Sample records for cleveland


    Institute of Scientific and Technical Information of China (English)


    GROVER CLEVELAND is a fine example of an American citizen whose crusading spirit carried him all the way to the White House-- in spite of strong opposition from both parties--and, after he had been defeated, it carried him to office once again--the only President ever to succeed his successor.

  2. Dr. Millie Cleveland: chiropractic achiever. (United States)

    Nash, J


    Dr. Mildred Genoa Allison-Cleveland, affectionately known as "Dr. Millie," was an important part of life at Cleveland Chiropractic College for over thirty years, serving first as a clerical assistant, then instructor, administrative assistant, and trusted right hand of her husband, Dr. Carl Cleveland, Jr. Yet Mildred Cleveland, like many other women who have helped the profession grow and survive over the years, has never been the subject of an article in print. In this paper, the author will strive to outline Dr. Mildred Cleveland's accomplishments, as well as to give the reader as clear a picture as possible of the woman who was the wife of one chiropractic pioneer and mother of another.

  3. Cleveland Clinic Rehabilitation Research Program (United States)


    functional impairments of the arm and hand , effects are weak and invariable. Limited succcess of rehabilitation is speculated to be associated with...Award Number: W81XWH-11-1-0707 TITLE: Cleveland Clinic Rehabilitation Research Program PRINCIPAL INVESTIGATOR: Vernon Lin, MD PhD CONTRACTING...CONTRACT NUMBER Cleveland Clinic Rehabilitation Research Program 5b. GRANT NUMBER W81XWH-11-1-0707 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d

  4. 77 FR 36331 - Noise Exposure Maps; Cleveland Hopkins International Airport, Cleveland, OH (United States)


    ... Noise Exposure Maps; Cleveland Hopkins International Airport, Cleveland, OH AGENCY: Federal Aviation... determination that the noise exposure maps submitted by the City of Cleveland for Cleveland Hopkins International Airport under the provisions of 49 U.S.C. 47501 et. seq (Aviation Safety and Noise Abatement...

  5. EnviroAtlas - Cleveland, OH - Block Groups (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset is the base layer for the Cleveland, OH EnviroAtlas community. The block groups are from the US Census Bureau and are included/excluded...

  6. 33 CFR 110.207 - Cleveland Harbor, Ohio. (United States)


    ... opposite Cleveland East Entrance Light to a due north line passing through the flashing white light on the... Breakwater from Cleveland West Breakwater Light. (2) East anchorage. The southeasterly portion of the East... and distances from Cleveland East Pierhead Light: 38°30′, 2,050 feet; 68°, 2,050 feet; 57°, 7,050...

  7. Building an engaged workforce at Cleveland Clinic

    Directory of Open Access Journals (Sweden)

    Patrnchak JM


    Full Text Available Joseph M PatrnchakCleveland Clinic, Cleveland, OH, USAAbstract: Employee engagement is widely recognized as a critical factor in organizational performance. This article examines an ongoing cultural development initiative at Cleveland Clinic designed to significantly increase employee engagement. Key components of this initiative include the introduction of serving leadership, new caregiver wellness and recognition programs, “Cleveland Clinic Experience” training focused on the institution’s core mission, and changes in the institutional vocabulary. Since 2008, the results include a dramatic improvement in engagement, as measured by the Gallup Q12 survey, with parallel improvements in patient satisfaction, as measured by the clinic's scores on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS survey. In addition to a discussion of the key components of the clinic’s engagement initiative, the article provides a partial review of the literature focused on employee engagement as well as a summary of “lessons learned” that may serve as a guide for others facing the challenge of increasing employee engagement in large, mature health care institutions.Keywords: health care, employee engagement, culture change, hospital performance, patient satisfaction

  8. Segregation Levels in Cleveland Public Schools and the Cleveland Voucher Program. School Choice Issues in the State (United States)

    Forster, Greg


    Examining the widespread claims that private schools have high segregation levels and vouchers will lead to greater segregation, this study finds that both assertions are empirically unsupportable. Private schools participating in Cleveland's voucher program are much less segregated than Cleveland's public schools. This means that students using…

  9. Contemporary art in medicine: the Cleveland Clinic art collection. (United States)

    Finkel, Jennifer


    Fine art is good medicine. It comforts, elevates the spirit, and affirms life and hope. Art in the healthcare setting, combined with outstanding care and service, creates an environment that encourages healing and supports the work of medical professionals. As one of the world's great medical centers, Cleveland Clinic has always included the arts in its healing environment. The four founders and subsequent leadership encouraged artistic and musical expression by employees. Distinguished artworks have long hung on the walls. In 1983, an Aesthetics Committee was officially formed at Cleveland Clinic to address issues of art and design in Cleveland Clinic facilities.

  10. EnviroAtlas - Cleveland, OH - Atlas Area Boundary (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset shows the boundary of the Cleveland, OH EnviroAtlas Community. It represents the outside edge of all the block groups included in the...

  11. EnviroAtlas - Cleveland, OH - Ecosystem Services by Block Group (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset presents environmental benefits of the urban forest in 1,442 block groups in Cleveland, Ohio. Carbon attributes, temperature reduction,...

  12. 75 FR 47632 - Thomson Reuters Legal, Legal Editorial Operations, Cleveland Office, Including Workers Whose... (United States)


    ... Employment and Training Administration Thomson Reuters Legal, Legal Editorial Operations, Cleveland Office..., applicable to workers of Thomson Reuters Legal, Legal Editorial Operations, Cleveland Office, Independence... that some workers separated from employment at the Independence, Ohio location of Thomson Reuters...

  13. EnviroAtlas - Cleveland, OH - One Meter Resolution Urban Land Cover Data (2011 and 2013) (United States)

    U.S. Environmental Protection Agency — The Cleveland, OH EnviroAtlas Meter-scale Urban Land Cover (MULC) dataset comprises 2,737 km2 around the city of Cleveland and portions of surrounding counties. The...

  14. Cleveland Clinic television series enhances branding in active market. (United States)

    Rees, T


    "Medical Miracles" premiered April 26. It is an information-packed series of programs showcasing The Cleveland Clinic's advanced medical practices. The Cleveland Clinic teamed with local NBC-affiliate, WKYC to develop half-hour shows on topics including neuro-sciences, orthopedics, eye, heart, pediatrics and cancer. As of this writing, three of the half-hour shows already have aired. They will resume in September, October and November, following a summer break. The collaboration is a healthy prospect all the way around. For Cleveland Clinic, it provides highly credible visibility in a competitive marketplace. And, according to WKYC president and general manager, Brooke Spectorsky, " Medical news and information is a high priority among our viewers."

  15. Cleveland's Multicultural Librarian: Eleanor (Edwards) Ledbetter, 1870-1954 (United States)

    Jones, Plummer Alston, Jr.


    Eleanor (Edwards) Ledbetter, who served immigrant populations in Cleveland throughout most of the Progressive Era and the Great Depression, was one of the first librarians to advocate for multiculturalism (then called cultural pluralism) as opposed to Americanism. In providing multicultural and multilingual library services for immigrants,…

  16. 76 FR 66250 - Television Broadcasting Services; Cleveland, OH (United States)


    ... From the Federal Register Online via the Government Publishing Office ] FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 73 Television Broadcasting Services; Cleveland, OH AGENCY: Federal Communications... CFR 1.415 and 1.420. List of Subjects in 47 CFR Part 73 Television, Television broadcasting....

  17. 78 FR 42733 - Safety Zone; Cleveland Dragon Boat Festival and Head of the Cuyahoga, Cuyahoga River, Cleveland, OH (United States)


    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Safety Zone; Cleveland Dragon Boat Festival and Head of... during the Dragon Boat Festival and Head of the Cuyahoga boating events. The safety zone established by... (HOTC) rowing regatta has occurred annually for over a decade and the Dragon Boat Festival for the...

  18. How Cleveland Clinic used TDABC to improve value. (United States)

    Donovan, Christopher J; Hopkins, Mike; Kimmel, Benjamin M; Koberna, Stephanie; Montie, Carrie A


    Cleveland Clinic partnered with Harvard Business School to conduct a pilot project to explore the differences between time-driven activity-based costing (TDABC) and relative value unit costing. The goal was to determine whether TDABC could improve the accuracy of cost information and identify value-improvement opportunities for two types of heart-value procedures. Using TDABC, leaders gained a detailed look into process steps that could be consolidated, reduced, or performed with a lower cost mix of personnel.

  19. 75 FR 9925 - Notice of Intent to Repatriate a Cultural Item: The Cleveland Museum of Natural History... (United States)


    ... intent to repatriate a cultural item in the possession of The Cleveland Museum of Natural History... National Park Service Notice of Intent to Repatriate a Cultural Item: The Cleveland Museum of Natural History, Cleveland, OH AGENCY: National Park Service, Interior. ACTION: Notice. Notice is here given...

  20. Joining the team: ethics consultation at the Cleveland Clinic. (United States)

    Agich, George J


    In this paper, I describe the development of ethics consultation services and their operation at the Cleveland Clinic; my own educational experiences and background and how I came to see the importance of setting and collaboration for successfully doing clinical ethics; the unique culture of the Cleveland Clinic and its influence on the ethics consultation services provided there; and, finally, the place of personal commitments and values on the conduct of ethics consultations. I stress the point that although philosophers (and perhaps other bioethicists without health professions training) are socialized and educated to do solitary work, successfully conducting ethics consultations requires relatively high levels of collaboration and cooperation that have not been sufficiently discussed. Although this paper is more a description than an analysis of the influence of institutional setting on ethics consultation, I would claim that attention to setting, either as the local scene of the consultation or the institutional and social framework, deserves more attention by bioethicists intent on understanding ethics consultation.

  1. Cleveland Harbor, Cuyahoga County, Ohio Confined Disposal Facility Project (Site 10B-15 Year) (United States)


    3.52 Cleveland Municipal Stadium, home of the Cleveland Indians baseball team and the Cleveland Browns football team, is located near the East Basin...o" Io . L 0 Ow> 0~i 0 I U C) > 00 I- w (n LLW LU 0000 00000aI 0 La w w w 0 26 ID E 0 ILI ki1 Ij I.- n W Ln 11.12 27 RSA ~ ~ ~~A a3?’t UJS 1 over r.0 V

  2. EnviroAtlas - Cleveland, OH - BenMAP Results by Block Group (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset demonstrates the effect of changes in pollution concentration on local populations in 1,442 block groups in Cleveland, Ohio. The US EPA's...

  3. The Day Nursery Association of Cleveland, Cleveland, Ohio: A Long History of Care for Children, Involvement of Parents, and Service to the Community. Model Programs--Childhood Education. (United States)

    American Institutes for Research in the Behavioral Sciences, Palo Alto, CA.

    The multi-faceted program of the Day Nursery Association of Cleveland is described in this booklet. Specific topics included are: a therapeutic nursery school, day nurseries for low-income neighborhoods, neighborhood day care homes and group centers, summer camp, and consultation services. Sources of more detailed information are provided for this…

  4. 77 FR 16800 - Radio Broadcasting Services; Dermott, AR, and Cleveland, MS (United States)


    ... COMMISSION 47 CFR Part 73 Radio Broadcasting Services; Dermott, AR, and Cleveland, MS AGENCY: Federal... 47 CFR Part 73 Radio, Radio broadcasting. Federal Communications Commission. Nazifa Sawez, Assistant... Commission requests comment on a petition filed by Delta Radio Network, LLC, proposing to amend the Table...

  5. 78 FR 27306 - Radio Broadcasting Services; Dermott, Arkansas, and Cleveland, Mississippi (United States)


    ... COMMISSION 47 CFR Part 73 Radio Broadcasting Services; Dermott, Arkansas, and Cleveland, Mississippi AGENCY... CFR part 73 Radio, Radio broadcasting. Federal Communications Commission. Nazifa Sawez, Assistant... Delta Radio Network, LLC, substitutes FM Channel 224A for 289A at Dermott, Arkansas, and substitutes...

  6. Preliminary Design of a Computerized Information System for Teacher Education Centers in Greater Cleveland. (United States)

    O'Gorman, David E.

    This report describes an information system designed to aid individuals within the Greated Cleveland Teacher Education Centers. Three components of the system are specified: information gathering or input, a data bank, and reports. Following an overview of the teacher education centers and information system, the primary design of the information…

  7. Calculating the Weather: Deductive Reasoning and Disciplinary "Telos" in Cleveland Abbe's Rhetorical Transformation of Meteorology (United States)

    Majdik, Zoltan P.; Platt, Carrie Anne; Meister, Mark


    This paper explores the rhetorical basis of a major paradigm change in meteorology, from a focus on inductive observation to deductive, mathematical reasoning. Analysis of Cleveland Abbe's "The Physical Basis of Long-Range Weather Forecasts" demonstrates how in his advocacy for a new paradigm, Abbe navigates the tension between piety to tradition…

  8. 75 FR 49528 - Thomson Reuters Legal, Legal Editorial Operations Cleveland Office Including Workers Whose... (United States)


    ... Employment and Training Administration Thomson Reuters Legal, Legal Editorial Operations Cleveland Office... Assistance on June 22, 2010, applicable to workers of Thomson Reuters Legal, Legal Editorial Operations... unemployment insurance (UI) tax account under the name West Publishing Corporation, a Thomson Reuters...

  9. Grover Cleveland High School Project CAUSA, 1985-1986. OEA Evaluation Report. (United States)

    New York City Board of Education, Brooklyn. Office of Educational Assessment.

    In 1985-86, Project CAUSA completed a three-year funding cycle at Grover Cleveland High School in Queens, New York. The project provided 132 newly arrived students from Italy and several Spanish-speaking countries with instruction in English as a second language (ESL), native language arts, and content areas. Basic goals were to help students…

  10. 78 FR 59650 - Reorganization of Foreign-Trade Zone 40 Under Alternative Site Framework Cleveland, Ohio (United States)


    ... Lorain Counties, Ohio, in and adjacent to the Cleveland Customs and Border Protection port of entry, FTZ... by September 30, 2020, to a five-year ASF sunset provision for magnet sites that would terminate... is admitted for a bona fide customs purpose by September 30, 2016. Signed at Washington, DC,...

  11. Sculpted landscapes: art & place in Cleveland's Cultural Gardens, 1916-2006. (United States)

    Tebeau, Mark


    Perhaps the world's first peace garden, the Cleveland Cultural Gardens embody the history of twentieth-century America and reveal the complex interrelations between art and place. This essay uses the Cleveland Cultural Gardens as a lens through which to explore how art and place have intersected over time. It explores how communities have negotiated questions of national, ethnic, and American identity and embedded those identities into the vernacular landscape. It considers how the particulars of place were embedded into a public garden and asks whether it is possible for public art to transcend its place—both in terms of geography and history. In some sense, the Gardens have transcended their place, but in others respects, their fortunes were bound inextricably to that place, to the economic, demographic, and cultural contours that shaped and reshaped Northern Ohio. As works of art, the Cleveland Cultural Gardens both have reflected the history of Cleveland and American industrial cities during the 20th century and revealed something of the dynamics that underscored the changing character of public art and gardens in American cities.

  12. Cleveland's Multicultural Librarian: Eleanor (Edwards) Ledbetter, 1870-1954 (United States)

    Jones, Plummer Alston, Jr.


    Eleanor (Edwards) Ledbetter, who served immigrant populations in Cleveland throughout most of the Progressive Era and the Great Depression, was one of the first librarians to advocate for multiculturalism (then called cultural pluralism) as opposed to Americanism. In providing multicultural and multilingual library services for immigrants,…

  13. Crucial Levy Goes down in Cleveland: Loss Could Mean Layoffs, Blow to Superintendent (United States)

    Gewertz, Catherine


    Cleveland voters soundly rejected a levy intended to bolster the school district's finances, a move widely interpreted as a referendum on the performance of its leader, Barbara Byrd-Bennett. Two-thirds of the voters who turned out for the Aug. 2 special election cast their ballots against Issue 3, which would have raised more than $45 million to…

  14. Supplement Analysis for the Watershed Management Program EIS - Libby Creek (Lower Cleveland) Stabilization Project

    Energy Technology Data Exchange (ETDEWEB)



    This project is follow-up to stream stabilization activities on Libby Creek that were initiated on the Upper Cleveland reach of Libby Creek 2 years ago. BPA now proposes to fund FWP to complete channel stabilization activities on the Lower Cleveland reach of Libby Creek, reduce sediment sources, convert overwidened portions of the stream into self-maintaining channel types, use natural stream stabilization techniques, and improve wildlife migratory corridors. This lower reach is about one river mile below the upper Cleveland Reach and the proposed activities are very similar to those conducted before. The current work would be constructed in two additional phases. The first phase of the Lower Cleveland project would be completed in the fall of 2004 (9/1/04--12/31/04), to include the upper 3,100 feet. The second phase will be constructed in the fall of 2005 (9/1/05--12/31/05), to include stabilizing the remaining 6,200 feet of stream. The Cleveland reaches are a spawning and rearing tributary for resident redband trout, and resident and fluvial bull trout migrating from the Kootenai River. The planned work at the two remaining phases calls for shaping cut banks; installing root wads and tree revetments; installing channel grade control structures; planting native vegetation; and installing cross vanes constructed from rock and trees to control channel gradient. In the past, this reach of Libby Creek has been degraded by past management practices, including road building, hydraulic and dredge mining, and riparian logging. This past activity has resulted in accelerated bank erosion along a number of meander bends, resulting in channel degradation and poor fish habitat. Currently the stream channel is over-widened and shallow having limited pool habitat. The current stream channel is over-widened and shallow, having limited pool habitat.

  15. From IDs to Ice Cream to "I, Claudius": Security Is in the Cards at Cleveland Hill Union Free School District. (United States)

    Passmore, Cheryl


    Describes the use of plastic identity badges with photographs and barcodes issued to all administrators, teachers, staff members, and students in grades 6-12 at the Cleveland Hill Union Free School District in Cheektowaga, New York. (PKP)

  16. Designing the Optimal Health Assessment System: the Cleveland Quality Choice (CHQC) example. (United States)

    Sirio, C A; Harper, D


    Cleveland Health Quality Choice (CHQC) is an ongoing collaborative partnership between business, hospitals, and physicians designed to assess the performance of health care institutions in the greater Cleveland metropolitan area. CHQC coordinates the collection of data for analysis of intensive care unit outcomes; general medical, surgical and obstetric outcomes; and patient satisfaction. CHQC has documented improved outcomes in all measured spheres over a 4-year period. Its success can be attributed to a leadership strategy focused on providing rigorously tested analytic tools and a shared vision regarding the value of outcome information in assessing institutional performance. CHQC can serve as a model for communities interested in creating joint programs between purchasers and providers of health care to measure health outcomes.

  17. The Cleveland-Cuyahoga County Food Policy Coalition: "we have evolved". (United States)

    Walsh, Colleen C; Taggart, Morgan; Freedman, Darcy A; Trapl, Erika S; Borawski, Elaine A


    Several pieces of legislation passed in Cleveland, Ohio, from 2007 to 2011, focused on improving the city's food environment through urban agriculture initiatives. We used qualitative, case study methods, including interviews with 7 key informants, to examine the policy development process and investigate the role of the Cleveland-Cuyahoga County Food Policy Coalition in developing and implementing 4 pieces of legislation. In this article, we focus on 2 pieces of legislation: zoning designation of an urban garden and allowance of small farm animals and bees on residential property. Five key themes emerged: impetus for policy came from community needs; education and raising awareness helped mitigate barriers; a cultural shift took place among policy makers; social connections and individual champions were needed; and concerns over food access and health influenced policy decisions. Legislative actions are important tools to influence the nutrition environment, as long as they are based on local needs and context.

  18. Reflective writing in the competency-based curriculum at the cleveland clinic lerner college of medicine. (United States)

    Isaacson, J Harry; Salas, Renee; Koch, Carl; McKenzie, Margaret


    The Cleveland Clinic Lerner College of Medicine of Case Western Reserve University is a five-year medical school where the major emphasis is to train physician investigators. In this article we describe our experience with reflective writing in our competency-based medical school, which has reflective practice as one of the nine core competencies. We outline how we use reflective writing as a way to help students develop their reflective practice skills. Reflective writing opportunities, excerpts of student pieces, and faculty and student perspectives are included. We have experienced the value of reflective writing in medical school education and believe elements of our program can be adapted to other training environments.

  19. The Cleveland Clinic Lou Ruvo Center for Brain Health: keeping memory alive. (United States)

    Cummings, Jeffrey; Zhong, Kate; Bernick, Charles


    The Cleveland Clinic Lou Ruvo Center for Brain Health (LRCBH) is a unique clinical and translational research enterprise that stems from the passion of Larry Ruvo to honor his father, Lou, a victim of Alzheimer's disease (AD). To attract national attention to AD, Mr. Ruvo convinced architect Frank Gehry to construct the remarkable building complex of the LRCBH in Las Vegas, Nevada. Cleveland Clinic assumed responsibility for running the clinical and research aspects of the LRCBH. The care provided in this novel architectural setting is innovative and emphasizes patients first care with integration of caregiver programs and clinical research opportunities. Standardization of care, outcomes measures, and process metrics provide a platform for assessing, studying, and exporting best practices in cognitive care. Clinical trials empower patients to help solve the diseases that afflict them. The combination of a passionate founder, dramatic architecture, clinical excellence, integrated care partner programs, and commitment to development of next generation treatments makes the LRCBH a unique model of integrated care and research.

  20. Detecting hidden volcanic explosions from Mt. Cleveland Volcano, Alaska with infrasound and ground-couples airwaves (United States)

    De Angelis, Slivio; Fee, David; Haney, Matthew; Schneider, David


    In Alaska, where many active volcanoes exist without ground-based instrumentation, the use of techniques suitable for distant monitoring is pivotal. In this study we report regional-scale seismic and infrasound observations of volcanic activity at Mt. Cleveland between December 2011 and August 2012. During this period, twenty explosions were detected by infrasound sensors as far away as 1827 km from the active vent, and ground-coupled acoustic waves were recorded at seismic stations across the Aleutian Arc. Several events resulting from the explosive disruption of small lava domes within the summit crater were confirmed by analysis of satellite remote sensing data. However, many explosions eluded initial, automated, analyses of satellite data due to poor weather conditions. Infrasound and seismic monitoring provided effective means for detecting these hidden events. We present results from the implementation of automatic infrasound and seismo-acoustic eruption detection algorithms, and review the challenges of real-time volcano monitoring operations in remote regions. We also model acoustic propagation in the Northern Pacific, showing how tropospheric ducting effects allow infrasound to travel long distances across the Aleutian Arc. The successful results of our investigation provide motivation for expanded efforts in infrasound monitoring across the Aleutians and contributes to our knowledge of the number and style of vulcanian eruptions at Mt. Cleveland.

  1. Zanjadora. Cleveland

    Directory of Open Access Journals (Sweden)

    Editorial, Equipo


    Full Text Available Una máquina auxiliar para la apertura de zanjas de pequeña luz, como las destinadas a contener las canalizaciones eléctricas, de gas, telefónicas y tuberías de pequeños y medianos diámetros es la zanjadora. Todos los equipos modernos de material auxiliar de las empresas constructoras disponen actualmente de esta valiosa y eficiente maquinaria.

  2. Unraveling Neighborhood Change Using Two-Wave Panel Analysis: A Case Study of Cleveland in the 1980s. (United States)

    Pandey, Shanta; Coulton, Claudia


    Provides analysis of neighborhood change in Cleveland (Ohio) in 1980s using two-wave panel design and causal modeling. Reports that relationship of poverty rate to housing values and rate of births to unmarried mothers is reciprocal, implying cycle of social and economic decline of neighborhood. Other findings are reported that suggest declining…

  3. Results From a Microbial Source-Tracking Study at Villa Angela Beach, Cleveland, Ohio, 2007 (United States)

    Bushon, Rebecca N.; Stelzer, Erin A.; Stoeckel, Donald M.


    During the 2007 recreational season at Villa Angela Beach in Cleveland, Ohio, scientists with the U.S. Geological Survey (USGS) and the Northeast Ohio Regional Sewer District (NEORSD) found high Escherichia coli (E. coli) concentrations that were not easily explained by results obtained to date in ongoing investigations of recreational water quality at the beach. To help understand the sources behind these elevated E. coli concentrations, the USGS and NEORSD sampled beach-area water for Bacteroides DNA markers. Bacteroides are a group of enteric bacteria that are being used in microbial source tracking, in hope that host-associated DNA markers could be used to indicate potential sources of E. coli in the Villa Angela environment. The USGS Ohio Water Microbiology Laboratory analyzed a total of 13 source samples (sewage and waterfowl feces) and 33 beach-area water and sand samples for three Bacteroides DNA markers. This report lists the results of those analyses, along with environmental conditions at Villa Angela on the dates that samples were collected.

  4. Healy Clean Coal Project: Healy coal firing at TRW Cleveland Test Facility. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Koyama, T.; Petrill, E.; Sheppard, D.


    A test burn of two Alaskan coals was conducted at TRW`s Cleveland test facility in support of the Healy Clean Coal Project, as part of Clean Coal Technology III Program in which a new power plant will be constructed using a TRW Coal Combustion System. This system features ash slagging technology combined with NO{sub x} and SO{sub x} control. The tests, funded by the Alaska Industrial Development and Export Authority (AIDEA) and TRW, were conducted to verify that the candidate Healy station coals could be successfully fired in the TRW coal combustor, to provide data required for scale-up to the utility project size requirements, and to produce sufficient flash-calcined material (FCM) for spray dryer tests to be conducted by Joy/NIRO. The tests demonstrated that both coals are viable candidates for the project, provided the data required for scale-up, and produced the FCM material. This report describes the modifications to the test facility which were required for the test burn, the tests run, and the results of the tests.

  5. Healy Clean Coal Project: Healy coal firing at TRW Cleveland Test Facility

    Energy Technology Data Exchange (ETDEWEB)

    Koyama, T.; Petrill, E.; Sheppard, D.


    A test burn of two Alaskan coals was conducted at TRW's Cleveland test facility in support of the Healy Clean Coal Project, as part of Clean Coal Technology III Program in which a new power plant will be constructed using a TRW Coal Combustion System. This system features ash slagging technology combined with NO{sub x} and SO{sub x} control. The tests, funded by the Alaska Industrial Development and Export Authority (AIDEA) and TRW, were conducted to verify that the candidate Healy station coals could be successfully fired in the TRW coal combustor, to provide data required for scale-up to the utility project size requirements, and to produce sufficient flash-calcined material (FCM) for spray dryer tests to be conducted by Joy/NIRO. The tests demonstrated that both coals are viable candidates for the project, provided the data required for scale-up, and produced the FCM material. This report describes the modifications to the test facility which were required for the test burn, the tests run, and the results of the tests.

  6. The portfolio approach to competency-based assessment at the Cleveland Clinic Lerner College of Medicine. (United States)

    Dannefer, Elaine F; Henson, Lindsey C


    Despite the rapid expansion of interest in competency-based assessment, few descriptions of assessment systems specifically designed for a competency-based curriculum have been reported. The purpose of this article is to describe the design of a portfolio approach to a comprehensive, competency-based assessment system that is fully integrated with the curriculum to foster an educational environment focused on learning. The educational design goal of the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University was to create an integrated educational program-curriculum and instructional methods, student assessment processes, and learning environment-to prepare medical students for success in careers as physician investigators. The first class in the five-year program matriculated in 2004. To graduate, a student must demonstrate mastery of nine competencies: research, medical knowledge, communication, professionalism, clinical skills, clinical reasoning, health care systems, personal development, and reflective practice. The portfolio provides a tool for collecting and managing multiple types of assessment evidence from multiple contexts and sources within the curriculum to document competence and promote reflective practice skills. This article describes how the portfolio was developed to provide both formative and summative assessment of student achievement in relation to the program's nine competencies.

  7. Walk-through survey report, Central Brass Manufacturing Company, Cleveland, Ohio, March 20, 1987

    Energy Technology Data Exchange (ETDEWEB)

    Zaebst, D.D.; Seligman, P.J.; Bloom, T.F.


    In order to evaluate controls used to reduce or eliminate worker exposures to lead, a survey was undertaken at the nonferrous foundry, Central Brass Manufacturing Company, Cleveland, Ohio. After a review of the exposure and blood lead monitoring data, along with interviews with management and union officials and a tour of the facility, the investigators conclude that there is evidence to support excessive exposures to work-place lead at the time of compensation claims made early in 1985. Since that time the company has taken steps to reduce these exposures. Some engineering controls had been installed in October of 1984, including portable flexible-duct local exhaust hoods, side draft local exhaust systems and traveling hoods. Improvements or replacements were also made to existing equipment including doubling the ventilation capacity of the exhaust system on polishing equipment and replacing local exhaust hoods on all grinding machines. All new employees receive a complete physical examination including audiometry, pulmonary function test, and blood-lead screening. The frequency of subsequent blood lead monitoring was based on the previous blood-levels. The respiratory protection program seemed generally adequate. With the improvements made, a correlation between the decline in ambient lead and blood-lead levels was noted.

  8. Volcanic gas measurements at Mount Cleveland, 14-15 August 2015 (United States)

    Werner, Cynthia A.; Kern, Christoph; Kelly, Peter


    On 14-15 August 2015, helicopter-based measurements were made of the volcanic gases emitted from Mount Cleveland, AK. An upward-looking differential optical absorption spectroscopy (DOAS) system was used to measure incident scattered solar ultraviolet radiation while traversing beneath the plume on multiple occasions 14-15 August. This data was used to derive SO2 emission rates. Additionally, a Multi-Component Gas Analyzer System (Multi-GAS) was used to make measurements of trace gas concentrations while on a dedicated measurement flight passing through the gas plume on 15 August (19:15 - 19:56 UTC). Radiance spectra and gas compositions were both recorded at 1 second time resolution. Each spectrum and gas measurement was stamped with the GPS time and location. Each spectrum was saved in a separate ASCII file which includes 2048 radiances measured in the 285 - 430 nm spectral region and metadata associated with each acquisition. The Multi-GAS measurements are saved in a spreadsheet in the *.csv format.

  9. Cleveland Clinic intelligent mouthguard: a new technology to accurately measure head impact in athletes and soldiers (United States)

    Bartsch, Adam; Samorezov, Sergey


    Nearly 2 million Traumatic Brain Injuries (TBI) occur in the U.S. each year, with societal costs approaching $60 billion. Including mild TBI and concussion, TBI's are prevalent in soldiers returning from Iraq and Afghanistan as well as in domestic athletes. Long-term risks of single and cumulative head impact dosage may present in the form of post traumatic stress disorder (PTSD), depression, suicide, Chronic Traumatic Encephalopathy (CTE), dementia, Alzheimer's and Parkinson's diseases. Quantifying head impact dosage and understanding associated risk factors for the development of long-term sequelae is critical toward developing guidelines for TBI exposure and post-exposure management. The current knowledge gap between head impact exposure and clinical outcomes limits the understanding of underlying TBI mechanisms, including effective treatment protocols and prevention methods for soldiers and athletes. In order to begin addressing this knowledge gap, Cleveland Clinic is developing the "Intelligent Mouthguard" head impact dosimeter. Current testing indicates the Intelligent Mouthguard can quantify linear acceleration with 3% error and angular acceleration with 17% error during impacts ranging from 10g to 174g and 850rad/s2 to 10000rad/s2, respectively. Correlation was high (R2 > 0.99, R2 = 0.98, respectively). Near-term development will be geared towards quantifying head impact dosages in vitro, longitudinally in athletes and to test new sensors for possible improved accuracy and reduced bias. Long-term, the IMG may be useful to soldiers to be paired with neurocognitive clinical data quantifying resultant TBI functional deficits.

  10. A tale of two rain gardens: Barriers and bridges to adaptive management of urban stormwater in Cleveland, Ohio. (United States)

    Chaffin, Brian C; Shuster, William D; Garmestani, Ahjond S; Furio, Brooke; Albro, Sandra L; Gardiner, Mary; Spring, MaLisa; Green, Olivia Odom


    Green infrastructure installations such as rain gardens and bioswales are increasingly regarded as viable tools to mitigate stormwater runoff at the parcel level. The use of adaptive management to implement and monitor green infrastructure projects as experimental attempts to manage stormwater has not been adequately explored as a way to optimize green infrastructure performance or increase social and political acceptance. Efforts to improve stormwater management through green infrastructure suffer from the complexity of overlapping jurisdictional boundaries, as well as interacting social and political forces that dictate the flow, consumption, conservation and disposal of urban wastewater flows. Within this urban milieu, adaptive management-rigorous experimentation applied as policy-can inform new wastewater management techniques such as the implementation of green infrastructure projects. In this article, we present a narrative of scientists and practitioners working together to apply an adaptive management approach to green infrastructure implementation for stormwater management in Cleveland, Ohio. In Cleveland, contextual legal requirements and environmental factors created an opportunity for government researchers, stormwater managers and community organizers to engage in the development of two distinct sets of rain gardens, each borne of unique social, economic and environmental processes. In this article we analyze social and political barriers to applying adaptive management as a framework for implementing green infrastructure experiments as policy. We conclude with a series of lessons learned and a reflection on the prospects for adaptive management to facilitate green infrastructure implementation for improved stormwater management.

  11. Post-Occupancy Evaluation (POE) Methodologies for School Facilities: A Case Study of the V. Sue Cleveland High School Post Occupancy Evaluation (United States)

    Harmon, Marcel; Larroque, Andre; Maniktala, Nate


    The New Mexico Public School Facilities Authority (NMPSFA) is the agency responsible for administering state-funded capital projects for schools statewide. Post occupancy evaluation (POE) is the tool selected by NMPSFA for measuring project outcomes. The basic POE process for V. Sue Cleveland High School (VSCHS) consisted of a series of field…

  12. Late Pliensbachian-early Toarcian paleoenvironmental changes in the Cleveland Basin: new clues from high-resolution trace element analysis (United States)

    Thibault, N.; Ruhl, M.; Ullmann, C. V.; Korte, C.; Kemp, D. B.; Hesselbo, S. P.


    The early Toarcian (~183 Ma ago) was characterized by massive carbon burial and a pronounced negative carbon-isotope excursion (CIE) in marine carbonate and marine and terrestrial organic matter. These features along with the high abundance of redox sensitive trace metals in that interval led to the recognition of a major oceanic anoxic event (OAE). More recently, an earlier companion of the early Toarcian CIE has been documented at the Pliensbachian/Toarcian (Pl/To) boundary in sections of NW Europe, but its expression in the sediment and possible causes are less constrained. One of the most studied areas for this interval is the Cleveland Basin, UK, which is well-studied for litho-, bio- and chemostratigraphy. Here, we present a new dataset of high-resolution element data produced by hand-held X-ray fluorescence analysis to test for the expression of redox-sensitive trace metals and detrital elements across the late Pliensbachian to middle Toarcian of the Cleveland Basin. The Pl/To boundary CIE is associated with low Total Organic Carbon (TOCoxygenation events that prevented massive deposition of organic matter. Trends from redox-sensitive elements such as Fe, V, Mo and U are in agreement with previous findings and scenarios of basin restriction across and after the early Toarcian OAE (McArthur et al., 2008). An interval of maximum enrichment in these elements immediately after the CIE is a feature very similar to the recent observations of Hermoso et al. (2013) in the Paris Basin. This suggests a similar tempo of regional anoxia and black shale deposition in NW Europe. These results also shed light on the behaviour of elements associated with organic matter and the sulphur cycle such as Ni, Cu, Zn and As. Cu is well-correlated to the TOC whereas As shows an enrichment in the interval of black shale deposition after the CIE and two distinct correlation lines with sulphur, one before and during the event, and one after the CIE. This suggests that more As could be

  13. Dome growth at Mount Cleveland, Aleutian Arc, quantified by time-series TerraSAR-X imagery (United States)

    Wang, Teng; Poland, Michael; Lu, Zhong


    Synthetic aperture radar imagery is widely used to study surface deformation induced by volcanic activity; however, it is rarely applied to quantify the evolution of lava domes, which is important for understanding hazards and magmatic system characteristics. We studied dome formation associated with eruptive activity at Mount Cleveland, Aleutian Volcanic Arc, in 2011–2012 using TerraSAR-X imagery. Interferometry and offset tracking show no consistent deformation and only motion of the crater rim, suggesting that ascending magma may pass through a preexisting conduit system without causing appreciable surface deformation. Amplitude imagery has proven useful for quantifying rates of vertical and areal growth of the lava dome within the crater from formation to removal by explosive activity to rebirth. We expect that this approach can be applied at other volcanoes that host growing lava domes and where hazards are highly dependent on dome geometry and growth rates.

  14. Late Pliensbachian-early Toarcian paleoenvironmental changes in the Cleveland Basin: new clues from high-resolution trace element analysis

    DEFF Research Database (Denmark)

    Thibault, Nicolas Rudolph; Ruhl, Micha; Ullmann, Clemens Vinzenz

    The early Toarcian (~183 Ma ago) was characterized by massive carbon burial and a pronounced negative carbon-isotope excursion (CIE) in marine carbonate and marine and terrestrial organic matter. These features along with the high abundance of redox sensitive trace metals in that interval led...... to the recognition of a major oceanic anoxic event (OAE). More recently, an earlier companion of the early Toarcian CIE has been documented at the Pliensbachian/Toarcian (Pl/To) boundary in sections of NW Europe, but its expression in the sediment and possible causes are less constrained. One of the most studied...... elements across the late Pliensbachian to middle Toarcian of the Cleveland Basin. The Pl/To boundary CIE is associated with low Total Organic Carbon (TOC

  15. Cleveland Clinic Lerner College of Medicine: an innovative approach to medical education and the training of physician investigators. (United States)

    Fishleder, Andrew J; Henson, Lindsey C; Hull, Alan L


    Cleveland Clinic Lerner College of Medicine (CCLCM) is an innovative, five-year medical education track within Case Western Reserve University School of Medicine (Case) with a focused mission to attract and educate a limited number of highly qualified persons who seek to become physician investigators. CCLCM curriculum governance, faculty appointments and promotions, and admissions committees are integrated with respective Case committees. The CCLCM curriculum is based on faculty-defined professional attributes that graduates are expected to develop. These attributes were used to create curricular and assessment principles that guided the development of an integrated basic science, clinical science, and research curriculum, conducted in an active learning environment. An organ-system approach is used to solidify an understanding of basic science discipline threads in the context of relevant clinical problems presented in PBL and case-based discussion formats. Clinical skills are introduced in the first year as part of the two-year longitudinal experience with a family practice or internal medicine physician. The research program provides all students with opportunities to learn and experience basic and translational research and clinical research before selecting a research topic for their 12- to 15-month master-level thesis project. All Case students participate in required and elective clinical curriculum after the second year, but CCLCM students return to the Cleveland Clinic on selected Friday afternoons for program-specific research and professionalism-learning activities. A unique portfolio-based assessment system is used to assess student achievements in nine competency areas, seven of which reflect the Accreditation Council for Graduate Medical Education competencies.

  16. Analysis of Volcanic Deposits From the 2001 Eruption of Mt. Cleveland, Alaska Using Multisensor Satellite Data and Field Observations (United States)

    Smith, S. J.; Dehn, J.; Moore, R. B.


    Eruptive characteristics and histories of Aleutian stratovolcanoes are some of the least understood because of their remote locations, yet they have the ability to cripple the heavily traveled air routes in this region. Remote sensing is useful for gathering information on remote eruption deposits and compliments field observations. Mount Cleveland, on the western part of Chuginadak Island, has been one of the most active of these Aleutian volcanoes over the past century, its most recent eruption disrupted air traffic from February to March 2001. Using field observations of pyroclastic fan deposits preceding an a\\'{}a lava flow down the western flank of Mount Cleveland in 2001 this study attempts to associate spectral characteristics of these deposits (from Advanced Spaceborne Thermal Emission and Reflectance Radiometer (ASTER), Landsat 7 Enhanced Thematic Mapper Plus (ETM+), Second European Remote Sensing Satellite (ERS-2), and RADARSAT-1) to similar characteristics around the entire volcano. By also using Advanced Very High Resolution Radiometer (AVHRR) and Moderate Resolution Imaging Spectroradiometer (MODIS) data this study will present a more accurate chronology of the 2001 eruption. Field observations of the pyroclastic fan deposit reveal the existence of two separate stratigraphic deposits, an initial smooth ˜10-30 m thick a\\'{}a block and ash deposit overlain by a rougher ˜1-15 m thin breadcrust bomb deposit. The southern and northeastern parts of the fan are dominated by the thin breadcrust bomb deposit with an average bomb area of 2.38 m2, while the northwestern part is dominated by very large a\\'{}a blocks with pull-apart fractures and a much larger average block area of 22.44 m2. Initial Landsat 7 ETM+ and photographic analysis of this pyroclastic fan displays a slight coloration difference between the two deposits. The stratigraphic sequence of the pyroclastic fan from 2001 suggests that there was 1) a warm to hot debris flow from the collapse of

  17. The Cleveland Sorting Test: a preliminary study of an alternate form of the Wisconsin Card-Sorting Test. (United States)

    Poreh, Amir; Pastel, Dan; Miller, Ashley; Levin, Jennifer


    During the past two decades, studies have repeatedly shown that the Wisconsin Card-Sorting Test (WCST) is not as sensitive to prefrontal-lobe functioning as was originally suspected. Specifically, both clinical and brain-imaging studies have shown that several distinct neural circuits contribute to one's ability to successfully complete different aspects of the test. Another limitation of the WCST is its length, which makes it difficult and frustrating for certain clinical populations. To address the above limitations, researchers have proposed the development of new indexes and the integration of an adaptive testing approach that will allow for the premature termination of the test. Unfortunately, given the proprietary nature of the WCST, none of the above recommendations have been adopted. The present preliminary study examined an alternate form of the 64-Item WCST (WCST-64), the Cleveland Sorting Test (CST-64). The normative data of the two measures as well as the total number of errors, perseverative responses, perseverative errors, and categories completed were compared using a repeated-measures design. Overall, the study supports psychometric approximation of the CST-64 and the WCST-64. Suggestions for future studies and modifications of the CST-64, including the use of recently proposed indexes and adaptive administration approaches, are provided.

  18. Quality of life after ileal pouch-anal anastomosis: an evaluation of diet and other factors using the Cleveland Global Quality of Life instrument.

    LENUS (Irish Health Repository)

    Coffey, J C


    PURPOSE: Although functional results after ileal pouch-anal anastomosis are excellent, imperfections of function do occur. In this setting, quality-of-life assessment is an invaluable tool in determining overall therapeutic efficacy. We evaluated the impact of dietary restrictions, preoperative diagnosis (ulcerative colitis vs. familial adenomatous polyposis), and pregnancy (after pouch insertion) on quality of life. METHODS: After ethical approval, 64 patients were reviewed (mean age, 31 (range, 15-54) years). Long-term quality of life in patients after ileal pouch-anal anastomosis was assessed using the Cleveland Global Quality of Life instrument or Fazio score. The Cleveland Global Quality of Life score is a novel quality-of-life instrument specifically designed for patients with ileal pouches. Stool frequency and continence were recorded to establish the functional status of this group. RESULTS: Sixty-one patients (95.3 percent) complained of some form of dietary restriction and adopted a fixed dietary regimen. All such patients felt that a breach of this regimen would impinge significantly on their quality of life. Late eating and alcohol were associated with diarrhea, whereas smoking was not. Constipation was infrequently reported. The mean Cleveland Global Quality of Life score of patients with ulcerative colitis (0.81 +\\/- 0.13) was greater than that of patients with ulcerative colitis and a background of pouchitis (0.78 +\\/- 0.16; P = 0.042). Whereas postoperative stool frequency in patients with familial adenomatous polyposis was always higher than the preoperative level (4 vs. 2 movements per day; P = 0.04), the Cleveland Global Quality of Life score of this group was lower than that of ulcerative colitis patients (0.77 vs. 0.81; P = 0.047). The Cleveland Global Quality of Life score of females who had had pregnancies after pouch formation was 0.70, significantly lower (P = 0.039) than that of ulcerative colitis patients, although pouch function was

  19. The artificial organ museum in Cleveland (1979-1999) moved to Houston, Texas, and named in 2002 as the ICMT Museum for Artificial Organs. (United States)

    Nosé, Yukihiko


    The artificial organ museum established in Cleveland, Ohio, in 1979 organized by the International Center for Artificial Organs and Transplantation (ICAOT), was moved to Houston, Texas, in 1999. The museum with expanded and renewed artificial organ exhibits was officially opened on the 8th and 9th of November, 2002, at the Cullen Pavilion of the original Memorial Hermann Hospital. This building is the oldest in the Texas Medical Center, which was built in 1922. The ICMT (International Center for Medical Technologies) Museum for Artificial Organs (Museum) was completed after phase I, II, and III expansions of the exhibit booths, which were made over the last two years. Approximately 250 historically important and currently widely used artificial organs are exhibited in the Museum. The official opening of the Museum was coordinated with the "Symposium on Artificial Organs: Past, Present, and Future" during two days in November. There were approximately 225 participants at these events, and approximately 40 pioneers and clinical experts in the development and practice of various types of artificial organs contributed. During these programs, a proposal to maintain human resources in addition to artificial organ hardware and software was made in addition to the Museum. This new organization would be called the International Academy of Artificial Organ Pioneers (Academy). All contributors to the symposium were invited to be members of the Academy. The attendants of the symposium accepted this proposal unanimously. An additional 40 individuals, who were recognized as contributors to artificial organ technologies, were later added to the original Academy members. Later, the effective utilization of the Museum and Academy was encompassed in the International Faculty for Health and Medical Technologies (Faculty), a new addition to the activities of the ICMT. Dr. Michael DeBakey was elected as Dean of the Faculty. This is considered a "university without walls," a "university

  20. Assistência circulatória com aparelho Heart Mate® na Cleveland Clinic Foundation: experiência inicial e futuras aplicações

    Directory of Open Access Journals (Sweden)

    Theófilo GAUZE


    Full Text Available Objetivo: Estudar a experiência inicial em assistência circulatória ventricular esquerda com o aparelho pneumático implantável Heart Mate® 1000 IP, analisando suas características e aplicações clínicas. Material e Métodos: Entre dez/91 e set/94 (45 meses 33 pacientes em choque cardiogênico por miocardiopatia isquêmica ou dilatada foram assistidos, com esse aparelho, por um tempo de 0 a 153 dias (média de 76 dias, nos pacientes que chegaram a ser transplantados. O diagnóstico, o tempo de assintência circulatória, os parâmetros hemodinâmicos (índice cardíaco, gradiente transpulmonar, fração de ejeção do ventrículo direito, resistência vascular pulmonar e variação da área do ventrículo direito, assim como as complicações clínicas são apresentados e discutidos. Valores pré e pós implante são apresentados como média +/- desvio padrão e comparados por teste T pareado. Resultados: A melhora hemodinâmica foi estatisticamente significante (pPurpose: To study and evaluate the current use of the Heart Mate® 1000 IP LVAD at the Cleveland Clinic Foundation. Methods: Between Dec/91 and Sept/94 the Heart Mate pneumatic LVAD was implanted in 33 severely shocked patients. Multiple hemodynamic measurements were done in the OR during implant, 24 hours later and just before the heart transplant. Numbers are presented in mean (+/- standard deviation and compared by paired T-test. Clinical outcome and complications are discussed. Results: Hemodynamic parameters markedly improved after device implantation (statistically significant. Support time ranged from 0 to 153 days (mean 76 in the group that reached the transplant. There were 9 (15% deaths due to right ventricular failure, sepsis and multiple organ failure. No thromboembolic events occurred. Conclusion: Treatment with the Heart Mate improved clinical outcome in high risk patients. The results encourage its application as a new alternative therapy to heart failure.

  1. Circulation, mixing, and transport in nearshore Lake Erie in the vicinity of Villa Angela Beach and Euclid Creek, Cleveland, Ohio, September 11-12, 2012 (United States)

    Jackson, P. Ryan


    Villa Angela Beach, on the Lake Erie lakeshore near Cleveland, Ohio, is adjacent to the mouth of Euclid Creek, a small, flashy stream draining approximately 23 square miles and susceptible to periodic contamination from combined sewer overflows (CSOs) (97 and 163 CSO events in 2010 and 2011, respectively). Concerns over high concentrations of Escherichia coli (E. coli) in water samples taken along this beach and frequent beach closures led to the collection of synoptic data in the nearshore area in an attempt to gain insights into mixing processes, circulation, and the potential for transport of bacteria and other CSO-related pollutants from various sources in Euclid Creek and along the lakefront. An integrated synoptic survey was completed by the U.S. Geological Survey on September 11–12, 2012, during low-flow conditions on Euclid Creek, which followed rain-induced high flows in the creek on September 8–9, 2012. Data-collection methods included deployment of an autonomous underwater vehicle and use of a manned boat equipped with an acoustic Doppler current profiler. Spatial distributions of water-quality measures and nearshore currents indicated that the mixing zone encompassing the mouth of Euclid Creek and Villa Angela Beach is dynamic and highly variable in extent, but can exhibit a large zone of recirculation that can, at times, be decoupled from local wind forcing. Observed circulation patterns during September 2012 indicated that pollutants from CSOs in Euclid Creek and water discharged from three shoreline CSO points within 2,000 feet of the beach could be trapped along Villa Angela Beach by interaction of nearshore currents and shoreline structures. In spite of observed coastal downwelling, denser water from Euclid Creek is shown to mix to the surface via offshore turbulent structures that span the full depth of flow. While the southwesterly longshore currents driving the recirculation pattern along the beach front were observed during the 2011–12

  2. Cleveland Clinic Rehabilitation Research Program (United States)


    Maxwell-Faraday Equations. (B) Due to the nature of circular MS coils, negligible current is induced from the center of the MS coil, described as the...the patients prior to enrollment. Figure 6. iSCI patients with more functional gains from therapy had increased demyelination in the...Clinical and Translational Science Association’s Clinical Research Unit assistance has helped attenuate any safety threats. B. Publications and

  3. Feasibility Study of Economics and Performance of Solar Photovoltaics at the Kolthoff Landfill in Cleveland, Ohio. A Study Prepared in Partnership with the Environmental Protection Agency for the RE-Powering America's Land Initiative: Siting Renewable Energy on Potentially Contaminated Land and Mine Sites

    Energy Technology Data Exchange (ETDEWEB)

    Salasovich, J.; Geiger, J.; Mosey, G.; Healey, V.


