeding on probing and the progression of periodontal destruction is suggested in many studies. One of the main goals of the periodontal treatment is the achievement of good control of the gingival inflammation and the reduction of the active periodontal sites.Aim: Evaluation of the effectiveness of treatment of severe chronic periodontitis with additional target antibiotic administration in comparison with the therapy with adjunctive antimicrobial combination amoxicillin + metronidazole and conventional mechanical periodontal treatment regarding the achieved control of the gingival inflammation and BoP.Results: Significant reduction of the gingival bleeding and the BoP is achieved in all groups. In the group with target antibiotic administration the final mean values of the GB (gingival bleeding and BoP (bleeding on probing are the lowest and could suggest a low risk for progression of the periodontal disease.
Energy-conserving site-design case study, Radisson, New York. Final report

Energy Technology Data Exchange (ETDEWEB)

1979-12-01

Radisson is a 2,950-acre new community currently being developed by the New York State Urban Development Corporation and located in central New York, 12 miles north-west of Syracuse. Case-study sites selected for this project are a 95-acre residential site and the 51-acre Town Center of the new community. Development on the Residential Site is a low-density (2.8 dwelling units/acre) mixture of single-family, townhouse and multi-family units. Development on the Town Center site is a mixture of small-scale commercial use (144,000 sq. ft.) and 330+ multi-family dwelling units. Energy-conserving plans developed for both sites have focused on passive measures to reduce energy use for space heating. Utility-system options have been identified for both sites, but require further study as to feasibility and cost. This report summarizes energy savings and cost differentials due to passive measures incorporated in both the residential and Town Center Plans. The future implementation schedule, also discussed, summarizes the procedures an schedule required for implementation of the passive measures, as well as further study required for the development of utility-system options. 4 tables.
Field Trials of the Multi-Source Approach for Resistivity and Induced Polarization Data Acquisition

Science.gov (United States)

LaBrecque, D. J.; Morelli, G.; Fischanger, F.; Lamoureux, P.; Brigham, R.

2013-12-01

Implementing systems of distributed receivers and transmitters for resistivity and induced polarization data is an almost inevitable result of the availability of wireless data communication modules and GPS modules offering precise timing and instrument locations. Such systems have a number of advantages; for example, they can be deployed around obstacles such as rivers, canyons, or mountains which would be difficult with traditional 'hard-wired' systems. However, deploying a system of identical, small, battery powered, transceivers, each capable of injecting a known current and measuring the induced potential has an additional and less obvious advantage in that multiple units can inject current simultaneously. The original purpose for using multiple simultaneous current sources (multi-source) was to increase signal levels. In traditional systems, to double the received signal you inject twice the current which requires you to apply twice the voltage and thus four times the power. Alternatively, one approach to increasing signal levels for large-scale surveys collected using small, battery powered transceivers is it to allow multiple units to transmit in parallel. In theory, using four 400 watt transmitters on separate, parallel dipoles yields roughly the same signal as a single 6400 watt transmitter. Furthermore, implementing the multi-source approach creates the opportunity to apply more complex current flow patterns than simple, parallel dipoles. For a perfect, noise-free system, multi-sources adds no new information to a data set that contains a comprehensive set of data collected using single sources. However, for realistic, noisy systems, it appears that multi-source data can substantially impact survey results. In preliminary model studies, the multi-source data produced such startling improvements in subsurface images that even the authors questioned their veracity. Between December of 2012 and July of 2013, we completed multi-source surveys at five sites
American Pancreatic Association Practice Guidelines in Chronic Pancreatitis: Evidence-Based Report on Diagnostic Guidelines

Science.gov (United States)

Conwell, Darwin L.; Lee, Linda S.; Yadav, Dhiraj; Longnecker, Daniel S.; Miller, Frank H.; Mortele, Koenraad J.; Levy, Michael J.; Kwon, Richard; Lieb, John G.; Stevens, Tyler; Toskes, Philip P.; Gardner, Timothy B.; Gelrud, Andres; Wu, Bechien U.; Forsmark, Christopher E.; Vege, Santhi S.

2016-01-01

The diagnosis of chronic pancreatitis remains challenging in early stages of the disease. This report defines the diagnostic criteria useful in the assessment of patients with suspected and established chronic pancreatitis. All current diagnostic procedures are reviewed and evidence based statements are provided about their utility and limitations. Diagnostic criteria for chronic pancreatitis are classified as definitive, probable or insufficient evidence. A diagnostic (STEP-wise; S-survey, T-tomography, E-endoscopy and P-pancreas function testing) algorithm is proposed that proceeds from a non-invasive to a more invasive approach. This algorithm maximizes specificity (low false positive rate) in subjects with chronic abdominal pain and equivocal imaging changes. Futhermore, a nomenclature is suggested to further characterize patients with established chronic pancreatitis based on TIGAR-O (T-toxic, I-idiopathic, G-genetic, A- autoimmune, R-recurrent and O-obstructive) etiology, gland morphology (Cambridge criteria) and physiologic state (exocrine, endocrine function) for uniformity across future multi-center research collaborations. This guideline will serve as a baseline manuscript that will be modified as new evidence becomes available and our knowledge of chronic pancreatitis improves. PMID:25333398
Cortical plasticity as a new endpoint measurement for chronic pain

Directory of Open Access Journals (Sweden)

Zhuo Min

2011-07-01

Full Text Available Abstract Animal models of chronic pain are widely used to investigate basic mechanisms of chronic pain and to evaluate potential novel drugs for treating chronic pain. Among the different criteria used to measure chronic pain, behavioral responses are commonly used as the end point measurements. However, not all chronic pain conditions can be easily measured by behavioral responses such as the headache, phantom pain and pain related to spinal cord injury. Here I propose that cortical indexes, that indicate neuronal plastic changes in pain-related cortical areas, can be used as endpoint measurements for chronic pain. Such cortical indexes are not only useful for those chronic pain conditions where a suitable animal model is lacking, but also serve as additional screening methods for potential drugs to treat chronic pain in humans. These cortical indexes are activity-dependent immediate early genes, electrophysiological identified plastic changes and biochemical assays of signaling proteins. It can be used to evaluate novel analgesic compounds that may act at peripheral or spinal sites. I hope that these new cortical endpoint measurements will facilitate our search for new, and more effective, pain medicines, and help to reduce false lead drug targets.

Porphyromonas endodontalis in chronic periodontitis: a clinical and microbiological cross-sectional study.

Science.gov (United States)

Lombardo Bedran, Telma Blanca; Marcantonio, Rosemary Adriana C; Spin Neto, Rubens; Alves Mayer, Marcia Pinto; Grenier, Daniel; Spolidorio, Luis Carlos; Spolidorio, Denise Palomari

2012-01-01

Although previous studies have shown the presence of Porphyromonas endodontalis in chronic periodontitis associated with periapical lesions, the occurrence of this pathogen in diseased periodontal sites without periapical lesions has been poorly investigated. The aims of this study were to quantify P. endodontalis in patients with chronic periodontitis without periapical lesions, to evaluate the potential correlation of P. endodontalis with Porphyromonas gingivalis and Tannerella forsythia, and to evaluate the ability of periodontal treatment to reduce these pathogens. Patients with generalized chronic periodontitis were selected by recording clinical attachment level (CAL), probing depth (PD), and bleeding on probing (BOP). Subgingival samples from 30 diseased nonadjacent sites (CAL≥5 mm, PD between 5 and 7 mm and positive BOP) and 30 healthy nonadjacent sites (PD≤3 mm and negative BOP) were collected and subjected to microbial analysis by quantitative polymerase chain reaction (qPCR) The variables of age, PD, CAL and BOP of all individuals were analyzed using the paired t-test (GrapPad Prism5(®)). Data of bacteria quantification were subjected to a normality test (D'Agostino-Pearson Test). For bacterial correlation analysis, the Spearman correlation was used. Our results showed that diseased sites had significantly higher levels of P. endodontalis compared to healthy sites, similar to the results obtained for P. gingivalis and T. forsythia. The numbers of all bacterial species were reduced significantly after mechanical periodontal treatment. P. endodontalis was significantly correlated with the presence of T. forsythia and P. gingivalis in the diseased group. Our results suggest that there is a high prevalence of P. endodontalis, P. gingivalis and T. forsythia in periodontitis sites and that mechanical periodontal treatment is effective at reducing the pathogens studied.
Comparative analysis of gingival crevicular fluid β-glucuronidase levels in health, chronic gingivitis and chronic periodontitis.

Science.gov (United States)

Sanara, P P; Shereef, Mohammed; Hegde, Shashikanth; Rajesh, K S; Arun Kumar, M S; Mohamed, Shabeer

2015-08-01

Current methods available for periodontal disease diagnosis are seriously deficient in terms of accuracy, in the ability to predict ongoing or future disease activity and indeed in determining whether previously diseased sites are in an arrested phase or still active. One area that is receiving a great deal of attention is the biochemical investigation of gingival crevicular fluid (GCF). β-glucuronidase (βG) is one of the enzymes found in GCF that is involved in degradation of the ground substance and fibrillar components of host connective tissue. GCF βG activity might be a good indicator or predictor of periodontal disease activity. This study was conducted to estimate and compare the GCF βG levels in patients with healthy periodontium, chronic gingivitis, and chronic periodontitis. Subjects were classified into three groups of 20 patients each; healthy individuals, chronic gingivitis, and chronic periodontitis. After recording the plaque index, gingival index and probing pocket depth, 1 μL GCF was collected by placing a calibrated microcapillary pipette extracrevicularly and transferred to sterile plastic vials containing 350 μL of normal saline with 1% bovine serum albumin. Analysis of βG was done by spectrophotometry. βG levels in GCF were significantly higher in chronic periodontitis group (mean value - 2.04743), followed by chronic gingivitis group (mean - 1.11510) and healthy group (0.53643). Increased βG levels were observed in patients with increased periodontal destruction, hence GCF βG levels can be used as biochemical marker for periodontal disease activity.
Chronic toxicology of cannabis.

Science.gov (United States)

Reece, Albert Stuart

2009-07-01

Cannabis is the most widely used illicit drug worldwide. As societies reconsider the legal status of cannabis, policy makers and clinicians require sound knowledge of the acute and chronic effects of cannabis. This review focuses on the latter. A systematic review of Medline, PubMed, PsychInfo, and Google Scholar using the search terms "cannabis," "marijuana," "marihuana," "toxicity," "complications," and "mechanisms" identified 5,198 papers. This list was screened by hand, and papers describing mechanisms and those published in more recent years were chosen preferentially for inclusion in this review. There is evidence of psychiatric, respiratory, cardiovascular, and bone toxicity associated with chronic cannabis use. Cannabis has now been implicated in the etiology of many major long-term psychiatric conditions including depression, anxiety, psychosis, bipolar disorder, and an amotivational state. Respiratory conditions linked with cannabis include reduced lung density, lung cysts, and chronic bronchitis. Cannabis has been linked in a dose-dependent manner with elevated rates of myocardial infarction and cardiac arrythmias. It is known to affect bone metabolism and also has teratogenic effects on the developing brain following perinatal exposure. Cannabis has been linked to cancers at eight sites, including children after in utero maternal exposure, and multiple molecular pathways to oncogenesis exist. Chronic cannabis use is associated with psychiatric, respiratory, cardiovascular, and bone effects. It also has oncogenic, teratogenic, and mutagenic effects all of which depend upon dose and duration of use.
Single- and Multi-Date Crop Identification Using PROBA-V 100 and 300 m S1 Products on Zlatia Test Site, Bulgaria

Directory of Open Access Journals (Sweden)

Eugenia Roumenina

2015-10-01

Full Text Available The monitoring of crops is of vital importance for food and environmental security in a global and European context. The main goal of this study was to assess the crop mapping performance provided by the 100 m spatial resolution of PROBA-V compared to coarser resolution data (e.g., PROBA-V at 300 m for a 2250 km2 test site in Bulgaria. The focus was on winter and summer crop mapping with three to five classes. For classification, single- and multi-date spectral data were used as well as NDVI time series. Our results demonstrate that crop identification using 100 m PROBA-V data performed significantly better in all experiments compared to the PROBA-V 300 m data. PROBA-V multispectral imagery, acquired in spring (March was the most appropriate for winter crop identification, while satellite data acquired in summer (July was superior for summer crop identification. The classification accuracy from PROBA-V 100 m compared to PROBA-V 300 m was improved by 5.8% to 14.8% depending on crop type. Stacked multi-date satellite images with three to four images gave overall classification accuracies of 74%–77% (PROBA-V 100 m data and 66%–70% (PROBA-V 300 m data with four classes (wheat, rapeseed, maize, and sunflower. This demonstrates that three to four image acquisitions, well distributed over the growing season, capture most of the spectral and temporal variability in our test site. Regarding the PROBA-V NDVI time series, useful results were only obtained if crops were grouped into two broader crop type classes (summer and winter crops. Mapping accuracies decreased significantly when mapping more classes. Again, a positive impact of the increased spatial resolution was noted. Together, the findings demonstrate the positive effect of the 100 m resolution PROBA-V data compared to the 300 m for crop mapping. This has important implications for future data provision and strengthens the arguments for a second generation of this mission originally designed
Can multi-criteria analysis models support the site selection for a repository for heat-generating waste?; Koennen multikriterielle Analysemodelle die Standortauswahl fuer ein Endlager fuer Waerme entwickelnde Abfaelle unterstuetzen?

Energy Technology Data Exchange (ETDEWEB)

Gutberlet, Daniela [DMT GmbH und Co.KG, Essen (Germany). Geschaeftsentwicklung Nukleare Entsorgung

2015-07-01

The decision for or against a potential site for a nuclear waste repository is highly complex and requires decision-makers to consider multiple assessment criteria. The complexity of each site and its characteristics, and the differing opinions among members of the public and advocacy groups mean t hat conflicts of interest are likely to arise. In this paper, the author suggests that multi-criteria analysis models could be used to provide methodological support during the selection process. The models can map these types of decision situations and suggest coherent solutions with relatively little formal effort. They allow users to compare different opt ions simultaneously and ensure that t heir decision-making Is conscious rather than arbitrary.
Urban Forest and Rural Cities: Multi-sited Households, Consumption Patterns, and Forest Resources in Amazonia

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Christine Padoch

2008-12-01

Full Text Available In much of the Amazon Basin, approximately 70% of the population lives in urban areas and urbanward migration continues. Based on data collected over more than a decade in two long-settled regions of Amazonia, we find that rural-urban migration in the region is an extended and complex process. Like recent rural-urban migrants worldwide, Amazonian migrants, although they may be counted as urban residents, are often not absent from rural areas but remain members of multi-sited households and continue to participate in rural-urban networks and in rural land-use decisions. Our research indicates that, despite their general poverty, these migrants have affected urban markets for both food and construction materials. We present two cases: that of açaí palm fruit in the estuary of the Amazon and of cheap construction timbers in the Peruvian Amazon. We find that many new Amazonian rural-urban migrants have maintained some important rural patterns of both consumption and knowledge. Through their consumer behavior, they are affecting the areal extent of forests; in the two floodplain regions discussed, tree cover is increasing. We also find changes in forest composition, reflecting the persistence of rural consumption patterns in cities resulting in increased demand for and production of açaí and cheap timber species.
Effects of chronic exposure in populations of Koeleria gracilis Pers. from the Semipalatinsk nuclear test site, Kazakhstan

International Nuclear Information System (INIS)

Geras'kin, S.A.; Oudalova, A.A.; Dikarev, V.G.; Dikareva, N.S.; Mozolin, E.M.; Hinton, T.; Spiridonov, S.I.; Copplestone, D.; Garnier-Laplace, J.

2012-01-01

Morphological and cytogenetic abnormalities were examined in crested hairgrass (Koeleria gracilis Pers.) populations inhabiting the Semipalatinsk nuclear test site (STS), Kazakhstan. Sampling of biological material and soil was carried out during 3 years (2005–2007) at 4 sites within the STS. Activity concentrations of 10 radionuclides and 8 heavy metals content in soils were measured. Doses absorbed by plants were estimated and varied, depending on the plot, from 4 up to 265 mGy/y. The frequency of cytogenetic alterations in apical meristem of germinated seeds from the highly contaminated plot significantly exceeded the level observed at other plots with lower levels of radioactive contamination during all three years of the study. A significant excess of chromosome aberrations, typical for radiation exposure, as well as a dependence of the frequency of these types of mutations on dose absorbed by plants were revealed. The results indicate the role radioactive contamination plays in the occurrence of cytogenetic effects. However, no radiation-dependent morphological alterations were detected in the progeny of the exposed populations. Given that the crested hairgrass populations have occupied the radioactively contaminated plots for some 50 years, adaptation to the radiation stress was not evident. The findings obtained were in agreement with the benchmark values proposed in the FASSET and ERICA projects to restrict radiation impacts on biota. - Highlights: ► Morphological and cytogenetic abnormalities were examined in plants from the STS. ► Annual doses absorbed by plants varied from 4 up to 265 mGy. ► Cytogenetic alterations in plants from the explosions epicenter exceeded the control. ► No radiation-dependent morphological alterations were detected in the progeny. ► Radio-adaptation in plant populations in 50 years of chronic exposure was not evident.
Radiographic features of esophageal involvement in chronic graft-vs.-host disease

International Nuclear Information System (INIS)

McDonald, G.B.; Sullivan, K.M.; Plumley, T.F.

1984-01-01

Chronic graft-vs.-host disease (GVHD) is an important late complication of allogeneic bone-marrow transplantation. It resembles several naturally occurring autoimmune diseases and involves the skin, mouth, eyes, liver, and esophagus. The radiographic findings of 14 symptomatic patients with chronic GVHD involving the esophagus were reviewed and found to include webs, ringlike narrowings, and tapering strictures in the mid and upper esophagus. Esophagoscopy revealed characteristic desquamation in the 13 patients studied, but barium studies detected this lesion in only one patient. Knowledge of the site and characteristics of esophageal involvement with chronic GVHD assists the radiologic evaluation of this disorder
Mild asthma and chronic bronchitis seem to influence functional exercise capacity: a multi-case control study.

Science.gov (United States)

Marcon, Alessandro; Girardi, Paolo; Ferrari, Marcello; Olivieri, Mario; Accordini, Simone; Bombieri, Cristina; Bortolami, Oscar; Braggion, Marco; Cappa, Veronica; Cazzoletti, Lucia; Locatelli, Francesca; Nicolis, Morena; Perbellini, Luigi; Sembeni, Silvia; Verlato, Giuseppe; Zanolin, Maria Elisabetta; de Marco, Roberto

2013-01-01

In the Genes Environment Interaction in Respiratory Diseases population-based multi-case control study, we investigated whether asthma, chronic bronchitis (CB) and rhinitis were associated with a reduced 6-minute walk distance (6MWD), and whether the 6MWD determinants were similar for subjects with/without respiratory diseases. Cases of asthma (n = 360), CB (n = 120), rhinitis (n = 203) and controls (no respiratory diseases: n = 302) were recruited. The variation in the 6MWD across the groups was analyzed by ANCOVA, adjusting for gender, age, height, weight and comorbidity. The 6MWD determinants were studied by linear regression, and heterogeneity across the cases and controls was investigated. The 6MWD differed across cases and controls (p = 0.01). It was shorter for cases of asthma (-17.1, 95% CI -28.3 to -5.8 m) and CB (-20.7, 95% CI: -36.6 to -4.8 m) than for controls (604 ± 68 m on average), but not for cases of rhinitis. The negative association between age and the 6MWD was significant for cases of CB, but not for the other groups (p = 0.001). Even at the level of severity found in the general population, asthma and CB could influence the 6MWD, which seems to reflect the functional exercise level for daily physical activities. The negative association between ageing and the 6MWD was particularly strong in subjects with CB. Our report adds to the mounting evidence that CB is not a trivial condition, especially in the ageing adult population, and it supports the importance of monitoring functional capacity and of physical reconditioning in mild asthma. Copyright © 2013 S. Karger AG, Basel.
Leukemia after radiotherapy for first primary cancers of various anatomic sites

International Nuclear Information System (INIS)

Boivin, J.F.; Hutchison, G.B.; Evans, F.B.; Abou-Daoud, K.T.; Junod, B.

