WorldWideScience

Sample records for chronic multi site

  1. 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 impact of BDNF on chronic pain, it seems an independent factor in the onset and persistence of chronic pain. © The Author(s) 2016.

  2. 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.

  3. Multi-Sited Resilience

    DEFF Research Database (Denmark)

    Olwig, Mette Fog

    2012-01-01

    Participatory methods to build local resilience often involve the organization of local community groups. When global organizations use such methods, it reflects a desire to incorporate local agency. They thereby acknowledge the ability of a society to be innovative and adapt when faced with natu......Participatory methods to build local resilience often involve the organization of local community groups. When global organizations use such methods, it reflects a desire to incorporate local agency. They thereby acknowledge the ability of a society to be innovative and adapt when faced...... 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....

  4. 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.

  5. 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.

  6. 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

  7. 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

    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. 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. 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. 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 brain of a monkey, which suggests the potential

  8. 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.

  9. 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

  10. Multi-Sited Comparison of "Doing Regulation"

    DEFF Research Database (Denmark)

    Sørensen, Estrid

    2008-01-01

    George Marcus (1995) understreger, at multi-sited etnografi indeholder en komparativ dimension. I forhold til den generelle definition af sammenligning mangler multi-sited etnografi dog et væsentligt komponent, nemlig det uforanderlige element, der går igen på tværs af kontekster - det såkaldte...

  11. Getting “Unstuck”: A Multi-Site Evaluation of the Efficacy of an Interdisciplinary Pain Intervention Program for Chronic Low Back Pain

    Directory of Open Access Journals (Sweden)

    Timothy Clark

    2016-06-01

    Full Text Available Chronic low back pain is one of the major health problems in the U.S., resulting in a large number of years of disability. To address the biopsychosocial nature of pain, interdisciplinary pain programs provide integrated interventions by an interdisciplinary team in a unified setting with unified goals. This study examined outcomes of an interdisciplinary program located at two sites with different staff, yet with a unified model of treatment and documentation. Efficacy at the combined sites was examined by comparing standard measures obtained upon admission to the program with measures at completion of a 3–4 week long program for 393 patients with chronic low back pain (CLBP. Repeated measures included pain severity, pain interference, efficacy of self-management strategies, hours of activity, depression, ability to do ADLs, and physical endurance. All repeated measures differed at the p < 0.001 level, with large effect sizes (0.66–0.85. Eighty-two percent of graduates reported being “very much improved” or “much improved”. A second analyses provided evidence that treatment effects were robust across sites with no differences (<0.001 found on five of seven selected outcome measures. A third analysis found that number of days of treatment was correlated on three of seven measures at the <0.01 level. However, the amount of variance explained by days of treatment was under 5% on even the most highly correlated measure. These finding are consistent with previous research and explore short-term effectiveness of treatment across treatment sites and with variable duration of treatment.

  12. 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.

  13. Reduced hypothalamic-pituitary-adrenal axis activity in chronic multi-site musculoskeletal pain: partly masked by depressive and anxiety disorders

    NARCIS (Netherlands)

    Generaal, E.; Vogelzangs, N.; MacFarlane, G.J.; Geenen, R.; Smit, J.H.; Penninx, B.W.J.H.; Dekker, J.

    2014-01-01

    BACKGROUND: Studies on hypothalamic-pituitary-adrenal axis (HPA-axis) function amongst patients with chronic pain show equivocal results and well-controlled cohort studies are rare in this field. The goal of our study was to examine whether HPA-axis dysfunction is associated with the presence and

  14. The influence of self-efficacy, fear-avoidance belief, and coping styles on quality of life for Chinese patients with chronic non-specific low back pain: A multi-site cross-sectional study.

    Science.gov (United States)

    Du, Shizheng; Hu, Lingli; Bai, Yamei; Dong, Jianshu; Jin, Shengji; Zhang, Heng; Zhu, Ying

    2017-11-23

    As a bio-psycho-social issue, chronic low back pain (CLBP) has been a significant topic in health management, and patients' quality of life (QOL) is gaining extensive attention. Self-efficacy, pain fear-avoidance belief (FAB), and coping styles play important roles in QOL of CLBP patients. However, it remains unclear how self-efficacy and FAB influence QOL through specific coping styles. This study aimed to explore the influencing paths of self-efficacy, FAB and coping styles on QOL of patients with CLBP. This study relies on a multi-site, cross-sectional design involving 221 CLBP patients. Stepwise multiple regression and structural equation modeling were employed. CLBP patients lived with a poor global QOL. Self-efficacy played a direct, positive role in predicting QOL for patients CLBP (β=0.35), and it also played an indirect, positive role in predicting QOL (β=0.19) through active coping styles (β=0.31). FAB played a direct, negative role in predicting QOL (β=-0.33), and it also played an indirect, negative role in predicting QOL (β=-0.32) through passive coping styles (β=0.32). Self-efficacy and FAB are both directly and indirectly related to the global QOL, and coping styles are important mediating variables. Self-efficacy and active coping are protective factors for QOL of CLBP patients, while FAB and passive coping are risk factors. Health education strategies are recommended by medical personnel to enhance CLBP patients' pain self-efficacy, decrease pain FAB, and modify pain coping styles, so that their global QOL can be improved. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  15. A multi-site approach towards integrating environmental ...

    African Journals Online (AJOL)

    (VFEA), they adopted a multi-site approach and obtained, in December 2003, the first ISO 14001 multi-site certification in South Africa. This proactive approach allows them better overall environmental performances through mutual motivation, information sharing and comparison of practices by the different participating ...

  16. Efficient multi-site-directed mutagenesis directly from genomic ...

    Indian Academy of Sciences (India)

    In this article, the traditional multi-site-directed mutagenesis method based on overlap extension PCR was improved specifically for complicated templates, such as genomic sequence or complementary DNA. This method was effectively applied for multi-site-directed mutagenesis directly from mouse genomic DNA, as well ...

  17. 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

  18. 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.

  19. 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…

  20. 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.

  1. AUTOETHNOGRAPHY AND MULTI-SITED ETHNOGRAPHY IN MIGRATION STUDIES

    Directory of Open Access Journals (Sweden)

    Lukasz Krzyzowski

    2010-01-01

    Full Text Available The article examines autoethnography (as a form of methodological nationalism, a conceptual tendency that is helpful in the process of the construction of a multi-sited research fi eld, (multi-sited ethnography, at two levels: spatial and temporal. I maintain that this type of data, (migration researcher’s experience and history of migration of the family and local community, allows a better understanding of the nature of migration, which is understood as a process of long duration. More importantly, today’s migrants perceive the migration of a hundred years ago, as well as the present, precisely as transmigration, and not as emigration or immigration.

  2. A multi-site approach towards integrating environmental ...

    African Journals Online (AJOL)

    Nine wineries and a water bottling plant situated in the Franschhoek Valley, South Africa, have decided to lead the way towards creating a safer and more sustainable environment in the Valley. As part of the Vignerons de Franschhoek ECO Association (VFEA), they adopted a multi-site approach and obtained, in December ...

  3. 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.

  4. A Gateway MultiSite recombination cloning toolkit.

    Science.gov (United States)

    Petersen, Lena K; Stowers, R Steven

    2011-01-01

    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).

  5. 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.

  6. Expansion of the Gateway MultiSite Recombination Cloning Toolkit

    Science.gov (United States)

    Shearin, Harold K.; Dvarishkis, Alisa R.; Kozeluh, Craig D.; Stowers, R. Steven

    2013-01-01

    Precise manipulation of transgene expression in genetic model organisms has led to advances in understanding fundamental mechanisms of development, physiology, and genetic disease. Transgene construction is, however, a precondition of transgene expression, and often limits the rate of experimental progress. Here we report an expansion of the modular Gateway MultiSite recombination-cloning platform for high efficiency transgene assembly. The expansion includes two additional destination vectors and entry clones for the LexA binary transcription system, among others. These new tools enhance the expression levels possible with Gateway MultiSite generated transgenes and make possible the generation of LexA drivers and reporters with Gateway MultiSite cloning. In vivo data from transgenic Drosophila functionally validating each novel component are presented and include neuronal LexA drivers, LexAop2 red and green fluorescent synaptic vesicle reporters, TDC2 and TRH LexA, GAL4, and QF drivers, and LexAop2, UAS, and QUAS channelrhodopsin2 T159C reporters. PMID:24204935

  7. 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...

  8. A queueing approach to multi-site enzyme kinetics

    Science.gov (United States)

    Hochendoner, Philip; Ogle, Curtis; Mather, William H.

    2014-01-01

    Multi-site enzymes, defined as where multiple substrate molecules can bind simultaneously to the same enzyme molecule, play a key role in a number of biological networks, with the Escherichia coli protease ClpXP a well-studied example. These enzymes can form a low latency ‘waiting line’ of substrate to the enzyme's catalytic core, such that the enzyme molecule can continue to collect substrate even when the catalytic core is occupied. To understand multi-site enzyme kinetics, we study a discrete stochastic model that includes a single catalytic core fed by a fixed number of substrate binding sites. A natural queueing systems analogy is found to provide substantial insight into the dynamics of the model. From this, we derive exact results for the probability distribution of the enzyme configuration and for the distribution of substrate departure times in the case of identical but distinguishable classes of substrate molecules. Comments are also provided for the case when different classes of substrate molecules are not processed identically. PMID:24904740

  9. 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.

  10. 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.

  11. Understanding uptake of continuous quality improvement in Indigenous primary health care: lessons from a multi-site case study of the Audit and Best Practice for Chronic Disease project

    Directory of Open Access Journals (Sweden)

    Togni Samantha

    2010-03-01

    Full Text Available Abstract Background Experimentation with continuous quality improvement (CQI processes is well underway in Indigenous Australian primary health care. To date, little research into how health organizations take up, support, and embed these complex innovations is available on which services can draw to inform implementation. In this paper, we examine the practices and processes in the policy and organisational contexts, and aim to explore the ways in which they interact to support and/or hinder services' participation in a large scale Indigenous primary health care CQI program. Methods We took a theory-driven approach, drawing on literature on the theory and effectiveness of CQI systems and the Greenhalgh diffusion of innovation framework. Data included routinely collected regional and service profile data; uptake of tools and progress through the first CQI cycle, and data collected quarterly from hub coordinators on their perceptions of barriers and enablers. A total of 48 interviews were also conducted with key people involved in the development, dissemination, and implementation of the Audit and Best Practice for Chronic Disease (ABCD project. We compiled the various data, conducted thematic analyses, and developed an in-depth narrative account of the processes of uptake and diffusion into services. Results Uptake of CQI was a complex and messy process that happened in fits and starts, was often characterised by conflicts and tensions, and was iterative, reactive, and transformational. Despite initial enthusiasm, the mixed successes during the first cycle were associated with the interaction of features of the environment, the service, the quality improvement process, and the stakeholders, which operated to produce a set of circumstances that either inhibited or enabled the process of change. Organisations had different levels of capacity to mobilize resources that could shift the balance toward supporting implementation. Different forms of

  12. Intra-unit correlations in seroconversion to Actinobacillus pleuropneumoniae and Mycoplasma hyopneumoniae at different levels in Danish multi-site pig production facilities

    DEFF Research Database (Denmark)

    Vigre, Håkan; Dohoo, I.R.; Stryhn, H.

    2004-01-01

    429 litters reared in 36 batches at six Danish multi-site farms chronically infected with the agents. At the farms, weaning age was 3-4.5 weeks, after which batches of pigs were reared using all-in/all-out management by room. Blood samples were collected shortly before: weaning, transfer from weaning......In this paper, multilevel logistic models which take into account the multilevel structure of multi-site pig production were used to estimate the variances between pigs produced in Danish multi-site pig production facilities regarding seroconversion to Actinobacillus pleuropneumoniae serotype 2 (Ap......-site to finishing-site, and sending the first pigs in the batch for slaughter (third sampling). Few pigs seroconverted at the weaning-sites, whereas considerable variation in seroconversion was observed at the finishing-sites. Multilevel logistic models (initially including four levels: farm, batch, litter, pig...

  13. SHRINE: enabling nationally scalable multi-site disease studies.

    Directory of Open Access Journals (Sweden)

    Andrew J McMurry

    Full Text Available Results of medical research studies are often contradictory or cannot be reproduced. One reason is that there may not be enough patient subjects available for observation for a long enough time period. Another reason is that patient populations may vary considerably with respect to geographic and demographic boundaries thus limiting how broadly the results apply. Even when similar patient populations are pooled together from multiple locations, differences in medical treatment and record systems can limit which outcome measures can be commonly analyzed. In total, these differences in medical research settings can lead to differing conclusions or can even prevent some studies from starting. We thus sought to create a patient research system that could aggregate as many patient observations as possible from a large number of hospitals in a uniform way. We call this system the 'Shared Health Research Information Network', with the following properties: (1 reuse electronic health data from everyday clinical care for research purposes, (2 respect patient privacy and hospital autonomy, (3 aggregate patient populations across many hospitals to achieve statistically significant sample sizes that can be validated independently of a single research setting, (4 harmonize the observation facts recorded at each institution such that queries can be made across many hospitals in parallel, (5 scale to regional and national collaborations. The purpose of this report is to provide open source software for multi-site clinical studies and to report on early uses of this application. At this time SHRINE implementations have been used for multi-site studies of autism co-morbidity, juvenile idiopathic arthritis, peripartum cardiomyopathy, colorectal cancer, diabetes, and others. The wide range of study objectives and growing adoption suggest that SHRINE may be applicable beyond the research uses and participating hospitals named in this report.

  14. SHRINE: enabling nationally scalable multi-site disease studies.

    Science.gov (United States)

    McMurry, Andrew J; Murphy, Shawn N; MacFadden, Douglas; Weber, Griffin; Simons, William W; Orechia, John; Bickel, Jonathan; Wattanasin, Nich; Gilbert, Clint; Trevvett, Philip; Churchill, Susanne; Kohane, Isaac S

    2013-01-01

    Results of medical research studies are often contradictory or cannot be reproduced. One reason is that there may not be enough patient subjects available for observation for a long enough time period. Another reason is that patient populations may vary considerably with respect to geographic and demographic boundaries thus limiting how broadly the results apply. Even when similar patient populations are pooled together from multiple locations, differences in medical treatment and record systems can limit which outcome measures can be commonly analyzed. In total, these differences in medical research settings can lead to differing conclusions or can even prevent some studies from starting. We thus sought to create a patient research system that could aggregate as many patient observations as possible from a large number of hospitals in a uniform way. We call this system the 'Shared Health Research Information Network', with the following properties: (1) reuse electronic health data from everyday clinical care for research purposes, (2) respect patient privacy and hospital autonomy, (3) aggregate patient populations across many hospitals to achieve statistically significant sample sizes that can be validated independently of a single research setting, (4) harmonize the observation facts recorded at each institution such that queries can be made across many hospitals in parallel, (5) scale to regional and national collaborations. The purpose of this report is to provide open source software for multi-site clinical studies and to report on early uses of this application. At this time SHRINE implementations have been used for multi-site studies of autism co-morbidity, juvenile idiopathic arthritis, peripartum cardiomyopathy, colorectal cancer, diabetes, and others. The wide range of study objectives and growing adoption suggest that SHRINE may be applicable beyond the research uses and participating hospitals named in this report.

  15. Painful myofascial trigger points and pain sites in men with chronic prostatitis/chronic pelvic pain syndrome.

    Science.gov (United States)

    Anderson, Rodney U; Sawyer, Timothy; Wise, David; Morey, Angie; Nathanson, Brian H

    2009-12-01

    A combination of manual physiotherapy and specific relaxation training effectively treats patients with chronic prostatitis/chronic pelvic pain syndrome. However, little information exists on myofascial trigger points and specific chronic pelvic pain symptoms. We documented relationships between trigger point sites and pain symptoms in men with chronic prostatitis/chronic pelvic pain syndrome. We randomly selected a cohort of 72 men who underwent treatment with physiotherapy and relaxation training from 2005 to 2008. Patients self-reported up to 7 pelvic pain sites before treatment and whether palpation of internal and external muscle trigger points reproduced the pain. Fisher's exact test was used to compare palpation responses, ie referral pain, stratified by reported pain site. Pain sensation at each anatomical site was reproduced by palpating at least 2 of 10 designated trigger points. Furthermore, 5 of 7 painful sites could be reproduced at least 50% of the time (p pain sites were the penis in 90.3% of men, the perineum in 77.8% and the rectum in 70.8%. Puborectalis/pubococcygeus and rectus abdominis trigger points reproduced penile pain more than 75% of the time (p pain in at least 80% of the patients at the respective pain sites (p painful sites in men with chronic prostatitis/chronic pelvic pain syndrome. Identifying the site of clusters of trigger points inside and outside the pelvic floor may assist in understanding the role of muscles in this disorder and provide focused therapeutic approaches.

  16. A Microstructure Based Multi-Site Crack Growth Model

    Science.gov (United States)

    Brockenbrough, J. R.; Fridy, J. M.; Weiland, H.

    A simple computational method to simulate component failures in engineered structures based on microstructure characteristics has been developed. The computational model deals directly with a large set of cracks in a defined geometrical region, and is capable of tracking the simultaneous growth and interaction of those cracks, including crack-tip shielding and link-up, until final failure. The Multi-Site Crack Growth (MSCG) tool is designed to start from either an initial uncracked state where cracks may nucleate from cracked particles or other microstructural features, or from an initial cracked state such as might be expected at a percentage of fatigue life expended. Alternatively, the input can be expected crack nucleation sites from microstructure simulations. The MSCG tool is designed based on microstructural origins of fatigue cracks, and the statistical distributions of microstructural parameters. Thus it is possible to extend this framework to corrosion-fatigue. The computational algorithms used enable rapid calculation of the complete crack growth geometry for the current loading cycle, including the current number of cracks, the maximum crack length, the average crack length, and the total cracked area. This makes application to life predictions possible as crack length, area, and number distribution are predicted for given number of load cycles. Example simulations of crack nucleation from large second phase particles will be given.

  17. NPP Multi-Biome: Summary Data from Intensive Studies at 125 Sites, 1936-2006

    Data.gov (United States)

    National Aeronautics and Space Administration — This data set, NPP Multi-Biome: Summary Data from Intensive Studies at 125 Sites, 1936-2006, contains a single shapefile that provides site-level summary statistics...

  18. Accumulation of plasma cells in inflamed sites: effects of antigen, nonspecific microbial activators, and chronic inflammation.

    OpenAIRE

    Mallison, S M; Smith, J. P.; Schenkein, H. A.; Tew, J G

    1991-01-01

    Plasma cells are common in chronically inflamed sites, including periodontal lesions. The aim of this study was to determine which factors contribute to this local accumulation of plasma cells. Specifically, we sought to evaluate the effects of specific antigen and nonspecific activators from an infectious agent associated with chronic inflammation (Fusobacterium nucleatum, an organism prominent in chronic periodontal lesions) and the effect of the chronic inflammation itself. Chronic inflamm...

  19. Using simulated annealing and genetic algorithms for solving a multi site land use allocation problem

    NARCIS (Netherlands)

    Aerts, J.C.J.H.; van Herwijnen, M.; Janssen, R.; Stewart, T.J.

    2005-01-01

    This study examines the use of spatial optimization techniques for multi-site land-use allocation problems (MLUA). 'Multi-site' refers to the problem of allocating more than one land-use type in an area, which are difficult problems as they involve multiple stakeholders with conflicting goals and

  20. 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…

  1. Development of a Multi-Site and Multi-Device Webgis-Based Tool for Tidal Current Energy Development

    Science.gov (United States)

    Ang, M. R. C. O.; Panganiban, I. K.; Mamador, C. C.; De Luna, O. D. G.; Bausas, M. D.; Cruz, J. P.

    2016-06-01

    A multi-site, multi-device and multi-criteria decision support tool designed to support the development of tidal current energy in the Philippines was developed. Its platform is based on Geographic Information Systems (GIS) which allows for the collection, storage, processing, analyses and display of geospatial data. Combining GIS tools with open source web development applications, it becomes a webGIS-based marine spatial planning tool. To date, the webGIS-based tool displays output maps and graphs of power and energy density, site suitability and site-device analysis. It enables stakeholders and the public easy access to the results of tidal current energy resource assessments and site suitability analyses. Results of the initial development showed that it is a promising decision support tool for ocean renewable energy project developments.

  2. 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...

  3. Accumulation of plasma cells in inflamed sites: effects of antigen, nonspecific microbial activators, and chronic inflammation.

    Science.gov (United States)

    Mallison, S M; Smith, J P; Schenkein, H A; Tew, J G

    1991-11-01

    Plasma cells are common in chronically inflamed sites, including periodontal lesions. The aim of this study was to determine which factors contribute to this local accumulation of plasma cells. Specifically, we sought to evaluate the effects of specific antigen and nonspecific activators from an infectious agent associated with chronic inflammation (Fusobacterium nucleatum, an organism prominent in chronic periodontal lesions) and the effect of the chronic inflammation itself. Chronic inflammation (14 to 17 days) was induced in horseradish peroxidase (HRP)-immune rabbits by subcutaneous injection of 50 microliters of sterile alum in several sites in their backs. Controls included sites injected with saline or more acute sites examined after 3 days of alum inflammation. Sites were challenged with HRP (the antigen), sonicated F. nucleatum (the nonspecific activator), or both together to see whether F. nucleatum has an adjuvant effect. Three days after challenge, HRP-specific antibody-forming cells (AFC) were enumerated after peroxidase histochemistry. In noninflamed sites or sites with acute inflammation, virtually no HRP-specific AFC were evident. In contrast, chronic inflammation alone was sufficient to elicit a specific AFC response (congruent to 10 cells per mm2). Addition of either F. nucleatum or HRP to the chronic lesion about doubled the number of HRP-specific AFC. However, a dramatic 8- to 15-fold (80 to 150/mm2) increase was seen in chronically inflamed sites challenged with antigen and activator together. Interestingly, the activator did not have this adjuvant effect in the acute sites or in normal skin. In short, accumulation of plasma cells in inflamed sites is promoted by chronic inflammation, activators of microbial origin, and specific antigen. This milieu can be expected to develop in some periodontal lesions and could help explain why gingival crevicular fluid from some sites may contain extraordinary levels of locally produced specific antibodies

  4. Study of multi-site chemical exchange in solution state by NMR: 1D ...

    Indian Academy of Sciences (India)

    This work demonstrates a simple 1D NMR approach employing multiply selective excitation to study multi-site exchange processes in solution, applying it to systems that exhibit three-site exchange. This approach involves simultaneous excitation of all - or a chosen subset of - the exchanging sites by using an appropriately ...

  5. Efficient multi-site-directed mutagenesis directly from genomic ...

    Indian Academy of Sciences (India)

    2012-09-29

    Sep 29, 2012 ... ces, containing suitable restriction-enzyme-cutting sites, were added at the 5′ ends of primer F1 and R3 respectively, which provided combination sites for the full-length forward. (FF) primer and full-length reverse (FR) primer respectively. Low concentration of primers was used so that the primers could be ...

  6. Standardization of electroencephalography for multi-site, multi-platform and multi-investigator studies: insights from the canadian biomarker integration network in depression.

    Science.gov (United States)

    Farzan, Faranak; Atluri, Sravya; Frehlich, Matthew; Dhami, Prabhjot; Kleffner, Killian; Price, Rae; Lam, Raymond W; Frey, Benicio N; Milev, Roumen; Ravindran, Arun; McAndrews, Mary Pat; Wong, Willy; Blumberger, Daniel; Daskalakis, Zafiris J; Vila-Rodriguez, Fidel; Alonso, Esther; Brenner, Colleen A; Liotti, Mario; Dharsee, Moyez; Arnott, Stephen R; Evans, Kenneth R; Rotzinger, Susan; Kennedy, Sidney H

    2017-08-07

    Subsequent to global initiatives in mapping the human brain and investigations of neurobiological markers for brain disorders, the number of multi-site studies involving the collection and sharing of large volumes of brain data, including electroencephalography (EEG), has been increasing. Among the complexities of conducting multi-site studies and increasing the shelf life of biological data beyond the original study are timely standardization and documentation of relevant study parameters. We present the insights gained and guidelines established within the EEG working group of the Canadian Biomarker Integration Network in Depression (CAN-BIND). CAN-BIND is a multi-site, multi-investigator, and multi-project network supported by the Ontario Brain Institute with access to Brain-CODE, an informatics platform that hosts a multitude of biological data across a growing list of brain pathologies. We describe our approaches and insights on documenting and standardizing parameters across the study design, data collection, monitoring, analysis, integration, knowledge-translation, and data archiving phases of CAN-BIND projects. We introduce a custom-built EEG toolbox to track data preprocessing with open-access for the scientific community. We also evaluate the impact of variation in equipment setup on the accuracy of acquired data. Collectively, this work is intended to inspire establishing comprehensive and standardized guidelines for multi-site studies.

  7. 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.

  8. Construction of a high-efficiency multi-site-directed mutagenesis ...

    African Journals Online (AJOL)

    Although site-directed mutagenesis has been used in many fields, it still has low rate of success and high cost because of low-yield target products. A modified method for multi-site-directed mutagenesis was developed with shifted primer design and cold-start polymerase chain reaction (PCR). The developed method was ...

  9. Multi-site N-Glycan mapping study 2: UHPLC.

    Science.gov (United States)

    Szekrényes, Ákos; Park, SungAe Suhr; Cosgrave, Eoin; Jones, Aled; Haxo, Ted; Kimzey, Michael; Pourkaveh, Shiva; Szabó, Zoltán; Sosic, Zoran; Feng, Peng; Sejwal, Preeti; Dent, Kelsey; Michels, David; Freckleton, Gordon; Qian, Jun; Lancaster, Catherine; Duffy, Toni; Schwartz, Melissa; Luo, Jiann-Kae; van Dyck, Jonathan; Leung, Pui-King; Olajos, Marcell; Kowle, Ronald; Gao, Kai; Wang, Wenbo; Wegstein, Jo; Tep, Samnang; Domokos, Apolka; Váradi, Csaba; Guttman, András

    2018-01-13

    In the first part of this publication, the results from an international study evaluating the precision (i.e., repeatability and reproducibility) of N-glycosylation analysis using capillary electrophoresis of APTS-labeled N-glycans were presented. The corresponding results from ultra-high performance liquid chromatography (UHPLC) with fluorescence detection are presented here from 12 participating sites. All participants used the same lot of samples, reagents, and columns to perform the assays. Elution time, peak area and peak area percent values were determined for all peaks ≥0.1% peak area, and statistical analysis was performed following ISO 5725-2 guideline principles. The results demonstrated adequate reproducibility, within any given site as well across all sites, indicating that standard UHPLC-based N-glycan analysis platforms are appropriate for general use. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  10. 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.

  11. 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…

  12. Multi-site implementation of health education programs for Latinas.

    Science.gov (United States)

    Sudarsan, Nora R; Jandorf, Lina; Erwin, Deborah O

    2011-04-01

    US Latinas are more likely to be diagnosed with late stage breast cancer and have nearly double the incidence of cervical cancer. A culturally customized educational program (Esperanza y Vida) was established in three locations to increase cancer awareness and screening. Educational programs (N = 159) were conducted, with participants randomized to either a breast and cervical (intervention) or diabetes (control) program. Variations in key factors, including gender, program location sites, language utilized, time/day of programs, and data collection method were detected, uncovering unique distributions across locations. Esperanza y Vida was successful in recruiting participants to health programs in three locations, each with a unique Latino population. Program site differences demonstrated educational and screening interventions can be implemented in multiple locations, with program variations reflecting local characteristics. These findings can be applied to outreach efforts to effectively increase participation and enhance screening practices and benefits in other regions.

  13. A multi-site approach towards integrating environmental ...

    African Journals Online (AJOL)

    driniev

    management in the wine production industry. A Walsdorff1*, M .... performance in any company or industry is that it should be a priority, and .... Lees recovery has only been implemented recently at 7 of the sites, leading to a significant improvement in wastewater management whilst 2 of the. 0.0. 2.0. 4.0. 6.0. 8.0. 10.0. A. B.

  14. Long-term adolescent multi-site musculoskeletal pain is associated with psychological distress and anxiety.

    Science.gov (United States)

    Auvinen, Juha; Eskola, Pasi J; Ohtonen, Hanni-Rosa; Paananen, Markus; Jokelainen, Jari; Timonen, Markku; Vahtera, Jussi; Leino-Arjas, Päivi; Karppinen, Jaro

    2017-02-01

    Although several studies have shown that adolescent musculoskeletal pain is associated with psychological problems in a cross-sectional setting, the associations of long-term musculoskeletal pain with psychological distress and anxiety are not known. The study included 1773 adolescents belonging to the Northern Finland Birth Cohort 1986. They received a postal questionnaire at the age of 16years and a follow-up questionnaire two years later. The first inquiry contained questions about the sites of musculoskeletal pain; the second had the same pain questions, along with measures of distress and anxiety. Risk ratios (RR) were assessed by log-linear regression analysis. Multi-site musculoskeletal pain (in ≥2 body locations) at both 16 and 18years was common, reported by 53% of girls and 30% of boys. Multi-site pain at both ages, compared to those with multi-site pain neither at 16 nor 18years, was associated with psychological distress at the age of 18 among both girls (RR 1.8 95% CI 1.2-2.7) and boys (RR 3.5 95% CI 2.1-5.9). For anxiety, the corresponding relative risks were 1.5 (95% CI 1.0-2.2) and 1.8 (95% CI 1.4-2.3), respectively. For short-term multi-site pain (prevalent only at the age of 16 or 18), these relative risks were between 0.8 and 2.3. Adolescents with long-term multi-site pain have higher levels of distress and anxiety than those without or with only short-term multi-site pain. Associations were found in both genders, but the relationship between pain and distress was more pronounced among boys. The associations had modest effect strength. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Comparison of discrete multi-criteria decision making methods for selection of afforestation sites

    OpenAIRE

    Estrella Maldonado, Rene; Delabastita, Ward; Wijffels, Anja; Van Orshoven, Jos

    2012-01-01

    This paper reports on a comparison of six Multi-Criteria Decision making Methods (MCDM) when used to rank sites for afforestation. ELECTRE III, PROMETHEE II, Analytic Hierarchy Process (AHP), Compromise Programming (CP), Stochastic Multi-criteria Accept- ability Analysis (SMAA-2) and Iterative Ideal Point Thresholding (IIPT) were applied to a ras- terized database containing a number of land units, with each land unit representing a group of spatially scattered pixels with iden...

  16. 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.

  17. 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.

  18. MULTI-SCALE COHERENT TURBULENCE AT TIDAL ENERGY SITES

    Energy Technology Data Exchange (ETDEWEB)

    Thomson, Jim; Kilcher, Levi; Harding, Samuel F.

    2014-11-05

    Turbulence is known to affect the performance and survivability of tidal turbines, yet characterization of turbulence in the field remains limited. Here, we refine and demonstrate a new approach to turbulence measurements, in which an array of multiple Acoustic Doppler Velocimeters (ADV) is suspended above the seabed at the hub height of a tidal turbine. These measurements provide information on the intensity, structure, and coherence of turbulence across the scale of a turbine rotor (< 10 m). Deployment of multiple moorings expands the analysis to array scales (> 10 m). Motion correction of the moored ADV data is essential to this approach and is verified using the turbulent kinetic energy spectra. Additional measurements include a bottommounted 5-beam Acoustic Doppler Current Profiler, from which scales can be assessed using the velocities a separation distances along a given beam. These methods are demonstrated with data collected at the site of the Snohomish PUD pilot project in Admiralty Inlet, Puget Sound, WA (USA). Coherent motion is found to be largely isotropic, such that coherence is high only at scales less than the advective length scale or the water depth, whichever is less.

  19. Elastic-plastic models for multi-site damage

    Science.gov (United States)

    Actis, Ricardo L.; Szabo, Barna A.

    1994-09-01

    This paper presents recent developments in advanced analysis methods for the computation of stress site damage. The method of solution is based on the p-version of the finite element method. Its implementation was designed to permit extraction of linear stress intensity factors using a superconvergent extraction method (known as the contour integral method) and evaluation of the J-integral following an elastic-plastic analysis. Coarse meshes are adequate for obtaining accurate results supported by p-convergence data. The elastic-plastic analysis is based on the deformation theory of plasticity and the von Mises yield criterion. The model problem consists of an aluminum plate with six equally spaced holes and a crack emanating from each hole. The cracks are of different sizes. The panel is subjected to a remote tensile load. Experimental results are available for the panel. The plasticity analysis provided the same limit load as the experimentally determined load. The results of elastic-plastic analysis were compared with the results of linear elastic analysis in an effort to evaluate how plastic zone sizes influence the crack growth rates. The onset of net-section yielding was determined also. The results show that crack growth rate is accelerated by the presence of adjacent damage, and the critical crack size is shorter when the effects of plasticity are taken into consideration. This work also addresses the effects of alternative stress-strain laws: The elastic-ideally-plastic material model is compared against the Ramberg-Osgood model.

  20. CANDIS treatment program for cannabis use disorders: findings from a randomized multi-site translational trial.

    Science.gov (United States)

    Hoch, E; Bühringer, G; Pixa, A; Dittmer, K; Henker, J; Seifert, A; Wittchen, H U

    2014-01-01

    In a recent paper, we reported the efficacy of a modular cognitive-behavioral intervention for treating adolescents and adults with cannabis use disorders (CUD). In this study, we examine the outcome of this intervention after translating it into clinical practice. A multi-site, randomized controlled trial of 279 treatment seekers with ICD-10 cannabis use disorders aged 16- 63 years was conducted in 11 outpatient addiction treatment centers in Germany. Patients were randomly assigned to an Active Treatment (AT, n=149) or Delayed Treatment Control (DTC, n=130). Treatment consisted of 10 sessions of fully manualized individual psychotherapy that combined Cognitive-Behavioral Therapy, Motivational EnhancementTherapy and problem-solving training. Assessments were conducted at baseline, during each therapy session, at post-treatment and at three and six month follow-ups. At post assessment 53.3% of AT patients reported abstinence (46.3% negative urine screenings) compared to 22% of DTC patients (17.7% negative drug screenings) (pcannabis use, number of cannabis dependence criteria, severity of dependence, as well as number and severity of cannabis-related problems. Effect sizes were moderate to high. While abstinence rates in the AT group decreased over the 3-month (negative urine screenings: 32.4%) and 6-month (negative urine screenings: 35.7%) follow-up periods, the effects in secondary outcomes were maintained. The intervention can successfully be translated to and applied in clinical practice. It has the potential to improve access to evidence-based care for chronic CUD patients. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  1. The oral cavity and age: a site of chronic inflammation?

    Directory of Open Access Journals (Sweden)

    Magnus Bäck

    Full Text Available BACKGROUND: Aging may be accompanied by a low grade chronic up-regulation of inflammatory mediators. A variety of endogenous locally released mediators as well as inflammatory cells have been reported in the human oral cavity. The aim of this investigation was to determine the presence of different classes of inflammatory mediators in human saliva and correlate the levels with age. METHODOLOGY AND PRINCIPAL FINDINGS: Unstimulated whole buccal salivary samples were obtained in the morning from 94 healthy volunteers within 30 minutes after waking. None of the participants had taken aspirin in the week prior to the saliva collection. Lysozyme activity, eicosanoid levels (prostaglandin E(2 and leukotriene B(4 and MMP-9 activity were measured. The antimicrobial activity (lysozyme activity was not correlated with age whereas PGE(2 levels were markedly correlated with age (r = 0.29; P40 years demonstrated a significant increase in the mean values for PGE(2 and MMP-9 activity with age. In addition, significant correlations were observed between LTB(4 and PGE(2 (r = 0.28; P<0.05; n = 56 and between LTB(4 levels and MMP-9 activity in smokers (r = 0.78; P<0.001; n = 15. CONCLUSIONS/SIGNIFICANCE: The presence of significant levels and activity of inflammatory mediators in saliva suggests that the oral cavity of healthy subjects may be in a constant low state of inflammation associated with age.

  2. Immediate Deployment of Waste Energy Recovery Technologies at Multi Sites

    Energy Technology Data Exchange (ETDEWEB)

    Dennis Castonguay

    2012-06-29

    Verso Paper Corp. implemented a portfolio of 13 commercially available proven industrial technologies each exceeding 30% minimum threshold efficiency and at least 25% efficiency increase. These sub-projects are a direct result of a grant received from the Department of Energy (DOE) through its FOA 0000044 (Deployment of Combined Heat and Power (CHP) Systems, District Energy Systems, Waste Energy Recovery Systems, and Efficient Industrial Equipment), which was funded by the American Recovery Act. These were installed at 3 sites in 2 states and are helping to reduce Verso costs, making the facilities more competitive. This created approximately 100 construction jobs (FTE's) and reduced impacted Verso facilities' expense budgets. These sub-projects were deployed at Verso paper mills located in Jay, Maine, Bucksport, Maine, and Sartell, Minnesota. The paper mills are the economic engines of the rural communities in which these mills are located. Reinvestment in waste energy recovery capital improvements is providing a stimulus to help maintain domestic jobs and to competitively position the US pulp and paper industry with rising energy costs. Energy efficiency improvements are also providing a positive environmental impact by reducing greenhouse gas emissions, the quantity of wastewater treated and discharged, and fossil fuel demand. As a result of these projects, when fully operating, Verso realized a total of approximately 1.5 TBtu/Year reduction in overall energy consumption, which is 119% of the project objectives. Note that three paper machines have since been permanently curtailed. However even with these shutdowns, the company still met its energy objectives. Note also that the Sartell mill's paper machine is down due to a recent fire which damaged the mill's electrical infrastructure (the company has not decided on the mill's future).

  3. Multi-site videoconference tutorials for medical students in Australia.

    Science.gov (United States)

    Smith, Anthony C; White, Megan M; McBride, Craig A; Kimble, Roy M; Armfield, Nigel R; Ware, Robert S; Coulthard, Mark G

    2012-10-01

    About two-thirds of medical students are distributed among the major metropolitan tertiary teaching hospitals in Queensland, while the remainder are sent to regional hospitals up to 500 km away. The aim of this study was to investigate the feasibility and effectiveness of conducting surgical tutorials via videoconferencing (VC) for medical students undertaking at remote hospitals. Surgical tutorials were offered to final-year medical students at the Royal Children's Hospital (RCH) in Brisbane and shared by VC to students undertaking clinical placement at nine remotely located hospitals in Queensland. We have conducted a retrospective review of service activity, student satisfaction and subject scores from 2008 to 2010. The main outcome measures were VC activity, medical students' satisfaction and student exam results pre- and post-introduction of the surgical tutorial programme. Between March 2009 and November 2010, a total of 57 VC tutorials were conducted during nine rotations for a total of 669 students. Approximately, 35% of students (236) attended tutorials face-to-face at the RCH while the remainder (including those at the Mater Children's Hospital in Brisbane and eight regional sites) participated via VC. A snapshot survey to measure satisfaction of both groups of students showed that overall satisfaction was very high. A total of 299 students completed the paediatrics and child health multiple-station assessment task exam in 2008, 326 in 2009 and 382 in 2010. The pre-intervention (tutorials not delivered by VC) median scores (interquartile range) of surgical and non-surgical questions were 5 (4-6) and 23 (21-25). Post-intervention, surgical scores increased significantly to 6 (5-7) (P < 0.001), while non-surgical scores remained similar at 23 (21-25) (P = 0.64). Our study demonstrates that VC is a feasible and effective method of engaging medical students regardless of their location. VC provides equitable access to medical teaching for medical students

  4. 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

    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...... consisting of PCE (perchloroethylene) has contaminated a fractured clay till aquitard overlaying a limestone aquifer. The exact shape and nature of the source is unknown and so is the importance of transport in the fractures. The result of the multi-model approach is a visual representation......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...

  5. 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

  6. 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

  7. 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…

  8. Fifteen minutes in limbo: On the intricacies of rapport in multi-sited fieldwork on tourism

    NARCIS (Netherlands)

    Tonnaer, A.A.C.

    2012-01-01

    In this article I discuss a revelatory moment that occurred in arguably the 15 slowest minutes of my ethnographic fieldwork on the cultural meeting between Indigenous people and tourists in Northern Australia. The challenge of doing multi-sited ethnography in tourism is to remain aware of our

  9. 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.; Hulsman, R. L.; Kusurkar, R. A.

    2017-01-01

    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…

  10. Use of personal digital assistants for data collection in a multi-site ...

    African Journals Online (AJOL)

    , quick turnaround time of data entry with good data quality, and convenience. Conclusion: Our study demonstrated the feasibility of utilizing PDAs for data collection in a multi-site observational study on HIV/AIDS stigma conducted in remote ...

  11. Field fracturing multi-sites project. Annual report, August 1, 1995--July 31, 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-12-31

    The objective of the Field Fracturing Multi-Sites Project (M-Site) is to conduct experiments to definitively determine hydraulic fracture dimensions using remote well and treatment well diagnostic techniques. In addition, experiments are to be conducted to provide data that will resolve significant unknowns with regard to hydraulic fracture modeling, fracture fluid rheology and fracture treatment design. These experiments will be supported by a well-characterized subsurface environment, as well as surface facilities and equipment conducive to acquiring high-quality data. The primary Project goal is to develop a fully characterized, tight reservoir-typical, field-scale hydraulic fracturing test site to diagnose, characterize, and test hydraulic fracturing technology and performance. It is anticipated that the research work being conducted by the multi-disciplinary team of GRI and DOE contractors will lead to the development of a commercial fracture mapping tool/service.

  12. Multi-criteria analysis of site selection for groundwater recharge with treated municipal wastewater.

    Science.gov (United States)

    Ahmadi, Mohammad Mehdi; Mahdavirad, Hadi; Bakhtiari, Bahram

    2017-08-01

    Geographic information systems (GIS) and remote sensing techniques are used as a decision support system to identify potential soil aquifer treatment (SAT) sites for groundwater recharge of Kerman aquifer, which is located in the southeast of Iran. These sites are identified using a single-objective multi-criteria analysis. To ensure technical feasibility, environmental sustainability, social acceptability and economical viability a number of criteria are considered for the site selection. The criteria selected for the different variables and acceptable ranges are based on standards published in national and international guidelines and technical documents. Multi-criteria evaluation was performed combining all produced thematic maps by means of the weighted index overlay method in order to select sites meeting all the criteria. The resulting map of this analysis shows potential sites are located in the north, southwest and southeast of the study area. Considering field observations, a potential site, which is located in the southwest of the study area, is proposed as the most suitable site for SAT. The result indicates that the study area has sufficient required suitable space for groundwater recharge with treated wastewater.

  13. 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.

  14. A therapeutic delivery system for chronic osteomyelitis via a multi-drug implant based on three-dimensional printing technology.

    Science.gov (United States)

    Wu, Weigang; Ye, Chenyi; Zheng, Qixin; Wu, Gui; Cheng, Zhaohui

    2016-08-01

    Chronic osteomyelitis is difficult to be cured and often relapses, which presents to be a great challenge to clinicians. We conducted this original study to explore the efficiency of therapeutic alliance for chronic osteomyelitis by a multi-drug implant based on three-dimensional printing technology. We designed and fabricated preciously a multi-drug implant with a multi-layered concentric cylinder construction by three-dimensional (3D) printing technology. Levofloxacin and tobramycin were incorporated into the drug implant in a specific sequence. The drug release property of the drug implant was assayed in vitro We also developed an animal model of chronic osteomyelitis to estimate the effect of the 3D printed multi-drug implant. The results showed that the multi-drug implant had a sustained and programmed drug release property. Levofloxacin and tobramycin which were released from the multi-drug implant worked in tandem to enhance pharmacodynamic action which was similar to a tumor chemotherapy program and were sufficient to treat chronic osteomyelitis. These findings imply that the administration of 3D printed multi-drug implant would be a potential therapeutic method for chronic osteomyelitis. Further studies are required. © The Author(s) 2016.

  15. 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......  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...... 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 similar to 1000 s. We list frequencies...

  16. Multi-agent system as a new approach to effective chronic heart failure management: key considerations.

    Science.gov (United States)

    Mohammadzadeh, Niloofar; Safdari, Reza; Rahimi, Azin

    2013-09-01

    Given the importance of the follow-up of chronic heart failure (CHF) patients to reduce common causes of re-admission and deterioration of their status that lead to imposing spiritual and physical costs on patients and society, modern technology tools should be used to the best advantage. The aim of this article is to explain key points which should be considered in designing an appropriate multi-agent system to improve CHF management. In this literature review articles were searched with keywords like multi-agent system, heart failure, chronic disease management in Science Direct, Google Scholar and PubMed databases without regard to the year of publications. Agents are an innovation in the field of artificial intelligence. Because agents are capable of solving complex and dynamic health problems, to take full advantage of e-Health, the healthcare system must take steps to make use of this technology. Key factors in CHF management through a multi-agent system approach must be considered such as organization, confidentiality in general aspects and design and architecture points in specific aspects. Note that use of agent systems only with a technical view is associated with many problems. Hence, in delivering healthcare to CHF patients, considering social and human aspects is essential. It is obvious that identifying and resolving technical and non-technical challenges is vital in the successful implementation of this technology.

  17. 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.

  18. System-of-system approaches and challenges for multi-site manufacturing

    OpenAIRE

    Ford, Simon; Rauschecker, Ursula; Athanassopoulou, Nikoletta

    2012-01-01

    In the multi-site manufacturing domain, systems-of-systems (SoS) are rarely called so. However, there exist a number of collaborative manufacturing paradigms which closely relate to system-of-system principles. These include distributed manufacturing, dispersed network manufacturing, virtual enterprises and cloud manufacturing/manufacturing-as-a-service. This paper provides an overview of these terms and paradigms, exploring their characteristics, overlaps and differences. These manufacturing...

  19. Site characterization using noninvasive single- and multi-station methods at southern California seismic stations

    Science.gov (United States)

    Yong, A.; Martin, A. J.; Pfau, J.; McPhillips, D.; Alvarez, M.; Lydeen, S.; Clerc, F.; Leue, N.

    2016-12-01

    In-situ measurements of shear-wave velocity (Vs) are used commonly to evaluate seismic response at earthquake monitoring station and project sites. Vs30, the time-averaged Vs in the upper 30 m, is a common parameter used to capture seismic site response and is used in almost all modern ground motion prediction equations. Traditional invasive downhole methods directly measure Vs; however, these methods are often cost- and/or environmentally-prohibitive and their results do not always reflect the lateral variability of seismic conditions beyond the immediate vicinity of the test site. In comparison, noninvasive methods record active- or passive-source data consisting of surface or body waves and are less prohibitive to use. Moreover, these methods use multiple horizontally-spaced surface receivers (multi-station array), thus, lateral variability beneath the array is accounted for in their results. Most noninvasive methods, however, indirectly measure Vs, and thus have inherent uncertainties. We have used a suite of noninvasive methods at ten stations in southern California. We record microseisms using standalone single-stations, located at the end- and mid-points of the measurement array, and over the same period, we also collect records from the seismic station. Using both single- and seismic-station records, we calculate the horizontal-to-vertical-spectra-ratios (HVSR), resonance frequency, and power spectral density to study site characteristics, including noise levels. For soil sites, we generally find insignificant lateral variability in subsurface conditions beneath our multi-station arrays by matching similar spectral peaks and frequencies in the three HVSR records; for rock sites, the magnitudes of the HVSR values are not as discernible. While we find general agreement in Vs30 computed using a variety of methods at each site, preliminary results for low-noise sites using standalone passive methods have large uncertainty in their computed Vs30 values.

  20. Potential interoperability problems facing multi-site radiation oncology centers in The Netherlands

    Science.gov (United States)

    Scheurleer, J.; Koken, Ph; Wessel, R.

    2014-03-01

    Aim: To identify potential interoperability problems facing multi-site Radiation Oncology (RO) departments in the Netherlands and solutions for unambiguous multi-system workflows. Specific challenges confronting the RO department of VUmc (RO-VUmc), which is soon to open a satellite department, were characterized. Methods: A nationwide questionnaire survey was conducted to identify possible interoperability problems and solutions. Further detailed information was obtained by in-depth interviews at 3 Dutch RO institutes that already operate in more than one site. Results: The survey had a 100% response rate (n=21). Altogether 95 interoperability problems were described. Most reported problems were on a strategic and semantic level. The majority were DICOM(-RT) and HL7 related (n=65), primarily between treatment planning and verification systems or between departmental and hospital systems. Seven were identified as being relevant for RO-VUmc. Departments have overcome interoperability problems with their own, or with tailor-made vendor solutions. There was little knowledge about or utilization of solutions developed by Integrating the Healthcare Enterprise Radiation Oncology (IHE-RO). Conclusions: Although interoperability problems are still common, solutions have been identified. Awareness of IHE-RO needs to be raised. No major new interoperability problems are predicted as RO-VUmc develops into a multi-site department.

  1. 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

  2. A Hierarchical Modeling Approach to Data Analysis and Study Design in a Multi-Site Experimental fMRI Study

    Science.gov (United States)

    Zhou, Bo; Konstorum, Anna; Duong, Thao; Tieu, Kinh H.; Wells, William M.; Brown, Gregory G.; Stern, Hal S.; Shahbaba, Babak

    2013-01-01

    We propose a hierarchical Bayesian model for analyzing multi-site experimental fMRI studies. Our method takes the hierarchical structure of the data (subjects are nested within sites, and there are multiple observations per subject) into account and allows for modeling between-site variation. Using posterior predictive model checking and model…

  3. 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.

  4. GIS Based Multi-Criteria Decision Analysis For Cement Plant Site Selection For Cuddalore District

    Science.gov (United States)

    Chhabra, A.

    2015-12-01

    India's cement industry is a vital part of its economy, providing employment to more than a million people. On the back of growing demands, due to increased construction and infrastructural activities cement market in India is expected to grow at a compound annual growth rate (CAGR) of 8.96 percent during the period 2014-2019. In this study, GIS-based spatial Multi Criteria Decision Analysis (MCDA) is used to determine the optimum and alternative sites to setup a cement plant. This technique contains a set of evaluation criteria which are quantifiable indicators of the extent to which decision objectives are realized. In intersection with available GIS (Geographical Information System) and local ancillary data, the outputs of image analysis serves as input for the multi-criteria decision making system. Moreover, the following steps were performed so as to represent the criteria in GIS layers, which underwent the GIS analysis in order to get several potential sites. Satellite imagery from LANDSAT 8 and ASTER DEM were used for the analysis. Cuddalore District in Tamil Nadu was selected as the study site as limestone mining is already being carried out in that region which meets the criteria of raw material for cement production. Several other criteria considered were land use land cover (LULC) classification (built-up area, river, forest cover, wet land, barren land, harvest land and agriculture land), slope, proximity to road, railway and drainage networks.

  5. Effect of Multi-layer Compression Bandage Systems on Leg Ulcers Associated with Chronic Venous Insufficiency

    Directory of Open Access Journals (Sweden)

    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.

  6. A framework for landfill site selection using geographic information systems and multi criteria decision making technique

    Science.gov (United States)

    Mat, Nur Azriati; Benjamin, Aida Mauziah; Abdul-Rahman, Syariza; Wibowo, Antoni

    2016-10-01

    The solid waste disposal is one of the facilities which can cause harm to human health and also contribute to severe environmental pollution if it is not properly managed. Therefore, an effective decision on a landfill site selection in order to identify the most suitable area as a new landfill is very important. Since 25 years ago, the integration of geographic information systems (GIS) and multi criteria decision analysis (MCDA) has drawn significant interest among researchers. This integrated technique is commonly used for land use planning and selecting a new landfill site is one of the plan. This paper proposes a framework of landfill site selection with a consideration of resource requirement. This framework is developed by using the integration of GIS and MCDA to identify an appropriate location for landfill siting. A list of selection criteria obtained from the literature considered in selecting the best landfill site is also presented. The results of this study could later be used to help the waste management team in developing an efficient solid waste management system.

  7. 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 power...... of root mean squared error on all forecast horizons. The predictive performance and the simplicity of the model setup make the boosted tree model a simple and attractive compliment to conventional forecasting techniques. (C) 2017 Elsevier Ltd. All rights reserved....

  8. 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....

  9. 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.

  10. 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.

  11. Constraining a global ecosystem model with multi-site eddy-covariance data

    Directory of Open Access Journals (Sweden)

    S. Kuppel

    2012-10-01

    Full Text Available Assimilation of in situ and satellite data in mechanistic terrestrial ecosystem models helps to constrain critical model parameters and reduce uncertainties in the simulated energy, water and carbon fluxes. So far the assimilation of eddy covariance measurements from flux-tower sites has been conducted mostly for individual sites ("single-site" optimization. Here we develop a variational data assimilation system to optimize 21 parameters of the ORCHIDEE biogeochemical model, using net CO2 flux (NEE and latent heat flux (LE measurements from 12 temperate deciduous broadleaf forest sites. We assess the potential of the model to simulate, with a single set of inverted parameters, the carbon and water fluxes at these 12 sites. We compare the fluxes obtained from this "multi-site" (MS optimization to those of the prior model, and of the "single-site" (SS optimizations. The model-data fit analysis shows that the MS approach decreases the daily root-mean-square difference (RMS to observed data by 22%, which is close to the SS optimizations (25% on average. We also show that the MS approach distinctively improves the simulation of the ecosystem respiration (Reco, and to a lesser extent the gross primary productivity (GPP, although we only assimilated net CO2 flux. A process-oriented parameter analysis indicates that the MS inversion system finds a unique combination of parameters which is not the simple average of the different SS sets of parameters. Finally, in an attempt to validate the optimized model against independent data, we observe that global-scale simulations with MS optimized parameters show an enhanced phase agreement between modeled leaf area index (LAI and satellite-based observations of normalized difference vegetation index (NDVI.

  12. Multi-system state shifts and cognitive deficits induced by chronic morphine during abstinence.

    Science.gov (United States)

    Niu, Haichen; Zhang, Guanqun; Li, Haiying; Zhang, Qiang; Li, Tongzhou; Ding, Sheng; Wang, Lei; Zhang, Zhonghai; Qiao, Yuehua; Hu, Min

    2017-02-15

    Chronic morphine administration induces neural plasticity followed by withdraw. And clinic observation indicates that obvious cognitive deficits are found during withdrawal. However, current neural substrates that regulate dysfunction in withdrawal are unknown. In our studies, chronic morphine administration was used to induce the spontaneous withdrawal model in rats. A series of cognitive abilities was tested to explore brain function. To further evaluate the neural substrates of dysfunction, Manganese-enhanced MRI(MEMRI) was used to map the dysfunctional regions in vivo.We observed that chronic morphine administration could induce obvious withdrawal behaviors in abstinence followed by cognitive impairments, such as impairments in working memory, reward, interaction and enhancement of anxiety. Our in-vivo MEMRI data using the voxel-wise comparisons showed that the manganese-enhanced signal intensity (VMI) within morphine withdrawal groups was increased in cingulate cortex (Cg), secondary motor cortex (M2), CA3 subfield of hippocampus, dorsal striatum (D-striatum), retrosplenial cortex (RS), shell subregion of NAc (AcbSh), core subregion of NAc (AcbC), central nucleus of amygdala (CeC), basolateral amygdaloid nucleus (BLA), central amygdaloid nucleus (CeM), anterior hypothalamic area, central (AHC), ventral tegmental area (VTA) and scaphoid thalamic nucleus (SC).However, decreasing of VMI was found in the ventrolateral striatum (V-striatum) and lateral posterior thalamic nucleus (LP) compared to the control group. These brain regions were beleived to be components of the memory, executive, limbic and regulatory systems. Therefore, our present studies indicate that withdrawal induced by chronic morphine adiministration could disturb brain function leading to multi-systems state shifts and cognitive deficits in abstinence. Copyright © 2016. Published by Elsevier B.V.

  13. Housing retention in single-site housing first for chronically homeless individuals with severe alcohol problems.

    Science.gov (United States)

    Collins, Susan E; Malone, Daniel K; Clifasefi, Seema L

    2013-12-01

    We studied housing retention and its predictors in the single-site Housing First model. 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. 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. We found that single-site Housing First programming fills a gap in housing options for chronically homeless people with severe alcohol problems.

  14. 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

    2018-02-07

    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.

  15. Multi-Site Calibration of Linear Reservoir Based Geomorphologic Rainfall-Runoff Models

    Directory of Open Access Journals (Sweden)

    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.