    The U.S. Environmental Protection Agency (EPA), Region 5, in accordance with the RE-Powering America's Land initiative, selected the Kolthoff Landfill site in Cleveland, Ohio, for a feasibility study of renewable energy production. The National Renewable Energy Laboratory (NREL) provided technical assistance for this project. The purpose of this report is to assess the site for a possible photovoltaic (PV) system installation and estimate the cost, performance, and site impacts of different PV options. In addition, the report recommends financing options that could assist in the implementation of a PV system at the site.

  4. DCS Hydraulics Submission for Cleveland County, OK (United States)

    Federal Emergency Management Agency, Department of Homeland Security — Recent developments in digital terrain and geospatial database management technology make it possible to protect this investment for existing and future projects to...

  5. EnviroAtlas - Metrics for Cleveland, OH (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas web service supports research and online mapping activities related to EnviroAtlas ( The layers in this web...

  6. Taxonomic Evaluation of Cleveland Harbor Lake Areas (United States)


    midge Chironomus dilutus (formerly C. tentans) and the amphipod Hyalella azteca (USEPA/USACE 1998a, 1998b; USEPA 1994). A relatively large number...bioassay organism is the amphipod Hyalella azteca . This organism was not found at the lake areas, and also has a tolerance value of 8. However... azteca is typically more sensitive to metals while the genus Chironomus was reported to be more sensitive to pesticides (Phipps et al. 1995; Milani et

  7. 77 FR 53142 - Safety Zone; Cleveland National Air Show, Cleveland, OH (United States)


    ....S. Navy Blue Angels and civilian aircraft and by personnel on the Burke ] Lakefront Airport grounds... minimal impact on the economy, will not interfere with other agencies, will not adversely alter the...

  8. Nausea and vomiting in advanced cancer: the Cleveland Clinic protocol. (United States)

    Gupta, Mona; Davis, Mellar; LeGrand, Susan; Walsh, Declan; Lagman, Ruth


    Nausea and vomiting are common and distressing symptoms in advanced cancer. Both are multifactorial and cause significant morbidity, nutritional failure, and reduced quality of life. Assessment includes a detailed history, physical examination and investigations for reversible causes. Assessment and management will be influenced by performance status, prognosis, and goals of care. Several drug classes are effective with some having the added benefit of multiple routes of administration. It is our institution's practice to recommend metoclopramide as the first drug with haloperidol as an alternative antiemetic. Dexamethasone should be used for patients with central nervous system metastases or bowel obstruction. If your patient is near death, empiric metoclopramide, haloperidol or chlorpromazine is used without further investigation. For patients with a better prognosis, we exclude reversible causes and use the same first-line antiemetics, metoclopramide and haloperidol. For those who do not respond to first-line single antiemetics, olanzapine is second line and ondansetron is third. Rarely do we use combination therapy or cannabinoids. Olanzapine as a single agent has a distinct advantage over antiemetic combinations. It improves compliance, reduces drug interactions and has several routes of administration. Antiemetics, anticholinergics, octreotide and dexamethasone are used in combination to treat bowel obstruction. In opiod-na'ive patients, we prefer haloperidol, glycopyrrolate and an opioid as the first-line treatment and add or substitute octreotide and dexamethasone in those who do not respond. Non-pharmacologic interventions (mechanical stents and percutaneous endoscopic gastrostomy tubes) are used when nausea is refractory to medical management or for home-going management to relieve symptoms, reduce drug costs and rehospitalization.

  9. EnviroAtlas - Cleveland, OH - Park Access by Block Group (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset shows the block group population that is within and beyond an easy walking distance (500m) of a park entrance. Park entrances were included...

  10. EnviroAtlas - Cleveland, OH - Impervious Proximity Gradient (United States)

    U.S. Environmental Protection Agency — In any given 1-square meter point in this EnviroAtlas dataset, the value shown gives the percentage of impervious surface within 1 square kilometer centered over the...

  11. EnviroAtlas - Cleveland, OH - Near Road Block Group Summary (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset addresses the tree buffer along heavily traveled roads. The roads are interstates, arterials, and collectors within the EnviroAtlas...

  12. 76 FR 8281 - Amendment to Class B Airspace; Cleveland, OH (United States)


    ... final rule action. The development of the CLE Class B airspace modification was a dynamic, iterative... provided by the Hopkins International Airport website, as well as a Department of Transportation statistic... International Airport website is the total airport operations; which reflect the IFR and VFR...

  13. Cleveland Harbor, Ohio. Section 3. Study. Termination Report. (United States)


    study reaches for ease of discussion. Each reach is a socioeconomic unit which can be identified by a recognizable geographic boundary. Within each...heavily modified.:beaches fronted 36 percent * :of the shore In three sepa- : . ::rate segements totalling S:::2.4 miles of beach. By : ::1938 only 4...and geographic spacing become less significant if averaged over time. Therefore, the long-term (1876-1973) recession rates are used for comparison

  14. Neuroimaging of Brain Injuries and Disorders at Cleveland Clinic (United States)


    interventions. Functional MRI is an imaging method that detects increases in cerebral blood volume, flow, and oxygenation that occur locally in response...contributed by primary blast to TBI are less known, although some similarities, such as edema and oxidative stress, common to mechanical TBI have been

  15. EnviroAtlas - Cleveland, OH - Proximity to Parks (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset shows the approximate walking distance from a park entrance at any given location within the EnviroAtlas community boundary. The zones are...

  16. EnviroAtlas - Cleveland, OH - Land Cover by Block Group (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the percentage of each block group that is classified as impervious, forest, green space, and wetlands. In this community, forest...

  17. EnviroAtlas - Cleveland, OH - Tree Cover Configuration and Connectivity (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset categorizes forest land cover into structural elements (e.g. core, edge, connector, etc.). In this community, forest is defined as Trees...

  18. EnviroAtlas - Cleveland, OH - Near Road Tree Buffer (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset addresses the tree buffer along heavily traveled roads. The roads are interstates, arterials, and collectors within the EnviroAtlas...

  19. Floodplain Mapping or Redelineation Submission for Cleveland County OK (United States)

    Federal Emergency Management Agency, Department of Homeland Security — The Floodplain Mapping/Redelineation study deliverables depict and quantify the flood risks for the study area. The primary risk classifications used are the...

  20. Cleveland Metropolitan School District Human Ware Audit: Findings and Recommendations (United States)

    Osher, David; Poirier, Jeffrey M.; Dwyer, Kevin P.; Hicks, Regenia; Brown, Leah J.; Lampron, Stephanie; Rodriguez, Carlos


    Children and youth require safe and supportive schools and communities if they are to succeed in school and thrive. These needs are particularly great for children who struggle with the impacts of chronic poverty, lead poisoning and lead effect, community and media violence, drugs and alcohol, trauma and loss. There are many such students in…

  1. EnviroAtlas - Cleveland, OH - Green Space Proximity Gradient (United States)

    U.S. Environmental Protection Agency — In any given 1-square meter point in this EnviroAtlas dataset, the value shown gives the percentage of square meters of greenspace within 1/4 square kilometer...


    Federal Emergency Management Agency, Department of Homeland Security — The Digital Flood Insurance Rate Map (DFIRM) Database depicts flood risk information and supporting data used to develop the risk data. The primary risk...

  3. 78 FR 14010 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures... (United States)


    ...-Chippewa County, VOR RWY 14, Amdt 5 Cleveland, OH, Cleveland-Hopkins Intl, ILS PRM RWY 6L, Orig-D, CANCELED Cleveland, OH, Cleveland-Hopkins Intl, ILS PRM RWY 24R, Amdt 1, CANCELED Cleveland, OH, Cleveland-Hopkins Intl, LDA PRM RWY 6R, Amdt 1C, CANCELED Cleveland, OH, Cleveland-Hopkins Intl, LDA PRM RWY 24L,...

  4. EnviroAtlas - Cleveland, OH - Potential Window Views of Water by Block Group (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the block group population and the percentage of the block group population that has potential views of water bodies. A potential...

  5. Empowering Communities for Environmental Decision-Making : Innovative Partnerships in Cleveland (USA)

    NARCIS (Netherlands)

    A.R. Edwards (Arthur)


    textabstractIn this chapter, we discuss the relation between public innovation and the empowerment of local communities. Specifically, we explore the significance of cooperative public innovation efforts for the capability of local communities to participate in environmental decision-making, focusin

  6. Periodic Inspections of Cleveland Harbor East Breakwater, Ohio, and Burns Harbor North Breakwater, Indiana (United States)


    81 39.707 929 1 236+50 15 41 32.230 81 39.711 930 1 236+50 20 41 32.230 81 39.711 931 1 236+50 20 41 32.231 81...232+85 20 41 32.194 81 39.775 1010 1 232+85 15 41 32.194 81 39.775 1011 1012 1 232+80 20 41 32.194 81

  7. Solar heating experiment on the Grover Cleveland School, Boston, Massachusetts. Annual report

    Energy Technology Data Exchange (ETDEWEB)


    This report presents quantitative and qualitative data obtained during the first full year's operation of an industrial type, solar heating system of pilot plant scale. A brief description of the system is given and operational data for the system is provided along with information on maintenance history, various relevant experiences, individual investigations and experiments, and problem areas which were experienced. (WDM)

  8. 77 FR 57116 - Cleveland J. Enmon, Jr., M.D.; Decision and Order (United States)


    ... lower back pain stemming from a car accident in which she was ejected from the vehicle. . Despite this... medications and lifestyle changes, diet, exercise, heat applications, physical therapy, possibly...

  9. TIGER/Line Shapefile, 2013, county, Cleveland County, OK, Current Address Ranges Relationship File (United States)

    US Census Bureau, Department of Commerce — The TIGER/Line shapefiles and related database files (.dbf) are an extract of selected geographic and cartographic information from the U.S. Census Bureau's Master...

  10. EnviroAtlas - Cleveland, OH - Estimated Intersection Density of Walkable Roads (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections...

  11. Dynamics of a split torque helicopter transmission. M.S. Thesis - Cleveland State Univ. (United States)

    Krantz, Timothy L.


    Split torque designs, proposed as alternatives to traditional planetary designs for helicopter main rotor transmissions, can save weight and be more reliable than traditional designs. This report presents the results of an analytical study of the system dynamics and performance of a split torque gearbox that uses a balance beam mechanism for load sharing. The Lagrange method was applied to develop a system of equations of motion. The mathematical model includes time-varying gear mesh stiffness, friction, and manufacturing errors. Cornell's method for calculating the stiffness of spur gear teeth was extended and applied to helical gears. The phenomenon of sidebands spaced at shaft frequencies about gear mesh fundamental frequencies was simulated by modeling total composite gear errors as sinusoid functions. Although the gearbox has symmetric geometry, the loads and motions of the two power paths differ. Friction must be considered to properly evaluate the balance beam mechanism. For the design studied, the balance beam is not an effective device for load sharing unless the coefficient of friction is less than 0.003. The complete system stiffness as represented by the stiffness matrix used in this analysis must be considered to precisely determine the optimal tooth indexing position.

  12. EnviroAtlas - Cleveland, OH - 51m Riparian Buffer Forest Cover (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the percentage of a 51-m riparian buffer that is forested. In this community, forest is defined as Trees & Forest and Woody...

  13. A preliminary report of multispectral scanner data from the Cleveland harbor study (United States)

    Shook, D.; Raquet, C.; Svehla, R.; Wachter, D.; Salzman, J.; Coney, T.; Gedney, D.


    Imagery obtained from an airborne multispectral scanner is presented. A synoptic view of the entire study area is shown for a number of time periods and for a number of spectral bands. Using several bands, sediment distributions, thermal plumes, and Rhodamine B dye distributions are shown.

  14. An Examination of Essential Popular Music Compact Disc Holdings at the Cleveland Public Library. (United States)

    Halliday, Blane

    In the 1970s and early 1980s, a few library researchers and scholars made a case for the importance of public libraries' acquisition of popular music, particularly rock music sound recordings. Their arguments were based on the anticipated historical and cultural importance of obtaining and maintaining a collection of these materials. Little new…

  15. EnviroAtlas - Cleveland, OH - 51m Riparian Buffer Vegetated Cover (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the percentage of a 51-m riparian buffer that is vegetated. In this community, vegetated cover is defined as Trees & Forest,...

  16. The correspondence and collaboration of Harvey Cushing and Irvine Page: Lessons from the Cleveland Clinic Archives. (United States)

    Abdullah, Kalil G; Lubelski, Daniel; Lautzenheiser, Frederick; Mroz, Thomas E


    Harvey Cushing is well-known as a pioneer of brain surgery and is considered the father of modern neurosurgery. However, Cushing's interests and contributions extend beyond neurosurgery. Through his determined interdisciplinary collaboration in medicine and biomedical research, Cushing was able to contribute to numerous fields including bacteriology, anesthesiology, and endocrinology. With regards to the latter, Cushing corresponds with Irvine Page, well-known for isolating serotonin, discovering the renin-angiotensin system, and postulating of the mosaic theory of hypertension. In a correspondence spanning 3 years, from January 1933 to April 1936, Cushing and Page collaborated to discover a substance responsible for hypertension. In this historical article, the authors review the letters to highlight the collaborative efforts between leaders in disparate fields driven by the scientific curiosity. As national research agencies are focusing their funds toward collaborative and interdisciplinary research, it is interesting to note the historical communication among the scientific leaders that led to discoveries in the respective fields.

  17. The correspondence and collaboration of Harvey Cushing and Irvine Page: Lessons from the Cleveland Clinic Archives


    Abdullah, Kalil G.; Daniel Lubelski; Frederick Lautzenheiser; Thomas E Mroz


    Harvey Cushing is well-known as a pioneer of brain surgery and is considered the father of modern neurosurgery. However, Cushing′s interests and contributions extend beyond neurosurgery. Through his determined interdisciplinary collaboration in medicine and biomedical research, Cushing was able to contribute to numerous fields including bacteriology, anesthesiology, and endocrinology. With regards to the latter, Cushing corresponds with Irvine Page, well-known for isolating serotonin, discove...

  18. The correspondence and collaboration of Harvey Cushing and Irvine Page: Lessons from the Cleveland Clinic Archives

    Directory of Open Access Journals (Sweden)

    Kalil G Abdullah


    Full Text Available Harvey Cushing is well-known as a pioneer of brain surgery and is considered the father of modern neurosurgery. However, Cushing′s interests and contributions extend beyond neurosurgery. Through his determined interdisciplinary collaboration in medicine and biomedical research, Cushing was able to contribute to numerous fields including bacteriology, anesthesiology, and endocrinology. With regards to the latter, Cushing corresponds with Irvine Page, well-known for isolating serotonin, discovering the renin-angiotensin system, and postulating of the mosaic theory of hypertension. In a correspondence spanning 3 years, from January 1933 to April 1936, Cushing and Page collaborated to discover a substance responsible for hypertension. In this historical article, the authors review the letters to highlight the collaborative efforts between leaders in disparate fields driven by the scientific curiosity. As national research agencies are focusing their funds toward collaborative and interdisciplinary research, it is interesting to note the historical communication among the scientific leaders that led to discoveries in the respective fields.

  19. EnviroAtlas - Cleveland, OH - Estimated Percent Green Space Along Walkable Roads (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates green space along walkable roads. Green space within 25 meters of the road centerline is included and the percentage is based on...

  20. EnviroAtlas - Cleveland, OH - Residents with Minimal Potential Window Views of Trees by Block Group (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset shows the total block group population and the percentage of the block group population that has little access to potential window views of...

  1. EnviroAtlas - Cleveland, OH - Estimated Percent Tree Cover Along Walkable Roads (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter...

  2. EnviroAtlas - Cleveland, OH - Riparian Buffer Land Cover by Block Group (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the percentage of forested, vegetated, and impervious land within 15- and 50-meters of hydrologically connected streams, rivers,...

  3. EnviroAtlas - Cleveland, OH - 15m Riparian Buffer Forest Cover (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the percentage of a 15-m riparian buffer that is forested. In this community, forest is defined as Trees & Forest and Woody...

  4. Grover Cleveland High School Project CAUSA 1984-1985. OEE Evaluation Report. (United States)

    New York City Board of Education, Brooklyn. Office of Educational Assessment.

    This program, Project CAUSA, provided instruction in English as a second language (ESL), native language arts, and content-area courses, in addition to a career and vocational training program focused on office and computer skills, to a selected group of 141 Hispanic and Italian immigrant students of limited English proficiency (LEP). Students…

  5. Grover Cleveland High School Project CAUSA 1983-1984. O.E.A. Evaluation Report. (United States)

    New York City Board of Education, Brooklyn. Office of Educational Assessment.

    This document evaluates Project CAUSA (Career Advancement Utilizing Student Abilities), which provides instruction in English as a Second Language (ESL), native language development, and content-area courses, in addition to a career and vocational training program, to 115 students of limited English proficiency (LEP) from Italy and Spanish…

  6. Wastewater Management Study for Cleveland-Akron Metropolitan and Three Rivers Watershed Areas. VIII. Public Involvement (United States)


    4I County Commissioner SOURS , EDWARD J., County Commissioner, Sandusky County (j SPEECE, MELVIN & JUNE, Rt. $1, Attica, Ohio Teacher & Landmark, Inc...much concerned about your farm, and I am too, but I am also concerned in another , aspect of this thing. We’re spending an awful lot of dough ’r for

  7. EnviroAtlas - Cleveland, OH - Demographics by Block Group Web Service (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas web service supports research and online mapping activities related to EnviroAtlas ( This EnviroAtlas...

  8. Election Districts and Precincts, Voting Precinct Shapefile, Published in unknown, Cleveland County. (United States)

    NSGIC GIS Inventory (aka Ramona) — This Election Districts and Precincts dataset, was produced all or in part from Other information as of unknown. It is described as 'Voting Precinct Shapefile'. Data...


    Federal Emergency Management Agency, Department of Homeland Security — The Digital Flood Insurance Rate Map (DFIRM) Database depicts flood risk information and supporting data used to develop the risk data. The primary risk...

  10. H11689: NOS Hydrographic Survey , Cleveland, Ohio, 2007-09-25 (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Oceanic and Atmospheric Administration (NOAA) has the statutory mandate to collect hydrographic data in support of nautical chart compilation for safe...

  11. 33 CFR 165.903 - Safety Zones: Cuyahoga River and Old River, Cleveland, OH. (United States)


    ... knuckle toward the upriver corner of the Nautica Stage. (7) The fender on the west bank of the river at 41... hundred seventy (270) foot section on the east bank of the river between the Columbus Road bridge (41..., which is the end of the chain link fence between The Club Mega and Shippers C & D. (b)...

  12. 75 FR 14459 - Notice of Intent to Repatriate Cultural Items: Western Reserve Historical Society, Cleveland, OH (United States)


    ... possible cultural affiliation of the objects with the Tlingit and Haida. Photographs of the items and... Central Council of the Tlingit & Haida Indian Tribes further identified the Double bladed dagger as ``Shak... consultation the museum reasonably believes these cultural items are culturally affiliated with the...

  13. A Guide for Developing an ADP Security Plan for Navy Finance Center, Cleveland, Ohio. (United States)


    modification, and disclosure, and users are protected against denial of service which may result from events such as fraud, misuse, espion - age...two systems. The major differences are that micro - waves are high frequency radio waves and that by using dif- ferent antennae, the size of the area...Acoustical (Audio). This system uses micro - phones to listen for intrusion sounds. When an intrusion sound is heard the alarm is set off. Because of

  14. EnviroAtlas - Cleveland, OH - 15m Riparian Buffer Vegetated Cover (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset describes the percentage of a 15-m riparian buffer that is vegetated. In this community, vegetated cover is defined as Trees & Forest,...

  15. EnviroAtlas - Cleveland, OH - Greenspace Around Schools by Block Group (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas data set shows the number of schools in each block group in the EnviroAtlas community boundary as well as the number of schools where less than 25%...

  16. EnviroAtlas - Cleveland, OH - Historic Places by Census Block Group (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the total number of historic places located within each Census Block Group (CBG). The historic places data were compiled from the...

  17. 78 FR 21515 - Prevailing Rate Systems; Redefinition of the St. Louis, MO; Southern Missouri; Cleveland, OH; and... (United States)


    ... requirements, Wages. U.S. Office of Personnel Management. John Berry, Director. Accordingly, the U.S. Office of... Phelps Pulaski Webster Area of Application. Survey area plus: Kansas: Cherokee Crawford Missouri:...

  18. 77 FR 68073 - Prevailing Rate Systems; Redefinition of the St. Louis, MO; Southern Missouri; Cleveland, OH; and... (United States)


    ... employees, Reporting and recordkeeping requirements, Wages. U.S. Office of Personnel Management. John Berry... Pulaski Webster Area of Application. Survey area plus: Kansas: Cherokee Crawford Missouri: Barry...

  19. Wastewater Management Study for Cleveland-Akron and Three Rivers Watershed Areas, 1970. Appendix III. Municipal Wastewater and Stormwater Runoff. (United States)


    organics. Breakpoint chlorination is used for ammonia nitrogen removal in lieu of clinoptilolite because the questions of resin detrition, recovery...project this change, some typical drainage districts were selected and synthetically urbanized as a function of the projected populations. Homes were i...physical scaling problems and performance limitations at ambient air temperatures less than 400 to 450F. Ion exchange using clinoptilolite , a naturally

  20. A day in the life: a case series of acute care palliative medicine--the Cleveland model. (United States)

    Lagman, Ruth; Walsh, Declan; Heintz, Jessica; Legrand, Susan B; Davis, Mellar P


    Palliative care in advanced disease is complex. Knowledge and experience of symptom control and management of multiple complications are essential. An interdisciplinary team is also required to meet the medical and psychosocial needs in life-limiting illness. Acute care palliative medicine is a new concept in the spectrum of palliative care services. Acute care palliative medicine, integrated into a tertiary academic medical center, provides expert medical management and specialized care as part of the spectrum of acute medical care services to this challenging patient population. The authors describe a case series to provide a snapshot of a typical day in an acute care inpatient palliative medicine unit. The cases illustrate the sophisticated medical care involved for each individual and the important skill sets of the palliative medicine specialist required to provide high-quality acute medical care for the very ill.

  1. 75 FR 18451 - Safety and Security Zones; Tall Ships Challenge 2010, Great Lakes; Cleveland, OH; Bay City, MI... (United States)


    ... Comments'' portion of the SUPPLEMENTARY INFORMATION section below for instructions on submitting comments..., anchored, or moored between 12:01 a.m. on June 23, 2010 and 12:01 a.m. on September 13, 2010. If you think... of Homeland Security Management Directive 023-01 and Commandant Instruction M16475.lD, which...

  2. 75 FR 33506 - Safety and Security Zones; Tall Ships Challenge 2010, Great Lakes, Cleveland, OH, Bay City, MI... (United States)


    ..., anchored, or moored between 12:01 a.m. on June 23, 2010 and 12:01 a.m. on September 13, 2010. Each zone... under Commandant Instruction M16475.lD and Department of Homeland Security Management Directive 023- 01... excluded, under figure 2-1, paragraph (34)(g) of the Instruction. An environmental analysis checklist and...

  3. Cleveland Harbor, Ohio Draft Reformulation Phase I General Design Memorandum and Draft Supplement to the Final Environmental Impact Statement. Revision. (United States)


    their property. Coal would arrive at this facility by train and oil would be shipped in 450-foot vessels. The coal and oil would then he blended to...The Water Resources of Cuyahoga County, OH, USGS, Columbus, OH, Bulletin No. 26, 123 pp. A-19 VC yIYMAP E A W) APPWHE>AD EAST ARRO *HFAt) BRAK *TP 8

  4. The Nation's Report Card Reading 2011 Trial Urban District Snapshot Report. Cleveland Metropolitan School District. Grade 4, Public Schools (United States)

    National Center for Education Statistics, 2011


    This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

  5. The Nation's Report Card Mathematics 2011 Trial Urban District Snapshot Report. Cleveland Metropolitan School District. Grade 4, Public Schools (United States)

    National Center for Education Statistics, 2011


    This one-page report presents overall results, achievement level percentages and average score results, scores at selected percentiles, average scores for district and large cities, results for student groups (school race, gender, and eligibility for National School Lunch Program) in 2011, and score gaps for student groups. In 2011, the average…

  6. Multi-dimensional modeling of a thermal energy storage canister. M.S. Thesis - Cleveland State Univ., Dec. 1990 (United States)

    Kerslake, Thomas W.


    The Solar Dynamic Power Module being developed for Space Station Freedom uses a eutectic mixture of LiF-CaF2 phase change material (PCM) contained in toroidal canisters for thermal energy storage. Presented are the results from heat transfer analyses of a PCM containment canister. One and two dimensional finite difference computer models are developed to analyze heat transfer in the canister walls, PCM, void, and heat engine working fluid coolant. The modes of heat transfer considered include conduction in canister walls and solid PCM, conduction and pseudo-free convection in liquid PCM, conduction and radiation across PCM vapor filled void regions, and forced convection in the heat engine working fluid. Void shape, location, growth or shrinkage (due to density difference between the solid and liquid PCM phases) are prescribed based on engineering judgment. The PCM phase change process is analyzed using the enthalpy method. The discussion of the results focuses on how canister thermal performance is affected by free convection in the liquid PCM and void heat transfer. Characterizing these effects is important for interpreting the relationship between ground-based canister performance (in 1-g) and expected on-orbit performance (in micro-g). Void regions accentuate canister hot spots and temperature gradients due to their large thermal resistance. Free convection reduces the extent of PCM superheating and lowers canister temperatures during a portion of the PCM thermal charge period. Surprisingly small differences in canister thermal performance result from operation on the ground and operation on-orbit. This lack of a strong gravity dependency is attributed to the large contribution of container walls in overall canister energy redistribution by conduction.

  7. Landslide susceptibility mapping using downscaled AMSR-E soil moisture: A case study from Cleveland Corral, California, US (United States)

    As soil moisture increases, slope stability decreases. Remotely sensed soil moisture data can provide routine updates of slope conditions necessary for landslide predictions. For regional scale landslide investigations, only remote sensing methods have the spatial and temporal resolution required to...

  8. System Identification of Damped Truss-Like Space Structures. Ph.D. Thesis - Cleveland State Univ., Mar. 1994 (United States)

    Armand, Sasan


    A spacecraft payload flown on a launch vehicle experiences dynamic loads. The dynamic loads are caused by various phenomena ranging from the start-up of the launch vehicle engine to wind gusts. A spacecraft payload should be designed to meet launch vehicle dynamic loads. One of the major steps taken towards determining the dynamic loads is to correlate the finite element model of the spacecraft with the test results of a modal survey test. A test-verified finite element model of the spacecraft should possess the same spatial properties (stiffness, mass, and damping) and modal properties (frequencies and mode shapes) as the test hardware representing the spacecraft. The test-verified and correlated finite element model of the spacecraft is then coupled with the finite element model of the launch vehicle for analysis of loads and stress. Modal survey testing, verification of a finite element model, and modification of the finite element model to match the modal survey test results can easily be accomplished if the spacecraft structure is simple. However, this is rarely the case. A simple structure here is defined as a structure where the influence of nonlinearity between force and displacement (uncertainty in a test, for example, with errors in input and output), and the influence of damping (structural, coulomb, and viscous) are not pronounced. The objective of this study is to develop system identification and correlation methods with the focus on the structural systems that possess nonproportional damping. Two approaches to correct the nonproportional damping matrix of a truss structure were studied, and have been implemented on truss-like structures such as the National Aeronautics and Space Administration's space station truss. The results of this study showed nearly 100 percent improvement of the correlated eigensystem over the analytical eigensystem. The first method showed excellent results with up to three modes used in the system identification process. The second method could handle more modes, but required more computer usage time, and the results were less accurate than those of the first method.

  9. In-Migration, Entrepreneurship and Rural-Urban Interdependencies: The Case of East Cleveland, North East England (United States)

    Kalantaridis, Christos


    In-migration is a key influence in the process of rural economic development in England, Continental Europe and the US. New arrivals are often viewed in the literature as contributors in new venture creation, as well as catalysts in enhancing rural-urban interdependencies in the countryside. This paper sets out to explore the validity of this view…

  10. EnviroAtlas - Cleveland, OH - Domestic Water Use per Day by U.S. Census Block Group (United States)

    U.S. Environmental Protection Agency — As included in this EnviroAtlas dataset, the community-level domestic water use is calculated using locally available water use data per capita in gallons of water...

  11. A tale of two rain gardens: Barriers and bridges to adaptive management of urban stormwater in Cleveland, Ohio (United States)

    Green infrastructure installations such as rain gardens and bioswales are increasingly regarded as viable tools to mitigate stormwater runoff at the parcel level. The use of adaptive management to implement and monitor green infrastructure projects as experimental attempts to man...

  12. 77 FR 25128 - Amended Land Management Plans for the Angeles, Cleveland, Los Padres, and San Bernardino National... (United States)


    ... modify the existing land use zones in the identified IRAs to include more Back Country Non-Motorized... and Game, Parks and Recreation, and Forestry and Fire ] Protection), Ventura County, and Orange County Fire Authority have agreed to participate as cooperating agencies. Other federal, state, and...

  13. Proceedings of ARO Workshop Biostructures as Composite Materials, Held in Cleveland, Ohio on October 23-25, 1989 (United States)


    has been produced directly from I the fungus mucor rouxii, through fermentation controls. Current efforts are addressed towards the characterization...Materials in Medicine. 3. Cassidy, J.J., Silverstein, M., Hiltner, A., and Beer , E., "An analytical model U of the creep mechanism in the intervertebral...collagen helix receptor site (top) and the telopeptide in 3-sheet cgnformation (bottom). B. Formation of the aldehyde on Lys 9• causes a rearrangement of

  14. Stage 2 Report for Reformulation Phase I General Design Memorandum, Cleveland Harbor, Ohio. Volume II. Appendices. Revision. (United States)


    difficult conditions for entering the harbor for this plan. The vessel masters were manimous in their preference for this plan over the modified "L...were completed on land and borings B-5 and B-Z9 in the lake. The samples obtained were subjected to a testing and evaluation program. A careful review of...Thus, we belleve that a 30 ft. pile of pellets may be achieved along the Cuyahoga River. As stated pre- viously, a careful monitoring system would have

  15. Testing and Evaluation of the 84 Sites and Reconnaissance of the Islands and Cleveland Property, Richard B. Russell Dam and Lake, Savannah River, Georgia and South Carolina. (United States)


    element might still be largely present. No definite features were found. The site might enable horizontal distributional studies to be made, based on...prior to the beginning of transit mapping, these were also done concurrently with the mapping. 2) A detailed transit map was made of the site area (Figure...working platform. This interpretation was further substantiated by a high density of coal clinkers in this unit and the absence of burned materials in

  16. Cleveland-Akron Metropolitan and Three Rivers Watershed Area. Wastewater Management Survey Scope Study. Appendix V. Land Treatment. Phase I Report. (United States)


    identified. 7. General Soil Map of Hancock County. ( Amanda , Biglick, and Washington Townships) Dept. of Natural Resources, Division of Lands and Soil...2,563 Belmont 23,296 Carroll 5,737Columbiana 19,778’ Coshocton 17,440 Gallia 6,941 Guernsey 4,369 Harrison 49,064 Hocking 3.177 I Holmes 2,479 Jackson

  17. Geologic Map of the Kings Mountain and Grover Quadrangles, Cleveland and Gaston Counties, North Carolina, and Cherokee and York Counties, South Carolina (United States)

    Horton, J. Wright


    This geologic map of the Kings Mountain and Grover 7.5-min quadrangles, N.C.-S.C., straddles a regional geological boundary between the Inner Piedmont and Carolina terranes. The Kings Mountain sequence (informal name) on the western flank of the Carolina terrane in this area includes the Neoproterozoic Battleground and Blacksburg Formations. The Battleground Formation has a lower part consisting of metavolcanic rocks and interlayered schist and an upper part consisting of quartz-sericite phyllite and schist interlayered with quartz-pebble metaconglomerate, aluminous quartzite, micaceous quartzite, manganiferous rock, and metavolcanic rocks. The Blacks-burg Formation consists of phyllitic metasiltstone interlayered with thinner units of marble, laminated micaceous quartzite, hornblende gneiss, and amphibolite. Layered metamorphic rocks of the Inner Piedmont terrane include muscovite-biotite gneiss, muscovite schist, and amphibolite. The Kings Mountain sequence has been intruded by metatonalite and metatrondhjemite (Neoproterozoic), metagabbro and metadiorite (Paleozoic?), and the High Shoals Granite (Pennsylvanian). Layered metamorphic rocks of the Inner Piedmont in this area have been intruded by the Toluca Granite (Ordovician?), the Cherryville Granite and associated pegmatite (Mississippian), and spodumene pegmatite (Mississippian). Diabase dikes (early Jurassic) are locally present throughout the area. Ductile fault zones of regional scale include the Kings Mountain and Kings Creek shear zones. In this area, the Kings Mountain shear zone forms the boundary between the Inner Piedmont and Carolina terranes, and the Kings Creek shear zone separates the Battleground Formation from the Blacksburg Formation. Structural styles change across the Kings Mountain shear zone from steeply dipping layers, foliations, and folds on the southeast to gently and moderately dipping layers, foliations, and recumbent folds on the northwest. Mineral assemblages in the Kings Mountain sequence show a westward decrease from upper amphibolite facies (sillimanite zone) near the High Shoals Granite in the eastern side of the map area to upper greenschist (epidote-amphibolite) facies in the south-central part of the area near the Kings Mountain shear zone. Amphibolite-facies mineral assemblages in the Inner Piedmont terrane increase in grade from the kyanite zone near the Kings Mountain shear zone to the sillimanite zone in the northwestern part of the map area. Surficial deposits include alluvium in the stream valleys and colluvium along ridges and steep slopes. These quadrangles are unusual in the richness and variety of the mineral deposits that they contain, which include spodumene (lithium), cassiterite (tin), mica, feldspar, silica, clay, marble, kyanite and sillimanite, barite, manganese, sand and gravel, gold, pyrite, and iron.

  18. Advanced Power Transmission Technology, Proceedings of a Symposium Held at NASA Lewis Research Center, Cleveland, Ohio on June 9-11, 1981. (United States)


    the "Quid Pro Quo" for facilities and support required by the Army. The ARRL experiment prospered and in 1968, Phil Carlson of the Lockheed-California...bevel gears are significantly higher than handbook formulas would indicate. To adequately understand the effects of spiral-bevel gear design parameters...vol. 34, Dec. 1963, pp. 63-74. 105 S. , . . .. . .• . .• 27. Wernitz, W.: Friction Drives. Mechanical Design and Systems Handbook , H. A. Rothbart

  19. Wastewater Management Alternatives for the Cleveland - Akron, Three Rivers Watershed Area. Technical Appendix - Phase II. System Design and Estimate of Cost. (United States)


    certain instances in heavily urbanized areas. Deep Tunnel - Figure 32 represents the total capital cost for deep tunnel construction in shale . The...Practiced at South Tahoe", (WPRD 52-01-67), August, 1971. 4. Burgess § Niple, Ltd., "Project Cost Study" for Northeast Ohio Water Development Plan...21. Burgess & Niple, Ltd., "Design Criteria for Northeast and Southwest Ohio Water Development Plans", Ohio Department of Natural Resources

  20. A scale model wind tunnel study of dispersion in the Cleveland area. Laboratory simulation of lake breeze effects on diffusion from ground level emissions (United States)

    Hoydysh, W. G.


    A wind tunnel simulation of the diffusion patterns in a sea breeze was attempted. The results indicate that the low level onshore flow was well simulated for neutral, stable, unstable, and elevated inversion conditions. Velocity, turbulence, shear stress, and temperature data were taken, and the spread of emissions from ground level sources was investigated. Comparison is made with theoretical predictions by E. Inoue and with the open, homogeneous plane field results of Pasquill. Agreement with the predictions by Inoue is good, and the comparison with Pasquill's results shows that the wind tunnel flows are shifted two categories towards more stable. The discrepancy may be explained as a matter of averaging time.

  1. Single Particulate SEM-EDX Analysis of Iron-Containing Coarse Particulate Matter in an Urban Environment: Sources and Distribution of Iron within Cleveland, Ohio (United States)

    The physicochemical properties of coarse-mode, iron-containing particles, and their temporal and spatial distributions are poorly understood. Single particle analysis combining x-ray elemental mapping and computer-controlled scanning electron microscopy (CCSEM-EDX) of passively ...

  2. Overview: NASA/AF/Navy Symposium on Aeroelasticity of Turbine Engines at NASA Lewis Laboratory, Cleveland, Ohio, October 27, 28, & 29, 1980. (United States)


    Boldman (13) and Carta (14); an annular cascade presentation, by Jutras (15); five papers on flutter in rotors by Stargardter (16), Jutras (17...Technologies Research Center * iA-2 4.7 - Cascade Experiments (cont’d) 15 "Experimental Analysis of Blade Instability," by R. Jutras , General Electric...Group, Comnerical Products Division 17 "A Program for Subsonic/Transonic Stall Flutter Study," by R. Jutras , General Electric Company, Aircraft

  3. The interface in tungsten fiber reinforced niobium metal-matrix composites. Final Report Ph.D. Thesis - Case Western Reserve Univ., Cleveland, OH (United States)

    Grobstein, Toni L.


    The creep resistance of tungsten fiber reinforced niobium metal-matrix composites was evaluated. The interface region between the fiber and matrix was characterized by microhardness and electron probe microanalysis measurements which indicated that its properties were between those of fiber and matrix. However, the measured properties of the composite exceeded those calculated by the rule of mixtures even when the interface zone was assumed to retain all the strength of the fiber. The composite structure appeared to enhance the strengths of both the fibers and the matrix above what they exhibited in stand-alone tests. The effect of fiber orientation and matrix alloy composition on the fiber/matrix interface were also evaluated. Small alloying additions of zirconium and tungsten to the niobium matrix affected the creep resistance of the composites only slightly. A decrease in the creep resistance of the composite with increasing zirconium content in the matrix was ascribed to an increase in the diffusion rate of the fiber/matrix interdiffusion reaction, and a slight increase in the creep resistance of the composite was observed with an addition of 9 w percent tungsten to the matrix. In addition, Kirkendall void formation was observed at the fiber/matrix interface; the void distribution differed depending on the fiber orientation relative to the stress axis.

  4. Cases from the Cleveland Clinic Foundation: What's Knowledge Got to Do with It? Ethics, Epistemology, and Intractable Conflicts in the Medical Setting. (United States)

    Kibbe, Bryan; Ford, Paul J


    This article utilizes the case of Ms H. to examine the contrasting ways that surrogate decision makers move from simply hearing information about the patient to actually knowing and understanding the patient's medical condition. The focus of the case is on a family's request to actually see the patient's wounds instead of being told about the wounds, and the role of clinical ethicists in facilitating this request. We argue that clinical ethicists have an important role to play in the work of converting information into knowledge and that this can serve as a valuable way forward in the midst of seemingly intractable conflicts in the medical setting.

  5. A tribute to Congresswoman Mary Rose Oakar: friend of the elderly, advocate for women, health care reformer, and champion for Cleveland. (United States)

    Halamandaris, V J


    Striking a balance between sensitive caring and political muscle, between aiding her Ohio constituents and mounting national crusades, Congresswoman Mary Rose Oakar is one of the most active members of the House Aging Committee. Her goals for the future are growing every day.

  6. 77 FR 37801 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures... (United States)


    ..., CANCELED Cleveland, OH, Cleveland-Hopkins Intl, ILS OR LOC RWY 28, Amdt 24A Wapakoneta, OH, Neil Armstrong... ``significant rule '' under DOT Regulatory Policies and Procedures (44 FR 11034; February 26,1979) ; and...

  7. 93rd Annual Meeting The Ohio Academy of Science April 27-29, 1984. Hosted by Case Western Reserve University and The Cleveland Museum of Natural History. Theme: Industry/Academia Relations. April Program Abstracts. (United States)

    Ohio Journal of Science, 1984


    Provides abstracts of papers dealing with various aspects of science, engineering, mathematics, computer science, science education, and other academic fields. Science education abstracts focus on such topics as microcomputers, industry relationships, curriculum and instructional strategies. Program descriptions are also included. (JN)

  8. Modeling of Multiphase Alumina-Loaded Jet Flow Fields. AIAA/ASME/SAE/ASEE Joint Propulsion Conference (34th) and Exhibit Held in Cleveland, OH on July 13-15, 1998 (United States)


    turbulence, particle drag, chemistry, and particle supercooling. The particle phase change is simulated kinetically and includes two solid Al2O3 crystalline structures : meta stable gamma and stable alpha forms.

  9. Randomized Algorithms for Systems and Control: Theory and Applications (United States)


    IEIIT-CNR Randomized Algorithms for Systems and Control: Theory and Applications NATO LS Glasgow, Pamplona , Cleveland @RT 2008 Roberto Tempo IEIIT...Glasgow, Pamplona , Cleveland @RT 2008 IEIIT-CNR References R. Tempo, G. Calafiore and F. Dabbene, “Randomized Algorithms for...Analysis and Control of Uncertain Systems,” Springer-Verlag, London, 2005 R Tempo and H Ishii “Monte Carlo and Las Vegas NATO LS Glasgow, Pamplona , Cleveland

  10. Annual Gaseous Electronics Conference (39th) Held in Madison, Wisconsin on 7-10 October 1986. Program and Abstracts. (United States)



  11. Dollar Summary of Prime Contract Awards by State, Place, and Contractor, FY83, Part 2 (Flint, Michigan - Wheatland, Wyoming). (United States)



  12. Tendinopathy of the long head of the biceps tendon: histopathologic analysis of the extra-articular biceps tendon and tenosynovium


    Streit JJ; Shishani Y; Rodgers M; Gobezie R


    Jonathan J Streit,1 Yousef Shishani,1 Mark Rodgers,2 Reuben Gobezie1 1The Cleveland Shoulder Institute, 2Department of Pathology, University Hospitals of Cleveland, Cleveland, OH, USA Background: Bicipital tendinitis is a common cause of anterior shoulder pain, but there is no evidence that acute inflammation of the extra-articular long head of the biceps (LHB) tendon is the root cause of this condition. We evaluated the histologic findings of the extra-articular portion of the LHB tendon an...

  13. Public Schools. Cuyahoga County Data Brief (United States)

    Center on Urban Poverty and Community Development (NJ1), 2010


    Public school enrollment has fallen in most districts in Cuyahoga County, consistent with the overall population loss. The largest decreases of more than 30% have been in Cleveland and East Cleveland districts. Several inner ring suburbs have also experienced large declines, while a few outlying suburbs show increased enrollments. High school…

  14. 78 FR 51170 - Proposed Collection; Comment Request (United States)


    ... of the Secretary Proposed Collection; Comment Request AGENCY: Defense Finance and Accounting Service... obtain a copy of the proposal and associated collection instruments, please write to the Defense Finance and Accounting Services-Cleveland, 1240 East 9th Street, Cleveland, OH 44199, ATTN: JFBDA--Mr....

  15. 77 FR 6091 - Proposed Collection; Comment Request (United States)


    ... of the Secretary Proposed Collection; Comment Request AGENCY: Defense Finance and Accounting Service... of 1995, the Defense Finance and Accounting Service announces a proposed public information... Operations, Defense Finance and Accounting Service--Cleveland, P.O. Box 998002, Cleveland, OH 44199-8002;...

  16. Using business intelligence to improve performance. (United States)

    Wadsworth, Tom; Graves, Brian; Glass, Steve; Harrison, A Marc; Donovan, Chris; Proctor, Andrew


    Cleveland Clinic's enterprise performance management program offers proof that comparisons of actual performance against strategic objectives can enable healthcare organization to achieve rapid organizational change. Here are four lessons Cleveland Clinic learned from this initiative: Align performance metrics with strategic initiatives. Structure dashboards for the CEO. Link performance to annual reviews. Customize dashboard views to the specific user.

  17. Room-Temperature Tensile Behavior of Oriented Tungsten Single Crystals with Rhenium in Dilute Solid Solution (United States)



  18. Oceanographic and surface meteorological data collected from station RECON Erie, Cleveland (CLV), by Great Lakes Environmental Research Laboratory and assembled by Great Lakes Observing System (GLOS) in the Great Lakes region from 2014-07-24 to 2016-06-30 (NODC Accession 0123652) (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NCEI Accession 0123652 contains oceanographic and surface meteorological data in netCDF formatted files, which follow the Climate and Forecast metadata convention...

  19. Behind the Curtain: Keeping Surgical Patients Warmer Fights Infection (United States)

    ... Cleveland Clinic, Ohio Photo courtesy of NIGMS Keeping Surgical Patients Warmer Fights Infection As recently as the mid- ... His research led to a new conclusion: Keep surgical patients warm. No new drugs, no fancy technology. Warming ...

  20. Compact Wireless BioMetric Monitoring and Real Time Processing System Project (United States)

    National Aeronautics and Space Administration — ZIN Technologies in collaboration with the Cleveland Clinic Foundation will use their combined experience and research and development expertise to develop a new...

  1. Mean annual runoff, precipitation, and evapotranspiration in the glaciated northeastern United States, 1951-80 (United States)

    U.S. Geological Survey, Department of the Interior — Two maps, compiled at 1:1,000,000 scale, depict mean annual runoff, precipitation, and evapotranspiration in the part of the United States east of Cleveland, Ohio...

  2. Ohio's First Electrolysis-Based Hydrogen Fueling Station (United States)

    Demattia, Brianne


    Presentation to the earth day coalition describing efforts with NASA GRC and Cleveland RTA on Ohio's hydrogen fueling station and bus demonstration. Project background and goals, challenges and successes, and current status.

  3. American Board of Obesity Medicine (ABOM) (United States)

    ... Medical Specialties (ABMS) member board or osteopathic medicine equivalent. Successful completion of an on-site clinical ... American Society for Metabolic and Bariatric Surgery Canadian Obesity Network Cleveland Clinic ...

  4. 16 CFR 0.19 - The Regional Offices. (United States)


    ... West Virginia. Federal Trade Commission, Eaton Center, Suite 200, 1111 Superior Avenue, Cleveland, Ohio... conferences with attorneys, consumers, and other members of the public on matters relating to the...

  5. Flight Research Building (Hangar) (United States)

    Federal Laboratory Consortium — The NASA Glenn Flight Research Building is located at the NASA Glenn Research Center with aircraft access to Cleveland Hopkins International Airport. The facility is...

  6. Plaadid / Berk Vaher

    Index Scriptorium Estoniae

    Vaher, Berk, 1975-


    Uutest plaatidest James Last "The Gentleman Of Music", Koufax "Social Life", Pixie Twins "Valgus ja varjud", Cleveland Watkiss "Victory's Happy Songbook", Hannah "Ballaadid", "Red Hot + Riot", Foo Fighters "One By One", Pearl Jam "Riot Act"

  7. Lobster Tail Ice Formation on Aerosurface (United States)


    Glace Ice formation commonly refered to as 'Lobster Tail' by scientists and engineers, is caused to form on the leading edge of a aircraft tail section in the icing research tunnel at the NASA Glenn Research Center, Cleveland, Ohio.

  8. 78 FR 20095 - Proposed Collection; Comment Request (United States)


    ... of the Secretary Proposed Collection; Comment Request AGENCY: Defense Finance and Accounting Service... of 1995, the Defense Finance and Accounting Service announces a proposed public information... to Defense Finance and Accounting Service--Cleveland, 1240 East Ninth Street, ATTN:...

  9. 75 FR 21977 - Earth Day, 2010 (United States)


    ... Nation watched in horror as the polluted and debris-choked Cuyahoga River in Cleveland, Ohio, caught fire... from today, when our children and grandchildren look back on what we did at this moment, let them...

  10. 76 FR 58822 - Announcement of Funding Awards; Fair Housing Initiatives Program; Fiscal Year 2010 (United States)


    ... or national origin in the sale, rental, or financing of most housing. In addition, the Fair Housing....00 Cleveland, East Point, GA 30344. Tennessee Fair Housing Council, Inc.: 107 Music Tracey...

  11. 77 FR 35424 - National Register of Historic Places; Notification of Pending Nominations and Related Actions (United States)


    ... review, we cannot guarantee that we will be able to do so. Dated: May 23, 2012. J. Paul Loether, Chief... Company Paper Mill and Sack Factory, 218 Cleveland St., Chagrin Falls, 12000391 Franklin County...