1986-01-01

The authors conducted a case-control study designed to evaluate the association between radiotherapy for a first primary cancer and subsequent leukemia risk. Study subjects were selected from four tumor registries (California, Connecticut, Kansas, and Massachusetts). Cases were subjects with two primary concers; the second cancer was a leukemia diagnosed one year or more after the diagnosis of the first primary cancer. Control subjects were patients with single cancers. Two control subjects were chosen for each case matched for tumor registry, site of the first primary cancer, date of diagnosis of the first primary cancer, age, sex, and duration of survival after the first primary cancer. Separate analyses were carried out for chronic lymphatic leukemia (166 cases) and all other leukemias (232 cases). The relative risk of chronic lymphatic leukemia after radiotherapy was 0.7 and did not differ significantly from unity. For all other leukemias, relative risks were 1.6 after radiotherapy for first primary cancers of all sites, 2.4 after radiotherapy to trunk sites, 2.2 after radiotherapy for breast cancer, and 10.3 after radiotherapy for cancer of the corpus uteri. These relative risks for leukemias other than chronic lymphatic leukemia all differed significantly from unity
Semipalatinsk nuclear test site: History of building and function

International Nuclear Information System (INIS)

Sergazina, G.M.; Balmukhanov, S.B.

1999-01-01

A vast materials on history of Semipalatinsk nuclear test site creation and it building and function are presented. Authors with big reliability report one page of Kazakhstan's history. In steppe on naked place thousands of soldiers and officers, construct and military specialists have built the nuclear site on which during 40 years were conducting nuclear tests . Prolonged chronic radiation on population living near by site results to tragedy which is confessed by General Assembly of United Nations. In the book aspects of test site conversion and rehabilitation of injured population are considered. The book consists of introduction, three chapters and conclusion. The book is intended to wide circle of readers. (author)
Middlesex FUSRAP Site - A Path to Site-Wide Closure - 13416

Energy Technology Data Exchange (ETDEWEB)

Miller, David M. [ECC, 110 Fieldcrest Ave, Ste 31, Edison, NJ, 08837 (United States); Edge, Helen [US Army Corps of Engineers - NYD, 26 Federal Plaza, Room 1811, New York, NY, 10278 (United States)

2013-07-01

The road-map to obtaining closure of the Middlesex Sampling Plant FUSRAP site in Middlesex, New Jersey (NJ) has required a multi-faceted approach, following the CERCLA Process. Since 1998, the US ACE, ECC, and other contractors have completed much of the work required for regulatory acceptance of site closure with unrestricted use. To date, three buildings have been decontaminated, demolished, and disposed of. Two interim storage piles have been removed and disposed of, followed by the additional removal and disposal of over 87,000 tons of radiologically and chemically-impacted subsurface soils by the summer of 2008. The US ACE received a determination from the EPA for the soils Operable Unit, (OU)-1, in September 2010 that the remedial excavations were acceptable, and meet the criteria for unrestricted use as required by the 2004 Record of Decision (ROD) for OU-1. Following the completion of OU-1, the project delivery team performed additional field investigation of the final Operable Unit for Middlesex, OU-2, Groundwater. As of December 2012, the project delivery team has completed a Supplemental Remedial Investigation, which will be followed with a streamlined Feasibility Study, Proposed Plan, and ROD. Several years of historical groundwater data was available from previous investigations and the FUSRAP Environmental Surveillance Program. Historical data indicated sporadic detections of Volatile Organic Compounds (VOCs), primarily trichloroethylene (TCE), carbon tetrachloride (CT), and methyl tert-butyl ether (MTBE), with no apparent trend or pattern indicating extent or source of the VOC impact. In 2008, the project delivery team initiated efforts to re-assess the Conceptual Site Model (CSM) for groundwater. The bedrock was re-evaluated as a leaky multi-unit aquifer, and a plan was developed for additional investigations for adequate bedrock characterization and delineation of groundwater contaminated primarily by CT, TCE, and tetrachloroethene (PCE). The
Using Chronic Absence in a Multi-Metric Accountability System. Policy Memo 16-1

Science.gov (United States)

Hough, Heather

2016-01-01

With the passage of the Every Student Succeeds Act (ESSA) of 2015, California must integrate additional measures of student and school performance into the state-wide accountability system. To support the conversation as policymakers consider if/how to include chronic absenteeism data in the state's accountability system, PACE has conducted an…
Multi-stage classification method oriented to aerial image based on low-rank recovery and multi-feature fusion sparse representation.

Science.gov (United States)

Ma, Xu; Cheng, Yongmei; Hao, Shuai

2016-12-10

Automatic classification of terrain surfaces from an aerial image is essential for an autonomous unmanned aerial vehicle (UAV) landing at an unprepared site by using vision. Diverse terrain surfaces may show similar spectral properties due to the illumination and noise that easily cause poor classification performance. To address this issue, a multi-stage classification algorithm based on low-rank recovery and multi-feature fusion sparse representation is proposed. First, color moments and Gabor texture feature are extracted from training data and stacked as column vectors of a dictionary. Then we perform low-rank matrix recovery for the dictionary by using augmented Lagrange multipliers and construct a multi-stage terrain classifier. Experimental results on an aerial map database that we prepared verify the classification accuracy and robustness of the proposed method.
Ground-based search for the brightest transiting planets with the Multi-site All-Sky CAmeRA: MASCARA

Science.gov (United States)

Snellen, Ignas A. G.; Stuik, Remko; Navarro, Ramon; Bettonvil, Felix; Kenworthy, Matthew; de Mooij, Ernst; Otten, Gilles; ter Horst, Rik; le Poole, Rudolf

2012-09-01

The Multi-site All-sky CAmeRA MASCARA is an instrument concept consisting of several stations across the globe, with each station containing a battery of low-cost cameras to monitor the near-entire sky at each location. Once all stations have been installed, MASCARA will be able to provide a nearly 24-hr coverage of the complete dark sky, down to magnitude 8, at sub-minute cadence. Its purpose is to find the brightest transiting exoplanet systems, expected in the V=4-8 magnitude range - currently not probed by space- or ground-based surveys. The bright/nearby transiting planet systems, which MASCARA will discover, will be the key targets for detailed planet atmosphere observations. We present studies on the initial design of a MASCARA station, including the camera housing, domes, and computer equipment, and on the photometric stability of low-cost cameras showing that a precision of 0.3-1% per hour can be readily achieved. We plan to roll out the first MASCARA station before the end of 2013. A 5-station MASCARA can within two years discover up to a dozen of the brightest transiting planet systems in the sky.
Depressive and post-traumatic stress symptoms following termination of pregnancy in South African women: A longitudinal study measuring the effects of chronic burden, crisis support and resilience.

Science.gov (United States)

Subramaney, Ugasvaree; Wyatt, Gail Elizabeth; Williams, John K; Zhang, Muyu; Liu, Hong Hu; Chin, Dorothy

2015-11-01

Termination of pregnancy (TOP) remains a controversial issue, regardless of legislation. Access to services as well as psychological effects may vary across the world. To better understand the psychological effects of TOP, this study describes the circumstances of 102 women who underwent a TOP from two socioeconomic sites in Johannesburg, South Africa, one serving women with few economic resources and the other serving women with adequate resources. The relationship between demographic characteristics, resilience and symptoms of post-traumatic stress disorder (PTSD) and depression before, 1 month after and 3 months after the procedure was also examined. Time since TOP, age, chronic burden, resilience and the interaction of site with religion and site with chronic burden were significant. In addition, site differences were found for religion and chronic burden in predicting depression scores. Women from both sites had significant decreases in depression scores over time. The interaction of time with site was not significant. Higher chronic burden scores correlated with higher depression scores. No variables were significant in the bivariate analysis for PTSD. Resilience, religion and chronic burden emerge as significant variables in women undergoing a first-trimester TOP, and warrant further assessment in studies of this nature.
Multi-Label Learning via Random Label Selection for Protein Subcellular Multi-Locations Prediction.

Science.gov (United States)

Wang, Xiao; Li, Guo-Zheng

2013-03-12

Prediction of protein subcellular localization is an important but challenging problem, particularly when proteins may simultaneously exist at, or move between, two or more different subcellular location sites. Most of the existing protein subcellular localization methods are only used to deal with the single-location proteins. In the past few years, only a few methods have been proposed to tackle proteins with multiple locations. However, they only adopt a simple strategy, that is, transforming the multi-location proteins to multiple proteins with single location, which doesn't take correlations among different subcellular locations into account. In this paper, a novel method named RALS (multi-label learning via RAndom Label Selection), is proposed to learn from multi-location proteins in an effective and efficient way. Through five-fold cross validation test on a benchmark dataset, we demonstrate our proposed method with consideration of label correlations obviously outperforms the baseline BR method without consideration of label correlations, indicating correlations among different subcellular locations really exist and contribute to improvement of prediction performance. Experimental results on two benchmark datasets also show that our proposed methods achieve significantly higher performance than some other state-of-the-art methods in predicting subcellular multi-locations of proteins. The prediction web server is available at http://levis.tongji.edu.cn:8080/bioinfo/MLPred-Euk/ for the public usage.
Gingival crevicular fluid proteomes in health, gingivitis and chronic periodontitis.

Science.gov (United States)

Huynh, A H S; Veith, P D; McGregor, N R; Adams, G G; Chen, D; Reynolds, E C; Ngo, L H; Darby, I B

2015-10-01

The aim of this study was to compare the proteome composition of gingival crevicular fluid obtained from healthy periodontium, gingivitis and chronic periodontitis affected sites. Owing to its site-specific nature, gingival crevicular fluid is ideal for studying biological processes that occur during periodontal health and disease progression. However, few studies have been conducted into the gingival crevicular fluid proteome due to the small volumes obtained. Fifteen males were chosen for each of three different groups, healthy periodontium, gingivitis and chronic periodontitis. They were categorized based on clinical measurements including probing depth, bleeding on probing, plaque index, radiographic bone level, modified gingival index and smoking status. Gingival crevicular fluid was collected from each patient, pooled into healthy, gingivitis and chronic periodontitis groups and their proteome analyzed by gel electrophoresis and liquid chromatography electrospray ionization ion trap tandem mass spectrometry. One hundred and twenty-one proteins in total were identified, and two-thirds of these were identified in all three conditions. Forty-two proteins were considered to have changed in abundance. Of note, cystatin B and cystatin S decreased in abundance from health to gingivitis and further in chronic periodontitis. Complement proteins demonstrated an increase from health to gingivitis followed by a decrease in chronic periodontitis. Immunoglobulins, keratin proteins, fibronectin, lactotransferrin precursor, 14-3-3 protein zeta/delta, neutrophil defensin 3 and alpha-actinin exhibited fluctuations in levels. The gingival crevicular fluid proteome in each clinical condition was different and its analysis may assist us in understanding periodontal pathogenesis. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
The GIN legal problems of multi-parties at the drill site

International Nuclear Information System (INIS)

Case, C.W.

1991-01-01

The presence of multiple parties working at a drilling site complicates the application of the environmental laws, rules and regulations. A critical decision prior to any physical activities needs to be made as to which person (i.e., company, partnership) will be charged with the obligation of being the designated Generator of hazardous waste for that site. This critical decision is dictated by the refusal of the EPA to assign more than one EPA Generator Identification Number (GIN) to a single drilling site. The decision as to which member of the multiple parties presence at the drill site will obtain the GIN has liability ramifications when a mistake is made in the cleanup of spilled hazardous waste or hazardous substances; an improper situation arises as to the transportation, storage, treatment and disposal of hazardous waste; the waste is improperly classified, or the biennial reporting of hazardous waste activities does not occur. Liability issues arise that go far beyond the ordinary contractual disputes seen in the past arising from drilling activities, with liability in some situations well in excess of any damage claims normally allowed under common law or statutory law in the State of Texas for non-environmental disputes. This paper reviews the liabilities and responsibilities of oil and gas drillers under the Resource Conservation and Recovery Act and the Comprehensive Environmental Response, Compensation and Liability Act
Improvement of Off-site Dose Assessment Code for Operating Nuclear Power Plant

Energy Technology Data Exchange (ETDEWEB)

Kim, Juyub; Kim, Juyoul; Shin, Kwangyoung [FNC Technology Co. Ltd., Yongin (Korea, Republic of); You, Songjae; Moon, Jongyi [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

2014-05-15

XOQDOQ code which calculates atmospheric Dispersion factor was included into INDAC also. A research on the improvement of off-site dose assessment system for an operating nuclear power plant was performed by KINS in 2011. As a result, following improvements were derived: - Separation of dose assessment for new and existing facilities - Update of food ingestion data - Consideration of multi-unit operation and so on In order to reflect the results, INDAC is under modification. INDAC is an integrated dose assessment code for an operating nuclear power plant and consists of three main modules: XOQDOQ, GASDOS and LIQDOS. The modules are under modification in order to improve the accuracy of assessment and usability. Assessment points for multi-unit release can be calculated through the improved code and the method on dose assessment for multi-unit release has been modified, so that the dose assessment result of multi-unit site becomes more realistic by relieving excessive conservatism. Finally, as the accuracy of calculation modules has been improved, the reliability of dose assessment result has been strengthened.

Spatial effect of new municipal solid waste landfill siting using different guidelines.

Science.gov (United States)

Ahmad, Siti Zubaidah; Ahamad, Mohd Sanusi S; Yusoff, Mohd Suffian

2014-01-01

Proper implementation of landfill siting with the right regulations and constraints can prevent undesirable long-term effects. Different countries have respective guidelines on criteria for new landfill sites. In this article, we perform a comparative study of municipal solid waste landfill siting criteria stated in the policies and guidelines of eight different constitutional bodies from Malaysia, Australia, India, U.S.A., Europe, China and the Middle East, and the World Bank. Subsequently, a geographic information system (GIS) multi-criteria evaluation model was applied to determine new suitable landfill sites using different criterion parameters using a constraint mapping technique and weighted linear combination. Application of Macro Modeler provided in the GIS-IDRISI Andes software helps in building and executing multi-step models. In addition, the analytic hierarchy process technique was included to determine the criterion weight of the decision maker's preferences as part of the weighted linear combination procedure. The differences in spatial results of suitable sites obtained signifies that dissimilarity in guideline specifications and requirements will have an effect on the decision-making process.
Porphyromonas endodontalis in chronic periodontitis: a clinical and microbiological cross-sectional study

OpenAIRE

Telma Blanca Lombardo Bedran; Rosemary Adriana C. Marcantonio; Rubens Spin Neto; Marcia Pinto Alves Mayer; Daniel Grenier; Luis Spolidorio; Denise Spolidorio

2012-01-01

Background: Although previous studies have shown the presence of Porphyromonas endodontalis in chronic periodontitis associated with periapical lesions, the occurrence of this pathogen in diseased periodontal sites without periapical lesions has been poorly investigated. Objective: The aims of this study were to quantify P. endodontalis in patients with chronic periodontitis without periapical lesions, to evaluate the potential correlation of P. endodontalis with Porphyromonas gingivalis and ...
Porphyromonas endodontalis in chronic periodontitis: a clinical and microbiological cross-sectional study

Science.gov (United States)

Lombardo Bedran, Telma Blanca; Marcantonio, Rosemary Adriana C.; Spin Neto, Rubens; Alves Mayer, Marcia Pinto; Grenier, Daniel; Spolidorio, Luis Carlos; Spolidorio, Denise Palomari

2012-01-01

Background Although previous studies have shown the presence of Porphyromonas endodontalis in chronic periodontitis associated with periapical lesions, the occurrence of this pathogen in diseased periodontal sites without periapical lesions has been poorly investigated. Objective The aims of this study were to quantify P. endodontalis in patients with chronic periodontitis without periapical lesions, to evaluate the potential correlation of P. endodontalis with Porphyromonas gingivalis and Tannerella forsythia, and to evaluate the ability of periodontal treatment to reduce these pathogens. Design Patients with generalized chronic periodontitis were selected by recording clinical attachment level (CAL), probing depth (PD), and bleeding on probing (BOP). Subgingival samples from 30 diseased nonadjacent sites (CAL≥5 mm, PD between 5 and 7 mm and positive BOP) and 30 healthy nonadjacent sites (PD≤3 mm and negative BOP) were collected and subjected to microbial analysis by quantitative polymerase chain reaction (qPCR) The variables of age, PD, CAL and BOP of all individuals were analyzed using the paired t-test (GrapPad Prism5®). Data of bacteria quantification were subjected to a normality test (D'Agostino-Pearson Test). For bacterial correlation analysis, the Spearman correlation was used. Results Our results showed that diseased sites had significantly higher levels of P. endodontalis compared to healthy sites, similar to the results obtained for P. gingivalis and T. forsythia. The numbers of all bacterial species were reduced significantly after mechanical periodontal treatment. P. endodontalis was significantly correlated with the presence of T. forsythia and P. gingivalis in the diseased group. Conclusion Our results suggest that there is a high prevalence of P. endodontalis, P. gingivalis and T. forsythia in periodontitis sites and that mechanical periodontal treatment is effective at reducing the pathogens studied. PMID:22232719
Porphyromonas endodontalis in chronic periodontitis: a clinical and microbiological cross-sectional study

Directory of Open Access Journals (Sweden)

Telma Blanca Lombardo Bedran

2012-01-01

Full Text Available Although previous studies have shown the presence of Porphyromonas endodontalis in chronic periodontitis associated with periapical lesions, the occurrence of this pathogen in diseased periodontal sites without periapical lesions has been poorly investigated.The aims of this study were to quantify P. endodontalis in patients with chronic periodontitis without periapical lesions, to evaluate the potential correlation of P. endodontalis with Porphyromonas gingivalis and Tannerella forsythia, and to evaluate the ability of periodontal treatment to reduce these pathogens.Patients with generalized chronic periodontitis were selected by recording clinical attachment level (CAL, probing depth (PD, and bleeding on probing (BOP. Subgingival samples from 30 diseased nonadjacent sites (CAL ≥ 5 mm, PD between 5 and 7 mm and positive BOP and 30 healthy nonadjacent sites (PD ≤ 3 mm and negative BOP were collected and subjected to microbial analysis by quantitative polymerase chain reaction (qPCR The variables of age, PD, CAL and BOP of all individuals were analyzed using the paired t-test (GrapPad Prism5®. Data of bacteria quantification were subjected to a normality test (D'Agostino-Pearson Test. For bacterial correlation analysis, the Spearman correlation was used.Our results showed that diseased sites had significantly higher levels of P. endodontalis compared to healthy sites, similar to the results obtained for P. gingivalis and T. forsythia. The numbers of all bacterial species were reduced significantly after mechanical periodontal treatment. P. endodontalis was significantly correlated with the presence of T. forsythia and P. gingivalis in the diseased group.Our results suggest that there is a high prevalence of P. endodontalis, P. gingivalis and T. forsythia in periodontitis sites and that mechanical periodontal treatment is effective at reducing the pathogens studied.
A MULTI-SITE CAMPAIGN TO MEASURE SOLAR-LIKE OSCILLATIONS IN PROCYON. II. MODE FREQUENCIES

International Nuclear Information System (INIS)

Bedding, Timothy R.; Bruntt, Hans; Kiss, Laszlo L.; Kjeldsen, Hans; Campante, Tiago L.; Appourchaux, Thierry; Bonanno, Alfio; Chaplin, William J.; Garcia, Rafael A.; Martic, Milena; Mosser, Benoit; Butler, R. Paul; O'Toole, Simon J.; Kambe, Eiji; Izumiura, Hideyuki; Ando, Hiroyasu; Sato, Bun'ei; Hartmann, Michael; Hatzes, Artie

2010-01-01

We have analyzed data from a multi-site campaign to observe oscillations in the F5 star Procyon. The data consist of high-precision velocities that we obtained over more than three weeks with 11 telescopes. A new method for adjusting the data weights allows us to suppress the sidelobes in the power spectrum. Stacking the power spectrum in a so-called echelle diagram reveals two clear ridges, which we identify with even and odd values of the angular degree (l = 0 and 2, and l = 1 and 3, respectively). We interpret a strong, narrow peak at 446 μHz that lies close to the l = 1 ridge as a mode with mixed character. We show that the frequencies of the ridge centroids and their separations are useful diagnostics for asteroseismology. In particular, variations in the large separation appear to indicate a glitch in the sound-speed profile at an acoustic depth of ∼1000 s. We list frequencies for 55 modes extracted from the data spanning 20 radial orders, a range comparable to the best solar data, which will provide valuable constraints for theoretical models. A preliminary comparison with published models shows that the offset between observed and calculated frequencies for the radial modes is very different for Procyon than for the Sun and other cool stars. We find the mean lifetime of the modes in Procyon to be 1.29 +0.55 -0.49 days, which is significantly shorter than the 2-4 days seen in the Sun.
OPTIMAL ALLOCATION OF LANDFILL DISPOSAL SITE: A FUZZY MULTI-CRITERIA APPROACH

Directory of Open Access Journals (Sweden)

Ajit P. Singh, A. K. Vidyarthi

2008-01-01

Full Text Available The arbitrary disposal through land-fill sites and also the unscientific management of solid wastes generated by domestic, commercial and industrial activities leading to serious problems of health, sanitation and environmental degradation in India demand an immediate proper solid waste disposal planning otherwise it may cause a serious problem, especially in small and medium-sized cities/towns if proper steps are not initiated now. The present paper aims to develop decision support systems to allocate the best landfill disposal site among the given alternative sites for Vidya Vihar, Pilani, Rajasthan, India. The technique is applied to determine the overall strategy for planning of solid waste disposal and management, while taking into account its environmental impact, as well as economical, technical and sustainable development issues. The model effectively reflects dynamic, interactive, and uncertain characteristics of the solid waste management system and provides decision-makers with a decision tool to make a better decision while choosing a municipal solid waste management strategy.
Chronic conditions and sleep problems among adults aged 50 years or over in nine countries: a multi-country study.