  16. 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 the sustainabi......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...... the sustainability of remediation alternatives by integrating environmental, societal, and economic criteria in the assessment. Materials and methods: The MCA includes five main decision criteria: remedial effect, remediation cost, remediation time, environmental impacts, and societal impacts. The main criteria...... are divided into a number of sub-criteria. The environmental impacts consider secondary impacts to the environment caused by remedial activities and are assessed by life-cycle assessment (LCA). The societal impacts mainly consider local impacts and are assessed in a more qualitative manner on a scale from 1...

  17. A multi-site approach towards integrating environmental management in the wine production industry.

    Science.gov (United States)

    Walsdorff, A; van Kraayenburg, M; Barnardt, C A

    2005-01-01

    Nine wineries and a water bottling plant situated in the Franschhoek Valley, South Africa, have decided to lead the way towards creating a safer and more sustainable environment in the Valley. As part of the Vignerons de Franschhoek ECO Association (VFEA), they adopted a multi-site approach and obtained, in December 2003, the first ISO 14001 multi-site certification in South Africa. This proactive approach allows them better overall environmental performances through mutual motivation, information sharing and comparison of practices by the different participating organisations of Franschhoek Valley. At the initiation of the project, the major concerns were associated with a lack of sound environmental management and training of employees. Of particular concern was also the lack of monitoring and measurement of environmental performance key indicators, especially in water consumption and wastewater disposal areas. Although the system is still in its juvenile stage, it already showed some effluent quality improvements through better wastewater management, better control over chemical stores as well as definite improvement in water management and increase in solid wastes recycling. The latter improvements will definitely entail long-term cost savings should the system be continually and properly maintained. It is the intention of the VFEA to create a more environmentally friendly and sustainable Valley by convincing others to be more environmentally responsive and expanding the ISO 14001 principles to other areas of the organisations including the farms, to other wineries and ultimately to the whole Franschhoek Valley.

  18. Stochastic generation of multi-site daily precipitation focusing on extreme events

    Science.gov (United States)

    Evin, Guillaume; Favre, Anne-Catherine; Hingray, Benoit

    2018-01-01

    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.

  19. 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.

  20. 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.

  1. On-site Rapid Diagnosis of Intracranial Hematoma using Portable Multi-slice Microwave Imaging System

    Science.gov (United States)

    Mobashsher, Ahmed Toaha; Abbosh, A. M.

    2016-11-01

    Rapid, on-the-spot diagnostic and monitoring systems are vital for the survival of patients with intracranial hematoma, as their conditions drastically deteriorate with time. To address the limited accessibility, high costs and static structure of currently used MRI and CT scanners, a portable non-invasive multi-slice microwave imaging system is presented for accurate 3D localization of hematoma inside human head. This diagnostic system provides fast data acquisition and imaging compared to the existing systems by means of a compact array of low-profile, unidirectional antennas with wideband operation. The 3D printed low-cost and portable system can be installed in an ambulance for rapid on-site diagnosis by paramedics. In this paper, the multi-slice head imaging system’s operating principle is numerically analysed and experimentally validated on realistic head phantoms. Quantitative analyses demonstrate that the multi-slice head imaging system is able to generate better quality reconstructed images providing 70% higher average signal to clutter ratio, 25% enhanced maximum signal to clutter ratio and with around 60% hematoma target localization compared to the previous head imaging systems. Nevertheless, numerical and experimental results demonstrate that previous reported 2D imaging systems are vulnerable to localization error, which is overcome in the presented multi-slice 3D imaging system. The non-ionizing system, which uses safe levels of very low microwave power, is also tested on human subjects. Results of realistic phantom and subjects demonstrate the feasibility of the system in future preclinical trials.

  2. 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.

  3. Social engagement and chronic disease risk behaviors: the Multi-Ethnic Study of Atherosclerosis.

    Science.gov (United States)

    Samuel, Laura J; Dennison Himmelfarb, Cheryl R; Szklo, Moyses; Seeman, Teresa E; Echeverria, Sandra E; Diez Roux, Ana V

    2015-02-01

    Although engagement in social networks is important to health, multiple different dimensions exist. This study identifies which dimensions are associated with chronic disease risk behaviors. Cross-sectional data on social support, loneliness, and neighborhood social cohesion from 5381 participants, aged 45-84 from the Multi-Ethnic Study of Atherosclerosis was used. After adjusting for individual characteristics and all social engagement variables, social support was associated with lower smoking prevalence (PR=0.88, 95% CI: 0.82, 0.94), higher probability of having quit (PR=1.03, 95% CI: 1.01, 1.06) and a slightly higher probability of achieving physical activity recommendations (PR=1.03, 95% CI: 1.01, 1.06). Neighborhood social cohesion was associated with very slightly higher probability of achieving recommended (PR=1.03, 95% CI: 1.01, 1.05) or any regular (PR=1.0, 95% CI: 1.01, 1.04) physical activity, and a higher probability of consuming at least five daily fruit and vegetable servings (PR=1.05, 95% CI: 1.01, 1.09). Both social support and neighborhood social cohesion, a less commonly considered aspect of social engagement, appear to be important for chronic disease prevention interventions and likely act via separate pathways. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Projection of Climate Change Based on Multi-Site Statistical Downscaling over Gilan area, Iran

    Directory of Open Access Journals (Sweden)

    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

  5. Gene Expression-Based Survival Prediction in Lung Adenocarcinoma: A Multi-Site, Blinded Validation Study

    Science.gov (United States)

    Shedden, Kerby; Taylor, Jeremy M.G.; Enkemann, Steve A.; Tsao, Ming S.; Yeatman, Timothy J.; Gerald, William L.; Eschrich, Steve; Jurisica, Igor; Venkatraman, Seshan E.; Meyerson, Matthew; Kuick, Rork; Dobbin, Kevin K.; Lively, Tracy; Jacobson, James W.; Beer, David G.; Giordano, Thomas J.; Misek, David E.; Chang, Andrew C.; Zhu, Chang Qi; Strumpf, Dan; Hanash, Samir; Shepherd, Francis A.; Ding, Kuyue; Seymour, Lesley; Naoki, Katsuhiko; Pennell, Nathan; Weir, Barbara; Verhaak, Roel; Ladd-Acosta, Christine; Golub, Todd; Gruidl, Mike; Szoke, Janos; Zakowski, Maureen; Rusch, Valerie; Kris, Mark; Viale, Agnes; Motoi, Noriko; Travis, William; Sharma, Anupama

    2009-01-01

    Although prognostic gene expression signatures for survival in early stage lung cancer have been proposed, for clinical application it is critical to establish their performance across different subject populations and in different laboratories. Here we report a large, training-testing, multi-site blinded validation study to characterize the performance of several prognostic models based on gene expression for 442 lung adenocarcinomas. The hypotheses proposed examined whether microarray measurements of gene expression either alone or combined with basic clinical covariates (stage, age, sex) can be used to predict overall survival in lung cancer subjects. Several models examined produced risk scores that substantially correlated with actual subject outcome. Most methods performed better with clinical data, supporting the combined use of clinical and molecular information when building prognostic models for early stage lung cancer. This study also provides the largest available set of microarray data with extensive pathological and clinical annotation for lung adenocarcinomas. PMID:18641660

  6. A frailty-contagion model for multi-site hourly precipitation driven by atmospheric covariates

    Science.gov (United States)

    Koch, Erwan; Naveau, Philippe

    2015-04-01

    Accurate stochastic simulations of hourly precipitation are needed for impact studies at local spatial scales. Statistically, hourly precipitation data represent a difficult challenge. They are non-negative, skewed, heavy tailed, contain a lot of zeros (dry hours) and they have complex temporal structures (e.g., long persistence of dry episodes). Inspired by frailty-contagion approaches used in finance and insurance, we propose a multi-site precipitation simulator that, given appropriate regional atmospheric variables, can simultaneously handle dry events and heavy rainfall periods. One advantage of our model is its conceptual simplicity in its dynamical structure. In particular, the temporal variability is represented by a common factor based on a few classical atmospheric covariates like temperatures, pressures and others. Our inference approach is tested on simulated data and applied on measurements made in the northern part of French Brittany.

  7. 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 probabilitie...... 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...

  8. Overcoming the Challenges of Unstructured Data in Multi-site, Electronic Medical Record-based Abstraction

    Science.gov (United States)

    Polnaszek, Brock; Gilmore-Bykovskyi, Andrea; Hovanes, Melissa; Roiland, Rachel; Ferguson, Patrick; Brown, Roger; Kind, Amy JH

    2014-01-01

    Background Unstructured data encountered during retrospective electronic medical record (EMR) abstraction has routinely been identified as challenging to reliably abstract, as this data is often recorded as free text, without limitations to format or structure. There is increased interest in reliably abstracting this type of data given its prominent role in care coordination and communication, yet limited methodological guidance exists. Objective As standard abstraction approaches resulted in sub-standard data reliability for unstructured data elements collected as part of a multi-site, retrospective EMR study of hospital discharge communication quality, our goal was to develop, apply and examine the utility of a phase-based approach to reliably abstract unstructured data. This approach is examined using the specific example of discharge communication for warfarin management. Research Design We adopted a “fit-for-use” framework to guide the development and evaluation of abstraction methods using a four step, phase-based approach including (1) team building, (2) identification of challenges, (3) adaptation of abstraction methods, and (4) systematic data quality monitoring. Measures Unstructured data elements were the focus of this study, including elements communicating steps in warfarin management (e.g., warfarin initiation) and medical follow-up (e.g., timeframe for follow-up). Results After implementation of the phase-based approach, inter-rater reliability for all unstructured data elements demonstrated kappas of ≥ 0.89 -- an average increase of + 0.25 for each unstructured data element. Conclusions As compared to standard abstraction methodologies, this phase-based approach was more time intensive, but did markedly increase abstraction reliability for unstructured data elements within multi-site EMR documentation. PMID:27624585

  9. Multi-site, multi-year monitoring of the oscillating Algol-type eclipsing binary CT Herculis

    Science.gov (United States)

    Lampens, P.; Strigachev, A.; Kim, S.-L.; Rodríguez, E.; López-González, M. J.; Vidal-Saínz, J.; Mkrtichian, D.; Koo, J.-R.; Kang, Y. B.; van Cauteren, P.; Wils, P.; Kraicheva, Z.; Dimitrov, D.; Southworth, J.; García Melendo, E.; Gómez Forellad, J. M.

    2011-10-01

    We present the results of a multi-site photometric campaign carried out in 2004-2008 for the Algol-type eclipsing binary system CT Her, the primary component of which displays δ Scuti-type oscillations. Our data consist of differential light curves collected in the filters B and V, which were analysed using the method of Wilson-Devinney (Phoebe). After identifying an adequate binary model and removing the best-fit light-curve solution, we performed a Fourier analysis of the residual B and V light curves to investigate the pulsational behaviour. We confirm the presence of rapid pulsations with a main period of 27.2 min. Up to eight significant frequencies with semi-amplitudes in the range 3 to 1 mmag were detected, all of which lie in the frequency range 43.5-53.5 d-1. This result is independent of the choice of the primary's effective temperature (8200 or 8700 K) since the light-curve models of the binary are very similar in both cases. This is yet another case of a complex frequency spectrum observed for an accreting δ Scuti-type star (after Y Cam). In addition, we demonstrate that the amplitudes of several pulsation frequencies provide evidence of variability on timescales as short as 1-2 years, perhaps even less. Moreover, our analysis takes into account some recently acquired spectra, from which we obtained the corresponding radial velocities for the years 2007-2009. Investigation of the O-C diagram shows that further monitoring of the epochs of eclipse minima of CT Her will cast new light on the evolution of its orbital period. Based on photometric data collected at the observatories listed in Table 1 and spectra acquired at the NAO, Bulgaria, and Calar Alto Observatory, Spain. The Skinakas Observatory is a collaborative project of the University of Crete, the Foundation for Research and Technology - Hellas, and the Max-Planck-Institut für Extraterrestrische Physik.Full Tables 3, 4, 9 and 12 are only available at the CDS via anonymous ftp to cdsarc

  10. USE OF FOCUS GROUPS IN MULTI-SITE, MULTI-ETHNIC RESEARCH PROJECTS FOR WOMEN’S HEALTH: A STUDY OF WOMEN ACROSS THE NATION (SWAN) EXAMPLE

    Science.gov (United States)

    Kagawa-Singer, Marjorie; Adler, Shelley R.; Mouton, Charles P.; Ory, Marcia; Underwood, Lynne G.

    2010-01-01

    Objective To outline the lessons learned about the use of focus groups for the multi-site, multi-ethnic longitudinal Study of Women Across the Nation (SWAN). Focus groups were designed to identify potential cultural differences in the incidence of symptoms and the meaning of transmenopause among women of diverse cultures, and to identify effective recruitment and retention strategies. Design Inductive and deductive focus groups for a multi-ethnic study. Setting Seven community research sites across the United States conducted focus groups with six ethnic populations: African American, Chinese American, Japanese American, Mexican American, non-Hispanic white, and Puerto Rican. Patients or Participants Community women from each ethnic group of color. Interventions A set of four/five focus groups in each ethnic group as the formative stage of the deductive, quantitative SWAN survey. Main Outcome Measures Identification of methodological advantages and challenges to the successful implementation of formative focus groups in a multi-ethnic, multi-site population-based epidemiologic study. Results We provide recommendations from our lessons learned to improve the use of focus groups in future studies with multi-ethnic populations. Conclusions Mixed methods using inductive and deductive approaches require the scientific integrity of both research paradigms. Adequate resources and time must be budgeted as essential parts of the overall strategy from the outset of study. Inductive cross-cultural researchers should be key team members, beginning with inception through each subsequent design phase to increase the scientific validity, generalizability, and comparability of the results across diverse ethnic groups, to assure the relevance, validity and applicability of the findings to the multicultural population of focus. PMID:19769020

  11. 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.

  12. 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.

  13. Reduced-complexity multi-site rainfall generation: one million years over night using the model TripleM

    Science.gov (United States)

    Breinl, Korbinian; Di Baldassarre, Giuliano; Girons Lopez, Marc

    2017-04-01

    We assess uncertainties of multi-site rainfall generation across spatial scales and different climatic conditions. Many research subjects in earth sciences such as floods, droughts or water balance simulations require the generation of long rainfall time series. In large study areas the simulation at multiple sites becomes indispensable to account for the spatial rainfall variability, but becomes more complex compared to a single site due to the intermittent nature of rainfall. Weather generators can be used for extrapolating rainfall time series, and various models have been presented in the literature. Even though the large majority of multi-site rainfall generators is based on similar methods, such as resampling techniques or Markovian processes, they often become too complex. We think that this complexity has been a limit for the application of such tools. Furthermore, the majority of multi-site rainfall generators found in the literature are either not publicly available or intended for being applied at small geographical scales, often only in temperate climates. Here we present a revised, and now publicly available, version of a multi-site rainfall generation code first applied in 2014 in Austria and France, which we call TripleM (Multisite Markov Model). We test this fast and robust code with daily rainfall observations from the United States, in a subtropical, tropical and temperate climate, using rain gauge networks with a maximum site distance above 1,000km, thereby generating one million years of synthetic time series. The modelling of these one million years takes one night on a recent desktop computer. In this research, we first start the simulations with a small station network of three sites and progressively increase the number of sites and the spatial extent, and analyze the changing uncertainties for multiple statistical metrics such as dry and wet spells, rainfall autocorrelation, lagged cross correlations and the inter-annual rainfall

  14. Predicting diffuse light-enhancement of GPP from plant functional traits: A multi-site synthesis

    Science.gov (United States)

    O'Halloran, T. L.; Barr, J. G.; Cook, B.; Goeckede, M.; Law, B. E.; Kueppers, L. M.; Riley, W. J.

    2013-12-01

    Diffuse light enhances canopy-scale photosynthesis because isotropic diffuse light penetrates deeper into the canopy, involves more leaf area in photosynthesis, and prevents the top of the canopy from becoming light saturated. However, the observational and modeling communities still have little understanding of how the 'Diffuse light Enhancement Effect' (DEE) varies across plant functional types or is constrained by factors such as nitrogen availability and plant structure. So far, variability in the strength of DEE across plant functional types (PFTs) remains poorly constrained, but canopy models indicate leaf area index (LAI) is a primary controller. While the very few existing multi-site, measurement-based syntheses of the DEE have provided valuable information on the variability of the DEE across a few plant functional types, no study has correlated measured metrics of DEE magnitude with direct measurements of canopy physical traits across a wide range of plant functional types. Here we report a new metric that is suitable for quantifying the DEE in both flux measurements and land surface models. We also present, for the first time, an examination of the relationship between the DEE metric and plant functional traits. Results from our 70+ site AmeriFlux and FLUXNET synthesis indicate that LAI is the strongest controller of the DEE across sites and PFTs, with less significant influences from foliar nitrogen, canopy height, and mean annual precipitation. Our results will enable direct evaluation and improvement of remote sensing algorithms and light use efficiency models (e.g. MODIS GPP), which to this point regard diffuse light fraction as a source of noise. Additionally, improving resolution of the DEE in prognostic land surface models, such as the Community Land Model (CLM), will greatly improve our ability to forecast future feedbacks to terrestrial carbon sequestration from changes in cloudiness and aerosol amount.

  15. Hepatic DNA hydroxymethylation is site-specifically altered by chronic alcohol consumption and aging.

    Science.gov (United States)

    Tammen, Stephanie A; Park, Lara K; Dolnikowski, Gregory G; Ausman, Lynne M; Friso, Simonetta; Choi, Sang-Woon

    2017-03-01

    Global DNA hydroxymethylation is markedly decreased in human cancers, including hepatocellular carcinoma, which is associated with chronic alcohol consumption and aging. Because gene-specific changes in hydroxymethylcytosine may affect gene transcription, giving rise to a carcinogenic environment, we determined genome-wide site-specific changes in hepatic hydroxymethylcytosine that are associated with chronic alcohol consumption and aging. Young (4 months) and old (18 months) male C57Bl/6 mice were fed either an ethanol-containing Lieber-DeCarli liquid diet or an isocaloric control diet for 5 weeks. Genomic and gene-specific hydroxymethylcytosine patterns were determined through hydroxymethyl DNA immunoprecipitation array in hepatic DNA. Hydroxymethylcytosine patterns were more perturbed by alcohol consumption in young mice than in old mice (431 differentially hydroxymethylated regions, DhMRs, in young vs 189 DhMRs in old). A CpG island ~2.5 kb upstream of the glucocorticoid receptor gene, Nr3c1, had increased hydroxymethylation as well as increased mRNA expression (p = 0.015) in young mice fed alcohol relative to the control group. Aging alone also altered hydroxymethylcytosine patterns, with 331 DhMRs, but alcohol attenuated this effect. Aging was associated with a decrease in hydroxymethylcytosine ~1 kb upstream of the leptin receptor gene, Lepr, and decreased transcription of this gene (p = 0.029). Nr3c1 and Lepr are both involved in hepatic lipid homeostasis and hepatosteatosis, which may create a carcinogenic environment. These results suggest that the location of hydroxymethylcytosine in the genome is site specific and not random, and that changes in hydroxymethylation may play a role in the liver's response to aging and alcohol.

  16. Chronic stress, depressive symptoms, anger, hostility, and risk of stroke and transient ischemic attack in the multi-ethnic study of atherosclerosis.

    Science.gov (United States)

    Everson-Rose, Susan A; Roetker, Nicholas S; Lutsey, Pamela L; Kershaw, Kiarri N; Longstreth, W T; Sacco, Ralph L; Diez Roux, Ana V; Alonso, Alvaro

    2014-08-01

    This study investigated chronic stress, depressive symptoms, anger, and hostility in relation to incident stroke and transient ischemic attacks in middle-aged and older adults. Data were from the Multi-Ethnic Study of Atherosclerosis (MESA), a population-based cohort study of 6749 adults, aged 45 to 84 years and free of clinical cardiovascular disease at baseline, conducted at 6 US sites. Chronic stress, depressive symptoms, trait anger, and hostility were assessed with standard questionnaires. The primary outcome was clinically adjudicated incident stroke or transient ischemic attacks during a median follow-up of 8.5 years. One hundred ninety-five incident events (147 strokes; 48 transient ischemic attacks) occurred during follow-up. A gradient of increasing risk was observed for depressive symptoms, chronic stress, and hostility (all P for trend ≤0.02) but not for trait anger (P>0.10). Hazard ratios (HRs) and 95% confidence intervals indicated significantly elevated risk for the highest-scoring relative to the lowest-scoring group for depressive symptoms (HR, 1.86; 95% confidence interval, 1.16-2.96), chronic stress (HR, 1.59; 95% confidence interval, 1.11-2.27), and hostility (HR, 2.22; 95% confidence interval, 1.29-3.81) adjusting for age, demographics, and site. HRs were attenuated but remained significant in risk factor-adjusted models. Associations were similar in models limited to stroke and in secondary analyses using time-varying variables. Higher levels of stress, hostility, and depressive symptoms are associated with significantly increased risk of incident stroke or transient ischemic attacks in middle-aged and older adults. Associations are not explained by known stroke risk factors. © 2014 American Heart Association, Inc.

  17. Progression marker of Parkinson's disease: a 4-year multi-site imaging study.

    Science.gov (United States)

    Burciu, Roxana G; Ofori, Edward; Archer, Derek B; Wu, Samuel S; Pasternak, Ofer; McFarland, Nikolaus R; Okun, Michael S; Vaillancourt, David E

    2017-08-01

    Progression markers of Parkinson's disease are crucial for successful therapeutic development. Recently, a diffusion magnetic resonance imaging analysis technique using a bitensor model was introduced allowing the estimation of the fractional volume of free water within a voxel, which is expected to increase in neurodegenerative disorders such as Parkinson's disease. Prior work demonstrated that free water in the posterior substantia nigra was elevated in Parkinson's disease compared to controls across single- and multi-site cohorts, and increased over 1 year in Parkinson's disease but not in controls at a single site. Here, the goal was to validate free water in the posterior substantia nigra as a progression marker in Parkinson's disease, and describe the pattern of progression of free water in patients with a 4-year follow-up tested in a multicentre international longitudinal study of de novo Parkinson's disease (http://www.ppmi-info.org/). The analyses examined: (i) 1-year changes in free water in 103 de novo patients with Parkinson's disease and 49 controls; (ii) 2- and 4-year changes in free water in a subset of 46 patients with Parkinson's disease imaged at baseline, 12, 24, and 48 months; (iii) whether 1- and 2-year changes in free water predict 4-year changes in the Hoehn and Yahr scale; and (iv) the relationship between 4-year changes in free water and striatal binding ratio in a subgroup of Parkinson's disease who had undergone both diffusion and dopamine transporter imaging. Results demonstrated that: (i) free water level in the posterior substantia nigra increased over 1 year in de novo Parkinson's disease but not in controls; (ii) free water kept increasing over 4 years in Parkinson's disease; (iii) sex and baseline free water predicted 4-year changes in free water; (iv) free water increases over 1 and 2 years were related to worsening on the Hoehn and Yahr scale over 4 years; and (v) the 4-year increase in free water was associated with the 4-year

  18. 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

  19. 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

  20. Cosmetic outcomes of laparoendoscopic single-site hysterectomy compared with multi-port surgery: randomized controlled trial.

    Science.gov (United States)

    Song, Taejong; Cho, Juhee; Kim, Tae-Joong; Kim, Im-Ryung; Hahm, Tae Soo; Kim, Byoung-Gie; Bae, Duk-Soo

    2013-01-01

    To compare cosmetic satisfaction with laparoendoscopic single-site surgery (LESS) compared with multi-port surgery. Randomized controlled trial (Canadian Task Force classification I). University hospital. Twenty women who underwent laparoscopically-assisted vaginal hysterectomy (LAVH) via LESS or multi-port surgery. Laparoendoscopic single-site surgery or multi-port surgery. Cosmetic satisfaction was assessed using the Body Image Questionnaire at baseline and at 1, 4, and 24 weeks after surgery. Of the 20 LESS procedures, 1 was converted to multi-port surgery because of severe adhesions, and 1 woman assigned to undergo multi-port surgery was lost to follow-up. The 2 surgery groups did not differ in clinical demographic data and surgical results or postoperative pain scores at 12, 24, and 36 hours. Compared with the multi-port group, the LESS group reported significantly higher cosmetic satisfaction at 1, 4, and 24 weeks after surgery (p surgery, LESS is not only a feasible approach with comparable operative outcomes but also has an advantage insofar as cosmetic outcome. Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.

  1. 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.

  2. 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

  3. Awareness of Diagnosis and Knowledge of HPV in Women Patients: Data from a Multi-Site Study

    Science.gov (United States)

    McCree, Donna Hubbard; Daley, Ellen M.; Gorbach, Pamina; Hamm, Robert M.; Sharpe, Patricia A.; Brandt, Heather M.; McFarlane, Mary; Kerndt, Peter; McDermott, Robert J.; Perrin, Karen M.; St. Lawrence, Janet S.

    2010-01-01

    Background: Persistent infection with high-risk types of human papillomavirus (HPV) is associated with cervical and other anogenital cancers. Purpose: This paper reports results of awareness of an HPV diagnosis and HPV knowledge from a multi-site study of HPV knowledge, attitudes and behavior, and the impact of an HPV diagnosis on women and their…

  4. Quality improvement of surgical prophylaxis in Dutch hospitals: evaluation of a multi-site intervention by time series analysis.

    NARCIS (Netherlands)

    Kasteren, M.E.E. van; Mannien, J.; Kullberg, B.J.; Boer, A.S. de; Nagelkerke, N.J.; Ridderhof, M.; Wille, J.C.; Gyssens, I.C.J.

    2005-01-01

    OBJECTIVES: Misuse of antibiotics in surgical prophylaxis is still quite common. The objectives of this study were to reduce the quantity and improve the quality of surgical prophylaxis and to reduce costs. METHODS: Prospective multi-site study of elective procedures in 13 Dutch hospitals. The

  5. 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.

  6. 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

    2017-07-01

    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.

  7. Medial collateral ligament reconstruction using bone-patellar tendon-bone allograft for chronic medial knee instability combined with multi-ligament injuries: a new technique.

    Science.gov (United States)

    Zheng, Xiaozuo; Li, Tong; Wang, Juan; Dong, Jiangtao; Gao, Shijun

    2016-07-22

    The medial collateral ligament (MCL) is the main static stabilizer of the medial knee. The surgical treatment was recommended in cases with serious medial collateral ligament insufficiency combined with multi-ligament injuries and chronic symptomatic medial instability. Several surgical techniques have been described for the MCL reconstruction, while potential problems including donor site morbidity, complicated procedure, and high risk of femoral tunnel collision were reported. In order to minimize such potential limitations, we describe a new medial reconstruction technique for MCL injury using bone-patellar tendon-bone (BPTB) allograft. A longitudinal incision at the medial knee was made. The centers of femoral and tibial attachments were gained through repeated isometricity test. Then, the bone grooves were made around the femoral and tibial centers. The appropriate BPTB allograft was selected, and both ends were trimmed. The prepared bone blocks were embedded into the grooves and fixed with cancellous screws. The programmed rehabilitation exercises were performed after the operation. A strong graft and bone-to-bone healing on both femoral and tibial attachment sites were obtained, and femoral tunnel collision during multi-ligament reconstruction was avoided. Satisfactory valgus and rotatory stability were gained. This novel MCL reconstruction technique using BPTB allograft can be safely performed, and the clinical outcome was favorable with satisfactory valgus and rotatory stability. More cases and additional follow-up results are needed to verify the overall effect of this technique.

  8. 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.

  9. 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.

  10. 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.

  11. Control of Asian soybean rust with mancozeb, a multi-site fungicide

    Directory of Open Access Journals (Sweden)

    Luís Henrique Carregal Pereira da Silva

    2015-03-01

    Full Text Available An experiment conducted in the field the action of mancozeb, a fungicide of multi-site action was tested, to control soybean rust caused by Phakopsora pachyrhizi. Its performance was compared to that of the mixture cyproconazole (DMI + azoxystrobin (QoI. The soybean cultivar NA 7337 RR was used with a population of 400,000 plants/ha cultivated in 20m2 plots. Treatments consisted of mancozeb levels (1.5 and 2.0 kg/ha applied four, six and eight times. The DMI + QoI mixture was applied three times at 0.3 L/ha + Nimbus. Rust severity was assessed six times in the plots and data were integrated as the area under the disease progress curve (AUDPC. The plots were harvested and grain yield was expressed as kg/ha. Data on AUDPC and yield were subjected to analysis of variance and means compared according to Turkey's test (p = 0.005. Treatments with mancozeb were superior to DMI + QoI mixture both for rust control and grain yield. Four applications of 2.0 k/ha mancozeb were more efficient than three applications of the mixture used as standard. Mancozeb has the potential to be added to fungicide mixtures in the establishment of soybean rust anti-resistance strategy.

  12. Multi-Site Simultaneous Time-Resolved Photometry with a Low Cost Electro-Optics System.

    Science.gov (United States)

    Gasdia, Forrest; Barjatya, Aroh; Bilardi, Sergei

    2017-05-30

    Sunlight reflected off of resident space objects can be used as an optical signal for astrometric orbit determination and for deducing geometric information about the object. With the increasing population of small satellites and debris in low Earth orbit, photometry is a powerful tool in operational support of space missions, whether for anomaly resolution or object identification. To accurately determine size, shape, spin rate, status of deployables, or attitude information of an unresolved resident space object, multi-hertz sample rate photometry is required to capture the relatively rapid changes in brightness that these objects can exhibit. OSCOM, which stands for Optical tracking and Spectral characterization of CubeSats for Operational Missions, is a low cost and portable telescope system capable of time-resolved small satellite photometry, and is field deployable on short notice for simultaneous observation from multiple sites. We present the electro-optical design principles behind OSCOM and light curves of the 1.5 U DICE-2 CubeSat and simultaneous observations of the main body of the ASTRO-H satellite after its fragmentation event.

  13. Multi-Site Simultaneous Time-Resolved Photometry with a Low Cost Electro-Optics System

    Directory of Open Access Journals (Sweden)

    Forrest Gasdia

    2017-05-01

    Full Text Available Sunlight reflected off of resident space objects can be used as an optical signal for astrometric orbit determination and for deducing geometric information about the object. With the increasing population of small satellites and debris in low Earth orbit, photometry is a powerful tool in operational support of space missions, whether for anomaly resolution or object identification. To accurately determine size, shape, spin rate, status of deployables, or attitude information of an unresolved resident space object, multi-hertz sample rate photometry is required to capture the relatively rapid changes in brightness that these objects can exhibit. OSCOM, which stands for Optical tracking and Spectral characterization of CubeSats for Operational Missions, is a low cost and portable telescope system capable of time-resolved small satellite photometry, and is field deployable on short notice for simultaneous observation from multiple sites. We present the electro-optical design principles behind OSCOM and light curves of the 1.5 U DICE-2 CubeSat and simultaneous observations of the main body of the ASTRO-H satellite after its fragmentation event.

  14. A Waveform Library Technique for Multi-Site Identification with the MAJORANA DEMONSTRATOR

    Science.gov (United States)

    Buuck, Micah; MAJORANA Collaboration

    2017-01-01

    The MAJORANA DEMONSTRATOR is a low-background array of 44.8 kg of germanium detectors searching for neutrinoless double-beta (0 νββ) decay in germanium-76, deployed 4,850 feet underground at the Sanford Underground Research Facility in Lead, South Dakota, USA. We aim to demonstrate background levels low enough to justify construction of a ton-scale experiment which will be able to fully probe the inverted-hierarchy region of the 0 νββ decay phase-space. In addition to reducing background through materials selection and experimental design, we are developing a range of analysis-based background-suppression techniques. One example is a waveform-library-based technique to reject background multi-site interactions. Here we present an overview of the technique and its current status. This material is based upon work supported by the U.S. Department of Energy, Office of Science, Office of Nuclear Physics, the Particle Astrophysics and Nuclear Physics Programs of the National Science Foundation, and the Sanford Underground Research Facility.

  15. Urban Forest and Rural Cities: Multi-sited Households, Consumption Patterns, and Forest Resources in Amazonia

    Directory of Open Access Journals (Sweden)

    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.

  16. MultiSite Gateway-Compatible Cell Type-Specific Gene-Inducible System for Plants.

    Science.gov (United States)

    Siligato, Riccardo; Wang, Xin; Yadav, Shri Ram; Lehesranta, Satu; Ma, Guojie; Ursache, Robertas; Sevilem, Iris; Zhang, Jing; Gorte, Maartje; Prasad, Kalika; Wrzaczek, Michael; Heidstra, Renze; Murphy, Angus; Scheres, Ben; Mähönen, Ari Pekka

    2016-02-01

    A powerful method to study gene function is expression or overexpression in an inducible, cell type-specific system followed by observation of consequent phenotypic changes and visualization of linked reporters in the target tissue. Multiple inducible gene overexpression systems have been developed for plants, but very few of these combine plant selection markers, control of expression domains, access to multiple promoters and protein fusion reporters, chemical induction, and high-throughput cloning capabilities. Here, we introduce a MultiSite Gateway-compatible inducible system for Arabidopsis (Arabidopsis thaliana) plants that provides the capability to generate such constructs in a single cloning step. The system is based on the tightly controlled, estrogen-inducible XVE system. We demonstrate that the transformants generated with this system exhibit the expected cell type-specific expression, similar to what is observed with constitutively expressed native promoters. With this new system, cloning of inducible constructs is no longer limited to a few special cases but can be used as a standard approach when gene function is studied. In addition, we present a set of entry clones consisting of histochemical and fluorescent reporter variants designed for gene and promoter expression studies. © 2016 American Society of Plant Biologists. All Rights Reserved.

  17. 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.

  18. [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.

  19. Multi-Component Reactive Transport Modeling of Field-Scale Bioremediation: The Schoolcraft Site

    Science.gov (United States)

    Phanikumar, M.; Hyndman, D. W.; Dybas, M. J.

    2003-12-01

    This paper describes three-dimensional multi-component reactive transport modeling for bioremediation of a carbon tetrachloride (CT) contaminated plume at the Schoolcraft site in Western Michigan. The denitrifying bacterium Pseudomonas Stutzeri Strain KC is used to mediate cometabolic reactions that degrade CT to harmless end products. CT contamination at this site occurred due its use in the past as a fumigant in grain silos. The goal of the field bioremediation design was to inoculate a transect perpendicular to the natural gradient flow of a CT plume with microbes that could effectively remediate the CT contamination through a series of pulsed nutrient injections. The final design consisted of fifteen wells spaced one meter apart in which each well can operate either as an injection or an extraction well depending on the event. This design allowed us to operate in a semi-passive mode of operation with only 6 hours of pumping per week. Our modeling approach integrates information from laboratory-scale studies aimed at understanding the relevant rates and processes under controlled conditions with plume-scale modeling in the presence of a high degree of hydraulic control and significant heterogeneity to delineate the important differences in processes/rates as we proceed from the laboratory to the field. We describe the development of a seven component reactive transport model that includes the transport of aqueous and sorbed-phase CT, mobile and immobile bacteria, acetate (electron donor), nitrate (electron acceptor) and tracer (bromide) and show detailed comparisons of observed and simulated concentrations at a number of wells and at different depths. Processes simulated in the model include advection, dispersion, degradation, two-site sorption, microbial attachment, detachment, growth and decay. We describe the influence of several modeling decisions (e.g., effects of dynamic partitioning, bioavailability and sorption) on the predictions of the model. Most

  20. Use of focus groups in multi-site, multi-ethnic research projects for women's health: a Study of Women Across the Nation (swan) example.

    Science.gov (United States)

    Kagawa-Singer, Marjorie; Adler, Shelley R; Mouton, Charles E; Ory, Marcia; Underwood, Lynne G

    2009-01-01

    To outline the lessons learned about the use of focus groups for the multisite, multi-ethnic longitudinal Study of Women Across the Nation (SWAN). Focus groups were designed to identify potential cultural differences in the incidence of symptoms and the meaning of transmenopause among women of diverse cultures, and to identify effective recruitment and retention strategies. Inductive and deductive focus groups for a multi-ethnic study. Seven community research sites across the United States conducted focus groups with six ethnic populations: African American, Chinese American, Japanese American, Mexican American, non-Hispanic white, and Puerto Rican. Community women from each ethnic group of color. A set of four/five focus groups in each ethnic group as the formative stage of the deductive, quantitative SWAN survey. Identification of methodological advantages and challenges to the successful implementation of formative focus groups in a multi-ethnic, multi-site population-based epidemiologic study. We provide recommendations from our lessons learned to improve the use of focus groups in future studies with multi-ethnic populations. Mixed methods using inductive and deductive approaches require the scientific integrity of both research paradigms. Adequate resources and time must be budgeted as essential parts of the overall strategy from the outset of study. Inductive cross-cultural researchers should be key team members, beginning with inception through each subsequent design phase to increase the scientific validity, generalizability, and comparability of the results across diverse ethnic groups, to assure the relevance, validity and applicability of the findings to the multicultural population of focus.

  1. 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

  2. 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.

  3. Crack Growth Prediction Methodology for Multi-Site Damage: Layered Analysis and Growth During Plasticity

    Science.gov (United States)

    James, Mark Anthony

    1999-01-01

    A finite element program has been developed to perform quasi-static, elastic-plastic crack growth simulations. The model provides a general framework for mixed-mode I/II elastic-plastic fracture analysis using small strain assumptions and plane stress, plane strain, and axisymmetric finite elements. Cracks are modeled explicitly in the mesh. As the cracks propagate, automatic remeshing algorithms delete the mesh local to the crack tip, extend the crack, and build a new mesh around the new tip. State variable mapping algorithms transfer stresses and displacements from the old mesh to the new mesh. The von Mises material model is implemented in the context of a non-linear Newton solution scheme. The fracture criterion is the critical crack tip opening displacement, and crack direction is predicted by the maximum tensile stress criterion at the crack tip. The implementation can accommodate multiple curving and interacting cracks. An additional fracture algorithm based on nodal release can be used to simulate fracture along a horizontal plane of symmetry. A core of plane strain elements can be used with the nodal release algorithm to simulate the triaxial state of stress near the crack tip. Verification and validation studies compare analysis results with experimental data and published three-dimensional analysis results. Fracture predictions using nodal release for compact tension, middle-crack tension, and multi-site damage test specimens produced accurate results for residual strength and link-up loads. Curving crack predictions using remeshing/mapping were compared with experimental data for an Arcan mixed-mode specimen. Loading angles from 0 degrees to 90 degrees were analyzed. The maximum tensile stress criterion was able to predict the crack direction and path for all loading angles in which the material failed in tension. Residual strength was also accurately predicted for these cases.

  4. A prospective, multi-site investigation of patient satisfaction and psychosocial status following cosmetic surgery.

    Science.gov (United States)

    Sarwer, David B; Gibbons, Lauren M; Magee, Leanne; Baker, James L; Casas, Laurie A; Glat, Paul M; Gold, Alan H; Jewell, Mark L; Larossa, Don; Nahai, Foad; Young, V Leroy

    2005-01-01

    Although several studies have investigated patient satisfaction and changes in body image following aesthetic plastic surgery, few have investigated more specific dimensions of body image, including dysphoric emotions that occur in specific social situations or body image quality of life. In addition, few studies have investigated changes in body image that may occur in concert with changes in more general areas of psychosocial functioning, such as depressive symptoms and self-esteem. This prospective, multi-site study investigated postoperative satisfaction and changes in psychosocial status following cosmetic surgery. One hundred patients recruited from 8 geographically diverse surgical practices completed psychometric measures of body image, depressive symptoms, and self-esteem prior to surgery. Seventy-two patients completed the 3-month postoperative assessment, 67 completed the 6-month assessment, and 63 completed the 12-month assessment. All statistical tests on changes after surgery were conducted using the sample of 72 patients who completed the 3-month assessment. A Last Observation Carried Forward analysis was used to account for patients who did not complete the subsequent follow-up assessments. In addition, they reported their postoperative satisfaction as well as self-rated attractiveness at the 3 postoperative assessment points. Eighty-seven percent of patients reported satisfaction with their postoperative outcomes. Patients also reported significant improvements in their overall appearance, as well as the appearance of the feature altered by surgery, at each of the postoperative assessment points. Patients experienced significant improvements in their overall body image, their degree of dissatisfaction with the feature altered by surgery, and the frequency of negative body image emotions in specific social situations. All of these improvements were maintained 12 months after surgery. These results add to a growing body of literature documenting

  5. A Multi-Criteria Decision Analysis System for Prioritizing Sites and Types of Low Impact Development Practices: Case of Korea

    Directory of Open Access Journals (Sweden)

    Jae Yeol Song

    2017-04-01

    Full Text Available This study developed a multi-criteria decision analysis (MCDA framework to prioritize sites and types of low impact development (LID practices. This framework was systemized as a web-based system coupled with the Storm Water Management Model (SWMM. Using TOPSIS method, which is a type of MCDA method, multiple types and sites of designated LID practices are prioritized. This system is named the Water Management Prioritization Module (WMPM. WMPM can simultaneously determine the priority of multiple LID types and sites. In this study, an infiltration trench and permeable pavement were considered for multiple sub-catchments in South Korea to demonstrate the WMPM procedures. The TOPSIS method was manually incorporated to select the vulnerable target sub-catchments and to prioritize the LID planning scenarios for multiple types and sites considering social, hydrologic and physical-geometric factors. In this application, the Delphi method and entropy theory were used to determine the subjective and objective weights, respectively.

  6. Ten Steps to Conducting a Large, Multi-Site, Longitudinal Investigation of Language and Reading in Young Children

    Science.gov (United States)

    Farquharson, Kelly; Murphy, Kimberly A.

    2016-01-01

    Purpose: This paper describes methodological procedures involving execution of a large-scale, multi-site longitudinal study of language and reading comprehension in young children. Researchers in the Language and Reading Research Consortium (LARRC) developed and implemented these procedures to ensure data integrity across multiple sites, schools, and grades. Specifically, major features of our approach, as well as lessons learned, are summarized in 10 steps essential for successful completion of a large-scale longitudinal investigation in early grades. Method: Over 5 years, children in preschool through third grade were administered a battery of 35 higher- and lower-level language, listening, and reading comprehension measures (RCM). Data were collected from children, their teachers, and their parents/guardians at four sites across the United States. Substantial and rigorous effort was aimed toward maintaining consistency in processes and data management across sites for children, assessors, and staff. Conclusion: With appropriate planning, flexibility, and communication strategies in place, LARRC developed and executed a successful multi-site longitudinal research study that will meet its goal of investigating the contribution and role of language skills in the development of children's listening and reading comprehension. Through dissemination of our design strategies and lessons learned, research teams embarking on similar endeavors can be better equipped to anticipate the challenges. PMID:27064308

  7. Ten Steps to a Conducting Large, Multi-site, Longitudinal Investigation of Language and Reading in Young Children

    Directory of Open Access Journals (Sweden)

    Language and Reading Research eConsortium

    2016-03-01

    Full Text Available Purpose: This paper describes methodological procedures involving execution of a large-scale, multi-site longitudinal study of language and reading comprehension in young children. Researchers in the Language and Reading Research Consortium (LARRC developed and implemented these procedures to ensure data integrity across multiple sites, schools, and grades. Specifically, major features of our approach, as well as lessons learned, are summarized in ten steps essential for successful completion of a large-scale longitudinal investigation in early grades. Method: Over five years, children in preschool through third grade were administered a battery of 35 higher- and lower-level language, listening, and reading comprehension measures. Data were collected from children, their teachers, and their parents/guardians at four sites across the United States. Substantial and rigorous effort was aimed toward maintaining consistency in processes and data management across sites for children, assessors, and staff. Conclusion: With appropriate planning, flexibility, and communication strategies in place, LARRC developed and executed a successful multi-site longitudinal research study that will meet its goal of investigating the contribution and role of language skills in the development of children’s listening and reading comprehension. Through dissemination of our design strategies and lessons learned, research teams embarking on similar endeavors can be better equipped to anticipate the challenges.

  8. 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.

  9. 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

  10. Characterization and monitoring of contaminated sites by multi-geophysical approach (IP, ERT and GPR).

    Science.gov (United States)

    Giampaolo, Valeria; Capozzoli, Luigi; Votta, Mario; Rizzo, Enzo

    2014-05-01

    The contamination of soils and groundwater by hydrocarbons, due to blow out, leakage from tank or pipe and oil spill, is a heavy environmental problem because infiltrated oil can persist in the ground for a long time leading to important changes on soils and physical and biogeochemical properties, which impact on ecosystems and shallow aquifers. The existing methods used for the characterization of hydrocarbon contaminated sites are invasive, time consuming and expensive. Therefore, in the last years, there was a growing interest in the use of geophysical methods for environmental monitoring (Börner et al., 1993; Vanhala, 1997; Atekwana et al., 2000; Chambers et al., 2004; Song et al., 2005; French et al., 2009). The goal of this work is to characterize underground contaminant distributions and monitoring a remediation activity using a multi-geophysical approach (cross-hole IP and ERT, GPR). The experiments consist in geophysical measurements both in surface and boreholes, to monitor a simulated hydrocarbon leachate into a ~1 m3 box. The tank is filled with quartz-rich sand (k = 1.16 x 10-12 m2) and it is equipped with six boreholes and 72 stainless steel ring electrodes, at 5 cm spacing, for cross-hole electrical resistivity and time-domain IP measurements. 25 additional stainless steel electrodes were installed at the surface of the tank. Two measurement phases were realized: first, we monitored electrical resistivity, IP, and dielectric conductivity of the uncontaminated soil; the second experimental phase consists in the geophysical monitoring of a crude oil controlled spill. Results showed significant changes in the responses of geoelectrical measurements in presence of a crude oil contamination. Instead IP results give a phase angle distribution related to the presence of hydrocarbon in the system but not so clear in the location of plume. Therefore, to clearly delineate the areas interested by contamination, we estimate the imaginary component of electrical

  11. Efficacy of cranial electrotherapy stimulation for neuropathic pain following spinal cord injury: a multi-site randomized controlled trial with a secondary 6-month open-label phase.

    Science.gov (United States)

    Tan, Gabriel; Rintala, Diana H; Jensen, Mark P; Richards, J Scott; Holmes, Sally Ann; Parachuri, Rama; Lashgari-Saegh, Shamsi; Price, Larry R

    2011-01-01

    Chronic pain is a significant problem for many individuals following spinal cord injury (SCI). Unfortunately, SCI-related neuropathic pain has proven to be largely refractory to analgesic medications and other available treatments. Cranial electrotherapy stimulation (CES) has been effective in managing some types of pain. It involves the application of a small amount of current through the head via ear clip electrodes. Explore the effectiveness of CES for neuropathic pain in persons with SCI and chronic pain. Multi-site, double-blind, sham-controlled study. Adults with SCI and chronic neuropathic pain at or below the level of injury were randomized to receive active or sham CES. Application of active CES or sham CES 1 hour daily for 21 days. Six-month open-label phase to assess 'as-needed' CES use. Change in pre- to post-session pain ratings as well as change in pain intensity, pain interference, pain quality, pain beliefs and coping strategies, general physical and mental health status, depressive symptomatology, perceived stress, and anxiety pre- to post-treatment. The active group reported a significantly greater average decrease in pain during daily treatments than the sham group (Kruskal-Wallis chi-square = 4.70, P < 0.05). During the 21-day trial, there was a significant group × time interaction for only one outcome variable; the active group showed larger pre- to post-treatment decreases in pain interference than the sham group did (F = 8.50, P < 0.01, d = 0.59). On average, CES appears to have provided a small but statistically significant improvement in pain intensity and pain interference with few troublesome side effects. Individual results varied from no pain relief to a great deal of relief.

  12. 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.

  13. Multi-channel array EMG in chronic neck-shoulder pain

    NARCIS (Netherlands)

    Kallenberg, L.A.C.

    2007-01-01

    Chronic muscular pain has become an important problem, affecting a considerable part of the working population in the industrialised countries. Chronic muscular pain is a multifactorial problem and comprises a range of conditions that are not all clinically well-defined. Subjective symptoms include

  14. Using multi-class queuing network to solve performance models of e-business sites.

    Science.gov (United States)

    Zheng, Xiao-ying; Chen, De-ren

    2004-01-01

    Due to e-business's variety of customers with different navigational patterns and demands, multi-class queuing network is a natural performance model for it. The open multi-class queuing network(QN) models are based on the assumption that no service center is saturated as a result of the combined loads of all the classes. Several formulas are used to calculate performance measures, including throughput, residence time, queue length, response time and the average number of requests. The solution technique of closed multi-class QN models is an approximate mean value analysis algorithm (MVA) based on three key equations, because the exact algorithm needs huge time and space requirement. As mixed multi-class QN models, include some open and some closed classes, the open classes should be eliminated to create a closed multi-class QN so that the closed model algorithm can be applied. Some corresponding examples are given to show how to apply the algorithms mentioned in this article. These examples indicate that multi-class QN is a reasonably accurate model of e-business and can be solved efficiently.

  15. Site systems engineering fiscal year 1999 multi-year work plan (MYWP) update for WBS 1.8.2.2

    Energy Technology Data Exchange (ETDEWEB)

    GRYGIEL, M.L.

    1998-10-08

    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.

  16. Generation of multi-site stochastic daily rainfall with four weather generators: a case study of Gloucester catchment in Australia

    Science.gov (United States)

    Fu, Guobin; Chiew, Francis H. S.; Shi, Xiaogang

    2017-11-01

    Four weather generators, namely, R-package version of the Generalised Linear Model for daily Climate time series (RGLIMCLIM), Stochastic Climate Library (SCL), R-package multi-site precipitation generator (RGENERATRPREC) and R-package Multi-site Auto-regressive Weather GENerator (RMAWGEN), were used to generate multi-sites stochastic daily rainfall for a small catchment in Australia. The results show the following: (1) All four models produced reasonable results in terms of annual, monthly and daily rainfall occurrence and amount, as well as daily extreme, multi-day extremes and dry/wet spell length. However, they also simulated a large range of variability, which not only demonstrates the advantages of multiple weather generators rather than a single model but also is more suitable for climate change and variability impact studies. (2) Every model has its own advantages and disadvantages due to their different theories and principles. This enhances the benefits of using multiple models. (3) The models can be further calibrated/improved to have a "better" performance in comparison with observations. However, it was chosen not to do so in this case study for two reasons: to obtain a full range of climate variability and to acknowledge the uncertainties associated with observation data. The latter are interpolated from limited stations and therefore have high pairwise correlations—ranging from 0.69 to 0.99 with a median and mean value of 0.87 and 0.88, respectively, for daily rainfall. These conclusions were drawn from a case study in Australia, but could be extended to general guidelines of using weather generators for climate change and variability studies.

  17. Multi-site delamination detection and quantification in composites through guided wave based global-local sensing

    Science.gov (United States)

    Tian, Zhenhua; Leckey, Cara; Yu, Lingyu

    2017-02-01

    This paper presents a guided wave based global-local sensing method for rapid detection and quantification of multi-site delamination damage in large composite panels. The global-local approach uses a hybrid system consisting of a piezoelectric transducer (PZT) for generating guided waves and a non-contact scanning laser Doppler vibrometer (SLDV) for acquiring guided wave data. The global-local method is performed in two steps. First, a phased array configured of a small number of SLDV scan points (for example 10×10 points in a rectangular grid array) performs inspection over the entire plate to detect and locate damage. Local areas are identified as potential damage regions for the second step. Then high density wavefield measurements are taken over the identified areas and wavefield analysis is performed to quantitatively evaluate the damage. For the proof of concept in case with multi-site damage, the global-local approach is demonstrated on a carbon fiber reinforced polymer (CFRP) composite plate with two sites of impact-induced delamination damage. In the first step, the locations of two delamination sites are detected by the phased array method. In the second step, the delamination size and shape are evaluated using wavefield analysis. The detected delamination location, size and shape agree well with those of ultrasonic C-scan and the method led to a 93% reduction in inspection time compared to a full SLDV dense grid scan.

  18. How school climate relates to chronic absence: A multi-level latent profile analysis.

    Science.gov (United States)

    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.

  19. A Multi-criteria Decision Analysis System for Prioritizing Sites and Types of Low Impact Development Practices

    Science.gov (United States)

    Song, Jae Yeol; Chung, Eun-Sung

    2017-04-01

    This study developed a multi-criteria decision analysis framework to prioritize sites and types of low impact development (LID) practices. This framework was systemized as a web-based system coupled with the Storm Water Management Model (SWMM) from the Environmental Protection Agency (EPA). Using the technique for order of preference by similarity to ideal solution (TOPSIS), which is a type of multi-criteria decision-making (MCDM) method, multiple types and sites of designated LID practices are prioritized. This system is named the Water Management Prioritization Module (WMPM) and is an improved version of the Water Management Analysis Module (WMAM) that automatically generates and simulates multiple scenarios of LID design and planning parameters for a single LID type. WMPM can simultaneously determine the priority of multiple LID types and sites. In this study, an infiltration trench and permeable pavement were considered for multiple sub-catchments in South Korea to demonstrate the WMPM procedures. The TOPSIS method was manually incorporated to select the vulnerable target sub-catchments and to prioritize the LID planning scenarios for multiple types and sites considering socio-economic, hydrologic and physical-geometric factors. In this application, the Delphi method and entropy theory were used to determine the subjective and objective weights, respectively. Comparing the ranks derived by this system, two sub-catchments, S16 and S4, out of 18 were considered to be the most suitable places for installing an infiltration trench and porous pavement to reduce the peak and total flow, respectively, considering both socio-economic factors and hydrological effectiveness. WMPM can help policy-makers to objectively develop urban water plans for sustainable development. Keywords: Low Impact Development, Multi-Criteria Decision Analysis, SWMM, TOPSIS, Water Management Prioritization Module (WMPM)

  20. 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.

  1. Design and Methods of a Multi-Site, Multi-Behavioral Treatment Trial for Menopausal Symptoms: The MsFLASH Experience

    Science.gov (United States)

    Sternfeld, Barbara; LaCroix, Andrea; Caan, Bette J.; Dunn, Andrea L.; Newton, Katherine M.; Reed, Susan D.; Guthrie, Katherine A; Booth-LaForce, Cathryn; Sherman, Karen J; Cohen, Lee; Freeman, Marlene P.; Carpenter, Janet S.; Hunt, Julie R.; Roberts, Melanie; Ensrud, Kristine E.

    2013-01-01

    Background Behavioral strategies are recommended for menopausal symptoms, but little evidence exists regarding efficacy. Purpose Describe design and methodology of a randomized controlled 3 by 2 factorial trial of yoga, exercise and omega-3 fatty acids. Methods Women from three geographic areas with a weekly average of ≥14 hot flashes/night sweats, who met exclusion/inclusion criteria, were randomized to 12 weeks of: 1) yoga classes and daily home practice; 2) supervised, facility-based aerobic exercise training; or 3) usual activity. Women in each arm were further randomized to either omega-3 supplement or placebo. Standardized training, on-going monitoring, and site visits were adopted to ensure consistency across sites and fidelity to the intervention. Participant adherence to the intervention protocol was monitored continuously, and retention was actively encouraged by staff. Information on adverse events was systematically collected. Results Of 7,377 women who responded to mass mailings, 355 (4.8%) were randomized; mean age was 54.7 (sd=3.7), 26.2% were African American, 81.7% were post-menopausal, and mean baseline frequency of daily hot flashes/night sweats was 7.6 (sd=3.8). Adherence of ≥ 80% was 59% for yoga, 77% for exercise training, and 80% for study pills. Final week 12 data were collected from 95.2% Conclusions Conducting a multi-site, multi-behavioral randomized trial for menopausal symptoms is challenging but feasible. Benefits included cost-effective study design, centralized recruitment, and methodologic standardization. PMID:23462342

  2. 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

  3. Diabetes and chronic kidney disease: an increasingly common multi-morbid disease in need of a paradigm shift in care.

    Science.gov (United States)

    Winocour, P H

    2017-12-16

    Diabetes is considered the commonest cause of end-stage renal disease. The increasing incidence of obesity and an ageing population, together, will lead to a greater number of people with diabetes associated with chronic kidney disease that could either be secondary to diabetic nephropathy or of different aetiology. Ageing and obesity influence approaches to the management of diabetes and accurate assessment of kidney disease. People with diabetes and chronic kidney disease consume a disproportionate component of expenditure on medical care. Guidelines on managing diabetes and kidney disease do not recognize the complex multi-morbid nature of the process. In addition to managing glycaemia and monitoring renal function, the assessment and management of cardiovascular disease risk factors and cardiovascular disease itself need to be factored into care. People with diabetes and diabetic nephropathy are more vulnerable to retinopathy and foot complications requiring coordinated care. People with diabetes and chronic kidney disease are more prone to anaemia and metabolic bone disease than those without diabetes at similar stages of chronic kidney disease, further increasing their vulnerability to acute complications from cardiovascular disease, foot emergencies and fractures. People with diabetes and chronic kidney disease are also more prone to hospitalization with infections and acute kidney injury. Given the 30-40% prevalence of kidney disease amongst people with diabetes, potentially >2% of the adult population would fit into this category, making it vital that new surveillance models of supported care are provided for those living with diabetes and kidney disease and for primary care teams who manage the vast majority of such people. © 2017 Diabetes UK.