  12. Genetics Home Reference: gnathodiaphyseal dysplasia (United States)

    ... the jaw. Affected individuals may develop bone infections (osteomyelitis) in the jaw, which can lead to pain, ... Diagnosis and Management Resources (2 links) Cleveland Clinic: Osteomyelitis MedlinePlus Encyclopedia: Bone Mineral Density Testing General Information ...

  13. 76 FR 18893 - Approval and Promulgation of Air Quality Implementation Plans; Ohio; Volatile Organic Compound... (United States)


    ... Organic Compound Emission Control Measures for Lithographic and Letterpress Printing in Cleveland AGENCY... volatile organic compound (VOC) rule. These rule revisions specify compliance dates for subject facilities... approved offset lithographic and letterpress printing volatile organic compound (VOC) rule for...

  14. Lorain Harbor, Ohio. Preliminary Feasibility Study (Stage 2). Review of Reports. Volume 1. Main Report. (United States)


    Republic Steel, Karl Kumant of U. S. Steel, and Victor Anderson of the Lake Pilots Association for their interest in and contribution to the study...Cleveland, OH and 90 miles east of Toledo , OH, accommodates the waterborne movement of bulk cargo to and from the city of Lorain and points inland. It...Routes 57 and 58. The Lorain-Elyria metropolitan area is served by Interstates 90 and 80, connecting between Toledo and Cleveland. Interstate 71

  15. WAVE3 is a Biomarker for Breast Cancer Progression and Metastasis (United States)


    Methodology/Principal Findings: Herein, we utilized both immuno-histo- chemistry (IHC) of primary human BC tumors as well as quantitative real-time RT...been extensively investigated. In the present study, we utilized immuno-histo- chemistry on primary human BC tumors to clearly demonstrate that high...Molecular Cardiology Cleveland Clinic Lerner Research Institute 9500 Euclid Avenue, NB-50 Cleveland, OH 44195 Phone: 216 444 7393 Fax: 216 445 8204

  16. A multimethod investigation including direct observation of 3751 patient visits to 120 dental offices


    Stephen Wotman; Demko, Catherine A.; Kristin Victoroff; et al.


    Stephen Wotman1, Catherine A Demko1, Kristin Victoroff1, Joseph J Sudano2, James A Lalumandier11Department of Community Dentistry, Case Western Reserve University, School of Dental Medicine, Cleveland, OH, USA; 2Center of Health Care Research and Policy, Case Western Reserve University, School of Medicine, Cleveland, OH, USAAbstract: This report defines verbal interactions between practitioners and patients as core activities of dental practice. Trained teams spent four days in 120 Ohio denta...

  17. The role and importance of economic evaluation of traditional herbal medicine use for chronic non-communicable diseases


    Hughes GD; Aboyade OM; Hill JD; Rasu RS


    Gail D Hughes,1 Oluwaseyi M Aboyade,1 John D Hill,2 Rafia S Rasu3 1South African Herbal Science and Medicine Institute, University of the Western Cape, Western Cape, South Africa; 2Department of Pharmacy, Cleveland Clinic, Cleveland, OH, 3School of Pharmacy, University of Kansas, Lawrence, KS, USA Background: Non-communicable diseases (NCD) constitute major public health problems globally, with an impact on morbidity and mortality ranking high and second to HIV/AIDS. Existing studies conduct...

  18. Ethical considerations in uterus transplantation


    Kavita Shah Arora, Kavita; Woessner,Jessica; Blake,Valarie


    Jessica R Woessner,1 Valarie K Blake,2 Kavita Shah Arora1,3 1Department of Obstetrics and Gynecology, MetroHealth Medical Center, Cleveland, OH, USA; 2College of Law, West Virginia University, Morgantown, WV, USA; 3Department of Bioethics, Case Western Reserve University, Cleveland, OH, USA Abstract: Uterus transplantation offers a novel treatment option for women with uterine factor infertility. While currently in the early clinical research phase, uterus transplantation will likely provide ...

  19. Profile of obinutuzumab for the treatment of patients with previously untreated chronic lymphocytic leukemia


    Hill BT; Kalaycio M


    Brian T Hill, Matt Kalaycio Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA Abstract: Chronic lymphocytic leukemia (CLL) is a hematologic malignancy derived from a clonal population of mature B-lymphocytes characterized by relatively low CD20 antigen expression. Although the disease often takes an indolent course, the majority of patients will eventually require therapy. Standard treatment for medically fit patients includes puri...

  20. Verification Test of the Change-of-Pace Station Wagon. (United States)


    Cleveland, Ohio, by Electric Vehicles Associates. It is a converted AMC Pacer station wagon. It is powered by 20 6-volt batteries that are connected to... Electric Station Wagon is an electrified version of an AMC Pacer wagon, converted by Electric Vehicle Associates, Inc., 9100 Bank St., Cleveland, OH...of Electric and Hybrid Vehicles isa. OECLASSIFICATION/DOWNGRADING SCHEDULE IS. DISTRIBUTION STATEMENT (of thil Report) Approved for public release

  1. Mechanical behavior of Fiber Reinforced SiC/RBSN Ceramic Matrix Composites: Theory and Experiment (United States)


    AD-A235 926 NASA AVSCOM Technical Memorandum 103688 Technical Report 91-C-004 Mechanical Behavior of Fiber Reinforced SiC/RBSN Ceramic Matrix Composites : Theory... CERAMIC MATRIX COMPOSITES : THEORY AND EXPERIMENT Abhisak Chulya* Department of Civil Engineering Cleveland State University Cleveland, Ohio 44115...tough and sufficiently stable continuous fiber- reinforced ceramic matrix composites (CMC) which can survive in oxidizing environ- ments at temperatures

  2. Artifacts in diagnostic ultrasound


    Hindi A; Peterson C; Barr RG


    Ammar Hindi,1 Cynthia Peterson,2 Richard G Barr3,41Department of Radiology, University Hospitals of Cleveland, Cleveland, Ohio, USA; 2Department of Allied Health, Kent State University, Salem, OH, USA; 3Department of Radiology, Northeastern Ohio Medical University, Rootstown, OH, USA; 4Radiology Consultants, Youngstown, OH, USAAbstract: Ultrasound artifacts are encountered daily in clinical practice and may be a source of confusion on interpretation. Some artifacts arise secondary to improper...

  3. Natalizumab for the treatment of relapsing multiple sclerosis


    Rudick, Richard A.; Michael A Panzara


    Richard A Rudick1, Michael A Panzara21Cleveland Clinic Foundation, Cleveland, OH, USA; 2Biogen Idec, Inc., Cambridge, MA, USAAbstract: Natalizumab is an α4-integrin antagonist approved as monotherapy for patients with relapsing multiple sclerosis (MS), based on demonstrated efficacy in the pivotal AFFIRM study (N = 942). Natalizumab monotherapy reduced risk of disability progression by 42%–54% and annualized relapse rate by 68% during a period of 2 years. Natalizumab was a...

  4. Fospropofol disodium injection for the sedation of patients undergoing colonoscopy


    Levitzky, Benjamin E; Vargo, John J.


    Benjamin E Levitzky1, John J Vargo21Department of Gastroenterology and Hepatology, 2Section of Therapeutic and Hepatobiliary Endoscopy, Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, Ohio, USAAbstract: Sedation plays a central role in making colonoscopy tolerable for patients and feasible for the endoscopist to perform. The array of agents used for endoscopic sedation continues to evolve. Fospropofol (FP), a prodrug of propofol with a slower pharmacokin...

  5. Engineer Aviation Units in the Southwest Pacific Theater During World War II (United States)


    Member Mr. Jonathan M. Williams, M.A. ., Member LTC Timothy A. Cleveland, M.S. Accepted this 17th day of June 2005 by: , Director, Graduate Degree...Chairman and members: Dr. Alex Bielakowski, LTC Timothy Cleveland, and Mr. Jonathan Williams, respectively. I am grateful for your mentorship and feedback...Allied Air Forces commanded by Major General Brett; and Allied Naval Forces commanded by Vice Admiral Herbert F. Leary . Brigadier General Julian F. Barnes

  6. A Better Way to Excise Inhibitory Molecules (CSPGs) from a Spinal Cord Injury Scar to Promote Regeneration (United States)


    Professor, Dept. of Medicine, Div. of Rheumatic Diseases Case Western Reserve University, Cleveland, OH 1991-97 Assistant Professor, Dept. of...Anatomy, Case Western Reserve University, Cleveland, OH 1997-98 Associate Professor, Dept. of Medicine, Div. of Rheumatic Diseases , Case Western...Leadership Award (Advancement of Women in Higher Education) for “an outstanding, innovative, and visionary leadership program – Circles of Power " 2008

  7. Dollar Summary of Prime Contract Awards by State, County, Contractor, and Place, FY83, Part 2 (Oceana, Michigan - Weston, Wyoming). (United States)



  8. New Research Methods Developed for Studying Diabetic Foot Ulceration (United States)


    Dr. Brian Davis, one of the Cleveland Clinic Foundation's researchers, has been investigating the risk factors related to diabetic foot ulceration, a problem that accounts for 20 percent of all hospital admissions for diabetic patients. He had developed a sensor pad to measure the friction and pressure forces under a person's foot when walking. As part of NASA Lewis Research Center's Space Act Agreement with the Cleveland Clinic Foundation, Dr. Davis requested Lewis' assistance in visualizing the data from the sensor pad. As a result, Lewis' Interactive Data Display System (IDDS) was installed at the Cleveland Clinic. This computer graphics program is normally used to visualize the flow of air through aircraft turbine engines, producing color two- and three-dimensional images.

  9. Installation of Ohio's First Electrolysis-Based Hydrogen Fueling Station (United States)

    Scheidegger, Brianne T.; Lively, Michael L.


    This paper describes progress made towards the installation of a hydrogen fueling station in Northeast Ohio. In collaboration with several entities in the Northeast Ohio area, the NASA Glenn Research Center is installing a hydrogen fueling station that uses electrolysis to generate hydrogen on-site. The installation of this station is scheduled for the spring of 2012 at the Greater Cleveland Regional Transit Authority s Hayden bus garage in East Cleveland. This will be the first electrolysis-based hydrogen fueling station in Ohio.

  10. A web Implementation: The Good and The Not-So-Good


    Bergsneider, Candice; Piraino, David; Fuerst, Michelle


    E-commerce, e-mail, e-greeting, e-this, and e-thate-verywhere you turn there is a new “e” word for an internet or Web application. We, at the Cleveland Clinic Foundation, have been “e-nlightened” and will discuss in this report the implementation of a webbased radiology information system (RIS) in our radiology division or “e-radiology” division. The application, IDXRad Version 10.0 from IDX Corp, Burlington, VT, is in use at the Cleveland Clinic Foundation and has both intranet (for use in R...

  11. 特级装备

    Institute of Scientific and Technical Information of China (English)

    Dan; Owen; Danny; Bird; 张君楠


    精品球具:日巡赛第一挖起杆实验室:球道木杆年中测试CLEVELAND CG TOURS约7500元比起你父亲甚至父亲的父亲所使用的刀背球杆,Cleveland CG tours实在太容易打了,就好像我们中国人用的筷子一样。它们的杆头更大,容错性也就更大,趾部方正,topline非常薄。Boo Weekley正在使用它们征战美巡赛。

  12. Music therapy in palliative medicine. (United States)

    Gallagher, L M; Huston, M J; Nelson, K A; Walsh, D; Steele, A L


    A partnership between The Cleveland Clinic Foundation and The Cleveland Music School Settlement has resulted in music therapy becoming a standard part of the care in our palliative medicine inpatient unit. This paper describes a music therapy program and its impact on patients, their families, and staff. A service delivery model is suggested for implementation and integration of music therapy within palliative medicine. Specific music therapy interventions, evaluation and documentation techniques are also mentioned. A description of patient and family responses to music therapy, staff satisfaction, and effectiveness of interventions is presented.

  13. The Mobi-C cervical disc for one-level and two-level cervical disc replacement: a review of the literature

    Directory of Open Access Journals (Sweden)

    Alvin MD


    Full Text Available Matthew D Alvin,1,2 Thomas E Mroz1,3,41Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, OH, USA; 2Case Western Reserve University School of Medicine, Cleveland, OH, USA; 3Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA; 4Department of Neurological Surgery, Cleveland Clinic, Cleveland, OH, USABackground: Cervical disc arthroplasty (CDA is a novel motion-preserving procedure that is an alternative to fusion. The Mobi-C disc prosthesis, one of many Food and Drug Administration (FDA-approved devices for CDA, is the only FDA-approved prosthesis for two-level CDA. Hence, it may allow for improved outcomes compared with multilevel fusion procedures.Purpose: To critically assess the available literature on CDA with the Mobi-C prosthesis, with a focus on two-level CDA.Methods: All clinical articles involving the Mobi-C disc prosthesis for CDA through September 1, 2014 were identified on Medline. Any paper that presented Mobi-C CDA clinical results was included. Study design, sample size, length of follow-up, use of statistical analysis, quality of life outcome scores, conflict of interest, and complications were recorded.Results: Fifteen studies were included that investigated Mobi-C CDA, only one of which was a level Ib randomized control trial. All studies included showed non-inferiority of one-level Mobi-C CDA to one-level anterior cervical discectomy and fusion (ACDF. Only one study analyzed outcomes of one-level versus two-level Mobi-C CDA, and only one study analyzed two-level Mobi-C CDA versus two-level ACDF. In comparison with other cervical disc prostheses, the Mobi-C prosthesis is associated with higher rates of heterotopic ossification (HO. Studies with conflicts of interest reported lower rates of HO. Adjacent segment degeneration or disease, along with other complications, were not assessed in most studies.Conclusion: One-level Mobi-C CDA is non-inferior, but not superior, to one-level ACDF for patients

  14. 76 FR 16377 - Chippewa National Forest Resource Advisory Committee (United States)


    ..., Minnesota. The committee is meeting as authorized under the Secure Rural Schools and Community Self... Chase on the Lake Hotel, Basement Conference Room, 502 Cleveland Boulevard, Walker, MN 56484. Written... consideration and a Public Forum. The agenda and any applicable documents may be previewed at the Secure...

  15. 76 FR 28210 - Chippewa National Forest Resource Advisory Committee (United States)


    ..., Minnesota. The committee is meeting as authorized under the Secure Rural Schools and Community Self...: The meeting will be held at the Chase on the Lake Hotel, Lower Conference Room, 502 Cleveland.... The agenda and any applicable documents may be previewed at the Secure Rural Schools RAC Web...

  16. Studying a Spacecraft Ventilation Fan: Progress and Possibilities (United States)

    Koch, L. Denielle


    This document describes a presentation delivered to the Acoustics Technical Working Group at a meeting held in Cleveland, Ohio on April 21-22, 2011. The information contained in this presentation is considered to be preliminary, intended to begin a general discussion among audience members on the challenges associated with spacecraft ventilation fans and possible avenues of continued research.

  17. A Review of Heavy-Fueled Rotary Engine Combustion Technologies (United States)


    Crown Point, IN) (73) is working with the U.S. Army Research Laboratory’s Vehicle Technology Directorate in Cleveland, OH, to develop a pulsed...thermal insulation and wear- resistant materials, such as ceramics (100). Moller (100) used Zirconia as a thermal barrier coating (TBC) and PS-200 as

  18. Library Automation: The Next Wave. (United States)

    Mason, Marilyn Gell


    Describes a long-range plan developed by the Cleveland Public Library to provide users with electronic information and full text delivery. Specific goals are addressed, including online catalog access and converting periodical holdings to electronic format; legal issues involving copyright are discussed; and pricing issues and user fees are…

  19. An Exemplar in Mentoring and Professional Development: Teaching Graduate Students Transferable Skills beyond the Discipline (United States)

    Weisblat, Gina; Sell, Christine


    If university research is to remain a high priority in the national education agenda, graduate students must be prepared to move into research positions. Cleveland State University created the Graduate Grant Writing Center to enhance students' understanding of research principles and ethics, appreciation of the value of collaborations and…

  20. The Urban Mathematics Collaborative Projects. Annual Report to the Ford Foundation. Program Report 86-1. (United States)

    Romberg, Thomas A.; Pitman, Allan

    Descriptions of major activities for each of the seven Urban Mathematics Collaborative Projects sponsored by the Ford Foundation are contained in this report. These include: (1) Cleveland Collaborative for Mathematics Education; (2) Los Angeles Collaborative: Professional Links with Urban Schools; (3) Philadelphia Urban Mathematics Collaborative;…

  1. 40 CFR 52.1885 - Control strategy: Ozone. (United States)


    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Control strategy: Ozone. 52.1885...: Ozone. (a) Part D—Approval. The following portions of the Ohio plan are approved: (1) The ozone portions...: Akron, Canton, Cincinnati, Cleveland, Columbus, Dayton, Toledo and Youngstown. (4) The...

  2. A Workshop Kit for Stimulating Involvement in the Development of Teacher Education Centers. (United States)

    Kroner, Francine B.; O'Gorman, David E.

    This paper describes a workshop kit developed for the Cleveland Commission on Higher Education which supplies materials supportive of a one to three-day workshop. The workshop is intended to stimulate school personnel to work together in planning a common teacher education center venture appropriate to a particular locale. Contents of the workshop…

  3. An Experiment with WWW Interactive Learning in University Education. (United States)

    McIntyre, David R.; Wolff, Francis G.


    Discusses an exploration with the use of interactive learning on the Web in an Introduction to C Programming Course taught at Cleveland State University, and compares the results with the same course taught during a previous semester using no interactive Web instruction. (Author/AEF)

  4. Protozoários intestinais de vertebrados observados em Salobra Intestinal protozoa from vertebrates observed at Salobra

    Directory of Open Access Journals (Sweden)

    C. Pereira


    Full Text Available Protozoa were collected by means of dry smears and cultures in Cleveland's medium contained in 2cm3 ampules. The isolation and subsequent cultivation of trichomonad organisms in ampules were generally successfull; but the cultures went down, when transferred to test-tubes in the same medium, apparently because of the liberation of characteristic pigment by Bacillus pyocyaneus.

  5. Don't Get Mad; Get Smart! (United States)

    Jackson, Jesse L.


    This address (to a joint session of the annual conventions of the NAWDAC and the ACPA in Cleveland, 1973) discusses the author's concerns about contemporary America. He discusses his opinions about racism, the fight for black equality, abortion, and other social issues in our country. The emphasis is on the position of blacks in our society. (EK)

  6. NATO (North Atlantic Treaty Organization) Politico-Military Consultation: Shaping Alliance Decisions, (United States)


    to the relative size of the country involved. Former Secretary General Manlio Brosio has observed that for the larger allies, consultation is "a way...consultation. 21. Manlio Brosio, "Consultation and the Atlantic Alliance," Survival 16 (May-June 1974): 117. 22. Cleveland, NATO: The Transatlantic

  7. General Aviation Pilot and Aircraft Activity Survey. Triannual Summary Report 1990 Data (United States)


    816-374-2160 Retail Sales Outlet, 8660 Cherry Lane, Laurel, MD 20707; Los Angeles Bookstore, Arco Plaza, Level (C), 505 South 301-953-7974. Order...RICO BERRY FIELD COMPOSITE SQUADRON GROUP 4 PUERTO RICO WING MT. JULIET, TENNESSEE PONCE, PUERTO RICO CLEVELAND COMPOSITE SQUADRON JUANA DIAZ HIGH

  8. Contractors Meeting in Propulsion Held in Boulder Colorado on June 10- 14, 1991 (United States)


    6448U 21000 Brookpark Road (202)767-4935 Cleveland OH 44135 AV297-4935 (216)433-2857 Dr Mohammad Samimy Dr G S Samuelsen Ohio State University Department...2521 La Jolla CA 92093 (619) 534-4284 Dr Emil Pfender Dr John Renie Department of Mechanical Engrg Department of Mechanical and I 125 Mechanical

  9. 76 FR 69288 - Cable Statutory License: Specialty Station List (United States)


    ..., Cleveland, OH. ABC and Fox affiliates offering syndicated programming throughout the day in English should... Communications Commission with respect to the retransmission of English-speaking stations in Puerto Rico. See, e..., Reynosa, Tamaulipas, Mexico. XHAB-TV, Matamoros, Tamaulipas, Mexico. Dated: November 2, 2011. Maria...

  10. Role of p53 in Mammary Epithelial Cell Senescence (United States)


    culture of normal human breast epithelial cells. Methods Cell Biol 1980, 21B:107-135. 23. Easty GC, Easty DM, Monaghan P, Ormerod MG, Neville AM...27, 2006 Monitoring Editor: John Cleveland Polycomb group (PcG) protein Bmi-1 is an important regulator of cell proliferation. It regulates cellular

  11. Transfer of cysto-urethroscopy skills from a virtual-reality simulator to the operating room : a randomized controlled trial

    NARCIS (Netherlands)

    Schout, Barbara M. A.; Ananias, Hildo J. K.; Bemelmans, Bart L. H.; d'Ancona, Frank C. H.; Muijtjens, Arno M. M.; Dolmans, Valerie E. M. G.; Scherpbier, Albert J. J. A.; Hendrikx, Ad J. M.


    OBJECTIVE To assess whether real-time cysto-urethroscopy (CUS) performance improves by simulator-based training (criterion or predictive validity), addressing the research question 'Does practical skills training on the URO Mentor (UM, Simbionix USA Corp., Cleveland, OH, USA) virtual-reality simulat

  12. Transfer of cysto-urethroscopy skills from a virtual-reality simulator to the operating room : a randomized controlled trial

    NARCIS (Netherlands)

    Schout, B.M.; Ananias, H.J.; Bemelmans, B.L.H.; Ancona, F.C.H. d'; Muijtjens, A.M.M.; Dolmans, V.E.; Scherpbier, A.J.J.A.; Hendrikx, A.J.M.


    OBJECTIVE: To assess whether real-time cysto-urethroscopy (CUS) performance improves by simulator-based training (criterion or predictive validity), addressing the research question 'Does practical skills training on the URO Mentor (UM, Simbionix USA Corp., Cleveland, OH, USA) virtual-reality simula

  13. Attracting New Audiences through Special Events. (United States)

    Christyson, M. Jane


    Explores reasons to create special events, change existing events, or discontinue events, in the pursuit of new audiences. Describes surveys of usership at Cleveland Metroparks to identify new audiences. Effective event design and implementation requires effective advertising, which is expensive, so a discussion of fund development, branding, and…

  14. Music Therapy for the Visually Impaired. (United States)

    Steele, Anita Louise; Crawford, Celeste


    The development and implementation of a music therapy program to achieve behavioral change in visually impaired children and adolescents are described. Goals targeted by the music therapist at the Cleveland Society for the Blind include altering unusual body movements, poor posture, and other mannerisms often associated with blindness. (SEW)

  15. Nitride Semiconductors for Ultraviolet Detection (United States)


    129, 2045, (1978). 5. C. J. Mogab, A. C. Adams and D. L. Flamm, J. Appl. Phys., 49, 3796 (1978). 6. S. Matsuo, J. Vac. Sci. Technol., 17, 587 (1980...Carolina State University Cleveland, OH 44106 Raleigh, NC 27695-7907 Dr. William J. Schaff Robert C. Linares Electrical Engineering Linares Management Assoc

  16. Joint Services Electronics Program. Annual Report (16th). Appendix (United States)


    Pof Eessoriof Engineering at Case Stastte ofiTechsoloy, wheebewasd IAssociate Professor from 1968 t 1960. Profesor from 1960 to 19,and a member of the...S58-M1w-SM󈧤-F3s4) wm an Asuistant Profesor of Elgisseriag at Case Imitme of TnchnOlogy. wus born in St. Louis, MO, in 1935. He received Cleveland, OH

  17. Meeting at the Crossroads: Women's Psychology and Girls' Development. (United States)

    Brown, Lyn Mikel; Gilligan, Carol

    A study explored girls' development and its implication for the psychology of women. From 1986-1990, nearly 100 girls between the ages of 7 and 18 at the Laurel School for Girls in Cleveland, Ohio, were interviewed. Most of the girls were from middle- or upper-middle-class families (80%), although some were scholarship students from working-class…

  18. Standardization and Whiteness: One and the Same? (United States)

    Weilbacher, Gary


    The article "There Is No Culturally Responsive Teaching Spoken Here: A Critical Race Perspective" by Cleveland Hayes and Brenda C. Juarez suggests that the current focus on meeting standards incorporates limited thoughtful discussions related to complex notions of diversity. Our response suggests a strong link between standardization and White…

  19. Standardization and Whiteness: One and the Same? A Response to "There Is No Culturally Responsive Teaching Spoken Here" (United States)

    Weilbacher, Gary


    The article "There Is No Culturally Responsive Teaching Spoken Here: A Critical Race Perspective" by Cleveland Hayes and Brenda C. Juarez suggests that the current focus on meeting standards incorporates limited thoughtful discussions related to complex notions of diversity. Our response suggests a strong link between standardization and White…

  20. Manufacturer’s Catalog Data of Automation and Surveillance Systems for Utility Plants at Fort Leonard Wood, Missouri, Volume 2 (United States)


    Coleman Company TC-2 4< By · · o a c:omputenzed build· ir utomation network, Schaum - burJ Hiah .Sc."’ool. Sdsaumbura. Ill., .., lluhed i eneiJY...Building Campus School *City Hall ♦English High School Grover Cleveland School ♦Lowell Technological Institute Chemistry -Science Building

  1. The SDF-1-CXCR4 Axis Functions Through p38-MAPK Signaling to Drive Breast Cancer Progression and Metastasis (United States)


    2002). Rubin JB, Kung AL, Klein RS, Chan JA, Sun Y, Schmidt K, Kieran MW, Luster AD, Segal RA.A small-molecule antagonist of CXCR4 inhibits... Melanie H. Howell, Michelle Lacey, Betty Y. Shih, Carol Carter-Wientjes, Thomas E. Cleveland, John A. McLachlan, Thomas E. Wiese, Barbara S. Beckman

  2. Forging Partnerships with Preschools. (United States)

    Bailie, Patti Ensel


    Describes a Head Start program for preschool children directed by the Nature Center at Shaker Lakes in Cleveland, Ohio. Presents information on the content of this program, which is also aligned with the regular Head Start curriculum. Lists contact phone numbers for more information. (YDS)

  3. Receptivity of a Cryogenic Coaxial Gas-Liquid Jet to Acoustic Disturbances (Briefing Charts) (United States)


    Distribution Unlimited 13. SUPPLEMENTARY NOTES Briefing Charts presented at 50th AIAA /ASME/SAE/ASEE Joint Propulsion Conference, Cleveland, OH, 28-30 July...of a Cryogenic Coaxial Gas-Liquid Jet to Acoustic Disturbances 50th AIAA /ASME/SAE/ASEE Joint Propulsion Conference Jeff Wegener, UCLA David Forliti

  4. Somatostatin and dopamine receptors as molecular targets for the medical treatment of Cushing’s disease

    NARCIS (Netherlands)

    C. de Bruin (Christiaan)


    textabstractHarvey Williams Cushing (1869-1939) was born as the 10th child of a well-educated, puritanical medical family in Cleveland (figure 1). He attended Yale University, graduated cum laude from Harvard Medical School and was trained as a general surgeon at Johns Hopkins under the famous but d

  5. Langston Hughes and his poem "Harlem"

    Institute of Scientific and Technical Information of China (English)



    @@ James Langston Hughes was born February 1,1902, in Joplin, Missouri. His parents divorced when he was a small child, and his father moved to Mexico. He was raised by his Grandmother until he was thirteen, when he moved to Lincoln,Illinois, to live with his mother and her husband, eventually settling in Cleveland, Ohio.

  6. The Use of an Expectancy-Value Model in Studying a University's Image. AIR Forum 1982 Paper. (United States)

    Muffo, John A.; Whipple, Thomas W.

    The use of an expectancy-value model, common to consumer marketing studies, in analyzing the market position of Cleveland State University was investigated. Attention was focused on showing how consumer attitude concepts and methodologies can be used in developing a strategic marketing plan. Six populations were identified as groups important to…

  7. 77 FR 63296 - Proposed Collection; Comment Request (United States)


    ... of the Secretary Proposed Collection; Comment Request AGENCY: Defense Finance and Accounting Service... Act of 1995, the Defense Finance and Accounting Service announces the proposed public information... to Defense Finance and Accounting Service--Cleveland, 1240 East Ninth St., ATTN: JBJDA--Mr....

  8. 78 FR 53429 - Proposed Information Collection; Comment Request (United States)


    ... Proposed Information Collection; Comment Request AGENCY: Defense Finance and Accounting Service (DFAS... Paperwork Reduction Act of 1995, the Defense Finance and Accounting Service announces a proposed public..., please write to the Defense Finance and Accounting Services-Cleveland, 1240 East 9th Street,...

  9. 77 FR 63298 - Proposed Collection; Comment Request (United States)


    ... of the Secretary Proposed Collection; Comment Request AGENCY: Defense Finance and Accounting Service... of 1995, the Defense Finance and Accounting Service announces the proposed public information... to Defense Finance and Accounting Service--Cleveland, 1240 East Ninth St., ATTN: JBJDA--Mr....

  10. 32 CFR 78.5 - Procedures. (United States)


    ...) Defense Finance and Accounting Service, Attn: DFAS/PRR/CL, 1240 East Ninth Street, Cleveland, OH 44199... from a State, the Director, Defense Finance and Accounting Service, or designee, will notify the State... propose substitute provisions. The letter shall be addressed to the Director, Defense Finance...

  11. 5 CFR Appendix A to Part 582 - List of Agents Designated To Accept Legal Process (United States)


    ... this chapter. I. Departments Department of Defense. Defense Finance and Accounting Service, Cleveland.... Commander, U.S. Army Finance and Accounting Office, Japan, ATTN: APAJ-RM-FA-E-CP, Unit 45005, APO AP 96343-0087, DSN 233-3362. Army Civilian Employees in Korea. Commander, 175th Finance and Accounting...

  12. Reading Study: 1989-90. (United States)

    Gallagher, Michael P.; Lanese, James

    The reading pariety study for 1989-90 provided information for the Cleveland, Ohio school district, parents, and community to determine what progress the school system is making toward parity in reading proficiency. Parity will be attained when statistically equivalent proportions of Black and White students score at or above the thirty-fourth…

  13. Assessment for 1983-4 School Year. Administrative/Supervisory Performance Review Process. Survey Results. (United States)

    Gallagher, Michael P.

    School administrators and supervisors who were evaluated using the Cleveland, Ohio City School District's Administrator/Supervisory Review Process were surveyed concerning their opinions of the review process. The questionnaire, which was returned by 203 principals, assistant principals, and other supervisory staff out of a total of 376…

  14. Cost-Effectiveness Affirmative Reading Skills Program, 1984-85. (United States)

    Gallagher, Michael P.

    The 1984-85 cost-effects study represents the third annual analysis of the components of Cleveland's Affirmative Reading Skills Plan, which offers three instructional strands--developmental (regular reading/language arts), support (additional enrichment, corrective or remedial), and compensatory (instruction for students having reading scores in…

  15. A Retrospective Chronicle of the Midwest School Social Work Council: Its Vision and Influence after Forty Years (United States)

    Raines, James C.


    In 2007, the Midwest School Social Work Council celebrated its fortieth anniversary in Cleveland, Ohio. This article reviews early efforts to build alliances of school social workers across state lines, the early collaborative relationship with the National Association of Social Workers, and the eventual need for a new organization. The Midwest…

  16. A Sexuality Curriculum for Gynecology Residents (United States)

    Levine, Stephen B.; And Others


    The summary report of an educational research program conducted with the obstetrics and gynecology residents at University Hospitals of Cleveland in 1976 is presented. The goals were to provide residents with basic knowledge about female sexual problems, assess skill and comfort in interviewing patients with sexual problems, document the effects…

  17. 77 FR 35751 - Wisconsin Central Ltd.-Abandonment Exemption-in Manitowoc County, WI (United States)


    ...--Exempt Abandonments to abandon 6.8 miles of rail line extending from milepost 69.0 in Newton to milepost 62.2 in Cleveland in Manitowoc County, WI. The line traverses United States Postal Service Zip Codes 53015 and 53063, and there are no stations on the line. WCL has certified that: (1) No local traffic...

  18. A Collaborative, Ongoing University Strategic Planning Framework: Process, Landmines, and Lessons (United States)

    Hill, Susan E. Kogler; Thomas, Edward G.; Keller, Lawrence F.


    This article examines the strategic planning process at Cleveland State University, a large metropolitan state university in Ohio. A faculty-administrative team used a communicative planning approach to develop a collaborative, ongoing, bottom-up, transparent strategic planning process. This team then spearheaded the process through plan…

  19. Association of Research Self-Efficacy with Medical Student Career Interests, Specialization, and Scholarship: A Case Study (United States)

    Bierer, S. Beth; Prayson, Richard A.; Dannefer, Elaine F.


    This study used variables proposed in social cognitive career theory (SCCT) to focus the evaluation of a research curriculum at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University (CCLCM). Eight cohorts of CCLCM medical students completed a web-based version of the six-scale Clinical Research Appraisal…

  20. Theoretical and Experimental Analysis of the Constant-Area, Supersonic- Supersonic Ejector (United States)


    nozzles were measured with either mercury, Meriam 3’, or water filled U-tube manometers, depen- ding on the magnitude of the pressure difference...Fig. 3.1-8). The automatic controller for the primary stagnation ’tProduct of the Meriam Instrument Company, Cleveland, Ohio. 38 pressure P P0 was

  1. Intelligent dc-dc Converter Technology Developed and Tested (United States)

    Button, Robert M.


    The NASA Glenn Research Center and the Cleveland State University have developed a digitally controlled dc-dc converter to research the benefits of flexible, digital control on power electronics and systems. Initial research and testing has shown that conventional dc-dc converters can benefit from improved performance by using digital-signal processors and nonlinear control algorithms.

  2. Through the Lens of the Students: Using Narrative Inquiry to Evaluate an Innovative Urban High School (United States)

    Weisblat, Gina; McClellan, Jeffrey


    MC Squared STEM High School is part of the Cleveland Metropolitan School District. It has a project-based curriculum that focuses on the core stem skills: science, technology, engineering, and math. As the school celebrated its first graduating class in 2012, administrators felt it was the right time to look back and evaluate the school's…

  3. Development of a Microcomputer-Based Adaptive Testing System. Phase I. Specification of Requirements and Preliminary Design. (United States)


    examinee had to recall the sequence. The "Auditory Memory for Numbers" test was similar except that the digits were presented orally by a tape recorder...Discs: Two 5 1/4 inch floppies Bus: Multibus or Q-bus Operating System: RT-11, CP/M Price: $7,465 TEC-86 Tecmar, Inc. 23600 Mercantile Rd., Cleveland

  4. A Preliminary Study of Classroom Motivators and De-Motivators from a Motivation-Hygiene Perspective (United States)

    Katt, James A.; Condly, Steven J.


    This study seeks to begin answering two simple questions: "What motivates our students?" and its corollary, "What prevents our students from being motivated?" The motivation-hygiene theory (F. Herzberg, "Work and the nature of man," World Publishing, Cleveland, OH, 1966), a well-tested theory from organizational psychology, holds that people's…

  5. The Practicing Librarian. (United States)

    Fineman, Marcia Pollack; And Others


    Describes three literacy organization and public library programs: Project LEARN (Cleveland, Ohio), which encourages higher-level beginning adult readers to want to read on their own; Greenville County (South Carolina) Library's Latchkey Kids Program; and policies on unattended and disruptive children developed by Iowa City and Cedar Rapids (Iowa)…

  6. Is Work Enough? The Experiences of Current and Former Welfare Mothers Who Work. (United States)

    Polit, Denise F.; Widom, Rebecca; Edin, Kathryn; Bowie, Stan; London, Andrew S.; Scott, Ellen K.; Valenzuela, Abel

    The Project on Devolution and Urban Change studied the effects of welfare reform in the counties encompassing the following cities: Cleveland, Ohio; Los Angeles, California; Miami, Florida; and Philadelphia, Pennsylvania. In May 1995, the 3,900 women in the sample were receiving public assistance and living in high-poverty neighborhoods. After 3-4…

  7. Soil solution interactions may limit Pb remediation using P amendments in an urban soil (United States)

    Lead (Pb) contaminated soils are a potential exposure hazard to the public. Amending soils with phosphorus (P) may reduce Pb soil hazards. Soil from Cleveland, OH containing 726 ± 14 mg Pb kg-1 was amended in a laboratory study with bone meal and triple super phospha...

  8. Death Education and Attitudes toward Euthanasia and Terminal Illness. (United States)

    Nagi, Mostafa H.; Lazerine, Neil G.


    Analyzed attitudes of 614 Protestant and Catholic Cleveland clergy toward terminal illness and euthanasia. Clergy responses revealed that, although eager to prolong life, terminally ill patients feared prolonged illness more than death. The controversial nature of euthanasia became more apparent with clergy who had more training in death…

  9. Nature in the City. (United States)

    Ferbert, Mary Lou


    Describes a science program developed by the Cleveland Museum of Natural History, "Nature in the City," in which students and teachers learn together about the natural community surrounding their school. Includes program's rationale, list of "adventures," and methods. Discusses strategies of Sherlock Holmes'"adventure" focusing on animal tracks…

  10. Interpreting Urban Geology. (United States)

    Hannibal, Joseph Timothy; Schmidt, Mark Thomas


    Describes field trips to urban locations for geological instruction. The program was developed by the Cleveland Museum of Natural History. Authors claim these field trips have been an effective and enjoyable way of conveying a wide variety of geological information to participants at all levels and backgrounds and have created favorable publicity.…

  11. Talking Typewriter. Title I Evaluation, 1972-1973. (United States)

    Logan, Juanita

    The Talking Typewriter Program has been operative in the Cleveland Public Schools as a strategy to improve the reading skills of identified fourth grade pupils in 12 Title I schools. A responsive and autotelic environment augmented by selected materials, special teaching techniques, the expertise of trained staff, and individualized tutoring…

  12. Healthy Students 2000: An Agenda for Continuous Improvement in America's Schools. (United States)

    Allensworth, Diane DeMuth; Symons, Cynthia Wolford; Olds, R. Scott

    This publication is a project replication kit for practitioners who want to improve their school health programs. The project used a multidisciplinary model of comprehensive school health education in three secondary schools within the Cleveland School District, Ohio. Based on the Healthy People 2000 initiative, this publication focuses on six…

  13. Hospital takes customer service to new level, sees positive effect on bottom line. (United States)


    Service with a smile boosts bottom line. Treating co-workers and patients like guests is the linchpin of a whole new philosophy at Bradley Memorial Hospital in Cleveland, TN. Administrators there insist a host of new customer service programs, from cap and gown graduation ceremonies to bunny bucks, has resulted in dramatic financial improvements and more satisfied patients and staff.

  14. 76 FR 19386 - Jacobo Dreszer, M.D., Decision and Order (United States)


    ... at 29 (quoting 21 CFR 1306.04(a)). While the ALJ properly noted the importance of expert testimony in..., at 1, 10. Previously, Dr. Kennedy was a Fellow with the Pain Therapy Unit of the Cleveland Clinic...; GX 76, at 5-6. \\4\\ He also co-edited and contributed to the State of Kentucky's Guidelines...

  15. Building Essential Skills for the Ohio Building and Construction Industry. Final Report. (United States)

    Pritz, Sandra G.; And Others

    The Center on Education and Training for Employment (CETE) at the Ohio State University worked in partnership with the Ohio State Building and Construction Trades Council (OSB&CT) to develop and deliver customized workplace literacy services for local union members in six major Ohio cities (Columbus, Cleveland, Cincinnati, Toledo, Dayton, and…

  16. Microstructures of Early Jurassic (Toarcian) shales of Northern Europe

    NARCIS (Netherlands)

    Houben, M.E.; Barnhoorn, A.; Wasch, L.; Trabucho-Alexandre, João; Peach, C.J.; Drury, M.R.


    The Toarcian (Early Jurassic) Posidonia Shale Formation is a possible unconventional gas source in Northern Europe and occurs within the Cleveland Basin (United Kingdom), the Anglo-Paris Basin (France), the Lower Saxony Basin and the Southwest Germany Basin (Germany), and the Roer Valley Graben, the

  17. 36 CFR Appendix B to Part 72 - List of Eligible Jurisdictions (United States)


    ... Cleveland, Ohio Cocoa, Florida Columbia, South Carolina Columbus, Georgia Columbus, Ohio Compton, California... West Haven, Connecticut West New York, New Jersey West Palm Beach, Florida Wheeling, West Virginia...., New Jersey Charleston Co., South Carolina Cook Co., Illinois Cuyahoga Co., Ohio Dade Co., Florida...

  18. Positive Education Program's Day Treatment Centers (United States)

    Fecser, Frank A.


    The Positive Education Program in Cleveland, Ohio, is grounded in the Re-EDucation philosophy and serves more than 700 students with emotional and behavioral disorders in eight day treatment centers. The centers blend special education with mental health in a school environment in which students and families are both supported and challenged as…

  19. Taking Your Talents to Business Communications: Analyzing Effective Communication through LeBron James's Career Moves (United States)

    Manisaligil, Alperen; Bilimoria, Diana


    We describe an in-class activity that helps students improve their skills in media selection and use to reinforce effective communication. The activity builds on media richness and channel expansion theories through an examination of the media selection and use of NBA athlete LeBron James and Cleveland Cavaliers majority owner Dan Gilbert during…

  20. A coping and communication support intervention tailored to older patients diagnosed with late-stage cancer

    Directory of Open Access Journals (Sweden)

    Julia Hannum Rose


    Full Text Available Julia Hannum Rose1,2,3, Rosanne Radziewicz4, Karen F Bowman5, Elizabeth E O’Toole11Case Western Reserve University School of Medicine, Cleveland, OH, USA; 2Louis Stokes Cleveland VAMC-GRECC, Cleveland, OH, USA; 3Center for Health Care Research and Policy, Case at MetroHealth Medical Center, Cleveland, OH, USA; 4Department of Nursing, MetroHealth Medical Center, Cleveland, OH, USA; 5Department of Sociology, Case Western Reserve University, Cleveland, OH, USAAbstract: As our society ages, increasing numbers of older Americans will be diagnosed and eventually will die of cancer. To date, psycho-oncology interventions for advanced cancer patients have been more successful in reaching younger adult age groups and generally have not been designed to respond to the unique needs and preferences of older patients. Theories and research on successful aging (Baltes and Baltes 1990; Baltes 1997, health information processing style (Miller 1995; Miller et al 2001 and non-directive client-centered therapy (Rogers 1951, 1967, have guided the development of a coping and communication support (CCS intervention. Key components of this age-sensitive and tailored intervention are described, including problem domains addressed, intervention strategies used and the role of the CCS practitioner. Age group comparisons in frequency of contact, problems raised and intervention strategies used during the first six weeks of follow up indicate that older patients were similar to middle-aged patients in their level of engagement, problems faced and intervention strategies used. Middle-aged patients were more likely to have problems communicating with family members at intervention start up and practical problems as well in follow up contacts. This is the first intervention study specifically designed to be age sensitive and to examine age differences in engagement from the early treatment phase for late-stage cancer through end of life. This tailored intervention is

  1. Four Experiments on the Perception of Bar Charts. (United States)

    Talbot, Justin; Setlur, Vidya; Anand, Anushka


    Bar charts are one of the most common visualization types. In a classic graphical perception paper, Cleveland & McGill studied how different bar chart designs impact the accuracy with which viewers can complete simple perceptual tasks. They found that people perform substantially worse on stacked bar charts than on aligned bar charts, and that comparisons between adjacent bars are more accurate than between widely separated bars. However, the study did not explore why these differences occur. In this paper, we describe a series of follow-up experiments to further explore and explain their results. While our results generally confirm Cleveland & McGill's ranking of various bar chart configurations, we provide additional insight into the bar chart reading task and the sources of participants' errors. We use our results to propose new hypotheses on the perception of bar charts.

  2. Update on the rational use of tositumomab and iodine-131 tositumomab radioimmunotherapy for the treatment of non-Hodgkin’s lymphoma

    Directory of Open Access Journals (Sweden)

    Michael J Burdick


    Full Text Available Michael J Burdick, Roger M MacklisDepartment of Radiation Oncology, Taussig Cancer Center and Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USAAbstract: Targeted radioimmunotherapy in non-Hodgkin’s B-cell lymphoma (NHL offers an efficacious therapy and minimal toxicity compared to conventional chemotherapy. Iodine 131 tositumomab (131I-TST is a murine monoclonal antibody against the CD20 cell surface protein and is directly covalently conjugated to 131I, a radioactive β and γ emitter. While initially approved for use in relapsed, refractory, or transformed low grade B-cell NHL, investigational uses with promising results include autologous stem cell transplant, intermediate grade NHL, and the frontline management of indolent NHL. This review summarizes the 131I-TST literature on mechanism of action, treatment indications, treatment delivery, efficacy, investigational uses, and future prospects.Keywords: tositumomab, radioimmunotherapy, non-Hodgkin’s lymphoma, Bexxar

  3. Prospective Clinical Study of Precision Oncology in Solid Tumors. (United States)

    Sohal, Davendra P S; Rini, Brian I; Khorana, Alok A; Dreicer, Robert; Abraham, Jame; Procop, Gary W; Saunthararajah, Yogen; Pennell, Nathan A; Stevenson, James P; Pelley, Robert; Estfan, Bassam; Shepard, Dale; Funchain, Pauline; Elson, Paul; Adelstein, David J; Bolwell, Brian J


    Systematic studies evaluating clinical benefit of tumor genomic profiling are lacking. We conducted a prospective study in 250 patients with select solid tumors at the Cleveland Clinic. Eligibility required histopathologic diagnosis, age of 18 years or older, Eastern Cooperative Oncology Group performance status 0-2, and written informed consent. Tumors were sequenced using FoundationOne (Cambridge, MA). Results were reviewed at the Cleveland Clinic Genomics Tumor Board. Outcomes included feasibility and clinical impact. Colorectal (25%), breast (18%), lung (13%), and pancreatobiliary (13%) cancers were the most common diagnoses. Median time from consent to result was 25 days (range = 3-140). Of 223 evaluable samples, 49% (n = 109) of patients were recommended a specific therapy, but only 11% (n = 24) received such therapy: 12 on clinical trials, nine off-label, three on-label. Lack of clinical trial access (n = 49) and clinical deterioration (n = 29) were the most common reasons for nonrecommendation/nonreceipt of genomics-driven therapy.

  4. First rib metamorphosis: its possible utility for human age-at-death estimation. (United States)

    Kunos, C A; Simpson, S W; Russell, K F; Hershkovitz, I


    Human first ribs demonstrate predictable, sequential changes in shape, size, and texture with increasing age, and thus, can be used as an indicator of age at death. Metamorphosis of the first rib's head, tubercle, and costal face was documented in a cross-sectional sample of preadult and adult first ribs of known age at death from the Hamann-Todd skeletal collection (Cleveland Museum of Natural History, Cleveland, Ohio). Blind tests of the usefulness of the first rib as an age indicator were conducted, including tabulation of intraobserver and interobserver inaccuracies and biases. First rib age estimates show inaccuracies and biases by decade comparable to those generated by other aging techniques. Indeed, the first rib method is useful as an isolated age indicator. When used in conjunction with other age indicators, the first rib improves the quality of summary age assessments.

  5. Fospropofol disodium injection for the sedation of patients undergoing colonoscopy

    Directory of Open Access Journals (Sweden)

    Benjamin E Levitzky


    Full Text Available Benjamin E Levitzky1, John J Vargo21Department of Gastroenterology and Hepatology, 2Section of Therapeutic and Hepatobiliary Endoscopy, Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, Ohio, USAAbstract: Sedation plays a central role in making colonoscopy tolerable for patients and feasible for the endoscopist to perform. The array of agents used for endoscopic sedation continues to evolve. Fospropofol (FP, a prodrug of propofol with a slower pharmacokinetic profi le, is currently under evaluation for use during endoscopic procedures. Preliminary data suggests that FP dosed at 6.5 mg/kg is well tolerated by most patients with perineal paresthesias being the most commonly experienced adverse effect. This article will examine the current literature on the use of FP for the sedation of patients undergoing colonoscopy, highlighting the pharmacokinetics, pharmacodynamics, risks, and common adverse events associated with the novel sedative/hypnotic.Keywords: fospropofol, Aquavan, propofol, sedation, colonoscopy

  6. A High Temperature Cyclic Oxidation Data Base for Selected Materials Tested at NASA Glenn Research Center (United States)

    Barrett, Charles A.


    The cyclic oxidation test results for some 1000 high temperature commercial and experimental alloys have been collected in an EXCEL database. This database represents over thirty years of research at NASA Glenn Research Center in Cleveland, Ohio. The data is in the form of a series of runs of specific weight change versus time values for a set of samples tested at a given temperature, cycle time, and exposure time. Included on each run is a set of embedded plots of the critical data. The nature of the data is discussed along with analysis of the cyclic oxidation process. In addition examples are given as to how a set of results can be analyzed. The data is assembled on a read-only compact disk which is available on request from Materials Durability Branch, NASA Glenn Research Center, Cleveland, Ohio.

  7. La “nueva” Doctrina Monroe de 1895 y sus implicaciones para el Caribe español: algunas interpretaciones coetáneas españolas



    Not available.

    El análisis de una selección de periódicos españoles de diversas ideologías políticas demuestra que la mayoría de los comentaristas relacionaban la política de Cleveland en la disputa anglo-venezolana en 1895 con la de McKinley en la crisis colonial española de 1895-1898, interpretando ambas intervenciones como una función de la Doctrina Monroe. Sin embargo, al contrario que el presidente Cleveland, McKinley no apeló a esta Doctrina como justificación de su p...