Directory of Open Access Journals (Sweden)

Ai Koyanagi

Full Text Available Data on the association between chronic conditions or the number of chronic conditions and sleep problems in low- or middle-income countries is scarce, and global comparisons of these associations with high-income countries have not been conducted.Data on 42116 individuals 50 years and older from nationally-representative samples of the Collaborative Research on Ageing in Europe (Finland, Poland, Spain and the World Health Organization's Study on Global Ageing and Adult Health (China, Ghana, India, Mexico, Russia, South Africa conducted between 2011-2012 and 2007-2010 respectively were analyzed.The association between nine chronic conditions (angina, arthritis, asthma, chronic lung disease, depression, diabetes, hypertension, obesity, and stroke and self-reported severe/extreme sleep problems in the past 30 days was estimated by logistic regression with multiple variables. The age-adjusted prevalence of sleep problems ranged from 2.8% (China to 17.0% (Poland. After adjustment for confounders, angina (OR 1.75-2.78, arthritis (OR 1.39-2.46, and depression (OR 1.75-5.12 were significantly associated with sleep problems in the majority or all of the countries. Sleep problems were also significantly associated with: asthma in Finland, Spain, and India; chronic lung disease in Poland, Spain, Ghana, and South Africa; diabetes in India; and stroke in China, Ghana, and India. A linear dose-dependent relationship between the number of chronic conditions and sleep problems was observed in all countries. Compared to no chronic conditions, the OR (95%CI for 1,2,3, and ≥ 4 chronic conditions was 1.41 (1.09-1.82, 2.55 (1.99-3.27, 3.22 (2.52-4.11, and 7.62 (5.88-9.87 respectively in the overall sample.Identifying co-existing sleep problems among patients with chronic conditions and treating them simultaneously may lead to better treatment outcome. Clinicians should be aware of the high risk for sleep problems among patients with multimorbidity. Future studies
Multi-Modal Active Perception for Autonomously Selecting Landing Sites on Icy Moons

Science.gov (United States)

Arora, A.; Furlong, P. M.; Wong, U.; Fong, T.; Sukkarieh, S.

2017-01-01

Selecting suitable landing sites is fundamental to achieving many mission objectives in planetary robotic lander missions. However, due to sensing limitations, landing sites which are both safe and scientifically valuable often cannot be determined reliably from orbit, particularly, in icy moon missions where orbital sensing data is noisy and incomplete. This paper presents an active perception approach to Entry Descent and Landing (EDL) which enables the lander to autonomously plan informative descent trajectories, acquire high quality sensing data during descent and exploit this additional information to select higher utility landing sites. Our approach consists of two components: probabilistic modeling of landing site features and approximate trajectory planning using a sampling based planner. The proposed framework allows the lander to plan long horizons paths and remain robust to noisy data. Results in simulated environments show large performance improvements over alternative approaches and show promise that our approach has strong potential to improve science return of not only icy moon missions but EDL systems in general.
Prevention of human cancer by modulation of chronic inflammatory processes

Energy Technology Data Exchange (ETDEWEB)

Ohshima, Hiroshi [International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon Cedex 08 (France)]. E-mail: ohshima@iarc.fr; Tazawa, Hiroshi [International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon Cedex 08 (France); Sylla, Bakary S. [International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon Cedex 08 (France); Sawa, Tomohiro [International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon Cedex 08 (France)

2005-12-11

Chronic inflammation induced by biological, chemical and physical factors has been associated with increased risk of human cancer at various sites. Inflammation facilitates the initiation of normal cells and their growth and progression to malignancy through production of pro-inflammatory cytokines and diverse reactive oxygen and nitrogen species. These also activate signaling molecules involved in inflammation and carcinogenesis such as nuclear transcription factor (NF-{kappa}B), inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2). Several chemopreventive agents act through inhibition of signaling pathways (e.g. NF-{kappa}B), inhibition of oxidant-generating enzymes (e.g. iNOS) and mediators of inflammation (e.g. COX-2), scavenging reactive oxygen and nitrogen species, and modulation of xenobiotic-metabolizing enzymes (especially phase II enzyme induction). Some anti-inflammatory drugs have been tested in clinical trials to prevent human cancer at several sites. Better understanding of the molecular mechanisms by which chronic inflammation increases cancer risk will lead to further development of new strategies for cancer prevention at many sites.
Brief interventions to reduce Ecstasy use: a multi-site randomized controlled trial.

Science.gov (United States)

Norberg, Melissa M; Hides, Leanne; Olivier, Jake; Khawar, Laila; McKetin, Rebecca; Copeland, Jan

2014-11-01

Studies examining the ability of motivational enhancement therapy (MET) to augment education provision among ecstasy users have produced mixed results and none have examined whether treatment fidelity was related to ecstasy use outcomes. The primary objectives of this multi-site, parallel, two-group randomized controlled trial were to determine if a single-session of MET could instill greater commitment to change and reduce ecstasy use and related problems more so than an education-only intervention and whether MET sessions delivered with higher treatment fidelity are associated with better outcomes. The secondary objective was to assess participants' satisfaction with their assigned interventions. Participants (N=174; Mage=23.62) at two Australian universities were allocated randomly to receive a 15-minute educational session on ecstasy use (n=85) or a 50-minute session of MET that included an educational component (n=89). Primary outcomes were assessed at baseline, and then at 4-, 16-, and 24-weeks postbaseline, while the secondary outcome measure was assessed 4-weeks postbaseline by researchers blind to treatment allocation. Overall, the treatment fidelity was acceptable to good in the MET condition. There were no statistical differences at follow-up between the groups on the primary outcomes of ecstasy use, ecstasy-related problems, and commitment to change. Both intervention groups reported a 50% reduction in their ecstasy use and a 20% reduction in the severity of their ecstasy-related problems at the 24-week follow up. Commitment to change slightly improved for both groups (9%-17%). Despite the lack of between-group statistical differences on primary outcomes, participants who received a single session of MET were slightly more satisfied with their intervention than those who received education only. MI fidelity was not associated with ecstasy use outcomes. Given these findings, future research should focus on examining mechanisms of change. Such work may
Recent Experience Using Active Love Wave Techniques to Characterize Seismographic Station Sites

Science.gov (United States)

Martin, A. J.; Yong, A.; Salomone, L.

2014-12-01

Active-source Love waves recorded by the multi-channel analysis of surface wave (MASLW) technique were recently analyzed in two site characterization projects. Between 2010 and 2011, the 2009 American Recovery and Reinvestment Act (ARRA) funded GEOVision to conduct geophysical investigations at 189 seismographic stations—185 in California and 4 in the Central Eastern U.S. (CEUS). The original project plan was to utilize active and passive Rayleigh wave-based techniques to obtain shear-wave velocity (VS) profiles to a minimum depth of 30 m and the time-averaged VS of the upper 30 meters (VS30). Early in the investigation it became evident that Rayleigh wave techniques, such as multi-channel analysis of surface waves (MASRW), were not effective at characterizing all sites. Shear-wave seismic refraction and MASLW techniques were therefore applied. The MASLW technique was deployed at a total of 38 sites, in addition to other methods, and used as the primary technique to characterize 22 sites, 5 of which were also characterized using Rayleigh wave techniques. In 2012, the Electric Power Research Institute funded characterization of 33 CEUS station sites. Based on experience from the ARRA investigation, both MASRW and MASLW data were acquired by GEOVision at 24 CEUS sites—the remaining 9 sites and 2 overlapping sites were characterized by University of Texas, Austin. Of the 24 sites characterized by GEOVision, 16 were characterized using MASLW data, 4 using both MASLW and MASRW data and 4 using MASRW data. Love wave techniques were often found to perform better, or at least yield phase velocity data that could be more readily modeled using the fundamental mode assumption, at shallow rock sites, sites with steep velocity gradients, and, sites with a thin, low velocity, surficial soil layer overlying stiffer sediments. These types of velocity structure often excite dominant higher modes in Rayleigh wave data, but not in Love wave data. At such sites, it may be possible
Primer on Use of Multi-Spectral and Infra Red Imaging for On-Site Inspections

Energy Technology Data Exchange (ETDEWEB)

Henderson, J R

2010-10-26

The purpose of an On-Site Inspection (OSI) is to determine whether a nuclear explosion has occurred in violation of the Comprehensive Nuclear Test Ban Treaty (CTBT), and to gather information which might assist in identifying the violator (CTBT, Article IV, Paragraph 35) Multi-Spectral and Infra Red Imaging (MSIR) is allowed by the treaty to detect observables which might help reduce the search area and thus expedite an OSI and make it more effective. MSIR is permitted from airborne measurements, and at and below the surface to search for anomalies and artifacts (CTBT, Protocol, Part II, Paragraph 69b). The three broad types of anomalies and artifacts MSIR is expected to be capable of observing are surface disturbances (disturbed earth, plant stress or anomalous surface materials), human artifacts (man-made roads, buildings and features), and thermal anomalies. The purpose of this Primer is to provide technical information on MSIR relevant to its use for OSI. It is expected that this information may be used for general background information, to inform decisions about the selection and testing of MSIR equipment, to develop operational guidance for MSIR use during an OSI, and to support the development of a training program for OSI Inspectors. References are provided so readers can pursue a topic in more detail than the summary information provided here. The following chapters will provide more information on how MSIR can support an OSI (Section 2), a short summary what Multi-Spectral Imaging and Infra Red Imaging is (Section 3), guidance from the CTBT regarding the use of MSIR (Section 4), and a description of several nuclear explosion scenarios (Section 5) and consequent observables (Section 6). The remaining sections focus on practical aspects of using MSIR for an OSI, such as specification and selection of MSIR equipment, operational considerations for deployment of MISR equipment from an aircraft, and the conduct of field exercises to mature MSIR for an OSI
Multi-criteria decision analysis integrated with GIS for radio ...

African Journals Online (AJOL)

Multi-criteria decision analysis integrated with GIS for radio astronomical observatory site selection in peninsular of Malaysia. R Umar, Z.Z. Abidin, Z.A. Ibrahim, M.K.A. Kamarudin, S.N. Hazmin, A Endut, H Juahir ...
Siting criteria based on the prevention of deterministic effects from plutonium inhalation exposures

International Nuclear Information System (INIS)

Sorensen, S.A.; Low, J.O.

1998-01-01

Siting criteria are established by regulatory authorities to evaluate potential accident scenarios associated with proposed nuclear facilities. The 0.25 Sv (25 rem) siting criteria adopted in the United States has been historically based on the prevention of deterministic effects from acute, whole-body exposures. The Department of Energy has extended the applicability of this criterion to radionuclides that deliver chronic, organ-specific irradiation through the specification of a 0.25 Sv (25 rem) committed effective dose equivalent siting criterion. A methodology is developed to determine siting criteria based on the prevention of deterministic effects from inhalation intakes of radionuclides which deliver chronic, organ-specific irradiation. Revised siting criteria, expressed in terms of committed effective dose equivalent, are proposed for nuclear facilities that handle primarily plutonium compounds. The analysis determined that a siting criterion of 1.2 Sv (120 rem) committed effective dose equivalent for inhalation exposures to weapons-grade plutonium meets the historical goal of preventing deterministic effects during a facility accident scenario. The criterion also meets the Nuclear Regulatory Commission and Department of Energy Nuclear Safety Goals provided that the frequency of the accident is sufficiently low
Association between chronic conditions and health-related quality of life: differences by level of urbanization in Peru.

Science.gov (United States)

Taype-Rondan, Alvaro; Abbs, Elizabeth Sarah; Lazo-Porras, Maria; Checkley, William; Gilman, Robert H; Smeeth, Liam; Miranda, J Jaime; Bernabe-Ortiz, Antonio

2017-12-01

To evaluate the role of urbanization as an effect modifier for the association between specific chronic conditions and number of conditions with health-related quality of life (QOL). We analyzed cross-sectional data from the CRONICAS Cohort Study conducted in Lima (highly urbanized), Tumbes (semi-urban), as well as rural and urban sites in Puno. Exposures of interest were chronic bronchitis, depressive mood, hypertension, type 2 diabetes, and a composite variable aggregating the number of chronic conditions (the four exposures plus heart disease and stroke). QOL outcomes were assessed with EuroQol's EQ-5D visual analogue scale (EQ-VAS). We fitted linear regressions with robust variance to evaluate the associations of interest. Study site was assessed as a potential effect modifier using the likelihood-ratio (LR) test. We evaluated data on 2433 subjects: 51.3% were female, mean age was 57.2 years. Study site was found to be an effect modifier only for the association between depressive mood and EQ-VAS score (LR test p < 0.001). Compared to those without depressive mood, participants with depressive mood scored -13.7 points on the EQ-VAS in Lima, -7.9 in urban Puno, -11.0 in semi-urban Tumbes, and -2.7 in rural Puno. Study site was not found to be an effect modifier for the association between the number of chronic conditions and EQ-VAS (LR test p = 0.64). The impact of depressive mood on EQ-VAS was larger in urban than in rural sites, while site was not an effect modifier for the remaining associations.
Multi-Unit Initiating Event Analysis for a Single-Unit Internal Events Level 1 PSA

Energy Technology Data Exchange (ETDEWEB)

Kim, Dong San; Park, Jin Hee; Lim, Ho Gon [KAERI, Daejeon (Korea, Republic of)

2016-05-15

The Fukushima nuclear accident in 2011 highlighted the importance of considering the risks from multi-unit accidents at a site. The ASME/ANS probabilistic risk assessment (PRA) standard also includes some requirements related to multi-unit aspects, one of which (IE-B5) is as follows: 'For multi-unit sites with shared systems, DO NOT SUBSUME multi-unit initiating events if they impact mitigation capability [1].' However, the existing single-unit PSA models do not explicitly consider multi-unit initiating events and hence systems shared by multiple units (e.g., alternate AC diesel generator) are fully credited for the single unit and ignores the need for the shared systems by other units at the same site [2]. This paper describes the results of the multi-unit initiating event (IE) analysis performed as a part of the at-power internal events Level 1 probabilistic safety assessment (PSA) for an OPR1000 single unit ('reference unit'). In this study, a multi-unit initiating event analysis for a single-unit PSA was performed, and using the results, dual-unit LOOP initiating event was added to the existing PSA model for the reference unit (OPR1000 type). Event trees were developed for dual-unit LOOP and dual-unit SBO which can be transferred from dual- unit LOOP. Moreover, CCF basic events for 5 diesel generators were modelled. In case of simultaneous SBO occurrences in both units, this study compared two different assumptions on the availability of the AAC D/G. As a result, when dual-unit LOOP initiating event was added to the existing single-unit PSA model, the total CDF increased by 1∼ 2% depending on the probability that the AAC D/G is available to a specific unit in case of simultaneous SBO in both units.
MO-F-CAMPUS-T-04: Implementation of a Standardized Monthly Quality Check for Linac Output Management in a Large Multi-Site Clinic

Energy Technology Data Exchange (ETDEWEB)

Xu, H; Yi, B; Prado, K [Univ. of Maryland School Of Medicine, Baltimore, MD (United States)

2015-06-15

Purpose: This work is to investigate the feasibility of a standardized monthly quality check (QC) of LINAC output determination in a multi-site, multi-LINAC institution. The QC was developed to determine individual LINAC output using the same optimized measurement setup and a constant calibration factor for all machines across the institution. Methods: The QA data over 4 years of 7 Varian machines over four sites, were analyzed. The monthly output constancy checks were performed using a fixed source-to-chamber-distance (SCD), with no couch position adjustment throughout the measurement cycle for all the photon energies: 6 and 18MV, and electron energies: 6, 9, 12, 16 and 20 MeV. The constant monthly output calibration factor (Nconst) was determined by averaging the machines’ output data, acquired with the same monthly ion chamber. If a different monthly ion chamber was used, Nconst was then re-normalized to consider its different NDW,Co-60. Here, the possible changes of Nconst over 4 years have been tracked, and the precision of output results based on this standardized monthly QA program relative to the TG-51 calibration for each machine was calculated. Any outlier of the group was investigated. Results: The possible changes of Nconst varied between 0–0.9% over 4 years. The normalization of absorbed-dose-to-water calibration factors corrects for up to 3.3% variations of different monthly QA chambers. The LINAC output precision based on this standardized monthly QC relative to the TG-51 output calibration is within 1% for 6MV photon energy and 2% for 18MV and all the electron energies. A human error in one TG-51 report was found through a close scrutiny of outlier data. Conclusion: This standardized QC allows for a reasonably simplified, precise and robust monthly LINAC output constancy check, with the increased sensitivity needed to detect possible human errors and machine problems.
Inadvertent Intruder Analysis For The Portsmouth On-Site Waste Disposal Facility (OSWDF)

Energy Technology Data Exchange (ETDEWEB)

Smith, Frank G. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Phifer, Mark A. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

2014-01-22

The inadvertent intruder analysis considers the radiological impacts to hypothetical persons who are assumed to inadvertently intrude on the Portsmouth OSWDF site after institutional control ceases 100 years after site closure. For the purposes of this analysis, we assume that the waste disposal in the OSWDF occurs at time zero, the site is under institutional control for the next 100 years, and inadvertent intrusion can occur over the following 1,000 year time period. Disposal of low-level radioactive waste in the OSWDF must meet a requirement to assess impacts on such individuals, and demonstrate that the effective dose equivalent to an intruder would not likely exceed 100 mrem per year for scenarios involving continuous exposure (i.e. chronic) or 500 mrem for scenarios involving a single acute exposure. The focus in development of exposure scenarios for inadvertent intruders was on selecting reasonable events that may occur, giving consideration to regional customs and construction practices. An important assumption in all scenarios is that an intruder has no prior knowledge of the existence of a waste disposal facility at the site. Results of the analysis show that a hypothetical inadvertent intruder at the OSWDF who, in the worst case scenario, resides on the site and consumes vegetables from a garden established on the site using contaminated soil (chronic agriculture scenario) would receive a maximum chronic dose of approximately 7.0 mrem/yr during the 1000 year period of assessment. This dose falls well below the DOE chronic dose limit of 100 mrem/yr. Results of the analysis also showed that a hypothetical inadvertent intruder at the OSWDF who, in the worst case scenario, excavates a basement in the soil that reaches the waste (acute basement construction scenario) would receive a maximum acute dose of approximately 0.25 mrem/yr during the 1000 year period of assessment. This dose falls well below the DOE acute dose limit of 500 mrem/yr. Disposal inventory
Multi-Morbidity in Hospitalised Older Patients: Who Are the Complex Elderly?