  4. N-CANDA data integration: anatomy of an asynchronous infrastructure for multi-site, multi-instrument longitudinal data capture.

    Science.gov (United States)

    Rohlfing, Torsten; Cummins, Kevin; Henthorn, Trevor; Chu, Weiwei; Nichols, B Nolan

    2014-01-01

    The infrastructure for data collection implemented by the National Consortium on Alcohol and NeuroDevelopment in Adolescence (N-CANDA) for data collection comprises several innovative features: (a) secure, asynchronous transfer and persistent storage of collected data via a revision control system; (b) two-stage import into a longitudinal database; and (c) use of a script-controlled web browser for data retrieval from a third-party, web-based neuropsychological test battery. The asynchronous operation of data transmission and import is of particular benefit, as it has allowed the consortium sites to begin data collection before the receiving database infrastructure had been deployed. Records were collected within 86 days of funding, 35 days after finalizing the collected instruments. Final instruments were added to the database import 225 days after instrument selection, with up to 173 records already collected at that time. Thus, the concepts implemented in N-CANDA's data collection system helped reduce project start-up time by several months. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. Addressing Chronic Malnutrition through Multi-sectoral, Sustainable Approaches: A Review of the Causes and Consequences

    Directory of Open Access Journals (Sweden)

    Kristina eReinhardt

    2014-08-01

    Full Text Available Chronic malnutrition, including stunting, is an important example of a global challenge that spans multiple sectors, specifically health, agriculture, and the environment. The objective of this paper is to review current knowledge on the causes and consequences of chronic malnutrition and their relationship with multiple sectors. Understanding the causes includes approaching chronic malnutrition from the basic, underlying, and immediate levels. The causes reach from macro-level environmental influences to specific micronutrient intake. In order to effectively address stunting, it is important to understand the timing of stunting and the ability of individuals to catch-up in terms of linear growth, cognitive ability, and immune function. The consequences of chronic malnutrition are transgenerational, and they have an impact at the individual, community, and national level in the short- and long-term. There are still many gaps in knowledge regarding both the causes and consequences of chronic malnutrition, particularly when it comes to the interaction with agriculture and the environment, and understanding these gaps is important to addressing the burden of chronic malnutrition through evidence-based interventions.

  6. A MultiSite Gateway Toolkit for Rapid Cloning of Vertebrate Expression Constructs with Diverse Research Applications.

    Science.gov (United States)

    Fowler, Daniel K; Stewart, Scott; Seredick, Steve; Eisen, Judith S; Stankunas, Kryn; Washbourne, Philip

    2016-01-01

    Recombination-based cloning is a quick and efficient way to generate expression vectors. Recent advancements have provided powerful recombinant DNA methods for molecular manipulations. Here, we describe a novel collection of three-fragment MultiSite Gateway cloning system-compatible vectors providing expanded molecular tools for vertebrate research. The components of this toolkit encompass a broad range of uses such as fluorescent imaging, dual gene expression, RNA interference, tandem affinity purification, chemically-inducible dimerization and lentiviral production. We demonstrate examples highlighting the utility of this toolkit for producing multi-component vertebrate expression vectors with diverse primary research applications. The vectors presented here are compatible with other Gateway toolkits and collections, facilitating the rapid generation of a broad range of innovative DNA constructs for biological research.

  7. 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

  8. Webinar Training: an acceptable, feasible and effective approach for multi-site medical record abstraction: the BOWII experience

    Directory of Open Access Journals (Sweden)

    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

  9. Staggered multi-site low-frequency electrostimulation effectively induces locomotor patterns in the isolated rat spinal cord.

    Science.gov (United States)

    Dose, F; Deumens, R; Forget, P; Taccola, G

    2016-02-01

    Experimental animal study. Epidural stimulation has been used to activate locomotor patterns after spinal injury and typically employs synchronous trains of high-frequency stimuli delivered directly to the dorsal cord, thereby recruiting multiple afferent nerve roots. Here we investigate how spinal locomotor networks integrate multi-site afferent input and address whether frequency coding is more important than amplitude to activate locomotor patterns. Italy and Belgium. To investigate the importance of input intensity and frequency in eliciting locomotor activity, we used isolated neonatal rat spinal cords to record episodes of fictive locomotion (FL) induced by electrical stimulation of single and multiple dorsal roots (DRs), employing different stimulating protocols. FL was efficiently induced through staggered delivery (delays 0.5 to 2 s) of low-frequency pulse trains (0.33 and 0.67 Hz) to three DRs at intensities sufficient to activate ventral root reflexes. Delivery of the same trains to a single DR or synchronously to multiple DRs remained ineffective. Multi-site staggered trains were more efficient than randomized pulse delivery. Weak trains simultaneously delivered to DRs failed to elicit FL. Locomotor rhythm resetting occurred with single pulses applied to various distant DRs. Electrical stimulation recruited spinal networks that generate locomotor programs when pulses were delivered to multiple sites at low frequency. This finding might help devising new protocols to optimize the increasingly more common use of epidural implantable arrays to treat spinal dysfunctions.

  10. 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.

  11. Dealing with incomplete and variable detectability in multi-year, multi-site monitoring of ecological populations

    Science.gov (United States)

    Converse, Sarah J.; Royle, J. Andrew; Gitzen, Robert A.; Millspaugh, Joshua J.; Cooper, Andrew B.; Licht, Daniel S.

    2012-01-01

    An ecological monitoring program should be viewed as a component of a larger framework designed to advance science and/or management, rather than as a stand-alone activity. Monitoring targets (the ecological variables of interest; e.g. abundance or occurrence of a species) should be set based on the needs of that framework (Nichols and Williams 2006; e.g. Chapters 2–4). Once such monitoring targets are set, the subsequent step in monitoring design involves consideration of the field and analytical methods that will be used to measure monitoring targets with adequate accuracy and precision. Long-term monitoring programs will involve replication of measurements over time, and possibly over space; that is, one location or each of multiple locations will be monitored multiple times, producing a collection of site visits (replicates). Clearly this replication is important for addressing spatial and temporal variability in the ecological resources of interest (Chapters 7–10), but it is worth considering how this replication can further be exploited to increase the effectiveness of monitoring. In particular, defensible monitoring of the majority of animal, and to a lesser degree plant, populations and communities will generally require investigators to account for imperfect detection (Chapters 4, 18). Raw indices of population state variables, such as abundance or occupancy (sensu MacKenzie et al. 2002), are rarely defensible when detection probabilities are < 1, because in those cases detection may vary over time and space in unpredictable ways. Myriad authors have discussed the risks inherent in making inference from monitoring data while failing to correct for differences in detection, resulting in indices that have an unknown relationship to the parameters of interest (e.g. Nichols 1992, Anderson 2001, MacKenzie et al. 2002, Williams et al. 2002, Anderson 2003, White 2005, Kéry and Schmidt 2008). While others have argued that indices may be preferable in some

  12. Modelling multi-site transmission of the human papillomavirus and its impact on vaccination effectiveness

    Directory of Open Access Journals (Sweden)

    P. Lemieux-Mellouki

    2017-12-01

    Conclusions: Modelling genital-site only transmission may overestimate vaccination impact if extragenital infections contribute to systemic natural immunity or underestimate vaccination impact if a high proportion of genital infections originate from extragenital infections. Under current understanding of heterosexual HPV transmission and immunity, a substantial bias from using uni-site models in predicting vaccination effectiveness against genital HPV infection is unlikely to occur.

  13. 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

  14. Integrating knowledge-based multi-criteria evaluation techniques with GIS for landfill site selection: A case study using AHP

    Science.gov (United States)

    Fagbohun, B. J.; Aladejana, O. O.

    2016-09-01

    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.

  15. Identifying N6-methyladenosine sites using multi-interval nucleotide pair position specificity and support vector machine

    Science.gov (United States)

    Xing, Pengwei; Su, Ran; Guo, Fei; Wei, Leyi

    2017-04-01

    N6-methyladenosine (m6A) refers to methylation of the adenosine nucleotide acid at the nitrogen-6 position. It plays an important role in a series of biological processes, such as splicing events, mRNA exporting, nascent mRNA synthesis, nuclear translocation and translation process. Numerous experiments have been done to successfully characterize m6A sites within sequences since high-resolution mapping of m6A sites was established. However, as the explosive growth of genomic sequences, using experimental methods to identify m6A sites are time-consuming and expensive. Thus, it is highly desirable to develop fast and accurate computational identification methods. In this study, we propose a sequence-based predictor called RAM-NPPS for identifying m6A sites within RNA sequences, in which we present a novel feature representation algorithm based on multi-interval nucleotide pair position specificity, and use support vector machine classifier to construct the prediction model. Comparison results show that our proposed method outperforms the state-of-the-art predictors on three benchmark datasets across the three species, indicating the effectiveness and robustness of our method. Moreover, an online webserver implementing the proposed predictor has been established at http://server.malab.cn/RAM-NPPS/. It is anticipated to be a useful prediction tool to assist biologists to reveal the mechanisms of m6A site functions.

  16. Integrating knowledge-based multi-criteria evaluation techniques with GIS for landfill site selection: A case study using AHP

    Directory of Open Access Journals (Sweden)

    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.

  17. Performance evaluation of ImmunoCAP® ISAC 112: a multi-site study.

    Science.gov (United States)

    van Hage, Marianne; Schmid-Grendelmeier, Peter; Skevaki, Chrysanthi; Plebani, Mario; Canonica, Walter; Kleine-Tebbe, Jörg; Nystrand, Mats; Jafari-Mamaghani, Mehrdad; Jakob, Thilo

    2017-03-01

    After the re-introduction of ImmunoCAP® ISAC sIgE 112 on the market, we undertook a study to evaluate the performance of this multiplex-based immunoassay for IgE measurements to allergen components. The study was carried out at 22 European and one South African site. Microarrays from different batches, eight specific IgE (sIgE) positive, three sIgE negative serum samples and a calibration sample were sent to participating laboratories where assays were performed according to the manufacturer's instructions. For both the negative and positive samples results were consistent between sites, with a very low frequency of false positive results (0.014%). A similar pattern of results for each of the samples was observed across the 23 sites. Homogeneity analysis of all measurements for each sample were well clustered, indicating good reproducibility; unsupervised hierarchical clustering and classification via random forests, showed clustering of identical samples independent of the assay site. Analysis of raw continuous data confirmed the good accuracy across the study sites; averaged standardized, site-specific ISU-E values fell close to the center of the distribution of measurements from all sites. After outlier filtering, variability across the whole study was estimated at 25.5%, with values of 22%, 27.1% and 22.4% for the 'Low', 'Moderate to High' and 'Very High' concentration categories, respectively. The study shows a robust performance of the ImmunoCAP® ISAC 112 immunoassay at different sites. Essentially the same results were obtained irrespective of assay site, laboratory-specific conditions and instruments, operator, or the use of microarrays from different batches.

  18. Etiology and mode of presentation of chronic liver diseases in India: A multi centric study.

    Science.gov (United States)

    Mukherjee, Partha S; Vishnubhatla, Sreenivas; Amarapurkar, Deepak N; Das, Kausik; Sood, Ajit; Chawla, Yogesh K; Eapen, Chundamannil E; Boddu, Prabhakar; Thomas, Varghese; Varshney, Subodh; Hidangmayum, Diamond Sharma; Bhaumik, Pradip; Thakur, Bhaskar; Acharya, Subrat K; Chowdhury, Abhijit

    2017-01-01

    There is a paucity of health policy relevant data for chronic liver disease from India, impeding formulation of an interventional strategy to address the issue. A prospective, multicentric study to delineate the etiology and clinical profile of chronic liver disease in India is reported here. A centrally coordinated and monitored web-based data repository was developed (Feb, 2010 to Jan, 2013) and analyzed. Eleven hospitals from different parts of India participated. Data were uploaded into a web based proforma and monitored by a single centre according to a standardized protocol. 1.28% (n = 266621) of all patients (n = 20701383) attending the eleven participating hospitals of India had liver disease. 65807 (24·68%) were diagnosed for the first time (new cases). Of these, 13014 (19·77%, median age 43 years, 73% males) cases of chronic liver disease were finally analyzed. 33.9% presented with decompensated cirrhosis. Alcoholism (34·3% of 4413) was the commonest cause of cirrhosis while Hepatitis B (33·3%) was predominant cause of chronic liver disease in general and non-cirrhotic chronic liver disease (40·8% out of 8163). There was significant interregional differences (hepatitis C in North, hepatitis B in East and South, alcohol in North-east, Non-alcoholic Fatty Liver Disease in West) in the predominant cause of chronic liver disease. Hepatitis B (46·8% of 438 cases) was the commonest cause of hepatocellular Cancer.11·7% had diabetes. Observations of our study will help guide a contextually relevant liver care policy for India and could serve as a framework for similar endeavor in other developing countries as well.

  19. Adsorption Sites of Hydrogen Atom on Pure and Mg-Doped Multi-Walled Carbon Nanotubes

    Directory of Open Access Journals (Sweden)

    A. A. Al-Ghamdi

    2012-01-01

    Full Text Available Hydrogen adsorption sites on pure multiwalled carbon nanotube (MWCNT and Mg-doped MWCNTs material system have been investigated using molecular dynamics (MD simulations as well as quantum chemical calculations. Through combining MWCNTs with Mg, the hydrogen adsorption sites energy on this Mg-MWCNTs system is found to be larger than that of the pure MWCNTs. Additionally, it was found that, through Mg-doping, new adsorption sites for hydrogen molecules are created in comparison with undoped nanotubes. It is also found that H atom is preferably adsorbed at every place near magnesium atom.

  20. OPTIMAL ALLOCATION OF LANDFILL DISPOSAL SITE: A FUZZY MULTI-CRITERIA APPROACH

    National Research Council Canada - National Science Library

    Singh, Ajit P; Vidyarthi, A. K

    2008-01-01

    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...

  1. The Archaeological Application of Multi-Sensor Remote Sensing Data in Qin Yongcheng Site

    Science.gov (United States)

    Wang, M.; Wan, Y.; Zhao, Z.

    2017-09-01

    Remote sensing archaeology bases on the use of remote sensing images and interpretation of the principles. The historic relics and sites are resulted from human activities and have constantly caused influences on the soil component, moisture content, temperature, vegetation growth and so on. Based on this thought, this paper proposed a new remote sensing model and approach that integrates optical and thermal infrared remote sensing data for archaeology. Taking the Qin Yongcheng site as the example, this method conducts a comprehensive analysis of key factors affecting archaeological application, that is, LST estimated with Landsat TM data, soil brightness, humidity and greenness obtained from GF-1 data, and then interprets the potential site targets. By conducting the field verification, it is shown that the interpreted potential sites are well consisted with the field investigations and have a high interpretation precision. It can provide a guide for further archaeological research.

  2. Mutation in an exonic splicing enhancer site causing chronic granulomatous disease

    NARCIS (Netherlands)

    de Boer, Martin; van Leeuwen, Karin; Geissler, Judy; Belohradsky, Bernd H.; Kuijpers, Taco W.; Roos, Dirk

    2017-01-01

    In a male patient suffering from X-linked chronic granulomatous disease (CGD) we found a c. 389G > T mutation in exon 5 of the CYBB gene. We have analyzed why 95% of the transcripts of this gene lacked exon 5, leading to a frameshift and premature termination codon. The mutation was located in a

  3. 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.

  4. 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

  5. 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.

  6. 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.

  7. Multi-site evaluation of the JULES land surface model using global and local data

    Directory of Open Access Journals (Sweden)

    D. Slevin

    2015-02-01

    Full Text Available This study evaluates the ability of the JULES land surface model (LSM to simulate photosynthesis using local and global data sets at 12 FLUXNET sites. Model parameters include site-specific (local values for each flux tower site and the default parameters used in the Hadley Centre Global Environmental Model (HadGEM climate model. Firstly, gross primary productivity (GPP estimates from driving JULES with data derived from local site measurements were compared to observations from the FLUXNET network. When using local data, the model is biased with total annual GPP underestimated by 16% across all sites compared to observations. Secondly, GPP estimates from driving JULES with data derived from global parameter and atmospheric reanalysis (on scales of 100 km or so were compared to FLUXNET observations. It was found that model performance decreases further, with total annual GPP underestimated by 30% across all sites compared to observations. When JULES was driven using local parameters and global meteorological data, it was shown that global data could be used in place of FLUXNET data with a 7% reduction in total annual simulated GPP. Thirdly, the global meteorological data sets, WFDEI and PRINCETON, were compared to local data to find that the WFDEI data set more closely matches the local meteorological measurements (FLUXNET. Finally, the JULES phenology model was tested by comparing results from simulations using the default phenology model to those forced with the remote sensing product MODIS leaf area index (LAI. Forcing the model with daily satellite LAI results in only small improvements in predicted GPP at a small number of sites, compared to using the default phenology model.

  8. Multiple Sites Ultrasonography of Peripheral Nerves in Differentiating Charcot–Marie–Tooth Type 1A from Chronic Inflammatory Demyelinating Polyradiculoneuropathy

    Directory of Open Access Journals (Sweden)

    Jingwen Niu

    2017-05-01

    Full Text Available IntroductionMultiple sites measurement of cross-sectional areas (CSA by ultrasound was performed to differentiate Charcot–Marie–Tooth type 1A (CMT1A and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP.MethodsNine patients with CMT1A, 28 patients with CIDP, and 14 healthy controls (HC were recruited prospectively. Consecutive ultrasonography scanning was performed from wrist to axilla on median and ulnar nerves. CSAs were measured at 10 predetermined sites of each nerve.ResultsCMT1A had significantly larger CSAs at all sites of median and ulnar nerves (p < 0.01. In CMT1A, CSAs increased gradually and homogeneously from distal to proximal along the nerve, except potential entrapment sites. CIDP displayed three different morphological patterns, including mild enlargement in 15 patients, prominent segmental enlargement in 12, and slight enlargement in 1, among which different treatment responses were observed. All patients with mild nerve enlargement treated with intravenous immunoglobulin were responsive (7/7, while less than half of those with prominent segmental enlargement (3/7 were responsive (p < 0.01.DiscussionConsecutive scan along the nerve and multiple sites measurement by ultrasound could supply more detailed morphological feature of the nerve and help to differentiate CMT1A from CIDP.

  9. Does resilience 'buffer' against depression in prostate cancer patients? A multi-site replication study.

    Science.gov (United States)

    Sharpley, C F; Bitsika, V; Wootten, A C; Christie, D R H

    2014-07-01

    Although psychological resilience has been shown to 'buffer' against depression following major stressors, no studies have reported on this relationship within the prostate cancer (PCa) population, many of whom are at elevated risk of depression, health problems and suicide. To investigate the effects of resilience upon anxiety and depression in the PCa population, postal surveys of 425 PCa patients were collected from two sites: 189 PCa patients at site 1 and 236 at site 2. Background data plus responses to depression and resilience scales were collected. Results indicated that total resilience score was a significant buffer against depression across both sites. Resilience had different underlying component factor structures across sites, but only one (common) factor significantly (inversely) predicted depression. Within that factor, only some specific items significantly predicted depression scores, suggesting a focused relationship between resilience and depression. It may be concluded that measures of resilience may be used to screen depression at-risk PCa patients. These patients might benefit from resilience training to enhance their ability to cope effectively with the stress of their diagnosis and treatment. A focus upon specific aspects of overall resilience may be of further benefit in both these processes. © 2014 John Wiley & Sons Ltd.

  10. "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…

  11. Evaluation of accuracy in implant site preparation performed in single- or multi-step drilling procedures.

    Science.gov (United States)

    Marheineke, Nadine; Scherer, Uta; Rücker, Martin; von See, Constantin; Rahlf, Björn; Gellrich, Nils-Claudius; Stoetzer, Marcus

    2017-12-17

    Dental implant failure and insufficient osseointegration are proven results of mechanical and thermal damage during the surgery process. We herein performed a comparative study of a less invasive single-step drilling preparation protocol and a conventional multiple drilling sequence. Accuracy of drilling holes was precisely analyzed and the influence of different levels of expertise of the handlers and additional use of drill template guidance was evaluated. Six experimental groups, deployed in an osseous study model, were representing template-guided and freehanded drilling actions in a stepwise drilling procedure in comparison to a single-drill protocol. Each experimental condition was studied by the drilling actions of respectively three persons without surgical knowledge as well as three highly experienced oral surgeons. Drilling actions were performed and diameters were recorded with a precision measuring instrument. Less experienced operators were able to significantly increase the drilling accuracy using a guiding template, especially when multi-step preparations are performed. Improved accuracy without template guidance was observed when experienced operators were executing single-step versus multi-step technique. Single-step drilling protocols have shown to produce more accurate results than multi-step procedures. The outcome of any protocol can be further improved by use of guiding templates. Operator experience can be a contributing factor. Single-step preparations are less invasive and are promoting osseointegration. Even highly experienced surgeons are achieving higher levels of accuracy by combining this technique with template guidance. Hereby template guidance enables a reduction of hands-on time and side effects during surgery and lead to a more predictable clinical diameter.

  12. 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 IC50 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.

  13. (/sup 3/H)muscimol binding sites increased in autopsied brains of chronic schizophrenics

    Energy Technology Data Exchange (ETDEWEB)

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

    1987-01-19

    (/sup 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 (/sup 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 (/sup 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.

  14. 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.

  15. 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.

  16. Multi-sensor fusion over the World Trade Center disaster site

    Science.gov (United States)

    Rodarmel, Craig; Scott, Lawrence; Simerlink, Deborah A.; Walker, Jeffrey

    2002-09-01

    The immense size and scope of the rescue and clean-up of the World Trade Center site created a need for data that would provide a total overview of the disaster area. To fulfill this need, the New York State Office for Technology (NYSOFT) contracted with EarthData International to collect airborne remote sensing data over Ground Zero with an airborne light detection and ranging (LIDAR) sensor, a high-resolution digital camera, and a thermal camera. The LIDAR data provided a three-dimensional elevation model of the ground surface that was used for volumetric calculations and also in the orthorectification of the digital images. The digital camera provided high-resolution imagery over the site to aide the rescuers in placement of equipment and other assets. In addition, the digital imagery was used to georeference the thermal imagery and also provided the visual background for the thermal data. The thermal camera aided in the location and tracking of underground fires. The combination of data from these three sensors provided the emergency crews with a timely, accurate overview containing a wealth of information of the rapidly changing disaster site. Because of the dynamic nature of the site, the data was acquired on a daily basis, processed, and turned over to NYSOFT within twelve hours of the collection. During processing, the three datasets were combined and georeferenced to allow them to be inserted into the client's geographic information systems.

  17. 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.

  18. Establishment of a integrative multi-omics expression database CKDdb in the context of chronic kidney disease (CKD).

    Science.gov (United States)

    Fernandes, Marco; Husi, Holger

    2017-01-12

    Complex human traits such as chronic kidney disease (CKD) are a major health and financial burden in modern societies. Currently, the description of the CKD onset and progression at the molecular level is still not fully understood. Meanwhile, the prolific use of high-throughput omic technologies in disease biomarker discovery studies yielded a vast amount of disjointed data that cannot be easily collated. Therefore, we aimed to develop a molecule-centric database featuring CKD-related experiments from available literature publications. We established the Chronic Kidney Disease database CKDdb, an integrated and clustered information resource that covers multi-omic studies (microRNAs, genomics, peptidomics, proteomics and metabolomics) of CKD and related disorders by performing literature data mining and manual curation. The CKDdb database contains differential expression data from 49395 molecule entries (redundant), of which 16885 are unique molecules (non-redundant) from 377 manually curated studies of 230 publications. This database was intentionally built to allow disease pathway analysis through a systems approach in order to yield biological meaning by integrating all existing information and therefore has the potential to unravel and gain an in-depth understanding of the key molecular events that modulate CKD pathogenesis.

  19. Evaluation of a multi-modal grounded theory approach to explore patients’ daily coping with breathlessness due to chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Bastrup, Lene; Dahl, Ronald; Pedersen, Preben Ulrich

    2013-01-01

    Conventional methods have not yet succeeded in capturing the complexity of how people with chronic obstructive pulmonary disease (COPD) cope with breathlessness during daily living. We used a multi-modal grounded theory (GT) approach to investigate coping. In this paper, we describe and evaluate...

  20. Effect of taping on multi-segmental foot kinematic patterns during walking in persons with chronic ankle instability.

    Science.gov (United States)

    Dingenen, Bart; Deschamps, Kevin; Delchambre, Frauke; Van Peer, Evelien; Staes, Filip F; Matricali, Giovanni A

    2017-09-01

    To evaluate multi-segmental foot kinematic patterns in chronic ankle instability (CAI) participants during walking, and to investigate the influence of high-Dye and low-Dye taping on these kinematic patterns. Cross-sectional study. Kinematic data of 12 non-injured controls and 15 CAI participants were measured with a three-dimensional motion analysis system during barefoot walking. In addition, the CAI participants walked with high-Dye and low-Dye taping. A rigid Plug-in gait model and the Rizzoli 3D Multi-Segment Foot Model were used to measure multi-segmental foot kinematic patterns. One-dimensional statistical parametric mapping was used to compare barefoot walking of the control and CAI group, and to evaluate differences between walking barefoot and walking with high-Dye and low-Dye taping within the CAI group. Compared to the control group, CAI participants showed a decreased ankle dorsiflexion during loading response (p=0.025) and a more inverted calcaneus in relation to the shank during the initial swing phase (p=0.024). A more inverted position of the metatarsus in relation to the midfoot was observed after low-Dye taping during almost the entire stance phase (p=0.017). No significant differences were found for high-Dye taping. Significant differences in kinematic patterns were found in the ankle joint and rearfoot, but not in the mid- and forefoot in CAI participants. The application of low-Dye taping resulted in a significantly increased inverted position of the forefoot, which can be considered as a less desirable effect for patients with CAI. No other effects of high-Dye and low-Dye taping on kinematic patterns were revealed. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  1. Multi-level assessment of chronic toxicity of estuarine sediments with the amphipod Gammarus locusta: I. Biochemical endpoints.

    Science.gov (United States)

    Neuparth, Teresa; Correia, Ana D; Costa, Filipe O; Lima, Gláucia; Costa, Maria Helena

    2005-07-01

    We report on biomarker responses conducted as part of a multi-level assessment of the chronic toxicity of estuarine sediments to the amphipod Gammarus locusta. A companion article accounts for organism and population-level effects. Five moderately contaminated sediments from two Portuguese estuaries, Sado and Tagus, were assessed. Three of them were muddy and two were sandy sediments. The objective was to assess sediments that were not acutely toxic. Three of the sediments met this criterion, the other two were diluted (50% and 75%) with clean sediment until acute toxicity was absent. Following 28-d exposures, the amphipods were analysed for whole-body metal bioaccumulation, metallothionein induction (MT), DNA strand breakage (SB) and lipid peroxidation (LP). Two of the muddy sediments did not cause chronic toxicity. These findings were consistent with responses at organism and population levels that showed higher growth rates and improvement of reproductive traits for amphipods exposed to these two sediments. Two other sediments, one muddy and one sandy, exhibited pronounced chronic toxicity, affecting SB, MT induction (in muddy sediment), survival and reproduction. Potential toxicants involved in these effects were identified. The last sandy sediment exhibited some loss of DNA integrity, however growth was also enhanced. Present results, together with the organism/population-level data, and also benthic communities information, were analysed under a weight-of-evidence approach. By providing evidence of exposure (or lack of it) to contaminants in sediments, the biomarkers here applied assisted in distinguishing toxicants' impacts in test organisms from the confounding influence of other geochemical features of the sediments.

  2. Conducting a large, multi-site survey about patients’ views on broad consent: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Maureen E. Smith

    2016-11-01

    Full Text Available Abstract Background As biobanks play an increasing role in the genomic research that will lead to precision medicine, input from diverse and large populations of patients in a variety of health care settings will be important in order to successfully carry out such studies. One important topic is participants’ views towards consent and data sharing, especially since the 2011 Advanced Notice of Proposed Rulemaking (ANPRM, and subsequently the 2015 Notice of Proposed Rulemaking (NPRM were issued by the Department of Health and Human Services (HHS and Office of Science and Technology Policy (OSTP. These notices required that participants consent to research uses of their de-identified tissue samples and most clinical data, and allowing such consent be obtained in a one-time, open-ended or “broad” fashion. Conducting a survey across multiple sites provides clear advantages to either a single site survey or using a large online database, and is a potentially powerful way of understanding the views of diverse populations on this topic. Methods A workgroup of the Electronic Medical Records and Genomics (eMERGE Network, a national consortium of 9 sites (13 separate institutions, 11 clinical centers supported by the National Human Genome Research Institute (NHGRI that combines DNA biorepositories with electronic medical record (EMR systems for large-scale genetic research, conducted a survey to understand patients’ views on consent, sample and data sharing for future research, biobank governance, data protection, and return of research results. Results Working across 9 sites to design and conduct a national survey presented challenges in organization, meeting human subjects guidelines at each institution, and survey development and implementation. The challenges were met through a committee structure to address each aspect of the project with representatives from all sites. Each committee’s output was integrated into the overall survey plan. A

  3. Conducting a large, multi-site survey about patients' views on broad consent: challenges and solutions.

    Science.gov (United States)

    Smith, Maureen E; Sanderson, Saskia C; Brothers, Kyle B; Myers, Melanie F; McCormick, Jennifer; Aufox, Sharon; Shrubsole, Martha J; Garrison, Nanibaá A; Mercaldo, Nathaniel D; Schildcrout, Jonathan S; Clayton, Ellen Wright; Antommaria, Armand H Matheny; Basford, Melissa; Brilliant, Murray; Connolly, John J; Fullerton, Stephanie M; Horowitz, Carol R; Jarvik, Gail P; Kaufman, Dave; Kitchner, Terri; Li, Rongling; Ludman, Evette J; McCarty, Catherine; McManus, Valerie; Stallings, Sarah; Williams, Janet L; Holm, Ingrid A

    2016-11-24

    As biobanks play an increasing role in the genomic research that will lead to precision medicine, input from diverse and large populations of patients in a variety of health care settings will be important in order to successfully carry out such studies. One important topic is participants' views towards consent and data sharing, especially since the 2011 Advanced Notice of Proposed Rulemaking (ANPRM), and subsequently the 2015 Notice of Proposed Rulemaking (NPRM) were issued by the Department of Health and Human Services (HHS) and Office of Science and Technology Policy (OSTP). These notices required that participants consent to research uses of their de-identified tissue samples and most clinical data, and allowing such consent be obtained in a one-time, open-ended or "broad" fashion. Conducting a survey across multiple sites provides clear advantages to either a single site survey or using a large online database, and is a potentially powerful way of understanding the views of diverse populations on this topic. A workgroup of the Electronic Medical Records and Genomics (eMERGE) Network, a national consortium of 9 sites (13 separate institutions, 11 clinical centers) supported by the National Human Genome Research Institute (NHGRI) that combines DNA biorepositories with electronic medical record (EMR) systems for large-scale genetic research, conducted a survey to understand patients' views on consent, sample and data sharing for future research, biobank governance, data protection, and return of research results. Working across 9 sites to design and conduct a national survey presented challenges in organization, meeting human subjects guidelines at each institution, and survey development and implementation. The challenges were met through a committee structure to address each aspect of the project with representatives from all sites. Each committee's output was integrated into the overall survey plan. A number of site-specific issues were successfully managed

  4. 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.

  5. 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

  6. Polymorphic sites at the immunoregulatory CTLA-4 gene are associated with chronic chagas disease and its clinical manifestations.

    Directory of Open Access Journals (Sweden)

    Fabrício C Dias

    Full Text Available BACKGROUND: Chagas disease affects approximately 10 million people mainly in Latin America. The immune regulation by the host seems to be an essential factor for disease evolution, and immune system inhibitory molecules such as CTLA-4 and PD-1 favor the maintenance of peripheral tolerance. Considering that polymorphisms at the immunoregulatory CTLA-4 and PDCD1 genes may alter their inhibitory function, we investigated the association of alleles, genotypes and haplotypes of polymorphic sites observed at the CTLA-4 and PDCD1 genes with different clinical manifestations of chronic Chagas disease (indeterminate, cardiac, digestive and mixed. METHODS: The polymorphisms at the CTLA-4 (-1722T/C, -318C/T and +49A/G and PDCD1 (PD-1.3G/A genes were typed using TaqMan methodology in 277 chronic Chagas disease patients classified into four groups, according to clinical characteristics, and 326 non-infected controls. RESULTS: Our results showed that CTLA-4 -1722CC genotype (22%, -1722C allele (27% and CTLA-4 TCG (8.6%, TCA (26% and CCA (15% haplotypes were strongly associated with the indeterminate form, while the CTLA-4-318CT genotype (82% and CTLA-4-318T allele (47% were found mainly in patients with the mixed form of the disease. The CTLA-4 TCG haplotype (10.2% was associated with the digestive form. On the other hand, the PD-1.3G/A polymorphism was not associated with chronic Chagas disease and its clinical manifestations. CONCLUSIONS: Here, we showed that alleles, genotypes and haplotypes reported to increase the expression of the regulatory molecule CTLA-4 were associated with the indeterminate form of the disease. Taken together, our data support the idea that polymorphic sites at immunoregulatory genes may influence the development of Chagas disease variants.

  7. Architectures and methodologies for future deployment of multi-site Zettabyte-Exascale data handling platforms

    CERN Document Server

    Acín, V; Boccali, T; Cancio, G; Collier, I P; Corney, D; Delaunay, B; Delfino, M; dell'Agnello, L; Flix, J; Fuhrmann, P; Gasthuber, M; Gülzow, V; Heiss, A; Lamanna, G; Macchi, P E; Maggi, M; Matthews, B; Neissner, C; Nief, J Y; Porto, M C; Sansum, A; Schulz, M; Shiers, J

    2015-01-01

    Several scientific fields, including Astrophysics, Astroparticle Physics, Cosmology, Nuclear and Particle Physics, and Research with Photons, are estimating that by the 2020 decade they will require data handling systems with data volumes approaching the Zettabyte distributed amongst as many as 10(18) individually addressable data objects (Zettabyte-Exascale systems). It may be convenient or necessary to deploy such systems using multiple physical sites. This paper describes the findings of a working group composed of experts from several

  8. Assay optimisation and technology transfer for multi-site immuno-monitoring in vaccine trials.

    Science.gov (United States)

    Smith, Steven G; Harris, Stephanie A; Satti, Iman; Bryan, Donna; Walker, K Barry; Dockrell, Hazel M; McShane, Helen; Ho, Mei Mei

    2017-01-01

    Cellular immunological assays are important tools for the monitoring of responses to T-cell-inducing vaccine candidates. As these bioassays are often technically complex and require considerable experience, careful technology transfer between laboratories is critical if high quality, reproducible data that allows comparison between sites, is to be generated. The aim of this study, funded by the European Union Framework Program 7-funded TRANSVAC project, was to optimise Standard Operating Procedures and the technology transfer process to maximise the reproducibility of three bioassays for interferon-gamma responses: enzyme-linked immunosorbent assay (ELISA), ex-vivo enzyme-linked immunospot and intracellular cytokine staining. We found that the initial variability in results generated across three different laboratories reduced following a combination of Standard Operating Procedure harmonisation and the undertaking of side-by-side training sessions in which assay operators performed each assay in the presence of an assay 'lead' operator. Mean inter-site coefficients of variance reduced following this training session when compared with the pre-training values, most notably for the ELISA assay. There was a trend for increased inter-site variability at lower response magnitudes for the ELISA and intracellular cytokine staining assays. In conclusion, we recommend that on-site operator training is an essential component of the assay technology transfer process and combined with harmonised Standard Operating Procedures will improve the quality, reproducibility and comparability of data produced across different laboratories. These data may be helpful in ongoing discussions of the potential risk/benefit of centralised immunological assay strategies for large clinical trials versus decentralised units.

  9. OPTIMAL ALLOCATION OF LANDFILL DISPOSAL SITE: A FUZZY MULTI-CRITERIA APPROACH

    OpenAIRE

    Ajit P. Singh, A. K. Vidyarthi

    2008-01-01

    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 t...

  10. Siting of Carsharing Stations Based on Spatial Multi-Criteria Evaluation: A Case Study of Shanghai EVCARD

    Directory of Open Access Journals (Sweden)

    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.

  11. 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.

  12. Assessing the relationship between environmental factors and malaria vector breeding sites in Swaziland using multi-scale remotely sensed data

    Directory of Open Access Journals (Sweden)

    Sabelo Nick Dlamini

    2015-06-01

    Full Text Available Many entomological studies have analyzed remotely sensed data to assess the relationship between malaria vector distribution and the associated environmental factors. However, the high cost of remotely sensed products with high spatial resolution has often resulted in analyses being conducted at coarse scales using open-source, archived remotely sensed data. In the present study, spatial prediction of potential breeding sites based on multi-scale remotely sensed information in conjunction with entomological data with special reference to presence or absence of larvae was realized. Selected water bodies were tested for mosquito larvae using the larva scooping method, and the results were compared with data on land cover, rainfall, land surface temperature (LST and altitude presented with high spatial resolution. To assess which environmental factors best predict larval presence or absence, Decision Tree methodology and logistic regression techniques were applied. Both approaches showed that some environmental predictors can reliably distinguish between the two alternatives (existence and non-existence of larvae. For example, the results suggest that larvae are mainly present in very small water pools related to human activities, such as subsistence farming that were also found to be the major determinant for vector breeding. Rainfall, LST and altitude, on the other hand, were less useful as a basis for mapping the distribution of breeding sites. In conclusion, we found that models linking presence of larvae with high-resolution land use have good predictive ability of identifying potential breeding sites.

  13. 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.

  14. Identification of DNA–protein Binding Sites through Multi-Scale Local Average Blocks on Sequence Information

    Directory of Open Access Journals (Sweden)

    Cong Shen

    2017-11-01

    Full Text Available DNA–protein interactions appear as pivotal roles in diverse biological procedures and are paramount for cell metabolism, while identifying them with computational means is a kind of prudent scenario in depleting in vitro and in vivo experimental charging. A variety of state-of-the-art investigations have been elucidated to improve the accuracy of the DNA–protein binding sites prediction. Nevertheless, structure-based approaches are limited under the condition without 3D information, and the predictive validity is still refinable. In this essay, we address a kind of competitive method called Multi-scale Local Average Blocks (MLAB algorithm to solve this issue. Different from structure-based routes, MLAB exploits a strategy that not only extracts local evolutionary information from primary sequences, but also using predicts solvent accessibility. Moreover, the construction about predictors of DNA–protein binding sites wields an ensemble weighted sparse representation model with random under-sampling. To evaluate the performance of MLAB, we conduct comprehensive experiments of DNA–protein binding sites prediction. MLAB gives M C C of 0.392 , 0.315 , 0.439 and 0.245 on PDNA-543, PDNA-41, PDNA-316 and PDNA-52 datasets, respectively. It shows that MLAB gains advantages by comparing with other outstanding methods. M C C for our method is increased by at least 0.053 , 0.015 and 0.064 on PDNA-543, PDNA-41 and PDNA-316 datasets, respectively.

  15. 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.

  16. Use of Multi-Objective Air Pollution Monitoring Sites and Online Air Pollution Monitoring System for Total Health Risk Assessment in Hyderabad, India

    Directory of Open Access Journals (Sweden)

    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 “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

  17. Infection with Dermatophilus congolensis at a contact hypersensitivity site and its relevance to chronic streptothricosis lesions in the cattle of West Africa.

    Science.gov (United States)

    Davis, D

    1984-01-01

    Guinea-pigs were sensitized to CDNB and infected with D. congolensis at the site of a subsequent application of this chemical. The bacterium was recovered from the skin over a longer period of time in sensitized individuals than in nonsensitized controls. Animals rendered tolerant to the chemical gave lower yields of bacteria than sensitized animals. However, the lesions produced at the site of infection did not become chronic. The growth of D. congolensis at a contact hypersensitivity site may possibly simulate infection in skin following an arthropod bite and be relevant to the pathogenesis of chronic streptothricosis lesions in the cattle of West Africa.

  18. 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.

  19. Multi-site-specific 16S rRNA Methyltransferase RsmF from Thermus thermophilus

    Energy Technology Data Exchange (ETDEWEB)

    Demirci, H.; Larsen, L; Hansen, T; Rasmussen, A; Cadambi, A; Gregory, S; Kirpekar, F; Jogl, G

    2010-01-01

    Cells devote a significant effort toward the production of multiple modified nucleotides in rRNAs, which fine tune the ribosome function. Here, we report that two methyltransferases, RsmB and RsmF, are responsible for all four 5-methylcytidine (m{sup 5}C) modifications in 16S rRNA of Thermus thermophilus. Like Escherichia coli RsmB, T. thermophilus RsmB produces m{sup 5}C967. In contrast to E. coli RsmF, which introduces a single m{sup 5}C1407 modification, T. thermophilus RsmF modifies three positions, generating m{sup 5}C1400 and m{sup 5}C1404 in addition to m{sup 5}C1407. These three residues are clustered near the decoding site of the ribosome, but are situated in distinct structural contexts, suggesting a requirement for flexibility in the RsmF active site that is absent from the E. coli enzyme. Two of these residues, C1400 and C1404, are sufficiently buried in the mature ribosome structure so as to require extensive unfolding of the rRNA to be accessible to RsmF. In vitro, T. thermophilus RsmF methylates C1400, C1404, and C1407 in a 30S subunit substrate, but only C1400 and C1404 when naked 16S rRNA is the substrate. The multispecificity of T. thermophilus RsmF is potentially explained by three crystal structures of the enzyme in a complex with cofactor S-adenosyl-methionine at up to 1.3 {angstrom} resolution. In addition to confirming the overall structural similarity to E. coli RsmF, these structures also reveal that key segments in the active site are likely to be dynamic in solution, thereby expanding substrate recognition by T. thermophilus RsmF.

  20. 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.

  1. Environmental assessment for the reuse of TNX as a multi-purpose pilot plant campus at the Savannah River Site

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    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.

  2. 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.

  3. Personality Profiles of Incoming Male and Female Medical Students: Results of a Multi-Site 9-Year Study.

    Science.gov (United States)

    Meit, Scott S; Borges, Nicole J; Early, Larry A

    2007-12-01

    This study conveys findings of a 9-year multi-site study of personality traits among incoming medical students. The purpose of the study was twofold. First, it assessed gender differences by exploring personality traits of incoming male and female medical students. Second, it sought to illuminate personality factors associated with those who choose a career in medicine by comparing personality characteristics of medical students to those of the general population. The Sixteen Personality Factor Questionnaire (16PF) was administered at four medical schools to two thousand one hundred seventy seven first-year medical students (1021 females; 1156 males). Study findings revealed significant personality differences between male and female medical students on 11 of 16 personality factors as well as substantial differences in personality functioning between medical students and the general population. Findings are described and future directions for analyses are presented.

  4. Purulent pericarditis, multi-site abscesses and ketoacidosis in a patient with newly diagnosed diabetes: a rare case report.

    Science.gov (United States)

    Lee, H-H; Chu, C-Y; Su, H-M; Lin, T-H; Voon, W-C; Lai, W-T; Sheu, S-H; Hsu, P-C

    2014-07-01

    Purulent pericarditis is an acute and fulminant disease characterized by pus accumulation in the pericardial space. Its incidence has declined substantially and the common pathogen has changed since the beginning of the antibiotic era; however, it is still found in some patients with immunocompromised conditions. We report a rare case in which the onset of diabetes mellitus presented as extremely high HbA1c concentration, ketoacidosis, multi-site abscesses and purulent pericarditis. After antibiotic therapy and pericardiocentesis, the purulent pericarditis still did not resolve and further intrapericardial thrombolytic therapy also failed. Finally, this patient was treated successfully by surgical debridement and pericardiectomy. In the immunocompromised state of severe hyperglycaemia, purulent pericarditis is a possible complication of uncontrolled infection. If purulent pericarditis cannot be cured using non-surgical treatments, such as antibiotic therapy, pericardiocentesis and intrapericardial thrombolytic therapy, a surgical pericardiectomy should be considered to avoid morbidity and mortality. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

  5. Towards a multi-site international public dataset for the validation of retinal image analysis software.

    Science.gov (United States)

    Trucco, Emanuele; Ruggeri, Alfredo

    2013-01-01

    This paper discusses concisely the main issues and challenges posed by the validation of retinal image analysis algorithms. It is designed to set the discussion for the IEEE EBMC 2013 invited session "From laboratory to clinic: the validation of retinal image processing tools ". The session carries forward an international initiative started at EMBC 2011, Boston, which resulted in the first large-consensus paper (14 international sites) on the validation of retinal image processing software, appearing in IOVS. This paper is meant as a focus for the session discussion, but the ubiquity and importance of validation makes its contents, arguably, of interest for the wider medical image processing community.

  6. Cooperative equilibrium curves generated by ordered ligand binding to multi-site molecules.

    Science.gov (United States)

    Michel, Denis

    2007-09-01

    The sigmoid shape of equilibrium curves in normal axes and Hill coefficients higher than unity, are indexes of cooperativity or homotropic allostery where the affinity for the ligand increases as saturation progresses. The mathematical transformation of the Adair scheme of equilibria in the Hill plot, reveals that sigmoid binding curves can also be generated by ordered ligand binding to a receptor with multiple binding sites of identical microscopic association constants. This mechanism only based on the law of mass action, could participate to some extent to certain cooperative effects observed in non-biological systems and perhaps in the physiological binding of oxygen to heme proteins.

  7. Multi-objective decisions in land-use planning involving chemical sites

    DEFF Research Database (Denmark)

    Rasmussen, B.; Bertelsen, I.; Burchard, V.

    1999-01-01

    A methodology for land-use planning involving chemical sites has been developed for making decisions in local and regional administrations. The methodology structures the planning process in seven steps, where one can loop through the steps several times.Essential parts of the methodology...... case studies from Sweden and Denmark have been used, and essential topics and results from two Danishcase studies are presented. The work described in this report is financially supported by the CEC Environment and Climate Programme (contract no. ENV4-CT96-0241)....

  8. 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 ARCHITECT immunoassay at 5 sites and showed an average bias of -0.28 to +0.85 ng/mL versus IMx Tacrolimus II immunoassay historical values and -0.21 to +0.68 ng/mL versus liquid chromatography/tandem mass spectrometry (LC-MSMS) Tacrolimus historical values. Method comparison studies were performed with the ARCHITECT Tacrolimus immunoassay on patient specimens with the following results: ARCHITECT Tacrolimus assay versus the 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

  9. Multi-band scattering of two atoms in a one-dimensional lattice with on-site interactions

    Science.gov (United States)

    Rittenhouse, Seth; Giannakeas, Panagiotis; Mehta, Nirav

    2017-04-01

    We examine a system of two-particles confined to a one-dimensional lattice described by a multi-band Hubbard model with on-site interactions. Asymptotically the two particles are relegated to remain in bands that are energetically accessible. However, when the particles occupy the same state, they can virtually scatter into bands that are energetically closed. We incorporate this virtual scattering by solving the Lippmann-Schwinger equation for the reactance matrix (K-matrix) using a lattice Green's operator. The resulting formula for the K-matrix for open band scattering bears a striking similarity to that which arrises from channel closing formulas in standard multi-channel scattering theory. We then apply this formula for two-body scattering in the lowest and first excited bands within a two band approximation. Within this approximation, virtual scattering into closed bands can create scattering resonances in the presence of bound states attached to closed bands in analogy to Feshbach or confinement induced resonances. This work was partially funded by Grants from the NSF and a the Research Corporation for Science Advancement.

  10. Economic and environmental optimization of a multi-site utility network for an industrial complex.

    Science.gov (United States)

    Kim, Sang Hun; Yoon, Sung-Geun; Chae, Song Hwa; Park, Sunwon

    2010-01-01

    Most chemical companies consume a lot of steam, water and electrical resources in the production process. Given recent record fuel costs, utility networks must be optimized to reduce the overall cost of production. Environmental concerns must also be considered when preparing modifications to satisfy the requirements for industrial utilities, since wastes discharged from the utility networks are restricted by environmental regulations. Construction of Eco-Industrial Parks (EIPs) has drawn attention as a promising approach for retrofitting existing industrial parks to improve energy efficiency. The optimization of the utility network within an industrial complex is one of the most important undertakings to minimize energy consumption and waste loads in the EIP. In this work, a systematic approach to optimize the utility network of an industrial complex is presented. An important issue in the optimization of a utility network is the desire of the companies to achieve high profits while complying with the environmental regulations. Therefore, the proposed optimization was performed with consideration of both economic and environmental factors. The proposed approach consists of unit modeling using thermodynamic principles, mass and energy balances, development of a multi-period Mixed Integer Linear Programming (MILP) model for the integration of utility systems in an industrial complex, and an economic/environmental analysis of the results. This approach is applied to the Yeosu Industrial Complex, considering seasonal utility demands. The results show that both the total utility cost and waste load are reduced by optimizing the utility network of an industrial complex. 2009 Elsevier Ltd. All rights reserved.

  11. A multi-analytical approach for the characterization of powders from the Pompeii archaeological site.

    Science.gov (United States)

    Canevali, Carmen; Gentile, Paolo; Orlandi, Marco; Modugno, Francesca; Lucejko, Jeannette Jacqueline; Colombini, Maria Perla; Brambilla, Laura; Goidanich, Sara; Riedo, Chiara; Chiantore, Oscar; Baraldi, Pietro; Baraldi, Cecilia; Gamberini, Maria Cristina

    2011-10-01

    Nine black powders found in Pompeii houses in three different types of bronze vessels (cylindrical theca atramentaria, unguentaries, and aryballoi) were characterized in order to assess a correspondence between the composition and the type of vessel and, possibly, to verify if these powders were inks or not. For the compositional characterization, a multi-analytical approach was adopted, which involved the use of scanning electron microscopy-energy dispersive X-ray, Fourier-transformed infrared spectroscopy, Raman, X-ray diffraction, electron paramagnetic resonance spectroscopy, thermogravimetric analysis, gas chromatography coupled with mass spectrometry (GC/MS), and pyrolysis GC/MS. Powders contained in cylindrical theca atramentaria form a homogeneous group, and their organic and inorganic compositions suggest that they were writing inks, while powders contained in unguentaries and aryballoi could have had several different uses, including writing inks and cosmetics. Furthermore, the composition profile of the powders found in cylindrical cases shows that, at 79 AD: , in Pompeii, carbon-based inks were still used for writing, and iron gall inks had not been introduced yet.

  12. Reliability of functional magnetic resonance imaging activation during working memory in a multi-site study: analysis from the North American Prodrome Longitudinal Study.

    Science.gov (United States)

    Forsyth, Jennifer K; McEwen, Sarah C; Gee, Dylan G; Bearden, Carrie E; Addington, Jean; Goodyear, Brad; Cadenhead, Kristin S; Mirzakhanian, Heline; Cornblatt, Barbara A; Olvet, Doreen M; Mathalon, Daniel H; McGlashan, Thomas H; Perkins, Diana O; Belger, Aysenil; Seidman, Larry J; Thermenos, Heidi W; Tsuang, Ming T; van Erp, Theo G M; Walker, Elaine F; Hamann, Stephan; Woods, Scott W; Qiu, Maolin; Cannon, Tyrone D

    2014-08-15

    Multi-site neuroimaging studies offer an efficient means to study brain functioning in large samples of individuals with rare conditions; however, they present new challenges given that aggregating data across sites introduces additional variability into measures of interest. Assessing the reliability of brain activation across study sites and comparing statistical methods for pooling functional data are critical to ensuring the validity of aggregating data across sites. The current study used two samples of healthy individuals to assess the feasibility and reliability of aggregating multi-site functional magnetic resonance imaging (fMRI) data from a Sternberg-style verbal working memory task. Participants were recruited as part of the North American Prodrome Longitudinal Study (NAPLS), which comprises eight fMRI scanning sites across the United States and Canada. In the first study sample (n=8), one participant from each home site traveled to each of the sites and was scanned while completing the task on two consecutive days. Reliability was examined using generalizability theory. Results indicated that blood oxygen level-dependent (BOLD) signal was reproducible across sites and was highly reliable, or generalizable, across scanning sites and testing days for core working memory ROIs (generalizability ICCs=0.81 for left dorsolateral prefrontal cortex, 0.95 for left superior parietal cortex). In the second study sample (n=154), two statistical methods for aggregating fMRI data across sites for all healthy individuals recruited as control participants in the NAPLS study were compared. Control participants were scanned on one occasion at the site from which they were recruited. Results from the image-based meta-analysis (IBMA) method and mixed effects model with site covariance method both showed robust activation in expected regions (i.e. dorsolateral prefrontal cortex, anterior cingulate cortex, supplementary motor cortex, superior parietal cortex, inferior

  13. Assessment of the anti-Naja haje antibodies elicited in a low dose multi-site immunization protocol.

    Science.gov (United States)

    El-Kady, E M; Ibrahim, N M; Wahby, A F

    2009-09-15

    The horse antibodies to Naja haje (Nh) elicited in a low dose multi-site immunization protocol were investigated from binding perspective in the context of antivenom maturation. We found that, this protocol evoked the production of lethality neutralizing avid antibodies in the first round of immunization which increases over the successive immunization rounds. The changes and the relative changes in the antibody parameters of each horse were taken as a measure for the efficacy of its immune system to respond by gaining and magnifying the antivenom parameters. While the avidity increases over the successive immunization rounds towards a maturation ceiling, the avidity gain and relative gain decreases. While the ED(50) gain increases over the immunization rounds, the relative ED(50) gain of the strong responder horse-1 is steadier than for the weak responders horse-2 and horse-3. The profiles for the gain and the relative gain of ELISA titers by three horses are pronouncedly different, reflecting great variations in the immune response by the individual animals. A late antigen dependent avidity pulse was detected after the last dose of the second immunization period, demonstrating that antibody maturation continues during the rest periods. The avidity pulse appears as an increase in avidity which returns to a base level within four weeks. These results indicted that maturation of antibodies to lethality neutralization relevant venom epitopes rather than maturation of antivenoms is the most important potency determining factor. Eventually, a main advantage of the low dose multi-site immunization protocol is the production of highly avid antibodies at the primary immunizations which is mostly crucial for the production of highly potent antivenoms.