  8. Biochemical Effects of Cadmium Exposure and the Potential Pharmacologic Significance of Cadmium Mediated Hydrolase Inhibition (United States)


    increase Cd absorption from the intestines (Larson and Piscator 1971; Itokawa, Abe et al. 197 4; Pond and Walker 1975). Pyridoxine, vitamin B 6 , is...considerations on uptake and retention of cadmium in human kidney cortex. Cadmium in the Environment. L. Friberg, M. Piscator and G. F. Nordberg. Cleveland...Columbia, Missouri, University of Missouri. Larson, S.-E. and M. Piscator (1971). "Effect of cadmium on skeletal tissue in normal and calcium

  9. Effectiveness of Acupressure Treatment for Pain Management and Fatigue Relief in Gulf War Veterans (United States)


    with GWI. Aim 2 is to investigate the relationship between EEG measures, specifically the corticomuscular coherence and power spectra in theta...Cleveland Clinic, but is available on a limited basis (no cost) to assist the study team with technical issues . Investigational Site Investigators...setup and data analysis. As a result of Dr. Bayram’s addition, the research team has purchased a new 8-channel EEG /EMG system that is more suitable

  10. The business of palliative medicine--part 6: clinical operations in a comprehensive integrated program. (United States)

    Lagman, Ruth L; Walsh, Declan; LeGrand, Susan B; Davis, Mellar P


    The medical care of individuals with advanced disease is complex and has historically been fragmented and suboptimal. Palliative medicine attempts to address these needs. The Harry R. Horvitz Center for Palliative Medicine at the Cleveland Clinic is an established comprehensive integrated program. Structured and seamless clinical operations are important to ensure the best delivery of high-quality medical care and continuity for those affected by life-limiting illness.

  11. Navy and Marine Corps Officers’ Attitudes Toward the Don’t Ask, Don’t Tell Policy (United States)


    PAGES 165 14. SUBJECT TERMS Homosexuality , Gays , Lesbians , DADT, “Don’t Ask, Don’t Tell,” sexual orientation discrimination, inequality, prejudice...rights for homosexuals , but the respondents felt that gays and lesbians should not receive “special privileges” (Cleveland & Ohl, 1994). 8 gay or lesbian (National Defense Research Institute, 2010). Many people argue that the increased visibility of homosexuals has led to a shift in

  12. Susceptibility of Inbred Mice to Leishmania major Infection: Genetic Analysis of Macrophage Activation and Innate Resistance to Disease in Individual Progeny of P/J (Susceptible) and C3H/HeN (Resistant) Mice (United States)


    mediated immu- ease and defective macrophage activation in Bx mice that nity in mice highly susceptible to Leishmania tropica . J. Exp. could not be...inbred mice to Leishmania tropica infec- tion: correlation of susceptibility with in vitro defective macro- LITERATURE CITED phage microbicidal...probability and phage activation to kill Leishmania tropica : characterization of statistics. Chemical Rubber Co., Cleveland. P/J mouse macrophage defects for

  13. VITAL: Vanguard Investigations of Therapeutic Approaches to Lung Cancer (United States)


    reported to be constitutively expressed in many vertebrate tissues (mouse, rat, chicken ) [Lewis et al., 1985; Sullivan and Cleveland, 1986]. Classes III and...microtubules from chicken contain different b-tubulin polypeptides. J Biol Chem 258:7870–7875. Raff EC. 1994. The role of multiple tubulin isoforms in...Fig. 2), a naturally occurring antibiotic , upregulates DR5 expression through a CHOP‑dependent mecha‑ nism and enhances TRAIL‑induced apoptosis in

  14. Motivation a Necessary Personnel Management Tool in the Air Force. (United States)


    psychologists has written on the subject of job motivation. Some greats such as Abraham H. Maslow, Douglas McGregor, and Frederick Herzberg have become... Frederick Herzberg , Instructor 7. Herzberg , Frederick . Work and the Nature of Man. Cleveland, OH: World Publishing Company, 1966 8. Air Command and Staff...Individuals , such as Maslow, McGregor, Herzberg , Likert, Vroom, Argyris, and others tried to formulate theories to "explain the complex behavior of

  15. Integration of Lower Level Supervisors into the Management Structure. (United States)


    is Frederick Herzberg (1968). In his Motivation-Hygiene Theory, Herzberg suggests that some "hygiene" factors can be labeled dissatisfiers. When...identified by Herzberg are: l Achievement--The individual must feel a sense of accomplishment. * The work itself--Individuals can only be motivated by jobs...middle: positions and problems of the foreman." Appled Anthropology, 1945, 4, 1-28. Herzberg , F. Work and the Nature of Man. Cleveland, OH: The World

  16. Concepts, The Journal of Defense Systems Acquisition Management. Spring 1982, Volume 5, Number 2. Two Perspectives on Multiyear Procurement European Overview Part II Competition: Does It Lower Costs? (United States)


    maintaining morale of people at a satisfactory level. - , Frederick Herzberg pioneered some of the early efforts to learn about task satisfaction and...Gulf Publishing, 1964. 6. Frederick Herzberg , Work and the Nature of Man, Cleveland, World Publishing, 1966. Management Heritage for the 󈨔s 1...34 Frederick Taylor, the father of scientific management, was its chief exponent, and all of his work- improvement efforts were directed at the task. Taylor

  17. The Determinants of Job Satisfaction Among United States Air Force Security Police (United States)


    of the job diagnostic survey: Good news and bad news. Journal of Applied Psychology 70: 461-468. Herzberg , Frederick 1966 Work and the Nature of...Man. Cleveland: World Publishing Company. Herzberg , Frederick , Bernard Mausner, Richard O. Peterson, and Dora F. Capwell 1957 Job Attitudes...Review of Research and Opinion. Pittsburgh: Psychological Service of Pittsburgh. Herzberg , Frederick , Bernard Mausner, and Barbara B. Snyderman 1959

  18. Directionally Solidified Multifunctional Ceramics (United States)


    34Microestructura y comportamiento plastico de perovsquitas conductoras protonicas de alata temperatura". Boletin d la Sociedad Espanola de Ceramica y...De Lopez and A. Sayir, "Microstructure and Mechanical Properties of High Temperature Protonic Conductors Fabricated by Melt Growth," Boletin de la...For High Temperature Environments," NASA TM-2004-213211, Glenn Research Center, Cleveland, OH, August 2004. 36. Cover page of Boletin de la Sociedad

  19. The Role of Veterans Affairs in Support of DOD in Biodefense (United States)


    appreciate the deeper and intricate geopolitics of the Iranian dilemma . Further thanks must go to Dr. Bruscino, who enlightened me on the relevance of...Presbyterian Hospital nurse , who had made a round trip commercial flight between Dallas and Cleveland.26 The multiple Ebola diagnoses elevated... nursing home care, and healthcare services to active members of the Armed Forces during and immediately following a period of war, or a period of

  20. Special Article: Howard Dittrick: curator to the McMechans' legacy journal. (United States)

    Bause, George S; Edmonson, James M


    A noted medical historian and museum curator, Canadian American Howard Dittrick was a Cleveland gynecologist who served as Directing Editor of Current Researches in Anesthesia and Analgesia (1940-1954). In the aftermath of World War II, even after Congresses of Anesthetists had resumed, Dittrick and his editorial board allowed their yellow, then tan-covered journal, the so-called "yellow peril," to languish into near irrelevance.

  1. The Value Impact of New Residential Construction and Neighborhood Disinvestment on Residential Sales Price


    Robert A. Simons; Quercia, Roberto G.; Ivan Maric


    The topic of neighborhood redevelopment is central to residential appraisal and the lending process. We examine both the effect of neighborhood upgrading and decline, captured by subsidized new residential construction and sustained property tax delinquency respectively, on the sales price of one-to-two family homes. The research uses a two stage hedonic price model of 12,100 individual residential sales in Cleveland, Ohio during 1992-94. Results show a significant positive effect of $670 on ...

  2. A research program in neutrino physics, cosmic rays and elementary particles. Progress report for Task A

    Energy Technology Data Exchange (ETDEWEB)

    Reines, F.; Sobel, H.W.


    Physics interests of the group are focused primarily on tests of conservation laws and studies of fundamental interactions between particles. There is also a significant interest in astrophysics and cosmic rays. Task A consists of three experimental programs; a Double-Beta Decay study (currently at the Hoover Dam), a Reactor Neutrino program (until this year at Savannah River), and the IMB Proton Decay experiment in a Cleveland salt mine. Discussion of the research in each area is given.

  3. Computational Electromagnetics (United States)


    a collaboration between Caltech’s postdoctoral associate N. Albin and OB) have shown that, for a variety of reasons, the first-order...KZK approximation", Nathan Albin , Oscar P. Bruno, Theresa Y. Cheung and Robin O. Cleveland, preprint, (2011) "A Spectral FC Solver for the Compressible...Navier-Stokes Equations in General Domains I: Explicit time-stepping" Nathan Albin and Oscar P. Bruno, To appear in Journal of Computational Physics

  4. The Headwaters District: A History of the Pittsburgh District, U.S. Army Corps of Engineers (United States)


    Thayer, and the dredge Octavia were launched and sent to patrol the lower Ohio, Mississippi, Missouri, and Arkansas rivers. Major Henry Clay Long, son...I l-- -------.1 BUTLER B •• ver River : I BEAVER : , BEAVER • FAlLS : I BEAVER. I ,------- - I ’ ___ I I I r--,--- :J ,- " CLARION ARMSTRONG...and build two military hospitals, one north of Pittsburgh and the other near Cleveland. After map study, Colonel Vogel decided Butler , Pennsylvania

  5. Measurement and Modeling of Volatile Particle Emissions from Military Aircraft (United States)


    Cleveland OH. 11. Yu, Z., et al., Characterization of Lubrication Oil Emissions from Aircraft Engines. Environmental Science & Technology , 2010. 44...operations. Environmental Science & Technology , 2006. 40(14): p. 4406-4413. 26. Anderson, B.E., G. Chen, and D.R. Blake, Hydrocarbon emissions from...pollution sources. 2. C-1 through C-30 organic compounds from medium duty diesel trucks. Environmental Science & Technology , 1999. 33(10): p. 1578-1587

  6. Oceanography: 1998 Paris Meeting Abstracts: Coastal and Marginal Seas. Volume 11, Number 2. (United States)


    Millan (1), Joan Cleveland (2) - (1) Centra de investigacion Cientifica y Educacion , Superior de Ensenada, Apdo. MSP-45: Spatial Patterns of Plankter...Education Superior de Ensenada, Ensenada (CICESE), B.C. Mexico.Km. 107 Carr. Tijuana-Ensenada, Ensenada, B.C. Mexico; (2) Environment characteris- tics in the upper 150 meters where the temperature and salinity exhibited strong seasonal variability as influ- enced by

  7. Interpretation of Core Length in Shear Coaxial Rocket Injectors from X-ray Radiography Measurements (Briefing Charts) (United States)


    Shear Coaxial Rocket Injectors from X-ray Radiography Measurements 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT...ASE/ASEE Joint Propulsion Conference, Cleveland, OH, 29 July 2014. PA#14365 14. ABSTRACT Shear coaxial injectors are so named because they rely on...DISTRIBUTION A: Approved for public release; distribution unlimited. Clearance #  Interpretation of Core Length in Shear Coaxial Rocket Injectors from

  8. Interpretation of Core Length in Shear Coaxial Rocket Injectors from X-ray Radiography Measurements (United States)


    Shear Coaxial Rocket Injectors from X-ray Radiography Measurements 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT...ASME/SAE/ASEE Joint Propulsion Conference, Cleveland, OH, 28-30 July, 2014. PA#14340 14. ABSTRACT Shear coaxial injectors are so named because they...Length in Shear Coaxial Rocket Injectors from X-ray Radiography Measurements S. Alexander Schumaker1, Stephen A. Danczyk2 and Malissa D.A. Lightfoot2

  9. Python Engine Installed in Altitude Wind Tunnel (United States)


    An engine mechanic checks instrumentation prior to an investigation of engine operating characteristics and thrust control of a large turboprop engine with counter-rotating propellers under high-altitude flight conditions in the 20-foot-dianieter test section of the Altitude Wind Tunnel at the Lewis Flight Propulsion Laboratory of the National Advisory Committee for Aeronautics, Cleveland, Ohio, now known as the John H. Glenn Research Center at Lewis Field.

  10. Compilation of 1986 Annual Reports of the Navy ELF (Extremely Low Frequency) Communications System Ecological Monitoring Program. Volume 2. TABS D-G. (United States)


    21) probably masked their presence by sheer chance. Year-round reproduction, with peaks in lay through August, appeared to be the rule in the species...from PPC and FST for the embryology data and homogeneous data from PRT and TMC for the hatching data (Table 27), we observe that the frequency of eggs...PIRLOT ROAD PANOLA PLAINS Tree swallow parental care & (iTI) (IC4) growth studies CLEVELAND PANOLA PLAINS Tree swallow embryology & homing HOMESTEAD

  11. Protecting children: the role of the law 1. Principles and key concepts. (United States)

    Griffith, Richard; Tengnah, Cassam


    The twentieth anniversary of the Cleveland Child Abuse scandal provides a timely reminder that children continue to be abused and this generally occurs in the community perpetrated by family members or close acquaintances. District nurses have a significant role in the prevention and identification of child abuse as they visit families in their homes. Fundamental to this crucial role is a working knowledge of the provisions and concepts of the Children Act 1989 that sets out the legal framework for protecting children.

  12. The Shock and Vibration Digest. Volume 15, Number 3 (United States)


    Fane J.J. Adamczyk, W. Stevans, and R. Jutras NASA Lewis Res. Ctr., Cleveland, OH 44135, J. Engrg. Power, Trans. ASME, 104 (3), pp 675-682 (July...Jefferys, E.R 456 Jenkins, J.E 468 Jha, V.K 469 Jhaveri, D.P 549 Jonasson, J.E 657 Jutras , R 491 Kadle, D.S 442 Kalyanasundaram, N 627

  13. DOD Financial Management: Marine Corps Statement of Budgetary Resources Audit Results and Lessons Learned (United States)


    Columbus DFAS–IN Defense Finance and Accounting Service–Indianapolis DIACAP DOD Information Assurance Certification and Accreditation Process...Technology Services Organization TSO–CL Technology Services Organization–Cleveland UD/MIPS Unit Diary /Marine Integrated Personnel System U.S.C...with DFAS–CL and DFAS– Columbus (DFAS–CO) to ensure that audit documentation will be available to support auditor requests. The DFAS-Indianapolis (DFAS

  14. Surviving in the age of price transparency. (United States)

    Donovan, Christopher J; Mazoh, Margery; Brown, James P; Moore, Sarah; Skalka, Christi


    *Healthcare organizations can develop a value-based pricing strategy that benefits both patients and the organization. *The value-based pricing strategy of the Cleveland Clinic is based on five key components of value-relationship to cost, payment considerations, quality, market tolerance, and consistency. *Seven interrelated work streams can be used to align pricing inputs around the five components of value-based pricing.

  15. Economic and technical analysis of retrofit to cogenerating district energy systems: North-Central cities

    Energy Technology Data Exchange (ETDEWEB)

    Santini, D.J.; Davis, A.A.; Marder, S.M.


    Six major US cities (Washington, DC, St. Louis, Cleveland, Milwaukee, Detroit, and Chicago) were studied to achieve reasonably accurate estimates of costs required to retrofit them with district energy systems. Demand estimates and energy-supply analyses are made, and component capital costs are estimated to arrive at annualized system costs. Finally, a comparison of alternative energy delivery options is made, and estimates of scarce-fuel savings are derived.

  16. Flying Saucer? Aliens? (United States)


    No, it's not a flying saucer, it is the domed top to a 70 foot long vacuum tank at the Lewis Research Center's Electric Propulsion Laboratory, Cleveland, Ohio. The three technicians shown here in protective clothing had just emerged from within the tank where they had been cleaning in the toxic mercury atmosphere, left after ion engine testing in the tank. Lewis has since been renamed the John H. Glenn Research Center.

  17. Current Practices and Trends in Mechanical Failure Prevention. Proceedings of the Meeting of the Mechanical Failures Prevention Group (44th) Held in Virginia Beach, Virginia 3-5 April 1990 (United States)


    technique can be based on ligament yield/rupture model which assumes that once the ligament between adjacent indications yields, the ligament is no...series of readings from the transducer showing the most wear in an installation in the thrust bearing of a 250MW steam turbine at the Cleveland 277...evaluatlon procedure based on the moire interferometry fringes. However in those earlier experiments, 309 remaining ligament of the specimen was always

  18. Arbitrator Evaluation and Selection: A Policy Capturing Approach. (United States)


    of court having jurisdiction in the county of the parties ( Labor Law Course:4253). It is apparent there are still other means of obtaining arbitration...Engineer Officer, UJSMC (1943-46) . Affiliated with American ( Labor Law Section), Ohio, Cuyahoga, and Cleveland Bar Associations; American Arbitration...Association, Public Employment Disputes Panel; Industrial Relations Research Association; International Society for Labor Law ; FMCS. P-ermanent

  19. Medical Robotic and Telesurgical Simulation and Education Research (United States)


    Cleveland, OH) for integration into the DVSS. This expansion of the system demonstrates the ability of the simulator platform to blend together... rubber resins. Since we were still 11 experimenting with the placement of the exercises, the first 3D printed dome structure was created with a...heavier shell material also solved the problem of anchoring the dome. The devices weight was now sufficient so that the natural movements of the

  20. Chemoprevention of Prostate Cancer by Naturally Occurring and Synthetic Organoselenium Compounds (United States)


    Cleveland Clinic Foundation, OH. Cell culture and organoselenium treatments AR LNCaP cells were maintained in RPMI-1640 medium with 10% heat ...maintained in RPMI-1640 medium with 10% heat -inactivated Fetal Bovine Serum (FBS). C4-2 cells were maintained under the same conditions but with 10% FBS...kidney graft rejection and as a component of arterial stents (8). Based on the preclinical effectiveness of mTOR inhibitors against a variety of cancer

  1. Electrochemical Interfaces and Electrode Processes: Electrochemical Oxidation of Small Organisms (United States)


    Oxygen Electrochemistry, Cleveland, OH, Oct. 29-Nov. 1, 1991, The Electrochemical Society , Vol. 92-11, pp. 440-473. 3. J. Prakash, D. Tryk, W. Aldred...and Industrial Electrolytic Processes," Vittorio de Nora Award Address at the 181 st National Meeting of the Electrochemical Society , Inc., St. Louis...The Electrochemical Society , Inc., Pennington, NJ, pp. 440-473. E. Contributed Presentations and Papers at Scientific Meetings and Workshops I. R.R

  2. Multiple Sponsor Support for Core Facilities: Effective Communication and Collaboration (United States)

    Colmenares, Clemencia


    The Lerner Research Institute's core services support all investigators at Cleveland Clinic, including a group of nearly 200 research faculty and their teams, as well as clinical research groups who need access to our centralized technologies. We offer approximately 20 different types of services and instruments ranging from preparation of media and cell lines to genomics and proteomics resources. Services are also available to the greater Cleveland scientific community, with selected cores open to “external” (i.e. non-Cleveland) users as long as capacity permits. Beyond the expected technical and scientific expertise, LRI researchers rely on the cores heavily for education and advice on emerging methodologies and research trends. Core structure is kept flexible by design; annual evaluations of the demand, cost-effectiveness, staffing, and customer satisfaction for each core guide decisions about continued operation or restructuring. The LRI cores are supported in part by the Cleveland Translational Science Collaborative, by the Case Comprehensive Cancer Center, and by multiple PPGs to individual investigators. Resolution of differences in objectives, policies, direction, reporting, and allowable practices among funding sources requires constant, highly effective communication. To this end, we have found that a seemingly pedestrian approach – frequent meetings, scrupulous meeting attendance and insightful, diplomatic selection of meeting participants and agendas – when used consistently and inclusively, has proven effective in resolving most conflicts and generating compromises. In the best of cases, this enlightened cooperativity can result in development of services beyond the standard core fare, such as the development of a service to distribute highly purified, elutriated human peripheral blood cells, made possible by the Clinical Research Unit Core Laboratory in collaboration with 2 PPGs and with the TTR component of the CTSC. Management of ongoing

  3. Anatomy of the bovine ascending aorta and brachiocephalic artery found unfavorable for total artificial heart implant. (United States)

    Karimov, Jamshid H; Sunagawa, Gengo; Such, Kimberly A; Sale, Shiva; Golding, Leonard A R; Moazami, Nader; Fukamachi, Kiyotaka


    The biocompatibility assessment of the Cleveland Clinic continuous-flow total artificial heart is an important part of the device developmental program. Surgical and postoperative management are key factors in achieving optimal outcomes. However, the presence of vascular anatomical abnormalities in experimental animal models is often unpredictable and may worsen the expected outcomes. We report a technical impediment encountered during total artificial heart implantation complicated by unfavorable bovine anatomy of the ascending aorta and brachiocephalic arterial trunk.

  4. Post-explant visualization of thrombi in outflow grafts and their junction to a continuous-flow total artificial heart using a high-definition miniaturized camera. (United States)

    Karimov, Jamshid H; Horvath, David; Sunagawa, Gengo; Byram, Nicole; Moazami, Nader; Golding, Leonard A R; Fukamachi, Kiyotaka


    Post-explant evaluation of the continuous-flow total artificial heart in preclinical studies can be extremely challenging because of the device's unique architecture. Determining the exact location of tissue regeneration, neointima formation, and thrombus is particularly important. In this report, we describe our first successful experience with visualizing the Cleveland Clinic continuous-flow total artificial heart using a custom-made high-definition miniature camera.

  5. Optimizing Soft Tissue Management and Spacer Design in Segmental Bone Defects (United States)


    mechanically robust, and less vascular. Samples for cell and CTP analysis are minced and digested in collagenase I and dispase. A standard assay for CTP-Os...Comments” section of the grading table. 2) Sternum autograft cancellous bone graft (ACBG) histology A scoring system for ACBG histology has...D’Alleyrand had continued his interaction with Drs. Pluhar and Muschler and the veterinary staff at Cleveland Clinic during the animal surgeries in Aim 2

  6. Optimization of Soft Tissue Management, Spacer Design, and Grafting Strategies for Large Segmental Bone Defects using the Chronic Caprine Tibial Defect Model (United States)


    and an “outer” layer (thicker, fibrous, mechanically robust, and less vascular. Samples for cell and CTP analysis are minced and digested in...Sternum autograft cancellous bone graft (ACBG) histology A scoring system for ACBG histology has been developed to define areas of hematopoietic marrow...D’Alleyrand) Dr. D’Alleyrand had continued his interaction with Drs. Pluhar and Muschler and the veterinary staff at Cleveland Clinic during the animal

  7. A prospective study of anxiety in ICD patients with a pilot randomized controlled trial of cognitive behavioral therapy for patients with moderate to severe anxiety

    DEFF Research Database (Denmark)

    Qintar, Mohammed; George, Jason J; Panko, Melanie


    PURPOSE: Stress and anxiety are potential consequences from arrhythmias and implantable cardioverter defibrillator (ICD) shocks that can contribute to substantial morbidity. We assessed anxiety associated with an ICD and whether cognitive behavioral therapy (CBT) reduces anxiety. METHODS: The identifier: NCT00851071. URL:

  8. Monitors Enable Medication Management in Patients' Homes (United States)


    Glenn Research Center awarded SBIR funding to ZIN Technologies to develop a platform that could incorporate sensors quantifying an astronaut’s health status and then communicate with the ground. ZIN created a device, developed the system further, and then formed Cleveland-based FlexLife Health to commercialize the technology. Today it is part of an anti-coagulation management system for people with cardiovascular disease.

  9. Stoma care is our affair for the senior citizens everywhere

    Directory of Open Access Journals (Sweden)

    M. Coyle


    Full Text Available The first reported colostomy was in 1776 and it was a caecostomy, or opening into the caecum. This was the first attempt to surgically help the problem of an imperforate anus. The first stomatherapist was a patient in the Cleveland Clinic, Ohio, U.S.A. Now there are 22 countries in the world with qualified stomatherapists. Stomatherapy was founded in South Africa in 1958 and in England in 1967.

  10. Empirical Evaluation of a Model of Team Collaboration Using Selected Transcripts from September 11, 2001 (United States)


    controlled, laboratory experimental environments, and were not applicable to this, or any, real-world scenario. However, this is not evidence that these...the hierarchy’s first mention is neither in the knowledge management nor information science field, but in early 20th century poetry (Cleveland, 1982...messages and searches, asking behavior logged by experimenter on collaboration logger. Possible indices include the ‘depth and breadth’ of

  11. Student nurses and the electronic medical record: a partnership of academia and healthcare. (United States)

    Bowers, Anna Mary; Kavanagh, Joan; Gregorich, Tom; Shumway, Julia; Campbell, Yolanda; Stafford, Susan


    The advent of the electronic medical record has brought a new challenge to nursing education. Although most nursing students are proficient in data entry and computer skills, they often do not comprehend how the information they enter becomes a vital component of interdisciplinary team communication. Furthermore, the electronic medical record becomes a repository for information that can be retrieved for the purpose of decision support. Developed by the Cleveland Clinic, the Deans' Roundtable, and University Hospitals of Cleveland, the Student Nurse Portal provides a means of assisting the student to understand how data entered into the computer transforms into information and knowledge, resulting in the wisdom that enables healthcare workers to provide optimal patient care. Current courses present the purpose of the electronic medical record and its roleas a powerful communication tool, but future courses will also help the student develop data entry and retrieval skills. Hosted on the Cleveland Clinic servers and available to students around-the-clock from any computer with Internet access, students have found the Student Nurse Portal to be a valuable tool in preparing for the use of the electronic medical record during their clinical experiences.

  12. Natural hydraulic fractures and the mechanical stratigraphy of shale-dominated strata (United States)

    Imber, Jonathan; Armstrong, Howard; Atar, Elizabeth; Clancy, Sarah; Daniels, Susan; Grattage, Joshua; Herringshaw, Liam; Trabucho-Alexandre, João; Warren, Cassandra; Wille, Jascha; Yahaya, Liyana


    The aim of this study is to investigate stratigraphic variations in the spatial distribution and density of natural hydraulic and other fractures within oil mature, shale-dominated strata from the Cleveland Basin, northeast England. The studied interval includes the Pliensbachian Cleveland Ironstone and Toarcian Whitby Mudstone Formations. The Cleveland Ironstone Formation (ca. 25m thick) consists of silt- and mudstone units with discrete ironstone layers (seams). Ironstones account for 20% of the thickness of the formation. The Whitby Mudstone Formation is up to ca. 100 m thick; up to 2% of its total thickness consists of discrete calcium carbonate horizons, such as the Top Jet Dogger. Natural hydraulic fractures, characterised by plumose marks and concentric arrest lines on fracture surfaces are ubiquitous throughout both formations; shear fractures with mm- to cm-scale displacements occur locally, particularly within silt- and mudstones. Natural hydraulic fractures locally contain thin, sometimes fibrous, calcite fills and are commonly observed to terminate at bedding plane interfaces between silt- or mudstone and carbonate beds. We have recorded fracture locations and apertures along 139 transects in both shale (i.e. silt- and mudstone intervals) and carbonate strata. Natural hydraulic and shear fractures, measured along transects up to 50m long within all lithologies in both formations, typically display uniform distributions. There is no correlation between spacing distribution and bulk extension in any lithology. Median fracture densities recorded within the Cleveland Ironstone Formation are higher in intervening ironstone beds (<2.1 fractures per m in ironstone layers) compared with dominant shales (<0.9 fractures per m in silt- and mudstones). A qualitatively similar pattern occurs within the Whitby Mudstone Formation. However, the absolute values of median fracture density within different members of the Whitby Mudstone Formation range from 2

  13. Neuromodulación de raíces sacras como tratamiento de la incontinencia fecal: Resultados preliminares Sacral root neuromodulation as treatment for fecal incontinence: Preliminary results

    Directory of Open Access Journals (Sweden)

    J. M. Navarro


    Full Text Available Presentamos nuestra experiencia inicial en el tratamiento de la incontinencia fecal (IF mediante neuromodulación de raíces sacras (NRS, a través de los resultados de un estudio prospectivo realizado con 26 pacientes en el que se comparan los valores basales en la escala de continencia de Wexner-Cleveland y en la capacidad para el retraso de la defecación, con los obtenidos tras un año de terapia con NRS. El estudio inicial de cada paciente incluía anamnesis, exploración general, ecografía y manometría rectal, así como unos diarios de continencia y de calidad de vida específicos para la IF de 3 semanas. Antes de la terapia con NRS, el valor medio en la escala Wexner-Cleveland fue de 15,00 ± 1,81 y el 62,50% de los pacientes tenía una capacidad de retraso de la defecación menor de 1 minuto. Tras un año de terapia con NRS, el valor medio en la escala de Wexner-Cleveland fue de 4,87 ± 2,54 (p = 0,0031 y el 75,01% de los pacientes presentaba una capacidad de retraso defecatorio mayor de 15 minutos (p = 0,0018. Hacemos, además, una descripción detalla de la técnica quirúrgica de la NRS, haciendo referencia a sus indicaciones y finalizamos revisando las distintas opciones terapéuticas para la IF mostrando nuestro algoritmo terapéutico para esta patología. La NRS es una técnica eficaz para el tratamiento de la IF en pacientes seleccionados que no han respondido a tratamiento conservador, biofeedback o correcciones anatómicas (esfinteroplastia, con una mínima morbilidad y susceptible de realizarse en un programa de cirugía ambulatoria.We present our initial experience in the treatment of fecal incontinence (FI with sacral root neuromodulation (SRN by reporting the results of a prospective study with 26 patients where baseline Wexner-Cleveland scale scores and ability to delay defecation were compard to results after one year with SRN. The initial study of patients included history taking, general examination, anal

  14. Sensitivity and bias of molecular marker-based aerosol source apportionment models to small conltibutions of coal combustion soot. (United States)

    Rutter, Andrew P; Snyder, David C; Schauer, James J; DeMinter, Jeff; Shelton, Brandon


    Carbonaceous atmospheric particulate matter (PM25) collected in the midwestern United States revealed that soot emissions from incomplete coal combustion were important sources of several organic molecular markers used in source apportionment studies. Despite not constituting a major source of organic carbon in the PM25, coal soot was an important source of polyaromatic hydrocarbons, hopanes, and elemental carbon. These marker compounds are becoming widely used for source apportionment of atmospheric organic PM, meaning that significant emissions of these marker compounds from unaccounted sources such as coal soot could bias apportionment results. This concept was demonstrated using measurements of atmospheric PM collected on a 1-in-6 day schedule at three monitoring sites in Ohio: Mingo Junction (near Steubenville), Cincinnati, and Cleveland. Impacts of coal sootwere measured to be significant at Mingo Junction and small at Cleveland and Cincinnati. As a result, biases in apportionment results were substantial at Mingo Junction and insignificant at Cleveland and Cincinnati. Misapportionments of organic carbon mass at Mingo Junction were significant when coal soot was detected in the particulate samples as identified bythe presence of picene, but when coal soot was not included in the model: gasoline engines (+8% to +58% of OC), smoking engines (0% to -17% of OC), biomass combustion (+1% to +11% of OC), diesel engines (-1% to -2% of OC), natural gas combustion (0% to -2% of OC), and unapportioned OC (0% to -47% of OC). These results suggest that the role of coal soot in source apportionment studies needs to be better examined in many parts of the United States and other parts of the world.

  15. Association between Hyperprolactinemia and Granulomatous Mastitis. (United States)

    Nikolaev, Anatoly; Blake, Cassann N; Carlson, Diane L


    Granulomatous mastitis (GM) is a relatively uncommon inflammatory breast lesion with multiple suggested etiologies. Although most GM cases show association with lactation and pregnancy, a minority of cases have been linked to hyperprolactinemia caused by either dopamine antagonist medications or with intracranial lesions, such as pituitary adenoma. The goal of this study is to review the GM cases reported in the literature with a specific emphasis on those cases associated with hyperprolactinemia and prolactinomas and to identify cases of GM seen at the Cleveland Clinic Florida which demonstrate co-occurrences of GM and intracranial lesions. CoPath and Epic data bases at Cleveland Clinic Florida were searched for cases describing inflammatory breast lesions in patients with pituitary pathology. Chart reviews were conducted and pertinent medical history was extracted for case reports. H&E-stained paraffin-embedded sections retrieved from Cleveland Clinic Florida pathology storage were evaluated by light microscopy. Four cases showing a co-occurrence of GM and hyperprolactinemia were consequently identified. A prolactin-secreting pituitary adenoma was present in two of the three GM cases. The third case demonstrated a concomitant craniopharyngioma, which was also associated with a rise in serum prolactin. This phenomenon was presumably attributable to compression, resulting in compromised transport of dopamine to the adenohypophysis and subsequent disinhibition of prolactin secretion by lactotrophs. The fourth patient with GM had a similar history of elevated prolactin. Classical histopathological features of GM were found in all four cases, including noncaseating granulomas, multinucleated giant cells, epithelioid histiocytes, and chronic inflammation. Intriguingly, complete resolution of inflammatory breast lesions along with normalization of prolactin levels occurred following the surgical excision of the craniopharyngioma, suggesting that intracranial lesion

  16. Critical appraisal of pazopanib as treatment for patients with advanced metastatic renal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Bukowski RM


    Full Text Available Ronald M BukowskiCleveland Clinic Taussig Cancer Center, Cleveland Clinic Foundation, Cleveland, OH, USAAbstract: The management of renal cell carcinoma (RCC has undergone significant changes during the past 10 years, with the treatment of metastatic RCC undergoing the most radical changes. These developments reflect an enhanced understanding of this tumor's underlying biology, which was then translated into the development of a new treatment paradigm. Current therapeutic approaches for the management of patients with metastatic RCC utilize knowledge of histology, molecular abnormalities, clinical prognostic factors, the natural history of this malignancy, and the treatment efficacy and toxicity of available agents. The treatment options available for patients with metastatic RCC have changed dramatically over the past 6 years. Interferon-α and interleukin-2 were the previous mainstays of therapy, but since December 2005, six new agents have been approved in the US for the treatment of advanced RCC. Three are multi-targeted tyrosine kinase inhibitors (TKI including sunitinib, sorafenib, and pazopanib, two target the mammalian target of rapamycin (temsirolimus and everolimus, and one is a humanized monoclonal antibody (bevacizumab in combination with interferon-α. The current review focuses on the newest TKI available to treat patients with metastatic RCC, pazopanib. The development of this agent both preclinically and clinically is reviewed. The efficacy and safety data from the pivotal clinical trials are discussed, and the potential role of pazopanib in the treatment of patients with metastatic RCC in comparison to other treatment alternatives is critically appraised. This agent has a favorable overall risk benefit, and the available data demonstrate efficacy in patients with metastatic RCC who are either treatment-naïve or cytokine refractory. It therefore represents another alternative for treatment of metastatic RCC patients

  17. Explosion Source Similarity Analysis via SVD (United States)

    Yedlin, Matthew; Ben Horin, Yochai; Margrave, Gary


    An important seismological ingredient for establishing a regional seismic nuclear discriminant is the similarity analysis of a sequence of explosion sources. To investigate source similarity, we are fortunate to have access to a sequence of 1805 three-component recordings of quarry blasts, shot from March 2002 to January 2015. The centroid of these blasts has an estimated location 36.3E and 29.9N. All blasts were detonated by JPMC (Jordan Phosphate Mines Co.) All data were recorded at the Israeli NDC, HFRI, located at 30.03N and 35.03E. Data were first winnowed based on the distribution of maximum amplitudes in the neighborhood of the P-wave arrival. The winnowed data were then detrended using the algorithm of Cleveland et al (1990). The detrended data were bandpass filtered between .1 to 12 Hz using an eighth order Butterworth filter. Finally, data were sorted based on maximum trace amplitude. Two similarity analysis approaches were used. First, for each component, the entire suite of traces was decomposed into its eigenvector representation, by employing singular-valued decomposition (SVD). The data were then reconstructed using 10 percent of the singular values, with the resulting enhancement of the S-wave and surface wave arrivals. The results of this first method are then compared to the second analysis method based on the eigenface decomposition analysis of Turk and Pentland (1991). While both methods yield similar results in enhancement of data arrivals and reduction of data redundancy, more analysis is required to calibrate the recorded data to charge size, a quantity that was not available for the current study. References Cleveland, R. B., Cleveland, W. S., McRae, J. E., and Terpenning, I., Stl: A seasonal-trend decomposition procedure based on loess, Journal of Official Statistics, 6, No. 1, 3-73, 1990. Turk, M. and Pentland, A., Eigenfaces for recognition. Journal of cognitive neuroscience, 3(1), 71-86, 1991.

  18. Tendinopathy of the long head of the biceps tendon: histopathologic analysis of the extra-articular biceps tendon and tenosynovium

    Directory of Open Access Journals (Sweden)

    Streit JJ


    Full Text Available Jonathan J Streit,1 Yousef Shishani,1 Mark Rodgers,2 Reuben Gobezie1 1The Cleveland Shoulder Institute, 2Department of Pathology, University Hospitals of Cleveland, Cleveland, OH, USA Background: Bicipital tendinitis is a common cause of anterior shoulder pain, but there is no evidence that acute inflammation of the extra-articular long head of the biceps (LHB tendon is the root cause of this condition. We evaluated the histologic findings of the extra-articular portion of the LHB tendon and synovial sheath in order to compare those findings to known histologic changes seen in other tendinopathies. Methods: Twenty-six consecutive patients (mean age 45.4±13.7 years underwent an open subpectoral biceps tenodesis for anterior shoulder pain localized to the bicipital groove. Excised tendons were sent for histologic analysis. Specimens were graded using a semiquantitative scoring system to evaluate tenocyte morphology, the presence of ground substance, collagen bundle characteristics, and vascular changes. Results: Chronic inflammation was noted in only two of 26 specimens, and no specimen demonstrated acute inflammation. Tenocyte enlargement and proliferation, characterized by increased roundness and size of the cell and nucleus with proteoglycan matrix expansion and myxoid degenerative changes, was found in all 26 specimens. Abundant ground substance, collagen bundle changes, and increased vascularization were visualized in all samples. Conclusion: Anterior shoulder pain attributed to the biceps tendon does not appear to be due to an inflammatory process in most cases. The histologic findings of the extra-articular portion of the LHB tendon and synovial sheath are similar to the pathologic findings in de Quervain tenosynovitis at the wrist, and may be due to a chronic degenerative process similar to this and other tendinopathies of the body. Keywords: biceps tendinitis, biceps tendinopathy, tenosynovium, anterior shoulder pain, long head biceps

  19. Spirituality and well being among elders: differences between elders with heart failure and those without heart failure

    Directory of Open Access Journals (Sweden)

    Mary T Quinn Griffin


    Full Text Available Mary T Quinn Griffin1, Yi-Hui Lee2, Ali Salman1, Yaewon Seo1, Patricia A Marin3, Randall C Starling3, Joyce J Fitzpatrick11Frances Payne Bolton School of Nursing Case Western Reserve University Cleveland, OH; 2College of Nursing and Health Wright State University Dayton, OH; 3Cleveland Clinic, Cleveland, OhioAbstract: Heart failure is a chronic debilitating disease that affects all aspects of a person’s life, including physical, mental and spiritual dimensions. The associations among these dimensions, and the relationship to overall health status, have not been clearly identified. The purpose of this quantitative, descriptive study was to explore differences between spirituality, depressive symptoms, and quality of life among elders with and without heart failure. A total of 44 elders with heart failure and 40 non-heart failure elders completed several questionnaires including: The Daily Spiritual Experiences Scale (DSES, Spirituality Index of Well-Being (SIWB, Center for Epidemiologic Studies Depression Scale (CES-D, and SF-12™ Health Survey. There were significant differences in the groups on gender and ethnicity; thus these variables were controlled in the analyses related to the dependent variables. After controlling for gender and ethnicity, there were significant differences in the physical component of quality of life and spiritual well-being. The heart failure patients had significantly lower physical quality of life but more spiritual well-being than the non-heart failure patients. There were no significant differences in daily spiritual experiences, mental component of quality of life, and depressive symptoms between the two groups.Keywords: spiritual experience, spiritual well-being, heart failure, depressive symptoms, quality of life, elders

  20. Recent findings within the microbiota–gut–brain–endocrine metabolic interactome

    Directory of Open Access Journals (Sweden)

    Obrenovich M


    Full Text Available Mark Obrenovich,1–4 Thriveen Sankar Chittoor Mana,5 Herleen Rai,2 Dorjee Shola,4,6 Christopher Sass,2,3 Benjamin McCloskey,4 Bruce S Levison7 1Pathology and Laboratory Medicine Service, 2Research Service, Cleveland Veterans Affairs Medical Center, 3Department of Chemistry, Cleveland State University, 4Gilgamesh Foundation, 5Division of Infectious Diseases and HIV Medicine, Case Western Reserve University, Cleveland, OH, 6Gene Targeting Resource Center, The Rockefeller University, New York, NY, 7Department of Pediatrics, University of Toledo, Toledo, OH, USA Purpose of review: We have established that many metabolic biomes exist within the complex mammalian gut. Substantial metabolism occurs within these biomes and is called co-metabolism of the host and resident microorganisms. This gut–brain–endocrine metabolic interaction emphasizes how bacteria can affect the brain and the hormonal axes in the process of co-metabolism. This review highlights new findings in this regard. Recent findings: In this review, we explore how the gut microbiota affect the development and regulation of the hypothalamic–pituitary–adrenal axis and neurochemistry from mental health and behavioral health to memory, depression, mood, anxiety, obesity, and the development of the blood–brain barrier. Summary: This review describes the implications of the findings for clinical practice or research. Interaction of small molecules within these biomes is now described collectively as a “metabolic interactome”. Metabolites of the gut–brain–endocrine axis and our overall gut health constantly shape the host phenotype in ways previously unimagined, and this niche represents potential targets for treatment and drug design, since the interaction or biochemical interplay results in net metabolite production and/or end products to exercise either positive or negative effects on human health. Keywords: neurotransmitters, gut brain axis, metabolomics, microbiota

  1. Perspectives of public spaces in Irkutsk. Visions, Alliances, Requirements

    Directory of Open Access Journals (Sweden)

    Barbara Engel


    Full Text Available Open spaces are ‘backbones’ of the city, important places of communication and identification of the urban society. In an era of increasing privatization and commercialization of urban spaces the design of public spaces remains as one of the most important responsibilities for the municipality. The article discusses possibilities for improving public spaces in Irkutsk. Three conceptional approaches – 1: Network of public spaces, 2: Integration of different interests, 3: Encouraging special features and spatial identity – by presenting international best practices (e.g. from Dresden, Cleveland, Oulu are recommended as approach for sustainable city development.

  2. Dangerous nutrition? Calcium, vitamin D, and shark cartilage nutritional supplements and cancer-related hypercalcemia. (United States)

    Lagman, Ruth; Walsh, Declan


    The use of nutritional supplements in the general population and in cancer patients has become very popular. These supplements are not perceived as medications and are presumed to be safe by cancer patients, who may however be at risk for hypercalcemia. We note that many of our patients who have developed symptomatic hypercalcemia were taking vitamin D, calcium, or shark cartilage supplements. We report eight cases of hypercalcemia in cancer patients seen at the Cleveland Clinic Foundation in whom these nutritional supplements may have contributed to the prevalence or severity of hypercalcemia.

  3. Baseline and verification tests of the Electric Vehicle Associates' Current Fare Station Wagon. Final test report, 27 March 1980-6 November 1981

    Energy Technology Data Exchange (ETDEWEB)

    Dowgiallo, E.J. Jr; Chapman, R.D.


    The EVA Current Fare Station Wagon, an electric vehicle, was tested at MERADCOM as part of a Department of Energy project to characterize the state-of-the-art of electric vehicles. The current Fare Wagon was manufactured in Cleveland, Ohio by Electric Vehicle Associates' Incorporated. It is powered by 22 6-V lead-acid batteries driving a 30-hp d.c. series motor through an SCR controller. The motor drives the rear wheels through a manually operated 4-speed transmission. Regenerative braking was provided.

  4. Second NASA Workshop on Wiring for Space Applications (United States)


    This document contains the proceedings of the Second NASA Workshop on Wiring for Space Applications held at NASA LeRC in Cleveland, OH, 6-7 Oct. 1993. The workshop was sponsored by NASA Headquarters Code QW Office of Safety and Mission Quality, Technical Standards Division and hosted by NASA LeRC, Power Technology Division, Electrical Components and Systems Branch. The workshop addressed key technology issues in the field of electrical power wiring for space applications. Speakers from government, industry, and academia presented and discussed topics on arc tracking phenomena, wiring system design, insulation constructions, and system protection. Presentation materials provided by the various speakers are included in this document.

  5. Thermophysical Properties of Matter - The TPRC Data Series. Volume 8. Thermal Radiative Properties - Nonmetallic Solids (United States)


    N 1 eooeeoee t~t-a>-i<ea>oe f-Hw^oj^< vino MNMMNNMn i S P u d d d d d d d d d o o d d o d d d d d d SNO(pa0WA(DCpt-O(P ^HU9tototet-t*t-t...Tuxedo, N. Y. and Parma Res. Center, Cleveland, Ohio. 1-58, 1960. [AD 239305] Los Alamos Scientific Lab., New Mexico . "Quarterly Status Report of

  6. Non-Equilibrium Plasma Applications for Water Purification Supporting Human Spaceflight and Terrestrial Point-of-Use (United States)

    Blankson, Isaiah M.; Foster, John E.; Adamovsky, Grigory


    2016 NASA Glenn Technology Day Panel Presentation on May 24, 2016. The panel description is: Environmental Impact: NASA Glenn Water Capabilities Both global water scarcity and water treatment concerns are two of the most predominant environmental issues of our time. Glenn researchers share insights on a snow sensing technique, hyper spectral imaging of Lake Erie algal blooms, and a discussion on non-equilibrium plasma applications for water purification supporting human spaceflight and terrestrial point-of-use. The panel moderator will be Bryan Stubbs, Executive Director of the Cleveland Water Alliance.

  7. 《A Running Hero》精读

    Institute of Scientific and Technical Information of China (English)



    Jesse Owens was born in Alabama.His real name was James Cleveland Owens.The nickname“Jessecame from his initials,J.C.As a child Owens liked to run.He was quite fast.In college he was on the track team.He won many races.In one track meet,he broke three world recordsand tied a fourth.He did it all in less than one hour。But his greatest moment came after college.It was the Summer Olympic Games of 1936.The games wereheld in Germany.Adolf Hitler ruled Germany.Hitler believed Germans were the best athletes.He wan...

  8. Mechanisms of Drug Resistance in Plasmodium Falciparum (United States)


    Puhbds I V. AS dwo aaut / 14i4-S1/n3/WU0 kfou~mis Characterization of the pfmdr2 gene for Plasmodlum falciparwm Mariano G. Zalis, Craig M. Wilson’, Yun...Alto, CA, USA J.E Manning, Irvine, CA, USA P. Borst, Amsterdam, The Netherlands T.F. McCutchan, Bethesda, MD, USA J.J. Cazzulo, Buenos Aires, Argentina...T.W. Nilsen, Cleveland, OH, USA R. Docampo, Urbana, IL, USA A.J. Parodi, Buenos Aires, Argentina J.E. Donelson, Iowa City, IA, USA M. Parsons

  9. Status and Evaluation of Microwave Furnace Capabilities at NASA Glenn Research Center (United States)

    Lizcano, Maricela; Mackey, Jonathan A.


    The microwave (MW) furnace is a HY-Tech Microwave Systems, 2 kW 2.45 GHz Single Mode Microwave Applicator operating in continuous wave (CW) with variable power. It is located in Cleveland, Ohio at NASA Glenn Research Center. Until recently, the furnace capabilities had not been fully realized due to unknown failure that subsequently damaged critical furnace components. Although the causes of the problems were unknown, an assessment of the furnace itself indicated operational failure may have been partially caused by power quality. This report summarizes the status of the MW furnace and evaluates its capabilities in materials processing.

  10. The type material of Mantodea (praying mantises) deposited in the National Museum of Natural History, Smithsonian Institution, USA. (United States)

    Svenson, Gavin J


    The collection of Mantodea of the National Museum of Natural History, Smithsonian Institution, includes 26 holotypes, 7 allotypes, 4 lectotypes, 23 paratypes, and 1 paralectotype. Four type specimens were designated as lectotypes within this work. Highly accurate measurement data, high resolution images of specimens and labels, verbatim label data, georeferenced coordinates, original and newly assigned database codes, and bibliographic data are presented for all primary types. Label data for all paratype specimens in the collection are provide in tabular form. The location of the USNM collection has been moved to the Cleveland Museum of Natural History as a loan under the Off-site Enhancement Program.

  11. Ashtabula Breakwater Common Tern (Sterna Hirundo) Nesting (United States)


    5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) U.S. Army Engineer Research and Development Center,Vicksburg,, MS ,39180 8...Cleveland, OH 44128 Carabineers 64 Local Hardware Supply Nickel Plated Links 110 Local Hardware Supply 5/32” PVC Clothesline (100 ft/pkg) 6 Local...EWN Technical Notes Collection ERDC TN-EWN-16-1. Vicksburg, MS : U.S. Army Engineer Research and Development Center.