Science.gov (United States)

Ruiz, Milagros; Bottle, Alex; Long, Susannah; Aylin, Paul

2015-01-01

No formal definition for the "complex elderly" exists; moreover, these older patients with high levels of multi-morbidity are not readily identified as such at point of hospitalisation, thus missing a valuable opportunity to manage the older patient appropriately within the hospital setting. To empirically identify the complex elderly patient based on degree of multi-morbidity. Retrospective observational study using administrative data. English hospitals during the financial year 2012-13. All admitted patients aged 65 years and over. By using exploratory analysis (correspondence analysis) we identify multi-morbidity groups based on 20 target conditions whose hospital prevalence was ≥ 1%. We examined a total of 2788900 hospital admissions. Multi-morbidity was highly prevalent, 62.8% had 2 or more of the targeted conditions while 4.7% had six or more. Multi-morbidity increased with age from 56% (65-69yr age-groups) up to 67% (80-84yr age-group). The average multi-morbidity was 3.2±1.2 (SD). Correspondence analysis revealed 3 distinct groups of older patients. Group 1 (multi-morbidity ≤2), associated with cancer and/or metastasis; Group 2 (multi-morbidity of 3, 4 or 5), associated with chronic pulmonary disease, lung disease, rheumatism and osteoporosis; finally Group 3 with the highest level of multi-morbidity (≥6) and associated with heart failure, cerebrovascular accident, diabetes, hypertension and myocardial infarction. By using widely available hospital administrative data, we propose patients in Groups 2 and 3 to be identified as the complex elderly. Identification of multi-morbidity patterns can help to predict the needs of the older patient and improve resource provision.
Multi-Morbidity in Hospitalised Older Patients: Who Are the Complex Elderly?

Directory of Open Access Journals (Sweden)

Milagros Ruiz

Full Text Available No formal definition for the "complex elderly" exists; moreover, these older patients with high levels of multi-morbidity are not readily identified as such at point of hospitalisation, thus missing a valuable opportunity to manage the older patient appropriately within the hospital setting.To empirically identify the complex elderly patient based on degree of multi-morbidity.Retrospective observational study using administrative data.English hospitals during the financial year 2012-13.All admitted patients aged 65 years and over.By using exploratory analysis (correspondence analysis we identify multi-morbidity groups based on 20 target conditions whose hospital prevalence was ≥ 1%.We examined a total of 2788900 hospital admissions. Multi-morbidity was highly prevalent, 62.8% had 2 or more of the targeted conditions while 4.7% had six or more. Multi-morbidity increased with age from 56% (65-69yr age-groups up to 67% (80-84yr age-group. The average multi-morbidity was 3.2±1.2 (SD. Correspondence analysis revealed 3 distinct groups of older patients. Group 1 (multi-morbidity ≤2, associated with cancer and/or metastasis; Group 2 (multi-morbidity of 3, 4 or 5, associated with chronic pulmonary disease, lung disease, rheumatism and osteoporosis; finally Group 3 with the highest level of multi-morbidity (≥6 and associated with heart failure, cerebrovascular accident, diabetes, hypertension and myocardial infarction.By using widely available hospital administrative data, we propose patients in Groups 2 and 3 to be identified as the complex elderly. Identification of multi-morbidity patterns can help to predict the needs of the older patient and improve resource provision.

Chronicity, crisis, and the 'end of AIDS'.

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Sangaramoorthy, Thurka

2018-01-11

In biomedical, public health, and popular discourses, the 'end of AIDS' has emerged as a predominant way to understand the future of HIV research and prevention. This approach is predicated on structuring and responding to HIV in ways that underscore its presumed lifelong nature. In this article, I examine the phenomenon of HIV chronicity that undergirds the 'end of AIDS' discourse. In particular, I explore how the logic of HIV chronicity, induced by technological advances in treatment and global financial and political investments, intensifies long-term uncertainty and prolonged crisis. Focusing on over 10 years of anthropological and public health research in the United States, I argue that HIV chronicity, and subsequently, the 'end of AIDS' discourse, obscure the on-going HIV crisis in particular global communities, especially among marginalised and ageing populations who live in under-resourced areas. By tracing the 'end of AIDS' discourse in my field sites and in other global locations, I describe how HIV chronicity signals a continuing global crisis and persistent social precarity rather than a 'break' with a hopeless past or a promising future free from AIDS.
Association of Geography and Ambient Air Pollution with Urine Metal Concentrations in Six US Cities: The Multi-Ethnic Study of Atherosclerosis

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Yuanjie Pang

2016-03-01

Full Text Available We investigated the associations of urinary concentrations of antimony, cadmium, tungsten and uranium with geographic locations and with ambient air pollution in 304 adults in the Multi-Ethnic Study of Atherosclerosis from six US cities. After adjustment for sociodemographics, body mass index, and smoking status, urinary cadmium was the highest in Winston-Salem among all study sites (the geometric mean [GM] in Winston-Salem was 0.84 µg/L [95% confidence interval (CI 0.57–1.22]. The adjusted GMs of urinary tungsten and uranium were highest in Los Angeles (0.11 µg/L [95% CI 0.08–0.16] and 0.019 µg/L [95% CI 0.016–0.023], respectively. The adjusted GM ratio comparing fine particulate matter (PM2.5 tertiles 2 and 3 with the lowest tertile were 1.64 (95% CI 1.05–2.56 and 3.55 (95% CI 2.24–5.63 for tungsten, and 1.18 (95% CI 0.94–1.48 and 1.70 (95% CI 1.34–2.14 for uranium. The results for tungsten remained similar after adjustment for study site. Urinary cadmium, tungsten and uranium concentrations differed by geographic locations in MESA (Multi-Ethnic Study of Atherosclerosis communities. PM2.5 levels could contribute to geographic differences in tungsten exposure. These findings highlight the need to implement preventive strategies to decrease toxic metal exposure and to evaluate the health effects of chronic exposure to those metals.
Investigating the Burden of Chronic Pain: An Inflammatory and Metabolic Composite

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Kimberly T. Sibille

2016-01-01

Full Text Available Background. Chronic pain is associated with increased morbidity and mortality, predominated by cardiovascular disease and cancer. Investigating related risk factor measures may elucidate the biological burden of chronic pain. Objectives. We hypothesized that chronic pain severity would be positively associated with the risk factor composite. Methods. Data from 12,982 participants in the 6th Tromsø study were analyzed. Questionnaires included demographics, health behaviors, medical comorbidities, and chronic pain symptoms. The risk factor composite was comprised of body mass index, fibrinogen, C-reactive protein, and triglycerides. Chronic pain severity was characterized by frequency, intensity, time/duration, and total number of pain sites. Results. Individuals with chronic pain had a greater risk factor composite than individuals without chronic pain controlling for covariates and after excluding inflammation-related health conditions (p<0.001. A significant “dose-response” relationship was demonstrated with pain severity (p<0.001. In individuals with chronic pain, the risk factor composite varied by health behavior, exercise, lower levels and smoking, and higher levels. Discussion. The risk factor composite was higher in individuals with chronic pain, greater with increasing pain severity, and influenced by health behaviors. Conclusions. Identification of a biological composite sensitive to pain severity and adaptive/maladaptive behaviors would have significant clinical and research utility.
Lessons learned from bacterial transport research at the South Oyster Site

Energy Technology Data Exchange (ETDEWEB)

Scheibe, T.; Hubbard, S.S.; Onstott, T.C.; DeFlaun, M.F.

2011-04-01

This paper provides a review of bacterial transport experiments conducted by a multi-investigator, multi-institution, multi-disciplinary team of researchers under the auspices of the U. S. Department of Energy (DOE). The experiments were conducted during the time period 1999-2001 at a field site near the town of Oyster, Virginia known as the South Oyster Site, and included four major experimental campaigns aimed at understanding and quantifying bacterial transport in the subsurface environment. Several key elements of the research are discussed here: (1) quantification of bacterial transport in physically, chemically and biologically heterogeneous aquifers, (2) evaluation of the efficacy of conventional colloid filtration theory, (3) scale effects in bacterial transport, (4) development of new methods for microbial enumeration and screening for low adhesion strains, (5) application of novel hydrogeophysical techniques for aquifer characterization, and (6) experiences regarding management of a large field research effort. Lessons learned are summarized in each of these areas. The body of literature resulting from South Oyster Site research has been widely cited and continues to influence research into the controls exerted by aquifer heterogeneity on reactive transport (including microbial transport). It also served as a model (and provided valuable experience) for subsequent and ongoing highly-instrumented field research efforts conducted by DOE-sponsored investigators.
Phlebitis risk varies by peripheral venous catheter site and increases after 96 hours: a large multi-centre prospective study.

Science.gov (United States)

Cicolini, Giancarlo; Manzoli, Lamberto; Simonetti, Valentina; Flacco, Maria Elena; Comparcini, Dania; Capasso, Lorenzo; Di Baldassarre, Angela; Eltaji Elfarouki, Ghaleb

2014-11-01

This multi-centre prospective field study evaluated whether peripheral venous catheter site of insertion influences the risk of catheter-related phlebitis. Potential predictors of phlebitis were also investigated. Millions of patients worldwide use peripheral venous catheters, which frequently cause local complications including phlebitis, infection and obstruction. Although phlebitis predictors have been broadly investigated, uncertainties remain on the potential effect of cannulation anatomical site, duration and the appropriate time for catheter removal. A prospective cohort design was carried out from January-June 2012. The clinical course of each patient who received a new peripheral venous catheter for any cause in five Italian hospitals was followed by trained nurses until catheter removal. The presence of phlebitis was assessed every 24 hours using the Visual Infusion Phlebitis score. Analyses were based upon multilevel mixed-effects regression. The final sample consisted of 1498 patients. The average time for catheters in situ was 65·6 hours and 23·6% of the catheters were in place beyond 96 hours. Overall phlebitis incidence was 15·4%, 94·4% of which were grade 1. The likelihood of phlebitis independently increased with increasing catheter duration, being highest after 96 hours. Compared with patients with catheter placed in the dorsum of the hand (22·8% of the sample), those with the catheter located in the antecubital fossa (34·1%) or forearm were less likely to have a phlebitis of any grade. Antecubital fossa and forearm veins may be preferential sites for peripheral venous cannulation. Our results support Centers for Disease Control and Prevention recommendations to replace catheters in adults no later than 96 hours. A relevant proportion of healthcare personnel did not adhere to such guidelines - more attention to this issue is required. © 2014 John Wiley & Sons Ltd.
Volatility and change in chronic pain severity predict outcomes of treatment for prescription opioid addiction.

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Worley, Matthew J; Heinzerling, Keith G; Shoptaw, Steven; Ling, Walter

2017-07-01

Buprenorphine-naloxone (BUP-NLX) can be used to manage prescription opioid addiction among persons with chronic pain, but post-treatment relapse is common and difficult to predict. This study estimated whether changes in pain over time and pain volatility during BUP-NLX maintenance would predict opioid use during the taper BUP-NLX taper. Secondary analysis of a multi-site clinical trial for prescription opioid addiction, using data obtained during a 12-week BUP-NLX stabilization and 4-week BUP-NLX taper. Community clinics affiliated with a national clinical trials network in 10 US cities. Subjects with chronic pain who entered the BUP-NLX taper phase (n = 125) with enrollment occurring from June 2006 to July 2009 (52% male, 88% Caucasian, 31% married). Outcomes were weekly biologically verified and self-reported opioid use from the 4-week taper phase. Predictors were estimates of baseline severity, rate of change and volatility in pain from weekly self-reports during the 12-week maintenance phase. Controlling for baseline pain and treatment condition, increased pain [odds ratio (OR) = 2.38, P = 0.02] and greater pain volatility (OR = 2.43, P = 0.04) predicted greater odds of positive opioid urine screen during BUP-NLX taper. Increased pain (IRR = 1.40, P = 0.04) and greater pain volatility [incidence-rate ratio (IRR) = 1.66, P = 0.009] also predicted greater frequency of self-reported opioid use. Adults with chronic pain receiving out-patient treatment with buprenorphine-naloxone (BUP-NLX) for prescription opioid addiction have an elevated risk for opioid use when tapering off maintenance treatment. Those with relative persistence in pain over time and greater volatility in pain during treatment are less likely to sustain abstinence during BUP-NLX taper. © 2017 Society for the Study of Addiction.
Under What Assumptions Do Site-by-Treatment Instruments Identify Average Causal Effects?

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Reardon, Sean F.; Raudenbush, Stephen W.

2013-01-01

The increasing availability of data from multi-site randomized trials provides a potential opportunity to use instrumental variables methods to study the effects of multiple hypothesized mediators of the effect of a treatment. We derive nine assumptions needed to identify the effects of multiple mediators when using site-by-treatment interactions…
Multi-Capacity Load Cell Concept

Directory of Open Access Journals (Sweden)

Seif. M. OSMAN

2014-09-01

Full Text Available Force measuring systems are usually used to calibrate force generated systems, it is not preferable to use load cells to measure forces less than 10 % of its nominal capacity. Several load cells are required to offer calibration facilities at sites to cover different ranges, this lead to difficulties in handling procedures, through the need for several carrying cases to carry this overweight in addition to the over cost of purchasing several load cells. This article concerns with introducing a new concept for designing a multi-capacity load cell as a new force standard in the field of measuring the force. This multi-capacity load cell will replace a set of load cells and reflects economically on the total cost and on easiness of handling procedures.
Enzyme-sharing as a cause of multi-stationarity in signalling systems

DEFF Research Database (Denmark)

Feliu, Elisenda; Wiuf, Carsten

2012-01-01

Multi-stationarity in biological systems is a mechanism of cellular decision-making. In particular, signalling pathways regulated by protein phosphorylation display features that facilitate a variety of responses to different biological inputs. The features that lead to multi-stationarity are of ......Multi-stationarity in biological systems is a mechanism of cellular decision-making. In particular, signalling pathways regulated by protein phosphorylation display features that facilitate a variety of responses to different biological inputs. The features that lead to multi......-stationarity are of particular interest to determine, as well as the stability, properties of the steady states. In this paper, we determine conditions for the emergence of multi-stationarity in small motifs without feedback that repeatedly occur in signalling pathways. We derive an explicit mathematical relationship ¿ between...... identify characteristics of the motifs that lead to multi-stationarity, and extend the view that multi-stationarity in signalling pathways arises from multi-site phosphorylation. Our approach relies on mass-action kinetics, and the conclusions are drawn in full generality without resorting to simulations...
Resolution of Localized Chronic Periodontitis Associated with Longstanding Calculus Deposits

OpenAIRE

Lai, Pin-Chuang; Walters, John D.

2014-01-01

This report, which is based on nonstandardized serial radiographs obtained over a period of 15 years, documents a case of localized chronic periodontitis associated with progressive deposition of calculus on the distal aspect of a mandibular second molar. The site was treated by scaling and root planing, followed by a course of adjunctive systemic azithromycin. Treatment yielded favorable reductions in probing depth and clinical inflammation, leaving only few isolated sites with pockets no de...
Multi-Channel Electronically Scanned Cryogenic Pressure Sensor And Method For Making Same

Science.gov (United States)

Chapman, John J. (Inventor); Hopson, Purnell, Jr. (Inventor); Holloway, Nancy M. (Inventor)

2001-01-01

A miniature, multi-channel, electronically scanned pressure measuring device uses electrostatically bonded silicon dies in a multi-element array. These dies are bonded at specific sites on a glass, pre-patterned substrate. Thermal data is multiplexed and recorded on each individual pressure measuring diaphragm. The device functions in a cryogenic environment without the need of heaters to keep the sensor at constant temperatures.
The Violence Prevention Community Meeting: A Multi-Site Study.

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Lanza, Marilyn; Ridenour, Marilyn; Hendricks, Scott; Rierdan, Jill; Zeiss, Robert; Schmidt, Satu; Lovelace, Jeff; Amandus, Harlan

2016-06-01

The Violence Prevention Community Meeting (VPCM) is a specialized form of community meeting in which avoiding violence and promoting non-violent problem solving and interpersonal civility are focal points. A nationwide study to assess the VPCM as an effective intervention to reduce workplace violence was undertaken. Seven acute locked psychiatric units of the Veterans Health Administration (VHA) throughout the United States participated in the study. All patients and all staff on the seven in-patient locked psychiatry units participated in the intervention (VPCM) or as a control (treatment as usual). The study was 21weeks at each site. The three time periods were pre-treatment weeks 1-3, treatment weeks 4-18, and post-treatment weeks 19-21. The VPCM was conducted during the treatment weeks. Overall rates of aggression declined by 0.6% (95% CI: -5.6%, 6.5%; nonsignificant) per week in the intervention hospitals and by 5.1% (95% CI: 0.4%, 9.6%; significant) per week for the control hospitals. Aggression decreased for both the intervention and control hospitals which could be due to enrollment in a research study and thus being more aware of their ability to address workplace violence at their site. Published by Elsevier Inc.
Efficiency of nonsurgical periodontal therapy in moderate chronic periodontitis.

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Mlachkova, Antoaneta M; Popova, Christina L

2014-01-01

Chronic periodontitis is defined as an inflammatory disease of the supporting tissues of teeth caused by microorganisms in the dental biofilm, resulting in progressive destruction of the periodontal ligament and alveolar bone with pocket formation and gingival recession. Treatment of chronic periodontitis aims at arresting the inflammation and stopping the loss of attachment by removal and control of the supra- and subgingival biofilm and establishing a local environment and microflora compatible with periodontal health. The AIM of this study was to evaluate the effectiveness of non-surgical therapy (scaling and root planning) in the treatment of moderate chronic periodontitis. The study included 30 patients aged between 33 and 75 years, of which 46.7% women and 53.3% men, diagnosed with moderate and, at some sites, severe periodontitis. They were treated with non-surgical periodontal therapy methods (scaling and root planning and curettage if indicated). Additionally, chemical plaque control with rinse water containing chlorhexidine was applied. The diagnostic and reassessment procedures included measuring the periodontal indices of 601 periodontal units before and after the therapy. The indices measured were the papillary bleeding index (PBI), the hygiene index (HI), the probing pocket depth (PPD) and the clinical attachment level (CAL). Significant reduction of plaque and gingival inflammation was found in all treated patients; we also found a statistically significant reduction of periodontal pockets with clinically measured depth 5 mm did not show statistically significant lower incidence rates probably due to the initially small percentage of deep pockets in the patients studied. There was a statistically significant reduction of all sites with attachment loss, the highest significance found at sites where the attachment loss was greater than 5 mm. The results of the study suggest that nonsurgical periodontal therapy is effective in managing the moderate
Hazard and operability study of the multi-function Waste Tank Facility. Revision 1

International Nuclear Information System (INIS)

Hughes, M.E.

1995-01-01

The Multi-Function Waste Tank Facility (MWTF) East site will be constructed on the west side of the 200E area and the MWTF West site will be constructed in the SW quadrant of the 200W site in the Hanford Area. This is a description of facility hazards that site personnel or the general public could potentially be exposed to during operation. A list of preliminary Design Basis Accidents was developed
Chronic sleep reduction, functioning at school and school achievement in preadolescents.

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Meijer, Anne Marie

2008-12-01

This study investigates the relationship between chronic sleep reduction, functioning at school and school achievement of boys and girls. To establish individual consequences of chronic sleep reduction (tiredness, sleepiness, loss of energy and emotional instability) the Chronic Sleep Reduction Questionnaire has been developed. A total of 436 children (219 boys, 216 girls, 1 [corrected] missing; mean age = 11 years and 5 months) from the seventh and eight grades of 12 elementary schools participated in this study. The inter-item reliability (Cronbach's alpha = 0.84) and test-retest reliability (r = 0.78) of the Chronic Sleep Reduction Questionnaire were satisfactory. The construct validity of the questionnaire as measured by a confirmative factor analysis was acceptable as well (CMIN/DF = 1.49; CFI = 0.94; RMSEA = 0.034). Cronbach's alpha's of the scales measuring functioning at school (teacher's influence, self-image as pupil, and achievement motivation) were 0.69, 0.86 and 0.79. School achievement was based on self-reported marks concerning six school subjects. To test the models concerning the relations of chronic sleep reduction, functioning at school, and school achievement, the covariance matrix of these variables were analysed by means of structural equation modelling. To test for differences between boys and girls a multi-group model is used. The models representing the relations between chronic sleep reduction - school achievement and chronic sleep reduction - functioning at school - school achievement fitted the data quite well. The impact of chronic sleep reduction on school achievement and functioning at school appeared to be different for boys and girls. Based on the results of this study, it may be concluded that chronic sleep reduction may affect school achievement directly and indirectly via functioning at school, with worse school marks as a consequence.
A comparison of chronic pain prevalence in Japan, Thailand, and myanmar.