  14. Impact of multi-tiered pharmacy benefits on attitudes of plan members with chronic disease states.

    Science.gov (United States)

    Nair, Kavita V; Ganther, Julie M; Valuck, Robert J; McCollum, Marianne M; Lewis, Sonya J

    2002-01-01

    To evaluate the effects of 2- and 3-tiered pharmacy benefit plans on member attitudes regarding their pharmacy benefits. We performed a mail survey and cross-sectional comparison of the outcome variables in a large managed care population in the western United States. Participants were persons with chronic disease states who were in 2- or 3-tier copay drug plans. A random sample of 10,662 was selected from a total of 25,008 members who had received 2 or more prescriptions for a drug commonly used to treat one of 5 conditions: hypertension, diabetes, dyslipidemia, gastroesophageal reflux disease (GERD), or arthritis. Statistical analysis included bivariate comparisons and regression analysis of the factors affecting member attitudes, including satisfaction, loyalty, health plan choices, and willingness to pay a higher out-of-pocket cost for medications. A response rate of 35.8% was obtained from continuously enrolled plan members. Respondents were older, sicker, and consumed more prescriptions than nonrespondents. There were significant differences in age and health plan characteristics between 2- and 3-tier plan members: respondents aged 65 or older represented 11.7% of 2-tier plan members and 54.7% of 3-tier plan members, and 10.0% of 2-tier plan members were in Medicare+Choice plans versus 61.4% in Medicare+Choice plans for 3-tier plan members (Pbrand-name medications, in general, they were not willing to pay more than 10 dollars (in addition to their copayment amount) for these medications. Older respondents and sicker individuals (those with higher scores on the Chronic Disease Indicator) appeared to have more positive attitudes toward their pharmacy benefit plans in general. Higher reported incomes by respondents were also associated with greater satisfaction with prescription drug coverage and increased loyalty toward the pharmacy benefit plan. Conversely, the more individuals spent for either their health care or prescription medications, the less satisfied

  15. Echoguided drug infiltration in chronic prostatitis: results of a multi-centre study.

    Science.gov (United States)

    Guercini, Federico; Pajoncini, Cinzia; Bard, Robert; Fiorentino, Francesco; Bini, Vittorio; Costantini, Elisabetta; Porena, Massimo

    2005-06-01

    In chronic prostatitis there are many causes that may provoke a therapeutical failure of a systemic antibiotic treatment. At the moment a consensus has not been reached on the efficacy of the many therapeutical options that are available with not one of these approaches being efficacious in all patients. In our view the main causes of treatment failure are the well-known hurdle to antibiotic diffusion inside the glandular parenchyma associated with the so-called intraprostatic bacterial biofilms and the possible presence of local auto-immune reactions. Given this background, we tested ultrasound guided intraprostate infiltration of a cocktail of antibiotics and betamethasone, for a therapeutical options. 320 patients, referred to us because of symptoms indicative of chronic prostatitis, were enrolled in this study. The inclusion criteria were the severity of the symptoms and the failure of repeated cycles of antibiotics in the previous 12 months. At the initial consultation patients completed the NIH Prostatitis Symptoms Index (NIH-CPSI). All underwent: a) digital rectal examination (DRE), b) transrectal prostatic ultrasound scan (TRUS), c) uroflowmetry, d) cultures of first voiding and after prostatic massage urine and cultures of sperm for saprophytic and pathogen germs, yeasts and protozoa, e) DNA amplification with polymerase chain reaction (PCR) on urine and sperm, for Chlamydia trachomatis, Mycoplasmas (Ureaplasma urealyticum and Mycoplasma hominis), Gonococcus, HPV and HCV Patients on the basis of laboratory results received a cocktail of antibiotics associated with betamethasone. The cocktail was administered as prostate infiltration. Administration was repeated after 7 and 14 days. Final assessment of the efficacy of therapy included not only the NIH-CPSI scores but also the patient's subjective judgement expressed as a "percentage overall improvement". The percentage judgements were arbitrarily divided into 4 classes: 0-30% no improvement (Class I); 30

  16. Multi-site evaluation of IKONOS data for classification of tropical coral reef environments

    Science.gov (United States)

    Andrefouet, S.; Kramer, Philip; Torres-Pulliza, D.; Joyce, K.E.; Hochberg, E.J.; Garza-Perez, R.; Mumby, P.J.; Riegl, Bernhard; Yamano, H.; White, W.H.; Zubia, M.; Brock, J.C.; Phinn, S.R.; Naseer, A.; Hatcher, B.G.; Muller-Karger, F. E.

    2003-01-01

    Ten IKONOS images of different coral reef sites distributed around the world were processed to assess the potential of 4-m resolution multispectral data for coral reef habitat mapping. Complexity of reef environments, established by field observation, ranged from 3 to 15 classes of benthic habitats containing various combinations of sediments, carbonate pavement, seagrass, algae, and corals in different geomorphologic zones (forereef, lagoon, patch reef, reef flats). Processing included corrections for sea surface roughness and bathymetry, unsupervised or supervised classification, and accuracy assessment based on ground-truth data. IKONOS classification results were compared with classified Landsat 7 imagery for simple to moderate complexity of reef habitats (5-11 classes). For both sensors, overall accuracies of the classifications show a general linear trend of decreasing accuracy with increasing habitat complexity. The IKONOS sensor performed better, with a 15-20% improvement in accuracy compared to Landsat. For IKONOS, overall accuracy was 77% for 4-5 classes, 71% for 7-8 classes, 65% in 9-11 classes, and 53% for more than 13 classes. The Landsat classification accuracy was systematically lower, with an average of 56% for 5-10 classes. Within this general trend, inter-site comparisons and specificities demonstrate the benefits of different approaches. Pre-segmentation of the different geomorphologic zones and depth correction provided different advantages in different environments. Our results help guide scientists and managers in applying IKONOS-class data for coral reef mapping applications. ?? 2003 Elsevier Inc. All rights reserved.

  17. Cholera Incidence and Mortality in Sub-Saharan African Sites during Multi-country Surveillance.

    Science.gov (United States)

    Sauvageot, Delphine; Njanpop-Lafourcade, Berthe-Marie; Akilimali, Laurent; Anne, Jean-Claude; Bidjada, Pawou; Bompangue, Didier; Bwire, Godfrey; Coulibaly, Daouda; Dengo-Baloi, Liliana; Dosso, Mireille; Orach, Christopher Garimoi; Inguane, Dorteia; Kagirita, Atek; Kacou-N'Douba, Adele; Keita, Sakoba; Kere Banla, Abiba; Kouame, Yao Jean-Pierre; Landoh, Dadja Essoya; Langa, Jose Paulo; Makumbi, Issa; Miwanda, Berthe; Malimbo, Muggaga; Mutombo, Guy; Mutombo, Annie; NGuetta, Emilienne Niamke; Saliou, Mamadou; Sarr, Veronique; Senga, Raphael Kakongo; Sory, Fode; Sema, Cynthia; Tante, Ouyi Valentin; Gessner, Bradford D; Mengel, Martin A

    2016-05-01

    Cholera burden in Africa remains unknown, often because of weak national surveillance systems. We analyzed data from the African Cholera Surveillance Network (www.africhol.org). During June 2011-December 2013, we conducted enhanced surveillance in seven zones and four outbreak sites in Togo, the Democratic Republic of Congo (DRC), Guinea, Uganda, Mozambique and Cote d'Ivoire. All health facilities treating cholera cases were included. Cholera incidences were calculated using culture-confirmed cholera cases and culture-confirmed cholera cases corrected for lack of culture testing usually due to overwhelmed health systems and imperfect test sensitivity. Of 13,377 reported suspected cases, 34% occurred in Conakry, Guinea, 47% in Goma, DRC, and 19% in the remaining sites. From 0-40% of suspected cases were aged under five years and from 0.3-86% had rice water stools. Within surveillance zones, 0-37% of suspected cases had confirmed cholera compared to 27-38% during outbreaks. Annual confirmed incidence per 10,000 population was cholera incidence, age distribution, clinical presentation, culture confirmation, and testing frequency. These results can help guide preventive activities, including vaccine use.

  18. An efficient statistical approach to multi-site downscaling of daily precipitation series in the context of climate change

    Science.gov (United States)

    Khalili, Malika; Van Nguyen, Van Thanh

    2017-10-01

    Global Climate Models (GCMs) have been extensively used in many climate change impact studies. However, the coarser resolution of these GCM outputs is not adequate to assess the potential effects of climate change on local scale. Downscaling techniques have thus been proposed to resolve this problem either by dynamical or statistical approaches. The statistical downscaling (SD) methods are widely privileged because of their simplicity of implementation and use. However, many of them ignore the observed spatial dependence between different locations, which significantly affects the impact study results. An improved multi-site SD approach is thus presented in this paper to downscaling of daily precipitation at many sites concurrently. This approach is based on a combination of multiple regression models for rainfall occurrences and amounts and the Singular Value Decomposition technique, which models the stochastic components of these regression models to preserve accurately the space-time statistical properties of the daily precipitation. Furthermore, this method was able to describe adequately the intermittency property of the precipitation processes. The proposed approach has been assessed using 10 rain gauges located in the southwest region of Quebec and southeast region of Ontario in Canada, and climate predictors from the National Centers for Environmental Prediction/National Centre for Atmospheric Research re-analysis data set. The results have indicated the ability of the proposed approach to reproduce accurately multiple observed statistical properties of the precipitation occurrences and amounts, the at-site temporal persistence, the spatial dependence between sites and the temporal variability and spatial intermittency of the precipitation processes.

  19. Multi-site validation of a soil organic matter model based on generally available input data

    Science.gov (United States)

    Franko, Uwe; Kolbe, Hartmut; Thiel, Enrico; Ließ, Ekkehard

    2010-05-01

    Regionalization of soil organic matter (SOM) dynamics by means of modelling is often restricted by the availability of model inputs on the used scale. Taking this into account the approach of the CANDY model (Franko et al., 1995) has been strongly simplified with a remarkable reduction of input requirements. This simplified model called Candy Carbon balance (CCB) was validated against a large number of long term datasets from arable field experiments mainly situated in Germany but also from some places in Europe altogether containing 41 sites with 65 experiments and a total number of 598 different treatments. The required input data are: - soil: clay content, soil classification - climate: rainfall and air temperature as long term averages - management: crop rotation with yields and organic amendments - SOM: at least one initial value; more observations for validation purpose During the calculation process the model makes use of some other soil parameters like silt content, bulk density, pore volume, field capacity and permanent wilting point. These data may be delivered by the user or if absent they will be calculated from pedotransfer functions. If the initial information includes not only organic Carbon (Corg) but also total Nitrogen (Nt) the SOM dynamics will be modelled for both elements. The CCB model follows the CANDY concept distributing SOM in a long term stabilized and a decomposable fraction. The long term stabilized part is calculated comparable to the CIPS model (Kuka,2005) taking the SOM in soil micro pores as highly stabilized so that its turnover can be neglected for this model application and hence will show no dynamics during simulation. Soil texture, rainfall, irrigation amount and air temperature are used to estimate the site specific biologic activity for SOM turnover in terms of Biological Active Time (BAT). Annual yield data are transformed to the amounts of organic matter input due to cropping that together with organic amendments are the

  20. A multi-sites analysis on the ozone effects on Gross Primary Production of European forests

    Energy Technology Data Exchange (ETDEWEB)

    Proietti, C. [Department of Environmental Biology, Sapienza University of Rome, Piazzale Aldo Moro, 5, 00185 Rome (Italy); Anav, A. [Italian National Agency for New Technologies, Energy and the Environment (ENEA), C.R. Casaccia, Via Anguillarese 301, 00123 S. Maria di Galeria, Rome (Italy); University of Exeter, College of Engineering, Mathematics and Physical Sciences, Exeter (United Kingdom); De Marco, A. [Italian National Agency for New Technologies, Energy and the Environment (ENEA), C.R. Casaccia, Via Anguillarese 301, 00123 S. Maria di Galeria, Rome (Italy); Sicard, P. [ACRI-HE, 260 route du Pin Montard BP234, 06904 Sophia Antipolis-cedex (France); Vitale, M., E-mail: marcello.vitale@uniroma1.it [Department of Environmental Biology, Sapienza University of Rome, Piazzale Aldo Moro, 5, 00185 Rome (Italy)

    2016-06-15

    Ozone (O{sub 3}) is both a greenhouse gas and a secondary air pollutant causing adverse impacts on forests ecosystems at different scales, from cellular to ecosystem level. Specifically, the phytotoxic nature of O{sub 3} can impair CO{sub 2} assimilation that, in turn affects forest productivity. This study aims to evaluate the effects of tropospheric O{sub 3} on Gross Primary Production (GPP) at 37 European forest sites during the time period 2000–2010. Due to the lack of carbon assimilation data at O{sub 3} monitoring stations (and vice-versa) this study makes a first attempt to combine high resolution MODIS Gross Primary Production (GPP) estimates and O{sub 3} measurement data. Partial Correlations, Anomalies Analysis and the Random Forests Analysis (RFA) were used to quantify the effects of tropospheric O{sub 3} concentration and its uptake on GPP and to evaluate the most important factors affecting inter-annual GPP changes. Our results showed, along a North-West/South-East European transect, a negative impact of O{sub 3} on GPP ranging from 0.4% to 30%, although a key role of meteorological parameters respect to pollutant variables in affecting GPP was found. In particular, meteorological parameters, namely air temperature (T), soil water content (SWC) and relative humidity (RH) are the most important predictors at 81% of test sites. Moreover, it is interesting to highlight a key role of SWC in the Mediterranean areas (Spanish, Italian and French test sites) confirming that, soil moisture and soil water availability affect vegetation growth and photosynthesis especially in arid or semi-arid ecosystems such as the Mediterranean climate regions. Considering the pivotal role of GPP in the global carbon balance and the O{sub 3} ability to reduce primary productivity of the forests, this study can help in assessing the O{sub 3} impacts on ecosystem services, including wood production and carbon sequestration. - Highlights: • Assessment of the surface O{sub 3

  1. Multi-site testing and evaluation of remote sensing instruments for wind energy applications

    DEFF Research Database (Denmark)

    Sanz Rodrigo, J.; Borbon Guillen, F.; Gomez Arranz, P.

    2013-01-01

    field, it is also investigated the influence of the background atmospheric stability by classifying the results with the Richardson number in flat terrain and the Froude number in complex terrain. The result is a thorough field calibration of the instruments for a wide range of terrain-flow conditions......A procedure for testing and evaluation of remote sensing instruments that makes use of two test sites in flat and complex terrain is presented. To illustrate the method, a system intercomparison experiment is presented involving one sodar and two lidars (pulsed and continuous-wave). The wind...... profilers are benchmarked with respect to reference cup anemometer and other mast-based instrumentation. The evaluation procedure comprises three steps: single-point regression, ensemble-averaged profile analysis and performance matrix summary. Apart from the influence of the terrain complexity on the flow...

  2. Multi-year estimates of plant and ecosystem 13C discrimination at AmeriFlux sites

    Science.gov (United States)

    Dang, X.; Lai, C.; Hollinger, D. Y.; Bush, S.; Randerson, J. T.; Law, B. E.; Schauer, A. J.; Ehleringer, J.

    2011-12-01

    We estimated plant and ecosystem 13C discrimination continuously at 8 AmeriFlux sites (Howland Forest, Harvard Forest, Wind River Forest, Rannells Prairie, Freeman Ranch, Chestnut Ridge, Metolius, and Marys River fir) over 8 years (2002-2009). We used an observation-based approach from weekly measurements of eddy covariance CO2 fluxes and their 13C/12C ratios to estimate photosynthetic 13C discrimination (△A) and respiration (δ13CR) on seasonal and interannual time scales. The coordinated, systematic flask sampling across the AmeriFlux subnetwork were used for cross-site synthesis of monthly flux estimates [Dang et al. Combining tower mixing ratio and community model data to estimate regional-scale net ecosystem carbon exchange by boundary layer inversion over 4 flux towers in the U.S.A., Journal of Geophysical Research-Biogeosciences, in press]. Here, we evaluated environmental factors that also influenced temporal variability in △A and δ13CR from daily to interannual time scales, comparing atmospheric 13C/12C measurements, leaf and needle organic matter, and tree ring cellulose. Across these major biomes that dominate the continent, we show differential ecophysiological responses to environmental stresses, among which water availability appeared to be a dominant factor. Our decadal measurement period provided robust estimates of atmospheric 13C discrimination by terrestrial ecosystems, but also suggest regions where enhanced monitoring efforts are required (e.g., 13C/12C emission from fire and urban metabolism; increased temporal resolution of 13C measurements in stress-sensitive ecosystems) to make atmospheric 13C/12C measurements an effective constraint for continental-scale assessments of the terrestrial carbon cycle.

  3. A multi-site study using high-resolution HLA genotyping by next generation sequencing.

    Science.gov (United States)

    Holcomb, C L; Höglund, B; Anderson, M W; Blake, L A; Böhme, I; Egholm, M; Ferriola, D; Gabriel, C; Gelber, S E; Goodridge, D; Hawbecker, S; Klein, R; Ladner, M; Lind, C; Monos, D; Pando, M J; Pröll, J; Sayer, D C; Schmitz-Agheguian, G; Simen, B B; Thiele, B; Trachtenberg, E A; Tyan, D B; Wassmuth, R; White, S; Erlich, H A

    2011-03-01

    The high degree of polymorphism at human leukocyte antigen (HLA) class I and class II loci makes high-resolution HLA typing challenging. Current typing methods, including Sanger sequencing, yield ambiguous typing results because of incomplete genomic coverage and inability to set phase for HLA allele determination. The 454 Life Sciences Genome Sequencer (GS FLX) next generation sequencing system coupled with conexio atf software can provide very high-resolution HLA genotyping. High-throughput genotyping can be achieved by use of primers with multiplex identifier (MID) tags to allow pooling of the amplicons generated from different individuals prior to sequencing. We have conducted a double-blind study in which eight laboratory sites performed amplicon sequencing using GS FLX standard chemistry and genotyped the same 20 samples for HLA-A, -B, -C, DPB1, DQA1, DQB1, DRB1, DRB3, DRB4, and DRB5 (DRB3/4/5) in a single sequencing run. The average sequence read length was 250 base pairs and the average number of sequence reads per amplicon was 672, providing confidence in the allele assignments. Of the 1280 genotypes considered, assignment was possible in 95% of the cases. Failure to assign genotypes was the result of researcher procedural error or the presence of a novel allele rather than a failure of sequencing technology. Concordance with known genotypes, in cases where assignment was possible, ranged from 95.3% to 99.4% for the eight sites, with overall concordance of 97.2%. We conclude that clonal pyrosequencing using the GS FLX platform and CONEXIO ATF software allows reliable identification of HLA genotypes at high resolution. © 2011 John Wiley & Sons A/S.

  4. Cholera Incidence and Mortality in Sub-Saharan African Sites during Multi-country Surveillance.

    Directory of Open Access Journals (Sweden)

    Delphine Sauvageot

    2016-05-01

    Full Text Available Cholera burden in Africa remains unknown, often because of weak national surveillance systems. We analyzed data from the African Cholera Surveillance Network (www.africhol.org.During June 2011-December 2013, we conducted enhanced surveillance in seven zones and four outbreak sites in Togo, the Democratic Republic of Congo (DRC, Guinea, Uganda, Mozambique and Cote d'Ivoire. All health facilities treating cholera cases were included. Cholera incidences were calculated using culture-confirmed cholera cases and culture-confirmed cholera cases corrected for lack of culture testing usually due to overwhelmed health systems and imperfect test sensitivity. Of 13,377 reported suspected cases, 34% occurred in Conakry, Guinea, 47% in Goma, DRC, and 19% in the remaining sites. From 0-40% of suspected cases were aged under five years and from 0.3-86% had rice water stools. Within surveillance zones, 0-37% of suspected cases had confirmed cholera compared to 27-38% during outbreaks. Annual confirmed incidence per 10,000 population was <0.5 in surveillance zones, except Goma where it was 4.6. Goma and Conakry had corrected incidences of 20.2 and 5.8 respectively, while the other zones a median of 0.3. During outbreaks, corrected incidence varied from 2.6 to 13.0. Case fatality ratios ranged from 0-10% (median, 1% by country.Across different African epidemiological contexts, substantial variation occurred in cholera incidence, age distribution, clinical presentation, culture confirmation, and testing frequency. These results can help guide preventive activities, including vaccine use.

  5. Multi-configuration electromagnetic induction measurements at long term agricultural test sites in Germany with different fertilizer and irrigation managements

    Science.gov (United States)

    Kaufmann, Manuela Sarah; von Hebel, Christian; Brogi, Cosimo; Baumecker, Michael; Döring, Thomas; Amelung, Wulf; Vereecken, Harry; van der Kruk, Jan

    2017-04-01

    Electromagnetic induction (EMI) data are often being used to investigate large scale soil properties including clay content, soil water content, and salinity changes for a wide range of applications. For agricultural sites, different management practices such as organic/mineral fertilization, tillage, and/or irrigation are important when interpreting the measured apparent electrical conductivity (ECa). Here, we present EMI data recorded at two long term field experiment (LTFE) agricultural test sites in Thyrow near Berlin (Germany), where different long term fertilizer and irrigation management practices were applied. We used two fixed-boom multi-coil EMI instruments that simultaneously measure over nine different depths of investigation (DOI), recording information ranging between the very shallow (0-0.25 m) ploughing zone including the organic matter and the surface soil (A-Horizon) down to the relatively deep (0-2.7 m) subsoil (B-Horizon) or even substratum (C-Horizon). At both test sites, the prevailing sandy to silty sand in the A- and B-Horizon is underlain by a glacial till C-Horizon resulting in generally low ECa values between 0.5 and 5 mS/m. At one test site, a "static nutrient deficiency experiment" is performed since 1937, where organic fertilizer (farm yard manure) and mineral fertilizers (nitrogen-phosphate-potassium (NPK) and liming) are applied at specific grids. Comparing the fertilizer application grid to the measured EMI data, the lowest ECa values coincide to unfertilized grids whereas the ECa values increase with liming, farm yard manure, and NPK. The visually observed correlation between ECa and the liming treatment was possibly due to the increased pH of the soil, because the fertilizer application increases ion contents that increase the soil electrical conductivity. At the second test site, a "Static Irrigation and Fertilizer Experiment" is conducted, where next to the fertilizer treatment (farm yard manure and nitrogen) part of the field

  6. 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 50years 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. © 2013 Elsevier B.V. All rights reserved.

  7. Significant Role of Segmental Duplications and SIDD Sites in Chromosomal Translocations of Hematological Malignancies: A Multi-parametric Bioinformatic Analysis.

    Science.gov (United States)

    Daga, Aditi; Ansari, Afzal; Pandya, Medha; Shah, Krupa; Patel, Shanaya; Rawal, Rakesh; Umrania, Valentina

    2016-11-28

    Recurrent non-random chromosomal translocations are hallmark characteristics of leukemogenesis, and however, molecular mechanisms underlying these rearrangements are less explored. The fundamental question is, why and how chromosomes break and reunite so precisely in the genome. Meticulous understanding of mechanism leading to chromosomal rearrangement can be achieved by characterizing breakpoints. To address this hypothesis, a novel multi-parametric computational approach for characterization of major leukemic translocations within and around breakpoint region was performed. To best of our knowledge, this bioinformatic analysis is unique in finding the presence of segmental duplications (SDs) flanking breakpoints of all major leukemic translocation. Breakpoint islands (BpIs) were analyzed for stress-induced duplex destabilization (SIDD) sites along with other complex genomic architecture and physicochemical properties. Our study distinctly emphasizes on the probable correlative role of SDs, SIDD sites and various genomic features in the occurrence of breakpoints. Further, it also highlights potential features which may be playing a crucial role in causing double-strand breaks, leading to translocation.

  8. Rule-Mining for the Early Prediction of Chronic Kidney Disease Based on Metabolomics and Multi-Source Data.

    Directory of Open Access Journals (Sweden)

    Margaux Luck

    Full Text Available 1H Nuclear Magnetic Resonance (NMR-based metabolic profiling is very promising for the diagnostic of the stages of chronic kidney disease (CKD. Because of the high dimension of NMR spectra datasets and the complex mixture of metabolites in biological samples, the identification of discriminant biomarkers of a disease is challenging. None of the widely used chemometric methods in NMR metabolomics performs a local exhaustive exploration of the data. We developed a descriptive and easily understandable approach that searches for discriminant local phenomena using an original exhaustive rule-mining algorithm in order to predict two groups of patients: 1 patients having low to mild CKD stages with no renal failure and 2 patients having moderate to established CKD stages with renal failure. Our predictive algorithm explores the m-dimensional variable space to capture the local overdensities of the two groups of patients under the form of easily interpretable rules. Afterwards, a L2-penalized logistic regression on the discriminant rules was used to build predictive models of the CKD stages. We explored a complex multi-source dataset that included the clinical, demographic, clinical chemistry, renal pathology and urine metabolomic data of a cohort of 110 patients. Given this multi-source dataset and the complex nature of metabolomic data, we analyzed 1- and 2-dimensional rules in order to integrate the information carried by the interactions between the variables. The results indicated that our local algorithm is a valuable analytical method for the precise characterization of multivariate CKD stage profiles and as efficient as the classical global model using chi2 variable section with an approximately 70% of good classification level. The resulting predictive models predominantly identify urinary metabolites (such as 3-hydroxyisovalerate, carnitine, citrate, dimethylsulfone, creatinine and N-methylnicotinamide as relevant variables indicating that

  9. Endothelial microparticles in mild chronic obstructive pulmonary disease and emphysema. The Multi-Ethnic Study of Atherosclerosis Chronic Obstructive Pulmonary Disease study.

    Science.gov (United States)

    Thomashow, Michael A; Shimbo, Daichi; Parikh, Megha A; Hoffman, Eric A; Vogel-Claussen, Jens; Hueper, Katja; Fu, Jessie; Liu, Chia-Ying; Bluemke, David A; Ventetuolo, Corey E; Doyle, Margaret F; Barr, R Graham

    2013-07-01

    Basic research implicates alveolar endothelial cell apoptosis in the pathogenesis of chronic obstructive pulmonary disease (COPD) and emphysema. However, information on endothelial microparticles (EMPs) in mild COPD and emphysema is lacking. We hypothesized that levels of CD31(+) EMPs phenotypic for endothelial cell apoptosis would be elevated in COPD and associated with percent emphysema on computed tomography (CT). Associations with pulmonary microvascular blood flow (PMBF), diffusing capacity, and hyperinflation were also examined. The Multi-Ethnic Study of Atherosclerosis COPD Study recruited participants with COPD and control subjects age 50-79 years with greater than or equal to 10 pack-years without clinical cardiovascular disease. CD31(+) EMPs were measured using flow cytometry in 180 participants who also underwent CTs and spirometry. CD62E(+) EMPs phenotypic for endothelial cell activation were also measured. COPD was defined by standard criteria. Percent emphysema was defined as regions less than -950 Hounsfield units on full-lung scans. PMBF was assessed on gadolinium-enhanced magnetic resonance imaging. Hyperinflation was defined as residual volume/total lung capacity. Linear regression was used to adjust for potential confounding factors. CD31(+) EMPs were elevated in COPD compared with control subjects (P = 0.03) and were notably increased in mild COPD (P = 0.03). CD31(+) EMPs were positively related to percent emphysema (P = 0.045) and were inversely associated with PMBF (P = 0.047) and diffusing capacity (P = 0.01). In contrast, CD62E(+) EMPs were elevated in severe COPD (P = 0.003) and hyperinflation (P = 0.001). CD31(+) EMPs, suggestive of endothelial cell apoptosis, were elevated in mild COPD and emphysema. In contrast, CD62E(+) EMPs indicative of endothelial activation were elevated in severe COPD and hyperinflation.

  10. Multi-site evaluation of terrestrial evaporation models using FLUXNET data

    KAUST Repository

    Ershadi, Ali

    2014-04-01

    We evaluated the performance of four commonly applied land surface evaporation models using a high-quality dataset of selected FLUXNET towers. The models that were examined include an energy balance approach (Surface Energy Balance System; SEBS), a combination-type technique (single-source Penman-Monteith; PM), a complementary method (advection-aridity; AA) and a radiation based approach (modified Priestley-Taylor; PT-JPL). Twenty FLUXNET towers were selected based upon satisfying stringent forcing data requirements and representing a wide range of biomes. These towers encompassed a number of grassland, cropland, shrubland, evergreen needleleaf forest and deciduous broadleaf forest sites. Based on the mean value of the Nash-Sutcliffe efficiency (NSE) and the root mean squared difference (RMSD), the order of overall performance of the models from best to worst were: ensemble mean of models (0.61, 64), PT-JPL (0.59, 66), SEBS (0.42, 84), PM (0.26, 105) and AA (0.18, 105) [statistics stated as (NSE, RMSD in Wm-2)]. Although PT-JPL uses a relatively simple and largely empirical formulation of the evaporative process, the technique showed improved performance compared to PM, possibly due to its partitioning of total evaporation (canopy transpiration, soil evaporation, wet canopy evaporation) and lower uncertainties in the required forcing data. The SEBS model showed low performance over tall and heterogeneous canopies, which was likely a consequence of the effects of the roughness sub-layer parameterization employed in this scheme. However, SEBS performed well overall. Relative to PT-JPL and SEBS, the PM and AA showed low performance over the majority of sites, due to their sensitivity to the parameterization of resistances. Importantly, it should be noted that no single model was consistently best across all biomes. Indeed, this outcome highlights the need for further evaluation of each model\\'s structure and parameterizations to identify sensitivities and their

  11. Monitoring of infrastructural sites by means of advanced multi-temporal DInSAR methods

    Science.gov (United States)

    Vollrath, Andreas; Zucca, Francesco; Stramondo, Salvatore

    2013-10-01

    With the launch of Sentinel-1, advanced interferometric measurements will become more applicable then ever. The foreseen standard Wide Area Product (WAP), with its higher spatial and temporal resolution than comparable SAR missions, will provide the basement for the use of new wide scale and multitemporal analysis. By now the use of SAR interferometry methods with respect to risk assessment are mainly conducted for active tectonic zones, plate boundaries, volcanoes as well as urban areas, where local surface movement rates exceed the expected error and enough pixels per area contain a relatively stable phase. This study, in contrast, aims to focus on infrastructural sites that are located outside cities and are therefore surrounded by rural landscapes. The stumbling bock was given by the communication letter by the European Commission with regard to the stress tests of nuclear power plants in Europe in 2012. It is mentioned that continuously re-evaluated risk and safety assessments are necessary to guarantee highest possible security to the European citizens and environment. This is also true for other infrastructural sites, that are prone to diverse geophysical hazards. In combination with GPS and broadband seismology, multitemporal Differential Interferometric SAR approaches demonstrated great potential in contributing valuable information to surface movement phenomenas. At this stage of the project, first results of the Stamps-MTI approach (combined PSInSAR and SBAS) will be presented for the industrial area around Priolo Gargallo in South East Sicily by using ENVISAT ASAR IM mode data from 2003-2010. This area is located between the Malta Escarpment fault system and the Hyblean plateau and is prone to earthquake and tsunami risk. It features a high density of oil refineries that are directly located at the coast. The general potential of these techniques with respect to the SENTINEL-1 mission will be shown for this area and a road-map for further improvements

  12. EFFECTIVNESS OF TARGET ANTIMICROBIAL THERAPY OF SEVERE CHRONIC PERIODONTITIS PART I: REDUCTION OF GINGIVAL INFLAMATION AND ACTIVE PERIODONTAL DISEASE SITES

    Directory of Open Access Journals (Sweden)

    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.

  13. Chronic stress-like syndrome as a consequence of medial site subthalamic stimulation in Parkinson's disease.

    Science.gov (United States)

    Růžička, Filip; Jech, Robert; Nováková, Lucie; Urgošík, Dušan; Bezdíček, Ondřej; Vymazal, Josef; Růžička, Evžen

    2015-02-01

    Considering the functional organization of the subthalamic nucleus (STN), we hypothesized that subthalamic deep brain stimulation (STN-DBS) in Parkinson's disease might have a differential impact on the hypothalamic-pituitary-adrenal axis in relation to the position of active stimulating contact within the STN. In addition, we searched for any STN-DBS-related morning plasma cortisol changes in association with postoperative anxiety and weight gain. A plasma cortisol measurement was performed on the day of initiation of bilateral STN-DBS and repeated after 1 and 17 months in twenty patients with advanced Parkinson's disease. The body weight change and anxiety scores following the implantation were assessed as well. The electrode positions in the STN were determined on T1-weighted magnetic resonance images. After initiation of stimulation, cortisol levels significantly decreased and the cortisol changes after 1 and 17 months strongly correlated with the position of active contact in the subthalamic area. Patients with at least one contact located more medially in the STN experienced a significantly greater decrease of cortisol than those with one or both active contacts more laterally. Furthermore, the lower cortisol levels were strongly associated with higher trait anxiety and weight gain. These changes mimicked the effects of chronic stress and suggest the disturbing impact of STN-DBS on limbic and motivational systems. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. The Wound Intelligence System: early issues and findings from multi-site tests.

    Science.gov (United States)

    Bates-Jensen, B; McNees, P

    1996-01-01

    The purpose of this manuscript is to address a gap in our efforts to incrementally improve wound care practice through evidence-based practice. The Pressure Sore Status Tool (PSST) provides data to extend evidence-based practice beyond clinical trials and into the clinical area itself. The computerized PSST was evaluated over one year through over 70 beta sites. Two studies which were part of that evaluation period are described which give a comparative analysis of wound stage and PSST scores, and similarities and differences in wound characteristics of four types of wounds: arterial/ischemic ulcers, neuropathic ulcers, pressure ulcers, and venous ulcers. In the first study, a relationship between PSST scores and staging scores for the presenting wound was present, indicating promise for the utilization of the PSST as an alternative to staging scores for describing changes in wound status. However, in the second study, clear difference was not noticeable between the four wound types, suggesting that discriminations regarding wound type may not be able to be made from PSST assessments. The goal of these studies was to provide feedback on the use of the computerized PSST, thereby providing feedback based on objective outcomes of the practice of clinicians themselves.

  15. Developing restoration planting mixes for active ski slopes: a multi-site reference community approach.

    Science.gov (United States)

    Burt, Jennifer Williamson

    2012-03-01

    Downhill ski areas occupy large expanses of mountainous lands where restoration of ecosystem function is of increasing importance and interest. Establishing diverse native plant communities on ski runs should enhance sediment and water retention, wildlife habitat, biodiversity and aesthetics. Because ski slopes are managed for recreation, ski slope revegetation mixes must consist of low-stature or herbaceous plants that can tolerate typical environmental conditions on ski slopes (high elevation, disturbed soils, open, steep slopes). The most appropriate reference communities for selecting ski slope revegetation species are thus successional, or seral plant communities in similar environments (i.e., other ski slopes). Using results from a broad-scale reference community analysis, I evaluated plant communities naturally occurring on ski slopes from 21 active and abandoned ski areas throughout the northern Sierra Nevada to identify native plant species suitable for use in ski slope restoration. I constructed a baseline planting palette of regionally appropriate plant species (for restoration of either newly created or already existing ski runs) that is functionally diverse and is likely to succeed across a broad range of environments. I also identify a more comprehensive list of species for more specialized planting mixes based on site-specific goals and particular environmental settings. Establishing seral plant communities may be an appropriate restoration goal for many other types of managed lands, including roadsides, firebreaks and utility rights-of-way. This study describes an ecological (and potentially cost-effective) approach to developing restoration planting palettes for such managed lands.

  16. Multi-site assimilation of a terrestrial biosphere model (BETHY) using satellite derived soil moisture data

    Science.gov (United States)

    Wu, Mousong; Sholze, Marko

    2017-04-01

    We investigated the importance of soil moisture data on assimilation of a terrestrial biosphere model (BETHY) for a long time period from 2010 to 2015. Totally, 101 parameters related to carbon turnover, soil respiration, as well as soil texture were selected for optimization within a carbon cycle data assimilation system (CCDAS). Soil moisture data from Soil Moisture and Ocean Salinity (SMOS) product was derived for 10 sites representing different plant function types (PFTs) as well as different climate zones. Uncertainty of SMOS soil moisture data was also estimated using triple collocation analysis (TCA) method by comparing with ASCAT dataset and BETHY forward simulation results. Assimilation of soil moisture to the system improved soil moisture as well as net primary productivity(NPP) and net ecosystem productivity (NEP) when compared with soil moisture derived from in-situ measurements and fluxnet datasets. Parameter uncertainties were largely reduced relatively to prior values. Using SMOS soil moisture data for assimilation of a terrestrial biosphere model proved to be an efficient approach in reducing uncertainty in ecosystem fluxes simulation. It could be further used in regional an global assimilation work to constrain carbon dioxide concentration simulation by combining with other sources of measurements.

  17. A fuzzy analytic network process for multi-criteria evaluation of contaminated site remedial countermeasures.

    Science.gov (United States)

    Promentilla, Michael Angelo B; Furuichi, T; Ishii, K; Tanikawa, N

    2008-08-01

    The Analytic Network Process (ANP) has been proposed to incorporate interdependence and feedback effect in the prioritization of remedial countermeasures using a hierarchical network decision model, but this approach seems to be incapable of capturing the vagueness and fuzziness during value judgment elicitation. The aim of this paper is to present an evaluation method using a fuzzy ANP (FANP) approach to address this shortcoming. Triangular fuzzy numbers (TFN) and their degree of fuzziness are used in the semantic scale as human judgment expressed in natural language is most often vague and fuzzy. The method employs the alpha-cuts, interval arithmetic and optimism index to transform the fuzzy comparative judgment matrix into set of crisp matrices, and then calculates the desired priorities using the eigenvector method. A numerical example, which was drawn from a real-life case study of an uncontrolled landfill in Japan, is presented to demonstrate the process. Results from the sensitivity analysis describe how the fuzziness in judgment could affect the solution robustness of the prioritization method. The proposed FANP approach therefore could effectively deal with the uncertain judgment inherent in the decision making process and derive the meaningful priorities explicitly from a complex decision structure in the evaluation of contaminated site remedial countermeasures.

  18. Dental conditions in inpatients with schizophrenia: A large-scale multi-site survey

    Science.gov (United States)

    2012-01-01

    Background Clinical relevance of dental caries is often underestimated in patients with schizophrenia. The objective of this study was to examine dental caries and to identify clinical and demographic variables associated with poor dental condition in patients with schizophrenia. Methods Inpatients with schizophrenia received a visual oral examination of their dental caries, using the decayed-missing-filled teeth (DMFT) index. This study was conducted in multiple sites in Japan, between October and December, 2010. A univariate general linear model was used to examine the effects of the following variables on the DMFT score: age, sex, smoking status, daily intake of sweets, dry mouth, frequency of daily tooth brushing, tremor, the Clinical Global Impression-Schizophrenia Overall severity score, and the Cumulative Illness Rating Scale for Geriatrics score. Results 523 patients were included in this study (mean ± SD age = 55.6 ± 13.4 years; 297 men). A univariate general linear model showed significant effects of age group, smoking, frequency of daily tooth brushing, and tremor (all p’s dental condition has been related with an increased risk of physical co-morbidities, physicians should be aware of patients’ dental status, especially for aged smoking patients with schizophrenia. Furthermore, for schizophrenia patients who do not regularly brush their teeth or who exhibit tremor, it may be advisable for caregivers to encourage and help them to perform tooth brushing more frequently. PMID:22901247

  19. A multi-site controlled trial of a cognitive skills program for mentally disordered offenders

    Directory of Open Access Journals (Sweden)

    Rees-Jones Angharad

    2012-05-01

    Full Text Available Abstract Background The effectiveness of offending behaviour programs in forensic mental health settings is not well established. Thus this study aimed to evaluate the Reasoning and Rehabilitation Mental Health program (R&R2 MHP among a mentally disordered offender (MDO population. Methods A sample of 121 adult males drawn from 10 forensic mental health sites completed questionnaires at baseline and post-treatment to assess violent attitudes, locus of control, social problem-solving and anger. An informant measure of social and psychological functioning, including disruptive behaviour, was completed by unit staff at the same time. At three month follow-up patients completed again the violent attitudes and locus of control questionnaires. The data of 67 patients who participated in the group condition were compared with 54 waiting-list controls who received treatment as usual. Results 78% of group participants completed the program. In contrast to controls, significant treatment effects were found at outcome on self-reported measures of violent attitudes, rational problem-solving and anger cognitions. Improvements were endorsed by informant ratings of social and psychological functioning within the establishments. At follow-up significant treatment effects were found for both violent attitudes and locus of control. Conclusions R&R2 MHP was effective in a sample of MDOs and had a comparatively low drop-out rate. Future research should use a randomized controlled design.

  20. Integration Site and Clonal Expansion in Human Chronic Retroviral Infection and Gene Therapy

    Science.gov (United States)

    Niederer, Heather A.; Bangham, Charles R. M.

    2014-01-01

    Retroviral vectors have been successfully used therapeutically to restore expression of genes in a range of single-gene diseases, including several primary immunodeficiency disorders. Although clinical trials have shown remarkable results, there have also been a number of severe adverse events involving malignant outgrowth of a transformed clonal population. This clonal expansion is influenced by the integration site profile of the viral integrase, the transgene expressed, and the effect of the viral promoters on the neighbouring host genome. Infection with the pathogenic human retrovirus HTLV-1 also causes clonal expansion of cells containing an integrated HTLV-1 provirus. Although the majority of HTLV-1-infected people remain asymptomatic, up to 5% develop an aggressive T cell malignancy. In this review we discuss recent findings on the role of the genomic integration site in determining the clonality and the potential for malignant transformation of cells carrying integrated HTLV-1 or gene therapy vectors, and how these results have contributed to the understanding of HTLV-1 pathogenesis and to improvements in gene therapy vector safety. PMID:25365582

  1. A Randomized Trial of Off-Site Collaborative Care for Depression in Chronic Hepatitis C Virus.

    Science.gov (United States)

    Kanwal, Fasiha; Pyne, Jeffrey M; Tavakoli-Tabasi, Shahriar; Nicholson, Susan; Dieckgraefe, Brian; Storay, Erma; Goetz, Matthew Bidwell; Kramer, Jennifer R; Smith, Donna; Sansgiry, Shubhada; Tansel, Aylin; Gifford, Allen L; Asch, Steven M

    2017-09-11

    To test the effectiveness of a collaborative depression care model in improving depression and hepatitis C virus (HCV) care. Hepatitis C virus clinic patients who screened positive for depression at four Veterans Affairs Hospitals. We compared off-site depression collaborative care (delivered by depression care manager, pharmacist, and psychiatrist) with usual care in a randomized trial. Primary depression outcomes were treatment response (≥50 percent decrease in 20-item Hopkins Symptoms Checklist [SCL-20] score), remission (mean SCL-20 score, DFDs). Primary HCV outcome was receipt of HCV treatment. Patient data were collected by self-report telephone surveys at baseline and 12 months, and from electronic medical records. Baseline screening identified 292 HCV-infected patients with depression, and 242 patients completed 12-month follow-up (82.9 percent). Intervention participants were more likely to report depression treatment response, remission, and more DFDs than usual care participants. Intervention participants were more likely to receive antiviral treatment; however, the difference was not statistically significant. Off-site depression collaborative care improved depression outcomes in HCV patients and may serve as a model for collaboration between mental health and specialty physical health providers in other high co-occurring conditions. © Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  2. 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.

  3. Dental conditions in inpatients with schizophrenia: A large-scale multi-site survey

    Directory of Open Access Journals (Sweden)

    Tani Hideaki

    2012-08-01

    Full Text Available Abstract Background Clinical relevance of dental caries is often underestimated in patients with schizophrenia. The objective of this study was to examine dental caries and to identify clinical and demographic variables associated with poor dental condition in patients with schizophrenia. Methods Inpatients with schizophrenia received a visual oral examination of their dental caries, using the decayed-missing-filled teeth (DMFT index. This study was conducted in multiple sites in Japan, between October and December, 2010. A univariate general linear model was used to examine the effects of the following variables on the DMFT score: age, sex, smoking status, daily intake of sweets, dry mouth, frequency of daily tooth brushing, tremor, the Clinical Global Impression-Schizophrenia Overall severity score, and the Cumulative Illness Rating Scale for Geriatrics score. Results 523 patients were included in this study (mean ± SD age = 55.6 ± 13.4 years; 297 men. A univariate general linear model showed significant effects of age group, smoking, frequency of daily tooth brushing, and tremor (all p’s (23, 483 = 3.55, p 2 = 0.42 . In other words, older age, smoking, tremor burden, and less frequent tooth brushing were associated with a greater DMFT score. Conclusions Given that poor dental condition has been related with an increased risk of physical co-morbidities, physicians should be aware of patients’ dental status, especially for aged smoking patients with schizophrenia. Furthermore, for schizophrenia patients who do not regularly brush their teeth or who exhibit tremor, it may be advisable for caregivers to encourage and help them to perform tooth brushing more frequently.

  4. CHRONIC ZINC SCREENING WATER EFFECT RATIO FOR THE H-12 OUTFALL, SAVANNAH RIVER SITE

    Energy Technology Data Exchange (ETDEWEB)

    Coughlin, D.; Looney, B.; Millings, M.

    2009-01-13

    In response to proposed Zn limits for the NPDES outfall H-12, a Zn screening Water Effects Ratio (WER) study was conducted to determine if a full site-specific WER is warranted. Using standard assumptions for relating the lab results to the stream, the screening WER data were consistent with the proposed Zn limit and suggest that a full WER would result in a similar limit. Addition of a humate amendment to the outfall water reduced Zn toxicity, but the toxicity reduction was relatively small and unlikely to impact proposed Zn limits. The screening WER data indicated that the time and expense required to perform a full WER for Zn is not warranted.

  5. Quality assurance of data collection in the multi-site community randomized trial and prevalence survey of the children?s healthy living program

    OpenAIRE

    Yamanaka, Ashley; Fialkowski, Marie Kainoa; Wilkens, Lynne; Li, Fenfang; Ettienne, Reynolette; Fleming, Travis; Power, Julianne; DEENIK, JONATHAN; Coleman, Patricia; Leon Guerrero, Rachael; Novotny, Rachel

    2016-01-01

    Background Quality assurance plays an important role in research by assuring data integrity, and thus, valid study results. We aim to describe and share the results of the quality assurance process used to guide the data collection process in a multi-site childhood obesity prevalence study and intervention trial across the US Affiliated Pacific Region. Methods Quality assurance assessments following a standardized protocol were conducted by one assessor in every participating site. Results we...

  6. Multi-Site Application of the Geomechanical Approach for Natural Fracture Exploration

    Energy Technology Data Exchange (ETDEWEB)

    R. L. Billingsley; V. Kuuskraa

    2006-03-31

    In order to predict the nature and distribution of natural fracturing, Advanced Resources Inc. (ARI) incorporated concepts of rock mechanics, geologic history, and local geology into a geomechanical approach for natural fracture prediction within mildly deformed, tight (low-permeability) gas reservoirs. Under the auspices of this project, ARI utilized and refined this approach in tight gas reservoir characterization and exploratory activities in three basins: the Piceance, Wind River and the Anadarko. The primary focus of this report is the knowledge gained on natural fractural prediction along with practical applications for enhancing gas recovery and commerciality. Of importance to tight formation gas production are two broad categories of natural fractures: (1) shear related natural fractures and (2) extensional (opening mode) natural fractures. While arising from different origins this natural fracture type differentiation based on morphology is sometimes inter related. Predicting fracture distribution successfully is largely a function of collecting and understanding the available relevant data in conjunction with a methodology appropriate to the fracture origin. Initially ARI envisioned the geomechanical approach to natural fracture prediction as the use of elastic rock mechanics methods to project the nature and distribution of natural fracturing within mildly deformed, tight (low permeability) gas reservoirs. Technical issues and inconsistencies during the project prompted re-evaluation of these initial assumptions. ARI's philosophy for the geomechanical tools was one of heuristic development through field site testing and iterative enhancements to make it a better tool. The technology and underlying concepts were refined considerably during the course of the project. As with any new tool, there was a substantial learning curve. Through a heuristic approach, addressing these discoveries with additional software and concepts resulted in a stronger set

  7. 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

  8. 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…

  9. Post Admission Cognitive Therapy (PACT) for the Inpatient Treatment of Military Personnel with Suicidal Behaviors: A Multi-Site Randomized Controlled Trial

    Science.gov (United States)

    2013-02-01

    0106 TITLE: Post Admission Cognitive Therapy (PACT) for the Inpatient Treatment of Military Personnel with Suicidal Behaviors : A Multi- Site...evaluate the efficacy of a cognitive behavioral intervention, titled, Post Admission Cognitive Therapy (PACT), for military personnel psychiatrically...EUC) or (2) EUC. The PACT+EUC condition will consist of six 60-90 minute individual cognitive behavioral therapy sessions administered over

  10. The Setting-up of Multi-Site School Collaboratives: The Benefits of This Organizational Reform in Terms of Networking Opportunities and Their Effects

    Science.gov (United States)

    Mifsud, Denise

    2015-01-01

    This article, which is set within the Maltese education scenario of unfolding decentralization through the setting-up of multi-site school collaboratives (legally termed "colleges") via a policy mandate, explores a particular aspect of this reform--that of "networking". This is examined in terms of the potential for…

  11. 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.

  12. Sites of peripheral artery occlusive disease as a predictor for all-cause and cardiovascular mortality in chronic hemodialysis.

    Directory of Open Access Journals (Sweden)

    Ming-Hsien Tsai

    Full Text Available The ankle-brachial blood pressure (BP index (ABI not only indicates the presence of peripheral artery occlusive disease (PAOD but predicts mortality in patients undergoing hemodialysis (HD. However, whether the site of PAOD can provide additional contribution to predicting mortality have not been investigated yet. Our primary objective was to determine the associations between the site of PAOD and all-cause and cardiovascular mortality in chronic HD (CHD patients.A retrospective cohort study was conducted to evaluate 444 Taiwanese CHD patients between December 2006 and June 2013. The site of PAOD together with other explanatory variables such as demographic data, body mass index, a history of cardiovascular diseases, HD vintage, biochemical data, and cardiothoracic ratio (CTR were assessed by the Cox proportional hazards regression model.The frequency of PAOD was 14.6% in both legs, 4.9% in the right side only, and 5.1% in the left side only. During the study period, 127 all-cause and 93 cardiovascular deaths occurred. PAOD site was found to have significant predictive power for all-cause mortality with the order of 3.04 (95% CI: 1.56-5.90 hazard ratio on the right side, 2.48 (95% CI: 1.27-4.82 on the left side, and 4.11 (95% CI: 2.76-6.13 on both sides. The corresponding figures for cardiovascular mortality were 3.81 (95% CI: 1.87-7.76 on the right side, 2.76 (95% CI: 1.30-5.82 on the left side, and 3.95 (95% CI: 2.45-6.36 on both sides. After adjustment for other explanatory variables, only right-sided PAOD still remained to have significant predictive power for all-cause and cardiovascular mortality and bilateral PAOD kept the significant association with all-cause mortality.The site of PAOD revealed various predictive powers for all-cause and cardiovascular mortality in CHD patients and only right-sided PAOD remained an independent predictor for both types of mortality making allowance for relevant confounding factors.

  13. Sites of peripheral artery occlusive disease as a predictor for all-cause and cardiovascular mortality in chronic hemodialysis.

    Science.gov (United States)

    Tsai, Ming-Hsien; Liou, Hung-Hsiang; Leu, Jyh-Gang; Yen, Ming-Fang; Chen, Hsiu-Hsi

    2015-01-01

    The ankle-brachial blood pressure (BP) index (ABI) not only indicates the presence of peripheral artery occlusive disease (PAOD) but predicts mortality in patients undergoing hemodialysis (HD). However, whether the site of PAOD can provide additional contribution to predicting mortality have not been investigated yet. Our primary objective was to determine the associations between the site of PAOD and all-cause and cardiovascular mortality in chronic HD (CHD) patients. A retrospective cohort study was conducted to evaluate 444 Taiwanese CHD patients between December 2006 and June 2013. The site of PAOD together with other explanatory variables such as demographic data, body mass index, a history of cardiovascular diseases, HD vintage, biochemical data, and cardiothoracic ratio (CTR) were assessed by the Cox proportional hazards regression model. The frequency of PAOD was 14.6% in both legs, 4.9% in the right side only, and 5.1% in the left side only. During the study period, 127 all-cause and 93 cardiovascular deaths occurred. PAOD site was found to have significant predictive power for all-cause mortality with the order of 3.04 (95% CI: 1.56-5.90) hazard ratio on the right side, 2.48 (95% CI: 1.27-4.82) on the left side, and 4.11 (95% CI: 2.76-6.13) on both sides. The corresponding figures for cardiovascular mortality were 3.81 (95% CI: 1.87-7.76) on the right side, 2.76 (95% CI: 1.30-5.82) on the left side, and 3.95 (95% CI: 2.45-6.36) on both sides. After adjustment for other explanatory variables, only right-sided PAOD still remained to have significant predictive power for all-cause and cardiovascular mortality and bilateral PAOD kept the significant association with all-cause mortality. The site of PAOD revealed various predictive powers for all-cause and cardiovascular mortality in CHD patients and only right-sided PAOD remained an independent predictor for both types of mortality making allowance for relevant confounding factors.

  14. 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.

  15. Responsiveness of the Eating Disorders Quality of Life Scale (EDQLS in a longitudinal multi-site sample

    Directory of Open Access Journals (Sweden)

    Adair Carol E

    2010-08-01

    Full Text Available Abstract Background In eating disorders (EDs, treatment outcome measurement has traditionally focused on symptom reduction rather than functioning or quality of life (QoL. The Eating Disorders Quality of Life Scale (EDQLS was recently developed to allow for measurement of broader outcomes. We examined responsiveness of the EDQLS in a longitudinal multi-site study. Methods The EDQLS and comparator generic QoL scales were collected in person at baseline, and 3 and 6 months from 130 participants (mean age 25.6 years; range 14-60 in 12 treatment programs in four Canadian provinces. Total score differences across the time points and responsiveness were examined using both anchor- and distribution-based methods. Results 98 (75% and 85 (65% responses were received at 3 and 6 months respectively. No statistically significant differences were found between the baseline sample and those lost to follow-up on any measured characteristic. Mean EDQLS total scores increased from 110 (SD = 24 to 124.5 (SD = 29 at 3 months and 129 (SD = 28 at 6 months, and the difference by time was tested using a general linear model (GLM to account for repeated measurement (p Conclusions The EDQLS is responsive to change in geographically diverse and clinically heterogeneous programs over a relatively short time period in adolescents and adults. It shows promise as an outcome measure for both research and clinical practice.

  16. Multi-Site Simultaneous Time-Resolved Photometry with a Low Cost Electro-Optics System †

    Science.gov (United States)

    Gasdia, Forrest; Barjatya, Aroh; Bilardi, Sergei

    2017-01-01

    Sunlight reflected off of resident space objects can be used as an optical signal for astrometric orbit determination and for deducing geometric information about the object. With the increasing population of small satellites and debris in low Earth orbit, photometry is a powerful tool in operational support of space missions, whether for anomaly resolution or object identification. To accurately determine size, shape, spin rate, status of deployables, or attitude information of an unresolved resident space object, multi-hertz sample rate photometry is required to capture the relatively rapid changes in brightness that these objects can exhibit. OSCOM, which stands for Optical tracking and Spectral characterization of CubeSats for Operational Missions, is a low cost and portable telescope system capable of time-resolved small satellite photometry, and is field deployable on short notice for simultaneous observation from multiple sites. We present the electro-optical design principles behind OSCOM and light curves of the 1.5 U DICE-2 CubeSat and simultaneous observations of the main body of the ASTRO-H satellite after its fragmentation event. PMID:28556802

  17. Two-year results of a prospective, multi-site investigation of patient satisfaction and psychosocial status following cosmetic surgery.

    Science.gov (United States)

    Sarwer, David B; Infield, Alison L; Baker, James L; Casas, Laurie A; Glat, Paul M; Gold, Alan H; Jewell, Mark L; Larossa, Don; Nahai, Foad; Young, V Leroy

    2008-01-01

    The number of cosmetic surgical and nonsurgical procedures performed in the United States has increased by 500% over the past 10 years. Most studies of psychosocial functioning following aesthetic procedures have reported high levels of patient satisfaction and improved functioning; however, nearly all these studies focused only on changes during the first posttreatment year. This paper reports on the 2-year results of a prospective, multi-site investigation of postoperative satisfaction and changes in psychosocial status following cosmetic surgery. One hundred patients from 8 surgical practices completed psychometric measures of body image, depressive symptoms, and self-esteem before surgery. Patients completed the same measures again at 3, 6, 12, and 24 months postoperatively. In addition, they reported their postoperative satisfaction as well as self-rated attractiveness at the 4 postoperative assessment points. Patients reported improvements in their overall appearance and body image, the appearance of and their degree of dissatisfaction with the feature altered by surgery, and the frequency of negative body image emotions in specific social situations through 24 months after surgery. These improvements were first evident at 3 months postoperatively and were maintained, without deterioration, through 2 years following surgery. Patients reported high rates of satisfaction and improvements in body image within the first 3 months of cosmetic surgery. These improvements were well maintained through the first 2 postoperative years.

  18. Aircraft Field Exercise to Develop Multi-Spectral and Infrared Imaging for CTBT On-Site Inspections

    Energy Technology Data Exchange (ETDEWEB)

    Henderson, J R [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Smith, M O [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Zelinski, M E [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2010-08-23

    The Comprehensive Test Ban Treaty (CTBT) permits Multi-Spectral and InfraRed Imaging (MSIR) to be performed as part of an On-Site Inspection (OSI) for the purpose of reducing the search area for the location of a possible underground nuclear explosion (UNE). Dedicated airborne MSIR measurements have not been made in conjunction with historical or recent UNE’s. Satellite data has been used to show that MSIR observables can be used to reduce the search area, but the satellite data do not have the spatial resolution or spectral and thermal capabilities desired to fully characterize the MSIR observables. Consequently, there is insufficient information currently available to confidently specify an MSIR instrument to be used on an Additional Overflight as part of an OSI. The potential MSIR observables are known, but not well characterized. The possibility of using airborne MSIR measurements to characterize some of those observables has been assessed here for a variety of field exercise scenarios. The main challenge in making aircraft measurements is to have confidence that the field conditions will accurately reproduce the MSIR observable compared to a UNE. The four types of events expected to generate relevant MSIR observables are (1) underground coal fires, (2) road traffic measurements, (3) underground mining operations, and (4) certain carefully staged explosions, such as the Source Physics Experiment.