  12. Workshop on Gas Channels (United States)


    Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, Clevelanders was that Workshop was a great success—in terms of the quality of the participants, the presentations, and the discussions that... Garvin , Ph.D. Title: “NO transport by aquaporin 1” 2:35pm - 2:45pm: Question/Answer Session 2:45pm - 3:10pm: Afternoon Break 3:10pm

  13. Costs of urban area retrofit to district heating and cooling systems: north-central cities

    Energy Technology Data Exchange (ETDEWEB)

    Santini, D J; Davis, A A; Marder, S M


    This study considers the major urbanized areas of six U.S. cities (Washington, D.C.; St. Louis; Cleveland; Milwaukee; Detroit; Chicago) to arrive at reasonably accurate estimates of costs required to retrofit them with district heating and cooling systems. Only costs associated with heating and hot water are addressed here. Demand estimates and energy-supply analyses are made, and component capital costs are estimated to arrive at annualized system costs. Finally, a comparison of alternative energy-delivery options is made, and estimates of scarce-fuel savings are derived. 39 refs., 12 figs., 14 tables.

  14. Procedures, Requirements and Challenges Associated with Analysis of Environmental Samples for Chemical Warfare Material (CWM) (United States)


    TN • Edwards AFB , CA • Ogden, UT • Ft. McClellan , AL • Camp Sibert, AL • Brooksville AAF, FL • Cleveland Plant, OH • Holloman AFB , NM • Lowry BGR...0.064) 19 (0.018) 100 (0.053) Approved for Public Release CONUS Projects • England AFB , LA • Redstone Arsenal, AL • Spring Valley DC • Memphis Depot...Deseret Chemical Depot, UT • Rocky Mt Arsenal, CO • Dover AFB , DE • Bluegrass, KY• Newport, IN • Dugway, UT Approved for Public Release OCONUS Projects

  15. Application of Autonomous Spacecraft Power Control Technology to Terrestrial Microgrids (United States)

    Dever, Timothy P.; Trase, Larry M.; Soeder, James F.


    This paper describes the potential of the power campus located at the NASA Glenn Research Center (GRC) in Cleveland, Ohio for microgrid development. First, the benefits provided by microgrids to the terrestrial power grid are described, and an overview of Technology Needs for microgrid development is presented. Next, GRC's work on development of autonomous control for manned deep space vehicles, which are essentially islanded microgrids, is covered, and contribution of each of these developments to the microgrid Technology Needs is detailed. Finally, a description is provided of GRC's existing physical assets which can be applied to microgrid technology development, and a phased plan for development of a microgrid test facility is presented.

  16. Virtual reality training versus blended learning of laparoscopic cholecystectomy

    DEFF Research Database (Denmark)

    Nickel, Felix; Brzoska, Julia Anja; Gondan, Matthias;


    Objective: This study compared virtual reality (VR) training with low cost blended learning (BL) in a structured training program. Background: Training of laparoscopic skills outside the operating room is mandatory to reduce operative times and risks. Methods: Laparoscopy-naïve medical students...... were randomized in two groups stratified for gender. The BL group (n = 42) used E-learning for laparoscopic cholecystectomy (LC) and practiced basic skills with box trainers. The VR group (n = 42) trained basic skills and LC on the LAP Mentor II (Simbionix, Cleveland, USA). Each group trained 3×4 hours...

  17. Computer-assisted information management for the pediatric residency review process. (United States)

    Kallen, R J


    Directors of training programs must systematically compile information on the patient population used for graduate education. The revised special requirements and application form of the Residency Review Committee for Pediatrics of the Accreditation Council for Graduate Medical Education call for detailed information on the patient-centered activities of residents. Since data on patient contacts cumulate rapidly, the Pediatrics Residency Program of the Mt. Sinai Medical Center in Cleveland, Ohio, instituted a microcomputer-assisted information management system. Under the system, a personal computer with a fixed disk and data-base management software provides the means for documenting the residents' patient contacts and learning experiences.

  18. Test Results from a Simulated High Voltage Lunar Power Transmission Line (United States)

    Birchenough, Arthur; Hervol, David


    The Alternator Test Unit (ATU) in the Lunar Power System Facility (LPSF) located at the NASA Glenn Research Center (GRC) in Cleveland, OH was modified to simulate high voltage transmission capability. The testbed simulated a 1 km transmission cable length from the ATU to the LPSF using resistors and inductors installed between the distribution transformers. Power factor correction circuitry was used to compensate for the reactance of the distribution system to improve the overall power factor. This test demonstrated that a permanent magnet alternator can successfully provide high frequency AC power to a lunar facility located at a distance.

  19. Test Results From a Simulated High-Voltage Lunar Power Transmission Line (United States)

    Birchenough, Arthur; Hervol, David


    The Alternator Test Unit (ATU) in the Lunar Power System Facility (LPSF) located at the NASA Glenn Research Center (GRC) in Cleveland, Ohio was modified to simulate high-voltage transmission capability. The testbed simulated a 1 km transmission cable length from the ATU to the LPSF using resistors and inductors installed between the distribution transformers. Power factor correction circuitry was used to compensate for the reactance of the distribution system to improve the overall power factor. This test demonstrated that a permanent magnet alternator can successfully provide high-frequency ac power to a lunar facility located at a distance.

  20. Moderate hypothermia technique for chronic implantation of a total artificial heart in calves. (United States)

    Karimov, Jamshid H; Grady, Patrick; Sinkewich, Martin; Sunagawa, Gengo; Dessoffy, Raymond; Byram, Nicole; Moazami, Nader; Fukamachi, Kiyotaka


    The benefit of whole-body hypothermia in preventing ischemic injury during cardiac surgical operations is well documented. However, application of hypothermia during in vivo total artificial heart implantation has not become widespread because of limited understanding of the proper techniques and restrictions implied by constitutional and physiological characteristics specific to each animal model. Similarly, the literature on hypothermic set-up in total artificial heart implantation has also been limited. Herein we present our experience using hypothermia in bovine models implanted with the Cleveland Clinic continuous-flow total artificial heart.

  1. Cost competitiveness of a solar cell array power source for ATS-6 educational TV terminal (United States)

    Masters, R. M.


    A cost comparison is made between a terrestrial solar cell array power system and a variety of other power sources for the ATS-6 Satellite Instructional Television Experiment (SITE) TV terminals in India. The solar array system was sized for a typical Indian location, Lahore. Based on present capital and fuel costs, the solar cell array power system is a close competitor to the least expensive alternate power system. A feasibility demonstration of a terrestrial solar cell array system powering an ATS-6 receiver terminal at Cleveland, Ohio is described.

  2. A Survey of Jet Aircraft PM by TEM in APEX III (United States)

    VanderWal, Randy L.; Bryg, Victoria M.


    Based upon field testing during the NASA led APEX III campaign conducted in November 2005 at the NASA Glenn Research Center in coordination with Continental Airlines and Cleveland Hopkins International Airport. This paper reports observations of particulate emissions collected from a suite of jet engine aircraft to assess differences and similarities in soot macro- micro- and nanostructure using transmission electron microscopy (TEM). Aggregates are compact, primary particle sizes varied and nanostructure mixed. Comparisons are made to more familiar laboratory flame-generated soot as a well-studied point of reference. Results are interpreted in terms of turbulence interacting with the different stages of particle formation and growth.

  3. Warfighter Performance (United States)


    Synthetic and Systems Biology, Microbial Fuel Cells Sentinel Cells,  Biomaterials Dr. Linda Chrisey, Dr. Laura Kienker Warfighter Performance  CASEVAC...Personnel Command • Deputy Chief, Navy Dental Corps • CO, Navy Expeditionary Medical Unit • COO, Rutgers / Cleveland Clinic Regen Med research consortium...Commander, Carrier Air Wing 9 • CO, Electronic Attack Squadrons VAQ-139, VAQ-129 Education • DDS, Doctor of Dental Surgery • PhD, Cell

  4. Energy study of rail passenger transportation. Volume 2. Description of operating systems. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Henderson, C.; Ellis, H. T.; Wilhelm, J. P.


    The rail passenger systems of the US are described in terms of selected physical, operating, and economic characteristics, and relates services rendered to energy usage and costs. Rail passenger transportation exists in 4 distinct forms: intercity railroads, suburban railroads, heavy-rail transit, and light-rail transit. Each form varies in technical equipment, design of facilities, operating practices, size of systems. Specific data for the national rail passenger network and the Boston, Chicago, Cleveland, New York, Philadelphia, Pittsburgh, and San Francisco regions and the Washington Metropolitan area transit authority are presented.

  5. Dollar Summary of Prime Contract Awards by Contractor, State or Country, and Place, FY84, Part 6, (Magnasync/Moviola Corp-Parker Marine Contracting). (United States)



  6. Supramolecular Polymers with Orthogonal Functionality (United States)


    OMB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. Case Western Reserve University 10900 Euclid Ave. Cleveland, OH 44106 -4919...Block 13: Supplementary Note © 2014 . Published in Macromolecules, Vol. Ed. 0 47, (24) (2014), ( (24). DoD Components reserve a royalty-free...Zn(Mebip-PEB-Mebip)](NTf2)2/(UPy-PEB-UPy) and [Fe- (Mebip-PEB-Mebip)](ClO4)2/(UPy-PEB-UPy) blends in which the ratio between the MSP and the hydrogen

  7. Lung transplantation in chronic obstructive pulmonary disease: patient selection and special considerations

    Directory of Open Access Journals (Sweden)

    Lane CR


    Full Text Available C Randall Lane, Adriano R Tonelli Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA Abstract: Chronic obstructive pulmonary disease (COPD is a leading cause of mortality and morbidity. Lung transplantation is one of the few treatments available for end-stage COPD with the potential to improve survival and quality of life. The selection of candidates and timing of listing present challenges, as COPD tends to progress fairly slowly, and survival after lung transplantation remains limited. Though the natural course of COPD is difficult to predict, the use of assessments of functional status and multivariable indices such as the BODE index can help identify which patients with COPD are at increased risk for mortality, and hence which are more likely to benefit from lung transplantation. Patients with COPD can undergo either single or bilateral lung transplantation. Although many studies suggest better long-term survival with bilateral lung transplant, especially in younger patients, this continues to be debated, and definitive recommendations about this cannot be made. Patients may be more susceptible to particular complications of transplant for COPD, including native lung hyperinflation, and development of lung cancer. Keywords: emphysema, pulmonary hypertension, mortality, prognosis, outcomes, alpha-1 antitrypsin deficiency

  8. A multimethod investigation including direct observation of 3751 patient visits to 120 dental offices

    Directory of Open Access Journals (Sweden)

    Stephen Wotman


    Full Text Available Stephen Wotman1, Catherine A Demko1, Kristin Victoroff1, Joseph J Sudano2, James A Lalumandier11Department of Community Dentistry, Case Western Reserve University, School of Dental Medicine, Cleveland, OH, USA; 2Center of Health Care Research and Policy, Case Western Reserve University, School of Medicine, Cleveland, OH, USAAbstract: This report defines verbal interactions between practitioners and patients as core activities of dental practice. Trained teams spent four days in 120 Ohio dental practices observing 3751 patient encounters with dentists and hygienists. Direct observation of practice characteristics, procedures performed, and how procedure and nonprocedure time was utilized during patient visits was recorded using a modified Davis Observation Code that classified patient contact time into 24 behavioral categories. Dentist, hygienist, and patient characteristics were gathered by questionnaire. The most common nonprocedure behaviors observed for dentists were chatting, evaluation feedback, history taking, and answering patient questions. Hygienists added preventive counseling. We distinguish between preventive procedures and counseling in actual dental offices that are members of a practice-based research network. Almost a third of the dentist’s and half of the hygienist’s patient contact time is utilized for nonprocedure behaviors during patient encounters. These interactions may be linked to patient and practitioner satisfaction and effectiveness of self-care instruction.Keywords: dental practice, dental practice core activities, direct observation of dental practice, Dental Davis Observation Code, dentist, hygienist patient behaviors

  9. Update on quetiapine in the treatment of bipolar disorder: results from the BOLDER studies

    Directory of Open Access Journals (Sweden)

    Prashant Gajwani


    Full Text Available Prashant Gajwani1, David J Muzina2, David E Kemp3, Keming Gao1, Joseph R Calabrese11Case Western Reserve University (CWRU School of Medicine, 2Cleveland Clinic Lerner College of Medicine of CWRU, 3Case Western Reserve University, Cleveland OH, USAAbstract: The essential features of bipolar affective disorder involve the cyclical occurrence of high (manic or hypomanic episodes and low mood states. Depressive episodes in both bipolar I and II disorder are more numerous and last for longer duration than either manic or hypomanic episodes. In addition depressive episodes are associated with higher morbidity and mortality. While multiple agents, including all 5 atypical antipsychotics, have demonstrated efficacy and earned US FDA indication for manic phase of bipolar illness, the acute treatment of bipolar depression is less well-studied. The first treatment approved by the US FDA for acute bipolar depression was the combination of the atypical antipsychotic olanzapine and the antidepressant fluoxetine. Recently, quetiapine monotherapy has demonstrated efficacy in the treatment of depressive episodes associated with both bipolar I and II disorder and has earned US FDA indication for the same.Keywords: bipolar disorder, quetiapine, BOLDER studies

  10. Challenges for heart disease stem cell therapy

    Directory of Open Access Journals (Sweden)

    Hoover-Plow J


    Full Text Available Jane Hoover-Plow, Yanqing GongDepartments of Cardiovascular Medicine and Molecular Cardiology, Joseph J Jacobs Center for Thrombosis and Vascular Biology, Cleveland Clinic Lerner Research Institute, Cleveland, OH, USAAbstract: Cardiovascular diseases (CVDs are the leading cause of death worldwide. The use of stem cells to improve recovery of the injured heart after myocardial infarction (MI is an important emerging therapeutic strategy. However, recent reviews of clinical trials of stem cell therapy for MI and ischemic heart disease recovery report that less than half of the trials found only small improvements in cardiac function. In clinical trials, bone marrow, peripheral blood, or umbilical cord blood cells were used as the source of stem cells delivered by intracoronary infusion. Some trials administered only a stem cell mobilizing agent that recruits endogenous sources of stem cells. Important challenges to improve the effectiveness of stem cell therapy for CVD include: (1 improved identification, recruitment, and expansion of autologous stem cells; (2 identification of mobilizing and homing agents that increase recruitment; and (3 development of strategies to improve stem cell survival and engraftment of both endogenous and exogenous sources of stem cells. This review is an overview of stem cell therapy for CVD and discusses the challenges these three areas present for maximum optimization of the efficacy of stem cell therapy for heart disease, and new strategies in progress.Keywords: mobilization, expansion, homing, survival, engraftment

  11. A syllabus for fellowship education in palliative medicine. (United States)

    LeGrand, Susan B; Walsh, Declan; Nelson, Kristine A; Davis, Mellar P


    Recent years have seen significant growth in palliative medicine training programs and positions. There are plans to pursue palliative medicine specialty status with the American Board of Medical Specialties and accreditation of fellowship programs with the American College of Graduate Medical Education. A work group of program directors, supported initially by the Cleveland Clinic and then by the American Board of Hospice and Palliative Medicine, has recently published standards for fellowship training. Despite this, fundamental questions remain about defining the field and delineating the knowledge and skills expected following completion of specialty training. In this article, we describe the first fellowship program in palliative medicine (PMP) in the United States, developed and supported by the Cleveland Clinic Foundation. The program has been implemented as part of the Harry R. Horvitz Center for Palliative Medicine, founded in 1987 as the first comprehensive integrated US program in this field. This training program, in existence since 1989, features a traditional rotational structure with an inpatient primary care service, inpatient consult services, and an outpatient consult/hospice service. This article outlines the syllabus developed for this fellowship, given what we believe to be the essential knowledge base for the field of palliative medicine.

  12. Healing leadership: the serving leader's impact on patient outcomes in a clinical environment

    Directory of Open Access Journals (Sweden)

    Andenoro A


    Full Text Available Chris Nagel1, Anthony C Andenoro21Medical Operations – Continuous Improvement, Cleveland Clinic, Cleveland, OH; 2Department of Organizational Leadership, Gonzaga University, Spokane, WA, USAAbstract: The future of health care is a topic that has significant importance to patients and caregivers alike for generations to come. As the health care industry becomes more complex, leadership and the examination of how to most effectively apply it to meet efficiency standards and optimize the patient experience will become paramount. Through this paper the authors provide the foundation for meeting this need through an innovative and socially adept framework that identifies the critical character attributes of a serving leader and the powerful impact that serving leaders can have on patient outcomes in the health care setting. This framework is grounded in a leadership theoretical foundation and contextually examined through qualitative methods. As the business of health care becomes more complex and more competitive, finding ways to improve processes and create healing environments conducive to improved patient outcomes will differentiate average health care and excellent health care in the future. This paper provides the impetus for successfully addressing these needs through the development of serving leaders, and three specific characteristics: emotional care, presence, and awareness.Keywords: servant leadership, health care, patient outcomes

  13. Preventive treatment in migraine and the new US guidelines

    Directory of Open Access Journals (Sweden)

    Estemalik E


    Full Text Available E Estemalik, S TepperCleveland Clinic, Neurological Center for Pain, Cleveland, Ohio, USAAbstract: Migraine headaches are among the most common headache disorders seen in various practices. The prevalence of migraine headaches is 18% in women and 6% in men. While millions of Americans suffer from migraine headaches, roughly 3%–13% of identified migraine patients are on preventive therapy, while an estimated 38% actually need a preventive agent. The challenge among physicians is not only when to start a daily preventive agent but which preventive agent to choose. Circumstances warranting prevention have been described in the past, and in 2012, a new set of guidelines with an evidence review on preventive medications was published. A second set of guidelines provided evidence on nonsteroidal anti-inflammatory drugs, herbs, minerals, and vitamins for prevention of episodic migraine. This article describes the updated US guidelines for the prevention of migraines and also outlines the major studies from which these guidelines were derived.Keywords: US guidelines, Canadian guidelines, classification, preventive medication

  14. Prophylaxis of migraine: general principles and patient acceptance

    Directory of Open Access Journals (Sweden)

    Domenico D’Amico


    Full Text Available Domenico D’Amico1, Stewart J Tepper21Headache Center, Department of Neurological Sciences, C Besta Neurological Institute, Milan, Italy; 2Center for Headache and Pain, Neurological Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USAAbstract: Migraine is a chronic neurological condition with episodic exacerbations. Migraine is highly prevalent, and associated with significant pain, disability, and diminished quality of life. Migraine management is an important health care issue. Migraine management includes avoidance of trigger factors, lifestyle modifications, non-pharmacological therapies, and medications. Pharmacological treatment is traditionally divided into acute or symptomatic treatment, and preventive treatment or prophylaxis. Many migraine patients can be treated using only acute treatment. Patients with severe and/or frequent migraines require long-term preventive therapy. Prophylaxis requires daily administration of anti-migraine compounds with potential adverse events or contraindications, and may also interfere with other concurrent conditions and treatments. These problems may induce patients to reject the idea of a preventive treatment, leading to poor patient adherence. This paper reviews the main factors influencing patient acceptance of anti-migraine prophylaxis, providing practical suggestions to enhance patient willingness to accept pharmacological anti-migraine preventive therapy. We also provide information about the main clinical characteristics of migraine, and their negative consequences. The circumstances warranting prophylaxis in migraine patients as well as the main characteristics of the compounds currently used in migraine prophylaxis will also be briefly discussed, focusing on those aspects which can enhance patient acceptance and adherence.Keywords: migraine, prophylaxis, preventive therapy, acceptance, adherence

  15. Assessment and monitoring of patients receiving chemotherapy for multiple myeloma: strategies to improve outcomes

    Directory of Open Access Journals (Sweden)

    Faiman B


    Full Text Available Beth Faiman, Jason Valent Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA Abstract: Improved understanding as to the biology of multiple myeloma (MM and the bone marrow microenvironment has led to the development of new drugs to treat MM. This explosion of new and highly effective drugs has led to dramatic advances in the management of MM and underscores the need for supportive care. Impressive and deep response rates to chemotherapy, monoclonal antibodies, and small molecule drugs provide hope of a cure or prolonged remission for the majority of individuals. For most patients, long-term, continuous therapy is often required to suppress the malignant plasma cell clone, thus requiring clinicians to become more astute in assessment, monitoring, and intervention of side effects as well as monitoring response to therapy. Appropriate diagnosis and monitoring strategies are essential to ensure that patients receive the appropriate chemotherapy and supportive therapy at relapse, and that side effects are appropriately managed to allow for continued therapy and adherence to the regimen. Multiple drugs with complex regimens are currently available with varying side effect profiles. Knowledge of the drugs used to treat MM and the common adverse events will allow for preventative strategies to mitigate adverse events and prompt intervention. The purpose of this paper is to review updates in the diagnosis and management of MM, and to provide strategies for assessment and monitoring of patients receiving chemotherapy for MM. Keywords: multiple myeloma, treatment, symptoms, assessment, monitoring, symptom management, targeted therapies

  16. Biologics in the management of psoriasis

    Directory of Open Access Journals (Sweden)

    Jennifer D Bahner


    Full Text Available Jennifer D Bahner1, Lauren Y Cao2, Neil J Korman11Department of Dermatology, University Hospitals Case Medical Center, Cleveland, Ohio, USA; 2Case Western Reserve University School of Medicine, Cleveland, Ohio, USAAbstract: Psoriasis is a chronic inflammatory systemic disease for which there exist topical, ultraviolet, systemic, and biologic treatments. Biologic agents selectively interfere with the immune mechanisms responsible for psoriasis. Etanercept, infliximab, and adalimumab target tumor necrosis factor-alpha and have demonstrated efficacy in the treatment of psoriasis and psoriatic arthritis. Alefacept and efalizumab target T lymphocytes, are effective in the treatment of psoriasis, but are not approved for psoriatic arthritis. Finally, ustekinumab and ABT-874 target interleukin-12 and interleukin-23, and they have demonstrated efficacy in the treatment of psoriasis. The objective of this review is to present efficacy and safety data from randomized controlled trials of the biologic agents in the treatment of psoriasis.Keywords: biologics, psoriasis, tumor necrosis factor, interleukin-12/23

  17. Metastatic clear cell carcinoma of the kidney: therapeutic role of bevacizumab

    Directory of Open Access Journals (Sweden)

    Ronald M Bukowski


    Full Text Available Ronald M BukowskiCleveland Clinic Taussig Cancer Center, CCF Lerner College of Medicine of CWRU Cleveland, OH, USAAbstract: The biology and pathogenesis of clear cell carcinoma of the kidney has been extensively investgated, and the role of von Hipple-Landau gene inactivation and tumor associated angiogenesis is now recognized. Development of vascular endothelial growth factor inhibitors and phase 3 clinical trials utilizing this class of agents has produced a new treatment paradigm for patients with metastatic renal cell carcinoma (RCC. One of the active regimens identified is the combination of bevacizumab and interferon-α. Recently published reports provided evidence of the clinical and biologic activity of this therapy. The current manuscript reviews the background and rationale for the activity of bevacizumab in RCC, and results from recent clinical trials with this agent alone or in combination with targeted agents or cytokines. The role of this therapy in contrast to other targeted agents is reviewed, and the potential utility as well as questions raised by recent studies are discussed.Keywords: metastatic renal cell carcinoma, bevacizumab, interferon-α

  18. State-of-the-art sports facility's HVAC

    Energy Technology Data Exchange (ETDEWEB)

    Horton, M.K. (Gateway Sports Complex, Cleveland, OH (United States))


    This article describes the HVAC systems design to keep Cleveland's new Gateway sports and entertainment complex comfortable. This magnificent new facility embraces the 42,000-seat Jacobs Field, with its natural grass playing surface, and the 21,000-seat Arena at Gateway (the official name will be announced at its August 1 opening). The Arena is the new home of the Cleveland Cavaliers NBA basketball team and the Lumberjacks IHL ice hockey team. Other events that will be held here include arena football, circuses, ice shows, and concerts. It is anticipated that the Arena will be in use in excess of 200 days a year for these and other functions. The ballpark and the arena are separated by Gateway Plaza, a large illuminated public space that also will be the site of various entertainment events. An air conditioned pedestrian bridge, approximately 0.7 miles in length, connects the Arena with the Regional Transit Authority's downtown rapid transit station. Other enclosed walkways connect the Arena with two parking garages (3,158 vehicles total) and the larger garage with Jacobs Field.

  19. Potential role of gabapentin and extended- release gabapentin in the management of menopausal hot flashes

    Directory of Open Access Journals (Sweden)

    Yadav M


    Full Text Available Manisha Yadav, Judith Volkar Center for Specialized Women’s Health, Cleveland Clinic Foundation, Cleveland, Ohio, USA Abstract: About 80% of postmenopausal women experience vasomotor symptoms, such as hot flashes and night sweats – symptoms that are associated with sleep disruption and can lead to fatigue and mood changes. Moreover, hot flashes can be embarrassing for women, causing difficulties at work and in their social lives. Many therapies have been advocated for relief of vasomotor symptoms, but only hormone therapy has been US Food and Drug Administration approved. However, after the Women's Health Initiative Study suggested that there was a correlation between hormone therapy and increased risk for breast cancer and cardiovascular events, many women stopped taking hormone therapy, and many do not want to initiate it. Hormone therapy is also contraindicated in certain women, such as those with a history of hormone-stimulated cancer like breast and uterine cancer. Gabapentin (Neurontin has shown efficacy in relieving vasomotor symptoms and is used as off-label for this indication. A new extended-release formulation of gabapentin has also shown efficacy in treating hot flashes and improving sleep quality with possibly fewer side effects than regular gabapentin. Keywords: Hot flushes, vasomotor symptoms, postmenopausal, hormone-sensitive cancer, non-hormonal therapy, gastric-retentive, Breeze

  20. Transitions of care in anticoagulated patients

    Directory of Open Access Journals (Sweden)

    Michota F


    Full Text Available Franklin Michota Department of Hospital Medicine, Cleveland Clinic, Cleveland, OH, USA Abstract: Anticoagulation is an effective therapeutic means of reducing thrombotic risk in patients with various conditions, including atrial fibrillation, mechanical heart valves, and major surgery. By its nature, anticoagulation increases the risk of bleeding; this risk is particularly high during transitions of care. Established anticoagulants are not ideal, due to requirements for parenteral administration, narrow therapeutic indices, and/or a need for frequent therapeutic monitoring. The development of effective oral anticoagulants that are administered as a fixed dose, have low potential for drug-drug and drug-food interactions, do not require regular anticoagulation monitoring, and are suitable for both inpatient and outpatient use is to be welcomed. Three new oral anticoagulants, the direct thrombin inhibitor, dabigatran etexilate, and the factor Xa inhibitors, rivaroxaban and apixaban, have been approved in the US for reducing the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation; rivaroxaban is also approved for prophylaxis and treatment of deep vein thrombosis, which may lead to pulmonary embolism in patients undergoing knee or hip replacement surgery. This review examines current options for anticoagulant therapy, with a focus on maintaining efficacy and safety during transitions of care. The characteristics of dabigatran etexilate, rivaroxaban, and apixaban are discussed in the context of traditional anticoagulant therapy. Keywords: hemorrhagic events, oral anticoagulation, parenteral anticoagulation, stroke, transitions of care

  1. Critical appraisal of laropiprant and extended-release niacin combination in the management of mixed dyslipidemias and primary hypercholesterolemia

    Directory of Open Access Journals (Sweden)

    Ayman A Hussein


    Full Text Available Ayman A Hussein, Stephen J NichollsCardiovascular Medicine Department, Cleveland Clinic Foundation, Cleveland, OH, USAAbstract: Niacin is a B-complex vitamin which has been used for decades for the management of mixed dyslipidemias and primary hypercholesterolemia. It decreases the risk of cardiovascular events either when used as a monotherapy or in combination with other lipid lowering medications. However, a major limitation to its use is niacin-induced flushing occurring even with the extended-release formulations. Laropiprant, a selective prostaglandin-2 receptor inhibitor, specifically targets the cascade of events causing the flushing. It has been recently used in combination with extended-release niacin. This article will review the early experience with this combination with focus on efficacy, safety, tolerability and current place in therapy. Early data are promising and suggest that more patients in clinical practice will benefit from niacin combined with laropiprant. Ongoing clinical trials will provide a better insight on the long-term safety of the drug and its efficacy for reducing cardiovascular events.Keywords: niacin, laropiprant, dyslipidemias, hypercholesterolemia

  2. Anorectal function and outcomes after transanal minimally invasive surgery for rectal tumors

    Directory of Open Access Journals (Sweden)

    Feza Y Karakayali


    Full Text Available Background: Transanal endoscopic microsurgery is a minimally invasive technique that allows full-thickness resection and suture closure of the defect for large rectal adenomas, selected low-risk rectal cancers, or small cancers in patients who have a high risk for major surgery. Our aim, in the given prospective study was to report our initial clinical experience with TAMIS, and to evaluate its effects on postoperative anorectal functions. Materials and Methods: In 10 patients treated with TAMIS for benign and malignant rectal tumors, preoperative and postoperative anorectal function was evaluated with anorectal manometry and Cleveland Clinic Incontinence Score. Results: The mean distance of the tumors from the anal verge was 5.6 cm, and mean tumor diameter was 2.6 cm. All resection margins were tumor free. There was no difference in preoperative and 3-week postoperative anorectalmanometry findings; only mean minimum rectal sensory volume was lower at 3 weeks after surgery. The Cleveland Clinic Incontinence Score was normal in all patients except one which resolved by 6 weeks after surgery.The mean postoperative follow-up was 28 weeks without any recurrences. Conclusion: Transanal minimally invasive surgery is a safe and effective procedure for treatment of rectal tumors and can be performed without impairing anorectal functions.

  3. Integrating clinical medicine into biomedical graduate education to promote translational research: strategies from two new PhD programs. (United States)

    Smith, Carolyn L; Jarrett, Marcia; Bierer, S Beth


    For several decades, a barrier has existed between research and clinical medicine, making it difficult for aspiring scientists to gain exposure to human pathophysiology and access to clinical/translational research mentors during their graduate training. In 2005, the Howard Hughes Medical Institute announced the Med Into Grad initiative to support graduate programs that integrate clinical knowledge into PhD biomedical training, with the goal of preparing a new cadre of translational researchers to work at the interface of the basic sciences and clinical medicine. Two institutions, Baylor College of Medicine and the Cleveland Clinic/Case Western Reserve University, developed new PhD programs in translational biology and/or molecular medicine. These programs teach the topics and skills that today's translational researchers must learn and expose students to clinical medicine. In this article, the authors compare and contrast the history, implementation, and evaluation of the Translational Biology and Molecular Medicine program at Baylor College of Medicine and the Molecular Medicine program at the Cleveland Clinic/Case Western Reserve University. The authors also demonstrate the feasibility of creating a multidisciplinary graduate program in molecular medicine that integrates pathophysiology and clinical medicine without extending training time. They conclude with a discussion of the similarities in training approaches that exist despite the fact that each program was independently developed and offer observations that emerged during their collaboration that may benefit others who are considering developing similar programs.

  4. Historical and Critical Review on Biophysical Economics (United States)

    Adigüzel, Yekbun


    Biophysical economics is initiated with the long history of the relation of economics with ecological basis and biophysical perspectives of the physiocrats. It inherently has social, economic, biological, environmental, natural, physical, and scientific grounds. Biological entities in economy like the resources, consumers, populations, and parts of production systems, etc. could all be dealt by biophysical economics. Considering this wide scope, current work is a “biophysical economics at a glance” rather than a comprehensive review of the full range of topics that may just be adequately covered in a book-length work. However, the sense of its wide range of applications is aimed to be provided to the reader in this work. Here, modern approaches and biophysical growth theory are presented after the long history and an overview of the concepts in biophysical economics. Examples of the recent studies are provided at the end with discussions. This review is also related to the work by Cleveland, “Biophysical Economics: From Physiocracy to Ecological Economics and Industrial Ecology” [C. J. Cleveland, in Advances in Bioeconomics and Sustainability: Essay in Honor of Nicholas Gerogescu-Roegen, eds. J. Gowdy and K. Mayumi (Edward Elgar Publishing, Cheltenham, England, 1999), pp. 125-154.]. Relevant parts include critics and comments on the presented concepts in a parallelized fashion with the Cleveland’s work.

  5. Lightweight Aggregate Made from Dredged Material in Green Roof Construction for Stormwater Management

    Directory of Open Access Journals (Sweden)

    Rui Liu


    Full Text Available More than 1.15 million cubic meters (1.5 million cubic yards of sediment require annual removal from harbors and ports along Ohio’s Lake Erie coast. Disposing of these materials into landfills depletes land resources, while open water placement of these materials deteriorates water quality. There are more than 14,000 acres of revitalizing brownfields in Cleveland, U.S., many containing up to 90% impervious surface, which does not allow “infiltration” based stormwater practices required by contemporary site-based stormwater regulation. This study investigates the potential of sintering the dredged material from the Harbor of Cleveland in Lake Erie to produce lightweight aggregate (LWA, and apply the LWA to green roof construction. Chemical and thermal analyses revealed the sintered material can serve for LWA production when preheated at 550 °C and sintered at a higher temperature. Through dewatering, drying, sieving, pellet making, preheating, and sintering with varying temperatures (900–1100 °C, LWAs with porous microstructures are produced with specific gravities ranging from 1.46 to 1.74, and water absorption capacities ranging from 11% to 23%. The water absorption capacity of the aggregate decreases as sintering temperature increases. The LWA was incorporated into the growing media of a green roof plot, which has higher water retention capacity than the conventional green roof system.

  6. Deairing Techniques for Double-Ended Centrifugal Total Artificial Heart Implantation. (United States)

    Karimov, Jamshid H; Horvath, David J; Byram, Nicole; Sunagawa, Gengo; Grady, Patrick; Sinkewich, Martin; Moazami, Nader; Sale, Shiva; Golding, Leonard A R; Fukamachi, Kiyotaka


    The unique device architecture of the Cleveland Clinic continuous-flow total artificial heart (CFTAH) requires dedicated and specific air-removal techniques during device implantation in vivo. These procedures comprise special surgical techniques and intraoperative manipulations, as well as engineering design changes and optimizations to the device itself. The current study evaluated the optimal air-removal techniques during the Cleveland Clinic double-ended centrifugal CFTAH in vivo implants (n = 17). Techniques and pump design iterations consisted of developing a priming method for the device and the use of built-in deairing ports in the early cases (n = 5). In the remaining cases (n = 12), deairing ports were not used. Dedicated air-removal ports were not considered an essential design requirement, and such ports may represent an additional risk for pump thrombosis. Careful passive deairing was found to be an effective measure with a centrifugal pump of this design. In this report, the techniques and design changes that were made during this CFTAH development program to enable effective residual air removal and prevention of air embolism during in vivo device implantation are explained.

  7. La “nueva” Doctrina Monroe de 1895 y sus implicaciones para el Caribe español: algunas interpretaciones coetáneas españolas

    Directory of Open Access Journals (Sweden)

    Hilton, Sylvia L.


    Full Text Available Not available.

    El análisis de una selección de periódicos españoles de diversas ideologías políticas demuestra que la mayoría de los comentaristas relacionaban la política de Cleveland en la disputa anglo-venezolana en 1895 con la de McKinley en la crisis colonial española de 1895-1898, interpretando ambas intervenciones como una función de la Doctrina Monroe. Sin embargo, al contrario que el presidente Cleveland, McKinley no apeló a esta Doctrina como justificación de su política exterior iberoamericana o de su actitud ante la guerra hispano- cubana, por lo que se interpreta que las referencias a ella en el discurso periodístico peninsular de estos años obedecen a móviles más relacionados con los resortes y objetivos de la propia retórica periodística, dentro del contexto de la política española, tanto doméstica y colonial como internacional. Esto explica las contradicciones y diferencias interpretativas en torno a la Doctrina Monroe que se reflejan en la prensa española.

  8. Abatacept in the treatment of polyarticular JIA: development, clinical utility, and place in therapy

    Directory of Open Access Journals (Sweden)

    Ofra Goldzweig


    Full Text Available Ofra Goldzweig1, Philip J Hashkes2,31Rainbow Babies and Children's Hospital, Cleveland, OH, USA; 2Pediatric Rheumatology Unit, Shaare Zedek Medical Center, Jerusalem, Israel; 3Cleveland Clinic Lerner Medical School of Case Western Reserve University, Cleveland, OH, USAAbstract: Juvenile idiopathic arthritis (JIA is a group of chronic arthritides affecting children. The polyarthritis category, affecting five or more joints in the first six months, tends to be more aggressive, leading to a destructive joint disease with significant morbidity, disability, and costs to society. The current treatment regimen, which primarily combines methotrexate and tumor necrosis factor alpha (TNF-α blockade, still leaves a significant group of patients with an inadequate response. Therefore, the development of new medications that act via other mechanisms of pathogenesis is necessary. T cell lymphocytes are key components in the immune reaction in JIA. Cytotoxic lymphocyte-associated antigen-4 (CTLA-4 is a potent inhibitor of the costimulation pathway necessary to activate T cells. Abatacept is a recombinant fusion protein comprising the extracellular part of human CTLA-4 connected to a modified Fc part of IgG-1. In a randomized, multinational, blinded withdrawal study in children with polyarticular JIA, abatacept was found to be effective in about 70% of the patients, including 39% of TNF-α blockade failures, with significantly fewer flares occurring during the withdrawal phase than in patients receiving placebo. Abatacept continued to show good efficacy in a three-year open-label extension study, with a beneficial effect on health-related quality of life. The safety profile of abatacept is generally good. In 2008, the US Food and Drug Administration approved abatacept for use in children over six years of age with JIA and a polyarticular course. In 2010, the European Medicines Agency gave approval for abatacept to be used in combination with methotrexate for

  9. Multi-objective decision-making under uncertainty: Fuzzy logic methods (United States)

    Hardy, Terry L.


    Fuzzy logic allows for quantitative representation of vague or fuzzy objectives, and therefore is well-suited for multi-objective decision-making. This paper presents methods employing fuzzy logic concepts to assist in the decision-making process. In addition, this paper describes software developed at NASA Lewis Research Center for assisting in the decision-making process. Two diverse examples are used to illustrate the use of fuzzy logic in choosing an alternative among many options and objectives. One example is the selection of a lunar lander ascent propulsion system, and the other example is the selection of an aeration system for improving the water quality of the Cuyahoga River in Cleveland, Ohio. The fuzzy logic techniques provided here are powerful tools which complement existing approaches, and therefore should be considered in future decision-making activities.

  10. 肠造口治疗的全球化发展概况%Enterostomal therapy nursing world wide

    Institute of Scientific and Technical Information of China (English)

    Patricia Blackley


    @@ 造口治疗(enterostomal therapy, ET)是基于患者、家属、专业医护人员以及社会大众对健康护理的不断需求而发展起来的.1958年美国医生 Turnbull和他的一个回肠造口患者 Norma N. Gill在克里夫兰医学中心(Cleveland Clinic)开始了造口治疗护理的临床实践,并于1961年在该中心设立了正式的造口治疗教育项目,使其成为一门专业的医学护理学科,这是现代造口治疗护理的起源.

  11. Astronomy in the Digital Universe (United States)

    Haisch, Bernard M.; Lindblom, J.; Terzian, Y.


    The Digital Universe is an Internet project whose mission is to provide free, accurate, unbiased information covering all aspects of human knowledge, and to inspire humans to learn, make use of, and expand this knowledge. It is planned to be a decades long effort, inspired by the Encyclopedia Galactica concept popularized by Carl Sagan, and is being developed by the non-profit Digital Universe Foundation. A worldwide network of experts is responsible for selecting content featured within the Digital Universe. The first publicly available content is the Encyclopedia of Earth, a Boston University project headed by Prof. Cutler Cleveland, which will be part of the Earth Portal. The second major content area will be an analogous Encyclopedia of the Cosmos to be part of the Cosmos Portal. It is anticipated that this will evolve into a major resource for astronomy education. Authors and topic editors are now being recruited for the Encyclopedia of the Cosmos.

  12. Thermal Analysis of Cryogenic Hydrogen Liquid Separator (United States)

    Congiardo, Jared F.; Fortier, Craig R. (Editor)


    During launch for the new Space Launch System (SLS) liquid hydrogen is bleed through the engines during replenish, pre-press, and extended pre-press to condition the engines prior to launch. The predicted bleed flow rates are larger than for the shuttle program. A consequence of the increased flow rates is having liquif hydrogen in the vent system, which the facilities was never designed to handle. To remedy the problem a liquid separator is being designed in the system to accumulated the liquid propellant and protect the facility flare stack (which can only handle gas). The attached document is a presentation of the current thermalfluid analysis performed for the separator and will be presented at the Thermal and Fluid Analysis Workshop (NASA workshop) next week in Cleveland, Ohio.

  13. Technology Assessment of Doe's 55-we Stirling Technology Demonstrator Convector (TDC) (United States)

    Furlong, Richard; Shaltens, Richard


    The Department of Energy (DOE), Germantown, Maryland and the NASA Glenn Research Center (GRC), Cleveland, Ohio are developing a Stirling Convertor for an advanced radioisotope power system as a potential power source for spacecraft on-board electric power for NASA deep space science missions. The Stirling Convertor is being evaluated as an alternative high efficiency power source to replace Radioisotope Thermoelectric Generators (RTGs). Stirling Technology Company (STC), Kennewick, Washington, is developing the highly efficient, long life 55-We free-piston Stirling Convertor known as the Technology Demonstrator Convertor (TDC) under contract to DOE. GRC provides Stirling technology expertise under a Space Act Agreement with the DOE. Lockheed Martin Astronautics (LMA), Valley Forge, Pennsylvania is the current power system integrator for the Advanced Radioisotope Power System (ARPS) Project for the DOE. JPL is responsible for the Outer Planets/Solar Probe Project for NASA.

  14. The business of palliative medicine - part 5: service utilization in a comprehensive integrated program. (United States)

    Estfan, Bassam; Davis, Mellar P; Walsh, Declan; Heintz, Jessica; Shaheen, Philip E; Cheema, Bushra; LeGrand, Susan B; Lagman, Ruth L


    The aim of palliative medicine is to provide multidisciplinary comprehensive care in advanced illness. Patient and family utilization of various product service lines offered by the Harry R Horvitz Center for Palliative Medicine at the Cleveland Clinic Foundation was studied. Newly referred patients were followed up prospectively until 85% had either died or been lost to follow-up. Demographic, clinical, and referral data were recorded; subsequent product service line utilization was updated daily. The total study period was 171 days, and 238 patients entered. Acute care inpatient unit, outpatient clinic visits, and 24-hour phone contacts were the most frequently used product service lines. Patients had a median of 3 contacts (range, 1 to 27) with individual service lines. Multiple palliative medicine product service lines were utilized often, with repeated use of the individual service lines. A comprehensive integrated palliative medicine program is necessary to fully meet the complex needs of those with advanced disease.

  15. Acute inpatient palliative medicine in a cancer center: clinical problems and medical interventions--a prospective study. (United States)

    Lagman, Ruth; Rivera, Nilo; Walsh, Declan; LeGrand, Susan; Davis, Mellar P


    The clinical characteristics and medical interventions of the 100 consecutive cancer admissions to the acute care inpatient palliative medicine unit at the Cleveland Clinic for 2 months are described. Median age was 62 years (range, 31 to 92 years). The male-female ratio was 1:1. Most admissions were referred by hematology-oncology and had prior antineoplastic therapy. Reasons for admission were symptom control and cancer-related complications. Patients underwent invasive diagnostic and therapeutic procedures, hydration, transfusions, radiation, or chemotherapy, or a combination, during their admission. Most were discharged home with hospice care or had outpatient clinic follow-up. The mortality rate was 20%. Aggressive multidisciplinary management of symptoms, disease complications, comorbid conditions, and psychosocial problems were provided. Palliative medicine physicians provided continuity of care in the outpatient clinic and at home. An acute inpatient palliative medicine unit within a tertiary level medical center has a definable and important role in comprehensive cancer care.

  16. The financial benefits of acute inpatient palliative medicine: an inter-institutional comparative analysis by all patient refined-diagnosis related group and case mix index. (United States)

    Davis, Mellar P; Walsh, Declan; LeGrand, Susan B; Lagman, Ruth L; Harrison, Betty; Rybicki, Lisa


    Financial comparisons of acute care hospital services are possible using the Centers for Medicare & Medicaid Services case mix index (CMI) and All Patient Refined-Diagnosis Related Group (APR-DRG) data. We compared The Cleveland Clinic's Inpatient Palliative Medicine (CCIPM) acute care unit's CMI and APR-DRG data with national and peer institution data. Total mean charges per admission to the CCIPM unit were 7,800 dollars lower than at other peer institutions despite an equivalent severity of illness and longer length of stay and higher mortality in the CCIPM unit. The lower charges were due primarily to lower laboratory and pharmaceutical charges. We conclude that an acute inpatient palliative medicine unit operating within a comprehensive integrated palliative medicine program is cost-effective in providing specialized care for people with advanced disease.

  17. Forensic Evidence in Homicide Investigations and Prosecutions. (United States)

    McEwen, Tom; Regoeczi, Wendy


    Even though forensic evidence is collected at virtually every homicide scene, only a few studies have examined its role in investigation and prosecution. This article adds to the literature by providing the results of a study of 294 homicide cases (315 victims) occurring in Cleveland, Ohio, between 2008 and 2011. Through a logistic regression on open versus closed cases, the collection of knives, administration of gunshot residue (GSR) kits, and clothing at the scene were positively and significantly related to case closures, while collection of ballistics evidence and DNA evidence were statistically significant in the opposite direction. With regard to analysis, the clearance rate for cases with probative results (i.e., matches or exclusions) was 63.1% compared to a closure rate of 56.3% for cases without probative results. However, only 23 cases had probative results prior to arrest compared to 128 cases with probative results after arrest.

  18. 袋里乾坤

    Institute of Scientific and Technical Information of China (English)


    年轻的英国球员大卫·豪威尔(David Howell)在HSBC汇丰冠军赛上打败老虎后,一下子成为世界高尔夫的焦点。现在,这位冠军中的冠军,就向球迷们介绍陪他征战世界的伙伴们。1号木杆我的1号木杆是Cleveland Launcher COMP,杆面角度9.5°。它兼具石墨的轻盈和金属钛的力度,这样的设计使击

  19. Small Engine Technology (SET) Task 24 Business and Regional Aircraft System Studies (United States)

    Lieber, Lysbeth


    This final report has been prepared by Honeywell Engines & Systems, Phoenix, Arizona, a unit of Honeywell International Inc., documenting work performed during the period June 1999 through December 1999 for the National Aeronautics and Space Administration (NASA) Glenn Research Center, Cleveland, Ohio, under the Small Engine Technology (SET) Program, Contract No. NAS3-27483, Task Order 24, Business and Regional Aircraft System Studies. The work performed under SET Task 24 consisted of evaluating the noise reduction benefits compared to the baseline noise levels of representative 1992 technology aircraft, obtained by applying different combinations of noise reduction technologies to five business and regional aircraft configurations. This report focuses on the selection of the aircraft configurations and noise reduction technologies, the prediction of noise levels for those aircraft, and the comparison of the noise levels with those of the baseline aircraft.

  20. Going to the fare (Rapid transit)

    Energy Technology Data Exchange (ETDEWEB)

    Myers, E.T.


    A survey of rider responses to fare increases revealed that a fare increase will generally result in a ridership loss on mass transit systems, while commuter train ridership may rise under the same increase. This is because the suburban commuter very often depends more on such transportation than the urban rider does, as the latter can sometimes walk to his destination, especially if the fare becomes prohibitive. Different approaches to setting urban transit fares and commuter fares and the effect of increasing or decreasing fares on ridership are explored for Philadelphia's SEPTA lines, San Francisco's BART, Chicago's CTA and North Western commuter lines, Boston's MBTA, Cleveland's Regional Transit Authority, and the New York-New Jersey Port Authority's Lindenwold line. (1 graph, 2 photos)

  1. Baseline and verification tests of the electric vehicle associates' current fare station wagon. Final test report, March 27, 1980-November 6, 1981

    Energy Technology Data Exchange (ETDEWEB)

    Dowgiallo, E.J. Jr.; Chapman, R.D.


    The EVA Current Fare Wagon was manufactured by Electric Vehicle Associates, Incorporated (EVA) of Cleveland, Ohio. It is now available from Lectra Motors Corp. of Las Vegas, Nevada. The vehicle was tested under the direction of MERADCOM from 27 March 1980 to 6 November 1981. The tests are part of a Department of Energy project to assess advances in electric vehicle design. This report presents the performance test results on the EVA Current Fare Wagon. The EVA Current Fare Wagon is a 1980 Ford Fairmont station wagon which has been converted to an electric vehicle. The propulsion system is made up of a Cableform controller, a series-wound 30-hp Reliance Electric Motor, and 22 6-V lead-acid batteries. The Current Fare Wagon is also equipped with regenerative braking. Further details of the vehicle are given in the Vehicle Summary Data Sheet, Appendix A. The results of this testing are given in Table 1.