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Sakakibara, Toshihiko; Wang, Zhuo; Paholpak, Permsak; Kosuwon, Weerachai; Oo, Myint; Kasai, Yuichi

2013-01-01

Pain has been regarded as important in the improvement of quality of life (QOL). In the advanced countries of Europe and the North America, a number of large-scale epidemiological surveys on pain, particularly chronic pain, have thus been performed in general populations. However, few epidemiological surveys of chronic pain have been reported from developing countries, and no surveys appear to have examined chronic pain in the least developed countries. To compare the incidence of chronic pain in Asian countries, using Japan as an advanced country, Thailand as a developing country, and Myanmar as one of the least developed countries. Cross-sectional study in 4 hospitals. A university hospital and a general hospital in Japan, a university hospital in Thailand, and a general hospital in Myanmar. Patients were 1,000 nursing staff working in Japan, 448 nursing staff working in Thailand, and 405 nursing staff working in Myanmar. The survey was performed by requesting all nursing staff to anonymously answer the questionnaire. Data were used to calculate chronic pain prevalence, pain site, presence or absence of consultation with doctors, methods of handling pain other than consultation with doctors, and whether pain was controlled for each country. The results were then compared between countries. The prevalence of chronic pain in Myanmar was 5.9%, which was significantly lower (P Myanmar, no clear certain tendencies were observed. The most frequent method for handling pain other than consultation with doctors was over-the-counter drugs in Japan, massage in Thailand, and relaxation therapy (meditation) in Myanmar. Limitations of this study were the cross-sectional design study, the small number of hospitals included, the limitation of patients to nursing staff, and the omission from the questionnaire of questions regarding body height and weight, working situation, family background, trauma history, sports activity history, smoking history, psychological/character tests
Sensory dissociation in chronic low back pain: Two case reports.

Science.gov (United States)

Adamczyk, Wacław M; Luedtke, Kerstin; Saulicz, Oskar; Saulicz, Edward

2018-08-01

Patients with chronic low back pain often report that they do not perceive their painful back accurately. Previous studies confirmed that sensory dissociation and/or discrepancy between perceived body image and actual size is one of the specific traits of patients with chronic pain. Current approaches for measuring sensory dissociation are limited to two-point-discrimination or rely on pain drawings not allowing for quantitative analysis. This case study reports the sensory dissociation of two cases with chronic low back pain using a recently published test (point-to-point-test (PTP)) and a newly developed test (two-point-estimation (TPE)). Both patients mislocalized tactile stimuli delivered to the painful location compared to non-painful locations (PTP test). In addition, both patients perceived their painful lumbar region differently from non-painful sites above and below and contralateral to the painful site. TPE data showed two distinct clinical patterns of sensory dissociation: one patient perceived the two-point distance in the painful area as expanded, while the other patient perceived it as shrunk. The latter pattern of sensory dissociation (i.e., pattern shrunk) is likely to respond to sensory training. Whether enlarged patterns of sensory dissociation are more resistant to treatment remains unknown but would explain the low effectiveness of previous studies using sensory training in chronic low back pain populations. Subgrouping patients according to their sensory discrimination pattern could contribute to the choice and effectiveness of the treatment approach.
Multi-criteria selection of offshore wind farms: Case study for the Baltic States

International Nuclear Information System (INIS)

Chaouachi, Aymen; Covrig, Catalin Felix; Ardelean, Mircea

2017-01-01

This paper presents a multi-criteria selection approach for offshore wind sites assessment. The proposed site selection framework takes into consideration the electricity network’s operating security aspects, economic investment, operation costs and capacity performances relative to each potential site. The selection decision is made through Analytic Hierarchy Process (AHP), with an inherited flexibility that aims to allow end users to adjust the expected benefits accordingly to their respective and global priorities. The proposed site selection framework is implemented as an interactive case study for three Baltic States in the 2020 time horizon, based on real data and exhaustive power network models, taking into consideration the foreseen upgrades and network reinforcements. For each country the optimal offshore wind sites are assessed under multiple weight contribution scenarios, reflecting the characteristics of market design, regulatory aspects or renewable integration targets. - Highlights: • We use a multi-criteria selection approach for offshore wind sites assessment. • Security aspects, economic investment, operation costs and capacity performances are included. • The selection decision is made through an Analytic Hierarchy Process (AHP). • We implement the methodology as a case study for three Baltic States in the 2020 time horizon.
Chronic pancreatitis

Science.gov (United States)

Chronic pancreatitis - chronic; Pancreatitis - chronic - discharge; Pancreatic insufficiency - chronic; Acute pancreatitis - chronic ... abuse over many years. Repeated episodes of acute pancreatitis can lead to chronic pancreatitis. Genetics may be ...
Genetic efficiency of low-dose chronic irradiation in mammals and fish

International Nuclear Information System (INIS)

Goncharova, R.; Ryabokon, N.; Smolich, I.; Slukvin, A.

2001-01-01

The problem of biological effects of low-dose chronic irradiation is central radiobiological problem and seems to be very important for human monitoring and risk assessment Since 1986 we are engaged in studying genetic effects of low-dose chronic irradiation in natural populations of small mammals (bank vole - Clethrioiiomys glareolus) inhabiting radiocontaminated monitoring sites, in laboratory hybrid mice CBA*C57BI/6 j exposed to chronic irradiation at radiocontaminated sites, as well as in pond carp (Cyprinus carpio) reared in fish farms in areas contaminated due to the Chernobyl accident. The mean ground depositions in monitoring sites were 8-2330 kBq/m 2 and the mean bottom depositions in ponds were 52-3235 Bq/kg for Cs 137. We used conventional cytogenetics and genetics tests [1-3] and the following approaches in studying on genetic effects of low-dose chronic irradiation: Radiation exposures from external γ- and internal α, β, γ-irradiation from incorporated radionuclides were estimated for each specimen tested. Regression analysis of dose-effect relationships based on comparison of individual genetic end-points with individual absorbed doses was carried out We observed statistically significant changes in the frequencies of genetic end-points, which have been studied in somatic and germ cells, as well as in embryos of irradiated mammals and fish. So, the frequencies of chromosome aberrations in bank vole populations had up to 7-fold increase in comparison with background and pre-accident levels. It is of great importance to emphasize high radio-sensitivity of fertilized eggs (zygotes) and pond carp, embryos produced by chronically irradiated parents. Regression analysis allowed to reveal dependence of the studied parameters' frequencies on radiation exposure namely on the concentrations of basic dose forming radionuclides, absorbed dose rate and whole body absorbed dose. In most cases, dose-effect relationships were better approximated by non

Big GABA: Edited MR spectroscopy at 24 research sites.

Science.gov (United States)

Mikkelsen, Mark; Barker, Peter B; Bhattacharyya, Pallab K; Brix, Maiken K; Buur, Pieter F; Cecil, Kim M; Chan, Kimberly L; Chen, David Y-T; Craven, Alexander R; Cuypers, Koen; Dacko, Michael; Duncan, Niall W; Dydak, Ulrike; Edmondson, David A; Ende, Gabriele; Ersland, Lars; Gao, Fei; Greenhouse, Ian; Harris, Ashley D; He, Naying; Heba, Stefanie; Hoggard, Nigel; Hsu, Tun-Wei; Jansen, Jacobus F A; Kangarlu, Alayar; Lange, Thomas; Lebel, R Marc; Li, Yan; Lin, Chien-Yuan E; Liou, Jy-Kang; Lirng, Jiing-Feng; Liu, Feng; Ma, Ruoyun; Maes, Celine; Moreno-Ortega, Marta; Murray, Scott O; Noah, Sean; Noeske, Ralph; Noseworthy, Michael D; Oeltzschner, Georg; Prisciandaro, James J; Puts, Nicolaas A J; Roberts, Timothy P L; Sack, Markus; Sailasuta, Napapon; Saleh, Muhammad G; Schallmo, Michael-Paul; Simard, Nicholas; Swinnen, Stephan P; Tegenthoff, Martin; Truong, Peter; Wang, Guangbin; Wilkinson, Iain D; Wittsack, Hans-Jörg; Xu, Hongmin; Yan, Fuhua; Zhang, Chencheng; Zipunnikov, Vadim; Zöllner, Helge J; Edden, Richard A E

2017-10-01

Magnetic resonance spectroscopy (MRS) is the only biomedical imaging method that can noninvasively detect endogenous signals from the neurotransmitter γ-aminobutyric acid (GABA) in the human brain. Its increasing popularity has been aided by improvements in scanner hardware and acquisition methodology, as well as by broader access to pulse sequences that can selectively detect GABA, in particular J-difference spectral editing sequences. Nevertheless, implementations of GABA-edited MRS remain diverse across research sites, making comparisons between studies challenging. This large-scale multi-vendor, multi-site study seeks to better understand the factors that impact measurement outcomes of GABA-edited MRS. An international consortium of 24 research sites was formed. Data from 272 healthy adults were acquired on scanners from the three major MRI vendors and analyzed using the Gannet processing pipeline. MRS data were acquired in the medial parietal lobe with standard GABA+ and macromolecule- (MM-) suppressed GABA editing. The coefficient of variation across the entire cohort was 12% for GABA+ measurements and 28% for MM-suppressed GABA measurements. A multilevel analysis revealed that most of the variance (72%) in the GABA+ data was accounted for by differences between participants within-site, while site-level differences accounted for comparatively more variance (20%) than vendor-level differences (8%). For MM-suppressed GABA data, the variance was distributed equally between site- (50%) and participant-level (50%) differences. The findings show that GABA+ measurements exhibit strong agreement when implemented with a standard protocol. There is, however, increased variability for MM-suppressed GABA measurements that is attributed in part to differences in site-to-site data acquisition. This study's protocol establishes a framework for future methodological standardization of GABA-edited MRS, while the results provide valuable benchmarks for the MRS community
Self-management interventions including action plans for exacerbations versus usual care in patients with chronic obstructive pulmonary disease

NARCIS (Netherlands)

Lenferink, Anke; Brusse-Keizer, Marjolein; van der Valk, Paul D.L.P.M.; Frith, Peter A.; Zwerink, Marlies; Monninkhof, Evelyn M.; van der Palen, Job; Effing-Tijdhof, Tanja W

2017-01-01

Background: Chronic Obstructive Pulmonary Disease (COPD) self-management interventions should be structured but personalised and often multi-component, with goals of motivating, engaging and supporting the patients to positively adapt their behaviour(s) and develop skills to better manage disease.
Altered Pain Sensitivity in Elderly Women with Chronic Neck Pain

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Uthaikhup, Sureeporn; Prasert, Romchat; Paungmali, Aatit; Boontha, Kritsana

2015-01-01

Background Age-related changes occur in both the peripheral and central nervous system, yet little is known about the influence of chronic pain on pain sensitivity in older persons. The aim of this study was to investigate pain sensitivity in elders with chronic neck pain compared to healthy elders. Methods Thirty elderly women with chronic neck pain and 30 controls were recruited. Measures of pain sensitivity included pressure pain thresholds, heat/cold pain thresholds and suprathreshold heat pain responses. The pain measures were assessed over the cervical spine and at a remote site, the tibialis anterior muscle. Results Elders with chronic neck pain had lower pressure pain threshold over the articular pillar of C5-C6 and decreased cold pain thresholds over the cervical spine and tibialis anterior muscle when compared with controls (p pain thresholds and suprathreshold heat pain responses (p > 0.05). Conclusion The presence of pain hypersensitivity in elderly women with chronic neck pain appears to be dependent on types of painful stimuli. This may reflect changes in the peripheral and central nervous system with age. PMID:26039149
'Multi-epitope-targeted' immune-specific therapy for a multiple sclerosis-like disease via engineered multi-epitope protein is superior to peptides.

Directory of Open Access Journals (Sweden)

Nathali Kaushansky

Full Text Available Antigen-induced peripheral tolerance is potentially one of the most efficient and specific therapeutic approaches for autoimmune diseases. Although highly effective in animal models, antigen-based strategies have not yet been translated into practicable human therapy, and several clinical trials using a single antigen or peptidic-epitope in multiple sclerosis (MS yielded disappointing results. In these clinical trials, however, the apparent complexity and dynamics of the pathogenic autoimmunity associated with MS, which result from the multiplicity of potential target antigens and "epitope spread", have not been sufficiently considered. Thus, targeting pathogenic T-cells reactive against a single antigen/epitope is unlikely to be sufficient; to be effective, immunospecific therapy to MS should logically neutralize concomitantly T-cells reactive against as many major target antigens/epitopes as possible. We investigated such "multi-epitope-targeting" approach in murine experimental autoimmune encephalomyelitis (EAE associated with a single ("classical" or multiple ("complex" anti-myelin autoreactivities, using cocktail of different encephalitogenic peptides vis-a-vis artificial multi-epitope-protein (designated Y-MSPc encompassing rationally selected MS-relevant epitopes of five major myelin antigens, as "multi-epitope-targeting" agents. Y-MSPc was superior to peptide(s in concomitantly downregulating pathogenic T-cells reactive against multiple myelin antigens/epitopes, via inducing more effective, longer lasting peripheral regulatory mechanisms (cytokine shift, anergy, and Foxp3+ CTLA4+ regulatory T-cells. Y-MSPc was also consistently more effective than the disease-inducing single peptide or peptide cocktail, not only in suppressing the development of "classical" or "complex EAE" or ameliorating ongoing disease, but most importantly, in reversing chronic EAE. Overall, our data emphasize that a "multi-epitope-targeting" strategy is required for
Environmental Interventions for Obesity and Chronic Disease Prevention.

Science.gov (United States)

Gittelsohn, Joel; Trude, Angela

2015-01-01

Innovative approaches are needed to impact obesity and other diet-related chronic diseases, including tested interventions at the environmental and policy levels. We have conducted multi-level community trials in low-income minority settings in the United States and other countries that test interventions to improve the food environment, support policy, and reduce the risk for developing obesity and other diet-related chronic diseases. All studies have examined change from pre- to post-study, comparing an intervention with a comparison group. Our results have shown consistent positive effects of these trials on consumer psychosocial factors, food purchasing, food preparation and diet, and, in some instances, obesity. We have recently implemented a systems science model to support programs and policies to improve urban food environments. Environmental interventions are a promising approach for addressing the global obesity epidemic due to their wide reach. Further work is needed to disseminate, expand and sustain these initiatives through policy at the city, state and federal levels.
Genetic variability in chronic irradiated plant populations - Polymorphism and activity of antioxidant enzymes in chronic irradiated plant populations

Energy Technology Data Exchange (ETDEWEB)

Volkova, Polina Y.; Geras' kin, Stanislav A. [Russian Institute of Agricultural Radiology and Agroecology, 249030, Obninsk, Kievskoe shosse 109 km (Russian Federation)

2014-07-01

Introduction: The gene pool of natural population is constantly changing in order to provide the greatest fitness at this time. Ability of population to adapt to changing environmental conditions depends on genetic polymorphism of traits which are operates by selection. Chronic stress exposure can change amount or structure intra-population variability. Therefore, it is necessary to analyze the relationships between genetic polymorphism and stress factors, such as radiation exposure. This studies my assist in the development of new bio-indication methods. Materials and methods: Studying sites: Bryansk region is the most contaminated region of Russia as a result of Chernobyl accident. The initial activity by {sup 137}Cs on this territory reached 1 MBq/m{sup 2} above surface. Our study conducted in several districts of Bryansk region, which are characterized the most dose rate. Experimental sites similar to climate characteristics, stand of trees is homogeneous, pine trees take up a significant part of phytocenosis. Heavy metals content in soils and cones be within background. Dose rates vary from 0.14 to 130 mGy/year. Object: Pinus sylvestris L.,the dominant tree species in North European and Asian boreal forests. Scots pine has a long maturation period (18-20 month), which means that significant DNA damage may accumulate in the undifferentiated stem cells, even at low doses (or dose rates) during exposure to low concentrations of contaminants Isozyme analysis: We evaluated isozyme polymorphism of three antioxidant enzymes: superoxide dismutase, glutatione reductase and glutatione peroxidase. Analysis of enzymes activities: We chose key enzymes of antioxidant system for this experiment: superoxide dismutase, catalase and peroxidase. Results and conclusions: We estimated frequency of each allele in reference and experimental populations. based It was showed that frequency of rare alleles increase in chronic irradiated populations, i.e. increase the sampling variance
Assessment of muscle mass and its association with protein intake in a multi-ethnic Asian population: relevance in chronic kidney disease.

Science.gov (United States)

Teo, Boon Wee; Toh, Qi Chun; Chan, Xue Wei; Xu, Hui; Li, Jia Liang; Lee, Evan Jc

2014-01-01

Clinical practice guidelines recommend objective nutritional assessments in managing chronic kidney disease (CKD) patients but were developed while referencing to a North-American population. Specific recommendations for assessing muscle mass were suggested (mid-arm circumference, MAC; corrected mid-arm muscle area, cAMA; mid-arm muscle circumference, MAMC). This study aimed to assess correlation and association of these assessments with dietary protein intake in a multi-ethnic Asian population of healthy and CKD patients. We analyzed 24-hour urine collections of selected participants to estimate total protein intake (TPI; g/day). Ideal body weight (IDW; kg) was calculated and muscle assessments conducted. Analyses involved correlation and linear regression, taking significance at ppatients and 103 healthy participants comprising of 51.0% male, 38.5% Chinese, 29.6% Malay, 23.6% Indian, and 8.4% others. The mean TPI was 58.9 ± 18.4 g/day in healthy participants and 53.6 ± 19.4 g/day in CKD patients. When normalized to ideal body weight, TPI-IDW (g/kg/day) was similar in healthy and CKD participants. Overall, TPI was associated with MAC (r=0.372, ppatients. Total protein intake was associated with muscle assessments in all participants. TPI normalized to IDW should only be used in CKD patients.
iLoc-Animal: a multi-label learning classifier for predicting subcellular localization of animal proteins.

Science.gov (United States)

Lin, Wei-Zhong; Fang, Jian-An; Xiao, Xuan; Chou, Kuo-Chen

2013-04-05

Predicting protein subcellular localization is a challenging problem, particularly when query proteins have multi-label features meaning that they may simultaneously exist at, or move between, two or more different subcellular location sites. Most of the existing methods can only be used to deal with the single-label proteins. Actually, multi-label proteins should not be ignored because they usually bear some special function worthy of in-depth studies. By introducing the "multi-label learning" approach, a new predictor, called iLoc-Animal, has been developed that can be used to deal with the systems containing both single- and multi-label animal (metazoan except human) proteins. Meanwhile, to measure the prediction quality of a multi-label system in a rigorous way, five indices were introduced; they are "Absolute-True", "Absolute-False" (or Hamming-Loss"), "Accuracy", "Precision", and "Recall". As a demonstration, the jackknife cross-validation was performed with iLoc-Animal on a benchmark dataset of animal proteins classified into the following 20 location sites: (1) acrosome, (2) cell membrane, (3) centriole, (4) centrosome, (5) cell cortex, (6) cytoplasm, (7) cytoskeleton, (8) endoplasmic reticulum, (9) endosome, (10) extracellular, (11) Golgi apparatus, (12) lysosome, (13) mitochondrion, (14) melanosome, (15) microsome, (16) nucleus, (17) peroxisome, (18) plasma membrane, (19) spindle, and (20) synapse, where many proteins belong to two or more locations. For such a complicated system, the outcomes achieved by iLoc-Animal for all the aforementioned five indices were quite encouraging, indicating that the predictor may become a useful tool in this area. It has not escaped our notice that the multi-label approach and the rigorous measurement metrics can also be used to investigate many other multi-label problems in molecular biology. As a user-friendly web-server, iLoc-Animal is freely accessible to the public at the web-site .
Immediate Regrafting of the Split Thickness Skin Graft Donor Site Assists Healing.