  19. MultiSite Gateway-Compatible Cell Type-Specific Gene-Inducible System for Plants1[OPEN

    Science.gov (United States)

    Siligato, Riccardo; Wang, Xin; Yadav, Shri Ram; Lehesranta, Satu; Ma, Guojie; Ursache, Robertas; Sevilem, Iris; Zhang, Jing; Gorte, Maartje; Prasad, Kalika; Heidstra, Renze

    2016-01-01

    A powerful method to study gene function is expression or overexpression in an inducible, cell type-specific system followed by observation of consequent phenotypic changes and visualization of linked reporters in the target tissue. Multiple inducible gene overexpression systems have been developed for plants, but very few of these combine plant selection markers, control of expression domains, access to multiple promoters and protein fusion reporters, chemical induction, and high-throughput cloning capabilities. Here, we introduce a MultiSite Gateway-compatible inducible system for Arabidopsis (Arabidopsis thaliana) plants that provides the capability to generate such constructs in a single cloning step. The system is based on the tightly controlled, estrogen-inducible XVE system. We demonstrate that the transformants generated with this system exhibit the expected cell type-specific expression, similar to what is observed with constitutively expressed native promoters. With this new system, cloning of inducible constructs is no longer limited to a few special cases but can be used as a standard approach when gene function is studied. In addition, we present a set of entry clones consisting of histochemical and fluorescent reporter variants designed for gene and promoter expression studies. PMID:26644504

  20. In-situ stress measurements at DOE's Multi-Well Experiment site, Mesaverde group, Rifle, Colorado

    Energy Technology Data Exchange (ETDEWEB)

    Warpinski, N.R.; Branagan, P.; Wilmer, R.

    1983-10-01

    Measurements of the vertical distribution of the minimum principal in-situ stress in the lower Mesaverde group (7300-8100 ft depth, 2225-2470 m) at DOE's Multi-Well Experiment site have been made by conducting small-volume, hydraulic-fracture stress tests through perforations. Accurate, reproducible results were obtained by conducting a number of repeat injections in each zone of interest using a specially designed pump system, modified high-resolution electronic equipment, and a down-hole shut-off tool with a bottom-hole pressure transducer. Stress tests were conducted in marine sandstones and shales as well as a coal, mudstone, and sandstone in a paludal depositional environment; these tests provide a detailed stress distribution in this region. The stress magnitudes were found to be dependent on lithology. Marine shales above and below the blanket sands have large horizontal stresses-near lithostatic with a frac gradient greater than 1.0 psi/ft (23 kPa/m). This indicates that these rocks do not behave elastically and processes such as creep and possibly fracturing are the dominant mechanisms controlling the stress state. On the other hand, sandstones and siltstones have much lower stresses with a frac gradient of 0.85-0.9 psi/ft (19-20 kPa/m). Containment of hydraulic fractures would be expected under these conditions.

  1. a Multi-Data Source and Multi-Sensor Approach for the 3d Reconstruction and Visualization of a Complex Archaelogical Site: the Case Study of Tolmo de Minateda

    Science.gov (United States)

    Torres-Martínez, J. A.; Seddaiu, M.; Rodríguez-Gonzálvez, P.; Hernández-López, D.; González-Aguilera, D.

    2015-02-01

    The complexity of archaeological sites hinders to get an integral modelling using the actual Geomatic techniques (i.e. aerial, closerange photogrammetry and terrestrial laser scanner) individually, so a multi-sensor approach is proposed as the best 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 dataset 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. Last but not least, safeguarding of tangible archaeological heritage and its associated intangible expressions entails a multi-source data approach in which heterogeneous material (historical documents, drawings, archaeological techniques, habit of living, etc.) should be collected and combined with the resulting hybrid 3D of "Tolmo de Minateda" located models. The proposed multi-data source and multi-sensor approach is applied to the study case of "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. In addition, the own defensive nature of the site (i.e. with the presence of three different defensive walls) together with the considerable stratification of the archaeological site (i.e. with different archaeological surfaces and constructive typologies) require that tangible and intangible archaeological heritage expressions can be integrated with the hybrid 3D models obtained, to analyse, understand and exploit the archaeological site by different experts and heritage stakeholders.

  2. A multi-resolution model to capture both global fluctuations of an enzyme and molecular recognition in the ligand-binding site

    CERN Document Server

    Fogarty, Aoife C; Kremer, Kurt

    2016-01-01

    In multi-resolution simulations, different system components are simultaneously modelled at different levels of resolution, these being smoothly coupled together. In the case of enzyme systems, computationally expensive atomistic detail is needed in the active site to capture the chemistry of substrate binding. Global properties of the rest of the protein also play an essential role, determining the structure and fluctuations of the binding site; however, these can be modelled on a coarser level. Similarly, in the most computationally efficient scheme only the solvent hydrating the active site requires atomistic detail. We present a methodology to couple atomistic and coarse-grained protein models, while solvating the atomistic part of the protein in atomistic water. This allows a free choice of which protein and solvent degrees of freedom to include atomistically, without loss of accuracy in the atomistic description. This multi-resolution methodology can successfully model stable ligand binding, and we furt...

  3. The development and implementation of the national evaluation strategy of Access to Care, a multi-site linkage to care initiative in the United States.

    Science.gov (United States)

    Kim, Jeeyon Janet; Maulsby, Cathy; Kinsky, Suzanne; Riordan, Maura; Charles, Vignetta; Jain, Kriti; Holtgrave, David R

    2014-10-01

    The Access to Care (A2C) is a multi-site initiative that seeks to increase the access to and retention in effective HIV healthcare and support services by people living with HIV across the United States. As the initiative implemented evidence-based programs in new settings with diverse populations, it was important to document these innovative efforts to contribute to the evidence base for best practices. In a partnership between Johns Hopkins University, AIDS United, and the A2C sites, a national evaluation strategy was developed and implemented to build knowledge about how linkage to care interventions could be most effectively implemented within the context of local, real-world settings. This article provides an overview of the efforts to develop and implement a national monitoring and evaluation strategy for a multi-site initiative. The findings may be of utility for other HIV interventions that are seeking to incorporate a monitoring and evaluation component into their efforts.

  4. 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

    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 ...

  5. 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.

  6. Multi-site quality and variability analysis of 3D FDG PET segmentations based on phantom and clinical image data.

    Science.gov (United States)

    Beichel, Reinhard R; Smith, Brian J; Bauer, Christian; Ulrich, Ethan J; Ahmadvand, Payam; Budzevich, Mikalai M; Gillies, Robert J; Goldgof, Dmitry; Grkovski, Milan; Hamarneh, Ghassan; Huang, Qiao; Kinahan, Paul E; Laymon, Charles M; Mountz, James M; Muzi, John P; Muzi, Mark; Nehmeh, Sadek; Oborski, Matthew J; Tan, Yongqiang; Zhao, Binsheng; Sunderland, John J; Buatti, John M

    2017-02-01

    segmentation approaches was as follows. On the phantom test set, the mean relative volume errors ranged from 29.9 to 87.8% of the ground truth reference volumes, and the repeat difference for each institution ranged between -36.4 to 39.9%. On the HNC test set, the mean relative volume error ranged between -50.5 to 701.5%, and the repeat difference for each institution ranged between -37.7 to 31.5%. In addition, performance measures per phantom insert/lesion size categories are given in the paper. On phantom data, regression analysis resulted in coefficient of variation (CV) components of 42.5% for scanners, 26.8% for institutional approaches, 21.1% for repeated segmentations, 14.3% for relative contrasts, 5.3% for count statistics (acquisition times), and 0.0% for repeated scans. Analysis showed that the CV components for approaches and repeated segmentations were significantly larger on the HNC test set with increases by 112.7% and 102.4%, respectively. Analysis results underline the importance of PET scanner reconstruction harmonization and imaging protocol standardization for quantification of lesion volumes. In addition, to enable a distributed multi-site analysis of FDG PET images, harmonization of analysis approaches and operator training in combination with highly automated segmentation methods seems to be advisable. Future work will focus on quantifying the impact of segmentation variation on radiomics system performance. © 2016 American Association of Physicists in Medicine.

  7. A multi-site feasibility study to assess fever and wheezing in children after influenza vaccines using text messaging.

    Science.gov (United States)

    Stockwell, Melissa S; Marchant, Colin D; Wodi, A Patrica; Barnett, Elizabeth D; Broder, Karen R; Jakob, Kathleen; Lewis, Paige; Kattan, Meyer; Rezendes, Anne Marie; Barrett, Angela; Sharma, Devindra; Fernandez, Nadira; LaRussa, Philip

    2017-10-28

    Using text messaging for vaccine safety monitoring, particularly for non-medically attended events, would be valuable for pandemic influenza and emergency vaccination program preparedness. We assessed the feasibility and acceptability of text messaging to evaluate fever and wheezing post-influenza vaccination in a prospective, observational, multi-site pediatric study. Children aged 2-11 years old, with an emphasis on children with asthma, were recruited during the 2014-2015 influenza season from three community-based clinics in New York City, and during the 2014-2015 and 2015-2016 seasons from a private practice in Fall River, Massachusetts. Parents of enrolled children receiving quadrivalent live attenuated (LAIV4) or inactivated influenza vaccine (IIV4) replied to text messages assessing respiratory symptoms (day 3 and 7, then weekly through day 42), and temperature on the night of vaccination and the next seven nights (day 0-7). Missing data were collected via diary (day 0-7 only) and phone. Phone confirmation was obtained for both presence and absence of respiratory symptoms. Reporting rates, fever (T≥100.4 °F) frequency, proportion of wheezing and/or chest tightness reports captured via text message versus all sources (text, phone, diary, electronic health record) and parental satisfaction were assessed. Across both seasons, 266 children were analyzed; 49.2% with asthma. Parental text message response rates were high (>70%) across sites. Overall, fever frequency was low (day 0-2: 4.1% [95% confidence interval (CI) 2.3-7.4%]; d3-7: 6.7% [95% CI 4.1-10.8%]). A third (39.2%) of parents reported a respiratory problem in their child, primarily cough. Most (88.2%) of the 52 wheezing and/or chest tightness reports were by text message. Most (88.1%) participants preferred text messaging over paper reporting. Text messaging can provide information about pediatric post-vaccination fever and wheezing and was viewed positively by parents. It could be a helpful tool

  8. Site selection of wind power plant using multi-criteria decision-making methods in GIS: A case study

    Directory of Open Access Journals (Sweden)

    E. Chamanehpour

    2017-06-01

    Full Text Available Wind energy due to abundance, minimal environmental pollution and high cost-effectiveness are considered as one of the best clean energies. One of the most important issues in the use of wind energy is the correct layout of suitable extraction locations of wind energy to generate electricity. The suitablesite selection to establish wind power plants based on the principles and criteria of a sustainable environmental advancement which in addition to cost-effectiveness and employment generation results in a cheap and inexhaustible energy source besides providing the basic information to attract domestic as well as foreign investments to use the wind energy. In the present study, 16 information layer consisting of: wind speed, temperature, altitude, slope, towns, villages, main and secondary routes, airport, protected areas, land use, rivers, wells, springs and aqueducts, earthquake acceleration and faults was considered as the basic decision-making criteria. Using multi-criteria decision-making methods in GIS environment viz. Analytical Hierarchy Process (AHP and Fuzzy methods, modelling of the suitable extraction sites of wind energy was carried out. The results exhibited that the best regions that can be nestled in the excellent class include Zirkouh of Ghaen, east of Darmian, east of Sarbishe, north of Khoosf and east of Deyhouk. Considering the calculations of the present study, from the total case study area, 3.3% in AHP method and 4.5% in Fuzzy method had excellent potential to use wind energy. Finally, the area located in the north-west of Khoosf was proposed as the best area to establish the wind power plant.

  9. A Multi-Site Assessment of the ACSCOT Field Triage Decision Scheme for Identifying Seriously Injured Children and Adults

    Science.gov (United States)

    Newgard, Craig D; Zive, Dana; Holmes, James F; Bulger, Eileen M; Staudenmayer, Kristan; Liao, Michael; Rea, Thomas; Hsia, Renee Y; Wang, N Ewen; Fleischman, Ross; Jui, Jonathan; Mann, N Clay; Haukoos, Jason S; Sporer, Karl A; Gubler, K Dean; Hedges, Jerris R

    2011-01-01

    Background ACSCOT has developed and updated field trauma triage protocols for decades, yet the ability to identify major trauma patients remains unclear. We estimate the diagnostic value of the Field Triage Decision Scheme for identifying major trauma patients (Injury Severity Score [ISS] ≥ 16) in a large and diverse multi-site cohort. Study Design This was a retrospective cohort study of injured children and adults transported by 94 EMS agencies to 122 hospitals in 7 regions of the Western U.S. from 2006 through 2008. Patients who met any of the field trauma triage criteria (per EMS personnel) were considered triage positive. Hospital outcome measures were probabilistically linked to EMS records through trauma registries, state discharge data and emergency department data. The primary outcome defining a “major trauma patient” was ISS ≥ 16. Results 122,345 injured patients were evaluated and transported by EMS over the 3-year period, of who 34.5% met at least one triage criterion and 5.8% had ISS ≥ 16. The overall sensitivity and specificity of the criteria for identifying major trauma patients were 85.8% (95% CI 85.0 – 86.6%) and 68.7% (95% CI 68.4 – 68.9%). Triage sensitivity and specificity differed by age: 84.1% and 66.4% (0 – 17 years); 89.5% and 64.3% (18 – 54 years); and 79.9% and 75.4% (≥ 55 years). Evaluating the diagnostic value of triage by hospital destination (transport to Level I/II trauma centers) did not substantially improve these findings. Conclusions The sensitivity of the Field Triage Decision Scheme for identifying major trauma patients is lower and specificity higher than previously described, particularly among elders. PMID:22107917

  10. Efficacy of a Process Improvement Intervention on Inmate Awareness of HIV Services: A Multi-Site Trial.

    Science.gov (United States)

    Swan, Holly; Hiller, Matthew L; Albizu-García, Carmen E; Pich, Michele; Patterson, Yvonne; O'Connell, Daniel J

    2015-06-01

    The prevalence of HIV among U.S. inmates is much greater than in the general population, creating public health concerns and cost issues for the criminal justice system. The HIV Services and Treatment Implementation in Corrections protocol of the NIDA funded Criminal Justice Drug Abuse Treatment Studies cooperative tested the efficacy of an organizational process improvement strategy on improving HIV services in correctional facilities. For this paper, we analyzed efficacy of this strategy on improving inmate awareness and perceptions of HIV services. The study used a multi-site (n=28) clustered randomized trial approach. Facilities randomized to the experimental condition used a coach-driven local change team approach to improve HIV services at their facility. Facilities in the control condition were given a directive to improve HIV services on their own. Surveys about awareness and perceptions of HIV services were administered anonymously to inmates who were incarcerated in study facilities at baseline (n=1253) and follow-up (n=1048). A series of one-way ANOVAs were run to test whether there were differences between inmates in the experimental and control facilities at baseline and follow-up. Differences were observed at baseline, with the experimental group having significantly lower scores than the control group on key variables. But, at post-test, following the intervention, these differences were no longer significant. Taken in context of the findings from the main study, these results suggest that the change team approach to improving HIV services in correctional facilities is efficacious for improving inmates' awareness and perceptions of HIV services.

  11. In-situ stress measurements at DOE's Multi-Well Experiment site, Mesaverde Group, Rifle, CO

    Energy Technology Data Exchange (ETDEWEB)

    Warpinski, N.R.

    1983-01-01

    Measurements of the vertical distribution of the minimum principal in situ stress in the lower Mesaverde group (7300 to 8100 ft depth) at DOE's Multi-Well Experiment site have been made by conducting small-volume, hydraulic-fracture stress tests through perforations. Accurate, reproducible results were obtained by conducting a number of repeat injections in each zone of interest using a specially designed pump system, modified high-resolution electronic equipment, and a down-hole shut-off tool with a bottom-hole pressure transducer. Stress tests were conducted in marine sandstones and shales as well as a coal, mudstone, and sandstone in a paludal depositional environment; these tests provide a detailed stress distribution in this region. The stress magnitudes were found to be dependent on lithology. Marine shales above and below the blanket sands have large horizontal stress - near lithostatic with a frac gradient greater than 1.0 psi/ft (23 kPa/m). This indicates that these rocks do not behave elastically and processes such as creep and possibly fracturing are the dominant mechanisms controlling the stress state. On the other hand, sandstones and siltstones have much lower stresses with a frac gradient of 0.85 to 0.9 psi/ft (19 to 20 kPa/m). Containment of hydraulic fractures would be expected under these conditions. Only three data points were obtained from the paludal interval; no significant stress differences were observed in the different lithologies. 19 references, 8 figures, 1 table.

  12. Production of potent polyvalent antivenom against three elapid venoms using a low dose, low volume, multi-site immunization protocol.

    Science.gov (United States)

    Chotwiwatthanakun, C; Pratanaphon, R; Akesowan, S; Sriprapat, S; Ratanabanangkoon, K

    2001-10-01

    The purpose of this study was to prepare a potent polyvalent antivenom against three elapids namely, the Thai cobra (Naja kaouthia, NK), the King cobra (Ophiophagus hannah, OH) and the banded krait (Bungarus fasciatus, BF). Two groups of horses were immunized. Group 1, comprising five horses, was immunized twice with a mixture of postsynaptic neurotoxins followed by an additional six immunizations with a mixture of crude venoms of the three elapids. Group 2, comprising four horses, was immunized with a mixture of crude venoms throughout the course. For the first immunization, the immunogens were emulsified in Complete Freund's adjuvant and injected using a low dose, low volume multi-site immunization protocol previously developed in this laboratory (Pratanaphon, R., Akesowan, S., Khow, O., Sriprapat, S. and Ratanabanangkoon, K. (1997) Production of highly potent horse antivenom against the Thai cobra (Naja kaouthia). Vaccine 15, 1523-1528). The second immunization was carried out with the immunogens in Incomplete Freund's adjuvant. Blood was drawn to assay the antibody titer by ELISA. Sera at the peak of ELISA titers were pooled and assayed for the median effective dose (ED(50)). The ED(50)'s of antivenom from Group 1 horses against NK, OH and BF venoms were 1.44, 0.22 and 0.23 ml serum/mg venom, respectively, while those from Group 2 horse sera were 0.88, 0.20 and 0.49 ml serum/mg venom, respectively. The potency of sera from Group 2 against BF venom was significantly higher, while the potencies against NK and OH venoms were comparable to those of the corresponding monovalent antivenoms produced under the same protocol. This potent, truly polyvalent antivenom should be useful in saving lives of victims envenomed by these elapids and the immunization protocol should be useful in the production of potent polyvalent antivenoms against other medically important elapids.

  13. Evaluation of port site hernias, chronic pain and recurrence rates after laparoscopic ventral hernia repair: a monocentric long-term study.

    Science.gov (United States)

    Liot, Emilie; Bréguet, Romain; Piguet, Valérie; Ris, Frédéric; Volonté, Francesco; Morel, Philippe

    2017-12-01

    The aim of this study was to evaluate hernia appearance at the trocar site after laparoscopic treatment of primary or incisional ventral hernias using an intraperitoneal prosthetic mesh. Chronic pain at the trocar site and primary hernia recurrence were also evaluated. Two-hundred and twenty-six consecutive patients who underwent a standardized laparoscopic hernia repair for primary or incisional ventral hernia at our centre between January 2000 and December 2008 were included. All patients had clinical and radiological examinations. Primary end points were port site hernia and the occurrence of chronic trocar site pain. Secondary end point was primary hernia recurrence. Seventy-eight patients were excluded: 6 declined to participate, 48 were unreachable, and 24 did not meet the inclusion criteria (nine underwent a single site laparoscopic approach, ten died of unrelated disease, three were unable to visit the hospital and two had relocated). After exclusion, 148 remained in our study. Mean follow-up was 49 ± 12.6 months. Mean age at the time of surgery was 60 years (range, 28-83) In total, 504 port sites were clinically and radiologically evaluated, and only one (0.02%) had secondary herniation. Three patients (2.0%) had a recurrent hernia, and 14 (9.5%) had developed chronic pain at time of assessment. Nine patients (6.1%) were re-operated for the recurrent hernia before the follow-up evaluation. The overall recurrence rate is, therefore, 8.1%. Only two minor complications and no major complications occurred after surgery. No mortality was observed. Laparoscopic repair for primary or incisional ventral hernias is a safe surgical approach, with low rates of hernia recurrence and a low morbidity rate. When fascial closure is maintained for 10 mm port sites, the incidence of port site hernias is very low. Five millimetre ports do not require closure.

  14. Endothelial Microparticles in Mild Chronic Obstructive Pulmonary Disease and Emphysema. The Multi-Ethnic Study of Atherosclerosis Chronic Obstructive Pulmonary Disease Study

    OpenAIRE

    Thomashow, Michael A.; Shimbo, Daichi; Parikh, Megha A.; Hoffman, Eric A.; Vogel-Claussen, Jens; Hueper, Katja; Fu, Jessie; Liu, Chia-Ying; Bluemke, David A.; Ventetuolo, Corey E.; Doyle, Margaret F.; Barr, R. Graham

    2013-01-01

    Rationale: Basic research implicates alveolar endothelial cell apoptosis in the pathogenesis of chronic obstructive pulmonary disease (COPD) and emphysema. However, information on endothelial microparticles (EMPs) in mild COPD and emphysema is lacking.

  15. 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.

  16. 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

    of the facilities. Despite the conceptual and contextual differences PA behavior is also affected by cultural and social values related to the specific site which not alone can be explained by intrapersonal, interpersonal or organizational factors. Discussion: The Ecological Model of Four Domains of Active Living......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...... 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...

  17. Data on master regulators and transcription factor binding sites found by upstream analysis of multi-omics data on methotrexate resistance of colon cancer.

    Science.gov (United States)

    Kel, AlexanderE

    2017-02-01

    Computational analysis of master regulators through the search for transcription factor binding sites followed by analysis of signal transduction networks of a cell is a new approach of causal analysis of multi-omics data. This paper contains results on analysis of multi-omics data that include transcriptomics, proteomics and epigenomics data of methotrexate (MTX) resistant colon cancer cell line. The data were used for analysis of mechanisms of resistance and for prediction of potential drug targets and promising compounds for reverting the MTX resistance of these cancer cells. We present all results of the analysis including the lists of identified transcription factors and their binding sites in genome and the list of predicted master regulators - potential drug targets. This data was generated in the study recently published in the article "Multi-omics "Upstream Analysis" of regulatory genomic regions helps identifying targets against methotrexate resistance of colon cancer" (Kel et al., 2016) [4]. These data are of interest for researchers from the field of multi-omics data analysis and for biologists who are interested in identification of novel drug targets against NTX resistance.

  18. Multi-criteria GIS-based siting of transfer station for municipal solid waste: The case of Kumasi Metropolitan Area, Ghana.

    Science.gov (United States)

    Bosompem, Christian; Stemn, Eric; Fei-Baffoe, Bernard

    2016-10-01

    The increase in the quantity of municipal solid waste generated as a result of population growth in most urban areas has resulted in the difficulty of locating suitable land areas to be used as landfills. To curb this, waste transfer stations are used. The Kumasi Metropolitan Area, even though it has an engineered landfill, is faced with the problem of waste collection from the generation centres to the final disposal site. Thus in this study, multi-criteria decision analysis incorporated into a geographic information system was used to determine potential waste transfer station sites. The key result established 11 sites located within six different sub-metros. This result can be used by decision makers for site selection of the waste transfer stations after taking into account other relevant ecological and economic factors. © The Author(s) 2016.

  19. No “Magic Bullet”: Exploring Community Mobilization Strategies Used in a Multi-site Community Based Randomized Controlled Trial: Project Accept (HPTN 043)

    OpenAIRE

    Tedrow, Virginia A.; Zelaya, Carla E.; Kennedy, Caitlin E.; Morin, Stephen F.; Khumalo-Sakutukwa, Gertrude; Sweat, Michael D.; Celentano, David D.

    2012-01-01

    As community-level interventions become more common in HIV prevention, processes such as community mobilization (CM) are increasingly utilized in public health programs and research. Project Accept, a multi-site community randomized controlled trial, is testing the hypothesis that CM coupled with community-based mobile voluntary counseling and testing and post-test support services will alter community norms and reduce the incidence of HIV. By using a multiple-case study approach, this qualit...

  20. Validation and Analysis of a Multi-site MIS Prospective Registry Through Sub-analysis of an MIS TLIF Subgroup

    Science.gov (United States)

    Raiszadeh, Kamshad; Raiszadeh, Ramin; Kim, Paul; Doerr, Todd; Siddiqi, Farhan; LaMotta, Ivan; Park, Paul; Templin, Cary; Gill, Sandeep; Liang, Kevin; Kim, Choll W.

    2014-01-01

    Study Design Retrospective analysis of multi-site, prospectively collected database. Objective To assess the validity and utility of a prospective spine registry by sub-analysis of patients treated with MIS TLIF. Background The MIS registry is a large-scale, multi-center series of prospectively collected clinical information on outcomes, complications, and adverse events for minimally invasive spine procedures for the treatment of degenerative lumbar conditions. Methods Analysis was performed on the MIS Prospective Registry database. A subgroup of patients treated by MIS TLIF technique was identified. Statistical analyses were performed on pre and post-operative data collected using validated health related quality of life outcome tools. Missing 1-year patient follow-up data was obtained through progressive correspondence modalities. Results Data analysis was performed on 98 MIS TLIF patients (56 female, 42 male) with a median age of 64.5 years (range 25-91 years) which were extracted from a total registry population of 478 patients. The one year follow-up rate was 87%. A total of 64 single-level, 23 two-level, 3 three-level, and 3 combined TLIFs staged with an MIS lateral procedure were included. The primary surgical indications were spondylolisthesis (27%), central stenosis (25%), foraminal stenosis (14%), post-laminectomy syndrome (14%) and degenerative scoliosis (6%). The peri-operative blood transfusion rate was 3%. Complications included intraoperative dural tear (n = 3), deep wound infection (n = 2), superficial dehiscence/cellulitis (n = 2). There was a 4% re-operation rate at the 1 year post-operative time point. Half of patients were discharged within 2 days (range 1-11 days, mean 2.97 days, median 2 days). All patients that were discharged on the first post-operative day (n = 14) underwent a single-level MIS TLIF procedure and had significantly lower pre-op disability index score than those discharged on POD 3-5 (43.7 ± 15.5 vs. 56.0 ± 18.3, p = 0

  1. Evaluation of a nurse practitioner disease management model for chronic heart failure: a multi-site implementation study.

    Science.gov (United States)

    Lowery, Julie; Hopp, Faith; Subramanian, Usha; Wiitala, Wyndy; Welsh, Deborah E; Larkin, Angela; Stemmer, Karen; Zak, Cassandra; Vaitkevicius, Peter

    2012-01-01

    While disease management appears to be effective in selected, small groups of CHF patients from randomized controlled trials, its effectiveness in a broader CHF patient population is not known. This prospective, quasi-experimental study compared patient outcomes under a nurse practitioner-led disease management model (intervention group) with outcomes under usual care (control group) in both primary and tertiary medical centers. The study included 969 veterans (458 intervention, 511 control) treated for CHF at six VA medical centers. Intervention patients had significantly fewer (pmanagement models for CHF can be translated into clinical practice, even without the benefits of a selected patient population and dedicated resources often found in RCTs. © 2011 Wiley Periodicals, Inc.

  2. 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.

  3. Inter-professional differences in compliance with standard precautions in operating theatres: a multi-site, mixed methods study.

    Science.gov (United States)

    Cutter, Jayne; Jordan, Sue

    2012-08-01

    Occupational acquisition of blood-borne infections has been reported following exposure to blood or body fluids. Consistent adherence to standard precautions will reduce the risk of infection. To identify: the frequency of self-reported adverse exposure to blood and body fluids among surgeons and scrub nurses during surgical procedures; contributory factors to such injuries; the extent of compliance with standard precautions; and factors influencing compliance with precautions. A multi-site mixed methods study incorporating a cross-sectional survey and interviews. Six NHS trusts in Wales between January 2006 and August 2008. Surgeons and scrub nurses and Senior Infection Control Nurses. A postal survey to all surgeons and scrub nurses, who engaged in exposure prone procedures, followed by face to face interviews with surgeons and scrub nurses, and telephone interviews with Infection Control Nurses. Response rate was 51.47% (315/612). Most 219/315 (69.5%) respondents reported sustaining an inoculation injury in the last five years: 183/315 (58.1%) reported sharps' injuries and 40/315 (12.7%) splashes. Being a surgeon and believing injuries to be an occupational hazard were significantly associated with increased risk of sharps' injuries (adjusted odds ratio 1.73, 95% confidence interval 1.04-2.88 and adjusted odds ratio 2.0, 1.11-3.5, respectively). Compliance was incomplete: 31/315 (10%) respondents always complied with all available precautions, 1/315 (0.003%) claimed never to comply with any precautions; 64/293 (21.8%) always used safety devices, 141/310 (45.5%) eye protection, 72 (23.2%) double gloves, and 259/307 (84.4%) avoided passing sharps from hand to hand. Others selected precautions according to their own assessment of risk. Surgeons were less likely to adopt eye protection (adjusted odds ratio 0.28, 0.11-0.71) and to attend training sessions (odds ratio 0.111, 0.061-0.19). The professions viewed the risks associated with their roles differently, with

  4. Multi-linear regression analysis, preliminary biotic ligand modeling, and cross species comparison of the effects of water chemistry on chronic lead toxicity in invertebrates.

    Science.gov (United States)

    Esbaugh, A J; Brix, K V; Mager, E M; De Schamphelaere, K; Grosell, M

    2012-03-01

    The current study examined the chronic toxicity of lead (Pb) to three invertebrate species: the cladoceran Ceriodaphnia dubia, the snail Lymnaea stagnalis and the rotifer Philodina rapida. The test media consisted of natural waters from across North America, varying in pertinent water chemistry parameters including dissolved organic carbon (DOC), calcium, pH and total CO(2). Chronic toxicity was assessed using reproductive endpoints for C. dubia and P. rapida while growth was assessed for L. stagnalis, with chronic toxicity varying markedly according to water chemistry. A multi-linear regression (MLR) approach was used to identify the relative importance of individual water chemistry components in predicting chronic Pb toxicity for each species. DOC was an integral component of MLR models for C. dubia and L. stagnalis, but surprisingly had no predictive impact on chronic Pb toxicity for P. rapida. Furthermore, sodium and total CO(2) were also identified as important factors affecting C. dubia toxicity; no other factors were predictive for L. stagnalis. The Pb toxicity of P. rapida was predicted by calcium and pH. The predictive power of the C. dubia and L. stagnalis MLR models was generally similar to that of the current C. dubia BLM, with R(2) values of 0.55 and 0.82 for the respective MLR models, compared to 0.45 and 0.79 for the respective BLMs. In contrast the BLM poorly predicted P. rapida toxicity (R(2)=0.19), as compared to the MLR (R(2)=0.92). The cross species variability in the effects of water chemistry, especially with respect to rotifers, suggests that cross species modeling of invertebrate chronic Pb toxicity using a C. dubia model may not always be appropriate. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Skin and chest wall dose with multi-catheter and MammoSite breast brachytherapy: Implications for late toxicity.

    Science.gov (United States)

    Cuttino, Laurie W; Todor, Dorin; Rosu, Miheala; Arthur, Douglas W

    2009-01-01

    Accelerated partial breast irradiation (APBI) continues to increase in popularity. Up to 14% of patients treated with the MammoSite (MS) report some degree of chronic pain, which may be related to chest wall toxicity. Reports from several institutions using the multicatheter (MC) technique have not shown associated elevated chest wall toxicity. Additionally, a recent investigation has suggested that increased toxicity may occur with the MS when the dose to the chest wall exceeds 125% of the prescribed dose. This investigation compares the skin and chest wall doses of a cohort of patients treated with the MC technique to a group treated with the MS. The dosimetric data for 43 patients treated with the MC technique and 83 patients treated with the MS at Virginia Commonwealth University were reviewed. This cohort represents consecutively treated patients from our most recent experience to minimize any learning curve effect on dosimetry. Plans were generated using 3D software (Brachyvision, Varian Medical Systems, Inc., Palo Alto, CA). Multiple dwell positions were used for all MS patients to optimize dose delivery. The minimum distances from the planning target volume to the skin and chest wall were calculated, as well as the maximum doses delivered to the skin and chest wall. The mean skin distances for patients treated with the MC technique and the MS were 0.5 and 0.9cm, respectively (pskin distance, the mean skin dose for the MC technique was only 2.3Gy per fraction (67% of prescription dose). The mean skin dose for the MS was 3.2Gy per fraction (94% of prescription dose, pskin dose for the MS was 3.6Gy per fraction (105% of prescription dose, pskin doses in excess of 125% for the MC and MS were 0% and 9.6%, respectively. The percentage of patients receiving chest wall doses in excess of 125% for the MC and MS were 0% and 38.6%, respectively. The MC technique results in more conformal dose delivery, with significantly lower mean skin and chest wall doses. Treatment

  6. CCS Site Optimization by Applying a Multi-objective Evolutionary Algorithm to Semi-Analytical Leakage Models

    Science.gov (United States)

    Cody, B. M.; Gonzalez-Nicolas, A.; Bau, D. A.

    2011-12-01

    Carbon capture and storage (CCS) has been proposed as a method of reducing global carbon dioxide (CO2) emissions. Although CCS has the potential to greatly retard greenhouse gas loading to the atmosphere while cleaner, more sustainable energy solutions are developed, there is a possibility that sequestered CO2 may leak and intrude into and adversely affect groundwater resources. It has been reported [1] that, while CO2 intrusion typically does not directly threaten underground drinking water resources, it may cause secondary effects, such as the mobilization of hazardous inorganic constituents present in aquifer minerals and changes in pH values. These risks must be fully understood and minimized before CCS project implementation. Combined management of project resources and leakage risk is crucial for the implementation of CCS. In this work, we present a method of: (a) minimizing the total CCS cost, the summation of major project costs with the cost associated with CO2 leakage; and (b) maximizing the mass of injected CO2, for a given proposed sequestration site. Optimization decision variables include the number of CO2 injection wells, injection rates, and injection well locations. The capital and operational costs of injection wells are directly related to injection well depth, location, injection flow rate, and injection duration. The cost of leakage is directly related to the mass of CO2 leaked through weak areas, such as abandoned oil wells, in the cap rock layers overlying the injected formation. Additional constraints on fluid overpressure caused by CO2 injection are imposed to maintain predefined effective stress levels that prevent cap rock fracturing. Here, both mass leakage and fluid overpressure are estimated using two semi-analytical models based upon work by [2,3]. A multi-objective evolutionary algorithm coupled with these semi-analytical leakage flow models is used to determine Pareto-optimal trade-off sets giving minimum total cost vs. maximum mass

  7. Multi-scale Geophysical Signatures of Biogenic Calcite and FeS Precipitation Using Rifle as a Model Site

    Science.gov (United States)

    Wu, Y.; Ajo-Franklin, J.; Williams, K. H.; Hubbard, S. S.; Nico, P. S.

    2008-12-01

    In-situ remediation strategies are frequently considered for cleanup of DOE sites. However, the impact of induced biogeochemical transformations on remediation efficacy is not well understood. For example, the generation of remediation end-products, such as gas bubbles, precipitates, and biomass, can alter the porosity and permeability of the system, rendering it challenging to subsequently introduce amendments and/or altering the hydrobiogeochemical conditions favorable for sustained remediation. An understanding of how reaction processes modify the properties of the porous medium is critical to the design, execution, and interpretation of in-situ remediation approaches.Rent hydrogeophysical and biogeophysical studies have demonstrated the sensitivity of geophysical methods to hydrobiogeochemical processes and end products. Geophysical methods offer spatiotemporally dense geophysical data which, through combining with direct measurements, can provide a unique opportunity to better characterize biogeochemical processes/end products and their effects on the porous medium in multi-scale heterogeneous systems. Here, we present a study of synchrotron and column-based geophysical signatures of precipitates induced through biostimulation. Our experiments utilize material from the DOE Rifle, CO Integrated Field Research Challenge Site (IFC), where biostimulation experiments are underway to reduce and immobilize subsurface uranium contamination. At the Rifle IFC, calcite and iron sulfide are the two major end products during bioremediation. These two phases often precipitate simultaneously and are mixed together geometrically. We use two platforms to investigate the geophysical signatures of Rifle-based precipitates evolve in response to biostimulation. At the smallest scale, we conducted time-lapse synchrotron x-ray microtomography of Rifle sediments using Beamline 8.3.2 of the LBNL Advanced Light Source. The resolution of this approach permits investigation of pore

  8. Seasonal and Diel Vocalization Patterns of Antarctic Blue Whale (Balaenoptera musculus intermedia in the Southern Indian Ocean: A Multi-Year and Multi-Site Study.

    Directory of Open Access Journals (Sweden)

    Emmanuelle C Leroy

    Full Text Available Passive acoustic monitoring is an efficient way to provide insights on the ecology of large whales. This approach allows for long-term and species-specific monitoring over large areas. In this study, we examined six years (2010 to 2015 of continuous acoustic recordings at up to seven different locations in the Central and Southern Indian Basin to assess the peak periods of presence, seasonality and migration movements of Antarctic blue whales (Balaenoptera musculus intermedia. An automated method is used to detect the Antarctic blue whale stereotyped call, known as Z-call. Detection results are analyzed in terms of distribution, seasonal presence and diel pattern of emission at each site. Z-calls are detected year-round at each site, except for one located in the equatorial Indian Ocean, and display highly seasonal distribution. This seasonality is stable across years for every site, but varies between sites. Z-calls are mainly detected during autumn and spring at the subantarctic locations, suggesting that these sites are on the Antarctic blue whale migration routes, and mostly during winter at the subtropical sites. In addition to these seasonal trends, there is a significant diel pattern in Z-call emission, with more Z-calls in daytime than in nighttime. This diel pattern may be related to the blue whale feeding ecology.

  9. Seasonal and Diel Vocalization Patterns of Antarctic Blue Whale (Balaenoptera musculus intermedia) in the Southern Indian Ocean: A Multi-Year and Multi-Site Study.

    Science.gov (United States)

    Leroy, Emmanuelle C; Samaran, Flore; Bonnel, Julien; Royer, Jean-Yves

    2016-01-01

    Passive acoustic monitoring is an efficient way to provide insights on the ecology of large whales. This approach allows for long-term and species-specific monitoring over large areas. In this study, we examined six years (2010 to 2015) of continuous acoustic recordings at up to seven different locations in the Central and Southern Indian Basin to assess the peak periods of presence, seasonality and migration movements of Antarctic blue whales (Balaenoptera musculus intermedia). An automated method is used to detect the Antarctic blue whale stereotyped call, known as Z-call. Detection results are analyzed in terms of distribution, seasonal presence and diel pattern of emission at each site. Z-calls are detected year-round at each site, except for one located in the equatorial Indian Ocean, and display highly seasonal distribution. This seasonality is stable across years for every site, but varies between sites. Z-calls are mainly detected during autumn and spring at the subantarctic locations, suggesting that these sites are on the Antarctic blue whale migration routes, and mostly during winter at the subtropical sites. In addition to these seasonal trends, there is a significant diel pattern in Z-call emission, with more Z-calls in daytime than in nighttime. This diel pattern may be related to the blue whale feeding ecology.

  10. 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

  11. A proof-of-principle study of multi-site real-time functional imaging at 3T and 7T: Implementation and validation.

    Science.gov (United States)

    Baecke, Sebastian; Lützkendorf, Ralf; Mallow, Johannes; Luchtmann, Michael; Tempelmann, Claus; Stadler, Jörg; Bernarding, Johannes

    2015-02-12

    Real-time functional Magnetic Resonance Imaging (rtfMRI) is used mainly for neurofeedback or for brain-computer interfaces (BCI). But multi-site rtfMRI could in fact help in the application of new interactive paradigms such as the monitoring of mutual information flow or the controlling of objects in shared virtual environments. For that reason, a previously developed framework that provided an integrated control and data analysis of rtfMRI experiments was extended to enable multi-site rtfMRI. Important new components included a data exchange platform for analyzing the data of both MR scanners independently and/or jointly. Information related to brain activation can be displayed separately or in a shared view. However, a signal calibration procedure had to be developed and integrated in order to permit the connecting of sites that had different hardware and to account for different inter-individual brain activation levels. The framework was successfully validated in a proof-of-principle study with twelve volunteers. Thus the overall concept, the calibration of grossly differing signals, and BCI functionality on each site proved to work as required. To model interactions between brains in real-time, more complex rules utilizing mutual activation patterns could easily be implemented to allow for new kinds of social fMRI experiments.

  12. 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.

  13. 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

  14. Multi-level assessment of chronic toxicity of estuarine sediments with the amphipod Gammarus locusta: II. Organism and population-level endpoints.

    Science.gov (United States)

    Costa, Filipe O; Neuparth, Teresa; Correia, Ana D; Costa, Maria Helena

    2005-07-01

    This study aimed to test the performance of the amphipod Gammarus locusta (L.) in chronic sediment toxicity tests. It constitutes part of a multi-level assessment of chronic toxicity of estuarine sediments, integrating organism and population-level endpoints with biochemical markers responses. Here we account for organism and population-level effects, while biomarker responses were reported in a companion article. Five moderately contaminated sediments from Sado and Tagus estuaries were tested, comprising 3 muddy and 2 sandy sediments. These sediments either did not show acute toxicity or were diluted with control sediment as much as required to remove acute toxicity. Subsequent chronic tests consisted of 28-day exposures with survival, individual growth and reproductive traits as endpoints. Two of the muddy sediments induced higher growth rates in the amphipods, and improved reproductive traits. This was understood to be a consequence of the amount of organic matter in the sediment, which was nutritionally beneficial to the amphipods, while concurrently decreasing contaminant bioavailability. Biomarker responses did not reveal toxicant-induced stress in amphipods exposed to these sediments. One of the sandy sediments was acutely toxic at 50% dilution, but in contrast stimulated amphipod growth when diluted 75%. This was presumed to be an indication of a hormetic response. Finally the two remaining contaminated sediments showed pronounced chronic toxicity, affecting survival and reproduction. The sex ratio of survivors was highly biased towards females, and offspring production was severely impaired. The particulars of the responses of this amphipod were examined, as well as strengths versus limitations of the sediment test. This study illustrates the utility of this chronic test for toxicity assessment of contaminated estuarine sediments, with potential application all along Atlantic Europe.

  15. A crisis in chronic pain care: an ethical analysis. Part three: Toward an integrative, multi-disciplinary pain medicine built around the needs of the patient.

    Science.gov (United States)

    Giordano, James; Schatman, Michael E

    2008-01-01

    A number of variables have contributed to the current crisis in chronic pain care and are affected by, and affect, the philosophies and politics that influence the socio-economic climate of the American healthcare system. Thus, we posit that managing the crisis in chronic pain care in the United States is contingent upon the development of a multi-focal healthcare paradigm that more thoroughly enables and fortifies research, its translation (in education and practice), and the implementation of, and support for, both the curative and healing approaches in medicine in general, and pain care specifically. These steps necessitate re-examination, if not revision of the health care system and its economics. The ethical imperative to consider and prudently employ cutting-edge diagnostic and therapeutic technologies in pain medicine is obligatory. However, "supply side prudence" is of little value if "demand side accessibility" is lacking. Revisions to health insurance plans advocated by the in-coming administration seek to create uniformity in basic health care services based upon re-assessment of the clinical effectiveness (versus merely cost) of treatments, including those that are "high tech." These plans attempt to allow every patient a more complete ability to deliberatively work with physicians to access those services and resources that maximize health functioning and goals. But even given these revisions, authentic pain care must take into account the interactive contexts of the painient individual. The biopsychosocial model of chronic pain management may have significant practical and ethical worth in this regard. A system of pain treatment operating from a biopsychosocial perspective necessitates integrative multi-disciplinarity. We propose a tiered, multi-disciplinary paradigm based upon the differing needs of each specific patient. But establishing such a system does not guarantee access, and distribution of these services and resources requires economic

  16. Analysis of multi-site drug-protein interactions by high-performance affinity chromatography: Binding by glimepiride to normal or glycated human serum albumin.

    Science.gov (United States)

    Matsuda, Ryan; Li, Zhao; Zheng, Xiwei; Hage, David S

    2015-08-21

    High-performance affinity chromatography (HPAC) was used in a variety of formats to examine multi-site interactions between glimepiride, a third-generation sulfonylurea drug, and normal or in vitro glycated forms of the transport protein human serum albumin (HSA). Frontal analysis revealed that glimepiride interacts with normal HSA and glycated HSA at a group of high affinity sites (association equilibrium constant, or Ka, 9.2-11.8×10(5)M(-1) at pH 7.4 and 37°C) and a group of lower affinity regions (Ka, 5.9-16×10(3)M(-1)). Zonal elution competition studies were designed and carried out in both normal- and reversed-role formats to investigate the binding by this drug at specific sites. These experiments indicated that glimepiride was interacting at both Sudlow sites I and II. Allosteric effects were also noted with R-warfarin at Sudlow site I and with tamoxifen at the tamoxifen site on HSA. The binding at Sudlow site I had a 2.1- to 2.3-fold increase in affinity in going from normal HSA to the glycated samples of HSA. There was no significant change in the affinity for glimepiride at Sudlow site II in going from normal HSA to a moderately glycated sample of HSA, but a slight decrease in affinity was seen in going to a more highly glycated HSA sample. These results demonstrated how various HPAC-based methods can be used to profile and characterize multi-site binding by a drug such as glimepiride to a protein and its modified forms. The information obtained from this study should be useful in providing a better understanding of how drug-protein binding may be affected by glycation and of how separation and analysis methods based on HPAC can be employed to study systems with complex interactions or that involve modified proteins. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Quality assurance of data collection in the multi-site community randomized trial and prevalence survey of the children's healthy living program.

    Science.gov (United States)

    Yamanaka, Ashley; Fialkowski, Marie Kainoa; Wilkens, Lynne; Li, Fenfang; Ettienne, Reynolette; Fleming, Travis; Power, Julianne; Deenik, Jonathan; Coleman, Patricia; Leon Guerrero, Rachael; Novotny, Rachel

    2016-09-02

    Quality assurance plays an important role in research by assuring data integrity, and thus, valid study results. We aim to describe and share the results of the quality assurance process used to guide the data collection process in a multi-site childhood obesity prevalence study and intervention trial across the US Affiliated Pacific Region. Quality assurance assessments following a standardized protocol were conducted by one assessor in every participating site. Results were summarized to examine and align the implementation of protocol procedures across diverse settings. Data collection protocols focused on food and physical activity were adhered to closely; however, protocols for handling completed forms and ensuring data security showed more variability. Quality assurance protocols are common in the clinical literature but are limited in multi-site community-based studies, especially in underserved populations. The reduction in the number of QA problems found in the second as compared to the first data collection periods for the intervention study attest to the value of this assessment. This paper can serve as a reference for similar studies wishing to implement quality assurance protocols of the data collection process to preserve data integrity and enhance the validity of study findings. NIH clinical trial #NCT01881373.

  18. Coprescribing naloxone for patients on chronic opioid therapy: Les-sons learned from a patient-safety initiative in primary care training sites.

    Science.gov (United States)

    Delaney, William; Huff, Jessica; Mini, Sandra; Thomas, Aiswarya; Tremaglio, Ralph

    To describe the development and implementation of a resident-led effort to increase coprescription of naloxone in a primary care setting. An exploratory, prospective pilot project to increase coprescription rates of naloxone. Four primary care offices in western Connecticut serving as medical home training sites for primary care residents. All patients on chronic opioid therapy. Over a 2-month period, eligible patients were identified and approached to receive a naloxone coprescription. Rate of coprescriptions written. Three out of four training sites were able to increase coprescription rates, and 26 percent of eligible patients were able to have a prescription written. Primary care practices, particularly primary care training sites, looking to implement a coprescription initiative should take several important factors into consideration during the planning stages, including naloxone availability and availability of the patient for naloxone education. More extensive research on best practices is needed.

  19. Novel multi-sugar assay for site-specific gastrointestinal permeability analysis: A randomized controlled crossover trial

    NARCIS (Netherlands)

    Wijck, van K.; Verlinden, T.J.M.; Eijk, van H.M.H.; Dekker, J.; Buurman, W.A.; Dejong, C.H.C.; Lenaerts, K.

    2013-01-01

    Background & aims: Increased gastrointestinal (GI) permeability is an important hallmark of many conditions, potentially leading to antigen exposure and sepsis. Current permeability tests are hampered by analytical limitations. This study aims to compare the accuracy of our multi-sugar (MS) and

  20. Imbalanced multi-modal multi-label learning for subcellular localization prediction of human proteins with both single and multiple sites.

    Directory of Open Access Journals (Sweden)

    Jianjun He

    Full Text Available It is well known that an important step toward understanding the functions of a protein is to determine its subcellular location. Although numerous prediction algorithms have been developed, most of them typically focused on the proteins with only one location. In recent years, researchers have begun to pay attention to the subcellular localization prediction of the proteins with multiple sites. However, almost all the existing approaches have failed to take into account the correlations among the locations caused by the proteins with multiple sites, which may be the important information for improving the prediction accuracy of the proteins with multiple sites. In this paper, a new algorithm which can effectively exploit the correlations among the locations is proposed by using gaussian process model. Besides, the algorithm also can realize optimal linear combination of various feature extraction technologies and could be robust to the imbalanced data set. Experimental results on a human protein data set show that the proposed algorithm is valid and can achieve better performance than the existing approaches.

  1. Wavelet-based evolutionary response of multi-span structures including wave-passage and site-response effects

    NARCIS (Netherlands)

    Dinh, V.N.; Basu, B.; Brinkgreve, R.B.J.

    2013-01-01

    Stochastic seismic wavelet-based evolutionary response of multispan structures including wave-passage and site-response effects is formulated in this paper. A procedure to estimate site-compatible parameters of surface-to-bedrock frequency response function (FRF) by using finite-element analysis of

  2. Progression of chronic kidney disease in a multi-ethnic community cohort of patients with diabetes mellitus.

    Science.gov (United States)

    Dreyer, G; Hull, S; Mathur, R; Chesser, A; Yaqoob, M M

    2013-08-01

    Ethnicity is a risk factor for the prevalence of severe chronic kidney disease among patients with diabetes. We studied the effect of ethnicity on progression of chronic kidney disease in people with diabetes managed in community settings. A 5-year retrospective, community-based cohort study of 3855 people with diabetes mellitus of white, black or South Asian ethnicity with an estimated glomerular filtration rate of chronic kidney disease progression was significantly greater in South Asian groups (-1.01 ml min⁻¹ 1.73 m⁻²) compared with white groups (-0.70 ml min⁻¹ 1.73 m⁻²) (P = 0.001). For those with proteinuria at baseline, the annual decline was greater at 2.05 ml min⁻¹ 1.73 m⁻², with both South Asian and black groups having a significantly faster rate of decline than white groups. For patients with diabetes and chronic kidney disease managed in primary care, the annual decline of renal function is less than previously thought and approximates the age-related annual decline of 1 ml min⁻¹ 1.73 m⁻². Patients with proteinuria and those of South Asian and Black ethnicity need additional monitoring as they are at greater risk of rapid chronic kidney disease progression. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

  3. Coarse-grained molecular simulation of epidermal growth factor receptor protein tyrosine kinase multi-site self-phosphorylation.

    Directory of Open Access Journals (Sweden)

    John G Koland

    2014-01-01

    Full Text Available Upon the ligand-dependent dimerization of the epidermal growth factor receptor (EGFR, the intrinsic protein tyrosine kinase (PTK activity of one receptor monomer is activated, and the dimeric receptor undergoes self-phosphorylation at any of eight candidate phosphorylation sites (P-sites in either of the two C-terminal (CT domains. While the structures of the extracellular ligand binding and intracellular PTK domains are known, that of the ∼225-amino acid CT domain is not, presumably because it is disordered. Receptor phosphorylation on CT domain P-sites is critical in signaling because of the binding of specific signaling effector molecules to individual phosphorylated P-sites. To investigate how the combination of conventional substrate recognition and the unique topological factors involved in the CT domain self-phosphorylation reaction lead to selectivity in P-site phosphorylation, we performed coarse-grained molecular simulations of the P-site/catalytic site binding reactions that precede EGFR self-phosphorylation events. Our results indicate that self-phosphorylation of the dimeric EGFR, although generally believed to occur in trans, may well occur with a similar efficiency in cis, with the P-sites of both receptor monomers being phosphorylated to a similar extent. An exception was the case of the most kinase-proximal P-site-992, the catalytic site binding of which occurred exclusively in cis via an intramolecular reaction. We discovered that the in cis interaction of P-site-992 with the catalytic site was facilitated by a cleft between the N-terminal and C-terminal lobes of the PTK domain that allows the short CT domain sequence tethering P-site-992 to the PTK core to reach the catalytic site. Our work provides several new mechanistic insights into the EGFR self-phosphorylation reaction, and demonstrates the potential of coarse-grained molecular simulation approaches for investigating the complexities of self-phosphorylation in

  4. The value of SPECT/CT in localizing pain site and prediction of treatment response in patients with chronic low back pain.

    Science.gov (United States)

    Lee, Inki; Budiawan, Hendra; Moon, Jee Youn; Cheon, Gi Jeong; Kim, Yong Chul; Paeng, Jin Chul; Kang, Keon Wook; Chung, June-Key; Lee, Dong Soo

    2014-12-01

    In many circumstances, causing sites of low back pain (LBP) cannot be determined only by anatomical imaging. Combined functional and morphological imaging such as bone scan with single-photon emission computed tomography/computed tomography (SPECT/CT) may be helpful in identifying active lesions. The purpose of this study was to evaluate the usefulness of bone SPECT/CT in localizing the pain site and the treatment of chronic LBP. One hundred seventy-five patients suffering from chronic LBP who underwent SPECT/CT were included, retrospectively. All of the patients received multiple general treatments according to the symptoms, and some of them underwent additional target-specific treatment based on SPECT/CT. Numerical rating scale (NRS) pain score was used to assess the pain intensity. Of 175 patients, 127 showed good response to the given therapies, while the rest did not. Overall, 79.4% of patients with definite active lesions showed good response. Patients with mild active or no lesions on SPECT/CT had relatively lower response rate of 63.0%. Good response was observed by the treatment with the guidance of active lesions identified on SPECT/CT. SPECT/CT could be useful in identifying active lesions in patients with chronic LBP and guiding the clinicians to use adequate treatment.

  5. The Baltodano Breast Reduction Score: A Nationwide, Multi-Institutional, Validated Approach to Reducing Surgical-Site Morbidity.

    Science.gov (United States)

    Baltodano, Pablo A; Reinhardt, Myrna Eliann; Ata, Ashar; Simjee, Usamah F; Roth, Malcolm Z; Patel, Ashit

    2017-08-01

    Breast reduction remains associated with significantly higher rates of overall morbidity, superficial surgical-site infections, and wound disruptions. The authors developed a validated risk model to identify patients at higher risk for postoperative surgical-site morbidity after breast reduction. A retrospective review was performed of all women undergoing breast reduction from the American College of Surgeons National Surgical Quality Improvement Program 2005 to 2012 data. Surgical-site morbidity included surgical-site infection and wound disruption events. Stepwise multivariable logistic regression identified risk factors associated with surgical-site morbidity. The model was validated using bootstrap replications (n = 100) and the Hosmer-Lemeshow test, and converted into the Baltodano breast reduction score, a clinical risk tool predictive of surgical-site morbidity. The authors identified 7068 breast reductions. Rate of 30-day surgical-site morbidity was 3.98 percent. Independent risk factors included resident participation (OR, 1.5; 95 percent CI, 1.1 to 2.0; p = 0.004), body mass index (for every 5-unit increase: OR, 1.3; 95 percent CI, 1.1 to 1.4; p morbidity associated with each risk score was estimated. Predicted and observed risks of surgical-site morbidity were highly comparable. The authors present the Baltodano breast reduction score, a validated risk-stratification tool for predicting 30-day surgical-site morbidity following breast reduction using data that are readily available to the clinician. This may allow targeted screening and intervention in high-risk patients, better counseling, selective resident participation, and ultimately a decrease in overall health care costs. Risk, III.