  2. First NASA Workshop on Wiring for Space Applications (United States)

    Hammond, Ahmad (Compiler); Stavnes, Mark W. (Compiler)


    This document contains the proceedings of the First NASA Workshop on Wiring for Space Applications held at NASA Lewis Research Center in Cleveland, OH, July 23-24, 1991. The workshop was sponsored by NASA Headquarters Code QE Office of Safety and Mission Quality, Technical Standards Division and hosted by the NASA Lewis Research Center, Power Technology Division, Electrical Components and Systems Branch. The workshop addressed key technology issues in the field of electrical power wiring for space applications. Speakers from government, industry and academia presented and discussed topics on arc tracking phenomena, wiring applications and requirements, and new candidate insulation materials and constructions. Presentation materials provided by the various speakers are included in this document.

  3. Aeronautical Mobile Airport Communications System (AeroMACS) (United States)

    Budinger, James M.; Hall, Edward


    To help increase the capacity and efficiency of the nation s airports, a secure wideband wireless communications system is proposed for use on the airport surface. This paper provides an overview of the research and development process for the Aeronautical Mobile Airport Communications System (AeroMACS). AeroMACS is based on a specific commercial profile of the Institute of Electrical and Electronics Engineers (IEEE) 802.16 standard known as Wireless Worldwide Interoperability for Microwave Access or WiMAX (WiMax Forum). The paper includes background on the need for global interoperability in air/ground data communications, describes potential AeroMACS applications, addresses allocated frequency spectrum constraints, summarizes the international standardization process, and provides findings and recommendations from the world s first AeroMACS prototype implemented in Cleveland, Ohio, USA.

  4. Teaching nurses to focus on the health needs of populations: a Master's Degree Program in Population Health Nursing. (United States)

    Frisch, Noreen Cavan; George, Valerie; Govoni, Amy L; Jennings-Sanders, Andrea; McCahon, Cheryl P


    Responding to the mandate to prepare nurses for practice in population-based healthcare, the faculty at Cleveland State University (CSU) developed a unique Master of Science in Nursing program to prepare Population Health Nurse Experts. The program prepares nurses to examine the health status of populations and to design, implement, and evaluate nursing interventions accounting for the varied factors impacting on the health of a defined group. The speciality of population health nursing is practiced by nurses who can use population sciences (epidemiology, demography, population projections, and population behavioral theories) along with post-baccalaureate nursing competencies to work with defined populations across care environments. The authors discuss a curriculum that prepares nurses for this emerging speciality.

  5. How Far Would a Home Run Really Have Gone? (United States)

    Sherwin, W. G.; Cheng, Y. C.; Chunko, J. D.; Eagan, T. P.; Brown, R. W.


    A controversial issue in professional baseball arises from attempts to estimate how far home run balls would have traveled if they had not hit some obstruction, such as a scoreboard or bleacher seating. A Runge-Kutta numerical simulation model is developed for baseball trajectories including the effects of velocity-dependent drag forces, velocity-dependent Magnus spin forces (including a model for the decrease of the spin rate over the trajectory), and the wind. The computational model is used to build a numerical catalog for the combination of initial ball speeds and angles that give rise to a set of trajectories that have the same final impact point (e.g., on the scoreboard). The data required by an observer to estimate the actual home run range are discussed. A homerun hit by Mark McGwire against the Cleveland Indians on 30 April 1997 that dented the Jacobs Field scoreboard is analyzed.

  6. The all-new 2. 5 V6-24 valve engine from Ford. Pt. 1. Der neue DOHC-24-Ventil-V6-Motor mit 2,5 l Hubraum fuer den Ford Mondeo. T. 1

    Energy Technology Data Exchange (ETDEWEB)

    Menne, R.J.; Coventry, B.D.; Rechs, M.; Klauke, J.

    The 2.5 V6 is an all-new aluminium engine, produced in Cleveland in the USA. It supplements the range of 4-valve gasoline engines for Ford's worldcar, the Mondeo in Europe and the Contour/Mystique in the US. Ford did not compromise on the basic layout of the engine, it features for example a 60 degree cylinder bank angle for optimum balancing and port-deactivation, which allows excellent 4-valve performance and at the same time demonstrates superior low end torque. Friction reduction was an important design objective train. Emphasis was also put on the reduction of noise, vibration and harshness (NVH) of the powertrain as a whole. The result is an extremely compact and light powertrain, most suitable for its application in front wheel driven cars. This article describes in some detail the concept of the engine and its important design features. (orig./HW)

  7. Visualizing and evaluating the growth of multi-institutional collaboration based on research network analysis. (United States)

    Luo, Jake; Pelfrey, Clara; Zhang, Guo-Qiang


    Research collaboration plays an important role in scientific productivity and academic innovation. Multi-institutional collaboration has become a vital approach for integrating multidisciplinary resources and expertise to enhance biomedical research. There is an increasing need for analyzing the effect of multi-institutional research collaboration. In this paper, we present a collaboration analysis pipeline based on research networks constructed from publication co-authorship relationship. Such research networks can be effectively used to render and analyze large-scale institutional collaboration. The co-authorship networks of the Cleveland Clinical and Translational Science Collaborative (CTSC) were visualized and analyzed. SciVal Expert™ was used to extract publication data of the CTSC members. The network was presented in informative and aesthetically appealing diagrams using the open source visualization package Gephi. The analytic result demonstrates the effectiveness of our approach, and it also indicates the substantial growth of research collaboration among the CTSC members crossing its partner institutions.

  8. InterWell: an integrated school-based primary care model. (United States)

    Whitehouse, Peter J


    The Intergenerational School is an innovative, high-performing public school in Cleveland, Ohio that fosters lifelong learning and individual and community health. Narrative approaches, information technology enhancements, art and music enrichments, and nature-based programming foster brain health in the service of purposeful and healthy living in the community. A newly designed integrated primary and public healthcare model, called InterWell, which is planned to be based in the school, has the potential to transform conceptions and practices of health. Interprofessional care supporting chronic disease self-management and transdisciplinary research are foundational to our model. Over the 13-year history of the school, barriers to acceptance of this model of education and health have been reduced and greater community support engendered, but challenges of priorities and funding remain. Can this new model help support human flourishing in this time of global ecological and social disruption?

  9. Air Breathing Propulsion Controls and Diagnostics Research at NASA Glenn Under NASA Aeronautics Research Mission Programs (United States)

    Garg, Sanjay


    The Intelligent Control and Autonomy Branch (ICA) at NASA (National Aeronautics and Space Administration) Glenn Research Center (GRC) in Cleveland, Ohio, is leading and participating in various projects in partnership with other organizations within GRC and across NASA, the U.S. aerospace industry, and academia to develop advanced controls and health management technologies that will help meet the goals of the NASA Aeronautics Research Mission Directorate (ARMD) Programs. These efforts are primarily under the various projects under the Advanced Air Vehicles Program (AAVP), Airspace Operations and Safety Program (AOSP) and Transformative Aeronautics Concepts Program (TAC). The ICA Branch is focused on advancing the state-of-the-art of aero-engine control and diagnostics technologies to help improve aviation safety, increase efficiency, and enable operation with reduced emissions. This paper describes the various ICA research efforts under the NASA Aeronautics Research Mission Programs with a summary of motivation, background, technical approach, and recent accomplishments for each of the research tasks.

  10. Doreen Norton OBE, MSc, SRN, FRCN (1922-2007): Pioneer who revolutionised pressure sore management and geriatric nursing to international acclaim. (United States)

    Denham, Michael J


    Doreen Norton was a delightful, widely respected nurse who devoted her life to improving the care of elderly people. She researched the neglected problem of pressure sores, revolutionised their nursing care, and thus achieved international fame. Her Pressure Sore Scale was established as a management tool and is still used today. She was a key member of the design team that produced the 'King's Fund Bed', researched equipment required on geriatric wards, assessed all geriatric long stay units in Scotland and established research as a valuable nursing tool within her profession and health authorities. She lectured extensively and her publications attracted worldwide acclamation. After her retirement, she was subsequently appointed to the world's first Chair of Gerontological Nursing in Cleveland, Ohio.

  11. Impact of a new condensed toluene mechanism on air quality model predictions in the US

    Directory of Open Access Journals (Sweden)

    G. Sarwar


    Full Text Available A new condensed toluene mechanism is incorporated into the Community Multiscale Air Quality Modeling system. Model simulations are performed using the CB05 chemical mechanism containing the existing (base and the new toluene mechanism for the western and eastern US for a summer month. With current estimates of tropospheric emission burden, the new toluene mechanism increases monthly mean daily maximum 8-h ozone by 1.0–3.0 ppbv in Los Angeles, Portland, Seattle, Chicago, Cleveland, northeastern US, and Detroit compared to that with the base toluene chemistry. It reduces model mean bias for ozone at elevated observed ozone mixing ratios. While the new mechanism increases predicted ozone, it does not enhance ozone production efficiency. Sensitivity study suggests that it can further enhance ozone if elevated toluene emissions are present. While changes in total fine particulate mass are small, predictions of in-cloud SOA increase substantially.

  12. Impact of a new condensed toluene mechanism on air quality model predictions in the US

    Directory of Open Access Journals (Sweden)

    G. Sarwar


    Full Text Available A new condensed toluene mechanism is incorporated into the Community Multiscale Air Quality Modeling system. Model simulations are performed using the CB05 chemical mechanism containing the existing (base and the new toluene mechanism for the western and eastern US for a summer month. With current estimates of tropospheric emission burden, the new toluene mechanism increases monthly mean daily maximum 8-h ozone by 1.0–3.0 ppbv in Los Angeles, Portland, Seattle, Chicago, Cleveland, northeastern US, and Detroit compared to that with the base toluene chemistry. It reduces model mean bias for ozone at elevated observed ozone concentrations. While the new mechanism increases predicted ozone, it does not enhance ozone production efficiency. A sensitivity study suggests that it can further enhance ozone if elevated toluene emissions are present. While it increases in-cloud secondary organic aerosol substantially, its impact on total fine particle mass concentration is small.

  13. Electromagnetic Scattered Field Evaluation and Data Compression Using Imaging Techniques (United States)

    Gupta, I. J.; Burnside, W. D.


    This is the final report on Project #727625 between The Ohio State University and NASA, Lewis Research Center, Cleveland, Ohio. Under this project, a data compression technique for scattered field data of electrically large targets is developed. The technique was applied to the scattered fields of two targets of interest. The backscattered fields of the scale models of these targets were measured in a ra compact range. For one of the targets, the backscattered fields were also calculated using XPATCH computer code. Using the technique all scattered field data sets were compressed successfully. A compression ratio of the order 40 was achieved. In this report, the technique is described briefly and some sample results are included.

  14. 2012 volcanic activity in Alaska: summary of events and response of the Alaska Volcano Observatory (United States)

    Herrick, Julie A.; Neal, Christina A.; Cameron, Cheryl E.; Dixon, James P.; McGimsey, Robert G.


    The Alaska Volcano Observatory (AVO) responded to eruptions, possible eruptions, volcanic unrest, or suspected unrest at 11 volcanic centers in Alaska during 2012. Of the two verified eruptions, one (Cleveland) was clearly magmatic and the other (Kanaga) was most likely a single phreatic explosion. Two other volcanoes had notable seismic swarms that probably were caused by magmatic intrusions (Iliamna and Little Sitkin). For each period of clear volcanic unrest, AVO staff increased monitoring vigilance as needed, reviewed eruptive histories of the volcanoes in question to help evaluate likely outcomes, and shared observations and interpretations with the public. 2012 also was the 100th anniversary of Alaska’s Katmai-Novarupta eruption of 1912, the largest eruption on Earth in the 20th century and one of the most important volcanic eruptions in modern times. AVO marked this occasion with several public events.

  15. 2013 volcanic activity in Alaska: summary of events and response of the Alaska Volcano Observatory (United States)

    Dixon, James P.; Cameron, Cheryl; McGimsey, Robert G.; Neal, Christina A.; Waythomas, Chris


    The Alaska Volcano Observatory (AVO) responded to eruptions, volcanic unrest or suspected unrest, and seismic events at 18 volcanic centers in Alaska during 2013. Beginning with the 2013 AVO Summary of Events, the annual description of the AVO seismograph network and activity, once a stand-alone publication, is now part of this report. Because of this change, the annual summary now contains an expanded description of seismic activity at Alaskan volcanoes. Eruptions occurred at three volcanic centers in 2013: Pavlof Volcano in May and June, Mount Veniaminof Volcano in June through December, and Cleveland Volcano throughout the year. None of these three eruptive events resulted in 24-hour staffing at AVO facilities in Anchorage or Fairbanks.

  16. 2008 Volcanic activity in Alaska, Kamchatka, and the Kurile Islands: Summary of events and response of the Alaska Volcano Observatory (United States)

    Neal, Christina A.; McGimsey, Robert G.; Dixon, James P.; Cameron, Cheryl E.; Nuzhdaev, Anton A.; Chibisova, Marina


    The Alaska Volcano Observatory (AVO) responded to eruptions, possible eruptions, and volcanic unrest or suspected unrest at seven separate volcanic centers in Alaska during 2008. Significant explosive eruptions at Okmok and Kasatochi Volcanoes in July and August dominated Observatory operations in the summer and autumn. AVO maintained 24-hour staffing at the Anchorage facility from July 12 through August 28. Minor eruptive activity continued at Veniaminof and Cleveland Volcanoes. Observed volcanic unrest at Cook Inlet's Redoubt Volcano presaged a significant eruption in the spring of 2009. AVO staff also participated in hazard communication regarding eruptions or unrest at nine volcanoes in Russia as part of a collaborative role in the Kamchatka and Sakhalin Volcanic Eruption Response Teams.

  17. Student perspectives on assessment: experience in a competency-based portfolio system. (United States)

    Altahawi, Faysal; Sisk, Bryan; Poloskey, Stacey; Hicks, Caitlin; Dannefer, Elaine F


    Despite considerable evidence recognizing the importance of learners' perceptions of the assessment process, there is little literature depicting the participants' experience. We aim to capture these perceptions in order to gain insights into the strengths and weaknesses of a competency-based assessment system. Cleveland Clinic Lerner College of Medicine has implemented a learner-centered portfolio assessment system built around competency standards and continuous formative feedback. Promotion of students is based upon their feedback-supported portfolio essays, but feedback itself is individualized and formative in nature under the umbrella of the competencies. Importantly, there are no grades or ranking awarded for the competencies or at promotion. Four students share personal reflections of their experience to illuminate themes from the subjective experience of the learner and to understand how to align the learners' interests with the requirements of an assessment program.

  18. Langston Hughes and his poem “Harlem”

    Institute of Scientific and Technical Information of China (English)



    James Langston Hughes was born February 1. 1902, in Joplin, Missouri. His parents divorced when he was a small child, and his father moved to Mexico. He was raised by his Grandmother until he was thirteen, when he moved to Lincoln,Illinois, to live with his mother and her husband, eventually settling in Cleveland, Ohio. It was in I,incoln, Illinois, that Hughes began writing poetry. Following graduation, he spent a year in Mexico and a year at Columbia University. During these years, he held old jobs as an assistant cook, launderer, and a busboy, and traveled to Africa and Europe working as a seaman. In November 1924, he moved to Washington,

  19. Control and Non-Payload Communications (CNPC) Prototype Radio - Generation 2 Flight Test Report (United States)

    Ishac, Joseph A.; Iannicca, Dennis C.; Shalkhauser, Kurt A.; Kachmar, Brian A.


    NASA Glenn Research Center conducted a series of flight tests for the purpose of evaluating air-to-ground communications links for future unmanned aircraft systems (UAS). The primary objective of the test effort was to evaluate the transition of the aircraft communications from one ground station to the next, and to monitor data flow during the "hand-off" event. To facilitate the testing, ground stations were installed at locations in Cleveland, Ohio and Albany, Ohio that each provides line-of-sight radio communications with an overflying aircraft. This report describes results from the flight tests including flight parameters, received signal strength measurements, data latency times, and performance observations for the air-to-ground channel.

  20. Chronologie de la vie et des œuvres de Constance Fenimore Woolson Chronology of Constance Fenimore Woolson’s Life and Work

    Directory of Open Access Journals (Sweden)

    Jeannine Hayat


    Full Text Available Français1840Constance Fenimore Woolson est née à Claremont, New Hampshire (5 mars. Elle était le sixième enfant de Charles Jarvis et de Hannah Cooper Pomeroy Woolson. Elle était, par sa mère, une petite-nièce de James Fenimore Cooper.Automne 1840Les Woolson déménagent à Cleveland, Ohio, après le décès de trois de leurs filles, atteintes de la scarlatine. Enfant et jeune fille, Constance voyage en Ohio, dans le Wisconsin et en Nouvelle Angleterre.Eté 1855Elle découvre l’île de Mackinac dans l...

  1. Prevalence and possible etiology of dental enamel hypoplasia. (United States)

    El-Najjar, M Y; DeSanti, M V; Ozebek, L


    Two hundred black and white adult human skeletons and 200 living black and white children from the greater Cleveland area were examined for evidence of enamel hypoplasia. Enamel hypoplasia, present in varying expressings (pits, lines and grooves), was found to be more prevalent in both skeletal samples, than in the living groups. In the majority of cases, sex differences between white and black males and females through time and space are highly significant for all tooth catagories. Regardless of the mechanisms behind it, prevalence of enamel hypoplasia for both white and black group has significantly declined through time. No evidence suggesting specific etiologies responsible for enamel hypoplasia can be found. In the majority of previously published reports, the etiology is still idiopathic. The reduction in the prevalence of enamel hypoplasia in the groups examined through time may be related to improved nutritional conditions and the elimination or decline of childhood diseases that have been implicated in this condition.

  2. HCMR interviews physician administrator leaders. Interview by Michael J. Enright. (United States)

    Edwards, C; Henry, R A; Kiser, W S; Mayberry, W E; Kaufman, R P


    This interview departs from HCMR's usual format, interviewing several leaders in health care administration for their ideas on current economic pressures, the impact of competition and joint ventures, attitudes toward equity and capital formation, and competition between the interest of clinical medicine and the cost of care. The physician administrators interviewed hold senior administrative positions: Charles Edwards, President and Chief Executive Officer of Scripps Clinic and Research Foundation; Robert A. Henry, President and Chief Executive Officer of Swedish-American Corporation; William S. Kiser, Chairman of the Board of Governors at Cleveland Clinic Foundation; W. Eugene Mayberry, Chairman of the Board of Governors at Mayo Clinic; and Ronald P. Kaufman, Vice-President for Medical Affairs of George Washington University Hospital. All are members of the Board of Regents or Fellows of the American College of Physician Executives.

  3. Large File Transfers from Space Using Multiple Ground Terminals and Delay-Tolerant Networking (United States)

    Ivancic, William D.; Paulsen, Phillip; Stewart, Dave; Eddy, Wesley; McKim, James; Taylor, John; Lynch, Scott; Heberle, Jay; Northam, James; Jackson, Chris; Wood, Lloyd


    We use Delay-Tolerant Networking (DTN) to break control loops between space-ground communication links and ground-ground communication links to increase overall file delivery efficiency, as well as to enable large files to be proactively fragmented and received across multiple ground stations. DTN proactive fragmentation and reactive fragmentation were demonstrated from the UK-DMC satellite using two independent ground stations. The files were reassembled at a bundle agent, located at Glenn Research Center in Cleveland Ohio. The first space-based demonstration of this occurred on September 30 and October 1, 2009. This paper details those experiments. Communication, delay-tolerant networking, DTN, satellite, Internet, protocols, bundle, IP, TCP.

  4. Coptotermes gestroi (Isoptera: Rhinotermitidae) in Brazil: possible origins inferred by mitochondrial cytochrome oxidase II gene sequences. (United States)

    Martins, C; Fontes, L R; Bueno, O C; Martins, V G


    The Asian subterranean termite, Coptotermes gestroi, originally from northeast India through Burma, Thailand, Malaysia, and the Indonesian archipelago, is a major termite pest introduced in several countries around the world, including Brazil. We sequenced the mitochondrial COII gene from individuals representing 23 populations. Phylogenetic analysis of COII gene sequences from this and other studies resulted in two main groups: (1) populations of Cleveland (USA) and four populations of Malaysia and (2) populations of Brazil, four populations of Malaysia, and one population from each of Thailand, Puerto Rico, and Key West (USA). Three new localities are reported here, considerably enlarging the distribution of C. gestroi in Brazil: Campo Grande (state of Mato Grosso do Sul), Itajaí (state of Santa Catarina), and Porto Alegre (state of Rio Grande do Sul).

  5. Computed tomography-guided biopsy. I. Overview. (United States)

    Haaga, J R; Reich, N E; Havrilla, T R; Alfidi, R J; Meaney, T F


    The authors are preparing a series of communications on CT-guided biopsy procedures to be published in future issues of this journal. The present article, which previously appeared in the Cleveland Clinic Quarterly, is intended to serve as an introduction to the concept of CT-guided biopsies. Because the principles of the biopsy procedure remain the same, we do not believe that a "rewrite" of the previously published article would be required. We hope that by presenting this article and subsequent articles concerning the use of CT-guided biopsies, the reader will acquire an appreciation of the proper role of this exciting new technique in comparison to the available imaging modalities. We believe that as individuals become more experienced with the imaging capabilities of these CT devices, they will want to develop the technique of obtaining biopsy confirmation of the imaging diagnosis.

  6. Enhancing the US Power Infrastructure

    Energy Technology Data Exchange (ETDEWEB)

    Charles Alexander


    The primary motivation for this set of research activities was to develop a foundation in several aspects of power in order to position Cleveland State University to lead a multiuniversity effort to secure funding for enhanced power system projects and to be able to eventually secure a NASA Space Power Systems Center status through the competitive bidding process. This was accomplished by focusing on these major project areas, (1) the design of the next generation nuclear-electric power generation system, (2) the design of a distributed, fault-tolerant, and modular power system, and (3) the development of the dynamics and control of active magnetic bearings for flywheel energy storage without using conventional sensors.

  7. NASA Lunar Dust Filtration and Separations Workshop Report (United States)

    Agui, Juan H.; Stocker, Dennis P.


    NASA Glenn Research Center hosted a 2.5-day workshop, entitled "NASA Lunar Dust Filtration and Separations Workshop" at the Ohio Aerospace Institute in Cleveland, Ohio, on November 18 to 20, 2008. The purpose of the workshop was to address the issues and challenges of particulate matter removal from the cabin atmospheres in the Altair lunar lander, lunar habitats, and in pressurized rovers. The presence of lunar regolith dust inside the pressurized volumes was a theme of particular interest. The workshop provided an opportunity for NASA, industry experts, and academia to identify and discuss the capabilities of current and developing air and gas particulate matter filtration and separations technologies as they may apply to NASA s needs. A goal of the workshop was to provide recommendations for strategic research areas in cabin atmospheric particulate matter removal and disposal technologies that will advance and/or supplement the baseline approach for these future lunar surface exploration missions.

  8. Concurrent and Collaborative Engineering Implementation in an R and D Organization (United States)

    DelRosario, Ruben; Davis, Jose M.; Keys, L. Ken


    Concurrent Engineering (CE), and Collaborative Engineering (or Collaborative Product Development - CPD) have emerged as new paradigms with significant impact in the development of new products and processes. With documented and substantiated success in the automotive and technology industries CE and, most recently, CPD are being touted as innovative management philosophies for many other business sectors including Research and De- velopment. This paper introduces two independent research initiatives conducted at the NASA Glenn Research Center (GRC) in Cleveland, Ohio investigating the application of CE and CPD in an RdiD environment. Since little research has been conducted in the use of CE and CPD in sectors other than the high mass production manufacturing, the objective of these independent studies is to provide a systematic evaluation of the applicability of these paradigms (concur- rent and collaborative) in a low/no production, service environment, in particular R&D.

  9. Cowden syndrome with Lhermitte- Duclos disease presenting as ataxia. (United States)

    Arun, K A; Sreejith, R; Hitha, B; Geetha, P; Sasidharan, P K


    Cowden syndrome or multiple hamartoma syndrome is a rare genodermatosis of autosomal dominant inheritance characterized by multiple hamartomatous lesions of ectodermal, mesodermal and endodermal origin. A 45-year-old man presented to us with a history of dural arteriovenous fistula and intracerebral bleed in the past with gradually progressive difficulty in walking. Magnetic resonance imaging (MRI) of the brain showed a heterogeneous lesion in the cerebellum which was diagnosed as adult Lhermitte-Duclos disease which is considered a component of Cowden syndrome. On examination we found florid skin and mucosal manifestations of Cowden syndrome. A family history of thyroid malignancy was also present. Using the Cleveland Clinic web calculator, the patient had an 82% chance of having a phosphatase and tensin homologue (PTEN) mutation.

  10. A novel colloid probe preparation method based on chemical etching technique

    Institute of Scientific and Technical Information of China (English)


    Several fundamental problems in hydrophobic force measurements using atomic force microscope (AFM) are discussed in this paper. A novel method for colloid probe preparation based on chemical etching technology is proposed, which is specially fit for the unique demands of hydrophobic force measurements by AFM. The features of three different approaches for determining spring constants of rectangular cantilevers, including geometric dimension, Cleveland and Sader methods are compared. The influences of the sizes of the colloids on the measurements of the hydrophobic force curves are investigated. Our experimental results showed that by selecting colloid probe with proper spring constant and tip size, the hydrophobic force and the complete hydrophobic interaction force curve can be measured by using AFM.

  11. Compilation and Analysis of 20- and 30-GHz Rain Fade Events at the ACTS NASA Ground Station: Statistics and Model Assessment (United States)

    Manning, Robert M.


    Since the beginning of the operational phase of the NASA Research Center's Advanced Communication Technology Satellite (ACTS), signal-fade measurements have been recorded at the NASA Ground Station located in Cleveland, Ohio, with the use of the 20- and 30-GHz beacon signals. Compilations of the daily data have been statistically analyzed on a monthly and yearly basis. Such analyses have yielded relevant parameters as (1) cumulative monthly and yearly probability distributions of signal attenuation by rain, (2) attenuation duration versus attenuation threshold probabilities, and (3) rate-of-fade probabilities. Not only are such data needed for a realistic data base to support the design and performance analysis of future satellite systems, but they are necessary to assess predictions made with the ACTS Rain Attenuation Prediction Model.

  12. Thrombotic Depositions on Right Impeller of Double-Ended Centrifugal Total Artificial Heart In Vivo. (United States)

    Karimov, Jamshid H; Horvath, David J; Okano, Shinji; Goodin, Mark; Sunagawa, Gengo; Byram, Nicole; Moazami, Nader; Golding, Leonard A R; Fukamachi, Kiyotaka


    The development of total artificial heart devices is a complex undertaking that includes chronic biocompatibility assessment of the device. It is considered particularly important to assess whether device design and features can be compatible long term in a biological environment. As part of the development program for the Cleveland Clinic continuous-flow total artificial heart (CFTAH), we evaluated the device for signs of thrombosis and biological material deposition in four animals that had achieved the intended 14-, 30-, or 90-day durations in each respective experiment. Explanted CFTAHs were analyzed for possible clot buildup at "susceptible" areas inside the pump, particularly the right pump impeller. Depositions of various consistency and shapes were observed. We here report our findings, along with macroscopic and microscopic analysis post explant, and provide computational fluid dynamics data with its potential implications for thrombus formation.

  13. Cancer Stem Cells: Targeting the Roots of Cancer, Seeds of Metastasis, and Sources of Therapy Resistance (United States)

    Adorno-Cruz, Valery; Kibria, Golam; Liu, Xia; Doherty, Mary; Junk, Damian J.; Guan, Dongyin; Hubert, Chris; Venere, Monica; Mulkearns-Hubert, Erin; Sinyuk, Maksim; Alvarado, Alvaro; Caplan, Arnold I.; Rich, Jeremy; Gerson, Stanton L.; Lathia, Justin; Liu, Huiping


    With the goal to remove the roots of cancer, eliminate metastatic seeds, and overcome therapy resistance, the 2014 inaugural International Cancer Stem Cell (CSC) Conference at Cleveland, OH, convened together over 320 investigators, including 55 invited world-class speakers, 25 short oral presenters, and 100 poster presenters, to gain an in-depth understanding of CSCs and explore therapeutic opportunities targeting CSCs. The meeting enabled intriguing discussions on several topics including: genetics and epigenetics; cancer origin and evolution; microenvironment and exosomes; metabolism and inflammation; metastasis and therapy resistance; single cell and heterogeneity; plasticity and reprogramming; as well as other new concepts. Reports of clinical trials targeting CSCs emphasized the urgent need for strategically designing combinational CSC-targeting therapies against cancer. PMID:25604264

  14. Employees' perceptions of justice in performance appraisals. (United States)

    Vasset, Frøydis; Marnburg, Einar; Furunes, Trude


    Of all the tasks undertaken by human resource managers, performance appraisals (PAs) are one of the most unpopular among employees (Meyer 1991, Murphy and Cleveland 1995, Holbrook 2002, Jackman and Strober 2003). As PA guides and plans show (Fletcher 2004, CatalystOne 2010), PAs can be implemented in similar ways in organisations throughout Europe and developed countries elsewhere. But, if employees perceive PA processes as unfair, they may reject the usefulness and validity of the information they receive and so may not be motivated to change behaviour. This article concerns perceptions of organisational justice and explains the results of a study of perceived fairness in PAs among nurses and auxiliary nurses in Norway's municipal health service.

  15. NASA's PEM Fuel Cell Power Plant Development Program for Space Applications (United States)

    Hoberecht, Mark A.


    A three-center NASA team led by the Glenn Research Center in Cleveland, Ohio is completing a five-year PEM fuel cell power plant development program for future space applications. The focus of the program has been to adapt commercial PEM fuel cell technology for space applications by addressing the key mission requirements of using pure oxygen as an oxidant and operating in a multi-gravity environment. Competing vendors developed breadboard units in the 1 to 5 kW power range during the first phase of the program, and a single vendor developed a nominal 10-kW engineering model power pant during the second phase of the program. Successful performance and environmental tests conducted by NASA established confidence that PEM fuel cell technology will be ready to meet the electrical power needs of future space missions.

  16. Cell scientist to watch - Andrew Holland. (United States)


    Andrew received his first degree in natural sciences from the University of Cambridge and a Masters degree from the University of Manchester, followed by a PhD with Stephen Taylor in Manchester. He then moved to California in 2007 with an EMBO long-term fellowship for his postdoctoral research with Don Cleveland at the Ludwig Institute for Cancer Research. In 2013, Andrew started his own lab as an Assistant Professor in the Department of Molecular Biology and Genetics at the Johns Hopkins University School of Medicine, having been named a Kimmel Scholar and a Pew-Stewart Scholar in 2014. Andrew's lab investigates the mechanisms controlling centrosome copy numbers during cell division and the links between centrosome amplification, genome instability and tumorigenesis.

  17. Heaven on Earth: Swedenborgian Correspondences in the Plan of Chicago

    Directory of Open Access Journals (Sweden)

    Kristen Schaffer


    Full Text Available Daniel Hudson Burnham, the Chicago architect and city planner, is recognized for his work on the development of American tall office building; for the construction of World’s Columbian Exposition of 1893; and for his city plans for Washington, D.C., Cleveland, San Francisco, and Chicago. He is also remembered for the quote “Make no little plans.” What is not recalled is his Swedenborgian faith nor how it influenced his work. Emanuel Swedenborg was a Swedish scientist and engineer who, beginning in the mid 1730s, underwent a spiritual awakening. The focus of his work changed to the mystical aspects of human experience. He believed that all Christian churches were dead and in need of revitalization and the key to revitalization was to be found in a new interpretation of scripture. His followers founded the Church of the New Jerusalem, sometimes referred to as the New Church or the Swedenborgian Church.

  18. Using Decision Trees in Data Mining for Predicting Factors Influencing of Heart Disease

    Directory of Open Access Journals (Sweden)

    Moloud Abdar


    Full Text Available Statistics from the World Health Organization (WHO shows that heart disease is one of the leading causes of mortality all over the world. Because of the importance of heart disease, in recent years, many studies have been conducted on this disease using data mining. The main objective of this study is to find a better decision tree algorithm and then use the algorithm for extracting rules in predicting heart disease. Cleveland data, including 303 records are used for this study. These data include 13 features and we have categorized them into five classes. In this paper, C5.0 algorithm with a accuracy value of 85.33% has a better performance compared to the rest of the algorithms used in this study. Considering the rules created by this algorithm, the attributes of Trestbps, Restecg, Thalach, Slope, Oldpeak, and CP were extracted as the most influential causes in predicting heart disease.

  19. Infantile nystagmus syndrome: Broadening the high-foveation-quality field with contact lenses

    Directory of Open Access Journals (Sweden)

    Giovanni Taibbi


    Full Text Available Giovanni Taibbi1,4,5, Zhong I Wang1,3, Louis F Dell’Osso1–31The Daroff-Dell’Osso Ocular Motility Laboratory, Louis Stokes Cleveland Department of Veterans Affairs Medical Center and CASE Medical School; 2Department of Neurology; 3Department of Biomedical Engineering, Case Western Reserve University and University Hospitals Case Medical Center, Cleveland, OH, USA; 4Pediatric Ophthalmology and Strabismus Unit, San Paolo Hospital, Milan, Italy; 5University of Milan, Milan, ItalyAbstract: We investigated the effects of contact lenses in broadening and improving the high-foveation-quality field in a subject with infantile nystagmus syndrome (INS. A high-speed, digitized video system was used for the eye-movement recording. The subject was asked to fixate a far target at different horizontal gaze angles with contact lenses inserted. Data from the subject while fixating at far without refractive correction and at near (at a convergence angle of 60 PD, were used for comparison. The eXpanded Nystagmus Acuity Function (NAFX was used to evaluate the foveation quality at each gaze angle. Contact lenses broadened the highfoveation-quality range of gaze angles in this subject. The broadening was comparable to that achieved during 60 PD of convergence although the NAFX values were lower. Contact lenses allowed the subject to see “more” (he had a wider range of high-foveation-quality gaze angles and “better” (he had improved foveation at each gaze angle. Instead of being contraindicated by INS, contact lenses emerge as a potentially important therapeutic option. Contact lenses employ afferent feedback via the ophthalmic division of the V cranial nerve to damp INS slow phases over a broadened range of gaze angles. This supports the proprioceptive hypothesis of INS improvement.Keywords: contact lenses, infantile nystagmus, visual function

  20. An evaluation of 'confirmatory' medical opinion given to English courts in 14 cases of alleged child sexual abuse. (United States)

    Pillai, Mary


    Fourteen cases of alleged child sexual abuse, where the medical opinion rated a high degree of concordance with the history or suspicion of abuse given to the doctor, were reviewed to evaluate the objectivity and reliability of the medical evidence. It was common practice for physicians conducting the medical examination to form conclusions that the child had been sexually abused on the basis of the examiner's willingness to accept statements by the child, the adolescent, the caregiver or the investigator without determining if this information was accurate and obtained through the use of appropriate interviewing techniques. In the prepubertal children, evaluation of the examination findings revealed anatomical descriptions that were normal or non-specific, rather than supportive of abuse. In the teenagers, inadequate consideration was made of the behavioural and physical differences that occur with adolescence. The physical findings were not interpreted using research derived knowledge concerning the variations of "normal" and the particular conditions that may be mistaken as abuse. The medical reports of these examinations suggest to this author a possibility of the significance and relevance of physical findings being unduly and unwittingly over-emphasised, despite the cases all having occurred post the Cleveland Inquiry [Butler Sloss E. Report into the Child Abuse Enquiry in Cleveland, 1987. London, HMSO] and some as recently as 2005. This may reflect emotional involvement in the case and the doctor taking on a role of advocacy for the child. It is sometimes difficult for physicians to step out of the medical role where they do have the responsibility to diagnose and into a role where their information is only a piece of the puzzle and it is the work of the court to determine if sexual abuse has occurred. The role confusion between medicine and forensics must be sorted out in order for physicians to provide an objective assessment. The main conclusion of this

  1. Trace-element budgets in the Ohio/Sunbury shales of Kentucky: Constraints on ocean circulation and primary productivity in the Devonian-Mississippian Appalachian Basin (United States)

    Perkins, R.B.; Piper, D.Z.; Mason, C.E.


    The hydrography of the Appalachian Basin in late Devonian-early Mississippian time is modeled based on the geochemistry of black shales and constrained by others' paleogeographic reconstructions. The model supports a robust exchange of basin bottom water with the open ocean, with residence times of less than forty years during deposition of the Cleveland Shale Member of the Ohio Shale. This is counter to previous interpretations of these carbon-rich units having accumulated under a stratified and stagnant water column, i.e., with a strongly restricted bottom bottom-water circulation. A robust circulation of bottom waters is further consistent with the palaeoclimatology, whereby eastern trade-winds drove upwelling and arid conditions limited terrestrial inputs of siliciclastic sediment, fresh waters, and riverine nutrients. The model suggests that primary productivity was high (~ 2??g C m- 2 d- 1), although no higher than in select locations in the ocean today. The flux of organic carbon settling through the water column and its deposition on the sea floor was similar to fluxes found in modern marine environments. Calculations based on the average accumulation rate of the marine fraction of Ni suggest the flux of organic carbon settling out of the water column was approximately 9% of primary productivity, versus an accumulation rate (burial) of organic carbon of 0.5% of primary productivity. Trace-element ratios of V:Mo and Cr:Mo in the marine sediment fraction indicate that bottom waters shifted from predominantly anoxic (sulfate reducing) during deposition of the Huron Shale Member of the Ohio Shale to predominantly suboxic (nitrate reducing) during deposition of the Cleveland Shale Member and the Sunbury Shale, but with anoxic conditions occurring intermittently throughout this period. ?? 2008 Elsevier B.V.

  2. A nomogram to predict the probability of passing the American Board of Internal Medicine examination

    Directory of Open Access Journals (Sweden)

    Andrei Brateanu


    Full Text Available Background : Although the American Board of Internal Medicine (ABIM certification is valued as a reflection of physicians’ experience, education, and expertise, limited methods exist to predict performance in the examination. Purpose : The objective of this study was to develop and validate a predictive tool based on variables common to all residency programs, regarding the probability of an internal medicine graduate passing the ABIM certification examination. Methods : The development cohort was obtained from the files of the Cleveland Clinic internal medicine residents who began training between 2004 and 2008. A multivariable logistic regression model was built to predict the ABIM passing rate. The model was represented as a nomogram, which was internally validated with bootstrap resamples. The external validation was done retrospectively on a cohort of residents who graduated from two other independent internal medicine residency programs between 2007 and 2011. Results : Of the 194 Cleveland Clinic graduates used for the nomogram development, 175 (90.2% successfully passed the ABIM certification examination. The final nomogram included four predictors: In-Training Examination (ITE scores in postgraduate year (PGY 1, 2, and 3, and the number of months of overnight calls in the last 6 months of residency. The nomogram achieved a concordance index (CI of 0.98 after correcting for over-fitting bias and allowed for the determination of an estimated probability of passing the ABIM exam. Of the 126 graduates from two other residency programs used for external validation, 116 (92.1% passed the ABIM examination. The nomogram CI in the external validation cohort was 0.94, suggesting outstanding discrimination. Conclusions : A simple user-friendly predictive tool, based on readily available data, was developed to predict the probability of passing the ABIM exam for internal medicine residents. This may guide program directors’ decision

  3. Prospective, open-label trial measuring satisfaction and convenience of two formulations of lamotrigine in subjects with mood disorders

    Directory of Open Access Journals (Sweden)

    Sajatovic M


    Full Text Available Martha Sajatovic,1 Thomas R Thompson,2 Kevin Nanry,3 Suzanne Edwards,2 Ranjani Manjunath21Case Western Reserve University School of Medicine and University Hospitals of Cleveland, Cleveland, OH, 2GlaxoSmithKline, Research Triangle Park, NC; 3Quintiles, Durham, NC, USABackground: Lamotrigine is an anticonvulsant drug indicated for the maintenance treatment of bipolar I disorder and for various types of epilepsy. An orally disintegrating tablet (ODT of lamotrigine was developed to provide a formulation option that might increase patient convenience and satisfaction.Methods: Subjects with mood disorders who reported difficulty swallowing currently prescribed lamotrigine immediate-release medication (baseline were enrolled and treated with lamotrigine ODT for three weeks (end of treatment. Subject satisfaction and convenience were measured using the Treatment Satisfaction Questionnaire for Medication (TSQM. Also measured were global psychopathology using the Clinical Global Impression severity index (CGI-S and depressive symptoms using the Beck Depression Inventory (BDI-II.Results: Lamotrigine ODT was found to be significantly more convenient to use than lamotrigine immediate-release (change in baseline TSQM convenience score: 23.3, n = 97, P < 0.001. The mean TSQM global satisfaction score was similar at baseline (76.3 and after treatment with lamotrigine ODT (76.0. There were no significant changes on CGI-S and BDI-II.Conclusion: Subjects reported that lamotrigine ODT was significantly more convenient than lamotrigine immediate-release, while both formulations were associated with good satisfaction. Lamotrigine ODT may be a treatment option for patients who have difficulty swallowing medication.Keywords: lamotrigine, epilepsy, antiepileptic drug, bipolar disorder, mood disorder

  4. Bringing the Future Within Reach: Celebrating 75 Years of the NASA John H. Glenn Research Center (United States)

    Arrighi, Robert S.


    The National Aeronautics and Space Administration (NASA) Glenn Research Center in Cleveland, Ohio, has been making the future for 75 years. The center's work with aircraft engines, high-energy fuels, communications technology, electric propulsion, energy conversion and storage, and materials and structures has been, and continues to be, crucial to both the Agency and the region. Glenn has partnered with industry, universities, and other agencies to continually advance technologies that are propelling the nation's aerospace community into the future. Nonetheless these continued accomplishments would not be possible without the legacy of our first three decades of research, which led to over one hundred R&D 100 Awards, three Robert J. Collier Trophies, and an Emmy. Glenn, which is located in Cleveland, Ohio, is 1 of 10 NASA field centers, and 1 of only 3 that stem from an earlier research organization-the National Advisory Committee for Aeronautics (NACA). Glenn began operation in 1942 as the NACA Aircraft Engine Research Laboratory (AERL). In 1947 the NACA renamed the lab the Flight Propulsion Laboratory to reflect the expansion of the research. In September 1948, following the death of the NACA's Director of Aeronautics, George Lewis, the NACA rededicated the lab as the Lewis Flight Propulsion Laboratory. On 1 October 1958, the lab was incorporated into the new NASA space agency and was renamed the NASA Lewis Research Center. Following John Glenn's return to space on the space shuttle, on 1 March 1999 the center name was changed once again, becoming the NASA John H. Glenn Research Center.

  5. Profile of obinutuzumab for the treatment of patients with previously untreated chronic lymphocytic leukemia

    Directory of Open Access Journals (Sweden)

    Hill BT


    Full Text Available Brian T Hill, Matt Kalaycio Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA Abstract: Chronic lymphocytic leukemia (CLL is a hematologic malignancy derived from a clonal population of mature B-lymphocytes characterized by relatively low CD20 antigen expression. Although the disease often takes an indolent course, the majority of patients will eventually require therapy. Standard treatment for medically fit patients includes purine analogs and/or alkylating agents in addition to the type I anti-CD20 monoclonal antibody, rituximab. This therapy is inherently myelosuppressive and can result in significant morbidity and even mortality in patients with impaired performance status due to age and/or medical comorbidities. Historically, treatment options for the elderly or frail patient population were limited to monotherapy with the oral alkylating agent, chlorambucil, rituximab, or another type I anti-CD20 monoclonal antibody ofatumumab. Recently, a newer-generation anti-CD20 monoclonal antibody, obinutuzumab, was developed for patients with CLL. Obinutuzumab is a humanized type II monoclonal antibody that appears to have more direct antibody-dependent cell-mediated cytotoxicity (ADCC and possibly more direct cytotoxicity in vitro than previously available type I antibodies. A large Phase III prospective randomized clinical trial for older patients with impaired renal function and/or significant medical comorbidities demonstrated that when compared to conventionally-dosed rituximab and chlorambucil, the combination of chlorambucil and obinutuzumab administered at a dose and schedule involving early loading doses improved response rates and progression-free survival without significantly increasing toxicity. Results of this pivotal trial led to the FDA (US Food and Drug Administration approval of obinutuzumab in combination with chlorambucil for frontline treatment of CLL. Obinutuzumab

  6. Insights into an Award-Winning Summer Internship Program: The First Six Years. (United States)

    Kashou, Anthony; Durairajanayagam, Damayanthi; Agarwal, Ashok


    Since its inception in 2008, the American Center for Reproductive Medicine's summer internship program in reproductive research and writing has trained 114 students from 23 states within the United States and 10 countries worldwide. Its fundamental goal is to inspire pre-medical and medical students to embrace a career as a physician-scientist. During this intensive course, established scientists and clinicians train interns in the essential principles and fundamental concepts of bench research and scientific writing. Over the first six years (2008~2013), interns have collectively published 98 research articles and performed 12 bench research projects on current and emerging topics in reproductive medicine. Interns have also developed and honed valuable soft skills including time management, communication and presentation skills, as well as life values, which all enhance personal and professional satisfaction. Program graduates are able to recognize the value of medical research and its potential to impact patient care and gain insight into their own career pathway. Between 2011 and 2014, the internship program was thrice awarded a Scholarship in Teaching Award by Case Western Reserve School of Medicine for its innovative teaching approach and positive impact on medical education and student careers. This report highlights the demographics, logistics, implementation, feedback, and results of the first six years of the American Center for Reproductive Medicine's summer internship program at Cleveland Clinic (Cleveland, OH, USA). This may be helpful to other research and academic institutions considering implementing a similar program. In addition, it creates awareness among potential physician-scientists of what the world of research has to offer in both scientific writing and bench research. Finally, it may stimulate further discussion regarding narrowing the gap between physicians and scientists and refinement of the current program.

  7. Microstructure Analysis of Directionally Solidified Aluminum Alloy Aboard the International Space Station (United States)

    Angart, Samuel Gilbert

    This thesis entails a detailed microstructure analysis of directionally solidified (DS) Al-7Si alloys processed in microgravity aboard the International Space Station and similar duplicate ground based experiments at Cleveland State University. In recent years, the European Space Agency (ESA) has conducted experiments on alloy solidification in microgravity. NASA and ESA have collaborated for three DS experiments with Al- 7 wt. % Si alloy, aboard the International Space Station (ISS) denoted as MICAST6, MICAST7 and MICAST12. The first two experiments were processed on the ISS in 2009 and 2010. MICAST12 was processed aboard the ISS in the spring of 2014; the resulting experimental results of MICAST12 are not discussed in this thesis. The primary goal of the thesis was to understand the effect of convection in primary dendrite arm spacings (PDAS) and radial macrosegregation within DS aluminum alloys. The MICAST experiments were processed with various solidification speeds and thermal gradients to produce alloy with differences in microstructure features. PDAS and radial macrosegregation were measured in the solidified ingot that developed during the transition from one solidification speed to another. To represent PDAS in DS alloy in the presence of no convection, the Hunt-Lu model was used to represent diffusion-controlled growth. By sectioning cross-sections throughout the entire length of solidified samples, PDAS was measured and calculated. The ground-based (1-g) experiments done at Cleveland State University CSU were also analyzed for comparison to the ISS experiments (0-g). During steady state in the microgravity environment, there was a reasonable agreement between the measured and calculated PDAS. In ground-based experiments, transverse sections exhibited obvious radial macrosegregation caused by thermosolutal convection resulting in a non-agreement with the Hunt-Lu model. Using a combination of image processing techniques and Electron Microprobe Analysis

  8. Evaluation and management of pediatric hypertensive crises: hypertensive urgency and hypertensive emergencies

    Directory of Open Access Journals (Sweden)

    Patel NH


    Full Text Available Nirali H Patel,1 Sarah K Romero,2 David C Kaelber31Division of Emergency Medicine, Akron Children's Hospital, Akron, OH, USA; 2Division of Emergency Medicine, Rainbow Babies and Children's Hospital, Cleveland, OH, USA; 3Departments of Information Services, Internal Medicine, Pediatrics, and Epidemiology and Biostatistics, The Center for Clinical Informatics Research and Education, The MetroHealth System and School of Medicine, Case Western Reserve University, Cleveland OH, USAAbstract: Hypertension (HTN in the pediatric population is estimated to have a world-wide prevalence of 2%-5%. As with adults, pediatric patients with HTN can present with hypertensive crises include hypertensive urgency and hypertensive emergencies. However, pediatric blood pressure problems have a greater chance of being from secondary causes of HTN, as opposed to primary HTN, than in adults. Thorough evaluation of a child with a hypertensive emergency includes accurate blood pressure readings, complete and focused symptom history, and appropriate past medical, surgical, and family history. Physical exam should include height, weight, four-limb blood pressures, a general overall examination and especially detailed cardiovascular and neurological examinations, including fundoscopic examination. Initial work-up should typically include electrocardiography, chest X-ray, serum chemistries, complete blood count, and urinalysis. Initial management of hypertensive emergencies generally includes the use of intravenous or oral antihypertensive medications, as well as appropriate, typically outpatient, follow-up. Emergency department goals for hypertensive crises are to (1 safely lower blood pressure, and (2 treat/minimize acute end organ damage, while (3 identifying underlying etiology. Intravenous antihypertensive medications are the treatment modality of choice for hypertensive emergencies with the goal of reducing systolic blood pressure by 25% of the original value over an 8

  9. A web implementation: the good and the not-so-good. (United States)

    Bergsneider, C; Piraino, D; Fuerst, M


    E-commerce, e-mail, e-greeting, e-this, and e-that everywhere you turn there is a new "e" word for an internet or Web application. We, at the Cleveland Clinic Foundation, have been "e-nlightened" and will discuss in this report the implementation of a web-based radiology information system (RIS) in our radiology division or "e-radiology" division. The application, IDXRad Version 10.0 from IDX Corp, Burlington, VT, is in use at the Cleveland Clinic Foundation and has both intranet (for use in Radiology) and internet (referring physician viewing) modules. We will concentrate on the features of using a web browser for the application's front-end, including easy prototyping for screen review, easier mock-ups of demonstrations by vendors and developers, and easier training as more people become web-addicted. Project communication can be facilitated with an internal project web page, and use of the web browser can accommodate quicker turnaround of software upgrades as the software code is centrally located. Compared with other technologies, including client/server, there is a smaller roll out cost when using a standard web browser. However, the new technology requires a change and changes are never implemented without challenges. A seasoned technologist using a legacy system can enter data quicker using function keys than using a graphical user interface and pointing and clicking through a series of pop-up windows. Also, effective use of a web browser depends on intuitive design for it to be easily implemented and accepted by the user. Some software packages will not work on both of the popular web browsers and then are tailored to specific release levels. As computer-based patient records become a standard, patient confidentiality must be enforced. The technical design and application security features that support the web-based software package will be discussed. Also web technologies have their own implementation issues.