Science.gov (United States)

Bradow, Brian P; Hallock, Geoffrey G; Wilcock, Samuel P

2017-05-01

Delayed or even lack of healing of a split-thickness skin graft (STSG) donor site is a potential problem with elderly patients or those with poor wound healing capabilities. A proactive solution that may minimize this risk is to regraft that donor site using otherwise discarded skin graft remnants. A prospective, nonrandomized, consecutive study was designed to compare the time to healing of the commonly used anterior thigh STSG donor site in patients who had routine dressings (n = 113) versus those with comorbidities known to adversely affect wound healing and had planned regrafting (n = 204). Those comorbidities included age (≥65 years), diabetes mellitus, peripheral vascular disease, chronic renal disease, and chronic steroid use. The average number of comorbidities in the regrafted subgroup versus those not regrafted was 1.41 and 0.31, respectively. This was considered to be a significant difference ( P skin graft materials when so indicated and can be a proactive solution to a potentially cumbersome dilemma.
Chronic 14-day exposure to insecticides or methylmercury modulates neuronal activity in primary rat cortical cultures

NARCIS (Netherlands)

Dingemans, Milou; Schütte, Marijke G; Wiersma, Daphne M M; de Groot, Aart; van Kleef, Gina; Wijnolts, Fiona; Westerink, Remco

2016-01-01

There is an increasing demand for in vitro test systems to detect neurotoxicity for use in chemical risk assessment. In this study, we evaluated the applicability of rat primary cortical cultures grown on multi-well micro-electrode arrays (mwMEAs) to detect effects of chronic 14-day exposure to
Studies on the coordinated operation and autonomous control for multi-modular nuclear power plants

International Nuclear Information System (INIS)

Hui Chao; Huang Xiaojin; Wang Jie

2011-01-01

The tendency has always been to build ever larger single-modular reactor plants with the objective of benefiting from economies of scale. These plants have compiled admirable safety records. Nevertheless, there is concern that conventional large single reactors have become too complex by reason of placing too much reliance on engineered safeguards. The multi-modular approach offers a solution in that its use of many small reactors in conjunction with several shared turbines permits a simpler core design while, at the same time, at least partially retaining economies of scale by increasing the number of modules. Specific advantages to the multi-modular approach are as follows. First, the small-sized of the reactor core may allow the incorporation of passive safety features such as natural circulation cooling on loss of off-site electricity. Second, the individual modules are to be sized so that components related to nuclear safety can be factory-fabricated. Moreover, once the major components are made, they are to be transported to the site for rapid installation. This construction method is expected to reduce the licensing effort because the modules will be pre-licensed, and only site-specific issues will have to be considered in the final licensing process. At present, related studies show that the multi-modular approach for Generation IV can retain both the inherent safety and good economies of scale. However, the unbalanced load operation of the multi-modular power plant in which each module operates at a different power level and strong coupling between multi modules creates a complex control challenge to safe operation and control. Firstly, this paper summarizes the unbalanced load operation characteristics and challenges faced by operation and control of multi-modular power plant in the dynamic operational characteristics and requirements of coordinated control between multi modules. Secondly, detailed analysis and comparison are given in the integral
Multi-site analytical evaluation of the Abbott ARCHITECT tacrolimus assay.

Science.gov (United States)

Wallemacq, Pierre; Goffinet, Jean-Sebastien; O'Morchoe, Susan; Rosiere, Thomas; Maine, Gregory T; Labalette, Myriam; Aimo, Giuseppe; Dickson, Diana; Schmidt, Ed; Schwinzer, Reinhard; Schmid, Rainer W

2009-04-01

The objective of this study was to evaluate the analytical performance of the Abbott ARCHITECT Tacrolimus immunoassay. Proficiency panels and specimens from a population of organ transplant recipients were analyzed in 6 clinical laboratories in Europe and the United States, and the results were compared with other methods. The ARCHITECT assay requires a whole blood specimen pretreatment step with methanol/zinc sulfate to precipitate protein and extract the drug, followed by a 30-minute immunoassay using anti-tacrolimus antibody-coated paramagnetic microparticles and an acridinium-tacrolimus tracer. The assay was free from hematocrit interference in the range 25%-55% and from interference by extremes of cholesterol, triglycerides, bilirubin, total protein, and uric acid. The total percent of coefficient of variations of the assay were 4.9%-7.6% at 3 ng/mL, 2.9%-4.6% at 8.6 ng/mL, and 3.1%-8.2% at 15.5 ng/mL. Limit of detection was Abbott IMx Tacrolimus II immunoassay (4 sites) yielded average biases between -0.94 and +0.26 ng/mL; ARCHITECT assay versus the Dade Dimension Tacrolimus immunoassay (2 sites) yielded average biases of -0.46 and +0.11 ng/mL; and ARCHITECT assay versus LC-MSMS methods at 2 sites yielded average biases of +0.51 and +1.63 ng/mL. Spearman correlation coefficients were >/=0.90 on all method comparisons. The ARCHITECT Tacrolimus assay is a semiautomated, robust, and highly sensitive immunoassay, representing an alternative approach for laboratories not equipped with LC-MSMS, and meets the 1 ng/mL recommendation of LOQ by the European Consensus Conference on Tacrolimus Optimization.
Quantitative assessment of lung volumes using multi-detector row computed tomography (MDCT) in patients with chronic obstructive pulmonary disease (COPD)

International Nuclear Information System (INIS)

Lee, Sang Min; Hur, Jin; Kim, Tae Hoon; Kim, Sang Jin; Kim, Hyung Jung

2008-01-01

To evaluate the clinical value of the multi-detector row computed tomography (MDCT) in the quantitative assessment of lung volumes and to assess the relationship between the MDCT results and disease severity as determined by a pulmonary function test (PFT) in Chronic Obstructive Pulmonary Disease (COPD) patients. We performed a PFT and MDCT on 39 COPD patients. Using the GOLD classifications, we divided the patients into three groups according to disease severity; stage I (mild, n = 10), stage II (moderate, n = 15), and stage III (severe, n = 14). Using the pulmo-CT software program, we measured the proportion of lung volumes with attenuation values below -910 and -950 HU. The mean FEV1 (% of predicted) and FEV1/FVC was 82.2 ± 2% and 66.2 ± 3% in stage I, 53.5 ± 11% and 52 ± 6% in stage II, and 32.3 ± 7% and 44.2% ± 13% in stage III, respectively. Differences in lung volume percentage at each of the thresholds (-910 and -950 HU) among the 3 stages were statistically significant (ρ < 0.01, ρ < 0.01) and correlated well with the FEV1 and FEV1/FVC (r = -0.803, r -0.766, r = -0.817, and r = -0.795, respectively). The volumetric measurement obtained by MDCT provides an accurate means of quantifying pulmonary emphysema
Pulmonary artery stiffness in chronic obstructive pulmonary disease (COPD) and emphysema: The Multi-Ethnic Study of Atherosclerosis (MESA) COPD Study.

Science.gov (United States)

Liu, Chia-Ying; Parikh, Megha; Bluemke, David A; Balte, Pallavi; Carr, James; Dashnaw, Stephen; Poor, Hooman D; Gomes, Antoinette S; Hoffman, Eric A; Kawut, Steven M; Lima, Joao A C; McAllister, David A; Prince, Martin A; Vogel-Claussen, Jens; Barr, R Graham

2018-01-01

Chronic obstructive pulmonary disease (COPD) and particularly emphysema are characterized by stiffness of the aorta, due in part to accelerated elastin degradation in the lungs and aorta. Stiffness of the pulmonary arteries (PAs) may also be increased in COPD and emphysema, but data are lacking. We assessed PA stiffness using MRI in patients with COPD and related these measurements to COPD severity and percent emphysema. The Multi-Ethnic Study of Atherosclerosis (MESA) COPD Study recruited 290 participants, age 50-79 years with 10 or more packyears and free of clinical cardiovascular disease. COPD severity were defined on postbronchodilator spirometry by ATS/ERS criteria. Percent emphysema was defined as the percentage of regions of the lung COPD compared with controls (P = 0.002) and was inversely correlated with COPD severity (P = 0.004). PA strain was inversely associated to percent emphysema (P = 0.01). PA strain was also markedly correlated with right ventricular diastolic dysfunction measured by E/A ratios in the fully adjusted mix models (P = 0.02). PA strain is reduced in COPD, related in part to percent emphysema on CT scan, which may have implications for pulmonary small vessel flow and right ventricular function. 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:262-271. © 2017 International Society for Magnetic Resonance in Medicine.
Fibrous Myopathy as a Complication of Repeated Intramuscular Injections for Chronic Headache

Directory of Open Access Journals (Sweden)

R Burnham

2006-01-01

Full Text Available Two cases of fibrous myopathy associated with repeated, long-term intramuscular injections for treatment of chronic temporomandibular joint pain and chronic headache, respectively, are described. Both patients developed severe, function-limiting contractures in upper and lower extremity muscles used as injection sites. In one of the cases, the contractures were painful. Electrophysiological testing, magnetic resonance imaging and muscle biopsy results were all consistent with myopathy and replacement of skeletal muscle with noncontractile fibrous tissue. These cases are presented to increase awareness of fibrous myopathy and to promote surveillance for this serious potential complication of long-term intramuscular injections in chronic headache and other pain patients.
Uranium mining sites - Thematic sheets

International Nuclear Information System (INIS)

2009-01-01

A first sheet proposes comments, data and key numbers about uranium extraction in France: general overview of uranium mining sites, status of waste rock and tailings after exploitation, site rehabilitation. The second sheet addresses the sources of exposure to ionizing radiations due to ancient uranium mining sites: discussion on the identification of these sources associated with these sites, properly due to mining activities or to tailings, or due to the transfer of radioactive substances towards water and to the contamination of sediments, description of the practice and assessment of radiological control of mining sites. A third sheet addresses the radiological exposure of public to waste rocks, and the dose assessment according to exposure scenarios: main exposure ways to be considered, studied exposure scenarios (passage on backfilled path and grounds, stay in buildings built on waste rocks, keeping mineralogical samples at home). The fourth sheet addresses research programmes of the IRSN on uranium and radon: epidemiological studies (performed on mine workers; on French and on European cohorts, French and European studies on the risk of lung cancer associated with radon in housing), study of the biological effects of chronic exposures. The last sheet addresses studies and expertises performed by the IRSN on ancient uranium mining sites in France: studies commissioned by public authorities, radioactivity control studies performed by the IRSN about mining sites, participation of the IRSN to actions to promote openness to civil society
Thermo-mechanical analysis for multi-level HLW repository concept

International Nuclear Information System (INIS)

Kwon, Sang Ki; Choi, Jong Won

2004-01-01

This work aims to investigate the influence of design parameters for the underground high-level nuclear waste repository with multi-level concept. B. Necessity o In order to construct an HLW repository in deep underground, it is required to select a site, which is far from major discontinuities. To dispose the whole spent fuels generated from the Korean nuclear power plants in a repository, the underground area of about 4km 2 is required. This would be a constraints for selecting an adequate repository site. It is recommended to dispose the two different spent fuels, PWR and CANDU, in different areas at the operation efficiency point of view. It is necessary to investigate the influence of parameters, which can affect the stability of multi-level repository. It is also needed to consider the influence of heat generated from the HLW and the high in situ stress in deep location. Therefore, thermo-mechanical coupling analysis should be carried out and the results should be compared with the results from single-level repository concept. Three-dimensional analysis is required to model the disposal tunnel and deposition hole. It is recommended to use the Korean geological condition and actually measured rock properties in Korea in order to achieve reliable modeling results. A FISH routine developed for effective modeling of Thermal-Mechanical coupling was implemented in the modeling using FLAC3D, which is a commercial three-dimensional FDM code. The thermal and mechanical properties of rock and rock mass achieved from Yusung drilling site, were used for the computer modeling. Different parameters such as level distance, waste type disposed on different levels, and time interval between the operation on different levels, were considered in the three-dimensional analysis. From the analysis, it was possible to derive adequate multi-level repository concept. Results and recommendations for application From the thermal-mechanical analysis for the multi-level repository
Chronic periodontitis is associated with erectile dysfunction. A case-control study in european population.

Science.gov (United States)

Martín, Amada; Bravo, Manuel; Arrabal, Miguel; Magán-Fernández, Antonio; Mesa, Francisco

2018-07-01

To determine the association between chronic periodontitis and erectile dysfunction adjusting for biochemical markers and other comorbidities. A case-control study was conducted on 158 male patients; 80 cases with erectile dysfunction according to the International Index of Erectile Function and 78 controls. Sociodemographic data were gathered, and a periodontal examination was performed. Testosterone, lipid profile, C-reactive protein and glycaemic parameters were assessed. All variables were compared between groups, and multivariate logistic regression analyses were performed. 74% of the cases were diagnosed with chronic periodontitis. Number of sites with pocket probing depth 4-6 mm (p = 0.05) and number of sites with clinical attachment loss >3 mm (p chronic periodontitis were more likely to have erectile dysfunction (OR=2.17; 95% CI (1.06-4.43); p = 0.03) independently of other confounders. Patients with erectile dysfunction showed worse periodontal condition. Chronic periodontitis seems to play a key role as a risk factor in the pathogenesis of erectile dysfunction independently of other morbidities. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Obsessive-compulsive disorder; chronic versus non-chronic symptoms

NARCIS (Netherlands)

Visser, H.A.; van Oppen, P.C.; van Megen, H.J.; Eikelenboom, M.; van Balkom, A.J.L.M.

2014-01-01

Objective Understanding chronicity in OCD is hampered by contradictory findings arising from dissimilar definitions of chronic OCD. The purpose of this study was to investigate the magnitude of chronicity in OCD and to examine if chronic OCD is critically different from non-chronic OCD, using a
Effect of chronic (-)-nicotine treatment on rat cerebral benzodiazepine receptors

International Nuclear Information System (INIS)

Magata, Yasuhiro; Kitano, Haruhiro; Shiozaki, Toshiki; Iida, Yasuhiko; Nishizawa, Sadahiko; Saji, Hideo; Konishi, Junji

2000-01-01

The purpose of this study was to clarify the effect of (-)-nicotine on cerebral benzodiazepine receptors (BzR) with radiotracer methods. The effect of (-)-nicotine on BzR was examined in in vitro studies using chronic (-)-nicotine-treated rats using 3 H-diazepam. The in vitro radioreceptor assay showed a 14% increase in the maximum number of binding sites of BzR in chronic (-)-nicotine-treated rats in comparison with the control rats. Moreover, a convenient in vivo uptake index of 125 I-iomazenil was calculated and a higher uptake of the radioactivity was observed in the chronic (-)-nicotine-treated group than in the control group. Although further studies of the mechanism of (-)-nicotine on such BzR changes are required, an increase in the amount of BzR in the cerebral cortex was found in rats that underwent chronic (-)-nicotine treatment, and this result contributed to the understanding of the effects of (-)-nicotine and smoking on neural functions

Premature epiphyseal fusion and degenerative arthritis in chronic recurrent multifocal osteomyelitis

International Nuclear Information System (INIS)

Piddo, C.; Reed, M.H.; Black, G.B.

2000-01-01

A 9-year-old boy was diagnosed with chronic recurrent multifocal osteomyelitis affecting multiple sites. During an 8-year follow-up he developed premature closure of a distal radial epiphysis and degenerative changes in the adjacent radiocarpal joint. (orig.)
Acute and sub-chronic toxicity studies of honokiol microemulsion.

Science.gov (United States)

Zhang, Qianqian; Li, Jianguo; Zhang, Wei; An, Quan; Wen, Jianhua; Wang, Aiping; Jin, Hongtao; Chen, Shizhong

2015-04-01

The purpose of this study was to investigate the acute and sub-chronic toxicity of honokiol microemulsion. In the acute toxicity tests, the mice were intravenously injected graded doses of honokiol microemulsion and were observed for toxic symptoms and mortality daily for 14 days. In the sub-chronic toxicity study, rats were injected honokiol microemulsion at doses of 100, 500, 2500 μg/kg body weight (BW) for 30 days. After 30 days treatment and 14 days recovery, the rats were sacrificed for hematological, biochemical and histological examination. In the acute toxicity tests, the estimated median lethal dosage (LD50) was 50.5mg/kg body weight in mice. In the sub-chronic toxicity tests, the non-toxic reaction dose was 500 μg/kg body weight. In each treatment group, degeneration or/and necrosis in vascular endothelial cells and structure change of vessel wall can be observed in the injection site (cauda vein) of a few animals while there were no changes in the vessels of other organs. The overall findings of this study indicate that the honokiol microemulsion is non-toxic up to 500 μg/kg body weight, and it has irritation to the vascular of the injection site which should be paid attention to in clinical medication. Copyright © 2015. Published by Elsevier Inc.
The assessment and treatment of back and neck pain: an initial investigation in a primary care practice-based research network.

Science.gov (United States)

Fischbein, Rebecca; McCormick, Kenelm; Selius, Brian A; Labuda Schrop, Susan; Hewit, Michael; Baughman, Kristin; Meeker, James

2015-09-01

The purpose of this study was to conduct an exploratory examination of the current state of non-malignant acute and chronic back and neck pain assessment and management among primary care providers in a multi-site, practice-based research network. Acute and chronic pain are distinct conditions that often require different assessment and management approaches, however, little research has examined assessment and management of acute and chronic pain as separate conditions. The large majority of patients with acute and chronic back and neck pain are managed in primary care settings. Given the differences between acute and chronic pain, it is necessary to identify differences in patient characteristics, practitioner evaluation, treatment and management in primary care settings. Over a two-week period, 24 practitioners in a multi-site practice-based research network completed 196 data cards about 39 patients experiencing acute back and neck pain and 157 patients suffering from chronic back and neck pain. Findings There were significant differences between the patients experiencing acute and chronic pain in regards to practitioner evaluation, current medication management and current treatment for depression. In addition, diagnostics differed between patients experiencing acute versus chronic back and neck pain. Further, primary care providers' review of online drug monitoring program reports during the current visit was associated with current medication management using short term opioids, long-term opioids or tramadol. Most research examining acute and chronic pain focuses on the low back. Additional research needs to be conducted to explore and compare acute and chronic pain across the whole spine.
[THE CHARACTERISTICS OF MORPHOLOGY OF BIOFILM OF PERIODONTIUM UNDER INFLAMMATORY DISEASES OF GUMS (CHRONIC CATARRHAL GINGIVITIS, CHRONIC PERIODONTITIS, CANDIDA-ASSOCIATED PERIODONTITIS) ACCORDING RESULTS OF ELECTRONIC MICROSCOPY].

Science.gov (United States)

Ippolitov, E V; Didenko, L V; Tzarev, V N

2015-12-01

The study was carried out to analyze morphology of biofilm of periodontium and to develop electronic microscopic criteria of differentiated diagnostic of inflammatory diseases of gums. The scanning electronic microscopy was applied to analyze samples of bioflm of periodont from 70 patients. Including ten patients with every nosologic form of groups with chronic catarrhal periodontitis. of light, mean and severe degree, chronic catarrhal gingivitis, Candida-associated paroperiodontitis and 20 healthy persons with intact periodontium. The analysis was implemented using dual-beam scanning electronic microscope Quanta 200 3D (FEI company, USA) and walk-through electronic micJEM 100B (JEOL, Japan). To detect marker DNA of periodont pathogenic bacteria in analyzed samples the kit of reagentsfor polymerase chain reaction "MultiDent-5" ("GenLab", Russia). The scanning electronic microscopy in combination with transmission electronic microscopy and polymerase chain reaction permits analyzing structure, composition and degree of development of biofilm of periodontium and to apply differentiated diagnostic of different nosologic forms of inflammatory diseases of periodontium, including light form of chronic periodontitis and gingivitis. The electronic microscopical indications of diseases ofperiodontium of inflammatory character are established: catarrhal gingivitis, (coccal morphological alternate), chronic periodontitis (bacillary morphological alternate), Candida-associated periodontitis (Candida morphological alternate of biofilm ofperiodontium).
Randomized Multi-site Trial of the Job Seekers’ Workshop in Patients with Substance Use Disorders

Science.gov (United States)

Svikis, Dace S.; Keyser-Marcus, Lori; Stitzer, Maxine; Rieckmann, Traci; Safford, Lauretta; Loeb, Peter; Allen, Tim; Luna-Anderson, Carol; Back, Sudie E.; Cohen, Judith; DeBernardi, Michael A.; Dillard, Bruce; Forcehimes, Alyssa; Jaffee, William; Killeen, Therese; Kolodner, Ken; Levy, Michael; Pallas, Diane; Perl, Harold I.; Potter, Jennifer Sharpe; Provost, Scott; Reese, Karen; Sampson, Royce R.; Sepulveda, Allison; Snead, Ned; Wong, Conrad J.; Zweben, Joan

2012-01-01

Background Unemployment is associated with negative outcomes both during and after drug abuse treatment. Interventions designed to increase rates of employment may also improve drug abuse treatment outcomes. The purpose of this multi-site clinical trial was to evaluate the Job Seekers’ Workshop (JSW), a three session, manualized program designed to train patients in the skills needed to find and secure a job. Method Study participants were recruited through the NIDA Clinical Trials Network (CTN) from six psychosocial counseling (n=327) and five methadone maintenance (n=301) drug treatment programs. Participants were randomly assigned to either standard care (program-specific services plus brochure with local employment resources) (SC) or standard care plus JSW. Three 4-hr small group JSW sessions were offered weekly by trained JSW facilitators with ongoing fidelity monitoring. Results JSW and SC participants had similar 12- and 24-week results for the primary outcome measure (i.e., obtaining a new taxed job or enrollment in a training program), Specifically, one-fifth of participants at 12 weeks (20.1 – 24.3%) and nearly one-third at 24 weeks (31.4–31.9%) had positive outcomes, with “obtaining a new taxed job” accounting for the majority of cases. Conclusion JSW group participants did not have higher rates of employment/training than SC controls. Rates of job acquisition were modest for both groups, suggesting more intensive interventions may be needed. Alternate targets (e.g., enhancing patient motivation, training in job-specific skills) warrant further study as well. PMID:21802222
Endocrine Abnormalities in Patients with Chronic Kidney Disease.