  6. Inference for finite-sample trajectories in dynamic multi-state site-occupancy models using hidden Markov model smoothing

    Science.gov (United States)

    Fiske, Ian J.; Royle, J. Andrew; Gross, Kevin

    2014-01-01

    Ecologists and wildlife biologists increasingly use latent variable models to study patterns of species occurrence when detection is imperfect. These models have recently been generalized to accommodate both a more expansive description of state than simple presence or absence, and Markovian dynamics in the latent state over successive sampling seasons. In this paper, we write these multi-season, multi-state models as hidden Markov models to find both maximum likelihood estimates of model parameters and finite-sample estimators of the trajectory of the latent state over time. These estimators are especially useful for characterizing population trends in species of conservation concern. We also develop parametric bootstrap procedures that allow formal inference about latent trend. We examine model behavior through simulation, and we apply the model to data from the North American Amphibian Monitoring Program.

  7. Calculation of site specific characterisation factors for metal ecotoxicity using decoupled multi species fate and exposure modelling

    DEFF Research Database (Denmark)

    Birkved, Morten; Strandesen, Maria; Larsen, HF

    2004-01-01

    of metals taking into account the speciation pattern under e.g. specific pH, DOM and salinity conditions. The study presented here indicates that CF’s calculated using the traditional assessment method known as single species assessment of metals, under realistic conditions differs significantly, due......Calculation of characterisation factors (CF’s) for metal ecotoxicity typically involves fate and exposure modelling of metals in multi-media models developed for assessment of organic compounds. Metals do not follow the fate patterns of organic chemicals, and the results will therefore most likely...... to the part of the metal species present as complexes which is very hard to account for in single species assessment. Preliminary results on the CF’s based on single species assessment and decoupled multi species assessment will be presented for 4 common metals....

  8. 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.

  9. A feasibility study of multi-site,intracellular recordings from mammalian neurons by extracellular gold mushroom-shaped microelectrodes

    OpenAIRE

    Ojovan, Silviya M.; Noha Rabieh; Nava Shmoel; Hadas Erez; Eilon Maydan; Ariel Cohen; Micha E. Spira

    2015-01-01

    The development of multi-electrode array platforms for large scale recording of neurons is at the forefront of neuro-engineering research efforts. Recently we demonstrated, at the proof-of-concept level, a breakthrough neuron-microelectrode interface in which cultured Aplysia neurons tightly engulf gold mushroom-shaped microelectrodes (gMμEs). While maintaining their extracellular position, the gMμEs record synaptic- and action-potentials with characteristic features of intracellular recordin...

  10. 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.

  11. Repeat 24-hour recalls and locally developed food composition databases: a feasible method to estimate dietary adequacy in a multi-site preconception maternal nutrition RCT

    Science.gov (United States)

    Lander, Rebecca L.; Hambidge, K. Michael; Krebs, Nancy F.; Westcott, Jamie E.; Garces, Ana; Figueroa, Lester; Tejeda, Gabriela; Lokangaka, Adrien; Diba, Tshilenge S.; Somannavar, Manjunath S.; Honnayya, Ranjitha; Ali, Sumera A.; Khan, Umber S.; McClure, Elizabeth M.; Thorsten, Vanessa R.; Stolka, Kristen B.

    2017-01-01

    ABSTRACT Background: Our aim was to utilize a feasible quantitative methodology to estimate the dietary adequacy of >900 first-trimester pregnant women in poor rural areas of the Democratic Republic of the Congo, Guatemala, India and Pakistan. This paper outlines the dietary methods used. Methods: Local nutritionists were trained at the sites by the lead study nutritionist and received ongoing mentoring throughout the study. Training topics focused on the standardized conduct of repeat multiple-pass 24-hr dietary recalls, including interview techniques, estimation of portion sizes, and construction of a unique site-specific food composition database (FCDB). Each FCDB was based on 13 food groups and included values for moisture, energy, 20 nutrients (i.e. macro- and micronutrients), and phytate (an anti-nutrient). Nutrient values for individual foods or beverages were taken from recently developed FAO-supported regional food composition tables or the USDA national nutrient database. Appropriate adjustments for differences in moisture and application of nutrient retention and yield factors after cooking were applied, as needed. Generic recipes for mixed dishes consumed by the study population were compiled at each site, followed by calculation of a median recipe per 100 g. Each recipe’s nutrient values were included in the FCDB. Final site FCDB checks were planned according to FAO/INFOODS guidelines. Discussion: This dietary strategy provides the opportunity to assess estimated mean group usual energy and nutrient intakes and estimated prevalence of the population ‘at risk’ of inadequate intakes in first-trimester pregnant women living in four low- and middle-income countries. While challenges and limitations exist, this methodology demonstrates the practical application of a quantitative dietary strategy for a large international multi-site nutrition trial, providing within- and between-site comparisons. Moreover, it provides an excellent opportunity for

  12. A Graphic Overlay Method for Selection of Osteotomy Site in Chronic Radial Head Dislocation: An Evaluation of 3D-printed Bone Models.

    Science.gov (United States)

    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.

  13. 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

  14. 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.

  15. Erectile Dysfunction in Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Outcomes from a Multi-Center Study and Risk Factor Analysis in a Single Center.

    Directory of Open Access Journals (Sweden)

    Yadong Zhang

    Full Text Available The aim of this study was to investigate the prevalence of erectile dysfunction (ED in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS and explore the influence of UPOINT domains, National Institutes of Health-CP symptom index (NIH-CPSI and other factors on ED prevalence. This was a prospective study of consecutive patients with CP/CPPS seen at 11 tertiary hospitals during January-July 2014. ED was diagnosed as a score of<21 on the International Index of Erectile Function (IIEF-5. Patients from one center were evaluated by the UPOINT system and NIH-CPSI. Each patient was assessed using clinical examination, asocio-demographic questionnaire, the Patient Health Questionnaire (PHQ, the Pain Catastrophizing Scale (PCS, NIH-CPSI and IIEF-5.1406 patients from 11 centers (mean age, 32.18 years; range 18-60 years were enrolled. ED was found in 638/1406 patients (45.4%, and was categorized as mild in 291(45.6%, moderate in 297(46.6% and severe in50(7.7%. 192 patients from one center(mean age,31.3 years; range 18-57 years were further studied.IIEF-5 score correlated negatively with NIH-CPSI(r = 0.251, PHQ (r = 0.355 and PCS (r = 0.322scores (P<0.001.PHQ score correlated positively with NIH-CPSI (r = 0.586 and PCS(r = 0.662 scores (P<0.001.NIH-CPSI, PHQ, PCS and IIEF-5 scores did not differ significantly between class IIIA and IIIB CP/CPPS. Multivariate logistic regression showed that UPOINT psychological (P domain and NIH-CPSI symptom severity were independent risk factors for ED in CP/CPPS. It is concluded that psychological factors and symptom severity are independent risk factors for ED in CP/CPPS.

  16. Sonication effect on the reaction of 4-bromo-1-methylbenzene with sodium sulfide in liquid-liquid multi-site phase-transfer catalysis condition - kinetic study.

    Science.gov (United States)

    Abimannan, Pachaiyappan; Selvaraj, Varathan; Rajendran, Venugopal

    2015-03-01

    The synthesis of di-p-tolylsulfane from the reaction of 4-bromo-1-methylbenzene (BMB) with sodium sulfide was carried out using a multi-site phase-transfer catalyst (MPTC) viz., 1,4-dihexyl-1,4-diazoniabicyclo[2.2.2]octanium dibromide and ultrasonic irradiation in a liquid-liquid reaction condition. The overall reaction rate is greatly enhanced when catalyzed by multi-site phase-transfer catalyst (MPTC) combined with sonication (40 kHz, 300 W) in a batch reactor than catalyzed by MPTC without sonication. Effects on the reaction due to various operating conditions, such as agitation speed, different ultrasound frequencies, different phase-transfer catalysts, different organic solvents, the amount of MPTC, temperature, amount of sodium sulfide, effect of sodium hydroxide, volume of n-hexane and the concentration of 4-bromo-1-methylbenzene. The reaction obeys a pseudo first-order rate law and a suitable mechanism was proposed based on the experimental observation. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. 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.

  18. Ultrasound assisted arylation of benzyl alcohol with 4-nitrochlorobenzene under a new multi-site phase-transfer catalyst in solid-liquid condition.

    Science.gov (United States)

    Selvaraj, Varathan; Abimannan, Pachaiyappan; Rajendran, Venugopal

    2014-09-01

    The ultrasound assisted preparation of 1-(benzyloxy)-4-nitrobenzene from the reaction of 4-chloronitrobenzene (CNB) and benzyl alcohol was carried out successfully using potassium hydroxide and catalyzed by a new multi-site phase-transfer catalyst (MPTC) viz., 1,3,5-triethyl-1,3,5-trihexyl-1,3,5-triazinane-1,3,5-triium trichloride in a solid-liquid reaction condition (SL-MPTC). The advantage of using SL-MPTC is to avoid a serious hydration of potassium salt of benzyl alcohol in the reaction between 4-chloronitrobenzene (CNB) and benzyl alcohol. The reaction is greatly enhanced in the solid-liquid system, catalyzed by multi-site quaternary ammonium salt (MPTC) and ultrasound irradiation (40 kHz, 300 W) in a batch reactor, it shows that the overall reaction greatly enhanced with ultrasound irradiation than without ultrasound. The reaction mechanism is proposed and verified by examining the experimental evidence. A kinetic model is proposed in which a pseudo first-order rate law is sufficient to describe the results, such as the effects of agitation speed, ultrasound, different phase transfer catalysts and the effect of organic solvents, the amount of newly prepared MPTC, the effect of temperature, the amount of water, the concentration of 4-chloronitrobenzene (CNB) and potassium hydroxide concentrations. The apparent rate constant (kapp) were investigated in detail. Rational explanations to account for the phenomena on the results were made. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Inhibitor mechanisms in the S1 binding site of the dopamine transporter defined by multi-site molecular tethering of photoactive cocaine analogs.

    Science.gov (United States)

    Krout, Danielle; Pramod, Akula Bala; Dahal, Rejwi Acharya; Tomlinson, Michael J; Sharma, Babita; Foster, James D; Zou, Mu-Fa; Boatang, Comfort; Newman, Amy Hauck; Lever, John R; Vaughan, Roxanne A; Henry, L Keith

    2017-10-15

    Dopamine transporter (DAT) blockers like cocaine and many other abused and therapeutic drugs bind and stabilize an inactive form of the transporter inhibiting reuptake of extracellular dopamine (DA). The resulting increases in DA lead to the ability of these drugs to induce psychomotor alterations and addiction, but paradoxical findings in animal models indicate that not all DAT antagonists induce cocaine-like behavioral outcomes. How this occurs is not known, but one possibility is that uptake inhibitors may bind at multiple locations or in different poses to stabilize distinct conformational transporter states associated with differential neurochemical endpoints. Understanding the molecular mechanisms governing the pharmacological inhibition of DAT is therefore key for understanding the requisite interactions for behavioral modulation and addiction. Previously, we leveraged complementary computational docking, mutagenesis, peptide mapping, and substituted cysteine accessibility strategies to identify the specific adduction site and binding pose for the crosslinkable, photoactive cocaine analog, RTI 82, which contains a photoactive azide attached at the 2β position of the tropane pharmacophore. Here, we utilize similar methodology with a different cocaine analog N-[4-(4-azido-3-I-iodophenyl)-butyl]-2-carbomethoxy-3-(4-chlorophenyl)tropane, MFZ 2-24, where the photoactive azide is attached to the tropane nitrogen. In contrast to RTI 82, which crosslinked into residue Phe319 of transmembrane domain (TM) 6, our findings show that MFZ 2-24 adducts to Leu80 in TM1 with modeling and biochemical data indicating that MFZ 2-24, like RTI 82, occupies the central S1 binding pocket with the (+)-charged tropane ring nitrogen coordinating with the (-)-charged carboxyl side chain of Asp79. The superimposition of the tropane ring in the three-dimensional binding poses of these two distinct ligands provides strong experimental evidence for cocaine binding to DAT in the S1 site

  20. 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.

  1. 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

  2. A multi-site review of policies affecting opportunities for children with developmental disabilities to become bilingual

    NARCIS (Netherlands)

    Pesco, D.; MacLeod, A.A.N.; Kay-Raining Bird, E.; Cleave, P.; Trudeau, N.; Scherba de Valenzuela, J.; Cain, K.; Marinova-Todd, S.H.; Colozzo, P.; Stahl, H.; Segers, P.C.J.; Verhoeven, L.T.W.

    2016-01-01

    This review of special education and language-in-education policies at six sites in four countries (Canada, United States, United Kingdom, and Netherlands) aimed to determine the opportunities for bilingualism provided at school for children with developmental disabilities (DD). While research has

  3. Comprehensive chronic laminar single-unit, multi-unit, and local field potential recording performance with planar single shank electrode arrays.

    Science.gov (United States)

    Kozai, Takashi D Y; Du, Zhanhong; Gugel, Zhannetta V; Smith, Matthew A; Chase, Steven M; Bodily, Lance M; Caparosa, Ellen M; Friedlander, Robert M; Cui, X Tracy

    2015-03-15

    Intracortical electrode arrays that can record extracellular action potentials from small, targeted groups of neurons are critical for basic neuroscience research and emerging clinical applications. In general, these electrode devices suffer from reliability and variability issues, which have led to comparative studies of existing and emerging electrode designs to optimize performance. Comparisons of different chronic recording devices have been limited to single-unit (SU) activity and employed a bulk averaging approach treating brain architecture as homogeneous with respect to electrode distribution. In this study, we optimize the methods and parameters to quantify evoked multi-unit (MU) and local field potential (LFP) recordings in eight mice visual cortices. These findings quantify the large recording differences stemming from anatomical differences in depth and the layer dependent relative changes to SU and MU recording performance over 6-months. For example, performance metrics in Layer V and stratum pyramidale were initially higher than Layer II/III, but decrease more rapidly. On the other hand, Layer II/III maintained recording metrics longer. In addition, chronic changes at the level of layer IV are evaluated using visually evoked current source density. The use of MU and LFP activity for evaluation and tracking biological depth provides a more comprehensive characterization of the electrophysiological performance landscape of microelectrodes. A more extensive spatial and temporal insight into the chronic electrophysiological performance over time will help uncover the biological and mechanical failure mechanisms of the neural electrodes and direct future research toward the elucidation of design optimization for specific applications. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Essential Resources for Implementation and Sustainability of Evidence-Based Health Promotion Programs: A Mixed Methods Multi-Site Case Study.

    Science.gov (United States)

    Dattalo, M; Wise, M; Ford Ii, J H; Abramson, B; Mahoney, J

    2017-04-01

    As of October 2016, use of federal Older Americans Act funds for health promotion and disease prevention will be restricted to the Administration on Aging's criteria for high-level evidence-based health promotion programs. Dissemination of these programs to rural communities remains limited. Therefore a strong need exists to identify strategies that facilitate program implementation and sustainability. The objective of this study was to compare organizational readiness and implementation strategies used by rural communities that achieved varying levels of success in sustaining evidence-based health promotion programs for older adults. We utilized a qualitative multi-site case study design to analyze the longitudinal experiences of eight rural sites working to implement evidence-based health promotion program over 3 years (8/2012-7/2015). Multiple sources of data (interviews, documents, reports, surveys) from each site informed the analysis. We used conventional content analysis to conduct a cross-case comparison to identify common features of rural counties that successfully implemented and sustained their target evidence-based health promotion program. Readiness to implement evidence-based programs as low at baseline as all site leaders described needing to secure additional resources for program implementation. Sites that successfully utilized six essential resources implemented and sustained greater numbers of workshops: (1) External Partnerships, (2) Agency Leadership Commitment, (3) Ongoing Source of Workshop Leaders, (4) Health Promotion Coordination Tasks Assigned to Specific Staff, (5) Organizational Stability, and (6) Change Team Engagement. The six essential resources described in this study can help rural communities assess their readiness to implement health promotion programs and work secure the resources necessary for successful implementation.

  5. A COPRAS-F base multi-criteria group decision making approach for site selection of wind farm

    Directory of Open Access Journals (Sweden)

    Nikhil Chandra Chatterjee

    2013-01-01

    Full Text Available Today global warming is on the rise and the natural resources are getting consumed at a faster rate. Power consumption has increased many folds to cater the human need. Thus renewable energy resources are the only option available at this juncture. Wind energy is one of the renewable energy. Location selection for wind farm takes an important role on power generation. However, the location selection is a complex multicriteria problem due to the criteria factors which are conflicting in nature as well as uncertain. The process becomes more complex when a group of decision makers are involved in decision making. In the present study, a COPRAS (COmplex PRoportional ASsessment based multi-criteria decision-making (MCDM methodology is done under fuzzy environment with the help of multiple decision makers. More specifically, this study is aimed to focus the applicability of COPRAS-F as a strategic decision making tools to handle the group decision-making problems.

  6. Adipose Tissue Is a Neglected Viral Reservoir and an Inflammatory Site during Chronic HIV and SIV Infection

    Science.gov (United States)

    Damouche, Abderaouf; Huot, Nicolas; Dejucq-Rainsford, Nathalie; Satie, Anne-Pascale; Mélard, Adeline; David, Ludivine; Gommet, Céline; Ghosn, Jade; Noel, Nicolas; Pourcher, Guillaume; Martinez, Valérie; Benoist, Stéphane; Béréziat, Véronique; Cosma, Antonio; Favier, Benoit; Vaslin, Bruno; Rouzioux, Christine; Capeau, Jacqueline; Müller-Trutwin, Michaela; Dereuddre-Bosquet, Nathalie; Le Grand, Roger; Lambotte, Olivier; Bourgeois, Christine

    2015-01-01

    Two of the crucial aspects of human immunodeficiency virus (HIV) infection are (i) viral persistence in reservoirs (precluding viral eradication) and (ii) chronic inflammation (directly associated with all-cause morbidities in antiretroviral therapy (ART)-controlled HIV-infected patients). The objective of the present study was to assess the potential involvement of adipose tissue in these two aspects. Adipose tissue is composed of adipocytes and the stromal vascular fraction (SVF); the latter comprises immune cells such as CD4+ T cells and macrophages (both of which are important target cells for HIV). The inflammatory potential of adipose tissue has been extensively described in the context of obesity. During HIV infection, the inflammatory profile of adipose tissue has been revealed by the occurrence of lipodystrophies (primarily related to ART). Data on the impact of HIV on the SVF (especially in individuals not receiving ART) are scarce. We first analyzed the impact of simian immunodeficiency virus (SIV) infection on abdominal subcutaneous and visceral adipose tissues in SIVmac251 infected macaques and found that both adipocytes and adipose tissue immune cells were affected. The adipocyte density was elevated, and adipose tissue immune cells presented enhanced immune activation and/or inflammatory profiles. We detected cell-associated SIV DNA and RNA in the SVF and in sorted CD4+ T cells and macrophages from adipose tissue. We demonstrated that SVF cells (including CD4+ T cells) are infected in ART-controlled HIV-infected patients. Importantly, the production of HIV RNA was detected by in situ hybridization, and after the in vitro reactivation of sorted CD4+ T cells from adipose tissue. We thus identified adipose tissue as a crucial cofactor in both viral persistence and chronic immune activation/inflammation during HIV infection. These observations open up new therapeutic strategies for limiting the size of the viral reservoir and decreasing low-grade chronic

  7. Adipose Tissue Is a Neglected Viral Reservoir and an Inflammatory Site during Chronic HIV and SIV Infection.

    Directory of Open Access Journals (Sweden)

    Abderaouf Damouche

    2015-09-01

    Full Text Available Two of the crucial aspects of human immunodeficiency virus (HIV infection are (i viral persistence in reservoirs (precluding viral eradication and (ii chronic inflammation (directly associated with all-cause morbidities in antiretroviral therapy (ART-controlled HIV-infected patients. The objective of the present study was to assess the potential involvement of adipose tissue in these two aspects. Adipose tissue is composed of adipocytes and the stromal vascular fraction (SVF; the latter comprises immune cells such as CD4+ T cells and macrophages (both of which are important target cells for HIV. The inflammatory potential of adipose tissue has been extensively described in the context of obesity. During HIV infection, the inflammatory profile of adipose tissue has been revealed by the occurrence of lipodystrophies (primarily related to ART. Data on the impact of HIV on the SVF (especially in individuals not receiving ART are scarce. We first analyzed the impact of simian immunodeficiency virus (SIV infection on abdominal subcutaneous and visceral adipose tissues in SIVmac251 infected macaques and found that both adipocytes and adipose tissue immune cells were affected. The adipocyte density was elevated, and adipose tissue immune cells presented enhanced immune activation and/or inflammatory profiles. We detected cell-associated SIV DNA and RNA in the SVF and in sorted CD4+ T cells and macrophages from adipose tissue. We demonstrated that SVF cells (including CD4+ T cells are infected in ART-controlled HIV-infected patients. Importantly, the production of HIV RNA was detected by in situ hybridization, and after the in vitro reactivation of sorted CD4+ T cells from adipose tissue. We thus identified adipose tissue as a crucial cofactor in both viral persistence and chronic immune activation/inflammation during HIV infection. These observations open up new therapeutic strategies for limiting the size of the viral reservoir and decreasing low

  8. Adipose Tissue Is a Neglected Viral Reservoir and an Inflammatory Site during Chronic HIV and SIV Infection.

    Science.gov (United States)

    Damouche, Abderaouf; Lazure, Thierry; Avettand-Fènoël, Véronique; Huot, Nicolas; Dejucq-Rainsford, Nathalie; Satie, Anne-Pascale; Mélard, Adeline; David, Ludivine; Gommet, Céline; Ghosn, Jade; Noel, Nicolas; Pourcher, Guillaume; Martinez, Valérie; Benoist, Stéphane; Béréziat, Véronique; Cosma, Antonio; Favier, Benoit; Vaslin, Bruno; Rouzioux, Christine; Capeau, Jacqueline; Müller-Trutwin, Michaela; Dereuddre-Bosquet, Nathalie; Le Grand, Roger; Lambotte, Olivier; Bourgeois, Christine

    2015-09-01

    Two of the crucial aspects of human immunodeficiency virus (HIV) infection are (i) viral persistence in reservoirs (precluding viral eradication) and (ii) chronic inflammation (directly associated with all-cause morbidities in antiretroviral therapy (ART)-controlled HIV-infected patients). The objective of the present study was to assess the potential involvement of adipose tissue in these two aspects. Adipose tissue is composed of adipocytes and the stromal vascular fraction (SVF); the latter comprises immune cells such as CD4+ T cells and macrophages (both of which are important target cells for HIV). The inflammatory potential of adipose tissue has been extensively described in the context of obesity. During HIV infection, the inflammatory profile of adipose tissue has been revealed by the occurrence of lipodystrophies (primarily related to ART). Data on the impact of HIV on the SVF (especially in individuals not receiving ART) are scarce. We first analyzed the impact of simian immunodeficiency virus (SIV) infection on abdominal subcutaneous and visceral adipose tissues in SIVmac251 infected macaques and found that both adipocytes and adipose tissue immune cells were affected. The adipocyte density was elevated, and adipose tissue immune cells presented enhanced immune activation and/or inflammatory profiles. We detected cell-associated SIV DNA and RNA in the SVF and in sorted CD4+ T cells and macrophages from adipose tissue. We demonstrated that SVF cells (including CD4+ T cells) are infected in ART-controlled HIV-infected patients. Importantly, the production of HIV RNA was detected by in situ hybridization, and after the in vitro reactivation of sorted CD4+ T cells from adipose tissue. We thus identified adipose tissue as a crucial cofactor in both viral persistence and chronic immune activation/inflammation during HIV infection. These observations open up new therapeutic strategies for limiting the size of the viral reservoir and decreasing low-grade chronic

  9. Self-Regulatory Fatigue: A Missing Link in Understanding Fibromyalgia and Other Chronic MultiSymptom Illnesses.

    Science.gov (United States)

    Nes, Lise Solberg; Ehlers, Shawna L; Whipple, Mary O; Vincent, Ann

    2017-04-01

    Patients with chronic multisymptom illnesses such as fibromyalgia syndrome (FMS) are experiencing a multitude of physical and mental challenges. Facing such challenges may drain capacity to self-regulate, and research suggests patients with these illnesses may experience self-regulatory fatigue (SRF). This study sought to examine whether SRF can be associated with quality of life (QoL) in patients with FMS. Patients (N = 258) diagnosed with FMS completed self-report measures related to demographics, SRF (Self-Regulatory Fatigue 18 [SRF-18]), anxiety (Generalized Anxiety Disorder questionnaire [GAD-7]), depression (Patient Health Questionnaire [PHQ-9]), physical fatigue (Multidimensional Fatigue Inventory [MFI]), symptoms related to FMS (Fibromyalgia Impact Questionnaire [FIQ]), and QoL (36-Item Short-Form Health Survey [SF-36]). Hierarchical regressions showed higher SRF to be associated with lower QoL in terms of lower overall physical QoL, with subscales related to physical functioning, role limitations-physical, bodily pain, and general health (all P's > 0.001), as well as lower overall mental QoL, with subscales related to vitality, social functioning, role limitations-emotional, and mental health (all P's > 0.001). Including traditional predictors such as anxiety, depression, physical fatigue, and FMS-related symptoms as covariates in the analyses reduced the link between SRF and QoL somewhat, but the associations remained generally strong, particularly for SRF and mental QoL. This is the first study to show higher SRF relating to lower QoL for patients with FMS. Results suggest that SRF is distinct from anxiety, depression, and fatigue, and predicts QoL above and beyond these traditional factors in the area of chronic multisymptom illnesses such as FMS. SRF may be a "missing link" in understanding the complex nature of chronic multisymptom illnesses. © 2016 World Institute of Pain.

  10. Optimizing Viable Leukocyte Sampling from the Female Genital Tract for Clinical Trials: An International Multi-Site Study

    Science.gov (United States)

    De Rosa, Stephen C.; Martinson, Jeffrey A.; Plants, Jill; Brady, Kirsten E.; Gumbi, Pamela P.; Adams, Devin J.; Vojtech, Lucia; Galloway, Christine G.; Fialkow, Michael; Lentz, Gretchen; Gao, Dayong; Shu, Zhiquan; Nyanga, Billy; Izulla, Preston; Kimani, Joshua; Kimwaki, Steve; Bere, Alfred; Moodie, Zoe; Landay, Alan L.; Passmore, Jo-Ann S.; Kaul, Rupert; Novak, Richard M.; McElrath, M. Juliana; Hladik, Florian

    2014-01-01

    Background Functional analysis of mononuclear leukocytes in the female genital mucosa is essential for understanding the immunologic effects of HIV vaccines and microbicides at the site of HIV exposure. However, the best female genital tract sampling technique is unclear. Methods and Findings We enrolled women from four sites in Africa and the US to compare three genital leukocyte sampling methods: cervicovaginal lavages (CVL), endocervical cytobrushes, and ectocervical biopsies. Absolute yields of mononuclear leukocyte subpopulations were determined by flow cytometric bead-based cell counting. Of the non-invasive sampling types, two combined sequential cytobrushes yielded significantly more viable mononuclear leukocytes than a CVL (pbiopsies. Sample yields were consistent between sites. In a subgroup analysis, we observed significant reproducibility between replicate same-day biopsies (r = 0.89, p = 0.0123). Visible red blood cells in cytobrushes increased leukocyte yields more than three-fold (p = 0.0078), but did not change their subpopulation profile, indicating that these leukocytes were still largely derived from the mucosa and not peripheral blood. We also confirmed that many CD4+ T cells in the female genital tract express the α4β7 integrin, an HIV envelope-binding mucosal homing receptor. Conclusions CVL sampling recovered the lowest number of viable mononuclear leukocytes. Two cervical cytobrushes yielded comparable total numbers of viable leukocytes to one biopsy, but cytobrushes and biopsies were biased toward macrophages and T lymphocytes, respectively. Our study also established the feasibility of obtaining consistent flow cytometric analyses of isolated genital cells from four study sites in the US and Africa. These data represent an important step towards implementing mucosal cell sampling in international clinical trials of HIV prevention. PMID:24454917

  11. Simulation of varying femoral attachment sites of medial patellofemoral ligament using a musculoskeletal multi-body model

    Directory of Open Access Journals (Sweden)

    Geier A.

    2015-09-01

    Full Text Available The medial patellofemoral ligament (MPFL is a key structure in the treatment of habitual and traumatic patellofemoral instability. However, there exists little knowledge about its behaviour during deep knee flexion after femoral refixation. Since improper femoral attachment sites may lead to unnatural length change patterns in the ligament and consequently to osteoarthritis due to pathological femoro-patellar contact pressure, the understanding of the patella kinematics and MPFL behaviour is crucial.

  12. A criticism of applications with multi-criteria decision analysis that are used for the site selection for the disposal of municipal solid wastes.

    Science.gov (United States)

    Kemal Korucu, M; Erdagi, Bora

    2012-12-01

    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. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Site selection for managed aquifer recharge using fuzzy rules: integrating geographical information system (GIS) tools and multi-criteria decision making

    Science.gov (United States)

    Malekmohammadi, Bahram; Ramezani Mehrian, Majid; Jafari, Hamid Reza

    2012-11-01

    One of the most important water-resources management strategies for arid lands is managed aquifer recharge (MAR). In establishing a MAR scheme, site selection is the prime prerequisite that can be assisted by geographic information system (GIS) tools. One of the most important uncertainties in the site-selection process using GIS is finite ranges or intervals resulting from data classification. In order to reduce these uncertainties, a novel method has been developed involving the integration of multi-criteria decision making (MCDM), GIS, and a fuzzy inference system (FIS). The Shemil-Ashkara plain in the Hormozgan Province of Iran was selected as the case study; slope, geology, groundwater depth, potential for runoff, land use, and groundwater electrical conductivity have been considered as site-selection factors. By defining fuzzy membership functions for the input layers and the output layer, and by constructing fuzzy rules, a FIS has been developed. Comparison of the results produced by the proposed method and the traditional simple additive weighted (SAW) method shows that the proposed method yields more precise results. In conclusion, fuzzy-set theory can be an effective method to overcome associated uncertainties in classification of geographic information data.

  14. A G-protein-coupled chemokine receptor: A putative insertion site for a multi-pathogen recombinant capripoxvirus vaccine strategy.

    Science.gov (United States)

    Cêtre-Sossah, Catherine; Dickmu, Simon; Kwiatek, Olivier; Albina, Emmanuel

    2017-09-01

    Capripoxviruses (CaPVs) have been shown to be ideal viral vectors for the development of recombinant multivalent vaccines to enable delivery of immunogenic genes from ruminant pathogens. So far, the viral thymidine kinase (TK) gene is the only gene used to generate recombinants. A putative non-essential gene encoding a G-protein-coupled chemokine receptor subfamily homologue (GPCR) was targeted as an additional insertion site. Peste des petits ruminants (PPR) was chosen as a disease model. A new recombinant CaPV expressing the viral attachment hemagglutinin (H) of the PPR virus (PPRV) in the GPCR insertion site (rKS1-HPPR-GPCR) was generated in the backbone North African isolate KS1 strain of lumpy skin disease virus (LSDV). Comparison with the recombinant CaPV expressing the H of PPRV in the TK gene (rKS1-HPPR-TK) shown to induce protection against both PPR and LSD in both sheep and goats was assessed. The suitability of the GPCR gene to be a putative additional insertion site in the CaPV genome is evaluated and discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. The impact of price discounts and calorie messaging on beverage consumption: a multi-site field study.

    Science.gov (United States)

    Jue, J Jane S; Press, Matthew J; McDonald, Daniel; Volpp, Kevin G; Asch, David A; Mitra, Nandita; Stanowski, Anthony C; Loewenstein, George

    2012-12-01

    To examine the efficacy of alternative approaches for shifting consumers toward zero calorie beverages. We examined the effect of price discounts and novel presentations of calorie information on sales of beverages. This prospective interrupted time-series quasi-experiment included three sites in Philadelphia, PA, Evanston, IL, and Detroit, MI. Each site received five interventions: (1) a 10% price discount on zero-calorie beverages; (2) the 10% discount plus discount messaging; (3) messaging comparing calorie information of sugared beverages with zero-calorie beverages; (4) messaging comparing exercise equivalent information; and (5) messaging comparing both calorie and exercise equivalent information. The main outcome was daily sales of bottled zero-calorie and sugared beverages. Data was collected from October 2009 until May 2010 and analyzed from May 2010 until May 2011. The overall analysis failed to demonstrate a consistent effect across all interventions. Two treatments had statistically significant effects: the discount plus discount messaging, with an increase in purchases of zero calorie beverages; and the calorie messaging intervention, with an increase in purchases of sugar-sweetened beverages. Individual site analysis results were similar. The effects of price discounts and calorie messaging in different forms on beverage purchases were inconsistent and frequently small. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. No “Magic Bullet”: Exploring Community Mobilization Strategies Used in a Multi-site Community Based Randomized Controlled Trial: Project Accept (HPTN 043)

    Science.gov (United States)

    Tedrow, Virginia A.; Zelaya, Carla E.; Kennedy, Caitlin E.; Morin, Stephen F.; Khumalo-Sakutukwa, Gertrude; Sweat, Michael D.; Celentano, David D.

    2012-01-01

    As community-level interventions become more common in HIV prevention, processes such as community mobilization (CM) are increasingly utilized in public health programs and research. Project Accept, a multi-site community randomized controlled trial, is testing the hypothesis that CM coupled with community-based mobile voluntary counseling and testing and post-test support services will alter community norms and reduce the incidence of HIV. By using a multiple-case study approach, this qualitative study identifies seven major community mobilization strategies used in Project Accept, including stakeholder buy-in, formation of community coalitions, community engagement, community participation, raising community awareness, involvement of leaders, and partnership building, and describes three key elements of mobilization success. PMID:21822627

  17. No "magic bullet": exploring community mobilization strategies used in a multi-site community based randomized controlled trial: Project Accept (HPTN 043).

    Science.gov (United States)

    Tedrow, Virginia A; Zelaya, Carla E; Kennedy, Caitlin E; Morin, Stephen F; Khumalo-Sakutukwa, Gertrude; Sweat, Michael D; Celentano, David D

    2012-07-01

    As community-level interventions become more common in HIV prevention, processes such as community mobilization (CM) are increasingly utilized in public health programs and research. Project Accept, a multi-site community randomized controlled trial, is testing the hypothesis that CM coupled with community-based mobile voluntary counseling and testing and post-test support services will alter community norms and reduce the incidence of HIV. By using a multiple-case study approach, this qualitative study identifies seven major community mobilization strategies used in Project Accept, including stakeholder buy-in, formation of community coalitions, community engagement, community participation, raising community awareness, involvement of leaders, and partnership building, and describes three key elements of mobilization success.

  18. An evaluation tool for assessing performance in priority setting and resource allocation: multi-site application to identify strengths and weaknesses.

    Science.gov (United States)

    Hall, William; Smith, Neale; Mitton, Craig; Gibson, Jennifer; Bryan, Stirling

    2016-01-01

    An evaluation tool should help improve formal priority setting and resource allocation (PSRA) processes in Canada and elsewhere. These are crucial to maximizing value from limited resources. On the basis of case studies, balanced scorecard development protocols and use-focused evaluation principles, an evaluation tool was developed based on an existing framework for high PSRA performance and implemented in two health care organizations in British Columbia, Canada. Implementation of the tool identified areas of strength, improvement and weakness in the pilot organizations' processes for PSRA including: communication, staff engagement and culture. Refinements were identified and incorporated into the tool for future application. This is the first documented multi-site application of such an evaluation tool. Broader dissemination should have use both in further refining the basis of the tool and in catalysing improved performance of PSRA practice. © The Author(s) 2015.

  19. Multi-criteria optimization of on-site heating, cooling and power generation with solid oxide fuel cell-gas turbine combined cycle units

    Energy Technology Data Exchange (ETDEWEB)

    K. Tanaka; M. Burer; D. Favrat; K. Yamada [UMIST, Manchester (United Kingdom). Tyndall Centre for Climate Change Research

    2003-07-01

    The implementation of integrated energy systems within urban areas is a promising CO{sub 2} emissions abatement measure. In this paper on-site heating, cooling and power generation based on a solid oxide fuel cell and gas turbine (SOFC-GT) combined cycle unit associated with a compression chiller and additional boilers has been considered from the viewpoints of cost and CO{sub 2} emissions. Physical and costing modelling of such a unit has been integrated within a new multi-criteria evolutionary algorithm for an assessment of the economic and environmental performances associated with optimal design and operation, for typical requirements of large office buildings in Tokyo. 9 refs., 8 figs., 2 tabs.

  20. Multi-isotope (carbon and chlorine) analysis for fingerprinting and site characterization at a fractured bedrock aquifer contaminated by chlorinated ethenes

    DEFF Research Database (Denmark)

    Palau, Jordi; Marchesi, Massimo; Chambon, Julie Claire Claudia

    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 δ13C 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 δ37Cl values for TCE...

  1. Multi-criteria site selection for fire services: the interaction with analytic hierarchy process and geographic information systems

    Directory of Open Access Journals (Sweden)

    T. Erden

    2010-10-01

    Full Text Available This study combines AHP and GIS to provide decision makers with a model to ensure optimal site location(s for fire stations selected. The roles of AHP and GIS in determining optimal locations are explained, criteria for site selection are outlined, and case study results for finding the optimal fire station locations in Istanbul, Turkey are included. The city of Istanbul has about 13 million residents and is the largest and most populated city in Turkey. The rapid and constant growth of Istanbul has resulted in the increased number of fire related cases. Fire incidents tend to increase year by year in parallel with city expansion, population and hazardous material facilities. Istanbul has seen a rise in reported fire incidents from 12 769 in 1994 to 30 089 in 2009 according to the interim report of Istanbul Metropolitan Municipality Department of Fire Brigade. The average response time was approximately 7 min 3 s in 2009. The goal of this study is to propose optimal sites for new fire station creation to allow the Fire Brigade in Istanbul to reduce the average response time to 5 min or less. After determining the necessity of suggesting additional fire stations, the following steps are taken into account: six criteria are considered in this analysis. They are: High Population Density (HPD; Proximity to Main Roads (PMR; Distance from Existing Fire Stations (DEF; Distance from Hazardous Material Facilities (DHM; Wooden Building Density (WBD; and Distance from the Areas Subjected to Earthquake Risk (DER. DHM criterion, with the weight of 40%, is the most important criterion in this analysis. The remaining criteria have a weight range from 9% to 16%. Moreover, the following steps are performed: representation of criterion map layers in GIS environment; classification of raster datasets; calculating the result raster map (suitability map for potential fire stations; and offering a model that supports decision makers in selecting fire station sites

  2. Use of Multi-Level Wells in Developing a 3-Dimensional Understanding of Groundwater Flow and Contaminant Migration at the Savannah River Site

    Energy Technology Data Exchange (ETDEWEB)

    Vangelas, K M; Nichols, R L; Flach, G P; Sappington, F; Simmons, J L; Betivas, C R; Shoffner, L R; Falise, F R

    2003-02-25

    Understanding the flow of groundwater and contaminants in 3-dimensions, along with hydraulic properties, is instrumental in selection and implementation of successful remediation efforts. Advances in multi-level groundwater monitoring at the Savannah River Site (SRS) are enabling engineers and geologists to collect the needed characterization data in an efficient, cost-effective manner. The SRS has developed a new multi-level groundwater monitoring well, "StrataSampler", which is being deployed for characterization and monitoring at several large groundwater plumes on the SRS. The installation method used allowed collection of data during the drilling process allowing optimization of screen placement within the aquifers and minimization of drilling costs and waste generation. Data generated during the installation of the StrataSamplers along with data collected from the installed wells is being used to understand the 3-dimensional nature of contaminant fate and transport. The L-Area Southern Groundwater Operable Unit is the first full-scale deployment of StrataSampler wells at SRS. Twenty-two StrataSampler wells with a total of 52 sampling zones were installed. The installation, development, hydraulic testing, sampling of the StrataSamplers at this unit and the resulting understanding of the contaminant plumes will be discussed in the paper and presentation.

  3. A feasibility study of multi-site,intracellular recordings from mammalian neurons by extracellular gold mushroom-shaped microelectrodes.

    Science.gov (United States)

    Ojovan, Silviya M; Rabieh, Noha; Shmoel, Nava; Erez, Hadas; Maydan, Eilon; Cohen, Ariel; Spira, Micha E

    2015-09-14

    The development of multi-electrode array platforms for large scale recording of neurons is at the forefront of neuro-engineering research efforts. Recently we demonstrated, at the proof-of-concept level, a breakthrough neuron-microelectrode interface in which cultured Aplysia neurons tightly engulf gold mushroom-shaped microelectrodes (gMμEs). While maintaining their extracellular position, the gMμEs record synaptic- and action-potentials with characteristic features of intracellular recordings. Here we examined the feasibility of using gMμEs for intracellular recordings from mammalian neurons. To that end we experimentally examined the innate size limits of cultured rat hippocampal neurons to engulf gMμEs and measured the width of the "extracellular" cleft formed between the neurons and the gold surface. Using the experimental results we next analyzed the expected range of gMμEs-neuron electrical coupling coefficients. We estimated that sufficient electrical coupling levels to record attenuated synaptic- and action-potentials can be reached using the gMμE-neuron configuration. The definition of the engulfment limits of the gMμEs caps diameter at ≤2-2.5 μm and the estimated electrical coupling coefficients from the simulations pave the way for rational development and application of the gMμE based concept for in-cell recordings from mammalian neurons.

  4. Validation of mismatch negativity and P3a for use in multi-site studies of schizophrenia: characterization of demographic, clinical, cognitive, and functional correlates in COGS-2.

    Science.gov (United States)

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

    2015-04-01

    Mismatch negativity (MMN) and P3a are auditory event-related potential (ERP) components that show robust deficits in schizophrenia (SZ) patients and exhibit qualities of endophenotypes, including substantial heritability, test-retest reliability, and trait-like stability. These measures also fulfill criteria for use as cognition and function-linked biomarkers in outcome studies, but have not yet been validated for use in large-scale multi-site clinical studies. This study tested the feasibility of adding MMN and P3a to the ongoing Consortium on the Genetics of Schizophrenia (COGS) study. The extent to which demographic, clinical, cognitive, and functional characteristics contribute to variability in MMN and P3a amplitudes was also examined. Participants (HCS n=824, SZ n=966) underwent testing at 5 geographically distributed COGS laboratories. Valid ERP recordings were obtained from 91% of HCS and 91% of SZ patients. Highly significant MMN (d=0.96) and P3a (d=0.93) amplitude reductions were observed in SZ patients, comparable in magnitude to those observed in single-lab studies with no appreciable differences across laboratories. Demographic characteristics accounted for 26% and 18% of the variance in MMN and P3a amplitudes, respectively. Significant relationships were observed among demographically-adjusted MMN and P3a measures and medication status as well as several clinical, cognitive, and functional characteristics of the SZ patients. This study demonstrates that MMN and P3a ERP biomarkers can be feasibly used in multi-site clinical studies. As with many clinical tests of brain function, demographic factors contribute to MMN and P3a amplitudes and should be carefully considered in future biomarker-informed clinical studies. Published by Elsevier B.V.

  5. Interprofessional collaboration and family member involvement in intensive care units: emerging themes from a multi-sited ethnography.

    Science.gov (United States)

    Reeves, Scott; McMillan, Sarah E; Kachan, Natasha; Paradis, Elise; Leslie, Myles; Kitto, Simon

    2015-05-01

    This article presents emerging findings from the first year of a two-year study, which employed ethnographic methods to explore the culture of interprofessional collaboration (IPC) and family member involvement in eight North American intensive care units (ICUs). The study utilized a comparative ethnographic approach - gathering observation, interview and documentary data relating to the behaviors and attitudes of healthcare providers and family members across several sites. In total, 504 hours of ICU-based observational data were gathered over a 12-month period in four ICUs based in two US cities. In addition, 56 semi-structured interviews were undertaken with a range of ICU staff (e.g. nurses, doctors and pharmacists) and family members. Documentary data (e.g. clinical guidelines and unit policies) were also collected to help develop an insight into how the different sites engaged organizationally with IPC and family member involvement. Directed content analysis enabled the identification and categorization of major themes within the data. An interprofessional conceptual framework was utilized to help frame the coding for the analysis. The preliminary findings presented in this paper illuminate a number of issues related to the nature of IPC and family member involvement within an ICU context. These findings are discussed in relation to the wider interprofessional and health services literature.

  6. Embarrassment When Illness Strikes A Close Relative: A World Mental Health Survey Consortium Multi-Site Study

    Science.gov (United States)

    Ahmedani, Brian K.; Kubiak, Sheryl Pimlott; Kessler, Ronald C.; de Graaf, Ron; Alonso, Jordi; Bruffaerts, Ronny; Zarkov, Zahari; Viana, Maria Carmen; Huang, Y.Q.; Hu, Chiyi; Posada-Villa, Jose A.; Lepine, Jean-Pierre; Angermeyer, Matthias C.; de Girolamo, Giovanni; Karam, Aimee N.; Medina-Mora, Maria Elena; Gureje, Oye; Ferry, Finola; Sagar, Rajesh; Anthony, James C.

    2014-01-01

    Background This global study seeks to estimate the degree to which a family member might feel embarrassed when a close relative is suffering from an alcohol, drug, or mental health condition (ADMC) versus a general medical condition (GMC). To date, most studies have considered embarrassment and stigma in society and internalized by the afflicted individual, but have not assessed family embarrassment in a large scale study. Method In 16 sites of the World Mental Health Surveys (WMHS), standardized assessments were completed including items on family embarrassment. Site matching was used to constrain local socially shared determinants of stigma-related feelings, enabling a conditional logistic regression model that estimates the embarrassment close relatives may hold in relation to family members affected by an ADMC, GMC, or both conditions. Results There was a statistically robust association such that subgroups with an ADMC-affected relative were more likely to feel embarrassed as compared to subgroups with a relative affected by a GMC (p<0.001), even with covariate adjustments for age and sex. Conclusions The pattern of evidence from this research is consistent with conceptual models for interventions that target individual- and family-level stigma-related feelings of embarrassment as might be part of the obstacles to effective early intervention and treatment for ADMC conditions. Macro-level interventions are underway, but micro-level interventions also may be required among family members, along with care for each person with an ADMC. PMID:23298443

  7. Laying the foundation for Connect to Protect: a multi-site community mobilization intervention to reduce HIV/AIDS incidence and prevalence among urban youth.

    Science.gov (United States)

    Ziff, Mauri A; Harper, Gary W; Chutuape, Kate S; Deeds, Bethany Griffin; Futterman, Donna; Francisco, Vincent T; Muenz, Larry R; Ellen, Jonathan M

    2006-05-01

    Despite the considerable resources that have been dedicated to HIV prevention interventions and services over the past decade, HIV incidence among young people in the United States remains alarmingly high. One reason is that the majority of prevention efforts continue to focus solely on modifying individual behavior, even though public health research strongly suggests that changes to a community's structural elements, such as their programs, practices, and laws or policies, may result in more effective and sustainable outcomes. Connect to Protect is a multi-city community mobilization intervention that focuses on altering or creating community structural elements in ways that will ultimately reduce youth HIV incidence and prevalence. The project, which spans 6 years, is sponsored by the Adolescent Medicine Trials Network for HIV/AIDS Interventions at multiple urban clinical research sites. This paper provides an overview of the study's three phases and describes key factors in setting a firm foundation for the initiation and execution of this type of undertaking. Connect to Protect's community mobilization approach to achieving structural change represents a relatively new and broad direction in HIV prevention research. To optimize opportunities for its success, time and resources must be initially placed into laying the groundwork. This includes activities such as building a strong overarching study infrastructure to ensure protocol tasks can be met across sites; tapping into local site and community expertise and knowledge; forming collaborative relationships between sites and community organizations and members; and fostering community input on and support for changes at a structural level. Failing to take steps such as these may lead to insurmountable implementation problems for an intervention of this kind.

  8. Laying the Foundation for Connect to Protect®: A Multi-Site Community Mobilization Intervention to Reduce HIV/AIDS Incidence and Prevalence among Urban Youth

    Science.gov (United States)

    Ziff, Mauri A.; Harper, Gary W.; Chutuape, Kate S.; Deeds, Bethany Griffin; Futterman, Donna; Francisco, Vincent T.; Muenz, Larry R.

    2006-01-01

    Despite the considerable resources that have been dedicated to HIV prevention interventions and services over the past decade, HIV incidence among young people in the United States remains alarmingly high. One reason is that the majority of prevention efforts continue to focus solely on modifying individual behavior, even though public health research strongly suggests that changes to a community's structural elements, such as their programs, practices, and laws or policies, may result in more effective and sustainable outcomes. Connect to Protect is a multi-city community mobilization intervention that focuses on altering or creating community structural elements in ways that will ultimately reduce youth HIV incidence and prevalence. The project, which spans 6 years, is sponsored by the Adolescent Medicine Trials Network for HIV/AIDS Interventions at multiple urban clinical research sites. This paper provides an overview of the study's three phases and describes key factors in setting a firm foundation for the initiation and execution of this type of undertaking. Connect to Protect's community mobilization approach to achieving structural change represents a relatively new and broad direction in HIV prevention research. To optimize opportunities for its success, time and resources must be initially placed into laying the groundwork. This includes activities such as building a strong overarching study infrastructure to ensure protocol tasks can be met across sites; tapping into local site and community expertise and knowledge; forming collaborative relationships between sites and community organizations and members; and fostering community input on and support for changes at a structural level. Failing to take steps such as these may lead to insurmountable implementation problems for an intervention of this kind. PMID:16739051

  9. Monitoring Natural World Heritage Sites: optimization of the monitoring system in Bogda with GIS-based multi-criteria decision analysis.

    Science.gov (United States)

    Wang, Zhaoguo; Du, Xishihui

    2016-07-01

    Natural World Heritage Sites (NWHSs) are invaluable treasure due to the uniqueness of each site. Proper monitoring and management can guarantee their protection from multiple threats. In this study, geographic information system (GIS)-based multi-criteria decision analysis (GIS-MCDA) was used to assess criteria layers acquired from the data available in the literature. A conceptual model for determining the priority area for monitoring in Bogda, China, was created based on outstanding universal values (OUV) and expert knowledge. Weights were assigned to each layer using the analytic hierarchy process (AHP) based on group decisions, encompassing three experts: one being a heritage site expert, another a forest ranger, and the other a heritage site manager. Subsequently, evaluation layers and constraint layers were used to generate a priority map and to determine the feasibility of monitoring in Bogda. Finally, a monitoring suitability map of Bogda was obtained by referencing priority and feasibility maps.The high-priority monitoring area is located in the montane forest belt, which exhibits high biodiversity and is the main tourist area of Bogda. The northern buffer zone of Bogda comprises the concentrated feasible monitoring areas, and the area closest to roads and monitoring facilities is highly feasible for NWHS monitoring. The suitability of an area in terms of monitoring is largely determined by the monitoring priority in that particular area. The majority of planned monitoring facilities are well distributed in both suitable and less suitable areas. Analysis results indicate that the protection of Bogda will be more scientifically based due to its effective and all-around planned monitoring system proposed by the declaration text of Xinjiang Tianshan, which is the essential file submitted to World Heritage Centre to inscribe as a NWHS.

  10. Failure to Confirm XMRV/MLVs in the Blood of Patients with Chronic Fatigue Syndrome: A Multi-laboratory Study

    Science.gov (United States)

    Simmons, Graham; Glynn, Simone A.; Komaroff, Anthony L.; Mikovits, Judy A.; Tobler, Leslie H.; Hackett, John; Tang, Ning; Switzer, William M.; Heneine, Walid; Hewlett, Indira K.; Zhao, Jiangqin; Lo, Shyh-Ching; Alter, Harvey J.; Linnen, Jeffrey M.; Gao, Kui; Coffin, John M.; Kearney, Mary F.; Ruscetti, Francis W.; Pfost, Max A.; Bethel, James; Kleinman, Steven; Holmberg, Jerry A.; Busch, Michael P.

    2012-01-01

    Murine leukemia viruses (MLV), including xenotropic-MLV-related virus (XMRV), have been controversially linked to chronic fatigue syndrome (CFS). To explore this issue in greater depth, we compiled coded replicate samples of blood from 15 subjects previously reported to be XMRV/MLV-positive (14 with CFS) and from 15 healthy donors previously determined to be negative for the viruses. These samples were distributed in a blinded fashion to nine laboratories which performed assays designed to detect XMRV/MLV nucleic acid, virus replication, and antibody. Only two laboratories reported evidence of XMRV/MLVs; however, replicate sample results showed disagreement and reactivity was similar among CFS subjects and negative controls. These results indicate that current assays do not reproducibly detect XMRV/MLV in blood samples and that blood donor screening is not warranted. PMID:21940862

  11. What controls the oxidative ratio of UK peats? A multi-site study of elemental CHNO concentrations in peat cores

    Science.gov (United States)

    Clay, Gareth; Worrall, Fred; Masiello, Carrie

    2013-04-01

    The oxidative ratio (OR) is the amount of CO2 sequestered in the terrestrial biosphere for each mol of O2 produced. The OR governs the effectiveness of a terrestrial biome to mitigate the impact of anthropogenic CO2 emissions and it has been used to calculate the balance of terrestrial and oceanic carbon sinks across the globe. However, few studies have investigated the controls of the variability in OR. What factors affect OR - climate? Soil type? Vegetation type? N deposition? Land use? Land use change? Small shifts in OR could have important implications in the global partitioning of CO2 between the atmosphere, biosphere, and oceans. This study looks at peat soils from a series of sites representing a climatic transect across the UK. Duplicate peat cores were taken, along with samples of above-ground vegetation and litter, from sites in northern Scotland (Forsinard), southern Scotland (Auchencorth), northern England (Moor House; Thorne Moor) through the Welsh borders (Whixhall Moss) and Somerset levels (Westhay Moor) to Dartmoor and Bodmin Moor in the south west of England. Sub-samples of the cores were analysed for their CHNO concentrations using a Costech ECS 4010 Elemental combustion system. Using the method of Masiello et al. (2008), OR values could be calculated from these elemental concentrations. Results show that OR values of UK peats varied between 0.82 and 1.27 with a median value of 1.08 which is within the range of world soils. There were significant differences in OR of the peat between sites with the data falling into two broad groupings - Group 1: Forsinard, Auchencorth, Dartmoor and Bodmin Moor; Group 2: Moor House, Thorne Moor, Westhay Moor, Whixhall Moss. Whilst there were significant changes (p < 0.05) in elemental ratios with increasing peat depth (increasing C:N ratio and decreasing O:C ratio) there was no significant difference overall in OR with depth. This paper will explore some of the possible controlling factors on these ratios. Local

  12. Uncertainties in Eddy Covariance fluxes due to post-field data processing: a multi-site, full factorial analysis

    Science.gov (United States)

    Sabbatini, S.; Fratini, G.; Arriga, N.; Papale, D.