  10. Natalizumab for the treatment of relapsing multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Richard A Rudick


    Full Text Available Richard A Rudick1, Michael A Panzara21Cleveland Clinic Foundation, Cleveland, OH, USA; 2Biogen Idec, Inc., Cambridge, MA, USAAbstract: Natalizumab is an α4-integrin antagonist approved as monotherapy for patients with relapsing multiple sclerosis (MS, based on demonstrated efficacy in the pivotal AFFIRM study (N = 942. Natalizumab monotherapy reduced risk of disability progression by 42%–54% and annualized relapse rate by 68% during a period of 2 years. Natalizumab was also associated with significant reductions in number of T2-hyperintense, gadolinium-enhancing, and T1-hypointense lesions and in volume of T2-hyperintense lesions (all p < 0.001 on magnetic resonance imaging. Furthermore, natalizumab-treated patients in AFFIRM experienced significant improvements from baseline in the physical and mental components of the Short Form-36 (p ≤ 0.01 and a 35% reduction in risk of clinically significant vision loss (p = 0.008 vs placebo. Natalizumab was well tolerated in phase 3 studies. Common adverse events were generally mild and included headache, fatigue, urinary tract infections, and arthralgia. Serious adverse events were similar between treatment groups. The incidence of serious hypersensitivity reactions associated with natalizumab was <1%. Progressive multifocal leukoencephalopathy was a rare complication of treatment, observed in 2 patients with MS who received natalizumab plus interferon β-1a. The robust clinical benefits of natalizumab, including benefits on patient-reported quality of life, make it an important addition to disease-modifying therapies available to patients with relapsing MS.Keywords: multiple sclerosis, natalizumab, α4-integrin antagonist

  11. Using MODIS data for understanding changes in seagrass meadow health: a case study in the Great Barrier Reef (Australia). (United States)

    Petus, Caroline; Collier, Catherine; Devlin, Michelle; Rasheed, Michael; McKenna, Skye


    Stretching more than 2000 km along the Queensland coast, the Great Barrier Reef Marine Park (GBR) shelters over 43,000 square km of seagrass meadows. Despite the status of marine protected area and World Heritage listing of the GBR, local seagrass meadows are under stress from reduced water quality levels; with reduction in the amount of light available for seagrass photosynthesis defined as the primary cause of seagrass loss throughout the GBR. Methods have been developed to map GBR plume water types by using MODIS quasi-true colour (hereafter true colour) images reclassified in function of their dominant colour. These data can be used as an interpretative tool for understanding changes in seagrass meadow health (as defined in this study by the seagrass area and abundance) at different spatial and temporal scales. We tested this method in Cleveland Bay, in the northern GBR, where substantial loss in seagrass area and biomass was detected by annual monitoring from 2007 to 2011. A strong correlation was found between bay-wide seagrass meadow area and biomass and exposure to turbid Primary (sediment-dominated) water type. There was also a strong correlation between the changes of biomass and area of individual meadows and exposure of seagrass ecosystems to Primary water type over the 5-year period. Seagrass meadows were also grouped according to the dominant species within each meadow, irrespective of location within Cleveland Bay. These consolidated community types did not correlate well with the exposure to Primary water type, and this is likely to be due to local environmental conditions with the individual meadows that comprise these groupings. This study proved that remote sensing data provide the synoptic window and repetitivity required to investigate changes in water quality conditions over time. Remote sensing data provide an opportunity to investigate the risk of marine-coastal ecosystems to light limitation due to increased water turbidity when in situ

  12. Ranibizumab: the evidence of its therapeutic value in neovascular age-related macular degeneration

    Directory of Open Access Journals (Sweden)

    Peter K. Kaiser


    Full Text Available Peter K. KaiserCole Eye Institute, The Cleveland Clinic Foundation, Cleveland, Ohio, USAIntroduction: Neovascular age-related macular degeneration (AMD is the leading cause of severe, irreversible visual impairment in people over 60 years of age. Neovascular AMD is characterized by abnormal growth of blood vessels under the retina, specifically the macula. These vessels leak blood and fluids, damaging the retina and its photoreceptors, resulting in permanent loss of central vision. Vascular endothelial growth factor-A (VEGF-A has been shown to play a critical role in the pathogenesis of neovascular AMD. In the US, ranibizumab, a VEGF-A blocker, is approved and indicated for the treatment of patients with neovascular AMD.Aims: To review the clinical evidence for ranibizumab in the treatment of neovascular AMD.Evidence review: Phase III clinical trial data have established ranibizumab as a safe and well-tolerated treatment for neovascular AMD. Monthly intravitreal injections of ranibizumab result in a statistically significantly greater proportion of patients losing <15 letters of visual acuity (VA and statistically significant increases in the mean number of letters gained compared with controls. Anatomically, ranibizumab results in stabilization in the mean area of choroidal neovascularization (CNV and statistically significant reductions in the mean area of leakage compared with controls. Although there is limited economic evidence available, ranibizumab therapy for neovascular AMD appears to deliver a significant degree of value gain in terms of quality of life when compared with other neovascular AMD interventions.Place in therapy: Clinical evidence establishes ranibizumab as a first-line therapy option for virtually all treatable neovascular AMD patients. Updating neovascular AMD treatment guidelines to reflect the evidence base for ranibizumab as a preferred first-line therapy would be beneficial for physicians in making informed treatment

  13. Zero-Gravity Locomotion Simulators: New Ground-Based Analogs for Microgravity Exercise Simulation (United States)

    Perusek, Gail P.; DeWitt, John K.; Cavanagh, Peter R.; Grodsinsky, Carlos M.; Gilkey, Kelly M.


    Maintaining health and fitness in crewmembers during space missions is essential for preserving performance for mission-critical tasks. NASA's Exercise Countermeasures Project (ECP) provides space exploration exercise hardware and monitoring requirements that lead to devices that are reliable, meet medical, vehicle, and habitat constraints, and use minimal vehicle and crew resources. ECP will also develop and validate efficient exercise prescriptions that minimize daily time needed for completion of exercise yet maximize performance for mission activities. In meeting these mission goals, NASA Glenn Research Center (Cleveland, OH, USA), in collaboration with the Cleveland Clinic (Cleveland, Ohio, USA), has developed a suite of zero-gravity locomotion simulators and associated technologies to address the need for ground-based test analog capability for simulating in-flight (microgravity) and surface (partial-gravity) exercise to advance the health and safety of astronaut crews and the next generation of space explorers. Various research areas can be explored. These include improving crew comfort during exercise, and understanding joint kinematics and muscle activation pattern differences relative to external loading mechanisms. In addition, exercise protocol and hardware optimization can be investigated, along with characterizing system dynamic response and the physiological demand associated with advanced exercise device concepts and performance of critical mission tasks for Exploration class missions. Three zero-gravity locomotion simulators are currently in use and the research focus for each will be presented. All of the devices are based on a supine subject suspension system, which simulates a reduced gravity environment by completely or partially offloading the weight of the exercising test subject s body. A platform for mounting treadmill is positioned perpendicularly to the test subject. The Cleveland Clinic Zero-g Locomotion Simulator (ZLS) utilizes a

  14. Validación prospectiva de siete sistemas locales e internacionales de evaluación del riesgo en cirugía cardíaca

    Directory of Open Access Journals (Sweden)

    Raúl A. Borracci


    Full Text Available Objetivos El presente trabajo se llevó a cabo con el propósito de evaluar el desempeño de siete scores de riesgo de mortalidad en cirugía cardíaca de uso corriente en nuestro medio. Material y métodos Se analizaron prospectivamente 502 pacientes sometidos a cirugía cardíaca entre 2004 y 2005.Se identificaron las variables preoperatorias para el cálculo de siete scores de riesgo de mortalidad, cuatro internacionales, Parsonnet, Ontario, EuroSCORE y Cleveland, y tres locales, CONAREC, Español y Favaloro. Para determinar la discriminación, la precisión y la calibración de cada score , se calculó el riesgo esperado promedio de cada uno, la bondad de ajuste de Hosmer y Lemeshow, el coeficiente Q , las áreas ROC, el índice de Shannon y tres métodos gráficos. Resultados La comparación de las áreas ROC para todo tipo de cirugía cardíaca mostró que el EuroSCORE tuvo la mejor área (78,7%, junto con el score del Español (78,6%. Aunque estos modelos tuvieron el valor predictivo más alto, no se encontraron diferencias estadísticas al compararlos con el resto de los modelos. Para la cirugía coronaria, el EuroSCORE nuevamente mostró la mejor predicción (76,3%, y luego el de Cleveland (76,0%, a pesar de que tampoco se hallaron diferencias estadísticas con el resto de los scores . Para todo tipo de cirugía, el Ontario tuvo el mejor índice de Shannon global (0,913, pero el peor índice de fallecidos (0,074, lo cual indica que otorgó riesgos esperados más bajos a los sobrevivientes, pero también riesgos bajos a los que murieron. Por su parte, el EuroSCORE se ubicó en segundo lugar para el índice global (0,905 y el de fallecidos (0,106. Para la cirugía coronaria, el Español tuvo el índice global más alto (0,945, pero también el índice de fallecidos más bajo (0,050, lo que señala una buena precisión en el primer caso y una mala precisión cuando sólo se consideran los fallecidos. En el EuroSCORE, los índices de

  15. A technology-enabled adherence enhancement system for people with bipolar disorder: results from a feasibility and patient acceptance analysis

    Directory of Open Access Journals (Sweden)

    Sajatovic M


    Full Text Available Martha Sajatovic,1 Michael S Davis,2 Kristin A Cassidy,3 Joseph Nestor,2 Johnny Sams,3 Edna Fuentes-Casiano3 1Department of Psychiatry and Neurological and Behavioral Outcomes Center, Case Western Reserve University School of Medicine and University Hospitals Case Medical Center, Cleveland, OH, USA; 2MedicaSafe, New York, NY, USA; 3Department of Psychiatry, Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, Cleveland, OH, USA Objective: As poor medication adherence is common in bipolar disorder (BD, technology-assisted approaches may help to monitor and enhance adherence. This study evaluated preliminary feasibility, patient satisfaction and effects on adherence, BD knowledge, and BD symptoms associated with the use of a multicomponent technology-assisted adherence enhancement system. Methods: This prospective study tested the system in five BD patients over a 15-day period. System components included: 1 an automated pill cap with remote monitoring sensor; 2 a multimedia adherence enhancement program; and 3 a treatment incentive program. This study evaluated system usability, patient satisfaction and effects on adherence (Morisky scale, knowledge (treatment knowledge test [TKT], and symptoms (internal state scale [ISS]. Results: Mean age of the sample was 62 years, 4/5 (80% Caucasian, and 4/5 (80% single/divorced or widowed. Most participants (4/5, 80% were on a single BD medication. Participants had BD for an average of 21 years. Challenges included attaching the pill sensor to standard pharmacy bottles for individuals using very large pill containers or those with multiday pill boxes. Three of five (60% individuals completed the full 15-day period. Usability scores were high overall. Mean Morisky scores improved. Means on all four subscales of the ISS were all in the direction of improvement. On the TKT, there was a 40% increase in mean scores. Conclusion: A multicomponent technology-assisted BD

  16. The role and importance of economic evaluation of traditional herbal medicine use for chronic non-communicable diseases

    Directory of Open Access Journals (Sweden)

    Hughes GD


    Full Text Available Gail D Hughes,1 Oluwaseyi M Aboyade,1 John D Hill,2 Rafia S Rasu3 1South African Herbal Science and Medicine Institute, University of the Western Cape, Western Cape, South Africa; 2Department of Pharmacy, Cleveland Clinic, Cleveland, OH, 3School of Pharmacy, University of Kansas, Lawrence, KS, USA Background: Non-communicable diseases (NCD constitute major public health problems globally, with an impact on morbidity and mortality ranking high and second to HIV/AIDS. Existing studies conducted in South Africa have demonstrated that people living with NCD rely on traditional herbal medicine (THM primarily or in combination with conventional drugs. The primary research focus has been on the clinical and experimental aspects of THM use for NCD, with limited data on the economic impact of health care delivery. Therefore, the purpose of this study will be to determine the cost and utilization of resources on THM in South Africa for NCD. Materials and methods: Study describes the methods toward incorporating cost estimations and economic evaluation illustrated with the Prospective Urban and rural Epidemiological (PURE study in South Africa. The South African PURE cohort is investigating the geographic and socioeconomic influence of THM spending and utilization, variations in spending based on perceived health status, marital status, and whether spending patterns have any impact on hospitalizations and disability. Data collection and evaluation plan: Since the individual costs of THM are not regulated nor do they have a standardized price value, information obtained through this study can be utilized to assess differences and determine underlying factors contributing to spending. This insight into THM spending patterns can aid in the development and implementation of guidelines or standardized legislation governing THM use and distribution. An economic evaluation and cost estimation model has been proposed, while the data collection is still ongoing

  17. T10B9 monoclonal antibody: A short-acting nonstimulating monoclonal antibody that spares γδ T-cells and treats and prevents cellular rejection

    Directory of Open Access Journals (Sweden)

    Thomas H Waid


    Full Text Available Thomas H Waid1, John S Thompson1, Maria Siemionow2, Stephen A Brown1 1Department of Internal Medicine, University of Kentucky, Lexington, Kentucky, USA; 2Cleveland Clinic, Cleveland, Ohio, USAAbstract: T10B9.1A-31/MEDI-500 is a nonmitogenic immunoglobulin M kappa murine monoclonal antibody (mAb directed against the alpha-beta (αβ heterodimer of the T-lymphocyte receptor complex. The hybridoma was first produced by fusing spleen cells from BALB/C mice immunized with human peripheral blood T-lymphocytes with SP2/O-Ag14 mutant myeloma cells. The mAb is produced and purified using multistep ion exchange and molecular sieve chromatography protocols. T10B9 has been used successfully to treat acute cellular rejection in renal transplantation and as an immunosuppression induction agent in heart and simultaneous kidney-pancreas transplantation. Because T10B9 is nonmitogenic and causes minimal cytokine release, both treatment of rejection and induction of immunosuppression were accomplished with significantly fewer and milder untoward effects (cytokine release syndrome than its comparator OKT3. Since T10B9 is directed against the αβ heterodimer of the CD3 epitope, it spares the gamma delta (γδ region. These gamma delta (γδ T cells have a unique role in the immune response controlling many serious human diseases and perhaps facilitating the development of immunologic tolerance. T10B9 has a relatively short duration of action, depleting T cells for only 10 to 14 days, unlike the protracted depletion seen with thymoglobulin and Campath-1H. There is no B-lymphocyte depletion with T10B9 as there is with both of the aforementioned reagents. The lack of prolonged lymphocyte depletion may account for less infection observed with T10B9 treatment.Keywords: T10B9.1A-31, γδ T-cell, monoclonal antibody, Campath-1H, thymoglobulin, OKT3

  18. Tailored lighting intervention improves measures of sleep, depression, and agitation in persons with Alzheimer’s disease and related dementia living in long-term care facilities

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    Figueiro MG


    Full Text Available Mariana G Figueiro,1 Barbara A Plitnick,1 Anna Lok,1 Geoffrey E Jones,1 Patricia Higgins,2,3 Thomas R Hornick,3,4 Mark S Rea1 1Lighting Research Center, Rensselaer Polytechnic Institute, Troy, NY, USA; 2School of Nursing, 3School of Medicine, Case Western Reserve University, 4Geriatric Research Education and Clinical Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, USABackground: Light therapy has shown great promise as a nonpharmacological method to improve symptoms associated with Alzheimer’s disease and related dementias (ADRD, with preliminary studies demonstrating that appropriately timed light exposure can improve nighttime sleep efficiency, reduce nocturnal wandering, and alleviate evening agitation. Since the human circadian system is maximally sensitive to short-wavelength (blue light, lower, more targeted lighting interventions for therapeutic purposes, can be used. Methods: The present study investigated the effectiveness of a tailored lighting intervention for individuals with ADRD living in nursing homes. Low-level “bluish-white” lighting designed to deliver high circadian stimulation during the daytime was installed in 14 nursing home resident rooms for a period of 4 weeks. Light–dark and rest–activity patterns were collected using a Daysimeter. Sleep time and sleep efficiency measures were obtained using the rest–activity data. Measures of sleep quality, depression, and agitation were collected using standardized questionnaires, at baseline, at the end of the 4-week lighting intervention, and 4 weeks after the lighting intervention was removed. Results: The lighting intervention significantly (P<0.05 decreased global sleep scores from the Pittsburgh Sleep Quality Index, and increased total sleep time and sleep efficiency. The lighting intervention also increased phasor magnitude, a measure of the 24-hour resonance between light–dark and rest–activity patterns, suggesting an increase

  19. Advanced Offshore Wind Turbine/Foundation Concept for the Great Lakes

    Energy Technology Data Exchange (ETDEWEB)

    Afjeh, Abdollah A. [Univ. of Toledo, OH (United States); Windpower, Nautica [Nautica Windpower, Olmsted Falls, OH (United States); Marrone, Joseph [OCC COWI, Vancouver (Canada); Wagner, Thomas [Nautica Windpower, Olmsted Falls, OH (United States)


    This project investigated a conceptual 2-bladed rotor wind turbine design and assessed its feasibility for installation in the Great Lakes. The levelized cost of energy was used for this purpose. A location in Lake Erie near the coast of Cleveland, Ohio was selected as the application site. The loading environment was defined using wind and wave data collected at a weather station in Lake Erie near Cleveland. In addition, the probability distributions of the annual significant wave height and wind speed were determined. A model of the dependence of the above two quantities was also developed and used in the study of wind turbine system loads. Loads from ice floes and ridges were also included.The NREL 5 MW 3-bladed rotor wind turbine concept was used as the baseline design. The proposed turbine design employs variable pitch blade control with tip-brakes and a teeter mechanism. The rotor diameter, rated power and the tower dimensions were selected to closely match those of the NREL 5 MW wind turbine.A semi-floating gravity base foundation was designed for this project primarily to adapt to regional logistical constraints to transport and install the gravity base foundation. This foundation consists of, from bottom to top, a base plate, a buoyancy chamber, a taper zone, a column (with ice cone), and a service platform. A compound upward-downward ice cone was selected to secure the foundation from moving because of ice impact.The turbine loads analysis was based on International ElectroTechnical Committee (IEC) Standard 61400-1, Class III winds. The NREL software FAST was the primary computational tool used in this study to determine all design load cases. An initial set of studies of the dynamics of wind turbines using Automatic Dynamic Analysis of Mechanical Systems (ADAMS) demonstrated that FAST and ADAMS load predictions were comparable. Because of its relative simplicity and short run times, FAST was selected for this study. For ice load calculations, a method

  20. Parenteral clevidipine for the acute control of blood pressure in the critically ill patient: a review

    Directory of Open Access Journals (Sweden)

    W Frank Peacock IV


    Full Text Available W Frank Peacock IV1, Jorge E Angeles2, Karina M Soto2, Philip D Lumb3,  Joseph Varon41The Cleveland Clinic, Cleveland, OH, USA; 2Universidad Autónoma de Baja California, Facultad de Medicina, Tijuana, México; 3Keck School of Medicine of University of Southern California, Los Angeles, CA, USA; 4The University of Texas Health Science Center at Houston, and The University of Texas Medical Branch at Galveston. St. Luke’s Episcopal Hospital/Texas Heart Institute, Houston, Texas, USAAbstract: Clevidipine is a new calcium channel blocker of the dihydropyridine class that is characterized by its ultra-short onset of action, vascular selectivity, small volume of distribution and extremely high clearance that coupled together result in an extremely short half-life of approximately 1 minute therefore permitting a rapid titration to the desired effect. Structurally similar to other dihydropyridines, clevidipine has an extra ester link that allows its rapid hydrolization to its inactive carboxylic acid metabolite in blood and extravascular tissues. Clevidipine’s metabolites are then primarily eliminated through urine and fecal pathways. Clevidipine does not affect cytochrome P450 (CYP enzymes and no clinically significant drug interactions have been determined. In trials like the ESCAPE trials, ECLIPSE, and VELOCITY, clevidipine demonstrated a significant improvement in the management of acute hypertension when compared to placebo as shown in both ESCAPE trials. The ECLIPSE trial compared clevidipine to other drugs currently used in the management of acute hypertension, such as sodium nitroprusside, nitroglycerine and nicardipine; clevidipine was superior to all three agents; in providing blood pressure support, safety and tolerability clevidipine also showed a significant reduction in mortality rate (4.7% vs 1.7%, P = 0.0445 when compared to sodium nitroprusside. In the VELOCITY trial clevidipine demonstrated a reduction in blood pressure of 6

  1. Interstitial Cystitis – Elucidation of Psychophysiologic and Autonomic Characteristics (the ICEPAC Study: design and methods

    Directory of Open Access Journals (Sweden)

    Chelimsky T


    Full Text Available Thomas Chelimsky,1 Gisela Chelimsky,1 N Patrick McCabe,2 Megan Louttit,3 Adonis Hijaz,3 Sangeeta Mahajan,3 Tatiana Sanses,3 CA Tony Buffington,4 Bradford Fenton,5 Thomas Janicki,3 Sarah Ialacci,2 Elias Veizi,3 Di Zhang,2 Firouz Daneshgari,2,3 Robert Elston,2 Jeffrey Janata2,31The Medical College of Wisconsin, Departments of Neurology and Gastroenterology, Milwaukee, WI, 2Case Western Reserve University, Department of Neurology, Cleveland, OH, 3University Hospitals Case Medical Center, School of Medicine, Cleveland, OH, 4The Ohio State University, Department of Veterinary Clinical Sciences, Columbus, OH, 5Summa Health System, Department of Gynecology, Akron, OH, USABackground and purpose: Interstitial cystitis/bladder pain syndrome (IC/BPS is relatively common and associated with severe pain, yet effective treatment remains elusive. Research typically emphasized the bladder's role, but given the high presence of systemic comorbidities, the authors hypothesized a pathophysiologic nervous system role. This paper reports the methodology and approach to study the nervous system in women with IC/BPS. The study compares neurologic, urologic, gynecologic, autonomic, gastrointestinal, and psychological features of women with IC/BPS, their female relatives, women with myofascial pelvic pain (MPP, and healthy controls to elucidate the role of central and peripheral processing.Methods and results: In total, 228 women (76 IC/BPS, 76 MPP, 38 family members, and 38 healthy controls will be recruited. Subjects undergo detailed screening, structured neurologic examination of limbs and pelvis, tender point examination, autonomic testing, electrogastrography, and assessment of comorbid functional dysautonomias. Interpreters are blinded to subject classification. Psychological and stress response characteristics are examined with assessments of stress, trauma history, general psychological function, and stress response quantification. As of December 2012, data

  2. Bulgecin A as a β-lactam enhancer for carbapenem-resistant Pseudomonas aeruginosa and carbapenem-resistant Acinetobacter baumannii clinical isolates containing various resistance mechanisms

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    Skalweit MJ


    Full Text Available Marion J Skalweit,1–5 Mei Li2 1Department of Medicine, 2Research Section, 3Infectious Diseases Section, Louis Stokes Cleveland Department of Veterans, 4Department of Medicine, 5Department of Biochemistry, Case Western Reserve University School of Medicine, Cleveland, OH, USA Abstract: Genetic screening of Pseudomonas aeruginosa (PSDA and Acinetobacter ­baumannii (ACB reveals genes that confer increased susceptibility to β-lactams when disrupted, suggesting novel drug targets. One such target is lytic transglycosylase. Bulgecin A (BlgA is a natural product of Pseudomonas mesoacidophila and a lytic transglycosolase inhibitor that works synergistically with β-lactams targeting PBP3 for Enterobacteriaceae. BlgA also weakly inhibits di-Zn2+ metallo-β-lactamases like L1 of Stenotrophomonas maltophilia. We hypothesized that because of its unique mechanism of action, BlgA could restore susceptibility to carbapenems in carbapenem-resistant PSDA (CR-PSDA and carbapenem-resistant ACB, as well as ACB resistant to sulbactam. A BlgA-containing extract was prepared using a previously published protocol. CR-PSDA clinical isolates demonstrating a variety of carbapenem resistance mechanisms (VIM-2 carbapenemases, efflux mechanisms, and AmpC producer expression were characterized with agar dilution minimum inhibitory concentration (MIC testing and polymerase chain reaction. Growth curves using these strains were prepared using meropenem, BlgA extract, and meropenem plus BlgA extract. A concentrated Blg A extract combined with low concentrations of meropenem, was able to inhibit the growth of clinical strains of CR-PSDA for strains that had meropenem MICs ≥8 mg/L by agar dilution, and a clinical strain of an OXA-24 producing ACB that had a meropenem MIC >32 mg/L and intermediate ampicillin/sulbactam susceptibility. Similar experiments were conducted on a TEM-1 producing ACB strain resistant to sulbactam. BlgA with ampicillin/sulbactam inhibited the growth

  3. A pilot study: portable out-of-center sleep testing as an early sleep apnea screening tool in acute ischemic stroke

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    Chernyshev OY


    Full Text Available Oleg Y Chernyshev,1 David E McCarty,1 Douglas E Moul,2 Cesar Liendo,1 Gloria C Caldito,1 Sai K Munjampalli,1 Roger E Kelley,3 Andrew L Chesson Jr1 1Division of Sleep Medicine, Department of Neurology, Louisiana State University Health Sciences Center at Shreveport, LA 2Sleep Disorders Center, Cleveland Clinic, Cleveland, OH, 3Department of Neurology, Tulane University, New Orleans, LA, USA Introduction: Prompt diagnosis of obstructive sleep apnea (OSA after acute ischemic stroke (AIS is critical for optimal clinical outcomes, but in-laboratory conventional polysomnograms (PSG are not routinely practical. Though portable out-of-center type III cardiopulmonary sleep studies (out-of-center cardiopulmonary sleep testing [OCST] are widely available, these studies have not been validated in patients who have recently suffered from AIS. We hypothesized that OCST in patients with AIS would yield similar results when compared to conventional PSG. Methods: Patients with AIS had simultaneous type III OCST and PSG studies performed within 72 hours from symptom onset. The accuracy of OCST was compared to PSG using: chi-square tests, receiver operatory characteristic curves, Bland–Altman plot, paired Student's t-test/Wilcoxon signed-rank test, and calculation of sensitivity, specificity, positive predictive value (PPV, and negative predictive value (NPV. Results: Twenty-one out of 23 subjects with AIS (age 61±9.4 years; 52% male; 58% African-American successfully completed both studies (9% technical failure. Nearly all (95% had Mallampati IV posterior oropharynx; the mean neck circumference was 16.8±1.6 in. and the mean body mass index (BMI was 30±7 kg/m2. The apnea hypopnea index (AHI provided by OCST was similar to that provided by PSG (19.8±18.0 vs 22.0±22.7, respectively; P=0.49. On identifying subjects by OCST with an AHI ≥5 on PSG, OCST had the following parameters: sensitivity 100%, specificity 85.7%, PPV 93%, and NPV 100%. On identifying

  4. Prevalence of comorbid retinal disease in patients with glaucoma at an academic medical center

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    Griffith JF


    Full Text Available Joseph F Griffith,1 Jeffrey L Goldberg2 1Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH, 2Shiley Eye Center, University of California San Diego, La Jolla, CA, USA Background: Patients with various retinal diseases and patients who have undergone retinal procedures and surgeries have an increased risk of developing ocular hypertension and glaucoma. Little is known about the epidemiology of comorbid retinal diseases in glaucoma patients. This study evaluated the prevalence of retinal comorbidities in a population of patients with five types of glaucoma.Methods: A longitudinal, retrospective study was conducted using International Classification of Disease (ICD-9 billing records from 2003 to 2010 at an academic medical center. Patients were classified as having primary open-angle glaucoma (POAG, low tension open-angle glaucoma (NTG, pigmentary open-angle glaucoma, chronic-angle closure glaucoma (CACG, or pseudoexfoliation glaucoma (PXG if they had at least three clinic visits with the same ICD-9 code. Patients were classified as having a retinal comorbidity if they had two visits with the same code. Variables were analyzed with the independent t-test, χ2 test, analysis of variance, or Fisher’s exact test.Results: A total of 5,154 patients had glaucoma, and 14.8% of these had a retinal comorbidity. The prevalence of comorbid retinal disease was higher in patients with POAG (15.7% than in those with NTG (10.7%, PXG (10.1%, or pigmentary open-angle glaucoma (3.7%; P<0.05. Two hundred and two patients had diabetic retinopathy, with POAG patients (4.5% having a higher prevalence than those with CACG (1.4% or PXG (0.6%; P<0.001. There were 297 patients who had macular degeneration and both POAG (2.0% and PXG patients (2.9% had a higher prevalence of nonexudative macular degeneration than those with CACG (0%; P<0.01. Patients with comorbid retinal disease had a higher prevalence of blindness and low vision than those without comorbid

  5. A single-arm, investigator-initiated study of the efficacy, safety, and tolerability of intravitreal aflibercept injection in subjects with exudative age-related macular degeneration previously treated with ranibizumab or bevacizumab (ASSESS study: 12-month analysis

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    Singh RP


    Full Text Available Rishi P Singh, Sunil K Srivastava, Justis P Ehlers, Fabiana Q Silva, Rumneek Bedi, Andrew P Schachat, Peter K Kaiser Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA Summary statement: In subjects with active exudative age-related macular degeneration, treating with a fixed intravitreal aflibercept injection dosing regimen for 12 months demonstrated improved anatomic and vision endpoints from baseline.Purpose: Switching therapies in neovascular age-related macular degeneration (AMD may offer an advantage for some patients. This study evaluates the efficacy of intravitreal aflibercept injection (IAI in subjects previously treated with ranibizumab and/or bevacizumab.Methods: Subjects (n=26 were given monthly 2 mg of IAI for 3 months, followed by 2 mg once in every 2 months for up to 12 months. The mean absolute change from baseline in central subfield thickness (CST measured by optical coherence tomography and the mean change from baseline in best-corrected visual acuity (BCVA early treatment in diabetic retinopathy study (ETDRS letter score were obtained. Additionally, the percentage of subjects who gained or lost ≥15 letters of vision and the percentage of subjects who are 20/40 or better or 20/200 or worse were evaluated.Results: There was a mean decrease in CST of -50.3  µm (P<0.001 and a mean increase in ETDRS BCVA of +9.2 letters (P<0.001. Twenty-seven percent of subjects experienced a  ≥15-letter improvement in visual acuity, and no subject lost ≥3 lines of vision from baseline. Fifty percent of subjects were 20/40 or better, and 11.5% of subjects were 20/200 or worse at month 12.Conclusion: Fixed IAI dosing regimen for 12 months demonstrated improved anatomic and vision endpoints in subjects with active exudative AMD. Keywords: aflibercept, age-related macular degeneration, bevacizumab, ranibizumab, vascular endothelial growth factors

  6. Overview of Propulsion Controls and Diagnostics Research at NASA Glenn (United States)

    Garg, Sanjay


    With the increased emphasis on aircraft safety, enhanced performance and affordability, and the need to reduce the environmental impact of aircraft, there are many new challenges being faced by the designers of aircraft propulsion systems. The Controls and Dynamics Branch (CDB) at NASA (National Aeronautics and Space Administration) Glenn Research Center (GRC) in Cleveland, Ohio, is leading and participating in various projects in partnership with other organizations within GRC and across NASA, the U.S. aerospace industry, and academia to develop advanced controls and health management technologies that will help meet these challenges through the concept of an Intelligent Engine. CDB conducts propulsion control and diagnostics research in support of various programs and projects under the NASA Aeronautics Research Mission Directorate and the Human Exploration and Operations Mission Directorate. The paper first provides an overview of the various research tasks in CDB relative to the NASA programs and projects, and briefly describes the progress being made on each of these tasks. The discussion here is at a high level providing the objectives of the tasks, the technical challenges in meeting the objectives and most recent accomplishments. References are provided for each of the technical tasks for the reader to familiarize themselves with the details.

  7. Abdominal Pain: A Comparison between Neurogenic Bowel Dysfunction and Chronic Idiopathic Constipation (United States)

    Finnerup, Nanna Brix; Christensen, Peter


    Introduction. Most spinal-cord-injured patients have constipation. One-third develop chronic abdominal pain 10 years or more after injury. Nevertheless, very little is known about the nature of abdominal pain after spinal cord injury (SCI). It may be neuropathic or caused by constipation. Aim. To compare characteristics of abdominal pain in SCI with able-bodied with chronic idiopathic constipation (CIC). Subjects and Methods. 21 SCI and 15 CIC patients were referred for treatment of bowel symptoms. Constipation-related symptoms were assessed with the Cleveland Constipation Scoring System and the International Spinal Cord Injury Basic Bowel Function Data Set. Characteristics of abdominal pain were described using the Brief Danish Pain Questionnaire. Total gastrointestinal transit times (GITT) were measured by radiopaque markers. Results. Seventeen (81%) SCI and 14 (93%) CIC patients reported abdominal pain or discomfort within the last month (P = 0.38). Pain was considered more intense by CIC than by SCI patients (P GITT. Conclusion. Most characteristics of abdominal pain among SCI patients resemble those of CIC. This indicates that constipation is a major cause of pain after SCI. PMID:24159329

  8. Abdominal Pain: A Comparison between Neurogenic Bowel Dysfunction and Chronic Idiopathic Constipation

    Directory of Open Access Journals (Sweden)

    Pia Møller Faaborg


    Full Text Available Introduction. Most spinal-cord-injured patients have constipation. One-third develop chronic abdominal pain 10 years or more after injury. Nevertheless, very little is known about the nature of abdominal pain after spinal cord injury (SCI. It may be neuropathic or caused by constipation. Aim. To compare characteristics of abdominal pain in SCI with able-bodied with chronic idiopathic constipation (CIC. Subjects and Methods. 21 SCI and 15 CIC patients were referred for treatment of bowel symptoms. Constipation-related symptoms were assessed with the Cleveland Constipation Scoring System and the International Spinal Cord Injury Basic Bowel Function Data Set. Characteristics of abdominal pain were described using the Brief Danish Pain Questionnaire. Total gastrointestinal transit times (GITT were measured by radiopaque markers. Results. Seventeen (81% SCI and 14 (93% CIC patients reported abdominal pain or discomfort within the last month (. Pain was considered more intense by CIC than by SCI patients (. Only minor differences were found in patient’s qualitative description of abdominal pain or in the location of pain. In neither SCI nor CIC was pain associated with GITT. Conclusion. Most characteristics of abdominal pain among SCI patients resemble those of CIC. This indicates that constipation is a major cause of pain after SCI.

  9. Improving education in primary care: development of an online curriculum using the blended learning model

    Directory of Open Access Journals (Sweden)

    Lewin Linda


    Full Text Available Abstract Background Standardizing the experiences of medical students in a community preceptorship where clinical sites vary by geography and discipline can be challenging. Computer-assisted learning is prevalent in medical education and can help standardize experiences, but often is not used to its fullest advantage. A blended learning curriculum combining web-based modules with face-to-face learning can ensure students obtain core curricular principles. Methods This course was developed and used at The Case Western Reserve University School of Medicine and its associated preceptorship sites in the greater Cleveland area. Leaders of a two-year elective continuity experience at the Case Western Reserve School of Medicine used adult learning principles to develop four interactive online modules presenting basics of office practice, difficult patient interviews, common primary care diagnoses, and disease prevention. They can be viewed at Students completed surveys rating the content and technical performance of each module and completed a Generalist OSCE exam at the end of the course. Results Participating students rated all aspects of the course highly; particularly those related to charting and direct patient care. Additionally, they scored very well on the Generalist OSCE exam. Conclusion Students found the web-based modules to be valuable and to enhance their clinical learning. The blended learning model is a useful tool in designing web-based curriculum for enhancing the clinical curriculum of medical students.

  10. NATO Advanced Research Workshop on Frontiers of High-Pressure Research

    CERN Document Server

    Etters, Richard


    The role of high pressure experiments in the discovery of supercon­ ducting materials with a T. above liquid nitrogen temperature has demon­ strated the importance of such experiments. The same role holds true in the tailoring of materials for optoelectronic devices. In addition, much progress has been made recently in the search for metallic hydro­ gen, and the application of high pressure in polymer research has brought forth interesting results. These facts together with the suc­ cess of previous small size meetings (such as the "First International Conference on the Physics of Solids at High Pressure", held in 1965 in Tucson, Arizona, U. S. A. ; "High Pressure and Low Temperature Physics", held in 1977 in Cleveland, Ohio, U. S. A. ; and "Physics of Solids Under High Pressure", held in 1981 in bad Honnef, Germany), motivated us to organize a workshop with emphasis on the newest results and trends in these fields of high pressure research. Furthermore, it was intended to mix experienced and young scien�...

  11. Clinical management of behavioral characteristics of Prader–Willi syndrome

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    Alan Y Ho


    Full Text Available Alan Y Ho, Anastasia DimitropoulosDepartment of Psychology, Case Western Reserve University, Cleveland, OH, USAAbstract: Prader–Willi syndrome (PWS is a complex neurodevelopmental disorder caused by an abnormality on the long arm of chromosome 15 (q11–q13 that results in a host of phenotypic characteristics, dominated primarily by hyperphagia and insatiable appetite. Characteristic behavioral disturbances in PWS include excessive interest in food, skin picking, difficulty with a change in routine, temper tantrums, obsessive and compulsive behaviors, and mood fluctuations. Individuals with PWS typically have intellectual disabilities (borderline to mild/moderate mental retardation and exhibit a higher overall behavior disturbance compared to individuals with similar intellectual disability. Due to its multisystem disorder, family members, caregivers, physicians, dieticians, and speech-language pathologists all play an important role in the management and treatment of symptoms in an individual with PWS. This article reviews current research on behavior and cognition in PWS and discusses management guidelines for this disorder.Keywords: Prader–Willi syndrome; neurodevelopment, hyperphagia, disability

  12. Deregulation, Distrust, and Democracy: State and Local Action to Ensure Equitable Access to Healthy, Sustainably Produced Food. (United States)

    Wiley, Lindsay F


    Environmental, public health, alternative food, and food justice advocates are working together to achieve incremental agricultural subsidy and nutrition assistance reforms that increase access to fresh fruits and vegetables. When it comes to targeting food and beverage products for increased regulation and decreased consumption, however, the priorities of various food reform movements diverge. This article argues that foundational legal issues, including preemption of state and local authority to protect the public's health and welfare, increasing First Amendment protection for commercial speech, and eroding judicial deference to legislative policy judgments, present a more promising avenue for collaboration across movements than discrete food reform priorities around issues like sugary drinks, genetic modification, or organics. Using the Vermont Genetically Modified Organism (GMO) Labeling Act litigation, the Kauai GMO Cultivation Ordinance litigation, the New York City Sugary Drinks Portion Rule litigation, and the Cleveland Trans Fat Ban litigation as case studies, I discuss the foundational legal challenges faced by diverse food reformers, even when their discrete reform priorities diverge. I also 'explore the broader implications of cooperation among groups that respond differently to the "irrationalities" (from the public health perspective) or "values" (from the environmental and alternative food perspective) that permeate public risk perception for democratic governance in the face of scientific uncertainty.

  13. Lack of musicality? Explaining anomalies in some senior Korean Christians’ hymn singing

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    Jee-Weon Cha


    Full Text Available This article launches an inquiry into the ways in which some senior Korean Christians sing Protestant hymns at a Korean church in Cleveland, OH. The majority of the church members sing hymns as they are written; several older members (aged 65 or over born in rural Korea, however, systematically transform them. The older singers tend to turn any diatonic hymn into a pentatonic melody, lowering fa down to mi and pulling ti up to do. Drawing on a variety of disciplines such as music theory, psychology, ethnography, and cultural history, I propose categorical perception as a key to understanding melodic transformation. Even though the piano accompanist at the church—who is rigidly Western music oriented—criticizes the older singers for their lack of musicality, numerous psychological studies suggest that the older Korean singers transform the hymns, precisely because they are musically trained, albeit in regional Korean folk singing practices. My fieldwork at the Annual Hymn Competition and my interview with the preacher of the church reinforce the idea that categorical perception is not only existent but also strongly cultural.

  14. The development of a solid-state hydrogen sensor for rocket engine leakage detection (United States)

    Liu, Chung-Chiun

    Hydrogen propellant leakage poses significant operational problems in the rocket propulsion industry as well as for space exploratory applications. Vigorous efforts have been devoted to minimizing hydrogen leakage in assembly, test, and launch operations related to hydrogen propellant. The objective has been to reduce the operational cost of assembling and maintaining hydrogen delivery systems. Specifically, efforts have been made to develop a hydrogen leak detection system for point-contact measurement. Under the auspices of Lewis Research Center, the Electronics Design Center at Case Western Reserve University, Cleveland, Ohio, has undertaken the development of a point-contact hydrogen gas sensor with potential applications to the hydrogen propellant industry. We envision a sensor array consisting of numbers of discrete hydrogen sensors that can be located in potential leak sites. Silicon-based microfabrication and micromachining techniques are used in the fabrication of these sensor prototypes. Evaluations of the sensor are carried out in-house at Case Western Reserve University as well as at Lewis Research Center and GenCorp Aerojet, Sacramento, California. The hydrogen gas sensor is not only applicable in a hydrogen propulsion system, but also usable in many other civilian and industrial settings. This includes vehicles or facility use, or in the production of hydrogen gas. Dual space and commercial uses of these point-contacted hydrogen sensors are feasible and will directly meet the needs and objectives of NASA as well as various industrial segments.

  15. Miles In Trail (MIT) Restrictions: A Perspective (United States)

    Kopardekar, Parimal; Green, Steven; Roherty, Tom; Aston, John


    Miles-in-trail restrictions are issued to meet the airport and/or airspace capacity. The purpose of this paper is to review the currently practiced miles-in-trail operations for traffic flow management at a typical en route Air Traffic Control Center. The paper describes roles and considerations of both traffic management coordinators and the controllers in planning, coordination, execution, and monitoring of miles-in-trail restrictions. The paper addresses the type of decisions that traffic management coordinators must make and the different information required to plan and monitor miles-in-trail restrictions. The implications of miles-in-trail restrictions on controller workload are also addressed. Using the Cleveland center as an example, the paper also identified some challenging traffic situations that required miles-in-trail restrictions on a regular basis. The paper is expected to benefit the research and development community as it provides the current challenges in traffic flow management and strengths and weakness of miles-in-trail operations.

  16. Debris-flow initiation from large, slow-moving landslides (United States)

    Reid, M.E.; Brien, D.L.; LaHusen, R.G.; Roering, J.J.; de la Fuente, J.; Ellen, S.D.; ,


    In some mountainous terrain, debris flows preferentially initiate from the toes and margins of larger, deeper, slower-moving landslides. During the wet winter of 1997, we began real-time monitoring of the large, active Cleveland Corral landslide complex in California, USA. When the main slide is actively moving, small, shallow, first-time slides on the toe and margins mobilize into debris flows and travel down adjacent gullies. We monitored the acceleration of one such failure; changes in velocity provided precursory indications of rapid failure. Three factors appear to aid the initiation of debris flows at this site: 1) locally steepened ground created by dynamic landslide movement, 2) elevated pore-water pressures and abundant soil moisture, and 3) locally cracked and dilated materials. This association between debris flows and large landslides can be widespread in some terrain. Detailed photographic mapping in two watersheds of northwestern California illustrates that the areal density of debris-flow source landsliding is about 3 to 7 times greater in steep geomorphically fresher landslide deposits than in steep ground outside landslide deposits. ?? 2003 Millpress.

  17. Summary of U.S. Geological Survey studies conducted in cooperation with the Citizen Potawatomi Nation, central Oklahoma, 2011–14 (United States)

    Andrews, William J.; Becker, Carol J.; Ryter, Derek W.; Smith, S. Jerrod


    The U.S. Geological Survey conducted hydrologic studies and published three U.S. Geological Survey scientific investigations reports in cooperation with the Citizen Potawatomi Nation from 2011 to 2014 to characterize the quality and quantity of water resources. The study areas of those reports consisted of approximately 960 square miles in parts of three counties in central Oklahoma. This study area has multiple abundant sources of water, being underlain by three principal aquifers (alluvial/terrace, Central Oklahoma, and Vamoosa-Ada), being bordered by two major rivers (North Canadian and Canadian), and having several smaller drainages including the Little River in the central part of the study area and Salt Creek in the southeastern part of the study area. The Central Oklahoma aquifer (also referred to as the “Garber-Wellington aquifer”) underlies approximately 3,000 square miles in central Oklahoma in parts of Cleveland, Logan, Lincoln, Oklahoma, and Pottawatomie Counties and much of the study area. Water from these aquifers is used for municipal, industrial, commercial, agricultural, and domestic supplies.

  18. Changes in Occupational Radiation Exposures after Incorporation of a Real-time Dosimetry System in the Interventional Radiology Suite. (United States)

    Poudel, Sashi; Weir, Lori; Dowling, Dawn; Medich, David C


    A statistical pilot study was retrospectively performed to analyze potential changes in occupational radiation exposures to Interventional Radiology (IR) staff at Lawrence General Hospital after implementation of the i2 Active Radiation Dosimetry System (Unfors RaySafe Inc, 6045 Cochran Road Cleveland, OH 44139-3302). In this study, the monthly OSL dosimetry records obtained during the eight-month period prior to i2 implementation were normalized to the number of procedures performed during each month and statistically compared to the normalized dosimetry records obtained for the 8-mo period after i2 implementation. The resulting statistics included calculation of the mean and standard deviation of the dose equivalences per procedure and included appropriate hypothesis tests to assess for statistically valid differences between the pre and post i2 study periods. Hypothesis testing was performed on three groups of staff present during an IR procedure: The first group included all members of the IR staff, the second group consisted of the IR radiologists, and the third group consisted of the IR technician staff. After implementing the i2 active dosimetry system, participating members of the Lawrence General IR staff had a reduction in the average dose equivalence per procedure of 43.1% ± 16.7% (p = 0.04). Similarly, Lawrence General IR radiologists had a 65.8% ± 33.6% (p=0.01) reduction while the technologists had a 45.0% ± 14.4% (p=0.03) reduction.

  19. Study: Long nursing shifts linked to burnout, job dissatisfaction, negative patient assessments. (United States)


    While nurses often choose to work 12-hour shifts, there is new evidence that too many of these longer shifts can lead to burnout and job dissatisfaction. Further, a new study suggests that patients are less satisfied with their care when nurses are working longer shifts, and patient outcomes may suffer as well. Experts recommend education around this issue for both staff nurses and nurse managers, and they urge administrators to devise sensible scheduling solutions. A three-year study, involving 23,000 registered nurses from four states, showed that nurses working shifts of 10 hours or longer were up to two and a half times more likely to experience burnout and dissatisfaction with their jobs than nurses working shorter shifts. Also, the study showed that seven out of 10 patient outcomes were adversely impacted by the longest nursing shifts. The Cleveland Clinic's 'parent shift' gives nurses the option of working shifts of six hours or less in exchange for less pay and no benefits. Administrators use these nurses to help their units manage busy hours or patient surges.

  20. Navegación costarricense por el río San Juan

    Directory of Open Access Journals (Sweden)

    Ricardo Wheelock Román


    Full Text Available El Estado de Nicaragua afirma que el Laudo Cleveland zanjó todas las cuestiones relativas a los límites fronterizos terrestres con Costa Rica, a la vez que no se reconoce la sentencia de la CJC de 1916 ya que se extralimitó en sus funciones. Por el Tratado Jerez-Cañas, Costa Rica sólo puede servirse del Río San Juan para "objetos de comercio" y entrando por San Juan del Norte, para que lleguen al interior de Costa Rica, el Tratado no especifica la viceversa, por lo que no puede ser usado para fines turísticos, vía de navegación o de abastecimiento 0 que el derecho de navegar "con objetos de comercio" se pueda , como extensión de soberanía y jurisdicción costarricense a los buques y personas de ese país que navegan por el Río San Juan, 10 que resultaría en negación de la soberanía de Nicaragua

  1. An Engine Research Program Focused on Low Pressure Turbine Aerodynamic Performance (United States)

    Castner, Raymond; Wyzykowski, John; Chiapetta, Santo; Adamczyk, John


    A comprehensive test program was performed in the Propulsion Systems Laboratory at the NASA Glenn Research Center, Cleveland Ohio using a highly instrumented Pratt and Whitney Canada PW 545 turbofan engine. A key objective of this program was the development of a high-altitude database on small, high-bypass ratio engine performance and operability. In particular, the program documents the impact of altitude (Reynolds Number) on the aero-performance of the low-pressure turbine (fan turbine). A second objective was to assess the ability of a state-of-the-art CFD code to predict the effect of Reynolds number on the efficiency of the low-pressure turbine. CFD simulation performed prior and after the engine tests will be presented and discussed. Key findings are the ability of a state-of-the art CFD code to accurately predict the impact of Reynolds Number on the efficiency and flow capacity of the low-pressure turbine. In addition the CFD simulations showed the turbulent intensity exiting the low-pressure turbine to be high (9%). The level is consistent with measurements taken within an engine.