Science.gov (United States)

Kuczera, Piotr; Adamczak, Marcin; Wiecek, Andrzej

2015-01-01

In patients with chronic kidney disease the alterations of the endocrine system may arise from several causes. The kidney is the site of degradation as well as synthesis of many different hormones. Moreover, a number of concomitant pathological conditions such as inflammation, metabolic acidosis and malnutrition may participate in the pathogenesis of endocrine abnormalities in this group of patients. The most pronounced endocrine abnormalities in patients with chronic kidney disease are the deficiencies of: calcitriol, testosterone, insulin-like growth factor and, erythropoietin (EPO). Additionally accumulation of several hormones, such as: prolactin, growth hormone and insulin frequently also occur. The clinical consequences of the abovementioned endocrine abnormalities are among others: anemia, infertility and bone diseases.
Design of multi-specificity in protein interfaces.

Directory of Open Access Journals (Sweden)

Elisabeth L Humphris

2007-08-01

Full Text Available Interactions in protein networks may place constraints on protein interface sequences to maintain correct and avoid unwanted interactions. Here we describe a "multi-constraint" protein design protocol to predict sequences optimized for multiple criteria, such as maintaining sets of interactions, and apply it to characterize the mechanism and extent to which 20 multi-specific proteins are constrained by binding to multiple partners. We find that multi-specific binding is accommodated by at least two distinct patterns. In the simplest case, all partners share key interactions, and sequences optimized for binding to either single or multiple partners recover only a subset of native amino acid residues as optimal. More interestingly, for signaling interfaces functioning as network "hubs," we identify a different, "multi-faceted" mode, where each binding partner prefers its own subset of wild-type residues within the promiscuous binding site. Here, integration of preferences across all partners results in sequences much more "native-like" than seen in optimization for any single binding partner alone, suggesting these interfaces are substantially optimized for multi-specificity. The two strategies make distinct predictions for interface evolution and design. Shared interfaces may be better small molecule targets, whereas multi-faceted interactions may be more "designable" for altered specificity patterns. The computational methodology presented here is generalizable for examining how naturally occurring protein sequences have been selected to satisfy a variety of positive and negative constraints, as well as for rationally designing proteins to have desired patterns of altered specificity.
Natural product-derived pharmacological modulators of Nrf2/ARE pathway for chronic diseases.

Science.gov (United States)

Kumar, Hemant; Kim, In-Su; More, Sandeep Vasant; Kim, Byung-Wook; Choi, Dong-Kug

2014-01-01

Covering: 2000 to 2013. Oxidative stress is the central component of chronic diseases. The nuclear factor erythroid 2-related factor 2/antioxidant response element (Nrf2/ARE) pathway is vital in the up-regulation of cytoprotective genes and enzymes in response to oxidative stress and treatment with certain dietary phytochemicals. Herein, we classify bioactive compounds derived from natural products that are Nrf2/ARE pathway activators and recapitulate the molecular mechanisms for inducing Nrf2 to provide favorable effects in experimental models of chronic diseases. Moreover, pharmacological inhibition of Nrf2 signalling has emerged as promising strategy against multi-drug resistance thereby improving the treatment efficacy. We have also enlisted natural product-derived inhibitors of Nrf2/ARE pathway.
Processes for design, construction and utilisation of arrays of light-emitting diodes and light-emitting diode-coupled optical fibres for multi-site brain light delivery.

Science.gov (United States)

Bernstein, Jacob G; Allen, Brian D; Guerra, Alexander A; Boyden, Edward S

2015-05-01

Optogenetics enables light to be used to control the activity of genetically targeted cells in the living brain. Optical fibers can be used to deliver light to deep targets, and LEDs can be spatially arranged to enable patterned light delivery. In combination, arrays of LED-coupled optical fibers can enable patterned light delivery to deep targets in the brain. Here we describe the process flow for making LED arrays and LED-coupled optical fiber arrays, explaining key optical, electrical, thermal, and mechanical design principles to enable the manufacturing, assembly, and testing of such multi-site targetable optical devices. We also explore accessory strategies such as surgical automation approaches as well as innovations to enable low-noise concurrent electrophysiology.
Cultural expressions of bodily awareness among chronically ill Filipino Americans.

Science.gov (United States)

Becker, Gay

2003-01-01

To describe Filipino Americans' cultural traditions surrounding bodily awareness, especially how the principle of balance informs their views, and the link to self-management of chronic illness. This qualitative study used semistructured interviews with 85 Filipino Americans between the ages of 46 and 97 years. Volunteers were recruited from numerous health care sites in 1 geographic location in the United States. Respondents had 1 or more chronic illnesses. Taped and transcribed interviews were coded and evaluated for themes. The concept of balance was central to Filipino Americans' portrayal of bodily awareness of signs and symptoms related to chronic illnesses, as well as to actions they took to manage their chronic illnesses. Efforts were made to control chronic illnesses through a variety of self-care practices. Diet posed a particular challenge because of the symbolic importance of food in Filipino culture and its use in the maintenance of social relationships. The ways in which Filipino Americans combine attention to the body, values of balance and harmony, and emphasis on social well-being result in heightened attention to bodily processes. Filipino Americans' emphasis on bodily awareness suggests that this particular cultural strength can be used to enhance chronic illness management. Awareness of the cultural traditions of Filipino Americans can facilitate patient education about how to manage chronic illnesses.
Medication regimen complexity and readmissions after hospitalization for heart failure, acute myocardial infarction, pneumonia, and chronic obstructive pulmonary disease

Directory of Open Access Journals (Sweden)

Nada Abou-Karam

2016-02-01

Full Text Available Objectives: Readmission rate is increasingly being viewed as a key indicator of health system performance. Medication regimen complexity index scores may be predictive of readmissions; however, few studies have examined this potential association. The primary objective of this study was to determine whether medication regimen complexity index is associated with all-cause 30-day readmission after admission for heart failure, acute myocardial infarction, pneumonia, or chronic obstructive pulmonary disease. Methods: This study was an institutional review board–approved, multi-center, case–control study. Patients admitted with a primary diagnosis of heart failure, acute myocardial infarction, pneumonia, or chronic obstructive pulmonary disease were randomly selected for inclusion. Patients were excluded if they discharged against medical advice or expired during their index visit. Block randomization was utilized for equal representation of index diagnosis and site. Discharge medication regimen complexity index scores were compared between subjects with readmission versus those without. Medication regimen complexity index score was then used as a predictor in logistic regression modeling for readmission. Results: Seven hundred and fifty-six patients were randomly selected for inclusion, and 101 (13.4% readmitted within 30 days. The readmission group had higher medication regimen complexity index scores than the no-readmission group (p < 0.01. However, after controlling for demographics, disease state, length of stay, site, and medication count, medication regimen complexity index was no longer a significant predictor of readmission (odds ratio 0.99, 95% confidence interval 0.97–1.01 or revisit (odds ratio 0.99, 95% confidence interval 0.98–1.02. Conclusion: There is little evidence to support the use of medication regimen complexity index in readmission prediction when other measures are available. Medication regimen complexity index
Structural and functional analysis of multi-interface domains.

Directory of Open Access Journals (Sweden)

Liang Zhao

Full Text Available A multi-interface domain is a domain that can shape multiple and distinctive binding sites to contact with many other domains, forming a hub in domain-domain interaction networks. The functions played by the multiple interfaces are usually different, but there is no strict bijection between the functions and interfaces as some subsets of the interfaces play the same function. This work applies graph theory and algorithms to discover fingerprints for the multiple interfaces of a domain and to establish associations between the interfaces and functions, based on a huge set of multi-interface proteins from PDB. We found that about 40% of proteins have the multi-interface property, however the involved multi-interface domains account for only a tiny fraction (1.8% of the total number of domains. The interfaces of these domains are distinguishable in terms of their fingerprints, indicating the functional specificity of the multiple interfaces in a domain. Furthermore, we observed that both cooperative and distinctive structural patterns, which will be useful for protein engineering, exist in the multiple interfaces of a domain.
Multi-element probabilistic collocation method in high dimensions

International Nuclear Information System (INIS)

Foo, Jasmine; Karniadakis, George Em

2010-01-01

We combine multi-element polynomial chaos with analysis of variance (ANOVA) functional decomposition to enhance the convergence rate of polynomial chaos in high dimensions and in problems with low stochastic regularity. Specifically, we employ the multi-element probabilistic collocation method MEPCM and so we refer to the new method as MEPCM-A. We investigate the dependence of the convergence of MEPCM-A on two decomposition parameters, the polynomial order μ and the effective dimension ν, with ν<< N, and N the nominal dimension. Numerical tests for multi-dimensional integration and for stochastic elliptic problems suggest that ν≥μ for monotonic convergence of the method. We also employ MEPCM-A to obtain error bars for the piezometric head at the Hanford nuclear waste site under stochastic hydraulic conductivity conditions. Finally, we compare the cost of MEPCM-A against Monte Carlo in several hundred dimensions, and we find MEPCM-A to be more efficient for up to 600 dimensions for a specific multi-dimensional integration problem involving a discontinuous function.
Multi-channel electronically scanned cryogenic pressure sensor

Science.gov (United States)

Chapman, John J. (Inventor); Hopson, Purnell, Jr. (Inventor); Kruse, Nancy M. H. (Inventor)

1995-01-01

A miniature, multi-channel, electronically scanned pressure measuring device uses electrostatically bonded silicon dies in a multielement array. These dies are bonded at specific sites on a glass, prepatterned substrate. Thermal data is multiplexed and recorded on each individual pressure measuring diaphragm. The device functions in a cryogenic environment without the need of heaters to keep the sensor at constant temperatures.
Documenting the location of systematic transrectal ultrasound-guided prostate biopsies: correlation with multi-parametric MRI.

Science.gov (United States)

Turkbey, Baris; Xu, Sheng; Kruecker, Jochen; Locklin, Julia; Pang, Yuxi; Shah, Vijay; Bernardo, Marcelino; Baccala, Angelo; Rastinehad, Ardeshir; Benjamin, Compton; Merino, Maria J; Wood, Bradford J; Choyke, Peter L; Pinto, Peter A

2011-03-29

During transrectal ultrasound (TRUS)-guided prostate biopsies, the actual location of the biopsy site is rarely documented. Here, we demonstrate the capability of TRUS-magnetic resonance imaging (MRI) image fusion to document the biopsy site and correlate biopsy results with multi-parametric MRI findings. Fifty consecutive patients (median age 61 years) with a median prostate-specific antigen (PSA) level of 5.8 ng/ml underwent 12-core TRUS-guided biopsy of the prostate. Pre-procedural T2-weighted magnetic resonance images were fused to TRUS. A disposable needle guide with miniature tracking sensors was attached to the TRUS probe to enable fusion with MRI. Real-time TRUS images during biopsy and the corresponding tracking information were recorded. Each biopsy site was superimposed onto the MRI. Each biopsy site was classified as positive or negative for cancer based on the results of each MRI sequence. Sensitivity, specificity, and receiver operating curve (ROC) area under the curve (AUC) values were calculated for multi-parametric MRI. Gleason scores for each multi-parametric MRI pattern were also evaluated. Six hundred and 5 systemic biopsy cores were analyzed in 50 patients, of whom 20 patients had 56 positive cores. MRI identified 34 of 56 positive cores. Overall, sensitivity, specificity, and ROC area values for multi-parametric MRI were 0.607, 0.727, 0.667, respectively. TRUS-MRI fusion after biopsy can be used to document the location of each biopsy site, which can then be correlated with MRI findings. Based on correlation with tracked biopsies, T2-weighted MRI and apparent diffusion coefficient maps derived from diffusion-weighted MRI are the most sensitive sequences, whereas the addition of delayed contrast enhancement MRI and three-dimensional magnetic resonance spectroscopy demonstrated higher specificity consistent with results obtained using radical prostatectomy specimens.
Multi-target electrochemical biosensing enabled by integrated CMOS electronics

International Nuclear Information System (INIS)

Rothe, J; Lewandowska, M K; Heer, F; Frey, O; Hierlemann, A

2011-01-01

An integrated electrochemical measurement system, based on CMOS technology, is presented, which allows the detection of several analytes in parallel (multi-analyte) and enables simultaneous monitoring at different locations (multi-site). The system comprises a 576-electrode CMOS sensor chip, an FPGA module for chip control and data processing, and the measurement laptop. The advantages of the highly versatile system are demonstrated by two applications. First, a label-free, hybridization-based DNA sensor is enabled by the possibility of large-scale integration in CMOS technology. Second, the detection of the neurotransmitter choline is presented by assembling the chip with biosensor microprobe arrays. The low noise level enables a limit of detection of, e.g., 0.3 µM choline. The fully integrated system is self-contained: it features cleaning, functionalization and measurement functions without the need for additional electrical equipment. With the power supplied by the laptop, the system is very suitable for on-site measurements
Multi-hierarchical movements in self-avoiding walks

Science.gov (United States)

Sakiyama, Tomoko; Gunji, Yukio-Pegio

2017-07-01

A self-avoiding walk (SAW) is a series of moves on a lattice that visit the same place only once. Several studies reported that repellent reactions of foragers to previously visited sites induced power-law tailed SAWs in animals. In this paper, we show that modelling the agent's multi-avoidance reactions to its trails enables it to show ballistic movements which result in heavy-tailed movements. There is no literature showing emergent ballistic movements in SAWs. While following SAWs, the agent in my model changed its reactions to marked patches (visited sites) by considering global trail patterns based on local trail patterns when the agent was surrounded by previously visited sites. As a result, we succeeded in producing ballistic walks by the agents which exhibited emergent power-law tailed movements.
New approach of second Romanian NPP siting

International Nuclear Information System (INIS)

Mauna, Traian

2010-01-01

The NPP sitting studies in Romania began before 1975. The first Romanian NPP CANDU 6 type reactor gone to erection in 1980 on Cernavoda site planned to have 5 units. Gained the experience from Cernavoda NPP sitting, the first mission of new multi-branch of specialists team was to choose new NPP sites adapting the NPP Cernavoda project to the new parameters of close water cooling circuit and hard less and no rock foundation strata. The studies were carrying out in different stages on the inner rivers Olt, Mures, Somes in Transylvania historical region. This paper tries to reconsider shortly the old analysis according to the last IAEA Safety Standards, taking into account the new NPP generation requirement. Paper is focused on geological aspects and other local sites characteristics. (authors)
Carboxyl-terminal multi-site phosphorylation regulates internalization and desensitization of the human sst2 somatostatin receptor.

Science.gov (United States)

Lehmann, Andreas; Kliewer, Andrea; Schütz, Dagmar; Nagel, Falko; Stumm, Ralf; Schulz, Stefan

2014-04-25

The somatostatin receptor 2 (sst2) is the pharmacological target of somatostatin analogs that are widely used in the diagnosis and treatment of human neuroendocrine tumors. We have recently shown that the stable somatostatin analogs octreotide and pasireotide (SOM230) stimulate distinct patterns of sst2 receptor phosphorylation and internalization. Like somatostatin, octreotide promotes the phosphorylation of at least six carboxyl-terminal serine and threonine residues namely S341, S343, T353, T354, T356 and T359, which in turn leads to a robust receptor endocytosis. Unlike somatostatin, pasireotide stimulates a selective phosphorylation of S341 and S343 of the human sst2 receptor followed by a partial receptor internalization. Here, we show that exchange of S341 and S343 by alanine is sufficient to block pasireotide-driven internalization, whereas mutation of T353, T354, T356 and T359 to alanine is required to strongly inhibited both octreotide- and somatostatin-induced internalization. Yet, combined mutation of T353, T354, T356 and T359 is not sufficient to prevent somatostatin-driven β-arrestin mobilization and receptor desensitization. Replacement of all fourteen carboxyl-terminal serine and threonine residues by alanine completely abrogates sst2 receptor internalization and β-arrestin mobilization in HEK293 cells. Together, our findings demonstrate for the first time that agonist-selective sst2 receptor internalization is regulated by multi-site phosphorylation of its carboxyl-terminal tail. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Is Vancomycine Still a Choice for Chronic Osteomyelitis Empirical Therapy in Iran?

Science.gov (United States)

Izadi, Morteza; Zamani, Mohammad Mahdi; Mousavi, Seyed Ahmad; Sadat, Seyed Mir Mostafa; Siami, Zeinab; Vais Ahmadi, Noushin; Jonaidi Jafari, Nematollah; Shirvani, Shahram; Majidi Fard, Mojgan; Imani Fooladi, Abbas Ali

2012-01-01

Background Pyogenic bacteria and especially Staphylococcus aurous (S. aurous) are the most common cause of chronic osteomyelitis. Not only treatment protocol of chronic osteomyelitis occasionally is amiss but also this malady responds to treatment difficultly. Objectives This study investigates antibiotic resistance pattern of S. aurous isolated from Iranian patients who suffer from chronic osteomyelitis by two methods: disk diffusion (Kirby bauyer) and E-test (Epsilometer test) to find Vancomycin susceptibility and MIC (Minimum inhibitory concentration). Patients and Methods One hundred and thirty one patients who suffer from chronic osteomyelitis which have been referred to both governmental and private hospitals at 2010 were tried out for culturing of osteomyelitis site (sites). Antibiotic susceptibility and MIC of isolated bacteria were investigated by Kirby bauyer and E-test respectively. Results Samples were collected from bone (73.4%), surrounding tissue (14.6%) and wound discharge (12%). S. aureus was isolated from 49.6% of the samples. According to disc diffusion, methicillin resistance S. aureus (MRSA) was 75% and Vancomycin resistance S. aurous (VRSA) was 0% and based on MIC, MRSA was 68.5% and VRSA was 0%. According to MIC experiments, maximum sensitivity was against to Vancomycin (90.2%) and ciprofloxacin (54.4%) respectively but based on disc diffusion, maximum sensitivity was against to Vancomycin (97.7%) and ciprofloxacin (43.2%), respectively (P = 0.001). E-test (9.8%) in comparison with Disc diffusion (2.3%) showed higher percent of intermediate susceptibility to Vancomycin (P = 0.017). Conclusions Comparison of antibiograms and MICs showed that Kirby bauyer technique especially for detection of VISA strains is not reliable comparison with E-test. Already VRSA strains have not detected in Iranian chronic osteomyelitis, Thus Vancomycin is the first choice for chronic osteomyelitis empirical therapy in Iran yet. PMID:23483042

Heart rate awareness in patients with chronic stable heart failure. A multi-center observational study.

LENUS (Irish Health Repository)

Moran, D

2014-08-23

We assessed adherence to European Society of Cardiology heart rate guidelines (i.e. heart rates less than 70bpm) in patients with chronic stable heart failure. We also investigated the percent of patients on target doses of rate controlling drugs.
Prescribing Antidepressants and Benzodiazepines in the Netherlands: Is Chronic Physical Illness Involved?