    2012-04-01

    Eddy Covariance (EC) is the only technologically available direct method to measure carbon and energy fluxes between ecosystems and atmosphere. However, uncertainties related to this method have not been exhaustively assessed yet, including those deriving from post-field data processing. The latter arise because there is no exact processing sequence established for any given situation, and the sequence itself is long and complex, with many processing steps and options available. However, the consistency and inter-comparability of flux estimates may be largely affected by the adoption of different processing sequences. The goal of our work is to quantify the uncertainty introduced in each processing step by the fact that different options are available, and to study how the overall uncertainty propagates throughout the processing sequence. We propose an easy-to-use methodology to assign a confidence level to the calculated fluxes of energy and mass, based on the adopted processing sequence, and on available information such as the EC system type (e.g. open vs. closed path), the climate and the ecosystem type. The proposed methodology synthesizes the results of a massive full-factorial experiment. We use one year of raw data from 15 European flux stations and process them so as to cover all possible combinations of the available options across a selection of the most relevant processing steps. The 15 sites have been selected to be representative of different ecosystems (forests, croplands and grasslands), climates (mediterranean, nordic, arid and humid) and instrumental setup (e.g. open vs. closed path). The software used for this analysis is EddyPro™ 3.0 (www.licor.com/eddypro). The critical processing steps, selected on the basis of the different options commonly used in the FLUXNET community, are: angle of attack correction; coordinate rotation; trend removal; time lag compensation; low- and high- frequency spectral correction; correction for air density

  13. A multi-site array for combined local electrochemistry and electrophysiology in the non-human primate brain.

    Science.gov (United States)

    Disney, Anita A; McKinney, Collin; Grissom, Larry; Lu, Xuekun; Reynolds, John H

    2015-11-30

    Currently, the primary technique employed in circuit-level study of the brain is electrophysiology, recording local field or action potentials (LFPs or APs). However most communication between neurons is chemical and the relationship between electrical activity within neurons and chemical signaling between them is not well understood in vivo, particularly for molecules that signal at least in part by non-synaptic transmission. We describe a multi-contact array and accompanying head stage circuit that together enable concurrent electrophysiological and electrochemical recording. The array is small (<200 μm) and can be assembled into a device of arbitrary length. It is therefore well-suited for use in all major in vivo model systems in neuroscience, including non-human primates where the large brain and need for daily insertion and removal of recording devices places particularly strict demands on design. We present a protocol for array fabrication. We then show that a device built in the manner described can record LFPs and perform enzyme-based amperometric detection of choline in the awake macaque monkey. Comparison with existing methods Existing methods allow single mode (electrophysiology or electrochemistry) recording. This system is designed for concurrent, dual-mode recording. It is also the only system designed explicitly to meet the challenges of recording in non-human primates. Our system offers the possibility for conducting in vivo studies in a range of species that examine the relationship between the electrical activity of neurons and their chemical environment, with exquisite spatial and temporal precision. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  14. The role of ICT in supporting disruptive innovation: a multi-site qualitative study of nurse practitioners in emergency departments.

    Science.gov (United States)

    Li, Julie; Westbrook, Johanna; Callen, Joanne; Georgiou, Andrew

    2012-04-02

    The disruptive potential of the Nurse Practitioner (NP) is evident in their ability to offer services traditionally provided by primary care practitioners and their provision of a health promotion model of care in response to changing health trends. No study has qualitatively investigated the role of the Emergency NP in Australia, nor the impact of Information and Communication Technology (ICT) on this disruptive workforce innovation. This study aimed to investigate ways in which Nurse Practitioners (NP) have incorporated the use of ICT as a mechanism to support their new clinical role within Emergency Departments. A cross-sectional qualitative study was undertaken in the Emergency Departments (EDs) of two large Australian metropolitan public teaching hospitals. Semi-structured, in-depth interviews were conducted with five nurse practitioners, four senior physicians and five senior nurses. Transcribed interviews were analysed using a grounded theory approach to develop themes in relation to the conceptualisation of the ED nurse practitioner role and the influences of ICT upon the role. Member checking of results was achieved by revisiting the sites to clarify findings with participants and further explore emergent themes. The role of the ENP was distinguished from those of Emergency nurses and physicians by two elements: advanced practice and holistic care, respectively. ICT supported the advanced practice dimension of the NP role in two ways: availability and completeness of electronic patient information enhanced timeliness and quality of diagnostic and therapeutic decision-making, expediting patient access to appropriate care. The ubiquity of patient data sourced from a central database supported and improved quality of communication between health professionals within and across sites, with wider diffusion of the Electronic Medical Record holding the potential to further facilitate team-based, holistic care. ICT is a facilitator through which the disruptive

  15. Activities and interim outcomes of a multi-site development project to promote cognitive support technology use and employment success among postsecondary students with traumatic brain injuries.

    Science.gov (United States)

    Hendricks, Deborah J; Sampson, Elaine; Rumrill, Phillip; Leopold, Anne; Elias, Eileen; Jacobs, Karen; Nardone, Amanda; Scherer, Marcia; Stauffer, Callista

    2015-01-01

    This article describes the activities and interim outcomes of a multi-site development project called Project Career, designed to promote cognitive support technology (CST) use and employment success for college and university students with traumatic brain injuries (TBIs). To obtain early intervention results from participants in Project Career's first 18 months of operation. Fifty-six students with TBI have participated to date across three implementation sites in Massachusetts, Ohio, and West Virginia, with 25 of these participants being military veterans. Descriptive analyses provide information regarding the participants, the barriers they face due to their TBI in obtaining a post-secondary education, and the impact services provided by Project Career have had to date in ameliorating those difficulties. Inferential statistical analyses provide preliminary results regarding program effectiveness. Preliminary results indicate the program is encouraging students to use CST strategies in the form of iPads and cognitive enhancement applications (also known as 'apps'). Significant results indicate participants are more positive, independent, and social; participants have a more positive attitude toward technology after six months in the program; and participants reported significantly improved experiences with technology during their first six months in the program. Participating students are actively preparing for their careers after graduation through a wide range of intensive vocational supports provided by project staff members.

  16. Liver histopathology of the southern watersnake, Nerodia fasciata fasciata, following chronic exposure to trace element-contaminated prey from a coal ash disposal site

    Energy Technology Data Exchange (ETDEWEB)

    Ganser, L.R.; Hopkins, W.A.; O' Neil, L.; Hasse, S.; Roe, J.H.; Sever, D.M. [St Marys College, Notre Dame, IN (USA). Dept. of Biology

    2003-03-01

    Previous studies have demonstrated the accumulation of arsenic, cadmium, selenium, strontium, and vanadium in livers of Southern Watersnakes fed fish from a coal-ash contaminated site. Our study is the first to investigate effects of trace element accumulation on cytology of snake liver. Snakes were born in the laboratory and raised for one or two years on diets consisting of varying proportions of contaminated fish. The majority (71%) of snakes fed contaminated prey did not exhibit any differences in liver histology when compared to control snakes fed an uncontaminated diet. In the remaining contaminant-exposed snakes, some aberrations were noted. The most prevalent pathology involved the proliferation of collagen fibers that resulted in narrowing or occlusion of sinusoids and increasing the mass of the intersinsuoidal parenychma. Fibrosis of the liver as a result of chronic injury has been reported previously in reptiles, but this is the first report that links such tissue damage to dietary contamination.

  17. Functional impacts of exoskeleton-based rehabilitation in chronic stroke: multi-joint versus single-joint robotic training.

    Science.gov (United States)

    Grimaldi, Giuliana; Manto, Mario

    2013-12-19

    Stroke is a major cause of disability in the world. The activities of upper limb segments are often compromised following a stroke, impairing most daily tasks. Robotic training is now considered amongst the rehabilitation methods applied to promote functional recovery. However, the implementation of robotic devices remains a major challenge for the bioengineering and clinical community. Latest exoskeletons with multiple degrees of freedom (DOF) may become particularly attractive, because of their low apparent inertia, the multiple actuators generating large torques, and the fact that patients can move the arm in the normal wide workspace. A recent study published in JNER by Milot and colleagues underlines that training with a 6-DOF exoskeleton impacts positively on motor function in patients being in stable phase of recovery after a stroke. Also, multi-joint robotic training was not found to be superior to single-joint robotic training. Although it is often considered that rehabilitation should start from simple movements to complex functional movements as the recovery evolves, this study challenges this widespread notion whose scientific basis has remained uncertain.

  18. Ultrasonographic Evaluation of Botulinum Toxin Injection Site for the Medial Approach to Tibialis Posterior Muscle in Chronic Stroke Patients with Spastic Equinovarus Foot: An Observational Study

    Directory of Open Access Journals (Sweden)

    Alessandro Picelli

    2017-11-01

    Full Text Available The tibialis posterior muscle is a frequent target for injection of botulinum toxin during the management of spastic equinovarus foot in adults with post-stroke spasticity. Although it is deep-seated, the needle insertion into the tibialis posterior muscle is usually performed using anatomical landmarks and safety information obtained from healthy subjects and cadavers. Our aim was to evaluate the botulinum toxin injection site for the medial approach to the tibialis posterior muscle in chronic stroke patients with spastic equinovarus foot. Forty-six patients were evaluated at the affected middle lower leg medial surface with ultrasonography according to the following parameters: tibialis posterior muscle depth, thickness, and echo intensity. As to the spastic tibialis posterior, we found a mean muscle depth of 26.5 mm and a mean muscle thickness of 10.1 mm. Furthermore we observed a median tibialis posterior muscle echo intensity of 3.00 on the Heckmatt scale. The tibialis posterior muscle thickness was found to be inversely associated with its depth (p < 0.001 and echo intensity (p = 0.006. Furthermore, tibialis posterior muscle depth was found to be directly associated with its echo intensity (p = 0.004. Our findings may usefully inform manual needle placement into the tibialis posterior for the botulinum toxin treatment of spastic equinovarus foot in chronic stroke patients.

  19. The role of ICT in supporting disruptive innovation: a multi-site qualitative study of nurse practitioners in emergency departments

    Directory of Open Access Journals (Sweden)

    Li Julie

    2012-04-01

    Full Text Available Abstract Background The disruptive potential of the Nurse Practitioner (NP is evident in their ability to offer services traditionally provided by primary care practitioners and their provision of a health promotion model of care in response to changing health trends. No study has qualitatively investigated the role of the Emergency NP in Australia, nor the impact of Information and Communication Technology (ICT on this disruptive workforce innovation. This study aimed to investigate ways in which Nurse Practitioners (NP have incorporated the use of ICT as a mechanism to support their new clinical role within Emergency Departments. Methods A cross-sectional qualitative study was undertaken in the Emergency Departments (EDs of two large Australian metropolitan public teaching hospitals. Semi-structured, in-depth interviews were conducted with five nurse practitioners, four senior physicians and five senior nurses. Transcribed interviews were analysed using a grounded theory approach to develop themes in relation to the conceptualisation of the ED nurse practitioner role and the influences of ICT upon the role. Member checking of results was achieved by revisiting the sites to clarify findings with participants and further explore emergent themes. Results The role of the ENP was distinguished from those of Emergency nurses and physicians by two elements: advanced practice and holistic care, respectively. ICT supported the advanced practice dimension of the NP role in two ways: availability and completeness of electronic patient information enhanced timeliness and quality of diagnostic and therapeutic decision-making, expediting patient access to appropriate care. The ubiquity of patient data sourced from a central database supported and improved quality of communication between health professionals within and across sites, with wider diffusion of the Electronic Medical Record holding the potential to further facilitate team-based, holistic care

  20. 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.

  1. Orthogonal Equations of Multi-Spectral Satellite Imagery for the Identification of Un-Excavated Archaeological Sites

    Directory of Open Access Journals (Sweden)

    Athos Agapiou

    2013-12-01

    Full Text Available This paper aims to introduce new linear orthogonal equations for different satellite data derived from QuickBird; IKONOS; WorldView-2; GeoEye-1, ASTER; Landsat 4 TM and Landsat 7 ETM+ sensors, in order to enhance the exposure of crop marks. The latest are of significant value for the detection of buried archaeological features using remote sensing techniques. The proposed transformations, re-projects the initial VNIR bands of the satellite image, into a new 3D coordinate system where the first component is the so called “crop mark”, the second component “vegetation” and the third component “soil”. For the purpose of this study, a large ground spectral signature database has been explored and analyzed separately for each different satellite image. The narrow band reflectance has been re-calculated using the Relative Spectral Response filters of each sensor, and then a PCA analysis was carried out. Subsequently, the first three PCA components were rotated in order to enhance the detection of crop marks. Finally, all proposed transformations have been successfully evaluated in different existing archaeological sites and some interesting crop marks have been exposed.

  2. A Generic Multi-Compartmental CNS Distribution Model Structure for 9 Drugs Allows Prediction of Human Brain Target Site Concentrations.

    Science.gov (United States)

    Yamamoto, Yumi; Välitalo, Pyry A; van den Berg, Dirk-Jan; Hartman, Robin; van den Brink, Willem; Wong, Yin Cheong; Huntjens, Dymphy R; Proost, Johannes H; Vermeulen, An; Krauwinkel, Walter; Bakshi, Suruchi; Aranzana-Climent, Vincent; Marchand, Sandrine; Dahyot-Fizelier, Claire; Couet, William; Danhof, Meindert; van Hasselt, Johan G C; de Lange, Elizabeth C M

    2017-02-01

    Predicting target site drug concentration in the brain is of key importance for the successful development of drugs acting on the central nervous system. We propose a generic mathematical model to describe the pharmacokinetics in brain compartments, and apply this model to predict human brain disposition. A mathematical model consisting of several physiological brain compartments in the rat was developed using rich concentration-time profiles from nine structurally diverse drugs in plasma, brain extracellular fluid, and two cerebrospinal fluid compartments. The effect of active drug transporters was also accounted for. Subsequently, the model was translated to predict human concentration-time profiles for acetaminophen and morphine, by scaling or replacing system- and drug-specific parameters in the model. A common model structure was identified that adequately described the rat pharmacokinetic profiles for each of the nine drugs across brain compartments, with good precision of structural model parameters (relative standard error human concentration-time profiles in different brain compartments well (symmetric mean absolute percentage error brain pharmacokinetic model was developed and its structure could adequately describe data across nine different drugs. The model could be successfully translated to predict human brain concentrations.

  3. Spirituality and religion in outpatients with schizophrenia: a multi-site comparative study of Switzerland, Canada, and the United States.

    Science.gov (United States)

    Mohr, Sylvia; Borras, Laurence; Nolan, Jennifer; Gillieron, Christiane; Brandt, Pierre-Yves; Eytan, Ariel; Leclerc, Claude; Perroud, Nader; Whetten, Kathryn; Pieper, Carl; Koenig, Harold G; Huguelet, Philippe

    2012-01-01

    To assess the importance of spirituality and religious coping among outpatients with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder living in three countries. A total of 276 outpatients (92 from Geneva, Switzerland, 121 from Trois-Rivières, Canada, and 63 from Durham, North Carolina), aged 18-65, were administered a semi-structured interview on the role of spirituality and religiousness in their lives and to cope with their illness. Religion is important for outpatients in each of the three country sites, and religious involvement is higher than in the general population. Religion was helpful (i.e., provided a positive sense of self and positive coping with the illness) among 87% of the participants and harmful (a source of despair and suffering) among 13%. Helpful religion was associated with better social, clinical and psychological status. The opposite was observed for the harmful aspects of religion. In addition, religion sometimes conflicted with psychiatric treatment. These results indicate that outpatients with schizophrenia or schizoaffective disorder often use spirituality and religion to cope with their illness, basically positively, yet sometimes negatively. These results underscore the importance of clinicians taking into account the spiritual and religious lives of patients with schizophrenia.

  4. Topical vancomycin to reduce surgical-site infections in neurosurgery: Study protocol for a multi-center, randomized controlled trial.

    Science.gov (United States)

    Jonokuchi, Alexander J; Knopman, Jared; Radwanski, Ryan E; Martinez, Moises A; Taylor, Blake Eaton Samuel; Rothbaum, Michael; Sullivan, Sean; Robison, Trae R; Lo, Eric; Christophe, Brandon R; Bruce, Eliza M; Khan, Sabrina; Kellner, Christopher P; Sigounas, Dimitri; Youngerman, Brett; Bagiella, Emilia; Angevine, Peter D; Lowy, Franklin D; Sander Connolly, E

    2018-01-01

    Surgical-site infections (SSIs) account for 20% of all healthcare-associated infections, are the most common nosocomial infection among surgical patients, and are a focus of quality improvement initiatives. Despite implementation of many quality care measures (e.g. prophylactic antibiotics), SSIs remain a significant cause of morbidity, mortality, and economic burden, particularly in the field of neurosurgery. Topical vancomycin is increasingly utilized in instrumented spinal and cardiothoracic procedures, where it has been shown to reduce the risk of SSIs. However, a randomized controlled trial assessing its efficacy in the general neurosurgical population has yet to be done. The principle aim of "Topical Vancomycin for Neurosurgery Wound Prophylaxis" (NCT02284126) is to determine whether prophylactic, topical vancomycin reduces the risk of SSIs in the adult neurosurgical population. This prospective, multicenter, patient-blinded, randomized controlled trial will enroll patients to receive the standard of care plus topical vancomycin, or the standard of care alone. The primary endpoint of this study is a SSI by postoperative day (POD) 30. Patients must be over 18years of age. Patients are excluded for renal insufficiency, vancomycin allergy, and some ineligible procedures. Univariate analysis and logistic regression will determine the effect of topical vancomycin on SSIs at 30days. A randomized controlled trial is needed to determine the efficacy of this treatment. Results of this trial are expected to directly influence the standard of care and prevention of SSIs in neurosurgical patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Correlates of Retention in HIV Care after Release from Jail: Results from a Multi-site Study

    Science.gov (United States)

    Althoff, Amy L.; Zelenev, Alexei; Meyer, Jaimie P.; Fu, Jeannia; Brown, Shan-Estelle; Vagenas, Panagiotis; Avery, Ann K.; Cruzado, Jacqueline; Spaulding, Anne C.; Altice, Frederick L.

    2013-01-01

    Retention in care is key to effective HIV treatment, but half of PLWHA in the U.S. are continuously engaged in care. Incarcerated individuals are an especially challenging population to retain, and empiric data specific to jail detainees is lacking. We prospectively evaluated correlates of retention in care for 867 HIV-infected jail detainees enrolled in a 10-site demonstration project. Sustained retention in care was defined as having a clinic visit during each quarter in the 6-month post-release period. The following were independently associated with retention: being male (AOR=2.10, p=<0.01), heroin use (AOR 1.49, p=0.04), having an HIV provider (AOR 1.67, p=0.02), and receipt of services: discharge planning (AOR 1.50, p=0.02) and disease management session (AOR 2.25, p=<0.01) during incarceration; needs assessment (AOR 1.59, p=0.02), HIV education (AOR 2.03, p=<0.01), and transportation assistance (AOR 1.54, p=0.02) after release. Provision of education and case management services improve retention in HIV care after release from jail. PMID:23161210

  6. Novel binding partners and differentially regulated phosphorylation sites clarify Eps8 as a multi-functional adaptor.

    Directory of Open Access Journals (Sweden)

    Debbie L Cunningham

    Full Text Available Eps8 is involved in both cell signalling and receptor trafficking. It is a known phosphorylation substrate for two proteins involved in the fibroblast growth factor receptor (FGFR signalling pathway: the receptor itself and Src. Here we report a differential proteomic analysis of Eps8 aimed to identify specific FGFR and Src family kinase dependent phosphosites and co-associated phosphodependent binding partners. This study reveals a total of 22 Eps8 pTyr and pSer/Thr phosphorylation sites, including those that are dependent on Src family and FGFR kinase activity. Peptide affinity purification of proteins that bind to a selection of the pTyr phosphosites has identified a range of novel Eps8 binding partners including members of the intracellular vesicle trafficking machinery (clathrin and AP-2, proteins which have been shown to regulate activated receptor trafficking (NBR1 and Vav2, and proteins involved in receptor signalling (IRS4 and Shp2. Collectively this study significantly extends the understanding of Eps8 post-translational modification by regulated phosphorylation, identifies novel Eps8 binding partners implicated in receptor trafficking and signalling, and confirms the functions of Eps8 at the nexus of receptor signalling and vesicular trafficking.

  7. Developing harm reduction in the context of youth substance use: insights from a multi-site qualitative analysis of young people's harm minimization strategies.

    Science.gov (United States)

    Jenkins, Emily K; Slemon, Allie; Haines-Saah, Rebecca J

    2017-07-31

    Youth substance use programming and educational strategies are frequently informed by prevention approaches that emphasize abstinence goals, which often do not resonate with youth in their lack of acknowledgment of young people's social context and how young people perceive positive effects of substance use. Further, approaches to drug prevention have been critiqued as adopting a one-size-fits-all approach and therefore inadequate in addressing substance use in the context of population variation and inequities. In response to the limitations of current approaches to prevention, programming informed by harm reduction principles that aims to minimize harms without requiring abstinence is emergent in school settings. However, youth perspectives informing harm reduction are limited in both research and program development. This paper draws on data from the Researching Adolescent Distress and Resilience (RADAR) study, which utilized an ethnographic approach to bring youth voice to the literature on mental health and substance use. Qualitative data collection included individual interviews (n = 86) with young people aged 13-18 across three communities-representing urban, suburban, and rural geographies-in British Columbia, Canada. A multi-site qualitative analysis of interview data was conducted to identify themes across and within each research site. Across all three sites, young people's individual experiences of substance use were shaped by geographic, socio-cultural, and political contexts, with youth describing their use in relation to the nature of substance use in peer groups and in the broader community. To manage their own substance use and reduce related harms, youth employed a variety of ad hoc harm minimization strategies that were reflective of their respective contexts. The findings from this study suggest the importance of harm reduction approaches that are contextually relevant and responsive to the lived experiences of youth. Youth perspectives in the

  8. The multi-factorial origins of Chronic Traumatic Encephalopathy (CTE) symptomology in post-career athletes: The athlete post-career adjustment (AP-CA) model.

    Science.gov (United States)

    Gaetz, Michael

    2017-05-01

    CTE has two prominent components: the pathophysiology that is detected in the brain postmortem and the symptomology that is present in the interval between retirement and end of life. CTE symptomology has been noted to include memory difficulties, aggression, depression, explosivity, and executive dysfunction at early stages progressing to problems with attention, mood swings, visuospatial difficulties, confusion, progressive dementia, and suicidality (e.g. McKee et al. (2012), Omalu et al. (2010a-c), McKee et al. (2009)). There are a number of assumptions embedded within the current CTE literature: The first is the assumption that CTE symptomology reported by athletes and their families is the product of the pathophysiology change detected post-mortem (e.g. McKee et al. (2009)). At present, there is little scientific evidence to suggest that all CTE symptomology is the product of CTE pathophysiology. It has been assumed that CTE pathophysiology causes CTE symptomology (Meehan et al. (2015), Iverson et al. (2016)) but this link has never been scientifically validated. The purpose of the present work is to provide a multi-factorial theoretical framework to account for the symptomology reported by some athletes who sustain neurotrauma during their careers that will lead to a more systematic approach to understanding post-career symptomology. There is significant overlap between the case reports of athletes with post-mortem diagnoses of CTE, and symptom profiles of those with a history of substance use, chronic pain, and athlete career transition stress. The athlete post-career adjustment (AP-CA) model is intended to explain some of the symptoms that athletes experience at the end of their careers or during retirement. The AP-CA model consists of four elements: neurotrauma, chronic pain, substance use, and career transition stress. Based on the existing literature, it is clear that any one of the four elements of the AP-CA model can account for a significant number of

  9. 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.

    Science.gov (United States)

    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

  10. The main rhinovirus respiratory tract adhesion site (ICAM-1) is upregulated in smokers and patients with chronic airflow limitation (CAL).

    Science.gov (United States)

    Shukla, Shakti Dhar; Mahmood, Malik Quasir; Weston, Steven; Latham, Roger; Muller, Hans Konrad; Sohal, Sukhwinder Singh; Walters, Eugene Haydn

    2017-01-05

    ICAM-1 is a major receptor for ~60% of human rhinoviruses, and non-typeable Haemophilus influenzae, two major pathogens in COPD. Increased cell-surface expression of ICAM-1 in response to tobacco smoke exposure has been suggested. We have investigated epithelial ICAM-1 expression in both the large and small airways, and lung parenchyma in smoking-related chronic airflow limitation (CAL) patients. We evaluated epithelial ICAM-1 expression in resected lung tissue: 8 smokers with normal spirometry (NLFS); 29 CAL patients (10 small-airway disease; 9 COPD-smokers; 10 COPD ex-smokers); Controls (NC): 15 normal airway/lung tissues. Immunostaining with anti-ICAM-1 monoclonal antibody was quantified with computerized image analysis. The percent and type of cells expressing ICAM-1 in large and small airway epithelium and parenchyma were enumerated, plus percentage of epithelial goblet and submucosal glands positive for ICAM- 1. A major increase in ICAM-1 expression in epithelial cells was found in both large (p < 0.006) and small airways (p < 0.004) of CAL subjects compared to NC, with NLFS being intermediate. In the CAL group, both basal and luminal areas stained heavily for ICAM-1, so did goblet cells and sub-mucosal glands, however in either NC or NLFS subjects, only epithelial cell luminal surfaces stained. ICAM-1 expression on alveolar pneumocytes (mainly type II) was slightly increased in CAL and NLFS (p < 0.01). Pack-years of smoking correlated with ICAM-1 expression (r = 0.49; p < 0.03). Airway ICAM-1 expression is markedly upregulated in CAL group, which could be crucial in rhinoviral and NTHi infections. The parenchymal ICAM-1 is affected by smoking, with no further enhancement in CAL subjects.

  11. Laparoendoscopic single-site radical hysterectomy with pelvic lymphadenectomy: initial multi-institutional experience for treatment of invasive cervical cancer.

    Science.gov (United States)

    Boruta, David M; Fagotti, Anna; Bradford, Leslie S; Escobar, Pedro F; Scambia, Giovanni; Kushnir, Christina L; Michener, Chad M; Fader, Amanda Nickles

    2014-01-01

    To describe the feasibility, safety, and outcomes of women with stage I cervical cancer treated with laparoendoscopic single-site surgery radical hysterectomy (LESS-RH). A retrospective descriptive study (Canadian Task Force classification III). Multiple academic teaching hospitals. Women with Fédération Internationale de Gynécologie et d'Obstétrique FIGO stage IA1 to IB1 cervical cancer. LESS-RH as the primary therapy for cervical cancer performed by a gynecologic oncologist with expertise in LESS. A multichannel, single-port access device; a flexible-tipped 5-mm laparoscope; and a multifunctional instrument were used in all cases. Clinicopathologic, surgical, and perioperative outcomes were analyzed. Twenty-two women were identified in whom a LESS-RH was attempted; 20 (91%) successfully underwent the procedure, including 19 in whom pelvic lymphadenectomy (PLND) was completed. Of the 2 converted procedures, 1 patient underwent 2-port laparoscopy secondary to truncal obesity, and 1 patient underwent conversion to laparotomy secondary to external iliac vein laceration during PLND. The median age and body mass index were 46 years and 23.3 kg/m(2), respectively. The median number of pelvic lymph nodes removed was 22. One patient experienced an intraoperative complication, and no patient required reoperation. The margins of excision were negative. One patient with 2 positive pelvic nodes and 1 patient with microscopic parametrial disease received adjuvant chemosensitized radiation; 3 additional patients received adjuvant radiation therapy secondary to an intermediate risk for recurrence. After a median follow up of 11 months, no recurrences were detected. LESS-RH/PLND is feasible and safe for select patients with stage I cervical cancer. Larger studies are needed to confirm whether the increased technical difficulty of this procedure justifies its use in routine gynecologic oncology practice. Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

  12. Solid Waste Management in Greater Shillong Planning Area (GSPA) Using Spatial Multi-Criteria Decision Analysis for Site Suitability Assessment

    Science.gov (United States)

    Mipun, B. S.; Hazarika, R.; Mondal, M.; Mukhopadhyay, S.

    2015-04-01

    In Shillong city the existing solid waste management system is mobile waste bins (72%). About 12 percent burn the waste generated by them. Door to door collection is about 5 percent. Over 2 percent households throw the wastes in the open space. Another 9 percent households throw their wastes into the waste bins located in the neighbourhood. The local headman takes care about half of the household's wastes, while Municipality takes care about 34 percent households. About 10 percent households are ignorant about the collection and disposal of wastes. Some NGO's takes care about 5 percent household's wastes. Awareness about segregation of waste into organic and non-bio degradable waste is 64 percent and a significant numbers do the segregation. In Shillong Municipality Board (SMB) area collects 45.91% (78.42 MT) waste, outside SMB area collection is 32.61% (45.99 MT) and entire GSPA the percentage of garbage collected is 41percent. The only dumping ground in GSPA is Marten, Mawiong, and the capacity to hold garbage is decreasing due to limited landfill. The sanitary landfill site is 5.0 acres that it is not enough to meet the demand. Out of he total area 170.69 sq. km. (GSPA) only 25.67% is most suitable and 18.58% is unsuitable to set up a new landfill area. Eastern part of the GSPA, is most suitable, which fulfils the entire criterion adopted in this study. In this the best-stated criterion are land cover (vacant space), slope (2000m) and elevation (1300-1500m). The eastern part of the GSPA is most suitable landfill location.

  13. YMDD motif mutations in chronic hepatitis B antiviral treatment naïve patients: a multi-center study

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    You-Wen Tan

    Full Text Available OBJECTIVE: This study aimed to determine the natural prevalence of variants of tyrosine-methionine-aspartic acid-aspartic acid (YMDD motif in patients with chronic hepatitis B (CHB, and to explore its relation with demographic and clinical features, hepatitis B virus (HBV genotypes, and HBV DNA levels. METHODS: A total of 1,042 antiviral treatment naïve CHB patients (including with lamivudine [LAM] in the past year were recruited from outpatient and inpatient departments of six centers from December 2008 to June 2010. YMDD variants were analyzed using the HBV drug resistance line probe assay (Inno-Lipa HBV-DR. HBV genotypes were detected with polymerase chain reaction (PCR microcosmic nucleic acid cross-ELISA, and HBV deoxyribonucleic acid (DNA was quantitated with real-time PCR. All serum samples underwent tests for HBV, HCV, and HDV with ELISA. RESULTS: YMDD variants were detected in 23.3% (243/1042 of CHB patients. YMDD mutation was accompanied by L180M mutation in 154 (76.9% patients. Both wild-type HBV and YMDD variant HBV were present in 231 of 243 patients. Interestingly, 12 patients had only YIDD and/or YVDD variants without wild YMDD motif. In addition, 27.2% (98/359 of HbeAg-positive patients had YMDD mutations, which was higher than that in HbeAg-negative patients (21.2%, 145/683. The incidence of YMDD varied among patients with different HBV genotypes, but the difference was not significant. Moreover, the incidence of YMDD in patients with high HBV DNA level was significantly higher than that in those with low HBV DNA level. CONCLUSION: Mutation of YMDD motif was detectable at a high rate in CHB patients in this study. The incidence of YMDD may be correlated with HBeAg and HBV DNA level.

  14. Introducing a multi-site program for early diagnosis of HIV infection among HIV-exposed infants in Tanzania.

    Science.gov (United States)

    Nuwagaba-Biribonwoha, Harriet; Werq-Semo, Bazghina; Abdallah, Aziz; Cunningham, Amy; Gamaliel, John G; Mtunga, Sevestine; Nankabirwa, Victoria; Malisa, Isaya; Gonzalez, Luis F; Massambu, Charles; Nash, Denis; Justman, Jessica; Abrams, Elaine J

    2010-06-17

    In Tanzania, less than a third of HIV infected children estimated to be in need of antiretroviral therapy (ART) are receiving it. In this setting where other infections and malnutrition mimic signs and symptoms of AIDS, early diagnosis of HIV among HIV-exposed infants without specialized virologic testing can be a complex process. We aimed to introduce an Early Infant Diagnosis (EID) pilot program using HIV DNA Polymerase Chain Reaction (PCR) testing with the intent of making EID nationally available based on lessons learned in the first 6 months of implementation. In September 2006, a molecular biology laboratory at Bugando Medical Center was established in order to perform HIV DNA PCR testing using Dried Blood Spots (DBS). Ninety-six health workers from 4 health facilities were trained in the identification and care of HIV-exposed infants, HIV testing algorithms and collection of DBS samples. Paper-based tracking systems for monitoring the program that fed into a simple electronic database were introduced at the sites and in the laboratory. Time from birth to first HIV DNA PCR testing and to receipt of test results were assessed using Kaplan-Meier curves. From October 2006 to March 2007, 510 HIV-exposed infants were identified from the 4 health facilities. Of these, 441(87%) infants had an HIV DNA PCR test at a median age of 4 months (IQR 1 to 8 months) and 75(17%) were PCR positive. Parents/guardians for a total of 242(55%) HIV-exposed infants returned to receive PCR test results, including 51/75 (68%) of those PCR positive, 187/361 (52%) of the PCR negative, and 4/5 (80%) of those with indeterminate PCR results. The median time between blood draw for PCR testing and receipt of test results by the parent or guardian was 5 weeks (range HIV-exposed infants. There was a high response as hundreds of HIV-exposed infants were registered and tested in a 6 month period. Challenges included the large proportion of parents not returning for PCR test results. Experience

  15. Immunological and physiological effects of chronic exposure of Peromyscus leucopus to Aroclor 1254 at a concentration similar to that found at contaminated sites

    Science.gov (United States)

    Segre, M.; Arena, S.M.; Greeley, E.H.; Melancon, M.J.; Graham, D.A.; French, J.B.

    2002-01-01

    Polychlorinated biphenyls (PCBs) are environmental contaminants known to cause adverse health effects to biological systems. Limited data are available on their effects on the immune system of wildlife species. Previously, we found that 4 and 6-week-old white-footed mice (Peromyscus leucopus) born from dams injected with a single dose (300 mg/kg) of Aroclor 1254, had altered immunological, hematological, and biochemical responses. Here, we examined the effect of transplacental lactational and postnatal exposure to Aroclor 1254, at a concentration similar to that found at contaminated sites, on various physiological parameters of 22-week-old white-footed mice. Liver weight and liver somatic index of PCB treated animals were significantly higher, the combined weights of the adrenal glands were significantly lower and EROD and BROD enzyme activity was significantly higher compared to control values. The number of thymocytes of the treated mice was significantly lower than that of the controls; however, thymocytes of treated mice had a higher proliferative response to the mitogen Con A. These alterations were correlated with the PCBs body burdens. Some toxic effects of chronic exposure to PCBs, at levels comparable to exposure found in contaminated sites in the USA, are still evident in adult P. leucopus.

  16. From 1D-Multi-Layer-Conductivity-Inversion to Pseudo-3D-Imaging of Quantified Electromagnetic Induction Data Acquired at a Heterogeneous Test Site

    Science.gov (United States)

    von Hebel, Christian; Rudolph, Sebastian; Huisman, Johan A.; van der Kruk, Jan; Vereecken, Harry

    2013-04-01

    Electromagnetic induction (EMI) systems enable the non-invasive spatial characterization of soil structural and hydrogeological variations, since the measured apparent electrical conductivity (ECa) can be related to changes in soil moisture, soil water, clay content and/or salinity. Due to the contactless operation, ECa maps of relatively large areas, i.e. field to (small) catchment scale, can be measured in reasonably short times. A multi-configuration EMI system with one electromagnetic field transmitter and various receivers with different offsets provide simultaneous ECa measurements that are representative of different sensing depths. Unfortunately, measured ECa values can only be considered as qualitative values due to external influences like the operator, cables or other metal objects. Of course, a better vertical characterization of the subsurface is possible when quantitative measurement values could be obtained. To obtain such quantitative ECa values, the measured EMI apparent conductivities are calibrated using a linear regression approach with predicted apparent conductivities obtained from a Maxwell-based full-solution forward model using inverted electrical resistivity tomography (ERT) data as input. These calibrated apparent conductivities enable a quantitative multi-layer-inversion to resolve for the electrical conductivity of certain layers. To invert for a large scale three-layer model, a one-dimensional (1D) shuffled-complex-evolution inversion scheme was parallelized and run on JUROPA - one of the supercomputers of the Forschungszentrum Jülich. This novel inversion routine was applied to calibrated electromagnetic induction data acquired at the Selhausen test site (Germany), which has a size of about 190 x 70 m. The test site is weakly inclined and a distinct gradient in soil texture is present with considerably higher gravel content at the upper part of the field. Parallel profiles with approximately three meter distance were measured using

  17. 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

  18. Analysis of host responses to Mycobacterium tuberculosis antigens in a multi-site study of subjects with different TB and HIV infection states in sub-Saharan Africa.

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    Jayne S Sutherland

    Full Text Available Tuberculosis (TB remains a global health threat with 9 million new cases and 1.4 million deaths per year. In order to develop a protective vaccine, we need to define the antigens expressed by Mycobacterium tuberculosis (Mtb, which are relevant to protective immunity in high-endemic areas.We analysed responses to 23 Mtb antigens in a total of 1247 subjects with different HIV and TB status across 5 geographically diverse sites in Africa (South Africa, The Gambia, Ethiopia, Malawi and Uganda. We used a 7-day whole blood assay followed by IFN-γ ELISA on the supernatants. Antigens included PPD, ESAT-6 and Ag85B (dominant antigens together with novel resuscitation-promoting factors (rpf, reactivation proteins, latency (Mtb DosR regulon-encoded antigens, starvation-induced antigens and secreted antigens.There was variation between sites in responses to the antigens, presumably due to underlying genetic and environmental differences. When results from all sites were combined, HIV- subjects with active TB showed significantly lower responses compared to both TST(- and TST(+ contacts to latency antigens (Rv0569, Rv1733, Rv1735, Rv1737 and the rpf Rv0867; whilst responses to ESAT-6/CFP-10 fusion protein (EC, PPD, Rv2029, TB10.3, and TB10.4 were significantly higher in TST(+ contacts (LTBI compared to TB and TST(- contacts fewer differences were seen in subjects with HIV co-infection, with responses to the mitogen PHA significantly lower in subjects with active TB compared to those with LTBI and no difference with any antigen.Our multi-site study design for testing novel Mtb antigens revealed promising antigens for future vaccine development. The IFN-γ ELISA is a cheap and useful tool for screening potential antigenicity in subjects with different ethnic backgrounds and across a spectrum of TB and HIV infection states. Analysis of cytokines other than IFN-γ is currently on-going to determine correlates of protection, which may be useful for vaccine

  19. Genomic comparison of multi-drug resistant invasive and colonizing Acinetobacter baumannii isolated from diverse human body sites reveals genomic plasticity

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    Hsiao William W

    2011-06-01

    Full Text Available Abstract Background Acinetobacter baumannii has recently emerged as a significant global pathogen, with a surprisingly rapid acquisition of antibiotic resistance and spread within hospitals and health care institutions. This study examines the genomic content of three A. baumannii strains isolated from distinct body sites. Isolates from blood, peri-anal, and wound sources were examined in an attempt to identify genetic features that could be correlated to each isolation source. Results Pulsed-field gel electrophoresis, multi-locus sequence typing and antibiotic resistance profiles demonstrated genotypic and phenotypic variation. Each isolate was sequenced to high-quality draft status, which allowed for comparative genomic analyses with existing A. baumannii genomes. A high resolution, whole genome alignment method detailed the phylogenetic relationships of sequenced A. baumannii and found no correlation between phylogeny and body site of isolation. This method identified genomic regions unique to both those isolates found on the surface of the skin or in wounds, termed colonization isolates, and those identified from body fluids, termed invasive isolates; these regions may play a role in the pathogenesis and spread of this important pathogen. A PCR-based screen of 74 A. baumanii isolates demonstrated that these unique genes are not exclusive to either phenotype or isolation source; however, a conserved genomic region exclusive to all sequenced A. baumannii was identified and verified. Conclusions The results of the comparative genome analysis and PCR assay show that A. baumannii is a diverse and genomically variable pathogen that appears to have the potential to cause a range of human disease regardless of the isolation source.

  20. Multi site polyadenylation and transcriptional response to stress of a vacuolar type H+-ATPase subunit A gene in Arabidopsis thaliana

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    Gogarten Johann

    2002-04-01

    Full Text Available Abstract Background Vacuolar type H+-ATPases play a critical role in the maintenance of vacuolar homeostasis in plant cells. V-ATPases are also involved in plants' defense against environmental stress. This research examined the expression and regulation of the catalytic subunit of the vacuolar type H+-ATPase in Arabidopsis thaliana and the effect of environmental stress on multiple transcripts generated by this gene. Results Evidence suggests that subunit A of the vacuolar type H+-ATPase is encoded by a single gene in Arabidopsis thaliana. Genome blot analysis showed no indication of a second subunit A gene being present. The single gene identified was shown by whole RNA blot analysis to be transcribed in all organs of the plant. Subunit A was shown by sequencing the 3' end of multiple cDNA clones to exhibit multi site polyadenylation. Four different poly (A tail attachment sites were revealed. Experiments were performed to determine the response of transcript levels for subunit A to environmental stress. A PCR based strategy was devised to amplify the four different transcripts from the subunit A gene. Conclusions Amplification of cDNA generated from seedlings exposed to cold, salt stress, and etiolation showed that transcript levels for subunit A of the vacuolar type H+-ATPase in Arabidopsis were responsive to stress conditions. Cold and salt stress resulted in a 2–4 fold increase in all four subunit A transcripts evaluated. Etiolation resulted in a slight increase in transcript levels. All four transcripts appeared to behave identically with respect to stress conditions tested with no significant differential regulation.

  1. The HIKCUPS trial: a multi-site randomized controlled trial of a combined physical activity skill-development and dietary modification program in overweight and obese children

    Directory of Open Access Journals (Sweden)

    Warren Janet M

    2007-01-01

    Full Text Available Abstract Background Childhood obesity is one of the most pressing health issues of our time. Key health organizations have recommended research be conducted on the effectiveness of well-designed interventions to combat childhood obesity that can be translated into a variety of settings. This paper describes the design and methods used in the Hunter Illawarra Kids Challenge Using Parent Support (HIKCUPS trial, an ongoing multi-site randomized controlled trial, in overweight/obese children comparing the efficacy of three interventions: 1 a parent-centered dietary modification program; 2 a child-centered physical activity skill-development program; and 3 a program combining both 1 and 2 above. Methods/Design Each intervention consists of three components: i 10-weekly face-to-face group sessions; ii a weekly homework component, completed between each face-to-face session and iii three telephone calls at monthly intervals following completion of the 10-week program. Details of the programs' methodological aspects of recruitment, randomization and statistical analyses are described here a priori. Discussion Importantly this paper describes how HIKCUPS addresses some of the short falls in the current literature pertaining to the efficacy of child obesity interventions. The HIKCUPS trial is funded by the National Medical Research Council, Australia.

  2. Design and baseline findings of a multi-site non-randomized evaluation of the effect of a health programme on microfinance clients in India.

    Science.gov (United States)

    Saha, Somen

    2013-10-12

    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. A quantitative survey at inception and twelve months post health intervention compare the primary outcome (incidence of childhood diarrhea), and secondary outcome (place of last delivery, toilet at home, and out-of-pocket expenditure on treatment). At baseline, the intervention and comparison communities were similar except for out-of-pocket expenditure on health. Low reported use of toilet at home indicates the areas are heading towards a sanitation crisis. This should be an area of program priority for the microfinance organizations. While respondents primarily rely on their savings for meeting treatment expenditure, borrowing from friends, relatives, and money-lenders remains other important source of meeting treatment expenditure in the community. Programs need to prioritize steps to ensure awareness about national health insurance schemes, entitlement to increase service utilization, and developing additional health financing safety nets for financing outpatient care, that are responsible for majority of health-debt. Finally we discuss implications of such programs for national policy makers.

  3. An introduction to the composition of the Multi-Site University Study of Identity and Culture (MUSIC): a collaborative approach to research and mentorship.

    Science.gov (United States)

    Weisskirch, Robert S; Zamboanga, Byron L; Ravert, Russell D; Whitbourne, Susan Krauss; Park, Irene J K; Lee, Richard M; Schwartz, Seth J

    2013-04-01

    The Multi-Site University Study of Identity and Culture (MUSIC) is the product of a research collaboration among faculty members from 30 colleges and universities from across the United States. Using Katz and Martin's (1997, p. 7) definition, the MUSIC research collaboration is "the working together of researchers to achieve the common goals of producing new scientific knowledge." The collaboration involved more than just coauthorship; it served "as a strategy to insert more energy, optimism, creativity and hope into the work of [researchers]" (Conoley & Conoley, 2010, p. 77). The philosophy underlying the MUSIC collaborative was intended to foster natural collaborations among researchers, to provide opportunities for scholarship and mentorship for early career and established researchers, and to support exploration of identity, cultural, and ethnic/racial research ideas by tapping the expertise and interests of the broad MUSIC network of collaborators. In this issue, five research articles present innovative findings from the MUSIC datasets. There are two themes across the articles. Research is emerging about broadening the constructs and measures of acculturation and ethnic identity and their relation to health risk behaviors and psychosocial and mental health outcomes. The second theme is about the relationship of perceived discrimination on behavioral and mental health outcomes among immigrant populations.

  4. A randomised, double blind, placebo-controlled, multi-centric parallel arm trial to assess the effects of homoeopathic medicines on chronic rhinosinusitis

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    Raj K Manchanda

    2014-01-01

    Full Text Available Background: Chronic rhinosinusitis (CRS is one of the most common illnesses interfering with patient′s quality of life and work. Observational studies conducted by the Council indicate positive outcome. This protocol has been developed to ascertain the usefulness of homoeopathic intervention in comparison with control group in a randomised control setting. Objectives: Primary objective is to evaluate the changes in TSS (Total Symptoms Score and SNOT-22 (Sino-nasal Outcome Test-22 within the two groups of the study (Homoeopathy + Placebo. Secondary objective is to evaluate changes in SNOT-22 at end of the trial, changes in Lund and Mackay staging of CT scan, rhinoscopy grading, absolute eosinophil count, global assessment by investigator and patient, and number of acute exacerbations of CRS (for frequency, duration and intensity as per TSS scale compared to placebo. Methods/Design: This is a randomised double blind, placebo-controlled, multi-centric parallel arm trial of 6 months (three months treatment and three months observation period with 14 days run-in period. The primary outcome is a composite of the changes in the TSS and SNOT-22 over 3 months from baseline with area under the curve and changes over 3 months in the Sinus Nasal Outcome Test 22 (SNOT-22 from baseline. Prescription shall be made as per the homoeopathic principles. Efficacy data will be analysed in the intention-to-treat population. Discussion: This trial will help to evaluate the efficacy of homoeopathic individualised treatment using LM-potencies versus placebo in patients suffering from CRS as per the homoeopathic dictum.

  5. Improvements in hand function in adults with chronic tetraplegia following a multi-day 10Hz rTMS intervention combined with repetitive task practice

    Science.gov (United States)

    Gomes-Osman, Joyce; Field-Fote, Edelle C.

    2014-01-01

    Background and Purpose Evidence suggests the use of stimulation to increase corticomotor excitability improves hand function in persons with cervical spinal cord injury (SCI). We assessed effects of multi-day application of 10Hz repetitive transcranial magnetic stimulation (rTMS) applied to the corticomotor hand area combined with repetitive task practice (RTP) in participants with tetraplegia and neurologically healthy participants. Methods Using a double-blind randomized crossover design, 11 participants with chronic tetraplegia and 10 neurologically healthy participants received 3 sessions of 10Hz rTMS+RTP and 3 sessions of sham-rTMS+RTP to the corticomotor hand region controlling the weaker hand. RTMS was interleaved with RTP of a skilled motor task between pulse trains. Hand function (Jebsen-Taylor Hand Function Test [JTT], pinch, and grasp strength) and corticomotor excitability (amplitude of motor-evoked potential) were assessed prior to and following the rTMS+RTP and sham-rTMS+RTP phases. We assessed significance using paired t-tests on pre-post differences and effect sizes using standardized response mean (SRM). Results RTMS+RTP was associated with larger effect sizes compared to sham-rTMS+RTP for improvement in JTT for both the trained hand (SRM=0.85 and 0.42, respectively), non-trained hand (0.55, 0.31, respectively), and for grasp strength of the trained hand in the SCI group (0.67, 0.39, respectively) alone. Effect sizes for all other measures were small and there were no statistical between-condition differences in the outcomes assessed. Discussion and Conclusions RTMS may be a valuable adjunct to RTP for improving hand function in persons with tetraplegia. Higher stimulation dose (frequency, intensity, number of sessions) may be associated with larger effects. Video Abstract available (See Supplemental Digital Conent 1) for more insights from the authors. PMID:25415549

  6. Strengthening the evidence and action on multi-sectoral partnerships in public health: an action research initiative

    National Research Council Canada - National Science Library

    C. D. Willis; J. K. Greene; A. Abramowicz; B. L. Riley

    2016-01-01

    .... Multi-sectoral Partnerships to Promote Healthy Living and Prevent Chronic Disease The Multi-sectoral Partnerships to Promote Healthy Living and Prevent Chronic Disease initiative, administered...

  7. Use of information and communication technologies to support effective work practice innovation in the health sector: a multi-site study

    Directory of Open Access Journals (Sweden)

    Georgiou Andrew

    2009-11-01

    Full Text Available Abstract Background Widespread adoption of information and communication technologies (ICT is a key strategy to meet the challenges facing health systems internationally of increasing demands, rising costs, limited resources and workforce shortages. Despite the rapid increase in ICT investment, uptake and acceptance has been slow and the benefits fewer than expected. Absent from the research literature has been a multi-site investigation of how ICT can support and drive innovative work practice. This Australian-based project will assess the factors that allow health service organisations to harness ICT, and the extent to which such systems drive the creation of new sustainable models of service delivery which increase capacity and provide rapid, safe, effective, affordable and sustainable health care. Design A multi-method approach will measure current ICT impact on workforce practices and develop and test new models of ICT use which support innovations in work practice. The research will focus on three large-scale commercial ICT systems being adopted in Australia and other countries: computerised ordering systems, ambulatory electronic medical record systems, and emergency medicine information systems. We will measure and analyse each system's role in supporting five key attributes of work practice innovation: changes in professionals' roles and responsibilities; integration of best practice into routine care; safe care practices; team-based care delivery; and active involvement of consumers in care. Discussion A socio-technical approach to the use of ICT will be adopted to examine and interpret the workforce and organisational complexities of the health sector. The project will also focus on ICT as a potentially disruptive innovation that challenges the way in which health care is delivered and consequently leads some health professionals to view it as a threat to traditional roles and responsibilities and a risk to existing models of care

  8. Use of information and communication technologies to support effective work practice innovation in the health sector: a multi-site study.

    Science.gov (United States)

    Westbrook, Johanna I; Braithwaite, Jeffrey; Gibson, Kathryn; Paoloni, Richard; Callen, Joanne; Georgiou, Andrew; Creswick, Nerida; Robertson, Louise

    2009-11-08

    Widespread adoption of information and communication technologies (ICT) is a key strategy to meet the challenges facing health systems internationally of increasing demands, rising costs, limited resources and workforce shortages. Despite the rapid increase in ICT investment, uptake and acceptance has been slow and the benefits fewer than expected. Absent from the research literature has been a multi-site investigation of how ICT can support and drive innovative work practice. This Australian-based project will assess the factors that allow health service organisations to harness ICT, and the extent to which such systems drive the creation of new sustainable models of service delivery which increase capacity and provide rapid, safe, effective, affordable and sustainable health care. A multi-method approach will measure current ICT impact on workforce practices and develop and test new models of ICT use which support innovations in work practice. The research will focus on three large-scale commercial ICT systems being adopted in Australia and other countries: computerised ordering systems, ambulatory electronic medical record systems, and emergency medicine information systems. We will measure and analyse each system's role in supporting five key attributes of work practice innovation: changes in professionals' roles and responsibilities; integration of best practice into routine care; safe care practices; team-based care delivery; and active involvement of consumers in care. A socio-technical approach to the use of ICT will be adopted to examine and interpret the workforce and organisational complexities of the health sector. The project will also focus on ICT as a potentially disruptive innovation that challenges the way in which health care is delivered and consequently leads some health professionals to view it as a threat to traditional roles and responsibilities and a risk to existing models of care delivery. Such views have stifled debate as well as wider

  9. The chronic infusion of nicotine into the developing chick embryo does not alter the density of (-)-[3H]nicotine-binding sites or vestibular function

    Science.gov (United States)

    Roll, R. L.; Jones, T. A.; Benowitz, N. L.; Morley, B. J.

    1993-01-01

    (-)-Nicotine (1.2 mg/day) or saline was infused into chick embryos (Gallus domesticus) for 10 days beginning 12 h beyond the eight day of incubation (E8 + 12 h). Twelve h beyond the eighteenth day of incubation (E18 + 12 h), the eggs were opened to access the embryos and subcutaneous skull electrodes placed. Short latency vestibular response thresholds and input/output functions were determined to assess neurophysiological consequences of chronic nicotine administration. Samples of serum and extraembryonic (amniotic and albumen) fluid were analyzed by gas chromatography-mass spectrometry to determine the levels of nicotine and its major metabolite, cotinine. The brains were removed and divided into diencephalon and mesencephalon and the density of (-)-[3H]nicotine binding sites in each brain area was measured. Nicotine and cotinine were found in the serum and extraembryonic fluid, but nicotinic receptors were not up-regulated in the brains of animals infused with nicotine in comparison to controls. Vestibular response thresholds also did not differ between nicotine-treated and control animals.

  10. Adenovirus-associated health risks for recreational activities in a multi-use coastal watershed based on site-specific quantitative microbial risk assessment.

    Science.gov (United States)

    Kundu, Arti; McBride, Graham; Wuertz, Stefan

    2013-10-15

    We used site-specific quantitative microbial risk assessment (QMRA) to assess the probability of adenovirus illness for three groups of swimmers: adults with primary contact, children with primary contact, and secondary contact regardless of age. Human enteroviruses and adenoviruses were monitored by qPCR in a multi-use watershed and Adenovirus type 40/41 was detected in 11% of 73 samples, ranging from 147 to 4117 genomes per liter. Enterovirus was detected only once (32 genomes per liter). Seven of eight virus detections occurred when E. coli concentrations were below the single sample maximum water quality criterion for contact recreation, and five of eight virus detections occurred when fecal coliforms were below the corresponding criterion. We employed dose-harmonization to convert viral genome measurements to TCID50 values needed for dose-response curves. The three scenarios considered different amounts of water ingestion and Monte Carlo simulation was used to account for the variability associated with the doses. The mean illness risk in children based on adenovirus measurements obtained over 11 months was estimated to be 3.5%, which is below the 3.6% risk considered tolerable by the current United States EPA recreational criteria for gastrointestinal illnesses (GI). The mean risks of GI illness for adults and secondary contact were 1.9% and 1.0%, respectively. These risks changed appreciably when different distributions were fitted to the data as determined by Monte Carlo simulations. In general, risk was at a maximum for the log-logistic distribution and lowest for the hockey stick distribution in all three selected scenarios. Also, under default assumptions, the risk was lowered considerably when assuming that only a small proportion of Adenovirus 40/41 (3%) was as infectious as Adenovirus type 4, compared to the assumption that all genomes were Adenovirus 4. In conclusion, site-specific QMRA on water-borne adenoviruses in this watershed provided a similar

  11. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study

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    Palepu Anita

    2012-08-01

    Full Text Available Abstract Background The aim of this study was to identify what is most important to the quality of life (QoL of those who experience homelessness by directly soliciting the views of homeless and hard-to-house Canadians themselves. These individuals live within a unique social context that differs considerably from that of the general population. To understand the life areas that are most important to them, it is critical to have direct input from target populations of homeless and hard-to-house persons. Methods Focus groups were conducted with 140 individuals aged 15 to 73 years who were homeless or hard-to-house to explore the circumstances in which they were living and to capture what they find to be important and relevant domains of QoL. Participants were recruited in Toronto, Ottawa, Montreal, and Vancouver. Content analysis was used to analyze the data. Results Six major content themes emerged: Health/health care; Living conditions; Financial situation; Employment situation; Relationships; and Recreational and leisure activities. These themes were linked to broader concepts that included having choices, stability, respect, and the same rights as other members of society. Conclusions These findings not only aid our understanding of QoL in this group, but may be used to develop measures that capture QoL in this population and help programs and policies become more effective in improving the life situation for persons who are homeless and hard-to-house. Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study.

  12. Cost analysis of a prospective multi-site cohort study of palliative care consultation teams for adults with advanced cancer: Where do cost-savings come from?

    Science.gov (United States)

    May, Peter; Garrido, Melissa M; Cassel, J Brian; Kelley, Amy S; Meier, Diane E; Normand, Charles; Smith, Thomas J; Morrison, R Sean

    2017-04-01

    Studies report cost-savings from hospital-based palliative care consultation teams compared to usual care only, but drivers of observed differences are unclear. To analyse cost-differences associated with palliative care consultation teams using two research questions: (Q1) What is the association between early palliative care consultation team intervention, and intensity of services and length of stay, compared to usual care only? (Q2) What is the association between early palliative care consultation team intervention and day-to-day hospital costs, compared to a later intervention? Prospective multi-site cohort study (2007-2011). Patients who received a consultation were placed in the intervention group, those who did not in the comparison group. Intervention group was stratified by timing, and groups were matched using propensity scores. Adults admitted to three US hospitals with advanced cancer. Principle analytic sample contains 863 patients ( nUC = 637; nPC EARLY = 177; nPC LATE = 49) discharged alive. Cost-savings from early palliative care accrue due to both reduced length of stay and reduced intensity of treatment, with an estimated 63% of savings associated with shorter length of stay. A reduction in day-to-day costs is observable in the days immediately following initial consult but does not persist indefinitely. A comparison of early and late palliative care consultation team cost-effects shows negligible difference once the intervention is administered. Reduced length of stay is the biggest driver of cost-saving from early consultation for patients with advanced cancer. Patient- and family-centred discussions on goals of care and transition planning initiated by palliative care consultation teams may be at least as important in driving cost-savings as the reduction of unnecessary tests and pharmaceuticals identified by previous studies.