  2. Time-space Kriging to address the spatiotemporal misalignment in the large datasets. (United States)

    Liang, Dong; Kumar, Naresh


    This paper presents a Bayesian hierarchical spatiotemporal method of interpolation, termed as Markov Cube Kriging (MCK). The classical Kriging methods become computationally prohibitive, especially for large datasets due to the O(n(3)) matrix decomposition. MCK offers novel and computationally efficient solutions to address spatiotemporal misalignment, mismatch in the spatiotemporal scales and missing values across space and time in large spatiotemporal datasets. MCK is flexible in that it allows for non-separable spatiotemporal structure and nonstationary covariance at the hierarchical spatiotemporal scales. Employing MCK we developed estimates of daily concentration of fine particulates matter ≤2.5 μm in aerodynamic diameter (PM2.5) at 2.5 km spatial grid for the Cleveland Metropolitan Statistical Area, 2000 to 2009. Our validation and cross-validation suggest that MCK achieved robust prediction of spatiotemporal random effects and underlying hierarchical and nonstationary spatiotemporal structure in air pollution data. MCK has important implications for environmental epidemiology and environmental sciences for exposure quantification and collocation of data from different sources, available at different spatiotemporal scales.

  3. Validation of an Adaptive Combustion Instability Control Method for Gas-Turbine Engines (United States)

    Kopasakis, George; DeLaat, John C.; Chang, Clarence T.


    This paper describes ongoing testing of an adaptive control method to suppress high frequency thermo-acoustic instabilities like those found in lean-burning, low emission combustors that are being developed for future aircraft gas turbine engines. The method called Adaptive Sliding Phasor Averaged Control, was previously tested in an experimental rig designed to simulate a combustor with an instability of about 530 Hz. Results published earlier, and briefly presented here, demonstrated that this method was effective in suppressing the instability. Because this test rig did not exhibit a well pronounced instability, a question remained regarding the effectiveness of the control methodology when applied to a more coherent instability. To answer this question, a modified combustor rig was assembled at the NASA Glenn Research Center in Cleveland, Ohio. The modified rig exhibited a more coherent, higher amplitude instability, but at a lower frequency of about 315 Hz. Test results show that this control method successfully reduced the instability pressure of the lower frequency test rig. In addition, due to a certain phenomena discovered and reported earlier, the so called Intra-Harmonic Coupling, a dramatic suppression of the instability was achieved by focusing control on the second harmonic of the instability. These results and their implications are discussed, as well as a hypothesis describing the mechanism of intra-harmonic coupling.

  4. Atomic Oxygen Treatment for Non-Contact Removal of Organic Protective Coatings from Painting Surfaces (United States)

    Rutledge, Sharon K.; Banks, Bruce A.; Cales, Michael


    Current techniques for removal of varnish (lacquer) and other organic protective coatings from paintings involve contact with the surface. This contact can remove pigment, or alter the shape and location of paint on the canvas surface. A thermal energy atomic oxygen plasma, developed to simulate the space environment in low Earth orbit, easily removes these organic materials. Uniform removal of organic protective coatings from the surfaces of paintings is accomplished through chemical reaction. Atomic oxygen will not react with oxides so that most paint pigments will not be affected by the reaction. For paintings containing organic pigments, the exposure can be carefully timed so that the removal stops just short of the pigment. Color samples of Alizarin Crimson, Sap Green, and Zinc White coated with Damar lacquer were exposed to atomic oxygen. The lacquer was easily removed from all of the samples. Additionally, no noticeable change in appearance was observed after the lacquer was reapplied. The same observations were made on a painted canvas test sample obtained from the Cleveland Museum of Art. Scanning electron microscope photographs showed a slight microscopic texturing of the vehicle after exposure. However, there was no removal or disturbance of the paint pigment on the surface. It appears that noncontact cleaning using atomic oxygen may provide a viable alternative to other cleaning techniques. It is especially attractive in cases where the organic protective surface cannot be acceptably or safely removed by conventional techniques.

  5. Warm Pressurant Gas Effects on the Liquid Hydrogen Bubble Point (United States)

    Hartwig, Jason W.; McQuillen, John B.; Chato, David J.


    This paper presents experimental results for the liquid hydrogen bubble point tests using warm pressurant gases conducted at the Cryogenic Components Cell 7 facility at the NASA Glenn Research Center in Cleveland, Ohio. The purpose of the test series was to determine the effect of elevating the temperature of the pressurant gas on the performance of a liquid acquisition device. Three fine mesh screen samples (325 x 2300, 450 x 2750, 510 x 3600) were tested in liquid hydrogen using cold and warm noncondensible (gaseous helium) and condensable (gaseous hydrogen) pressurization schemes. Gases were conditioned from 0 to 90 K above the liquid temperature. Results clearly indicate a degradation in bubble point pressure using warm gas, with a greater reduction in performance using condensable over noncondensible pressurization. Degradation in the bubble point pressure is inversely proportional to screen porosity, as the coarsest mesh demonstrated the highest degradation. Results here have implication on both pressurization and LAD system design for all future cryogenic propulsion systems. A detailed review of historical heated gas tests is also presented for comparison to current results.

  6. Interprofessional Flight Camp. (United States)

    Alfes, Celeste M; Rowe, Amanda S


    The Dorothy Ebersbach Academic Center for Flight Nursing in Cleveland, OH, holds an annual flight camp designed for master's degree nursing students in the acute care nurse practitioner program, subspecializing in flight nursing at the Frances Payne Bolton School of Nursing at Case Western Reserve University. The weeklong interprofessional training is also open to any health care provider working in an acute care setting and focuses on critical care updates, trauma, and emergency care within the critical care transport environment. This year, 29 graduate nursing students enrolled in a master's degree program from Puerto Rico attended. Although the emergency department in Puerto Rico sees and cares for trauma patients, there is no formal trauma training program. Furthermore, the country only has 1 rotor wing air medical transport service located at the Puerto Rico Medical Center in San Juan. Flight faculty and graduate teaching assistants spent approximately 9 months planning for their participation in our 13th annual flight camp. Students from Puerto Rico were extremely pleased with the learning experiences at camp and expressed particular interest in having more training time within the helicopter flight simulator.

  7. Performance Gains of Propellant Management Devices for Liquid Hydrogen Depots (United States)

    Hartwig, Jason W.; McQuillen, John B.; Chato, David J.


    This paper presents background, experimental design, and preliminary experimental results for the liquid hydrogen bubble point tests conducted at the Cryogenic Components Cell 7 facility at the NASA Glenn Research Center in Cleveland, Ohio. The purpose of the test series was to investigate the parameters that affect liquid acquisition device (LAD) performance in a liquid hydrogen (LH2) propellant tank, to mitigate risk in the final design of the LAD for the Cryogenic Propellant Storage and Transfer Technology Demonstration Mission, and to provide insight into optimal LAD operation for future LH2 depots. Preliminary test results show an increase in performance and screen retention over the low reference LH2 bubble point value for a 325 2300 screen in three separate ways, thus improving fundamental LH2 LAD performance. By using a finer mesh screen, operating at a colder liquid temperature, and pressurizing with a noncondensible pressurant gas, a significant increase in margin is achieved in bubble point pressure for LH2 screen channel LADs.

  8. Talking with members of the globalization of materials R&D study (United States)

    Byko, Maureen


    The Committee on Globalization of Materials Research and Development was appointed by the U.S. National Research Council in December 2003. Its charge: to assess the status and impacts of the globalization of materials R&D. The 12-member committee, which included representatives from both U.S. and international academia and industry, published its findings in August 2005 in the form of a report Globalization of Materials R&D —Time for a National Strategy. To gain some perspective on the report's findings, JOM spoke with representatives of the committee, retired from Alcoa; Gordon Geiger, director of the engineering management program and professor of industrial engineering at the University of Arizona; Jennie Hwang, president of H-Technologies Group in Cleveland. Ohio: and Michael Jaffe, director, Medical Device Concept Laboratory of New Jersey Institute of Technology and associate research professor at Rutgers University in Newark, New Jersey. See the sidebar for a listing of the committee's recommendations. The interviews were conducted by e-mail and telephone; respondents chose which questions to answer.

  9. Generation of Electrical Power from Stimulated Muscle Contractions Evaluated (United States)

    Lewandowski, Beth; Kilgore, Kevin; Ercegovic, David B.


    This project is a collaborative effort between NASA Glenn Research Center's Revolutionary Aeropropulsion Concepts (RAC) Project, part of the NASA Aerospace Propulsion and Power Program of the Aerospace Technology Enterprise, and Case Western Reserve University's Cleveland Functional Electrical Stimulation (FES) Center. The RAC Project foresees implantable power requirements for future applications such as organically based sensor platforms and robotics that can interface with the human senses. One of the goals of the FES Center is to develop a totally implantable neural prosthesis. This goal is based on feedback from patients who would prefer a system with an internal power source over the currently used system with an external power source. The conversion system under investigation would transform the energy produced from a stimulated muscle contraction into electrical energy. We hypothesize that the output power of the system will be greater than the input power necessary to initiate, sustain, and control the electrical conversion system because of the stored potential energy of the muscle. If the system can be made biocompatible, durable, and with the potential for sustained use, then the biological power source will be a viable solution.

  10. A case series discussing the anaesthetic management of pregnant patients with brain tumours [v2; ref status: indexed,

    Directory of Open Access Journals (Sweden)

    Alaa A Abd-Elsayed


    Full Text Available Pregnancy may aggravate the natural history of an intracranial tumour, and may even unmask a previously unknown diagnosis. Here we present a series of seven patients who had brain tumours during pregnancy. The aim of this case series is to characterize the current perioperative management and to suggest evidence based guidelines for the anaesthetic management of pregnant females with brain tumours. This is a retrospective study. Information on pregnant patients diagnosed with brain tumours that underwent caesarean section (CS and/or brain tumour resection from May 2003 through June 2008 was obtained from the Department of General Anaesthesia and the Rose Ella Burkhardt Brain Tumour & Neuro-Oncology Centre (BBTC at the Cleveland Clinic, OH, USA. The mean age was 34.5 years (range 29-40 years old. Six patients had glioma, two of whom had concomitant craniotomy and CS. Six cases had the tumour in the frontal lobe. Four cases were operated on under general anaesthesia and three underwent awake craniotomy. The neonatal outcomes of the six patients with elective or emergent delivery were six viable infants with normal Apgar scores. Pregnancy was terminated in the 7th patient. In conclusion, good knowledge of the variable anesthetic agents and their effects on the fetus is very important in managing those patients.

  11. White flight or flight from poverty?

    CERN Document Server

    Jego, C; Jego, Charles; Roehner, Bertrand M.


    The phenomenon of White flight is often illustrated by the case of Detroit whose population dropped from 1.80 million to 0.95 million between 1950 and 2000 while at the same time its Black and Hispanic component grew from 30 percent to 85 percent. But is this case really representative? The present paper shows that the phenomenon of White flight is in fact essentially a flight from poverty. As a confirmation, we show that the changes in White or Black populations are highly correlated which means that White flight is always paralleled by Black flight (and Hispanic flight as well). This broader interpretation of White flight accounts not only for the case of northern cities such as Cincinnati, Cleveland or Detroit, but for all population changes at county level, provided the population density is higher than a threshold of about 50 per square-kilometer which corresponds to moderately urbanized areas (as can be found in states like Indiana or Virginia for instance).

  12. Changes in Characteristics and Treatment Patterns of Patients with Newly Diagnosed Type 2 Diabetes in a Large United States Integrated Health System between 2008 and 2013 (United States)

    Pantalone, Kevin M.; Hobbs, Todd M.; Wells, Brian J.; Kong, Sheldon X.; Kattan, Michael W.; Bouchard, Jonathan; Chagin, Kevin M.; Yu, Changhong; Sakurada, Brian; Milinovich, Alex; Weng, Wayne; Bauman, Janine M.; Zimmerman, Robert S.


    To assess changes in the clinical characteristics and treatment patterns of patients with newly diagnosed type 2 diabetes (T2D), the electronic health record system at Cleveland Clinic was used to create cross-sectional summaries of all patients with new-onset T2D in 2008 and 2013. Differences between the 2008 and 2013 data sets were assessed after adjusting for age, gender, race, and income. Approximately one-third of patients with newly diagnosed T2D in 2008 and 2013 had an A1C ≥8%, suggesting the continued presence of a delayed recognition of the disease. Patients with newly diagnosed T2D in 2008 were older than those in 2013. Hypertension, cardiovascular disease, and neuropathy were highly prevalent among patients diagnosed with T2D. The prevalence of neuropathy, cerebrovascular disease, and peripheral vascular disease increased from 2008 to 2013. Metformin was the most commonly prescribed antidiabetic medication. Sulfonylurea usage remained unchanged, while use of thiazolidinediones decreased considerably. PMID:27398040

  13. Role of extended release quetiapine in the management of bipolar disorders

    Directory of Open Access Journals (Sweden)

    Rayan K Al Jurdi


    Full Text Available Rayan K Al Jurdi1,2, Lena A Dixit1, Martha Sajatovic3 1Baylor College of Medicine, Department of Psychiatry, Houston, Texas, USA; 2South Central Mental Illness Research and Clinical Core, Department of Veterans Affairs, Houston, Texas; 3Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, Ohio, USAAbstract: Atypical antipsychotics have become a widely utilized component of the bipolar disorder treatment armamentarium, with approximately 45% of bipolar patients prescribed atypicals. Over the last decade all atypical drugs except for clozapine have received a Food and Drug Administration (FDA bipolar indication. In October 2008, the FDA approved quetiapine XR monotherapy for the treatment of acute depressive episodes of bipolar disorder and acute manic or mixed episodes in bipolar I disorder based on two placebo-control trials. Quetiapine was also approved as adjunct therapy with lithium and divalproex for the treatment of acute manic or mixed episodes as well as maintenance of bipolar I disorder. In contrast to immediate release quetiapine which may require a twice-daily regimen, the XR formulation is intended for once-daily administration. This drug profile of quetiapine XR will address chemistry, pharmacodynamics, pharmacokinetics, metabolism, safety and tolerability and clinical trials in bipolar disorder.Keywords: quetiapine XR, bipolar disorder

  14. Chamber and field evaluations of air pollution tolerances of urban trees

    Energy Technology Data Exchange (ETDEWEB)

    Karnosky, D.F.


    Results are presented for a study of the relative air pollution tolerances of 32 urban-tree cultivars as determined by both chamber fumigations and field exposures. Tolerances to ozone and sulfur dioxide, alone and in combination, were determined using short-term, acute doses administered while the plants were inside a plastic fumigation chamber located inside the Cary Arboretum greenhouses. In a follow-up study still underway, representatives of the same cultivars were outplanted at four locations in the greater New York City area. To date, only oxidant-type injury has been observed on trees in the field plots. Cultivars tolerant to all chamber and field exposures were Acer platanoides Cleveland, Crimson King, Emerald Queen, Jade Glen, and Summershade; Acer rubrum Autumn Flame and Red Sunset; Acer saccharum Green Mountain and Temple's Upright; Fagus sylvatica Rotundifolia; Fraxinus pennsylvanica Summit; and Ginkgo biloba Fastigate and Sentry. Cultivars sensitive to ozone as determined by the chamber and field tests and that may serve as bioindicators of the presence of ozone were Gleditsia triacanthos inermis imperial and Platanus acerifolia Bloodgood.

  15. Making the grade in a portfolio-based system: student performance and the student perspective

    Directory of Open Access Journals (Sweden)

    Amy S. Nowacki


    Full Text Available Assessment is such an integral part of the educational system that we rarely reflect on its value and impact. Portfolios have gained in popularity, but much attention has emphasized the end-user and portfolio assessment. Here we focus on the portfolio creator (the student and examine whether their educational needs are met with such an assessment method. This study aims to investigate how assessment practices influence classroom performance and the learning experience of the student in a graduate education setting. Studied were 33 medical students at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, a program utilizing a portfolio-based system. The students may elect to simultaneously enroll in a Masters program; however, these programs employ traditional letter grades. Thus creating a unique opportunity to assess 25 portfolio only (P students and 8 portfolio and grade (PG students concurrently taking a course that counts for both programs. Classroom performance was measured via a comprehensive evaluation where the PG students scored modestly better (median total scores, 72% P vs. 76% PG. Additionally, a survey was conducted to gain insight into student’s perspective on how assessment method impacts the learning experience. The students in the PG group (those receiving a grade reported increased stress but greater affirmation and self-assurance regarding their knowledge and skill mastery. Incorporation of such affirmation remains a challenge for portfolio-based systems and an area for investigation and improvement.

  16. Suppression of Transient Events by Levitation (STABLE): Results From the USML-2 Mission. Experiment 38 (United States)

    Nurre, Gerald S.; Edberg, Donald L.


    Microgravity science payloads can be extremely sensitive to vibrations from machinery, acoustics, ventilation, and crew activity. Suppression of Transient Acceleration by Levitation (STABLE) is an active vibration isolation system designed to protect payloads from these disturbances. This paper gives an account of results from the flight demonstration of the STABLE microgravity isolation system, which was developed and successfully flight tested in orbit during USML-2, with the participation of Astronaut Fred Leslie. Following a very brief description of the operational principles, the hardware and software design, and performance criteria, results of the analysis of measured flight data are presented to provide an evaluation of system performance parameters, including acceleration attenuation, assessment of sway space, system power consumption, and other factors critical to the performance of an isolation system. Lessons learned and potential design improvements and evolutions are discussed. Data reduction by Robert Boucher of McDonnell Douglas Aerospace (MDA) was substantially assisted by Kenneth Hrovat of Tal-Cut, Inc., under support from National Aeronautics and Space Administration/Lewis Research Center (LeRC), Cleveland, OH.

  17. Monitoring Local Strain in a Thermal Barrier Coating System Under Thermal Mechanical Gas Turbine Operating Conditions (United States)

    Manero, Albert; Sofronsky, Stephen; Knipe, Kevin; Meid, Carla; Wischek, Janine; Okasinski, John; Almer, Jonathan; Karlsson, Anette M.; Raghavan, Seetha; Bartsch, Marion


    Advances in aircraft and land-based turbine engines have been increasing the extreme loading conditions on traditional engine components and have incited the need for improved performance with the use of protective coatings. These protective coatings shield the load-bearing super alloy blades from the high-temperature combustion gases by creating a thermal gradient over their thickness. This addition extends the life and performance of blades. A more complete understanding of the behavior, failure mechanics, and life expectancy for turbine blades and their coatings is needed to enhance and validate simulation models. As new thermal-barrier-coated materials and deposition methods are developed, strides to effectively test, evaluate, and prepare the technology for industry deployment are of paramount interest. Coupling the experience and expertise of researchers at the University of Central Florida, The German Aerospace Center, and Cleveland State University with the world-class synchrotron x-ray beam at the Advanced Photon Source in Argonne National Laboratory, the synergistic collaboration has yielded previously unseen measurements to look inside the coating layer system for in situ strain measurements during representative service loading. These findings quantify the in situ strain response on multilayer thermal barrier coatings and shed light on the elastic and nonelastic properties of the layers and the role of mechanical load and internal cooling variations on the response. The article discusses the experimental configuration and development of equipment to perform in situ strain measurements on multilayer thin coatings and provides an overview of the achievements thus far.

  18. Commentary: Recommendations and remaining questions for health care leadership training programs. (United States)

    Stoller, James K


    Effective leadership is critical for optimizing cost, access, and quality in health care. Creating a pipeline of effective health care leaders requires developing leadership competencies that differ from the usual criteria of clinical and scientific excellence by which physicians have traditionally been promoted to leadership positions. Specific competencies that differentiate effective leaders from average leaders, especially emotional intelligence and its component abilities, are essential for effective leadership.Adopting a long-standing practice from successful corporations, some health care institutions, medical societies, and business schools now offer leadership programs that address these differentiating leadership competencies. The author draws on experience with such programs through the Cleveland Clinic Academy to provide recommendations for health care leadership training and to identify unanswered questions about such programs.The author recommends that such training should be broadly available to all health care leadership communities (i.e., nurses, administrators, and physicians). A progressive curriculum, starting with foundational concepts and extending to coaching and feedback opportunities through experiential learning, recognizes the challenge of becoming an effective leader and the long time line needed to do so. Linking leadership courses to continuing medical education and to graduate credit opportunities is appealing to participants. Other recommendations focus on the importance of current leaders' involvement in nominating emerging leaders for participation, embedding leadership development discussions in faculty's professional reviews, and blending discussion of frameworks and theory with practical, experiential lessons. The author identifies questions about the benefits of formal health care leadership training that remain to be answered.

  19. Does plasmin have anticoagulant activity?

    Directory of Open Access Journals (Sweden)

    Jane Hoover-Plow


    Full Text Available Jane Hoover-PlowJoseph J Jacobs Center for Thrombosis and Vascular Biology, Departments of Cardiovascular Medicine and Molecular Cardiology, Lerner Research Institute Cleveland Clinic, Ohio, USAAbstract: The coagulation and fibrinolytic pathways regulate hemostasis and thrombosis, and an imbalance in these pathways may result in pathologic hemophilia or thrombosis. The plasminogen system is the primary proteolytic pathway for fibrinolysis, but also has important proteolytic functions in cell migration, extracellular matrix degradation, metalloproteinase activation, and hormone processing. Several studies have demonstrated plasmin cleavage and inactivation of several coagulation factors, suggesting plasmin may be not only be the primary fibrinolytic enzyme, but may have anticoagulant properties as well. The objective of this review is to examine both in vitro and in vivo evidence for plasmin inactivation of coagulation, and to consider whether plasmin may act as a physiological regulator of coagulation. While several studies have demonstrated strong evidence for plasmin cleavage and inactivation of coagulation factors FV, FVIII, FIX, and FX in vitro, in vivo evidence is lacking for a physiologic role for plasmin as an anticoagulant. However, inactivation of coagulation factors by plasmin may be useful as a localized anticoagulant therapy or as a combined thrombolytic and anticoagulant therapy.Keywords: thrombosis, anticoagulant, cardiovascular disease, plasminogen’s protease, blood

  20. 2003年英特尔国际科学与工程学大奖赛印象与感受

    Institute of Scientific and Technical Information of China (English)



    @@ 2003年5月11日至19日,英特尔国际科学与工程学大奖赛(Intel ISEF)在美国俄亥俄州的克里夫兰(Cleveland)举行,来自31个国家和4个地区的1346个课题的研究者和他们的部分指导教师参加了本次大奖赛,在此期间,2003英特尔教育家论坛(Intel Educator Academy)与ISEF同期举行,来自阿根廷、日本、韩国、俄罗斯等十几个国家及美国7个州的科学教育工作者出席了本次会议.作为中国代表,我参加了本届教育论坛并观摩了ISEF的全部主要活动.

  1. Heart Disease Diagnosis Utilizing Hybrid Fuzzy Wavelet Neural Network and Teaching Learning Based Optimization Algorithm

    Directory of Open Access Journals (Sweden)

    Jamal Salahaldeen Majeed Alneamy


    Full Text Available Among the various diseases that threaten human life is heart disease. This disease is considered to be one of the leading causes of death in the world. Actually, the medical diagnosis of heart disease is a complex task and must be made in an accurate manner. Therefore, a software has been developed based on advanced computer technologies to assist doctors in the diagnostic process. This paper intends to use the hybrid teaching learning based optimization (TLBO algorithm and fuzzy wavelet neural network (FWNN for heart disease diagnosis. The TLBO algorithm is applied to enhance performance of the FWNN. The hybrid TLBO algorithm with FWNN is used to classify the Cleveland heart disease dataset obtained from the University of California at Irvine (UCI machine learning repository. The performance of the proposed method (TLBO_FWNN is estimated using K-fold cross validation based on mean square error (MSE, classification accuracy, and the execution time. The experimental results show that TLBO_FWNN has an effective performance for diagnosing heart disease with 90.29% accuracy and superior performance compared to other methods in the literature.

  2. Terrestrial photovoltaic power systems with sunlight concentration. Annual progress report, January 1, 1975--December 31, 1975

    Energy Technology Data Exchange (ETDEWEB)

    Backus, C.E.


    This annual report is for the second year of a program to investigate the characteristics of the components and the total system using sunlight concentrated onto solar cells. The second year was primarily to experimentally investigate the conclusions of the first year of analytical studies. Cells have been fabricated that are designed for different intensities. Typically the efficiency of a cell will increase from its 11 percent at AM1 peak to efficiency at the designed concentration level and return to its initial efficiency at about 3 times its designed concentration level. The developed cells have been tested under high intensity simulators and in concentrated sunlight and have shown to have the predicted response. The experimental testing of passive cooling limitations for cooling cells with just finned arrangements in the back of the cell has been completed in the controlled environment of a wind tunnel. These experiments have confirmed the heat transfer coefficients that had been used in the analytical studies. Testing was done to collect heat transfer coefficients for actual wind conditions and these data show good agreement with the controlled wind tunnel data. Four photovoltaic/concentrator system experiments have been started with CR of about 3, 10, 25, and 100. System analysis has indicated that photovoltaic concentration systems may be attractive in low solar irradiation areas such as Cleveland.

  3. High Input Voltage, Silicon Carbide Power Processing Unit Performance Demonstration (United States)

    Bozak, Karin E.; Pinero, Luis R.; Scheidegger, Robert J.; Aulisio, Michael V.; Gonzalez, Marcelo C.; Birchenough, Arthur G.


    A silicon carbide brassboard power processing unit has been developed by the NASA Glenn Research Center in Cleveland, Ohio. The power processing unit operates from two sources: a nominal 300 Volt high voltage input bus and a nominal 28 Volt low voltage input bus. The design of the power processing unit includes four low voltage, low power auxiliary supplies, and two parallel 7.5 kilowatt (kW) discharge power supplies that are capable of providing up to 15 kilowatts of total power at 300 to 500 Volts (V) to the thruster. Additionally, the unit contains a housekeeping supply, high voltage input filter, low voltage input filter, and master control board, such that the complete brassboard unit is capable of operating a 12.5 kilowatt Hall effect thruster. The performance of the unit was characterized under both ambient and thermal vacuum test conditions, and the results demonstrate exceptional performance with full power efficiencies exceeding 97%. The unit was also tested with a 12.5kW Hall effect thruster to verify compatibility and output filter specifications. With space-qualified silicon carbide or similar high voltage, high efficiency power devices, this would provide a design solution to address the need for high power electric propulsion systems.

  4. The status of failure and reliability testing of artificial blood pumps. (United States)

    Patel, Sonna M; Throckmorton, Amy L; Untaroiu, Alexandrina; Allaire, Paul E; Wood, Houston G; Olsen, Don B


    Artificial blood pumps are today's most promising bridge-to-transplant, bridge-to-recovery, and destination therapy solutions for patients with congestive heart failure. There is a critical need for increased reliability and safety as the next generation of artificial blood pumps approach final development for long-term destination therapy. To date, extensive failure and reliability studies of these devices are considered intellectual property and thus remain unpublished. Presently, the Novacor N100PC, Thoratec VAD, and HeartMate LVAS (IP and XVE) comprise the only four artificial blood pumps commercially available for the treatment of congestive heart failure in the United States. The CardioWest TAH recently received premarket approval from the US Food and Drug Administration. With investigational device exemptions, the AB-180, AbioCor, LionHeart, DeBakey, and Flowmaker are approved for clinical testing. Other blood pumps, such as the American BioMed-Baylor TAH, CorAide, Cleveland Clinic-Nimbus TAH, HeartMate III, Hemadyne, and MagScrew TAH are currently in various stages of mock loop and animal testing, as indicated in published literature. This article extensively reviews in vitro testing, in vivo testing, and the early clinical testing of artificial blood pumps in the United States, as it relates to failure and reliability. This detailed literature review has not been published before and provides a thorough documentation of available data and testing procedures regarding failure and reliability of these various pumps.

  5. Summary of comments received from workshops on radiological criteria for decommissioning

    Energy Technology Data Exchange (ETDEWEB)

    Caplin, J.; Page, G.; Smith, D.; Wiblin, C. [Advanced Systems Technology, Inc., Atlanta, GA (United States)


    The Nuclear Regulatory Commission (NRC) is conducting an enhanced participatory rulemaking to establish radiological criteria for site cleanup and decommissioning of NRC-licensed facilities. Open public meetings were held during 1993 in Chicago, IL, San Francisco, CA, Boston, MA, Dallas, TX, Philadelphia, PA, Atlanta, GA, and Washington, DC. Interested parties were invited to provide input on the rulemaking issues before the NRC staff develops a draft proposed rule. This report summarizes 3,635 comments categorized from transcripts of the seven workshops and 1,677 comments from 100 NRC docketed letters from individuals and organizations. No analysis or response to the comments is included. The comments reflect a broad spectrum of viewpoints on the issues related to radiological criteria for site cleanup and decommissioning. The NRC also held public meetings on the scope of the Generic Environmental Impact Statement (GEIS) during July 1993. The GEIS meetings were held in Washington, DC., San Francisco, CA, Oklahoma City, OK, and Cleveland, OH. Related comments from these meetings were reviewed and comments which differed substantially from those from the workshops are also summarized in the body of the report. A summary of the comments from the GEIS scoping meetings is included as an Appendix.

  6. Impact of value based breast cancer care pathway implementation on pre-operative breast magnetic resonance imaging utilization (United States)

    McCray, Devina K. S.; Grobmyer, Stephen R.


    Background Bilateral breast magnetic resonance imaging (MRI) is commonly used in the diagnostic workup of breast cancer (BC) to assess extent of disease and identify occult foci of disease. However, evidence for routine use of pre-operative MRI is lacking. Breast MRI is costly and can lead to unnecessary tests and treatment delays. Clinical care pathways (care paths) are value-based guidelines, which define management recommendations derived by expert consensus and available evidence based data. At Cleveland Clinic, care paths created for newly diagnosed BC patients recommend selective use of pre-operative MRI. We evaluated the number of pre-operative MRIs ordered before and after implementing an institution wide BC care paths in April 2014. Methods A retrospective review was conducted of BC cases during the years 2012, 2014, and part of 2015. Patient, tumor and treatment characteristics were collected. Pre-operative MRI utilization was compared before and after care path implementation. Results We identified 1,515 BC patients during the study period. Patients were more likely to undergo pre-operative MRI in 2012 than 2014 (OR: 2.77; Pcare path indications. Conclusions Implementation of online BC care paths at our institution was associated with a decreased use of pre-operative MRI overall and in patients without a BC care path indication, driving value based care through the reduction of pre-operative breast MRIs. PMID:28210553

  7. Implementing a low-starch biscuit-free diet in zoo gorillas: the impact on health. (United States)

    Less, E H; Lukas, K E; Bergl, R; Ball, R; Kuhar, C W; Lavin, S R; Raghanti, M A; Wensvoort, J; Willis, M A; Dennis, P M


    In the wild, western lowland gorillas consume a diet high in fiber and low in caloric density. In contrast, many gorillas in zoos consume a diet that is high-calorie and low in fiber. Some items commonly used in captive gorilla diets contain high levels of starch and sugars, which are minimal in the natural diet of gorillas. There is a growing concern that captive gorillas may qualify as obese. Furthermore, the leading cause of death for adult male gorillas in zoos is heart disease. In humans, a diet that is high in simple carbohydrates is associated with both obesity and the incidence of heart disease. In response to these issues, we implemented a biscuit-free diet (free of biscuits and low in fruit) and measured serum biomarkers of obesity and insulin resistance pre- and post-diet change at three institutions: North Carolina Zoological Garden, Cleveland Metroparks Zoo, and Columbus Zoo and Aquarium. We also added a resistant starch supplement to gorilla diets at two of the above institutions. We anticipated that these diet changes would positively affect biomarkers of obesity and insulin resistance. Both diet manipulations led to a reduction in insulin. Resistant starch also decreased overall serum cholesterol levels. Future research will examine these health changes in a greater number of individuals to determine if the results remain consistent with these preliminary findings.

  8. Environmental Effects of Offshore Wind Development. Fiscal Year 2012 Progress Report

    Energy Technology Data Exchange (ETDEWEB)

    Copping, Andrea E.; Hanna, Luke A.; Butner, R. Scott; Carlson, Thomas J.; Halvorsen, Michele B.; Duberstein, Corey A.; Matzner, Shari; Whiting, Jonathan M.; Blake, Kara M.; Stavole, Jessica


    Potential environmental effects of offshore wind (OSW) energy projects are not well understood, and regulatory agencies are required to make decisions in spite of substantial uncertainty about environmental impacts and their long-term consequences. An understanding of risks associated with interactions between OSW installations and aquatic receptors, including animals, habitats, and ecosystems, can help define key uncertainties and focus regulatory actions and scientific studies on interactions of most concern. To examine the environmental risks associated with OSW developments in the U.S. Pacific Northwest National Laboratory (PNNL) focused on the following four priority research areas in FY 2012: • Environmental Risk Evaluation System (ERES) - Followed project developments on the two OSW projects that PNNL screened in FY 2011 for environmental consequence: Fishermen’s Energy off the coast of Atlantic City, NJ and LEEDCo. near Cleveland, OH in Lake Erie. • Tethys - Developed a smart knowledge base which houses environmental research, data and information pertaining to OSW energy: • Technical Assessment - Produced a new software to create an automated process of identifying and differentiating between flying organism such as birds and bats by using thermal imagery; and • North Atlantic Right Whales - Developed an environmental risk management system to mitigate the impacts on North Atlantic Right Whales (NARW) during installation and piledriving stages of OSW developments. By identifying and addressing the highest priority environmental risks for OSW devices and associated installations the ERES process assists project proponents, regulators, and stakeholders to engage in the most efficient and effective siting and permitting pathways.

  9. Use of a Closed-Loop Tracking Algorithm for Orientation Bias Determination of an S-Band Ground Station (United States)

    Welch, Bryan W.; Schrage, Dean S.; Piasecki, Marie T.


    The Space Communications and Navigation (SCaN) Testbed project completed installation and checkout testing of a new S-Band ground station at the NASA Glenn Research Center in Cleveland, Ohio in 2015. As with all ground stations, a key alignment process must be conducted to obtain offset angles in azimuth (AZ) and elevation (EL). In telescopes with AZ-EL gimbals, this is normally done with a two-star alignment process, where telescope-based pointing vectors are derived from catalogued locations with the AZ-EL bias angles derived from the pointing vector difference. For an antenna, the process is complicated without an optical asset. For the present study, the solution was to utilize the gimbal control algorithms closed-loop tracking capability to acquire the peak received power signal automatically from two distinct NASA Tracking and Data Relay Satellite (TDRS) spacecraft, without a human making the pointing adjustments. Briefly, the TDRS satellite acts as a simulated optical source and the alignment process proceeds exactly the same way as a one-star alignment. The data reduction process, which will be discussed in the paper, results in two bias angles which are retained for future pointing determination. Finally, the paper compares the test results and provides lessons learned from the activity.

  10. Association of the innate immunity and inflammation pathway with advanced prostate cancer risk.

    Directory of Open Access Journals (Sweden)

    Rémi Kazma

    Full Text Available Prostate cancer is the most frequent and second most lethal cancer in men in the United States. Innate immunity and inflammation may increase the risk of prostate cancer. To determine the role of innate immunity and inflammation in advanced prostate cancer, we investigated the association of 320 single nucleotide polymorphisms, located in 46 genes involved in this pathway, with disease risk using 494 cases with advanced disease and 536 controls from Cleveland, Ohio. Taken together, the whole pathway was associated with advanced prostate cancer risk (P = 0.02. Two sub-pathways (intracellular antiviral molecules and extracellular pattern recognition and four genes in these sub-pathways (TLR1, TLR6, OAS1, and OAS2 were nominally associated with advanced prostate cancer risk and harbor several SNPs nominally associated with advanced prostate cancer risk. Our results suggest that the innate immunity and inflammation pathway may play a modest role in the etiology of advanced prostate cancer through multiple small effects.

  11. Pathways, Networks and Systems Medicine Conferences

    Energy Technology Data Exchange (ETDEWEB)

    Nadeau, Joseph H. [Pacific Northwest Research Institute


    The 6th Pathways, Networks and Systems Medicine Conference was held at the Minoa Palace Conference Center, Chania, Crete, Greece (16-21 June 2008). The Organizing Committee was composed of Joe Nadeau (CWRU, Cleveland), Rudi Balling (German Research Centre, Brauschweig), David Galas (Institute for Systems Biology, Seattle), Lee Hood (Institute for Systems Biology, Seattle), Diane Isonaka (Seattle), Fotis Kafatos (Imperial College, London), John Lambris (Univ. Pennsylvania, Philadelphia),Harris Lewin (Univ. of Indiana, Urbana-Champaign), Edison Liu (Genome Institute of Singapore, Singapore), and Shankar Subramaniam (Univ. California, San Diego). A total of 101 individuals from 21 countries participated in the conference: USA (48), Canada (5), France (5), Austria (4), Germany (3), Italy (3), UK (3), Greece (2), New Zealand (2), Singapore (2), Argentina (1), Australia (1), Cuba (1), Denmark (1), Japan (1), Mexico (1), Netherlands (1), Spain (1), Sweden (1), Switzerland (1). With respect to speakers, 29 were established faculty members and 13 were graduate students or postdoctoral fellows. With respect to gender representation, among speakers, 13 were female and 28 were male, and among all participants 43 were female and 58 were male. Program these included the following topics: Cancer Pathways and Networks (Day 1), Metabolic Disease Networks (Day 2), Day 3 ? Organs, Pathways and Stem Cells (Day 3), and Day 4 ? Inflammation, Immunity, Microbes and the Environment (Day 4). Proceedings of the Conference were not published.

  12. Preserving fertility in young patients with lymphoma: an overview

    Directory of Open Access Journals (Sweden)

    Patel B


    Full Text Available Bansari Patel, Brooke V Rossi Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, OH, USA Abstract: Fertility preservation affords patients the ability to reproduce after the initial diagnosis and management of such malignancies as Hodgkin's and non-Hodgkin's lymphoma. Certain chemotherapy regimens and pelvic radiotherapy confer a high-risk of subsequent gonadal compromise in both males and females. Fortunately, early counseling and initiation of fertility-preservation strategies promptly after diagnosis enable patients to maintain hope for future reproduction. Well-established methods for fertility preservation include embryo and oocyte cryopreservation in females and sperm cryopreservation in males. These methods enable patients to utilize assisted reproductive technologies, including in vitro fertilization, at the time of desired childbearing in order to ensure genetic offspring. As most of these modalities are not feasible in some patient populations, including prepubescent patients, newer methods of fertility preservation must be created to ensure the ability to produce genetic offspring in lymphoma patients. This review provides insights into the impact of gonadotoxic treatment on ovarian and testicular function, and highlights current modalities in fertility preservation in both males and females. Keywords: fertility preservation, lymphoma, ART, egg freezing

  13. My Most Memorable AAS Meeting-December 1957, Butler University, Indianapolis, Indiana (United States)

    Edmondson, F. K.


    My attendance at AAS meetings began with the 46th meeting in September 1931 at the brand new Perkins Observatory. This was the first semester of my junior year at Indiana University. Professor Wilbur Cogshall, my astronomy professor, took me to the meeting, and paid my expenses for dormitory accommodations and meals. Hence, my attendance at AAS meetings covers a span of nearly 68 years. There have been so many "memorable" meetings that it is hard to pick just one. However, the 99th meeting in December 1957 at Butler University in Indianapolis, a joint meeting with the AAAS, is memorable because I was in a wheel chair and using crutches, following an injury to my right knee cap. I was a member of the AAAS Committee to select the "best paper" presented at the meeting to receive the Newcomb Cleveland Prize, and Martin Schwarzschild's first report of results from Project Stratoscope was on the program. I showed up at the Committee meeting in my wheel chair, and nominated Martin's paper for the "best paper" award. The Committee asked a lot of questions and then approved the paper by a unanimous vote. The wheel chair and crutches obviously played a role in convincing the Committee that I had strong feelings about the merits of Martin's paper. Allan Sandage was the Warner Prize Lecturer, and reported on the current status of his revision of the cosmic distance scale. Hubble's 1936 distances needed to be increased by a factor of five to ten.

  14. Diagnosing Coronary Heart Disease using Ensemble Machine Learning

    Directory of Open Access Journals (Sweden)

    Kathleen H. Miao


    Full Text Available Globally, heart disease is the leading cause of death for both men and women. One in every four people is afflicted with and dies of heart disease. Early and accurate diagnoses of heart disease thus are crucial in improving the chances of long-term survival for patients and saving millions of lives. In this research, an advanced ensemble machine learning technology, utilizing an adaptive Boosting algorithm, is developed for accurate coronary heart disease diagnosis and outcome predictions. The developed ensemble learning classification and prediction models were applied to 4 different data sets for coronary heart disease diagnosis, including patients diagnosed with heart disease from Cleveland Clinic Foundation (CCF, Hungarian Institute of Cardiology (HIC, Long Beach Medical Center (LBMC, and Switzerland University Hospital (SUH. The testing results showed that the developed ensemble learning classification and prediction models achieved model accuracies of 80.14% for CCF, 89.12% for HIC, 77.78% for LBMC, and 96.72% for SUH, exceeding the accuracies of previously published research. Therefore, coronary heart disease diagnoses derived from the developed ensemble learning classification and prediction models are reliable and clinically useful, and can aid patients globally, especially those from developing countries and areas where there are few heart disease diagnostic specialists.

  15. Antenna Technology and other Radio Frequency (RF) Communications Activities at the Glenn Research Center in Support of NASA's Exploration Vision (United States)

    Miranda, Felix A.


    NASA s Vision for Space Exploration outlines a very ambitious program for the next several decades of the Space Agency endeavors. Ahead is the completion of the International Space Station (ISS); safely flight the shuttle (STS) until 2010; develop and fly the Crew Exploration Vehicle (Orion) by no later than 2014; return to the moon by no later than 2020; extend human presence across the solar system and beyond; implement a sustainable and affordable human and robotic program; develop supporting innovative technologies, knowledge and infrastructure; and promote international and commercial participation in exploration. To achieve these goals, a series of enabling technologies must be developed or matured in a timely manner. Some of these technologies are: spacecraft RF technology (e.g., high power sources and large antennas which using surface receive arrays can get up to 1 Gbps from Mars), uplink arraying (reduce reliance on large ground-based antennas and high operation costs; single point of failure; enable greater data-rates or greater effective distance; scalable, evolvable, flexible scheduling), software define radio (i.e., reconfigurable, flexible interoperability allows for in flight updates open architecture; reduces mass, power, volume), and optical communications (high capacity communications with low mass/power required; significantly increases data rates for deep space). This presentation will discuss some of the work being performed at the NASA Glenn Research Center, Cleveland, Ohio, in antenna technology as well as other on-going RF communications efforts.

  16. Cine club

    CERN Multimedia

    Ciné club


    Thursday 5 February 2015 at 20:00 CERN Council Chamber Stranger Than Paradise     Directed by Jim Jarmusch - USA, 1984, 89 minutes A self-styled New York hipster is paid a surprise visit by his younger cousin from Budapest. From initial hostility and indifference a small degree of affection grows between the two. Along with a friend, they eventually end up visiting their aunt in the wastelands of Cleveland and then proceed to Florida where they lose all their money gambling before unwittingly gaining a fortune. Original version English; French subtitles   Thursday 12 February 2015 at 20:00 CERN Council Chamber Down by Law     Directed by Jim Jarmusch - USA, 1986, 107 minutes DJ Zack and pimp Jack end up in prison for being too laid-back to avoid being framed for crimes they didn't commit. They end up sharing a cell with eccentric Italian optimist Roberto, whose limited command of the English language is both entertaining and infuri...

  17. Official Portrait of Astronaut Neil Armstrong (United States)


    Neil Armstrong, donned in his space suit, poses for his official Apollo 11 portrait. Armstrong began his flight career as a naval aviator. He flew 78 combat missions during the Korean War. Armstrong joined the NASA predecessor, NACA (National Advisory Committee for Aeronautics), as a research pilot at the Lewis Laboratory in Cleveland and later transferred to the NACA High Speed Flight Station at Edwards AFB, California. He was a project pilot on many pioneering high speed aircraft, including the 4,000 mph X-15. He has flown over 200 different models of aircraft, including jets, rockets, helicopters, and gliders. In 1962, Armstrong was transferred to astronaut status. He served as command pilot for the Gemini 8 mission, launched March 16, 1966, and performed the first successful docking of two vehicles in space. In 1969, Armstrong was commander of Apollo 11, the first manned lunar landing mission, and gained the distinction of being the first man to land a craft on the Moon and the first man to step on its surface. Armstrong subsequently held the position of Deputy Associate Administrator for Aeronautics, NASA Headquarters Office of Advanced Research and Technology, from 1970 to 1971. He resigned from NASA in 1971.

  18. Electronic nicotine delivery system landscape in licensed tobacco retailers: results of a county-level survey in Oklahoma (United States)

    Brame, L S; Mowls, D S; Damphousse, K E; Beebe, L A


    Objectives Electronic nicotine delivery systems (ENDS) have recently emerged as a component of the tobacco retail environment. The aims of this study were to describe the availability, types of ENDS and placement of ENDS relative to traditional tobacco products at franchised licensed tobacco retailers and non-franchised licensed tobacco retailers. Design Observational study. Setting Franchised and non-franchised tobacco retailers in Cleveland County, Oklahoma, USA. Primary and secondary outcome measures The number of stores selling ENDS, the variability in brands of ENDS sold, the location of the ENDS within the retailers, the quantity of ENDS sold compared with traditional tobacco products, and the presence of outdoor signage. Results Data from 57 randomly sampled tobacco retailers were used to describe the presence of ENDS at independent non-franchised and franchised tobacco retailers. The overwhelming majority (90%) of licensed tobacco retailers sold ENDS, and differences were observed between franchised and non-franchised stores. 45 of the 51 retailers (88%) selling ENDS had them placed at the point of sale. 2 of the 21 franchised retailers (9.5%) had ENDS placed at ≤3½ feet above floor level compared to none of the 30 non-franchised retailers (0%). Conclusions This small study is the first to characterise ENDS within the tobacco retail environment in a county in Oklahoma, USA. The results from this study demonstrate the complexity of the tobacco retail landscape and generate questions for future studies regarding the incorporation and placement of ENDS in tobacco retail environments. PMID:27266774

  19. Preparedness for epidemic disease or bioterrorism: minimum cost planning for the location and staffing of urban point-of-dispensing centers. (United States)

    Bowen, William M; Chen, Jen-Yi; Tukel, Oya I


    Urban health authorities in the United States have been charged with developing plans for providing the infrastructure necessary to dispense prophylactic medications to their populations in the case of epidemic disease outbreak or bioterrorist attack. However, no specific method for such plans has been prescribed. This article formulates and demonstrates the use of an integer programming technique for helping to solve a part of the dispensing problem faced by cities, namely that of providing the federally required infrastructure at minimum cost, using their limited time and resources. Specifically, the technique minimizes the number of point-of-dispensing (POD) centers while covering every resident in all the census tracts within the city's jurisdiction. It also determines the optimal staffing requirement in terms of the number of nurses at each POD. This article includes a demonstration of the model using real data from Cleveland, OH, a mid-sized US city. Examples are provided of data and computational results for a variety of input parameter values such as population throughput rate, POD capacities, and distance limitations. The technique can be readily adapted to a wide range of urban areas.

  20. Design and Fabrication of a Dielectric Total Internal Reflecting Solar Concentrator and Associated Flux Extractor for Extreme High Temperature (2500K) Applications (United States)

    Soules, Jack A.; Buchele, Donald R.; Castle, Charles H.; Macosko, Robert P.


    The Analex Corporation, under contract to the NASA Lewis Research Center (LeRC), Cleveland, Ohio, recently evaluated the feasibility of utilizing refractive secondary concentrators for solar heat receivers operating at temperatures up to 2500K. The feasibility study pointed out a number of significant advantages provided by solid single crystal refractive devices over the more conventional hollow reflective compound parabolic concentrators (CPCs). In addition to the advantages of higher concentration ratio and efficiency, the refractive concentrator, when combined with a flux extractor rod, provides for flux tailoring within the heat receiver cavity. This is a highly desirable, almost mandatory, feature for solar thermal propulsion engine designs presently being considered for NASA and Air Force thermal applications. Following the feasibility evaluation, the NASA-LeRC, NASA-Marshall Space Flight Center (MSFC), and Analex Corporation teamed up to design, fabricate, and test a refractive secondary concentrator/flux extractor system for potential use in the NASA-MSFC "Shooting Star" flight experiment. This paper describes the advantages and technical challenges associated with the design methodologies developed and utilized and the material and fabrication limitations encountered.