Directory of Open Access Journals (Sweden)

Jacques Th. M. van Eijk

2010-01-01

Full Text Available In this study we assessed differences in new and repeat prescriptions of psycho-tropics between patients receiving prescriptions for drugs to treat a common chronic disease and people without such prescriptions. The study used the databases of two Dutch health insurance companies (3 million people. We selected all Dutch men and women aged 45 and older who were registered for six consecutive years (1999–2004. Our analyses both found a consistent relation between psycho-tropics on the one hand and physical illness on the other. People with multi-morbidity were prescribed these drugs most often, especially men and those younger than 65. Epidemiological studies showed a prevalence of depression among people with multi-morbidity to be twice as high as among people without such conditions. According to recent guidelines non-drug treatment may be the first therapy option for patients with non severe depression. If prescribed for a long time, benzodiazepine prescriptions are especially known to be addictive. Our data raise the question to what extent patients with a chronic physical disease suffering from co-occurring mental problems are prescribed psycho-tropics in accord with the guidelines that also advise mental support in case of non severe mental problems. Further research can answer this important question.
Self-management interventions including action plans for exacerbations versus usual care in patients with chronic obstructive pulmonary disease (Review)

NARCIS (Netherlands)

Lenferink, Anke; Brusse-Keizer, Marjolein; van der Valk, Paul; Frith, Peter A.; Zwerink, Marlies; Monninkhof, Evelyn M.; van der Palen, J.A.M.; Effing, Tanja

2017-01-01

Background Chronic Obstructive Pulmonary Disease (COPD) self-management interventions should be structured but personalised and often multi-component, with goals ofmotivating, engaging and supporting the patients to positively adapt their behaviour(s) and develop skills to better manage disease.
A multi-level qualitative analysis of Telehomecare in Ontario: challenges and opportunities

OpenAIRE

Hunting, Gemma; Shahid, Nida; Sahakyan, Yeva; Fan, Iris; Moneypenny, Crystal R.; Stanimirovic, Aleksandra; North, Taylor; Petrosyan, Yelena; Krahn, Murray D.; Rac, Valeria E.

2015-01-01

Background Despite research demonstrating the potential effectiveness of Telehomecare for people with Chronic Obstructive Pulmonary Disease and Heart Failure, broad-scale comprehensive evaluations are lacking. This article discusses the qualitative component of a mixed-method program evaluation of Telehomecare in Ontario, Canada. The objective of the qualitative component was to explore the multi-level factors and processes which facilitate or impede the implementation and adoption of the pro...
Preventing childhood obesity: the sentinel site for obesity prevention in Victoria, Australia.

Science.gov (United States)

Bell, A Colin; Simmons, Anne; Sanigorski, Andrea M; Kremer, Peter J; Swinburn, Boyd A

2008-12-01

In spite of greater awareness of the need for action to reduce obesity, the evidence on sustainable community approaches to prevent childhood and adolescent obesity is surprisingly sparse. This paper describes the design and methodological components of the Sentinel Site for Obesity Prevention, a demonstration site in the Barwon-South West region of Victoria, Australia, that aims to build the programs, skills and evidence necessary to attenuate and eventually reverse the obesity epidemic in children and adolescents. The Sentinel Site for Obesity Prevention is based on a partnership between the region's university (Deakin University) and its health, education and local government agencies. The three basic foundations of the Sentinel Site are: multi-strategy, multi-setting interventions; building community capacity; and undertaking program evaluations and population monitoring. Three intervention projects have been supported that cover different age groups (preschool: 2-5 years, primary school: 5-12 years, secondary school: 13-17 years), but that have many characteristics in common including: community participation and ownership of the project; an intervention duration of at least 3 years; and full evaluations with impact (behaviours) and outcome measures (anthropometry) compared with regionally representative comparison populations. We recommend the Sentinel Site approach to others for successfully building evidence for childhood obesity prevention and stimulating action on reducing the epidemic.
Surgical treatment of chronic idiopathic thrombocytopenic purpura: results in 107 cases

International Nuclear Information System (INIS)

Cola, B.; Tonielli, E.; Sacco, S.; Brulatti, M.; Franchini, A.

1986-01-01

Between 1972 and 1985, 107 patients with chronic Idiopathic Thrombocytopenic Purpura underwent splenectomy. Platelet life span and sites of sequestration were studied with labelled platelets and external scanning. Medical treatment was always of scarce and transient effectiveness and had considerable side effects. Splenectomy had minimal complications and mortality and caused no hazard of overwhelming sepsis in adults. The results of splenectomy were very satisfying, especially when platelet sequestration was mainly splenic (remission in about 90% of patients). Surgical treatment is at present the most effective in patients with chronic ITP
Multi-discipline Waste Acceptance Process at the Nevada National Security Site - 13573

Energy Technology Data Exchange (ETDEWEB)

Carilli, Jhon T. [US Department Of Energy, Nevada Site Office, P. O. Box 98518, Las Vegas, Nevada 89193-8518 (United States); Krenzien, Susan K. [Navarro-Intera, LLC, P. O. Box 98952, Las Vegas, Nevada 89193-8952 (United States)

2013-07-01

The Nevada National Security Site low-level radioactive waste disposal facility acceptance process requires multiple disciplines to ensure the protection of workers, the public, and the environment. These disciplines, which include waste acceptance, nuclear criticality, safety, permitting, operations, and performance assessment, combine into the overall waste acceptance process to assess low-level radioactive waste streams for disposal at the Area 5 Radioactive Waste Management Site. Four waste streams recently highlighted the integration of these disciplines: the Oak Ridge Radioisotope Thermoelectric Generators and Consolidated Edison Uranium Solidification Project material, West Valley Melter, and classified waste. (authors)
Multi-agency radiation survey and site investigation manual (MARSIM). Final report

International Nuclear Information System (INIS)

1997-12-01

The MARSSIM provides information on planning, conducting, evaluating, and documenting building surface and surface soil final status radiological surveys for demonstrating compliance with dose or risk-based regulations or standards. The MARSSIM is a multi-agency consensus document that was developed collaboratively by four Federal agencies having authority and control over radioactive materials: Department of Defense (DOD), Department of Energy (DOE), Environmental Protection Agency (EPA), and Nuclear Regulatory Commission (NRC). The MARSSIM's objective is to describe a consistent approach for planning, performing, and assessing building surface and surface soil final status surveys to meet established dose or risk-based release criteria, while at the same time encouraging an effective use of resources
Multi-agency radiation survey and site investigation manual (MARSIM). Final report

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-12-01

The MARSSIM provides information on planning, conducting, evaluating, and documenting building surface and surface soil final status radiological surveys for demonstrating compliance with dose or risk-based regulations or standards. The MARSSIM is a multi-agency consensus document that was developed collaboratively by four Federal agencies having authority and control over radioactive materials: Department of Defense (DOD), Department of Energy (DOE), Environmental Protection Agency (EPA), and Nuclear Regulatory Commission (NRC). The MARSSIM`s objective is to describe a consistent approach for planning, performing, and assessing building surface and surface soil final status surveys to meet established dose or risk-based release criteria, while at the same time encouraging an effective use of resources.
ADVANTAGES, DISADVANTAGES, AND LESSONS LEARNED FROM MULTI-REACTOR DECOMMISSIONING PROJECTS

International Nuclear Information System (INIS)

Morton, M.R.; Nielson, R.R.; Trevino, R.A.

2003-01-01

This paper discusses the Reactor Interim Safe Storage (ISS) Project within the decommissioning projects at the Hanford Site and reviews the lessons learned from performing four large reactor decommissioning projects sequentially. The advantages and disadvantages of this multi-reactor decommissioning project are highlighted
Case study: Accelerated schedule for MULTI LIMS installation

International Nuclear Information System (INIS)

Ibsen, T.G.

1994-05-01

This presentation focuses on the steps taken by the Westinghouse Hanford Company to meet an accelerated schedule for configuration and implementation of the MULTI LIMS in a multiple laboratory environment. The Westinghouse Hanford Company purchased the MULTI LIMS Laboratory Information Management System in August, 1993. Hardware delivery began in October, 1993. Less than four months later, the initial configuration was released for use in two Westinghouse Hanford Company laboratories. Several major obstacles were overcome during implementation. These include information gathering for base table loading, user training, acceptance of the new system by users of a legacy system, and hardware configuration issues. In summary, steps needed to be taken to meet the accelerated implementation schedule of the MULTI LIMS at the Hanford Site. The obstacles faced were overcome through the in-depth knowledge and help of the vendor and the dedication and drive of the technical staff
[Vascular calcifications in subjects with and without chronic renal failure: types, sites and risk factors].

Science.gov (United States)

Marinelli, Annibale; Di Napoli, Anteo

2017-04-01

Vascular calcifications worse outcomes in the general population and in patients on dialysis. We investigated 146 patients on chronic hemodialysis and 63 healthy controls with normal renal function under 65 years of age. All subjects underwent B-mode ultrasonography of common and internal carotid artery, abdominal aorta, common and superficial femoral artery and posterior tibial artery to assess the presence of intimal and medial calcifications. Intimal and media calcifications were present at the level of the carotid vessel, the abdominal aorta, the common femoral artery, the superficial femoral artery and the posterior tibial artery, respectively in 45%, 50%, 45%, 50%, 42% of patients on dialysis and in 5%, 15%, 24%, 5%, 2% of controls (p chronic hemodialysis. Ultrasonography currently available in Nephrology, is a sensitive, reproducible, inexpensive imaging technique to identify arterial intimal and medial calcification in high-risk cardiovascular subjects. Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.
What Impact Does Behavior of Doctors and Patients on Service Integration of Multi-institutional Readmission cross Township—county Hospitals in Rural China

OpenAIRE

Zhang, Yan; Tang, Wenxi; Zhang, Liang

2017-01-01

Background: With the change of rural residents’ disease spectrum and patients with chronic diseases boom, multi-institutional health service utilization of rural residents and the continuous service demands are growing sharply in rural China.Objective: Evaluate the service integration of multi-institutional readmission cross township—county hospitals (MRCTCH) in rural China, and figure out determines of service integration.Methods: This study featured 7 sample counties in rural China. Based o...
The Embodied GIS. Using Mixed Reality to explore multi-sensory archaeological landscapes

Directory of Open Access Journals (Sweden)

Stuart Eve

2017-06-01

Full Text Available We are at a turning point in development and thought about multi-sensorial engagement using digital mediation. From Oculus Rift VR goggles, Google Cardboard, noise-reducing headphones, vibrating-haptic simulating gloves, smell generators and virtual treadmills, every week a new technology or software emerges that can be used to virtualise, augment or diminish our reality, across all of our senses. In many cases these technologies have been used by archaeologists or museum professionals to didactically present or reconstruct archaeological sites or artefacts. However, Mixed Reality is rarely used to actively explore or analyse archaeological sites. This article explores a number of ways that these new multi-sensory developments can be harnessed and linked to a traditional GIS database using Mixed Reality. Through the example of three different sensory applications, I will demonstrate the implementation of an embodied GIS – allowing a multi-sensorial experience of archaeological data in situ, and enabling archaeologists to explore data in new ways, encouraging new interpretations by thinking and working through the body.
CHERISH (collaboration for hospitalised elders reducing the impact of stays in hospital): protocol for a multi-site improvement program to reduce geriatric syndromes in older inpatients.

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Mudge, Alison M; Banks, Merrilyn D; Barnett, Adrian G; Blackberry, Irene; Graves, Nicholas; Green, Theresa; Harvey, Gillian; Hubbard, Ruth E; Inouye, Sharon K; Kurrle, Sue; Lim, Kwang; McRae, Prue; Peel, Nancye M; Suna, Jessica; Young, Adrienne M

2017-01-09

Older inpatients are at risk of hospital-associated geriatric syndromes including delirium, functional decline, incontinence, falls and pressure injuries. These contribute to longer hospital stays, loss of independence, and death. Effective interventions to reduce geriatric syndromes remain poorly implemented due to their complexity, and require an organised approach to change care practices and systems. Eat Walk Engage is a complex multi-component intervention with structured implementation, which has shown reduced geriatric syndromes and length of stay in pilot studies at one hospital. This study will test effectiveness of implementing Eat Walk Engage using a multi-site cluster randomised trial to inform transferability of this intervention. A hybrid study design will evaluate the effectiveness and implementation strategy of Eat Walk Engage in a real-world setting. A multisite cluster randomised study will be conducted in 8 medical and surgical wards in 4 hospitals, with one ward in each site randomised to implement Eat Walk Engage (intervention) and one to continue usual care (control). Intervention wards will be supported to develop and implement locally tailored strategies to enhance early mobility, nutrition, and meaningful activities. Resources will include a trained, mentored facilitator, audit support, a trained healthcare assistant, and support by an expert facilitator team using the i-PARIHS implementation framework. Patient outcomes and process measures before and after intervention will be compared between intervention and control wards. Primary outcomes are any hospital-associated geriatric syndrome (delirium, functional decline, falls, pressure injuries, new incontinence) and length of stay. Secondary outcomes include discharge destination; 30-day mortality, function and quality of life; 6 month readmissions; and cost-effectiveness. Process measures including patient interviews, activity mapping and mealtime audits will inform interventions in each
Chronic cocaine administration induces opposite changes in dopamine receptors in the striatum and nucleus accumbens

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Goeders, N.E.; Kuhar, M.J.

1987-01-01

A variety of clinical and animal data suggest that the repeated administration of cocaine and related psychomotor stimulants may be associated with a behavioral sensitization whereby the same dose of the drug results in increasing behavioral pathology. This investigation was designed to determine the effects of chronic cocaine administration on the binding of [ 3 H]sulpiride, a relatively specific ligand for D2 dopaminergic receptors, in the rat brain using in vitro homogenate binding and light microscopic quantitative autoradiographic methodologies. Chronic daily injections of cocaine (10 mg/kg, i.p.) for 15 days resulted in a significant decrease in the maximum concentration of sulpiride binding sites in the striatum and a significant increase in the maximum number of these binding sites in the nucleus accumbens. No significant differences in binding affinity were observed in either brain region. These data suggest that chronic cocaine administration may result in differential effects on D2 receptors in the nigro-striatal and mesolimbic dopaminergic systems
Unexplained occurrence of multiple de novo pseudoaneurysms in patients with chronic kidney disease undergoing angioembolization for bleeding following percutaneous renal intervention: Are we dealing with infection or vasculitis?

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Debansu Sarkar

2013-01-01

Full Text Available Background and Objectives: Patients with chronic kidney disease (CKD are more prone for bleeding following percutaneous renal intervention, as compared to those with normal renal function. Causes are multi-factorial. Finding multiple aneurysms away from the site of renal intervention following initial angioembolization for hemorrhage is very unusual in these patients. Materials and Methods: Clinical and radiological findings of all the patients who underwent renal angiography for post-intervention bleed for a period of 5 years were reviewed and analyzed. Results: A total of 29 patients required angiography for post-intervention hemorrhage. Six patients had recurrence of hemorrhage for which they underwent repeat angiography. Four of these patients had appearance of multiple new aneurysms away from the site of percutaneous nephrostomy (PCN/percutaneous nephrolithotomy (PNL puncture and the site of previous bleeding. All the patients had CKD (creatinine >2.5 mg/dl. They were on prolonged preoperative urinary diversion and had polymicrobial urinary infection. Three patients had candiduria. None of these patients had re-bleeding after repeat embolization and treatment with antibacterial and antifungal agents. Conclusions: Development of multiple aneurysms away from the sites of punctures in patients with CKD following percutaneous intervention is very unusual. Its causation including infection with bacteria and fungus, reaction of embolizing material, and angiopathy needs to be explored.
Enhancing evidence-based diabetes and chronic disease control among local health departments: a multi-phase dissemination study with a stepped-wedge cluster randomized trial component.

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Parks, Renee G; Tabak, Rachel G; Allen, Peg; Baker, Elizabeth A; Stamatakis, Katherine A; Poehler, Allison R; Yan, Yan; Chin, Marshall H; Harris, Jenine K; Dobbins, Maureen; Brownson, Ross C

2017-10-18

The rates of diabetes and prediabetes in the USA are growing, significantly impacting the quality and length of life of those diagnosed and financially burdening society. Premature death and disability can be prevented through implementation of evidence-based programs and policies (EBPPs). Local health departments (LHDs) are uniquely positioned to implement diabetes control EBPPs because of their knowledge of, and focus on, community-level needs, contexts, and resources. There is a significant gap, however, between known diabetes control EBPPs and actual diabetes control activities conducted by LHDs. The purpose of this study is to determine how best to support the use of evidence-based public health for diabetes (and related chronic diseases) control among local-level public health practitioners. This paper describes the methods for a two-phase study with a stepped-wedge cluster randomized trial that will evaluate dissemination strategies to increase the uptake of public health knowledge and EBPPs for diabetes control among LHDs. Phase 1 includes development of measures to assess practitioner views on and organizational supports for evidence-based public health, data collection using a national online survey of LHD chronic disease practitioners, and a needs assessment of factors influencing the uptake of diabetes control EBPPs among LHDs within one state in the USA. Phase 2 involves conducting a stepped-wedge cluster randomized trial to assess effectiveness of dissemination strategies with local-level practitioners at LHDs to enhance capacity and organizational support for evidence-based diabetes prevention and control. Twelve LHDs will be selected and randomly assigned to one of the three groups that cross over from usual practice to receive the intervention (dissemination) strategies at 8-month intervals; the intervention duration for groups ranges from 8 to 24 months. Intervention (dissemination) strategies may include multi-day in-person workshops, electronic
Patterns and expenditures of multi-morbidity in an insured working population in the United States: insights for a sustainable health care system and building healthier lives.

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Greene, Robert; Dasso, Edwin; Ho, Sam; Frank, Jerry; Scandrett, Graeme; Genaidy, Ash

2013-12-01

The U.S. health care system is currently heading toward unsustainable health care expenditures and increased dissatisfaction with health outcomes. The objective of this population-based study is to uncover practical insights regarding patients with 1 or more chronic illnesses. A cross-sectional investigation was designed to gather data from health records drawn from diverse US geographic markets. A database of 9.74 million fully-insured, working individuals was used, together with members in the same households. Among nearly 3.43 million patients with claims, 2.22 million had chronic conditions. About 24.3% had 1 chronic condition and 40.4% had multi-morbidity. Health care expenditures for chronic conditions accounted for 92% of all costs (52% for chronic costs and 40% for nonchronic costs). Psychiatry, orthopedics-rheumatology, endocrinology, and cardiology areas accounted for two thirds of these chronic condition costs; nonchronic condition costs were dominated by otolaryngology, gastroenterology, dermatology, orthopedics-rheumatology conditions, and preventive services. About 50.1% of all households had 2 or more members with chronic conditions. In summary, multi-morbidity is prevalent not only among those older than age 65 years but also in younger and working individuals, and commonly occurs among several members of a household. The authors suggest that the disease-focused model of medicine should change to a more holistic illness-wellness model, emphasizing not only the physical but also the mental and social elements that can influence individual health. In that way the chronic care model could be broadened in context and content to improve the health of patients and households.
Mapping Collaborative Relations among Canada's Chronic Disease Prevention Organizations

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Hanusaik, Nancy; Maximova, Katerina; Paradis, Gilles; O'Loughlin, Jennifer L.

2016-01-01

In the field of chronic disease prevention (CDP), collaborations between organizations provide a vital framework for intersectoral engagement and exchanges of knowledge, expertise and resources. However, little is known about how the structures of preventive health systems actually articulate with CDP capacity and outcomes. Drawing upon data from the Public Health Organizational Capacity Study – a repeat census of all public health organizations in Canada – we used social network analysis to map and examine interorganizational collaborative relationships in the Canadian preventive health system. The network of relationships obtained through our study shows that provincial boundaries remain a major factor influencing collaborative patterns. Not only are collaborations scarce on the interprovincial level but they are also mostly limited to links with federal and multi-provincial organizations. Given this finding, federal or multi-provincial organizations that occupy central bridging positions in the Canadian CDP collaborative structure should serve as key players for shaping CDP practices in the country. PMID:27585030

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