  13. Predictors of viral suppression and rebound among HIV-positive men who have sex with men in a large multi-site Canadian cohort.

    Science.gov (United States)

    Tanner, Zachary; Lachowsky, Nathan; Ding, Erin; Samji, Hasina; Hull, Mark; Cescon, Angela; Patterson, Sophie; Chia, Jason; Leslie, Alia; Raboud, Janet; Loutfy, Mona; Cooper, Curtis; Klein, Marina; Machouf, Nima; Tsoukas, Christos; Montaner, Julio; Hogg, Robert S

    2016-10-21

    Gay, bisexual and other men who have sex with men (MSM) are disproportionately affected by HIV in Canada. Combination antiretroviral therapy has been shown to dramatically decrease progression to AIDS, premature death and HIV transmission. However, there are no comprehensive data regarding combination antiretroviral therapy outcomes among this population. We sought to identify socio-demographic and clinical correlates of viral suppression and rebound. Our analysis included MSM participants in the Canadian Observational Cohort, a multi-site cohort of HIV-positive adults from Canada's three most populous provinces, aged ≥18 years who first initiated combination antiretroviral therapy between 2000 and 2011. We used accelerated failure time models to identify factors predicting time to suppression (2 measures 200 copies/mL ≥30 days apart). Of 2,858 participants, 2,448 (86 %) achieved viral suppression in a median time of 5 months (Q1-Q3: 3-7 months). Viral suppression was significantly associated with later calendar year of antiretroviral therapy initiation, no history of injection drug use, lower baseline viral load, being on an initial regimen consisting of non-nucleoside reverse-transcriptase inhibitors, and older age. Among those who suppressed, 295 (12 %) experienced viral rebound. This was associated with earlier calendar year of antiretroviral therapy initiation, injection drug use history, younger age, higher baseline CD4 cell count, and living in British Columbia. Further strategies are required to optimize combination antiretroviral therapy outcomes in men who have sex with men in Canada, specifically targeting younger MSM and those with a history of injection drug use.

  14. Predictors of viral suppression and rebound among HIV-positive men who have sex with men in a large multi-site Canadian cohort

    Directory of Open Access Journals (Sweden)

    Zachary Tanner

    2016-10-01

    Full Text Available Abstract Background Gay, bisexual and other men who have sex with men (MSM are disproportionately affected by HIV in Canada. Combination antiretroviral therapy has been shown to dramatically decrease progression to AIDS, premature death and HIV transmission. However, there are no comprehensive data regarding combination antiretroviral therapy outcomes among this population. We sought to identify socio-demographic and clinical correlates of viral suppression and rebound. Methods Our analysis included MSM participants in the Canadian Observational Cohort, a multi-site cohort of HIV-positive adults from Canada’s three most populous provinces, aged ≥18 years who first initiated combination antiretroviral therapy between 2000 and 2011. We used accelerated failure time models to identify factors predicting time to suppression (2 measures 200 copies/mL ≥30 days apart. Results Of 2,858 participants, 2,448 (86 % achieved viral suppression in a median time of 5 months (Q1–Q3: 3–7 months. Viral suppression was significantly associated with later calendar year of antiretroviral therapy initiation, no history of injection drug use, lower baseline viral load, being on an initial regimen consisting of non-nucleoside reverse-transcriptase inhibitors, and older age. Among those who suppressed, 295 (12 % experienced viral rebound. This was associated with earlier calendar year of antiretroviral therapy initiation, injection drug use history, younger age, higher baseline CD4 cell count, and living in British Columbia. Conclusions Further strategies are required to optimize combination antiretroviral therapy outcomes in men who have sex with men in Canada, specifically targeting younger MSM and those with a history of injection drug use.

  15. Recognizing difficult trade-offs: values and treatment preferences for end-of-life care in a multi-site survey of adult patients in family practices.

    Science.gov (United States)

    Howard, Michelle; Bansback, Nick; Tan, Amy; Klein, Doug; Bernard, Carrie; Barwich, Doris; Dodek, Peter; Nijjar, Aman; Heyland, Daren K

    2017-12-06

    Decisions about care options and the use of life-sustaining treatments should be informed by a person's values and treatment preferences. The objective of this study was to examine the consistency of ratings of the importance of the values statements and the association between values statement ratings and the patient's expressed treatment preference. We conducted a multi-site survey in 20 family practices. Patients aged 50 and older self-completed a questionnaire assessing the importance of eight values (rated 1 to 10), and indicated their preference for use of life-sustaining treatment (5 options). We compared correlations among values to a priori hypotheses based on whether the value related to prolonging or shortening life, and examined expected relationships between importance of values and the preference option for life-sustaining treatment. Eight hundred ten patients participated (92% response rate). Of 24 a priori predicted correlations among values statements, 14 were statistically significant but nearly all were negligible in their magnitude and some were in the opposite direction than expected. For example, the correlation between importance of being comfortable and suffering as little as possible and the importance of living as long as possible should have been inversely correlated but was positively correlated (r = 0.08, p = 0.03). Correlations between importance of values items and preference were negligible, ranging from 0.03 to 0.13. Patients may not recognize that trade-offs in what is most important may be needed when considering the use of treatments. In the context of preparation for decision-making during serious illness, decision aids that highlight these trade-offs and connect values to preferences more directly may be more helpful than those that do not.

  16. The Importance of Medical Students' Attitudes Regarding Cognitive Competence for Teaching Applied Statistics: Multi-Site Study and Meta-Analysis.

    Science.gov (United States)

    Milic, Natasa M; Masic, Srdjan; Milin-Lazovic, Jelena; Trajkovic, Goran; Bukumiric, Zoran; Savic, Marko; Milic, Nikola V; Cirkovic, Andja; Gajic, Milan; Kostic, Mirjana; Ilic, Aleksandra; Stanisavljevic, Dejana

    2016-01-01

    The scientific community increasingly is recognizing the need to bolster standards of data analysis given the widespread concern that basic mistakes in data analysis are contributing to the irreproducibility of many published research findings. The aim of this study was to investigate students' attitudes towards statistics within a multi-site medical educational context, monitor their changes and impact on student achievement. In addition, we performed a systematic review to better support our future pedagogical decisions in teaching applied statistics to medical students. A validated Serbian Survey of Attitudes Towards Statistics (SATS-36) questionnaire was administered to medical students attending obligatory introductory courses in biostatistics from three medical universities in the Western Balkans. A systematic review of peer-reviewed publications was performed through searches of Scopus, Web of Science, Science Direct, Medline, and APA databases through 1994. A meta-analysis was performed for the correlation coefficients between SATS component scores and statistics achievement. Pooled estimates were calculated using random effects models. SATS-36 was completed by 461 medical students. Most of the students held positive attitudes towards statistics. Ability in mathematics and grade point average were associated in a multivariate regression model with the Cognitive Competence score, after adjusting for age, gender and computer ability. The results of 90 paired data showed that Affect, Cognitive Competence, and Effort scores demonstrated significant positive changes. The Cognitive Competence score showed the largest increase (M = 0.48, SD = 0.95). The positive correlation found between the Cognitive Competence score and students' achievement (r = 0.41; pStudents' subjective attitudes regarding Cognitive Competence at the beginning of the biostatistics course, which were directly linked to mathematical knowledge, affected their attitudes at the end of the course

  17. Characterization of snowfall properties at high-latitude sites through use of a combined Multi-Angle Snow Camera (MASC) and radar approach

    Science.gov (United States)

    Cooper, S.; Wood, N.; Garrett, T. J.; L'Ecuyer, T. S.; Pettersen, C.

    2016-12-01

    Estimates of snowfall rate derived from radar reflectivities alone are non-unique, as different combinations of snowfall rates and snowflake microphysical properties can conspire to produce nearly identical radar reflectivity signatures. Such ambiguities can result in retrieval uncertainties on the order of 100-200% for individual events. Here, we use observations of snowflake particle size distribution, fallspeed, and habit from the Multi-Angle Snow Camera (MASC) to constrain estimates of snowfall derived from radar reflectivities. MASC measurements of microphysical properties and uncertainties are introduced into a modified form of the optimal-estimation CloudSat snowfall algorithm (2C-SNOW-PROFILE) via the a priori guess and variance terms. Initial results focus on the MASC and Ka-band Zenith Radar (KaZR) measurements at the ARM NSA Barrow Climate Facility site. Use of MASC fallspeed, MASC PSD, and a CloudSat particle model as base assumptions resulted in retrieved total accumulations with a -17% difference relative to nearby National Weather Service observations averaged over five snow events. Use of different but reasonable combinations of retrieval assumptions resulted in estimated snowfall accumulations with differences ranging from -63% to + 86% for the same storm events. Retrieved snowfall rates were particularly sensitive to assumed fallspeed and habit, suggesting that MASC measurements may provide a path forward in reducing the non-uniqueness of the snowfall retrieval problem. Preliminary results also will be presented for the deployment of the MASC, MicroRain Radar (MRR), and Precipitation Imaging Package (PIP) to Haukeliseter, Norway during winter season 2016-17. These instruments will then be deployed to northern Sweden for winter 2017-18. It is hoped more accurate knowledge of snowfall properties dependent upon location and meteorological conditions will be useful for both weather and climate applications.

  18. Reliable multi-label learning via conformal predictor and random forest for syndrome differentiation of chronic fatigue in traditional Chinese medicine.

    Directory of Open Access Journals (Sweden)

    Huazhen Wang

    Full Text Available OBJECTIVE: Chronic Fatigue (CF still remains unclear about its etiology, pathophysiology, nomenclature and diagnostic criteria in the medical community. Traditional Chinese medicine (TCM adopts a unique diagnostic method, namely 'bian zheng lun zhi' or syndrome differentiation, to diagnose the CF with a set of syndrome factors, which can be regarded as the Multi-Label Learning (MLL problem in the machine learning literature. To obtain an effective and reliable diagnostic tool, we use Conformal Predictor (CP, Random Forest (RF and Problem Transformation method (PT for the syndrome differentiation of CF. METHODS AND MATERIALS: In this work, using PT method, CP-RF is extended to handle MLL problem. CP-RF applies RF to measure the confidence level (p-value of each label being the true label, and then selects multiple labels whose p-values are larger than the pre-defined significance level as the region prediction. In this paper, we compare the proposed CP-RF with typical CP-NBC(Naïve Bayes Classifier, CP-KNN(K-Nearest Neighbors and ML-KNN on CF dataset, which consists of 736 cases. Specifically, 95 symptoms are used to identify CF, and four syndrome factors are employed in the syndrome differentiation, including 'spleen deficiency', 'heart deficiency', 'liver stagnation' and 'qi deficiency'. THE RESULTS: CP-RF demonstrates an outstanding performance beyond CP-NBC, CP-KNN and ML-KNN under the general metrics of subset accuracy, hamming loss, one-error, coverage, ranking loss and average precision. Furthermore, the performance of CP-RF remains steady at the large scale of confidence levels from 80% to 100%, which indicates its robustness to the threshold determination. In addition, the confidence evaluation provided by CP is valid and well-calibrated. CONCLUSION: CP-RF not only offers outstanding performance but also provides valid confidence evaluation for the CF syndrome differentiation. It would be well applicable to TCM practitioners and

  19. Quantification of regional calcium burden in chronic total occlusion by 64-slice multi-detector computed tomography and procedural outcomes of percutaneous coronary intervention.

    Science.gov (United States)

    Cho, Jung Rae; Kim, Young Jin; Ahn, Chul-Min; Moon, Jae-Youn; Kim, Jung-Sun; Kim, Hyun-Soo; Kim, Myeong Kon; Ko, Young-Guk; Choi, Donghoon; Chung, Namsik; Choe, Kyu-Ok; Shim, Won-Heum; Cho, Seung-Yun; Jang, Yangsoo

    2010-11-05

    One of the most important reasons for failure of percutaneous coronary intervention (PCI) in chronic total occlusion (CTO) is calcified plaque, which either prevents passage of guide wire or ruptures after balloon inflation. We sought to evaluate whether quantified calcium contents of CTO on multi-detector computed tomography (MDCT) correlate with immediate procedural outcomes. Sixty-four patients with 72 CTO lesions who underwent 64-slice MDCT prior to PCI were investigated. The lesions were divided into 2 groups according to procedural outcomes (55 lesions with PCI-success group, 17 lesions with PCI-failure group). Clinical, angiographic and MDCT parameters, including regional calcium volume (RCaV), regional calcium score (RCaS), regional calcium equivalent mass (RCaEq), and relative calcium area at the most calcified cross section of CTO (%CaS/CSA), were compared between the two groups. The duration of CTO was shorter in PCI-success group than PCI-failure group (7.16 ± 10.5 vs 15.59 ± 14.92 months, p=0.011), and the procedural success rate was 76.3%. Regional calcium-related parameters (RCaV 52.86 ± 58.39 vs 7.26 ± 15.27 mm(3), p<0.001; RCaS 72.71 ± 78.4 vs 9.66 ± 20.2, p<0.001; RCaEq 12.58 ± 12.97 vs 1.84 ± 3.716 mgCaHA, p<0.001; %CaS/CSA 53.9 ± 20.3 vs 30.4 ± 17.1%, p=0.009) in the occluded segment were higher and the occlusion length was longer (37.44 ± 27.48 vs 22.00 ± 18.04 mm, p<0.021) in PCI-failure group compared to PCI-success group. Multivariate regression analysis showed that only %CaS/CSA was a significant determinant of PCI-failure. Precise quantification of regional calcification and measurement of the occluded segment by high resolution MDCT can deliver important information for predicting procedural outcomes in PCI of CTO. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

  20. Evaluation of the immunological and hematological effects of chronic exposure of adult Peromyscus leucopus to Aroclor 1254 at concentrations equivalent to those at contaminated sites

    Science.gov (United States)

    Arena, S.R.; Segre, M.; French, J.B.

    2000-01-01

    Polychlorinated biphenyls are known to cause adverse health effects to biological systems; however, limited data is available on their effects on the immune system of wild species. Previous work by our lab found that 4 and 6-week old white-footed mice (Perornyscus leucopus) born from dams injected with a single dose (300 mg/kg) of Aroclor 1254, had altered immunological, hematological, and biochemical responses. The present study examines various immunological parameters of 22-week old white footed mice born from dams chronically exposed to Aroclor 1254 at concentrations equivalent to those at contaminated sites. Females were fed diets containing either Aroclor 1254 in corn oil or corn off only, for 3 months, then bred; pups were maintained on the same diets as their mothers. At 22 weeks of age, 31 of the young Peromyscus were analyzed. Body and organ weights were taken and immune function was evaluated by assessing blood profiles, cellularity of thymus and spleen, antibody response to the antigen DNP-KLH, and the in vitro proliferative response to the T-cell mitogen Conconavalin A (Con A). Liver weights and liver to body weight ratios in the treated mice were significantly higher compared to controls, while the combined weights of the adrenal glands were significantly lower. In addition, the number of thymocytes in the treated mice was significantly lower than that of the controls; however, thymocytes of treated mice had a higher degree of proliferation to Con A. Taken together, these results and those obtained from our previous study, indicate that monitoring of vulnerable immunological parameters in white-footed mice may be a useful indicator of exposure.

  1. Comparing the Effect of Dressing Versus No-dressing on Exit Site Infection and Peritonitis in Chronic Ambulatory Peritoneal Dialysis Patients

    Directory of Open Access Journals (Sweden)

    Shahram Taheri

    2017-01-01

    Full Text Available Bachground: Peritonitis and exit site (ES infection are two main complications of peritoneal dialysis. There are some controversies regard to preventive strategies for ES care. In this study we compared peritonitis and ES infection rates in patients with and without dressing. Materials and Methods: This historical cohort study carried out on 72 patients under continuous ambulatory peritoneal dialysis treatment, 54 with dressing versus 18 patients without dressing, followed from October 1, 2010 to March 31, 2011 for peritonitis and ES infection. Results: A total of 17 episodes of ES infection occurred in 12 patients in dressing group, but no case was seen in no-dressing group (P = 0.02. Twenty-one episodes of peritonitis occurred in 15 patients in both groups (one episode every 20.6 patient-months. In no-dressing group two episodes occurred in only one patient (one episode every 54 patient-months, and in dressing group, 19 episode in 14 patients (one episode every 17.1 patient-months (P = 0.03. Peritonitis was significantly more frequent in male versus female in overall patients (38% vs. 14%, P = 0.025 and in dressing group (52% vs. 15%, P = 0.003. In dressing group, peritonitis was more frequent in diabetics versus non-diabetics (48% vs. 11%, P = 0.01. Odds ratio for developing peritonitis was 9.4 in dressing group (95% confidence interval [CI] =1.05 − 84.4; P = 0.045, and 4.4 in men (95% CI = 1.26 − 15.19; P = 0.02. Conclusion: In this study, chronic ES care without dressing was associated with lower risk of peritonitis and ES infection.

  2. The Importance of Medical Students' Attitudes Regarding Cognitive Competence for Teaching Applied Statistics: Multi-Site Study and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Natasa M Milic

    Full Text Available The scientific community increasingly is recognizing the need to bolster standards of data analysis given the widespread concern that basic mistakes in data analysis are contributing to the irreproducibility of many published research findings. The aim of this study was to investigate students' attitudes towards statistics within a multi-site medical educational context, monitor their changes and impact on student achievement. In addition, we performed a systematic review to better support our future pedagogical decisions in teaching applied statistics to medical students.A validated Serbian Survey of Attitudes Towards Statistics (SATS-36 questionnaire was administered to medical students attending obligatory introductory courses in biostatistics from three medical universities in the Western Balkans. A systematic review of peer-reviewed publications was performed through searches of Scopus, Web of Science, Science Direct, Medline, and APA databases through 1994. A meta-analysis was performed for the correlation coefficients between SATS component scores and statistics achievement. Pooled estimates were calculated using random effects models.SATS-36 was completed by 461 medical students. Most of the students held positive attitudes towards statistics. Ability in mathematics and grade point average were associated in a multivariate regression model with the Cognitive Competence score, after adjusting for age, gender and computer ability. The results of 90 paired data showed that Affect, Cognitive Competence, and Effort scores demonstrated significant positive changes. The Cognitive Competence score showed the largest increase (M = 0.48, SD = 0.95. The positive correlation found between the Cognitive Competence score and students' achievement (r = 0.41; p<0.001, was also shown in the meta-analysis (r = 0.37; 95% CI 0.32-0.41.Students' subjective attitudes regarding Cognitive Competence at the beginning of the biostatistics course, which were

  3. Emotion regulation group therapy for deliberate self-harm: a multi-site evaluation in routine care using an uncontrolled open trial design.

    Science.gov (United States)

    Sahlin, Hanna; Bjureberg, Johan; Gratz, Kim L; Tull, Matthew T; Hedman, Erik; Bjärehed, Jonas; Jokinen, Jussi; Lundh, Lars-Gunnar; Ljótsson, Brjánn; Hellner, Clara

    2017-10-05

    Emotion regulation group therapy (ERGT) has shown promising results in several efficacy trials. However, it has not been evaluated outside a research setting. In order to increase the availability of empirically supported treatments for individuals with borderline personality disorder and deliberate self-harm, an evaluation of ERGT in routine clinical care was conducted with therapists of different professional backgrounds who had received brief intensive training in ERGT prior to trial onset. Multi-site evaluation, using an uncontrolled open trial design with assessments at pretreatment, post-treatment and 6-month follow-up. 14 adult outpatient psychiatric clinics across Sweden. Ninety-five women (mean age=25.1 years) with borderline personality disorder (both threshold and subthreshold) and repeated self-harm were enrolled in the study. Ninety-three per cent of participants completed the post-treatment assessment and 88% completed the follow-up assessment. Primary outcome was self-harm frequency as measured with the Deliberate Self-Harm Inventory. Secondary outcomes included self-harm versatility, emotion dysregulation, other self-destructive behaviours, depression, anxiety, stress symptoms and interpersonal and vocational difficulties. ERGT is an adjunctive, 14-week, acceptance-based behavioural group treatment that directly targets both self-harm and its proposed underlying mechanism of emotion dysregulation. At post-treatment, intent-to-treat analyses revealed a significant improvement associated with a moderate effect size on the primary outcome of self-harm frequency (51%, reduction; Cohen's d=0.52, pself-harm versatility, emotion dysregulation, other self-destructive behaviours and general psychiatric symptomatology. These results were either maintained or further improved on at 6-month follow-up. ERGT appears to be a feasible, transportable and useful treatment for deliberate self-harm and other self-destructive behaviours, emotion dysregulation and

  4. 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 ...

  5. Infrarenal aorta as the donor site for bypasses to the superior mesenteric artery for chronic mesenteric ischemia: A prospective clinical series of 24 patients.

    Science.gov (United States)

    Illuminati, Giulio; Pizzardi, Giulia; Calio', Francesco G; Pasqua, Rocco; Masci, Federica; Vietri, Francesco

    2017-11-01

    Treatment of symptomatic, chronic mesenteric ischemia is indicated to relieve symptoms and prevent acute ischemia and death. Current therapeutic options include endovascular and open surgery. The purpose of this prospective study was to evaluate the results of bypasses to the superior mesenteric artery arising from the infrarenal aorta or infrarenal aortic grafts. From January 1999 to December 2016, 24 consecutive patients with a mean age of 61 years underwent a prosthetic bypass to the superior mesenteric artery. Nine patients (37%) presented with an associated clinically important stenosis of the celiac artery and 10 (42%) of the inferior mesenteric artery. Five patients (21%) received preoperative parenteral nutrition. Four patients (17%) underwent dual antiplatelet treatment. The donor site was the infrarenal aorta in 19 patients (79%) and an infrarenal, Dacron graft was used in 5 (21%). The origin of the bypass was from the distal infrarenal aorta or Dacron graft in 19 patients (79%) and from the proximal infrarenal aorta in 5 patients (21%). The graft material consisted of 7 mm polytetrafluoroethylene in 19 cases (79%) and 7 mm Dacron in 5 cases (21%). A concomitant bypass to the inferior mesenteric artery was performed in 4 patients (17%). The primary end points were postoperative mortality, morbidity, graft infection, late survival, primary patency, and symptom-free rate. The secondary end point was postoperative hemorrhagic complications. No postoperative mortality occurred. Postoperative morbidity included a prolonged postoperative ileus in 4 patients (17%), transitory postoperative increases in serum creatinine concentrations in 3 patients (12%), and myocardial ischemia in 2 patients (8%). No postoperative hemorrhagic complications or graft infection were observed. Overall, the cumulative survival rate was 77% at 60 months. The overall late-patency rate and freedom from recurrence of symptoms were both 87% at 60 months. Infrarenal aorta and

  6. The effect of chiropractic adjustment of innervation versus attachment site in the treatment of chronic, active myofascial trigger points of infraspinatus

    OpenAIRE

    2015-01-01

    M.Tech. (Chiropractic) PURPOSE: Shoulder pain has been identified to be one of the most common musculoskeletal problems found in a variety of different countries, showing characteristics of chronicity and recurrence. It is considered to be a main contributor towards nontraumatic upper limb pain. One of the identifiable causes of chronic or reoccuring shoulder pain may be attributed to myofascial pain syndrome which is caused by MTrP’s and produces symptoms that are similar to that of other...

  7. Experience in Remote Demolition of the Activated Biological Shielding of the Multi Purpose Research Reactor (MZFR) on the German Karlsruhe Site - 12208

    Energy Technology Data Exchange (ETDEWEB)

    Eisenmann, Beata; Fleisch, Joachim; Prechtl, Erwin; Suessdorf, Werner; Urban, Manfred [WAK Rueckbau- und Entsorgungs- GmbH, P.O.Box 12 63, 76339 Eggenstein-Leopoldshafen (Germany)

    2012-07-01

    In 2009, WAK Decommissioning and Waste Management GmbH (WAK) became owner and operator of the waste treatment facilities of Karlsruhe Institute of Technology (KIT) as well as of the prototype reactors, the Compact Sodium-Cooled Fast Reactor (KNK) and Multi-Purpose Reactor (MZFR), both being in an advanced stage of dismantling. Together with the dismantling and decontamination activities of the former WAK reprocessing facility since 1990, the envisaged demolishing of the R and D reactor FR2 and a hot cell facility, all governmentally funded nuclear decommissioning projects on the Karlsruhe site are concentrated under the WAK management. The small space typical of prototype research reactors represented a challenge also during the last phase of activated dismantling, dismantling of the activated biological shield of the MZFR. Successful demolition of the biological shield required detailed planning and extensive testing in the years before. In view of the limited space and the ambient dose rate that was too high for manual work, it was required to find a tool carrier system to take up and control various demolition and dismantling tools in a remote manner. The strategy formulated in the concept of dismantling the biological shield by means of a modified electro-hydraulic demolition excavator in an adaptable working scaffolding turned out to be feasible. The following boundary conditions were essential: - Remote exchange of the dismantling and removal tools in smallest space. - Positioning of various supply facilities on the working platform. - Avoiding of interfering edges. - Optimization of mass flow (removal of the dismantled mass from the working area). - Maintenance in the surroundings of the dismantling area (in the controlled area). - Testing and qualification of the facilities and training of the staff. Both the dismantling technique chosen and the proceeding selected proved to be successful. Using various designs of universal cutters developed on the basis of

  8. Surface-site reactivity in small-molecule adsorption: A theoretical study of thiol binding on multi-coordinated gold clusters

    Directory of Open Access Journals (Sweden)

    Elvis C. M. Ting

    2016-01-01

    Full Text Available Background: The adsorption of organic molecules on metal surfaces has a broad array of applications, from device engineering to medical diagnosis. The most extensively investigated class of metal–molecule complexes is the adsorption of thiols on gold.Results: In the present manuscript, we investigate the dependence of methylthiol adsorption structures and energies on the degree of unsaturation at the metal binding site. We designed an Au20 cluster with a broad range of metal site coordination numbers, from 3 to 9, and examined the binding conditions of methylthiol at the various sites.Conclusion: We found that despite the small molecular size, the dispersive interactions of the backbone are a determining factor in the molecular affinity for various sites. Kink sites were preferred binding locations due to the availability of multiple surface atoms for dispersive interactions with the methyl groups, whereas tip sites experienced low affinity, despite having low coordination numbers.

  9. Study of aerosol hygroscopic events over the Cabauw experimental site for atmospheric research (CESAR) using the multi-wavelength Raman lidar Caeli

    NARCIS (Netherlands)

    Fernández, A.J.; Apituley, A.; Veselovskii, I.; Suvorina, A.; Henzing, J.; Pujadas, M.; Artíñano, B.

    2015-01-01

    This article presents a study of aerosol optical and microphysical properties under different relative humidity (RH) but well mixed layer conditions using optical and microphysical aerosol properties from multi-wavelength (MW) Raman lidar and in-situ aerosol observations collected at the Cabauw

  10. Combining GIS Applications and Method of Multi-Criteria Decision-Making (AHP for Landfill Siting in Al-Hashimiyah Qadhaa, Babylon, Iraq

    Directory of Open Access Journals (Sweden)

    Ali Chabuk

    2017-10-01

    Full Text Available Landfill siting is a complex process. It is one of the major problems in waste management, where many factors should be taken into consideration when selecting a suitable site for landfill in any given area. At the present time, there are many random waste disposal sites distributed throughout Al-Hashimiyah Qadhaa in Iraq. In this study, the Geographic Information System (GIS and the Analytical Hierarchy Process (AHP were used to select the best sites for landfill. The process of selecting sites for landfill in Al-Hashimiyah Qadhaa comprised two steps. First, fifteen different criteria were mapped and incorporated into overlay analyses within GIS software to produce the final suitability index map for the site. The second step comprises the exclusion of unsuitable areas from the final map to simplify identification of the candidate sites for landfill in the study area. The weightings of criteria were identified using AHP, and the weightings of the sub-criteria of each criterion were determined based on multiple factors. In order to accommodate solid waste from 2020 until 2030, two suitable candidate landfill sites were determined which fulfill the required area of 1.013 km2 with areas of 1.374 km2 and 1.288 km2 respectively.

  11. When study site contributes to outcomes in a multi-center randomized trial: a secondary analysis of decisional conflict in men with localized prostate cancer.

    Science.gov (United States)

    Underhill, Meghan L; Hong, Fangxin; Berry, Donna L

    2014-10-25

    Evaluate baseline factors that may explain the influence of study site on decisional conflict (DC) in men from the Personal Patient Profile: Prostate (P3P) randomized trial. 476 cases from 5 P3P sites were included. Participants completed baseline demographic assessments, 4 subscales of the DC scale at baseline (uncertainty, informed, values clarity, and support), the Expanded Prostate Cancer Index Composite (short form) and the State-Trait Anxiety Inventory. Site data regarding typical practices were collected. Linear regressions were used to model the relation between baseline DC scores and study site adjusting for the list of variables. Baseline decisional uncertainly (p = 0.001) and informed (p = 0.03) subscales were significantly different across sites. Participant demographic and baseline measures were significantly different (p P3P and other decision support interventions. NCT00692653.

  12. 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.

  13. Ex vivo transcriptional profiling reveals a common set of genes important for the adaptation of Pseudomonas aeruginosa to chronically infected host sites

    NARCIS (Netherlands)

    Bielecki, P.; Komor, U.; Bielecka, A.; Müsken, M.; Puchalka, J.; Pletz, M.W.; Ballmann, M.; Martins Dos Santos, V.A.P.; Weiss, S.; Häussler, S.

    2013-01-01

    The opportunistic bacterium Pseudomonas aeruginosa is a major nosocomial pathogen causing both devastating acute and chronic persistent infections. During the course of an infection, P.¿ aeruginosa rapidly adapts to the specific conditions within the host. In the present study, we aimed at the

  14. Realities of ambulatory multi-drug treatment of chronic diseases in rural areas of Lublin Province, eastern Poland – comparison of situations in 2010 and 2013

    Directory of Open Access Journals (Sweden)

    Barbara Kołłątaj

    2015-09-01

    In 2013, most of surveyed patients (54.8% did not follow prescribed treatment plans (in 2010–43.1%. In most cases, medication non-adherence were the result of financial problems. Current regulations governing refunding of the costs of medicines may make effective ambulatory treatment of chronic diseases impossible.

  15. Effective Site for the Application of Extracorporeal Shock-Wave Therapy on Spasticity in Chronic Stroke: Muscle Belly or Myotendinous Junction

    OpenAIRE

    Yoon, Sang Ho; Shin, Min Kyung; Choi, Eun Jung; Kang, Hyo Jung

    2017-01-01

    Objective To compare the effect of extracorporeal shock-wave therapy (ESWT) applied at the muscle belly and myotendinous junction on spasticity in the upper and lower limbs of chronic stroke patients. Methods Of the 151 patients, a total of 80 patients with stroke-induced spasticity on the elbow flexor and 44 patients on the knee flexor were enrolled for a prospective, randomized clinical trial. The patients were divided into control, muscle belly, and myotendinous junction groups, and a tota...

  16. NEWTON - NEW portable multi-sensor scienTific instrument for non-invasive ON-site characterization of rock from planetary surface and sub-surfaces

    Science.gov (United States)

    Díaz-Michelena, M.; de Frutos, J.; Ordóñez, A. A.; Rivero, M. A.; Mesa, J. L.; González, L.; Lavín, C.; Aroca, C.; Sanz, M.; Maicas, M.; Prieto, J. L.; Cobos, P.; Pérez, M.; Kilian, R.; Baeza, O.; Langlais, B.; Thébault, E.; Grösser, J.; Pappusch, M.

    2017-09-01

    In space instrumentation, there is currently no instrument dedicated to susceptibly or complete magnetization measurements of rocks. Magnetic field instrument suites are generally vector (or scalar) magnetometers, which locally measure the magnetic field. When mounted on board rovers, the electromagnetic perturbations associated with motors and other elements make it difficult to reap the benefits from the inclusion of such instruments. However, magnetic characterization is essential to understand key aspects of the present and past history of planetary objects. The work presented here overcomes the limitations currently existing in space instrumentation by developing a new portable and compact multi-sensor instrument for ground breaking high-resolution magnetic characterization of planetary surfaces and sub-surfaces. This new technology introduces for the first time magnetic susceptometry (real and imaginary parts) as a complement to existing compact vector magnetometers for planetary exploration. This work aims to solve the limitations currently existing in space instrumentation by means of providing a new portable and compact multi-sensor instrument for use in space, science and planetary exploration to solve some of the open questions on the crustal and more generally planetary evolution within the Solar System.

  17. The vapor-phase multi-stage CMD test for characterizing contaminant mass discharge associated with VOC sources in the vadose zone: Application to three sites in different lifecycle stages of SVE operations.

    Science.gov (United States)

    Brusseau, M L; Mainhagu, J; Morrison, C; Carroll, K C

    2015-08-01

    Vapor-phase multi-stage contaminant mass discharge (CMD) tests were conducted at three field sites to measure mass discharge associated with contaminant sources located in the vadose zone. The three sites represent the three primary stages of the soil vapor extraction (SVE) operations lifecycle-pre/initial-SVE, mid-lifecycle, and near-closure. A CMD of 32g/d was obtained for a site at which soil vapor SVE has been in operation for approximately 6years, and for which mass removal is currently in the asymptotic stage. The contaminant removal behavior exhibited for the vapor extractions conducted at this site suggests that there is unlikely to be a significant mass of non-vapor-phase contaminant (e.g., DNAPL, sorbed phase) remaining in the advective domains, and that most remaining mass is likely located in poorly accessible domains. Given the conditions for this site, this remaining mass is hypothesized to be associated with the low-permeability (and higher water saturation) region in the vicinity of the saturated zone and capillary fringe. A CMD of 25g/d was obtained for a site wherein SVE has been in operation for several years but concentrations and mass-removal rates are still relatively high. A CMD of 270g/d was obtained for a site for which there were no prior SVE operations. The behavior exhibited for the vapor extractions conducted at this site suggest that non-vapor-phase contaminant mass (e.g., DNAPL) may be present in the advective domains. Hence, the asymptotic conditions observed for this site most likely derive from a combination of rate-limited mass transfer from DNAPL (and sorbed) phases present in the advective domain as well as mass residing in lower-permeability ("non-advective") regions. The CMD values obtained from the tests were used in conjunction with a recently developed vapor-discharge tool to evaluate the impact of the measured CMDs on groundwater quality. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. The Center for HIV/AIDS Vaccine Immunology (CHAVI) Multi-site Quality Assurance Program for Cryopreserved Human Peripheral Blood Mononuclear Cells

    Science.gov (United States)

    Sarzotti-Kelsoe, Marcella; Needham, Leila K.; Rountree, Wes; Bainbridge, John; Gray, Clive M.; Fiscus, Susan A.; Ferrari, Guido; Stevens, Wendy S.; Stager, Susan L.; Binz, Whitney; Louzao, Raul; Long, Kristy O.; Mokgotho, Pauline; Moodley, Niranjini; Mackay, Melanie; Kerkau, Melissa; McMillion, Takesha; Kirchherr, Jennifer; Soderberg, Kelly A.; Haynes, Barton F.; Denny, Thomas N.

    2014-01-01

    The Center for HIV/AIDS Vaccine Immunology (CHAVI) consortium was established to determine the host and virus factors associated with HIV transmission, infection and containment of virus replication, with the goal of advancing the development of an HIV protective vaccine. Studies to meet this goal required the use of cryopreserved Peripheral Blood Mononuclear Cell (PBMC) specimens, and therefore it was imperative that a quality assurance (QA) oversight program be developed to monitor PBMC samples obtained from study participants at multiple international sites. Nine site-affiliated laboratories in Africa and the USA collected and processed PBMCs, and cryopreserved PBMC were shipped to CHAVI repositories in Africa and the USA for long-term storage. A three-stage program was designed, based on Good Clinical Laboratory Practices (GCLP), to monitor PBMC integrity at each step of this process. The first stage evaluated the integrity of fresh PBMCs for initial viability, overall yield, and processing time at the site-affiliated laboratories (Stage 1); for the second stage, the repositories determined post-thaw viability and cell recovery of cryopreserved PBMC, received from the site-affiliated laboratories (Stage 2); the third stage assessed the long-term specimen storage at each repository (Stage 3). Overall, the CHAVI PBMC QA oversight program results highlight the relative importance of each of these stages to the ultimate goal of preserving specimen integrity from peripheral blood collection to long-term repository storage. PMID:24910414

  19. Equal Improvement in Men and Women in the Treatment of Urologic Chronic Pelvic Pain Syndrome Using a Multi-modal Protocol with an Internal Myofascial Trigger Point Wand.

    Science.gov (United States)

    Anderson, Rodney U; Wise, David; Sawyer, Tim; Nathanson, Brian H; Nevin Smith, J

    2016-06-01

    Both men and women require treatment for urologic chronic pelvic pain syndromes (UCPPS), which includes interstitial cystitis/painful bladder syndrome, pelvic floor dysfunction, and chronic prostatitis/chronic pelvic pain syndrome. However, it is unknown if men and women respond differently to a protocol that includes specific physical therapy self-treatment using an internal trigger point wand and training in paradoxical relaxation. We performed a retrospective analysis by gender in a single arm, open label, single center clinical trial designed to evaluate the safety and effectiveness of a protocol for the treatment of UCPPS from October, 2008 to May, 2011. 314 adult men (79.9 %) and 79 (20.1 %) women met inclusion criteria. The median duration of symptoms was 60 months. The protocol required an initial 6-day clinic for training followed by a 6-month self-treatment period. The treatment included self-administered pelvic floor trigger point release with an internal trigger point device for physical therapy along with paradoxical relaxation training. Notable gender differences in prior treatments were observed. Men had a lower median [Interquartile Range] NIH-CPSI score at baseline than women (27 [21, 31] vs. 29 [22, 33], p = 0.04). Using a 1-10 scale with 10 = Most Severe, the median reduction in trigger point sensitivity was 3 units for both men and women after 6 months therapy (p = 0.74). A modified Intention to Treat analysis and a multivariate regression analysis found similar results. We conclude that men and women have similar, significant reductions in trigger point sensitivity with this protocol.

  20. A multi-site analysis of the association between black carbon concentrations and vehicular idling, traffic, background pollution, and meteorology during school dismissals.

    Science.gov (United States)

    Richmond-Bryant, J; Bukiewicz, L; Kalin, R; Galarraga, C; Mirer, F

    2011-05-01

    A study was performed to assess the relationship between black carbon (BC), passing traffic, and vehicular idling outside New York City (NYC) schools during student dismissal. Monitoring was performed at three school sites in East Harlem, the Bronx, and Brooklyn for 1month per year over a two-year period from November 2006-October 2008. Monitoring at each site was conducted before and after the Asthma Free School Zone (AFSZ) asthma reduction education program was administered. Real-time equipment with a one-minute averaging interval was used to obtain the BC data, while volume counts of idling and passing school busses, trucks, and automobiles were collected each minute by study staff. These data were matched to ambient PM(2.5) and meteorology data obtained from the New York State Department of Environmental Conservation. A generalized additive model (GAM) model was run to examine the relationship between BC concentration and each variable while accounting for site-to-site differences. F-tests were employed to assess the significance of each of the predictor variables. The model results suggested that variability in ambient PM(2.5) concentration contributed 24% of the variability in transformed BC concentration, while variability in the number of idling busses and trucks on the street during dismissal contributed 20% of the variability in transformed BC concentration. The results of this study suggest that a combination of urban scale and local traffic control approaches in combination with cessation of school bus idling will produce improved local BC concentration outside schools. Published by Elsevier B.V.

  1. Multi-site genetic analysis of diffusion images and voxelwise heritability analysis: A pilot project of the ENIGMA–DTI working group

    OpenAIRE

    Jahanshad, Neda; Kochunov, Peter V.; Sprooten, Emma; Mandl, René C.; Nichols, Thomas E.; Almasy, Laura; Blangero, John; Brouwer, Rachel M.; Curran, Joanne E.; de Zubicaray, Greig I.; Duggirala, Ravi; Fox, Peter T.; Hong, L. Elliot; Landman, Bennett A.; Martin, Nicholas G.

    2013-01-01

    The ENIGMA (Enhancing NeuroImaging Genetics through Meta-Analysis) Consortium was set up to analyze brain measures and genotypes from multiple sites across the world to improve the power to detect genetic variants that influence the brain. Diffusion tensor imaging (DTI) yields quantitative measures sensitive to brain development and degeneration, and some common genetic variants may be associated with white matter integrity or connectivity. DTI measures, such as the fractional anisotropy (FA)...

  2. Site planning and integration fiscal year 1999 multi-year work plan (MYWP) update for WBS 1.8.2.1

    Energy Technology Data Exchange (ETDEWEB)

    SCHULTZ, E.A.

    1998-10-01

    The primary mission of the Site Planning and Integration (SP and I) project is to assist Fluor Daniel Project Direction to ensure that all work performed under the Project Hanford Management Contract (PHMC) is adequately planned, executed, controlled, and that performance is measured and reported in an integrated fashion. Furthermore, SP and I is responsible for the development, implementation, and management of systems and processes that integrate technical, schedule, and cost baselines for PHMC work.

  3. Application of a GIS Multi-Criteria Decision Analysis for the Identification of Intrinsic Suitable Sites in Costa Rica for the Application of Managed Aquifer Recharge (MAR through Spreading Methods

    Directory of Open Access Journals (Sweden)

    José Pablo Bonilla Valverde

    2016-09-01

    Full Text Available Costa Rica’s annual mean precipitation is above 3300 mm, but this precipitation is not evenly distributed in time or space, producing clear differentiated wet and dry seasons in most of the country. Droughts are also common phenomena which greatly affect the availability of water resources. Managed aquifer recharge (MAR schemes are being taken into consideration to enhance the underground water storage capacity of the country. The present study constitutes the first assessment for the identification of suitable sites for the implementation of MAR technology spreading methods (SM in Costa Rica. The suitable sites are identified by means of a geographic information system multi-criteria decision analysis (GIS-MCDA based on four criteria: hydrogeological aptitude, terrain slope, top soil texture and drainage network density. Four steps are performed in order to identify these sites: problem definition, screening for suitable areas, suitability mapping, and sensitivity analysis. The suitability map was divided in two zones after the screening: suitable and unsuitable, the first zone was further divided in five classes according to the weighted linear combination (WLC ranking. The results indicate that 61% of the country is suitable for conducting SM. This map is a tool for future implementation of MAR techniques in the country.

  4. Effective Site for the Application of Extracorporeal Shock-Wave Therapy on Spasticity in Chronic Stroke: Muscle Belly or Myotendinous Junction

    Science.gov (United States)

    2017-01-01

    Objective To compare the effect of extracorporeal shock-wave therapy (ESWT) applied at the muscle belly and myotendinous junction on spasticity in the upper and lower limbs of chronic stroke patients. Methods Of the 151 patients, a total of 80 patients with stroke-induced spasticity on the elbow flexor and 44 patients on the knee flexor were enrolled for a prospective, randomized clinical trial. The patients were divided into control, muscle belly, and myotendinous junction groups, and a total of three ESWT sessions (0.068–0.093 mJ/mm2, 1,500 shots) were conducted at one per week. A Modified Ashworth Scale (MAS) and Modified Tardieu Scale (MTS) were collected at the baseline and at 1 week after each session. Results After interventions, the MAS and MTS of both the belly and the junction groups showed positive effects from the ESWT on spasticity in the elbow and knee flexors, but the control group did not. The results also tended to improve after each session until the entire intervention was completed. However, there was no significant difference between the belly and junction groups. Conclusion ESWT could be effective for treating chronic spasticity after stroke when applied to muscle belly or myotendinous junction. PMID:28971038

  5. IL-10 disrupts the Brd4-docking sites to inhibit LPS-induced CXCL8 and TNF-α expression in monocytes: Implications for chronic obstructive pulmonary disease.

    Science.gov (United States)

    Castellucci, Monica; Rossato, Marzia; Calzetti, Federica; Tamassia, Nicola; Zeminian, Stefano; Cassatella, Marco A; Bazzoni, Flavia

    2015-09-01

    IL-10 is well known for its ability to block the expression and production of numerous proinflammatory cytokines, in this manner preventing the development of excessive or chronic immune activation. IL-10-induced transcriptional repression of CXCL8 and TNFA genes consists of 2 distinct phases: an early phase, occurring rapidly and in a protein synthesis-independent manner, followed by a second phase that is more delayed and dependent on protein synthesis. We sought to identify the mechanisms through which IL-10 rapidly and directly suppresses LPS-induced CXCL8 and TNF-α transcription, which might be defective under pathologic conditions. The molecular events triggered by IL-10 in LPS-activated monocytes at the CXCL8 and TNFA loci were investigated by using the chromatin immunoprecipitation assay. Inhibition of LPS-induced CXCL8 and TNF-α expression by IL-10 proceeds through a common mechanism targeting LPS-induced phosphorylation of the nuclear factor κB p65 serine 276 residue (pS276p65). As a result, all the pS276p65-dependent events occurring at the CXCL8 and TNFA loci are consistently reduced, ultimately leading to a reduction in transcript elongation. Additionally, IL-10 selectively controls CXCL8 transcript elongation through histone deacetylase (HDAC) 2-dependent covalent chromatin modifications, disrupting the assembly of the transcriptional machinery. Remarkably, PBMCs from patients with acute-phase chronic obstructive pulmonary disease, which express negligible HDAC2 levels, are scarcely affected by IL-10 in terms of inhibition of CXCL8 expression. This study provides mechanistic evidence that IL-10 creates a chromatin environment that decreases the transcriptional rate of CXCL8 and TNF-α to Toll-like receptor 4-activating signals. Data identify novel molecular targets for therapeutic strategies aimed at dampening inflammation in pathologies such as chronic obstructive pulmonary disease, in which reduced intracellular HDAC2 levels have been described

  6. The Response of the Alpine Dwarf Shrub Salix herbacea to Altered Snowmelt Timing: Lessons from a Multi-Site Transplant Experiment.

    Science.gov (United States)

    Sedlacek, Janosch; Wheeler, Julia A; Cortés, Andrés J; Bossdorf, Oliver; Hoch, Guenter; Lexer, Christian; Wipf, Sonja; Karrenberg, Sophie; van Kleunen, Mark; Rixen, Christian

    2015-01-01

    Climate change is altering spring snowmelt patterns in alpine and arctic ecosystems, and these changes may alter plant phenology, growth and reproduction. To predict how alpine plants respond to shifts in snowmelt timing, we need to understand trait plasticity, its effects on growth and reproduction, and the degree to which plants experience a home-site advantage. We tested how the common, long-lived dwarf shrub Salix herbacea responded to changing spring snowmelt time by reciprocally transplanting turfs of S. herbacea between early-exposure ridge and late-exposure snowbed microhabitats. After the transplant, we monitored phenological, morphological and fitness traits, as well as leaf damage, during two growing seasons. Salix herbacea leafed out earlier, but had a longer development time and produced smaller leaves on ridges relative to snowbeds. Longer phenological development times and smaller leaves were associated with reduced sexual reproduction on ridges. On snowbeds, larger leaves and intermediate development times were associated with increased clonal reproduction. Clonal and sexual reproduction showed no response to altered snowmelt time. We found no home-site advantage in terms of sexual and clonal reproduction. Leaf damage probability depended on snowmelt and thus exposure period, but had no short-term effect on fitness traits. We conclude that the studied populations of S. herbacea can respond to shifts in snowmelt by plastic changes in phenology and leaf size, while maintaining levels of clonal and sexual reproduction. The lack of a home-site advantage suggests that S. herbacea may not be adapted to different microhabitats. The studied populations are thus unlikely to react to climate change by rapid adaptation, but their responses will also not be constrained by small-scale local adaptation. In the short term, snowbed plants may persist due to high stem densities. However, in the long term, reduction in leaf size and flowering, a longer phenological

  7. The Global ECT-MRI Research Collaboration (GEMRIC): Establishing a multi-site investigation of the neural mechanisms underlying response to electroconvulsive therapy.

    Science.gov (United States)

    Oltedal, Leif; Bartsch, Hauke; Sørhaug, Ole Johan Evjenth; Kessler, Ute; Abbott, Christopher; Dols, Annemieke; Stek, Max L; Ersland, Lars; Emsell, Louise; van Eijndhoven, Philip; Argyelan, Miklos; Tendolkar, Indira; Nordanskog, Pia; Hamilton, Paul; Jorgensen, Martin Balslev; Sommer, Iris E; Heringa, Sophie M; Draganski, Bogdan; Redlich, Ronny; Dannlowski, Udo; Kugel, Harald; Bouckaert, Filip; Sienaert, Pascal; Anand, Amit; Espinoza, Randall; Narr, Katherine L; Holland, Dominic; Dale, Anders M; Oedegaard, Ketil J

    2017-01-01

    Major depression, currently the world's primary cause of disability, leads to profound personal suffering and increased risk of suicide. Unfortunately, the success of antidepressant treatment varies amongst individuals and can take weeks to months in those who respond. Electroconvulsive therapy (ECT), generally prescribed for the most severely depressed and when standard treatments fail, produces a more rapid response and remains the most effective intervention for severe depression. Exploring the neurobiological effects of ECT is thus an ideal approach to better understand the mechanisms of successful therapeutic response. Though several recent neuroimaging studies show structural and functional changes associated with ECT, not all brain changes associate with clinical outcome. Larger studies that can address individual differences in clinical and treatment parameters may better target biological factors relating to or predictive of ECT-related therapeutic response. We have thus formed the Global ECT-MRI Research Collaboration (GEMRIC) that aims to combine longitudinal neuroimaging as well as clinical, behavioral and other physiological data across multiple independent sites. Here, we summarize the ECT sample characteristics from currently participating sites, and the common data-repository and standardized image analysis pipeline developed for this initiative. This includes data harmonization across sites and MRI platforms, and a method for obtaining unbiased estimates of structural change based on longitudinal measurements with serial MRI scans. The optimized analysis pipeline, together with the large and heterogeneous combined GEMRIC dataset, will provide new opportunities to elucidate the mechanisms of ECT response and the factors mediating and predictive of clinical outcomes, which may ultimately lead to more effective personalized treatment approaches.

  8. The green economy for sustainable development: a spatial multi-criteria analysis - ordered weighted averaging approach in the siting process for short rotation forestry in the Basilicata Region, Italy

    Directory of Open Access Journals (Sweden)

    Severino Romano

    2013-09-01

    Full Text Available Optimising bioenergy chains and the creation of a bio-energy district can make a positive contribution to territorial development, land use planning and employment, while reducing environmental pollution. Energy planning issues are complex problems with multiple decision makers and criteria. Given the spatial nature of the problem, the present paper proposes a spatial multi-criteria analysis approach for supporting decision makers in the site selection process for short rotation forestry planting in the Basilicata Region, southern Italy. The methodology applied in the decision-support system is ordered weighted averaging, extended by means of fuzzy linguistic quantifiers. The purpose of the research is to formulate a systematic procedure to analyse complex decision problems, while supplying decision makers with a flexible tool to decide on possible agro-energy policies. The outcomes of the analysis may support decision makers in defining targeted agro-energy policies and help the private sector to identify the most appropriate cropping plan.

  9. 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

    Directory of Open Access Journals (Sweden)

    Jacob Gold Bernstein

    2015-05-01

    Full Text Available Optogenetics enables light to be used to control the activity of genetically targeted cells in the living brain. Optical fibres can be used to deliver light to deep targets, and light-emitting diodes (LEDs can be spatially arranged to enable patterned light delivery. In combination, arrays of LED-coupled optical fibres can enable patterned light delivery to deep targets in the brain. Here the authors describe the process flow for making LED arrays and LED-coupled optical fibre arrays, explaining key optical, electrical, thermal and mechanical design principles to enable the manufacturing, assembly and testing of such multi-site targetable optical devices. They also explore accessory strategies such as surgical automation approaches as well as innovations to enable low-noise concurrent electrophysiology.

  10. Added-value from a multi-criteria selection of donor catchments in the prediction of continuous streamflow series at ungauged pollution control-sites

    Directory of Open Access Journals (Sweden)

    G. Drogue

    2016-05-01

    Full Text Available We explore the potential of a multi-criteria selection of donor catchments in the prediction of continuous streamflow series by the spatial proximity method. Three criteria have been used: (1 spatial proximity; (2 physical similarity; (3 stream gauging network topology. An extensive assessment of our spatial proximity method variant is made on a 149 catchment-data set located in the Rhine-Meuse catchment. The competitiveness of the method is evaluated against spatial interpolation of catchment model parameters with ordinary kriging. We found that the spatial proximity approach is more efficient than ordinary kriging. When distance to upstream/downstream stream gauge stations is considered as a second order criterion in the selection of donor catchments, an unprecedented level of efficiency is reached for nested catchments. Nevertheless, the spatial proximity method does not take advantage from physical similarity between donor catchments and receiver catchments because catchments that are the most hydrologically similar to each catchment poorly match with the catchments that are the most physically similar to each catchment.

  11. Shared active site architecture between archaeal PolD and multi-subunit RNA polymerases revealed by X-ray crystallography

    Science.gov (United States)

    Sauguet, Ludovic; Raia, Pierre; Henneke, Ghislaine; Delarue, Marc

    2016-01-01

    Archaeal replicative DNA polymerase D (PolD) constitute an atypical class of DNA polymerases made of a proofreading exonuclease subunit (DP1) and a larger polymerase catalytic subunit (DP2), both with unknown structures. We have determined the crystal structures of Pyrococcus abyssi DP1 and DP2 at 2.5 and 2.2 Å resolution, respectively, revealing a catalytic core strikingly different from all other known DNA polymerases (DNAPs). Rather, the PolD DP2 catalytic core has the same ‘double-psi β-barrel' architecture seen in the RNA polymerase (RNAP) superfamily, which includes multi-subunit transcriptases of all domains of life, homodimeric RNA-silencing pathway RNAPs and atypical viral RNAPs. This finding bridges together, in non-viral world, DNA transcription and DNA replication within the same protein superfamily. This study documents further the complex evolutionary history of the DNA replication apparatus in different domains of life and proposes a classification of all extant DNAPs. PMID:27548043

  12. Prevalence of non-syndromic orofacial clefts among Jews and Arabs, by type, site, gender and geography: a multi-center study in Israel.

    Science.gov (United States)

    Shapira, Yehoshua; Haklai, Ziona; Blum, Itay; Shpack, Nir; Amitai, Yona

    2014-12-01

    Orofacial clefts are the most common craniofacial congenital malformations, with significant anatomic, ethnic, racial and gender differences. To investigate the prevalence, distribution and characteristic features of various types of non-syndromic clefts among Israeli Jews and Arabs. We conducted a retrospective multi-center survey in 13 major hospitals in Israel for the period 1993-2005. To obtain the true prevalence and detailed clinical characteristics, data on liveborn infants with non-syndromic clefts were obtained from the Ministry of Health's National Birth Defect Registry and completed by chart reviews in the 13 surveyed hospitals. Of 976,578 liveborn infants, 684 presented unilateral or bilateral clefts, with a prevalence of 7.00/10,000 live births; 479 were Jews and 205 were Arabs. The prevalence was higher among Arabs compared to Jews (11.12 and 6.22 per 10,000 live births in Arabs and Jews, respectively, P 0.00001). Males had higher cleft rates than females (7.69/10,000 and 6.17/10,000 live births, respectively, P = 0.05). Males had more cleft lips (P prevalence of non-syndromic clefts was 7.00/10,000 live births. The markedly higher rate in Arabs is related to the high rate of consanguinity. Both very young and old maternal age represents a higher risk of clefts in their offspring.

  13. Multi-site clinical evaluation of DW-MRI as a treatment response metric for breast cancer patients undergoing neoadjuvant chemotherapy.

    Science.gov (United States)

    Galbán, Craig J; Ma, Bing; Malyarenko, Dariya; Pickles, Martin D; Heist, Kevin; Henry, Norah L; Schott, Anne F; Neal, Colleen H; Hylton, Nola M; Rehemtulla, Alnawaz; Johnson, Timothy D; Meyer, Charles R; Chenevert, Thomas L; Turnbull, Lindsay W; Ross, Brian D

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